JPH078447A - Automatic inserting device for endoscope - Google Patents

Abstract

PURPOSE:To provide the automatic inserting device for an endoscope, by which self-travelling can be executed in a vascular cavity even if an ordinary endoscope is used, and a sufficient stroke and sufficient driving force can be obtained without enlarging the outside diameter of an insertion part, and also, its function can be displayed enough even in a state that the insertion part is curved. CONSTITUTION:An insertion part 3 of an endoscope 1 is provided with a channel 8 which can be inserted through a probe 12, and also, a probe advancing/ retreating device 11 for advancing and retreating the probe 12, and on the other hand, the tip part of the insertion part 3 and the tip part of the probe 12, are provided with a first and a second balloons 5a, 5b which can be expanded and contracted in the diameter direction respectively, so that these first and second balloons 5a, 5b and the probe advancing/retreating device 11 are subjected to driving control by a fluid supply device 7 and a controller 17.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for automatically inserting an endoscope into a body lumen.

[0002]

2. Description of the Related Art For example, when an endoscope is inserted into a duct such as the large intestine or small intestine of a living body to observe or treat the inside of the duct, the insertion resistance is small because the duct is thin and bent. Is large, it is difficult to guide the distal end constituent portion of the insertion portion to the target site even if the insertion portion is pushed forward from the outside, and skill is required.

Therefore, in order to solve the above problems, for example, Japanese Patent Publication No. 51-15678 and USP.
As shown in the specification of US Pat. No. 4,690,131, an automatic insertion device that allows self-propagation in a duct has been developed. All of these are equipped with balloons that can be inflated and deflated in the radial direction before and after the flexible tube that is axially expandable and contract, and by expanding and contracting these balloons alternately, the flexible tube between the two balloons expands and contracts. This is an automatic insertion device.

[0004]

However, the above-mentioned automatic insertion device is an endoscope manufactured for automatic insertion in which a bellows, an overtube or the like is mounted on the insertion portion of the endoscope, The insertion part of the endoscope becomes thick.
Furthermore, it is necessary to secure a space for inserting a pressure tube that supplies and discharges a fluid to the balloon in the insertion portion, which also causes a problem that the insertion portion of the endoscope becomes thick. .

Further, since the bellows are propelled by expansion and contraction,
There was a problem that a sufficient stroke and a sufficient propulsive force could not be obtained, and that the function could not be fully exerted when the insertion portion was curved.

The present invention has been made in view of the above circumstances, and its purpose is to enable self-propagation within a lumen even when an ordinary endoscope is used, and to change the outer diameter of the insertion portion. An object of the present invention is to provide an automatic endoscope insertion device that can obtain a sufficient stroke and a sufficient propulsive force without being thickened and can sufficiently exhibit its function even when the insertion portion is curved.

[0007]

In order to achieve the above object, the present invention provides an endoscope having a channel through which a probe can be inserted in an insertion portion, and a probe advance / retreat for advancing or retracting the probe in the channel. A device, an actuator that is provided between the tip of the probe or between the probe and the insertion part, and that can expand and contract in the radial direction, and drive control means that cooperates the actuator and the probe advancing and retracting device. There is something I did.

Insert the insertion part of the endoscope into a duct such as the large intestine,
When the insertion portion travels inside the pipeline, the rear actuator is inflated to grip a portion of the pipeline. Next, the probe is moved forward by the probe advancing / retreating device to cause the front actuator to project forward, and then the front actuator is expanded to grip the conduit. Next, the rear actuator is contracted, and the insertion section is advanced to advance it to the vicinity of the front actuator. By repeating this operation, the insertion part is advanced inside the duct.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 show a first embodiment, and FIG.
The endoscope 1 shown in FIG. 1 includes an operation unit 2 and an insertion unit 3,
A tip forming section 4 is provided at the tip of the insertion section 3.
A first balloon 5a, which is an actuator that can be expanded / contracted in the radial direction by a fluid pressure such as air, is attached to the tip forming portion 4. This first balloon 5a
A fluid supply device 7 such as a compressor is connected to the balloon 5a via a pressure tube 6 for supplying / discharging a fluid to / from the balloon 5a.

The insertion portion 3 of the endoscope 1 is provided with a channel 8 for inserting a treatment tool such as forceps, and one end of the channel 8 is connected to a forceps opening body 9 provided in the operation portion 2 and the other end is provided. Communicates with the opening 10 of the tip forming portion 4. Further, a probe advancing / retreating device 11 for automatically advancing / retreating a treatment tool is attached near the forceps mouthpiece 9, and this may be detachable from the forceps mouthpiece 9.

As shown in FIG. 2, the probe advancing / retreating device 11 is provided with a forceps insertion hole 13 for inserting a probe 12 as a treatment tool in the forceps opening body 9. A part of the rollers 14 and 14 are provided. The one roller 14 is rotationally driven by a motor 15, and the pair of rollers 14 and 14 can move the probe 12 forward and backward while sandwiching the probe 12.

The motor 15 may be an electromagnetic motor,
A piezoelectric motor such as an ultrasonic motor may be used.
Is connected to the control device 17 by a cable 16. The fluid supply device 7 is also connected to the control device 17 by a cable 18.

The probe 1 inserted in the channel 8
The distal end portion 2 of the probe 2 projects from the opening 10 of the distal end forming portion 4 of the endoscope 1, and the distal end of the probe 12 is provided with the second balloon 5b. In addition, a lumen (not shown) is provided in the probe 12 for transmitting a fluid to the second balloon 5b, and a proximal end portion of the probe 12 is connected to the fluid supply device 7.

The fluid supply device 7 is provided by being incorporated in a part of an ordinary endoscope unit (light source, video processor, monitor, etc.), and supplies and discharges fluid as well as air and water for the endoscope 1. Alternatively, it may be a separate body from the endoscope unit. Further, the control device 17 may be incorporated in, for example, a part of the video processor, or may be completely separate. Further, the cable 16 of the probe advancing / retreating device 11 of the treatment instrument is also connected to a light source device (not shown) through the operation section 2 of the endoscope 1 and the universal cord 19, and is connected to the control device 17 from the light source device. May be.

In this case, when the probe advancing / retreating device 11 is attached to the forceps mouthpiece 9, it is also electrically connected (of course, it is not a detachable type, but is an integral type from the beginning). May be). Further, the probe 12 is a catheter (a multi-lumen structure in which there is a lumen that opens at the tip in addition to the lumen that sends fluid to the second balloon 5b), and even when the probe 12 is inserted into the channel 8, The catheter may be used for discharging / sucking the blood.

Further, an ultrasonic wave transmitting / receiving means may be provided in the second balloon 5b at the tip of the probe 12 so that ultrasonic inspection can be performed at the same time as the scope moves back and forth. The second balloon 5b is inflated with a liquid. The first balloon 5a and the pressure tube 6
Is attachable to and detachable from the insertion portion 3, but may be integrated.

Next, the operation of the first embodiment will be described. As shown in FIG. 1, when the insertion section 3 of the endoscope 1 is inserted into, for example, the large intestine 20 and the insertion section 3 travels inside the large intestine 20, as shown in (a) of FIG. The balloon 5a is inflated to grip a part of the large intestine 20.

Next, as shown in (b) of the figure, the rollers 14 and 14 of the probe advancing / retreating device 11 are rotated to feed the probe 12 while sandwiching it, and the probe 12 is advanced to move the second balloon 5b. It is made to project to the front of the tip forming part 4. Then, the second balloon 5b is inflated so that the large intestine 2
Grip 0.

Next, as shown in (c) of the figure, the first balloon 5a is deflated and the insertion portion 3 is advanced to advance the tip forming portion 4 to the vicinity of the second balloon 5b. next,
As shown in (d) of the figure, the first balloon 5a is inflated to grip the large intestine 20. Next, returning to (a) in the figure, the second balloon 5b is deflated.

In this way, the inflation / deflation of the first and second balloons 5a and 5b by the fluid supply device 7 and the forward movement of the probe 12 by the probe advancing / retreating device 11 are repeated, and the insertion portion 3 of the endoscope 1 is inserted into the large intestine 20. And move it forward in the tip part 4
To the target site. That is, the fluid supply device 7 and the probe advancing / retreating device 11 are cooperatively controlled by the control device 17.

When the probe 12 is moved back and forth, it is fed while being held by the rollers 14 of the probe forward / backward device 11, but an auxiliary hand may be used.
In particular, when advancing the insertion part 3, (b) to (c)
You may push in the insertion part 3 by hand.

As described above, the insertion portion 3 of the endoscope 1 may be advanced in the large intestine 20 (relative to the anus) by the so-called caterpillar movement, or the large intestine 20 may be used.
In long sagging parts such as the sigmoid colon and the transverse colon, rather than advancing the insertion part 3 (relative to the anus), the long sagging intestinal tract can be recoiled,
The usage may be such that the insertion portion 3 is advanced (relative to the anus) after being substantially straightened.

As described above, the normal endoscope 1 is operated by moving the insertion portion 3 of the endoscope 1 forward and backward by utilizing the probe 12 inserted into the channel 8 provided in the insertion portion 3 of the endoscope 1. It can be used, and the insertion portion 3 can be automatically advanced and retracted without increasing the diameter of the insertion portion 3.

FIG. 4 shows a second embodiment. This embodiment is basically the same as the first embodiment, but uses a shape memory alloy as an actuator. That is,
As shown in FIG. 4, a plurality of linear or plate-shaped shape memory alloys 21 are attached between the front hard portion 22 and the rear hard portion 23. A cable 24 for electrically heating the shape memory alloy 21 is connected to the rear hard portion 23.

The front rigid portion 22 is attached to the probe 12 instead of the second balloon 5b of the first embodiment, and the rear rigid portion 23 is detachably attached to the distal end portion of the insertion portion 3 of the endoscope 1. It is attached.

According to this embodiment, the fluid supply device 7 as in the first embodiment is unnecessary, and by providing a power source and a control device (not shown) for electrically heating the shape memory alloy 21, Memory alloy 21 expands radially
Can be shrunk. That is, (a) of FIG. 4 shows before heating by energization, and (b) of FIG. 4 shows after heating. By heating by energization, the shape memory alloy 21 has a shape that expands (bends) in the radial direction (in the axial direction). Shrink). Therefore, similarly to the first embodiment, the endoscope 1 can be advanced and retracted in the duct of the large intestine 20 and the like. Further, the pressurizing tube 6 is not required, and the diameter can be made smaller than that of the first embodiment, and the fluid supply device 7
Is unnecessary, and the overall size of the system can be reduced.

FIG. 5 shows a third embodiment. FIG. 5 (a)
Shows a state in which the insertion portion 3 of the endoscope 1 is inserted into the duct of the living body via the overtube 3a. The probe 12 is inserted through the channel 8 provided in the insertion portion 3,
2 is attached to the tip of the probe 12 protruding from the tip forming portion 4.
Two balloons 25, 26 and a telescopic tube 2 in the middle
7 is provided. The telescopic tube 27 can be expanded and contracted in the axial direction by pressurizing and depressurizing a fluid such as air. As shown in FIG.
Around the circumference of the regulating member 28 for regulating its radial expansion.
A plurality of (threads, rubber, hard rings, etc.) are provided. Of course, the telescopic tube 27 may be a bellows-shaped tube.

As described above, in order to deliver the fluid to the two balloons 25 and 26 and the telescopic tube 27, at least three pressurizing tubes (which may be a three-lumen multi-lumen tube) are internally provided in the probe 12. It is inserted and connected to the two balloons 25 and 26 and the telescopic tube 27.

Also, as shown in FIG.
There is only one lumen 29 for sending fluid,
Between the balloon 25 and the telescopic tube 27, and the balloon 2
The structure in which the nozzles 30 and 31 are provided between the 6 and the telescopic tube 27 may be used. In this case, the fluid sent from the lumen 29 expands the balloon 26, and then the nozzle 30
The more leaking fluid expands the expansion tube 27 in the axial direction, and the fluid leaking at the nozzle 31 expands the balloon 25. When the fluid is sucked from the lumen 29, the expandable tube 27 and the balloon 25 are contracted in order from the balloon 26, and the nozzle 3
The effect of 0,31 causes a time difference.

Next, the operation of the third embodiment will be described. The fluid supply / discharge of the fluid to / from the balloons 25 and 26 and the telescopic tube 27 is performed by the same fluid supply device 7 as in the first embodiment. In this embodiment, the probe 12 itself can be self-propelled. That is, the probe 12 protruding from the distal end constituent portion 4 of the insertion portion 3 of the endoscope 1 is attached to the balloon 25, 2
When the balloon 25 is advanced by a certain distance by expansion / contraction in the radial direction and expansion / contraction in the axial direction of the expansion / contraction tube 27, the intestinal wall is gripped by expansion in the radial direction of the balloons 25 and 26. In this state, the probe advancing / retreating device 11 is driven to draw the insertion section 3 closer, but the insertion section 3 may be pushed by hand in an auxiliary manner.

The controller 17 may control the probe 12 to advance and retreat for a certain cycle and then drive the probe advancing and retracting device 11, and also to determine how much the probe 12 has advanced with respect to the channel 8. May be obtained by measuring the amount of rotation of the roller 14 of the probe advancing / retreating device 11, and the probe advancing / retreating device 11 may be controlled to drive when the probe 12 advances a certain distance. That is,
The probe 12 serves as a self-propelled guide wire.

Therefore, according to this embodiment, since the balloon or the shape memory alloy actuator is not attached to the distal end portion of the insertion portion 3, the normal endoscope 1 can be used as it is. After inserting the insertion portion 3 of the endoscope 1 into the living body, it may be determined whether or not to use the probe 12.

FIG. 6 shows a fourth embodiment, and the basic construction is the same as that of the first embodiment. As shown in FIG. 6, in this embodiment, the probe advancing / retreating device 32 is incorporated in the distal end hard portion 33 of the endoscope 1. That is, in the vicinity of the opening of the channel 8, at least one roller 34 and a motor 35 that rotates the roller 34 are provided in the hard tip portion 33. The motor 35 is connected to the control device 17 via a lead wire (not shown). Of course, like the first embodiment, the forceps mouth body 9 may be provided with the probe advancing / retreating device 11 to provide a plurality of probe advancing / retreating devices. The other structure is similar to that of the first embodiment.

Therefore, according to this embodiment, the advance / retreat of the probe 12 can be performed by the probe advancing / retreating device 32 incorporated in the distal end hard portion 33 of the insertion portion 3 of the endoscope 1, and there are a plurality of probe advancing / retreating devices. In this case, the driving may be performed in synchronization with each other, or the driving may be controlled by sequentially shifting the driving.

For example, in an endoscope that is inserted into the small intestine, as it is deeply inserted into the small intestine, a number of flexible insertion portions form loops. Therefore, even if an attempt is made to move the probe back and forth near the forceps mouth of the operation part, the resistance of the conduit cannot be increased and retracted. However, if a probe advancing / retreating device is provided at least on the distal end side of the insertion portion of the endoscope as in this embodiment, the probe can be advanced / retracted even in the deep small intestine, since the probe is pushed by hand on the hand side.

FIG. 7 shows an endoscope having an automatic insertion function. Two balloons 37 and 38 and a telescopic tube between them are provided at the tip of the insertion portion 36a of the endoscope 36 which is inserted into the small intestine. A self-propelled device 40 composed of 39 is provided. Further, 41 is an overtube, and this overtube 41 includes the balloons 37, 38 and the telescopic tube 3.
In the depressurized state, the endoscope 9 can be inserted through the endoscope 36, and the overtube 41 is provided with the bending portion 42.

The telescopic tube 39 may be the one shown in the third embodiment, or, as shown in FIG. 7 (c), it is composed of a multi-lumen tube 43 and the central lumen 44 thereof is illuminated. Also, an observation optical system or the like may be incorporated. The bending lumen 45 around the central lumen 44 is an airtightly partitioned room, and pressure tubes (not shown, the same number as the number of bending lumens) for pressurizing them are used for the respective bending. It is provided in an endoscope 36 communicating with the lumen.

Since the insertion portion 36a of the endoscope 36 is flexible, the overtube 41 is attached to the endoscope 3 up to the upper part of the jejunum.
Insert while pushing in the state of being fitted to (6) ((a) in the same figure) (using bending. In this state, the insertion part becomes slightly stiff). From there, the self-propelled device 40 self-propels to the deep part of the small intestine. In the type shown in FIG. 7C, when the bending lumen is entirely pressed, the multi-lumen tube 43 extends in the axial direction, and when partially pressed, the multi-lumen tube 43 can be bent in the direction opposite to the pressed lumen. Therefore, the examination time of the small intestine sondescope is significantly reduced.

[0039]

As described above, according to the present invention, the insertion portion of the endoscope can be self-propelled in the duct by the actuator that can be expanded / contracted in the radial direction and the probe advancing / retreating device. It is possible to easily observe and treat such a duct.
Moreover, there is an effect that a sufficient stroke and a sufficient propulsive force can be obtained without increasing the diameter of the insertion portion of the endoscope, and that the function can be sufficiently exhibited even when the insertion portion is curved.

[Brief description of drawings]

FIG. 1 is a perspective view of an endoscope insertion device showing a first embodiment of the present invention.

FIG. 2 is a side view of the probe advancing / retreating device of the embodiment.

FIG. 3 is an operation explanatory view of the same embodiment.

FIG. 4 is a perspective view of an actuator showing a second embodiment of the present invention.

5A and 5B show a third embodiment of the present invention, wherein FIG. 5A is a perspective view of a distal end portion of an endoscope, and FIG. 5B is a sectional view taken along line xx of FIG.

FIG. 6 is a perspective view of a distal end portion of an endoscope showing a fourth embodiment of the present invention.

FIG. 7 shows an endoscope having an automatic insertion function, (a)
(B) is a perspective view and (c) is a front view.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Endoscope 3 ... Insertion part 5a ... 1st balloon 5b ... 2nd balloon 7 ... Fluid supply device 8 ... Channel 11 ... Probe advancing / retreating device 17 ... Control device

Claims (1)

[Claims] 1. An endoscope having a channel through which a probe can be inserted in an insertion portion, a probe advancing / retreating device for advancing or retracting the probe in the channel, and a tip portion of the probe or between the probe and the insertion portion. A device for automatically inserting an endoscope, comprising: an actuator capable of expanding / contracting in a radial direction provided on the drive unit; and drive control means for cooperating the actuator and the probe advancing / retreating device.