JP4348484B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscope apparatus, and in particular, by inserting an insertion assisting tool and an insertion part that are put on the insertion part of the endoscope alternately, the insertion part is inserted into a deep digestive tract such as a small intestine or a large intestine, and observation is performed. The present invention relates to an endoscope apparatus that performs the above.

  When inserting the insertion part of the endoscope into the deep digestive tract such as the small intestine, simply pushing the insertion part makes it difficult for force to be transmitted to the distal end of the insertion part due to the complicated bending of the intestinal tract. Have difficulty. For example, if excessive bending or bending occurs in the insertion portion, the insertion portion cannot be inserted further deeper. Therefore, a method has been proposed in which an insertion aid is put on the insertion portion of the endoscope and inserted into the body cavity, and the insertion portion is guided by this insertion aid to prevent excessive bending or bending of the insertion portion. Yes.

Patent Document 1 discloses an endoscope apparatus in which a first balloon is provided at a distal end portion of an insertion portion of an endoscope and a second balloon is provided at a distal end portion of an insertion assisting tool (also referred to as an overtube or a sliding tube). Are listed. According to this endoscope apparatus, first, as shown in FIG. 13A, the endoscope is inserted into the intestinal tract 3 with the insertion aid 2 covered on the insertion portion 1 of the endoscope, and the distal end portion of the insertion portion 1 is inserted. Insert 1a as deep as possible. And as shown in FIG.13 (b), the 1st balloon 4 with which the front-end | tip part 1a was mounted | worn is expanded and it fixes to the intestinal tract 3. FIG. Next, as shown in FIG. 13 (c), the insertion portion 1 is brought close to the hand to remove excess deflection of the insertion portion 1, and the insertion portion 1 is made as straight as possible. Next, as shown in FIG. 13 (d), the insertion assisting tool 2 is pushed along the insertion portion 1, and the distal end portion 2 a of the insertion assisting tool 2 is disposed in the vicinity of the distal end portion 1 a of the insertion portion 1. Then, as shown in FIG. 13 (e), the second balloon 5 is inflated to fix the distal end portion 2 a of the insertion assisting tool 2 to the intestinal tract 3. Next, as shown in FIG. 13F, after the first balloon 4 is deflated, the insertion portion 1 is inserted again as much as possible. At that time, since the insertion portion 1 is guided by the insertion assisting tool 2, the insertion portion 1 can be smoothly inserted. By repeating the above operation, the distal end portion 1a of the insertion portion 1 can be inserted deeply even in the intestinal tract 3 bent in a complicated manner.
Japanese Patent Laid-Open No. 51-11689

  However, since Patent Document 1 inserts the insertion portion while contracting the intestinal tract, there is a problem that it is not known to which position in the intestinal tract the distal end of the insertion portion is inserted. Therefore, even if a lesion is found in the intestinal tract, there is a problem in that it is difficult to know where the lesion has been found, and this may hinder the observation or treatment again.

  Therefore, conventionally, the number of insertions of the insertion part and the insertion aid is counted and used as a guide for the tip position of the insertion part. However, when observing the small intestine or large intestine, as described above, the insertion portion and the insertion aid must be inserted alternately and repeatedly, and the number of insertions is large because the same operation is repeated many times. There was a risk of not knowing.

  The present invention has been made in view of such circumstances, and provides an endoscope apparatus capable of grasping the insertion amount of the insertion portion even when the insertion portion and the insertion assisting tool are repeatedly inserted. With the goal.

  According to a first aspect of the present invention, in order to achieve the above-mentioned object, an insertion part inserted into a body cavity is connected to a hand operation part, and the first balloon is mounted near the distal end of the insertion part. A mirror, an insertion aid that is placed over the insertion portion to guide the insertion of the insertion portion into the body cavity, and a second balloon is mounted in the vicinity of the distal end thereof, and the first balloon and the second balloon are inflated A measuring apparatus for measuring a movement amount of only the insertion direction of the insertion portion relative to the insertion assisting tool in an endoscope apparatus that alternately inserts the insertion portion and the insertion assisting tool. And a calculation device that calculates the total amount of insertion of the insertion portion into the body cavity by integrating the amount of movement in the insertion direction of the insertion portion measured by the measurement device. .

  According to the first aspect of the present invention, the total amount of insertion can be obtained by measuring the amount of movement of the insertion portion with respect to the insertion assisting tool only in the insertion direction and integrating the amount of movement only in the insertion direction. . Thereby, it can be grasped to which position in the body cavity the distal end of the insertion portion has been inserted.

  According to a second aspect of the present invention, in the first aspect of the present invention, the measuring device is rotatably supported by the insertion assisting tool and is in contact with the outer peripheral surface of the insertion portion. A rotation roller and a rotation speed detection sensor for detecting the rotation speed of the roller in one direction, and obtaining a movement amount of the insertion portion only in the insertion direction based on a detection value of the rotation speed detection sensor; It is characterized by.

  According to the second aspect of the present invention, the amount of movement of the insertion portion only in the insertion direction relative to the insertion assisting tool can be measured by bringing a roller into contact with the insertion portion and detecting the number of rotations in one direction of the roller.

  According to a third aspect of the present invention, in the first or second aspect of the present invention, the display unit that displays the total amount of insertion calculated by the calculation device is an intestinal tract excluding the total amount of insertion relative to the total length of the intestinal tract. It is a remaining amount meter that displays the remaining amount. According to the invention of claim 3, since the display unit is a remaining amount meter, it is possible to know not only the total amount of insertion but also the remaining amount of the intestinal tract, and to know how long the endoscope can be inserted into the intestinal tract. it can.

  According to a fourth aspect of the present invention, in the first or second aspect of the present invention, a display unit that displays a total sum of insertion amounts calculated by the calculation device is provided at a proximal end portion of the insertion assisting tool. .

  According to the endoscope apparatus according to the present invention, since the total amount of insertion of the insertion portion into the body cavity can be obtained, it is possible to grasp to which position in the body cavity the distal end of the insertion portion has been inserted. .

  Hereinafter, preferred embodiments of an endoscope apparatus according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a system configuration diagram showing an embodiment of an endoscope apparatus according to the present invention. As shown in FIG. 1, the endoscope apparatus mainly includes an endoscope 10, a light source device 20, a processor 30, a balloon control device 66, and an insertion assisting tool 70.

  The endoscope 10 includes an insertion portion 12 that is inserted into a body cavity and a hand operation portion 14 that is connected to the insertion portion 12, and a universal cable 16 is connected to the hand operation portion 14. An LG connector 18 is provided at the tip of the universal cable 16, and the LG connector 18 is connected to the light source device 20. In addition, an electrical connector 24 is connected to the LG connector 18 via a cable 22, and the electrical connector 24 is coupled to the processor 30. The LG connector 18 is connected to an air / water supply tube 26 that supplies air and water, and a suction tube 28 that sucks air.

  The hand operation unit 14 is provided with an air / water supply button 32, a suction button 34, and a shutter button 36, and a pair of angle knobs 38 and 38 and a forceps insertion unit 40. Further, a supply / suction port 44 for supplying a fluid to a first balloon 42 (to be described later) or sucking a fluid from the first balloon 42 is provided at the proximal end portion of the hand operation unit 14. Hereinafter, although an example using air as a fluid will be described, other fluids such as an inert gas or water may be used.

  The insertion portion 12 includes a distal end portion 46, a bending portion 48, and a flexible portion 50. The bending portion 48 is remotely operated by rotating a pair of angle knobs 38, 38 provided on the hand operating portion 14. Curved operation. Thereby, the front end surface 47 of the front end portion 46 can be directed in a desired direction.

  As shown in FIG. 2, an observation optical system 52, illumination optical systems 54 and 54, an air / water supply nozzle 56, a forceps port 58, and the like are provided on the distal end surface 47 of the distal end portion 46. A CCD (not shown) is disposed behind the observation optical system 52, and a signal cable is connected to a substrate that supports the CCD. The signal cable is inserted into the insertion section 12, the hand operating section 14, and the universal cable 16 of FIG. 1, extends to the electrical connector 24, and is connected to the processor 30. Therefore, the observation image captured by the observation optical system 52 is formed on the light receiving surface of the CCD and converted into an electric signal, and this electric signal is output to the processor 30 via the signal cable and converted into a video signal. Is done. As a result, the observation image is displayed on the monitor 60 connected to the processor 30.

  An exit end of a light guide (not shown) is disposed behind the illumination optical systems 54 and 54 in FIG. The light guide is inserted through the insertion portion 12, the hand operating portion 14, and the universal cable 16 of FIG. 1, and the incident end is disposed on the LG connector 18. Thereby, the illumination light emitted from the light source device 20 is transmitted to the illumination optical systems 54 and 54 via the light guide, and is emitted from the illumination optical systems 54 and 54.

  The air / water supply nozzle 56 (see FIG. 2) communicates with a valve (not shown) operated by the air / water supply button 32 and further communicates with the air / water supply tube 26. Accordingly, by operating the air / water supply button 32, air or water is jetted from the air / water supply nozzle 56 toward the observation optical system 52.

  The forceps port 58 (see FIG. 2) communicates with the forceps insertion portion 40, communicates with a valve (not shown) operated by the suction button 34, and further communicates with the suction tube 28. Therefore, by operating the suction button 34, a lesioned part or the like is sucked from the forceps opening 58, and the treatment tool is led out from the forceps opening 58 by inserting the treatment tool from the forceps insertion part 40.

  As shown in FIG. 2, a first balloon 42 made of an elastic body such as rubber is attached to the outer peripheral surface of the insertion portion 12. The first balloon 42 is formed in a substantially cylindrical shape with both ends narrowed, and after the insertion portion 12 is inserted, the first balloon 42 is mounted by fixing the both ends of the first balloon 42 to the insertion portion 12. The fixing method of the both ends of the 1st balloon 42 is performed by winding a thread | yarn around the both ends of the 1st balloon 42, for example, and making the 1st balloon 42 adhere to the outer peripheral surface of the insertion part 12 over the perimeter. Instead of winding the thread, a fixing ring may be fitted to both end portions of the first balloon 42.

  A ventilation hole 62 is formed at the attachment position of the first balloon 42 of the insertion portion 12. The vent hole 62 communicates with the supply / suction port 44 of the hand operation unit 14 of FIG. A tube 64 is connected to the supply / suction port 44, and this tube 64 is connected to a balloon control device 66. The balloon control device 66 is a device that supplies air to the first balloon 42 via the tube 64 and sucks air, and controls the air pressure at that time, and an operation button 68 provided on the front surface. Operated by. The first balloon 42 is inflated into a substantially spherical shape by supplying air, and sticks to the outer surface of the insertion portion 12 by sucking air.

  On the other hand, the insertion assisting tool 70 is formed in a cylindrical shape, has an inner diameter that is slightly larger than the outer diameter of the insertion portion 12, and has sufficient flexibility. A rigid gripping portion 74 is provided at the proximal end of the insertion assisting tool 70, and the insertion portion 12 is inserted from the gripping portion 74.

  A balloon air supply port 78 is provided on the proximal end side of the insertion assisting tool 70. An air supply tube 76 having an inner diameter of about 1 mm is connected to the balloon air supply port 78, and this tube 76 is bonded to the outer peripheral surface of the insertion assisting tool 70 and extends to the tip of the insertion assisting tool 70. ing.

  A latex second balloon 72 is mounted in the vicinity of the distal end of the insertion assisting tool 70. The second balloon 72 is formed in a substantially cylindrical shape with both ends narrowed, and is attached with the insertion assisting tool 70 penetrating therethrough. The tube 76 described above is opened inside the second balloon 72, and the second balloon 72 is communicated with the balloon air supply port 78 via the tube 76. A distal end of a tube 80 is connected to the balloon air supply port 78, and a proximal end of the tube 80 is connected to the balloon control device 66 described above. Accordingly, when air is supplied to the balloon air supply port 78 by the balloon control device 66, the air is blown into the second balloon 72 and inflated. When air is sucked from the balloon air supply port 78, air is sucked from the second balloon 72 and the second balloon 72 is deflated. 1 is an inlet for injecting a lubricant such as water into the insertion assisting tool 70.

  Next, an operation method of the endoscope apparatus configured as described above will be described with reference to FIGS.

  First, as shown in FIG. 3A, the insertion portion 12 is inserted into the intestinal tract (for example, the descending leg of the duodenum) with the insertion assisting tool 70 placed on the insertion portion 12. At this time, the first balloon 42 and the second balloon 72 are deflated.

  Next, as shown in FIG. 3B, the second balloon 72 is inflated by supplying air to the second balloon 72 in a state where the distal end of the insertion assisting tool 70 is inserted up to the bent portion of the intestinal tract 90. As a result, the second balloon 72 is locked to the intestinal tract 90, and the distal end of the insertion assisting tool 70 is fixed to the intestinal tract 90.

  Next, as shown in FIG.3 (c), only the insertion part 12 of the endoscope 10 is inserted in the deep part of the intestinal tract 90 (insertion operation). Then, as shown in FIG. 3D, air is supplied to the first balloon 42 to be inflated. Thereby, the first balloon 42 is fixed to the intestinal tract 90 (fixing operation).

  Next, after the air is sucked from the second balloon 72 and the second balloon 72 is contracted, the insertion assisting tool 70 is pushed in and inserted along the insertion portion 12 as shown in FIG. Push-in operation). And after holding the front-end | tip of the insertion auxiliary tool 70 to the vicinity of the 1st balloon 42, as shown in FIG.3 (f), air is sent to the 2nd balloon 72, and it is expanded. Thereby, the second balloon 72 is fixed to the intestinal tract 90. That is, the intestinal tract 90 is grasped by the second balloon 72 (gripping operation).

  Next, as shown in FIG. 3 (g), the insertion assisting tool 70 is brought together (hand feeding operation). Thereby, the intestinal tract 90 is in a contracted state, and the extra bending or bending of the insertion assisting tool 70 is eliminated.

  Next, as shown in FIG. 3 (h), air is sucked from the first balloon 42 to contract the first tube 42. And the front-end | tip part 46 of the insertion part 12 is inserted in the deep part of the intestinal tract 90 as much as possible. That is, the insertion operation shown in FIG. Thereby, the front-end | tip part 46 of the insertion part 12 can be inserted in the deep part of the intestinal tract 90. FIG. When inserting the insertion portion 12 into a deeper portion, after performing a fixing operation as shown in FIG. 3D, a pushing operation as shown in FIG. ), A hand-drawing operation as shown in FIG. 3G, and an insertion operation as shown in FIG. Thereby, the insertion part 12 can be further inserted into the deep part of the intestinal tract 90.

  By the way, the endoscope apparatus according to the present invention is provided with a total insertion amount measuring means for measuring a total sum of insertion amounts of the insertion portion 12 into the body cavity.

  FIG. 4 is a schematic diagram showing the configuration of the total insertion amount measuring means of the first embodiment, and shows a cross-sectional view of the proximal end portion of the insertion assisting tool 70 that covers the insertion portion 12. FIG. 5 is a cross-sectional view taken along line 5-5 of FIG.

  As shown in FIG. 5, three rollers 100, 100, 100 are rotatably supported by the gripping portion 74 of the insertion assisting tool 70. The rollers 100, 100, 100 are arranged at equiangular intervals and in a state of protruding from the inner peripheral surface of the insertion assisting tool 70. All the rollers 100 are brought into contact with the insertion portion 12 when the insertion portion 12 is inserted into the insertion assisting tool 70. Accordingly, when the insertion portion 12 is moved with respect to the insertion assisting tool 70, all the rollers 100 are rotated.

  A gear 102 is connected to one of the rollers 100 so that the rotational force of the roller 100 is transmitted to the gear 102. The gear 102 is connected to the sensor 104 via a not-shown one-way clutch, and only the rotational speed in one direction of the gear 102 is detected by the sensor 104. The detected rotation direction is the direction in which the gear 102 rotates when the insertion portion 12 is inserted.

  The control device 106 is connected to the sensor 104, and converts the rotational speed of the gear 102 detected by the sensor 104 into an insertion amount of the insertion unit 12. Then, the total sum of the insertion amounts is obtained by integrating the converted values. The control device 106 causes the display unit 108 to display the total amount of insertion thus obtained.

  The display unit 108 is provided on the outer peripheral surface of the holding unit 74 of the insertion assisting tool 70. The display unit 108 displays an image indicating the total amount of insertion. For example, as shown in FIG. 6, a remaining amount meter 109 is displayed. In the remaining amount meter 109, the full length L1 represents the full length of the intestinal tract, and the length L2 of the lighted portion represents the sum of the insertion portions. Therefore, the remaining length L3 represents the remaining part of the intestine. Therefore, it is possible to grasp how much the insertion portion 12 has been inserted into the intestine and how much can be inserted by simply looking at the remaining amount meter 109. Note that the image displayed on the display unit 108 only needs to indicate the total sum of the insertion amounts. For example, the total sum of the insertion units may be indicated by a number.

  According to the first embodiment configured as described above, when the insertion portion 12 is inserted relative to the insertion assisting tool 70 (that is, when the insertion operation of FIG. 3C is performed), the roller 100 is moved. The insertion part 12 is rotated. Then, the rotational speed of the roller 100 is detected by the sensor 104 and converted into the insertion amount of the insertion portion 12 by the control device 106. Further, the control device 106 integrates the converted insertion amount values to obtain the total amount of insertion amounts. Therefore, the surgeon can confirm the total amount of insertion by looking at the display unit 108, and can grasp to which position of the intestinal tract the distal end of the insertion unit 12 has been inserted. In particular, according to the first embodiment, since the remaining amount meter 109 is displayed on the display unit 108, it is possible to grasp how much the insertion unit 12 can be inserted into the intestinal tract.

  In the above-described first embodiment, the display unit 108 that displays the total amount of insertion is provided on the grip 74 of the insertion assisting tool 70. However, the position of the display unit 108 is not particularly limited, and A display unit may be provided on the outer surface of the hand operation unit 14 of the mirror 10 or a dedicated external monitor may be provided. Or you may display the sum total of an insertion part on the monitor 60 of FIG. In this case, since the observation image obtained by the endoscope 10 is displayed on the monitor 60, the total sum of the insertion portions can be grasped while viewing the observation image.

  Further, in the first embodiment described above, the control device 106 is provided in the grasping portion 74 of the insertion assisting tool 70, but the position of the control device 106 is not particularly limited, and the hand operating portion 14 of the endoscope 10 is not limited. Or a dedicated control device may be provided outside. Alternatively, a similar function may be provided in the processor 30 of FIG.

  Similarly, in the second to sixth embodiments described later, the positions of the display unit and the control device are not particularly limited, and various modes are possible.

  FIG. 7 is a schematic diagram showing the configuration of the total insertion amount measuring means of the second embodiment.

  A distal end portion of the string-like member 110 is detachably connected to the grip portion 74 of the insertion assisting tool 70 shown in FIG. The base end portion of the string-like member 110 is taken up by a take-up roller 112 provided in the hand operation unit 14. The winding roller 112 is urged in the direction of the arrow (that is, a method of winding the string-like member 110) by an urging means (not shown), so that the extra bending of the string-like member 110 can be eliminated.

  The string-like member 110 is unwound from the take-up roller 112 when the insertion assisting tool 70 is relatively moved toward the distal end side of the insertion portion 12, and conversely, the insertion assisting tool 70 is relatively moved toward the proximal end side of the insertion portion 12. When it is made to wind, it is automatically wound around the winding roller 112. The length of the string-like member 110 is such that when the insertion assisting tool 70 is moved to the distal end side of the insertion portion 12, the insertion assisting tool 70 before the distal end of the insertion assisting tool 70 contacts the first balloon 42. It is set to a length that regulates the insertion operation.

  A sensor 114 is attached to the winding roller 112, and this sensor 114 detects the number of rotations when winding the string-like member 110. The sensor 114 is connected to the control device 116, and the control device 116 converts the number of rotations of the winding roller 112 detected by the sensor 114 into a winding amount of the string-like member 110. Then, the converted values are integrated, and the integrated value is displayed on the monitor 60 of FIG.

  In the second embodiment configured as described above, when the insertion portion 12 is inserted relative to the insertion assisting tool 70, the distance between the proximal end portion of the insertion assisting tool 70 and the hand operating portion 12 is reduced. The surplus string-like member 110 is left, and the surplus string-like member 110 is automatically wound around the take-up roller 112. At that time, the rotational speed of the winding roller 112 is measured by the sensor 114, and the measured value is converted into a winding amount of the string-like member 110 by the control device 116 and integrated. Since the winding amount of the string-like member 110 corresponds to the relative insertion amount of the insertion portion 12, the sum of the insertion amounts can be obtained by integrating the winding amount of the string-like member 110. Since this value is displayed on the monitor 60 (see FIG. 1), the surgeon can grasp the total amount of insertion while viewing the observation image obtained by the endoscope 10.

  In the second embodiment, when the insertion assisting tool 70 is relatively inserted into the insertion portion 12 (that is, when the pushing operation in FIG. 3E is performed), the distal end of the insertion assisting tool 70 is moved. When approaching the first balloon 42, the string-like member 110 serves as a stopper to restrict the insertion operation of the insertion assisting tool 70. Accordingly, it is possible to prevent the first balloon 42 from being damaged by the tip of the insertion assisting tool 70 coming into contact with the first balloon 42.

  In the second embodiment described above, the number of rotations of the winding roller 112 is detected by the sensor 114, and the detected value is converted into the winding amount of the string-like member 110. However, the string-like member 110 is obtained by another method. The amount of winding may be detected. For example, a roller may be brought into contact with the string-like member 110, and the rotation speed of this roller may be obtained.

  Furthermore, in the second embodiment described above, the take-up roller 112 is provided in the hand operation unit 14, but it may be provided in the grip portion 74 of the insertion assisting tool 70.

  FIG. 8 is a schematic diagram showing the configuration of the total insertion amount measuring means of the third embodiment.

  As shown in FIG. 8, a plurality of index lines 120, 120... Are formed on the outer peripheral surface of the insertion portion 12. The index lines 120, 120... Are formed at predetermined intervals in the axial direction of the insertion portion 12, and each index line 120 is formed so as to go around the insertion portion 12.

  On the other hand, an optical sensor 122 is provided on the inner peripheral surface side of the grip portion 74 of the insertion assisting tool 70. The optical sensor 122 includes a light projecting element and a light receiving element, emits light from the light projecting element toward the outer peripheral surface of the insertion assisting tool 12, and receives the reflected light by the light receiving element. And the index line 120 formed in the insertion part 12 is detected by the change of the received light quantity.

  The control device 124 is connected to the optical sensor 122 and converts the detection value of the optical sensor 122 into a relative insertion amount. Then, the converted values are integrated to obtain the total sum of the insertion portions. Further, the obtained value is displayed on the display unit 126 provided on the outer peripheral surface of the gripping unit 74.

  According to the third embodiment configured as described above, the insertion amount can be detected by the optical sensor 122 when the insertion portion 12 is inserted relative to the insertion assisting tool 70. And since the total of the insertion amount obtained by integrating | accumulating this insertion amount is displayed on the display part 126, the surgeon can grasp | ascertain the total of insertion amount.

  Further, according to the third embodiment, since the optical sensor 122 is used, measurement can be performed without contact with the insertion portion 12 and the insertion assisting tool 70. Therefore, when the insertion part 12 and the insertion assistance tool 70 are moved relatively, it can be moved smoothly.

  In the third embodiment described above, the optical detection index lines 120, 120... Are formed on the outer peripheral surface of the insertion portion 12. However, any indicator that can be detected by the optical sensor 122 may be used. You may utilize the scale etc. which were previously formed in the outer peripheral surface. Moreover, you may give the coating from which the reflectance gradually differs from the front end side of the insertion part 12 to a base end side.

  FIG. 9 is a schematic diagram showing the configuration of the total insertion amount measuring means of the fourth embodiment.

  As shown in FIG. 9, a plurality of magnetic bodies 130, 130... Are provided inside the insertion portion 12. The magnetic bodies 130, 130... Are arranged at predetermined intervals in the axial direction of the insertion portion 12. Each magnetic body 130 is formed in a ring shape, and the contents such as the light guide and the tube described above are inserted through the inside of the magnetic body 130. The shape of the magnetic body 130 is not particularly limited, and for example, a magnetic tape or the like may be attached to the outer peripheral surface of the insertion portion 12.

  On the other hand, a magnetic sensor 132 that detects the magnetic body 130 is provided in the gripping portion 74 of the insertion assisting tool 70. The magnetic sensor 132 is connected to the control device 134, and the control device 134 calculates the relative insertion amount based on the detection value of the magnetic sensor 132, and further adds this value to obtain the total sum of the insertion portions. Then, the obtained value is displayed on the display unit 136 provided on the outer peripheral surface of the gripping unit 74.

  According to the fourth embodiment configured as described above, the insertion amount can be detected by the magnetic sensor 132 when the insertion portion 12 is inserted relative to the insertion assisting tool 70. Then, since the total of the insertion amounts obtained by integrating the insertion amounts is displayed on the display unit 136, the surgeon can grasp the total of the insertion amounts.

  Further, according to the fourth embodiment, since the magnetic sensor 132 is used, measurement can be performed without contact with the insertion portion 12 and the insertion assisting tool 70. Therefore, when the insertion part 12 and the insertion assistance tool 70 are moved relatively, it can be moved smoothly.

  In the fourth embodiment, an IC chip may be embedded instead of the magnetic body 130, and information stored in the IC chip may be read out.

  FIG. 10 is a schematic diagram showing the configuration of the total insertion amount measuring means of the fifth embodiment.

  As shown in FIG. 10, in the fifth embodiment, a pair of contact sensors 140 and 142 that detect contact with each other are provided. The contact sensor 140 is attached to the proximal end surface of the insertion assisting tool 70, and the contact sensor 142 is formed in a ring shape and is detachably attached to the proximal end position of the insertion portion 12. Therefore, when the insertion portion 12 is inserted relative to the insertion assisting tool 70, the contact sensor 140 and the contact sensor 142 come into contact with each other. Note that the attachment position of the contact sensor 142 is not limited to the proximal end position of the insertion portion 12, and may be attached to the hand operation portion 14, for example. Further, the shape of the contact sensors 140 and 142 is not particularly limited, but it is preferable that one of the contact sensors 140 and 142 is formed in a ring shape so as to be surely contacted.

  The contact sensor 142 is connected to the control device 144, and the control device 144 counts the number of times that the contact sensors 140 and 142 are in contact. And the sum total of relative insertion amount is calculated | required by the counted frequency | count and the difference of the length of the insertion part 12 and the insertion auxiliary tool 70. FIG. Further, the obtained value is displayed on the monitor 60 of FIG.

  According to the fifth embodiment configured as described above, each time the insertion portion 12 is inserted, the contact sensors 140 and 142 come into contact and the number of times is counted. Then, the counted number is converted into the total amount of insertion and displayed on the monitor 60. Therefore, the surgeon can grasp the total amount of insertion.

  Further, according to the fifth embodiment, since the contact sensor 142 may be attached to the insertion portion 12, it is not necessary to provide the endoscope 10 with special measurement means such as an index.

  FIG. 11 is a schematic diagram showing the configuration of the total insertion amount measuring means of the sixth embodiment. 6th Embodiment is an example which calculates | requires the sum total of the amount of insertion by measuring the amount of attraction | suction when the insertion part 12 and the insertion auxiliary tool 70 are drawn from the inside of a body cavity simultaneously.

  As shown in FIG. 11, in the sixth embodiment, a mouthpiece 150 is used. The mouthpiece 150 is formed with a through hole 150A having an inner diameter slightly larger than the outer diameter of the insertion assisting tool 70, and the insertion assisting tool 70 is inserted into the through hole 150A. The mouthpiece 150 and the insertion aid 70 can be fixed as necessary. An optical sensor 152 and a magnetic sensor 154 are provided on the inner peripheral surface side of the through hole 150 </ b> A of the mouthpiece 150. The optical sensor 152 is a sensor that detects an index line 156 described later, and the magnetic sensor 154 is a sensor that detects a magnetic body 158 described later. The mouthpiece 150 configured as described above is fixed to the mouth of the subject as the subject holds it.

  On the other hand, on the outer peripheral surface of the insertion assisting tool 70, a plurality of index lines 156, 156... For optical detection are formed. The index lines 156, 156... Are formed at predetermined intervals in the axial direction of the insertion assisting tool 70, and each index line 156 is formed so as to go around the insertion portion 12. The index line 156 may be any mark for optical detection, and the shape and the like are not particularly limited.

  A plurality of magnetic bodies 158, 158,... Are provided inside the insertion portion 12. The magnetic bodies 158 are arranged at predetermined intervals in the axial direction of the insertion portion 12. Each magnetic body 158 is formed in a ring shape, and the contents such as the light guide and the tube described above are inserted through the inside of the magnetic body 158. The shape of the magnetic body 158 is not particularly limited, and for example, a magnetic tape or the like may be attached.

  The optical sensor 152 described above irradiates the inspection light toward the outer peripheral surface of the insertion assisting tool 70 and detects the index line 156 by receiving the reflected light. Therefore, the amount of attraction when the insertion assisting tool 70 is attracted can be detected from the detection value of the optical sensor 152.

  On the other hand, the magnetic sensor 154 detects the magnetic body 158 by detecting magnetic fluctuations. Therefore, the amount of attraction when the insertion portion 12 is attracted can be detected by the detection value of the magnetic sensor 154.

  The control device 160 is connected to the optical sensor 152 and the magnetic sensor 154, and the amount of the insertion assisting tool 70 detected by the optical sensor 152 and the amount of the insertion portion 12 detected by the magnetic sensor 154 are different. When it changes at the same time, it memorizes the amount of attraction. Then, the attracted amounts are integrated, and the total amount of insertion is calculated based on the integrated value. Further, the sum of the calculated insertion amounts is displayed on the monitor 60 of FIG.

  According to the sixth embodiment configured as described above, when the insertion portion 12 and the insertion assisting tool 70 are attracted simultaneously (see FIG. 3G), the control device 106 detects this, and the amount of attraction is reduced. Measured. Since the amount of attraction when the insertion portion 12 and the insertion assisting tool 70 are pulled simultaneously corresponds to the amount of contraction of the intestinal tract 90, the sum of the amount of attraction corresponds to the sum of the amount of contraction of the intestinal tract 90. Therefore, if the insertion amount of the insertion unit 12 at that time is added to the sum of the attracting amounts, the sum of the insertion amounts can be obtained. Note that the insertion amount of the insertion portion 12 can also be measured by the magnetic sensor 154.

  In the sixth embodiment described above, the optical sensor 152 and the magnetic sensor 154 are attached to the mouthpiece 150, but these sensors are inserted into the body cavity (that is, the insertion portion 12 such as the mouth and anus of the subject). As long as it is fixed to the insertion slot). Therefore, the optical sensor 152 and the magnetic sensor 154 may be attached and fixed to the insertion opening, or the optical sensor 152 and the magnetic sensor 154 may be attached to a guide tube or the like fixed to the insertion opening.

  In the sixth embodiment described above, the insertion amount of the insertion assisting tool 70 is detected by the optical sensor 152, and the insertion amount of the insertion portion 12 is detected by the magnetic sensor 154. However, the insertion amount detection method is limited to this. Not what you want. For example, when the insertion assisting tool 70 is made of a transparent material and an index line for optical detection is formed on the outer surface of the insertion portion 12, the insertion amount of the insertion portion 12 can be detected by the optical sensor 152. .

  Furthermore, in the above-described sixth embodiment, the amount of insertion of the insertion portion 12 and the insertion assisting tool 70 is measured to determine the total amount of insertion, but the relative insertion amount of the insertion portion 12 is measured using the same device. Thus, the total amount of insertion can be obtained. That is, the relative insertion amount of the insertion portion 12 with respect to the insertion assisting tool 70 is obtained from the difference between the insertion amount of the insertion assisting tool 70 detected by the optical sensor 152 and the insertion amount of the insertion portion 12 detected by the magnetic sensor 154. it can. Therefore, the sum of the insertion amounts can be obtained by integrating the relative insertion amounts.

  The first to sixth embodiments described above are examples of a double balloon type endoscope apparatus in which the first balloon 42 is attached to the insertion portion 12 and the second balloon 72 is attached to the insertion assisting tool 70. However, the present invention can also be applied to an endoscope apparatus without a balloon. For example, in the case of an endoscope apparatus without the first balloon 42, the insertion portion 12 can be fixed in the body cavity by bending the bending portion 48 and hooking the distal end portion 46 into the body cavity. Can be inserted deep into the body cavity. Also in the case of such an endoscope apparatus, the total insertion amount of the insertion portion 12 can be grasped by applying the present invention.

  Moreover, although the 1st-6th embodiment mentioned above utilized the insertion auxiliary tool 70 as an overtube inserted from a test subject's mouth, as shown to Fig.12 (a)-FIG.12 (c), test subject It may be used as a sliding tube inserted from the anus. In the figure, an example in which the first balloon 42 is not attached to the insertion portion 12 will be described, but the first balloon 42 may be attached.

  First, as shown in FIG. 12A, the insertion portion 12 is inserted into the insertion assisting tool 70 in advance, and the insertion assisting tool 70 is drawn toward the hand operating portion 14 side. At that time, the second balloon 72 is deflated. In this state, the insertion part 12 is inserted into the large intestine 170 from the subject's anus.

  When the distal end portion 46 of the insertion portion 12 passes through the sigmoid colon portion 171 and reaches the left colon curvature 172, the bending portion 48 of the insertion portion 12 is curved, and the distal end portion 46 is hooked on the left colon curvature 172. .

  Next, as shown in FIG. 12B, the insertion portion 12 located in the sigmoid colon portion 171 is made substantially linear, and the sigmoid colon portion 171 is made substantially linear.

  Next, as shown in FIG. 12C, the insertion assisting tool 70 is inserted into the large intestine 170 along the insertion portion 12. And it inserts, confirming the front-end | tip position of the insertion auxiliary tool 70 by X-ray fluoroscopy, and inserts until the front-end | tip passes the sigmoid colon part 171. As a result, the sigmoid colon 171 is held substantially linearly by the insertion assisting tool 70.

  Next, the second balloon 72 provided at the distal end portion of the insertion assisting tool 70 is inflated. Thereby, since the second balloon 72 presses the inner wall surface of the large intestine 170, the distal end portion of the insertion assisting tool 70 is fixed to the large intestine 170. In this state, when the insertion portion 12 is further pushed in, the sigmoid colon portion 171 is held in a substantially straight shape by the insertion assisting tool 70 and the insertion assisting tool 70 is fixed to the large intestine 170. The insertion operation can be easily performed.

  As described above, even when the insertion assisting tool 70 is used for the purpose of holding the sigmoid colon portion 171 in a substantially straight line shape, the insertion amount is calculated by calculating the total amount of insertion of the insertion portion 12 by applying the present invention. The amount can be accurately grasped.

  Furthermore, the operation method of the endoscope apparatus of the first to sixth embodiments described above is not limited to the procedure shown in FIG. 3, and the effect of the present invention can be obtained even with the operation method shown in FIG. It is done. That is, in the first to fifth embodiments, when the insertion portion 1 is inserted as shown in FIGS. 13A and 13F, the relative insertion amount of the insertion portion 1 with respect to the insertion assisting tool 2 is measured. By integrating this, the total amount of insertion can be obtained. In the sixth embodiment, as shown in FIG. 13C, when the insertion portion 1 and the insertion assisting tool 2 are simultaneously pulled from the body cavity, the amount of attraction is measured, and the integrated amount of the measured values is calculated. The total amount of insertion can be obtained by

System configuration diagram showing an embodiment of an endoscope apparatus according to the present invention The perspective view which shows the front-end | tip part of the insertion part of FIG. Explanatory drawing which shows the operating method of the endoscope apparatus of FIG. The schematic diagram which shows the structure of the total insertion amount measurement means of 1st Embodiment. Sectional view along line 5-5 in FIG. Figure showing a display example The schematic diagram which shows the structure of the total insertion amount measurement means of 2nd Embodiment. The schematic diagram which shows the structure of the total insertion amount measurement means of 3rd Embodiment. The schematic diagram which shows the structure of the total insertion amount measurement means of 4th Embodiment. The schematic diagram which shows the structure of the total insertion amount measurement means of 5th Embodiment. The schematic diagram which shows the structure of the total insertion amount measurement means of 6th Embodiment. Explanatory drawing which shows the operation method different from FIG. Explanatory drawing which shows the operation method of the conventional endoscope apparatus

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 42 ... 1st balloon, 46 ... Tip part, 48 ... Bending part, 60 ... Monitor, 66 ... Balloon control apparatus, 70 ... Insertion aid, 72 ... second balloon 90 ... intestinal tract 100 ... roller 104 ... sensor 106 ... control device 108 ... display unit 110 ... string member 112 winding roller 114 ... sensor 116 ... control device 120 ... Index line 122... Optical sensor 130 130 Magnetic body 132 Magnetic sensor 140 142 Contact sensor 150 Mouthpiece 152 Optical sensor 154 Magnetic sensor 156 Index line 158 Magnetic body

Claims (4)

An endoscope in which an insertion portion to be inserted into the body cavity is connected to the hand operation portion and a first balloon is mounted near the distal end of the insertion portion, and the insertion portion is inserted into the body cavity of the insertion portion. An insertion assisting tool that guides the insertion into the first balloon and has a second balloon mounted in the vicinity of the distal end thereof, and a balloon control device that inflates and deflates the first balloon and the second balloon. In an endoscopic device that alternately inserts auxiliary tools,
A measuring device that measures the amount of movement of only the insertion direction of the insertion portion with respect to the insertion assisting tool;
A calculation device that calculates the total amount of insertion into the body cavity of the insertion unit by integrating the amount of movement of the insertion unit only in the insertion direction measured by the measurement device;
An endoscope apparatus comprising: The measuring device is
A roller that is rotatably supported by the insertion assisting tool, is in contact with the outer peripheral surface of the insertion portion, and rotates by insertion of the insertion portion;
A rotational speed detection sensor for detecting the rotational speed of the roller in one direction,
The endoscope apparatus according to claim 1, wherein a movement amount of only the insertion direction of the insertion portion is obtained based on a detection value of the rotation speed detection sensor.   The display unit that displays the total amount of insertion calculated by the calculation device is a remaining amount meter that displays the remaining amount of the intestinal tract excluding the total amount of insertion relative to the total length of the intestinal tract. The endoscope apparatus according to 1 or 2.   The endoscope apparatus according to claim 1, wherein a display unit that displays a total amount of insertion amounts calculated by the calculation device is provided at a proximal end portion of the insertion assisting tool.

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