JP6236410B2 - Lacrimal endoscope - Google Patents

Description

  The present invention relates to a lacrimal endoscope.

  The lacrimal endoscope is used for diagnosis and treatment of lacrimal tract diseases. A lacrimal endoscope generally has a thin insertion portion. The doctor inserts the insertion part of the lacrimal endoscope from the patient's punctum, and reaches the lower nasal passage through the lacrimal duct, lacrimal sac, and lacrimal sac through the nasolacrimal duct (bone lacrimal duct).

  As such a lacrimal endoscope, Patent Document 1 describes a configuration in which a part of an insertion portion is curved.

JP 2004-16317 A

  Here, there are individual differences in the medical structure of the lacrimal passage, such as the shape of the lacrimal canal and nasolacrimal duct, and the positional relationship between the opening of the nasolacrimal duct and the lower nasal passage (lower turbinate). Therefore, when inserting the lacrimal endoscope, a doctor needs to perform complicated operations such as moving the insertion portion three-dimensionally or adding a twist.

  On the other hand, when the insertion part of the lacrimal endoscope is inserted into the bony nasolacrimal duct, the degree of freedom of lacrimal endoscope operation is greatly limited. FIG. 8 is a diagram schematically showing the skull F of the patient. As shown in FIG. 8, when the lacrimal endoscope is operated with the insertion portion of the lacrimal endoscope inserted into the bony nasolacrimal duct ND, depending on the running angle of the bony nasolacrimal duct ND, The frontal head (frontal bone FB) and lacrimal endoscope X (insertion portion Y) interfere with each other, making it difficult to perform the test. For patients with deep facial sculpture, interference with the forehead is more pronounced. In addition, if an attempt is made to insert forcefully in such a state, the insertion portion may be deformed.

  An object of the present invention is to provide a lacrimal endoscope that can be easily inserted into any lacrimal passage.

  In order to solve the above-described problem, a lacrimal endoscope according to claim 1 includes an image transmission unit, an insertion unit including an objective lens provided at a distal end of the image transmission unit, and an illumination unit, and a base of the insertion unit. A lacrimal endoscope having a grip portion provided on an end side, wherein the insertion portion has a first bending portion and a second bending portion that are bent at a predetermined angle.

  According to such a lacrimal endoscope, since the insertion portion hardly interferes with the patient's forehead, insertion into the lacrimal passage is facilitated.

  In order to solve the above problem, a lacrimal endoscope according to claim 2 is the lacrimal endoscope according to claim 1, wherein the angle of the second bending portion is the first bending portion. Greater than the angle.

  Alternatively, in order to solve the above problem, a lacrimal endoscope according to claim 3 is the lacrimal endoscope according to claim 1, wherein the angle of the second bending portion is the first bending portion. Smaller than the angle.

  As described above, by increasing the angle of the curved portion that is more likely to interfere with the forehead, interference with the forehead can be reduced.

  Alternatively, in order to solve the above problem, a lacrimal endoscope according to claim 4 is the lacrimal endoscope according to claim 1, wherein the angle of the second bending portion and the angle of the first bending portion are It is equal to the angle.

  In this way, even when the angles of the two curved portions are equal, the insertion portion is unlikely to interfere with the patient's forehead, so that insertion into the lacrimal passage is facilitated.

  In order to solve the above problem, a lacrimal endoscope according to claim 3 is the lacrimal endoscope according to claim 1 or 2, wherein the insertion portion includes a distal end portion where the objective lens is located, A first straight portion connected to the gripping portion; and a second straight portion located between the tip portion and the first straight portion, wherein the first curved portion is the tip portion. And the second straight part, and the second curved part is formed at a connection part between the second straight part and the first straight part.

  According to such a configuration, since the insertion portion hardly interferes with the patient's forehead, insertion into the lacrimal passage is facilitated.

  In order to solve the above problem, a lacrimal endoscope according to claim 4 is the lacrimal endoscope according to claim 3, wherein the first bending portion and the second bending portion are The first straight portion is curved in the same direction.

  In this way, by bending the two bending portions in the same direction, a doctor can easily grasp which direction the tip of the lacrimal endoscope is facing. Therefore, insertion into the lacrimal passage becomes easier.

It is a figure showing the whole lacrimal endoscope system composition concerning an embodiment. It is a figure which shows the structure of the lacrimal endoscope which concerns on embodiment. It is a figure which shows the insertion part of the lacrimal endoscope which concerns on embodiment. It is a figure which shows the insertion part of the lacrimal endoscope which concerns on embodiment. It is a figure which shows the shape of the insertion part of the lacrimal duct endoscope which concerns on embodiment. It is a figure which shows the shape of the insertion part of the lacrimal duct endoscope which concerns on embodiment. It is a figure which shows the insertion state of the lacrimal endoscope which concerns on embodiment. It is a figure which shows the insertion state of the lacrimal endoscope which concerns on embodiment. It is a figure which shows the insertion state of the conventional lacrimal endoscope.

== Outline of the lacrimal endoscope system ==
FIG. 1 is a schematic diagram showing an overall configuration of a lacrimal endoscope system 1 according to the present embodiment. The lacrimal endoscope system 1 includes a lacrimal endoscope 2, an imaging system 3, and a monitor 4.

  The lacrimal endoscope 2 is an endoscope for observing the inside of the lacrimal passage. The lacrimal endoscope 2 includes an insertion portion 2a, a grip portion 2b, a cable portion 2c, and the like (details will be described later). The imaging system 3 includes an image processing device, processes an image obtained by the lacrimal endoscope 2 and displays the image on the monitor 4. The imaging system 3 includes a light source device, and supplies illumination light for the lacrimal duct endoscope 2 to illuminate the inside of the lacrimal path.

== Overview of lacrimal endoscope ==
FIG. 2 is a schematic diagram showing the overall configuration of the lacrimal endoscope 2 according to the present embodiment. FIG. 3 is a front view of the insertion portion 2a as viewed from the distal end side. 4 is a cross-sectional view taken along the line AA in FIG.

  The insertion portion 2a is a portion that is inserted into the lacrimal passage from the patient's punctum. The insertion portion 2 a has an exterior pipe 20. The exterior pipe 20 is made of a metal such as stainless steel. An image guide fiber 21, an objective lens 22, a plurality of light guide fibers 23, and a water injection channel 24 are provided in the exterior pipe 20 (see FIGS. 3 and 4).

  The image guide fiber 21 transmits an image obtained through the objective lens 22 provided on the distal end side thereof to the imaging system 3. The image guide fiber 21 is made of quartz, multicomponent glass, plastic, or the like. The light guide fiber 23 conducts light from the light source device in the imaging system 3 and illuminates the inside of the lacrimal passage. The light guide fiber 23 is made of glass, plastic or the like. The water injection channel 24 supplies physiological saline or the like into the lacrimal passage. The image guide fiber 21 is an example of “image transmission means”, and the light guide fiber 23 is an example of “illumination means”.

  In addition, as the “image transmission means”, an image sensor such as a CMOS or a CCD may be used in addition to the image guide fiber 21. In this case, an image sensor is disposed on the distal end side of the insertion portion 2a. Moreover, you may use LED as an "illuminating means." In this case, the LED is arranged on the distal end side of the insertion portion 2a.

  The grip portion 2b is a portion that the operator grips when using the lacrimal endoscope 2. The distal end side of the grip portion 2b is connected to the proximal end side (the proximal end side of the straight portion L2) of the insertion portion 2a. A water injection cap 25 is provided on the proximal end side of the grip portion 2b. The water injection cap 25 is a portion to which a syringe or the like filled with physiological saline or the like is connected, and is provided for supplying physiological saline or the like into the water injection channel 24.

  A cable portion 2c is connected to the side surface of the proximal end side of the grip portion 2b. The cable portion 2 c is branched into two via the cable branch portion 26. An image guide plug 27 is provided at one end of the branch, and a light guide plug 28 is provided at the other end.

  The image guide fiber 21 extends from the insertion portion 2 a to the image guide plug 27 through the grip portion 2 b and the cable branch portion 26. By connecting the image guide plug 27 to the camera side socket of the imaging system 3, the lacrimal endoscope 2 can transmit the image obtained by the image guide fiber 21 to the imaging system 3.

  The light guide fiber 23 extends from the insertion portion 2 a to the light guide plug 28 through the grip portion 2 b and the cable branch portion 26. By connecting the light guide plug 28 to the light source side socket of the imaging system 3, the lacrimal endoscope 2 can illuminate the inside of the lacrimal passage.

== Details of the insertion part ==
Next, details of the insertion portion 2a will be described with reference to FIGS. FIG. 5 is a side view of the insertion portion 2a. The insertion portion 2a according to the present embodiment includes a distal end portion L1, a first straight portion L2, a second straight portion L3, a first bending portion C1, and a second bending portion C2.

  The distal end portion L1 is a portion on the distal end side of the insertion portion 2a. The tip L1 in this embodiment is a portion where the objective lens 22 is located (see FIG. 4).

  The first straight line portion L2 and the second straight line portion L3 are straight portions of the insertion portion 2a. One end (base end side) of the first straight line portion L2 is connected to the grip portion 2b. The second straight line portion L3 is located between the tip end portion L1 and the first straight line portion L2. The length of each part in the insertion portion 2a is the longest in the second straight line portion L3, followed by the first straight line portion L2 and the distal end portion L1.

  The first bending portion C1 and the second bending portion C2 are bent at a predetermined angle. The first curved portion C1 is formed at a connection portion between the tip portion L1 and the second straight portion L3. That is, the distal end side of the first curved portion C1 is connected to the distal end portion L1 (the proximal end side of the distal end portion L1), and the proximal end side is connected to the second linear portion L3 (the distal end side of the second linear portion L3). It is connected. The second curved portion C2 is formed at a connection portion between the second straight portion L3 and the first straight portion L2. That is, the distal end side of the second curved portion C2 is connected to the second linear portion L3 (the base end side of the second linear portion L3), and the base end side is the first linear portion L2 (the first linear portion). L1 tip side).

  In the present embodiment, the first bending portion C1 and the second bending portion C2 are in the same direction (upward in the drawing in FIGS. 4 and 5) with respect to the longitudinal direction of the first straight portion L2 (gripping portion 2b). It is curved. In this way, by bending a plurality of bending portions in the same direction, a doctor who operates the lacrimal endoscope 2 can easily understand which direction the tip is directed. Therefore, the procedure can be performed smoothly and there is little pain to the patient.

  Further, as shown in FIG. 5, in the present embodiment, the inclination angle α of the second straight line portion L3 with respect to the first straight line portion L2 is larger than the inclination angle β of the tip end portion L1 with respect to the first straight line portion L2. It has become. However, the inclination angle α and the inclination angle β may be the same angle, or the inclination angle α may be smaller than the inclination angle β.

  The number of bending portions formed in the insertion portion 2a is not particularly limited, but two bending portions are more preferable in order to easily grasp the direction of the distal end of the lacrimal endoscope 2.

  Moreover, the angle of the 1st bending part C1 and the angle of the 2nd bending part C2 may be equal, and may differ. Here, the angle of the first curved portion C1 is an angle (angle A shown in FIG. 4) formed by the distal end portion L1 and the second linear portion L3. The angle of the second curved portion C2 is an angle (angle B shown in FIG. 4) formed by the first straight portion L2 and the second straight portion L3.

  For example, the angle of the second bending portion C2 can be formed larger than the angle of the first bending portion C1. When the lacrimal endoscope 2 is operated in a state where the insertion portion 2a is inserted into the bony nasolacrimal duct, interference between the insertion portion 2a on the hand side (the gripping portion 2b side) and the forehead is more likely to occur. Therefore, it is possible to effectively avoid interference with the forehead by increasing the angle of the bending portion (second bending portion C2) on the hand side. Or you may form the angle of the 2nd curved part C2 smaller than the angle of the 1st curved part C1, depending on the difference in the skeleton of the patient and the like.

  As shown in FIG. 6, the insertion portion 2a includes a distal end portion L1, a first bending portion C1, and a second bending portion C2, and does not include the first straight portion L2 and the second straight portion L3. It is good also as a structure.

  7A and 7B are diagrams showing an example in which the lacrimal endoscope 2 according to this embodiment is inserted into the lacrimal passage. FIG. 7A is a front perspective view of the skull and is an enlarged view of the eye portion. FIG. 7B is a side view of the skull, and shows a state in which the distal end of the insertion portion 2a is inserted into the bony nasolacrimal duct ND from the lacrimal fossa FSL (see FIG. 7A). It should be noted that the lacrimal endoscope 2 shown in FIG. 7A and the lacrimal endoscope 2 shown in FIG. By providing the first curved portion C1, it is easy to guide the insertion portion 2a to the bony nasolacrimal duct ND through the lacrimal tubule bent from the punctum. Then, by providing the second curved portion C2, even when the lacrimal endoscope 2 is operated in a state where the insertion portion 2a is inserted into the bony nasolacrimal duct ND, the insertion portion 2a becomes the frontal bone FB. It becomes difficult to interfere with. That is, since the operability of the lacrimal endoscope 2 is improved, the doctor can easily perform the insertion operation of the lacrimal endoscope 2. Therefore, the burden on the patient is small. In addition, since an excessive force is not applied to the lacrimal endoscope 2, it is possible to prevent the insertion portion 2a from being deformed. In the configuration of the present invention, in particular, when the osseous nasolacrimal duct ND is inclined forward or rotated, it is difficult to guide the insertion portion 2a to the osseous nasolacrimal duct ND in the conventional configuration. It is effective.

  The above embodiment is presented as an example and does not limit the scope of the invention. The above configurations can be implemented in appropriate combination, and various omissions, replacements, and changes can be made without departing from the scope of the invention. Those embodiments and modifications thereof are included in the invention described in the claims and equivalents thereof as well as included in the scope and gist of the invention.

DESCRIPTION OF SYMBOLS 1 Endoscope system for lacrimal passage 2 Endoscope for lacrimal passage 2a Insertion part 2b Gripping part 2c Cable part 3 Imaging system 4 Monitor 20 Exterior pipe 21 Image guide fiber 22 Objective lens 23 Light guide fiber 24 Injection channel 25 Injection port 26 Cable branch Part 27 Image guide plug 28 Light guide plug L1 Tip part L2 First straight part L3 Second straight part C1 First curved part C2 Second curved part

Claims (1)

An lacrimal endoscope having an image transmission means, an objective lens provided at the distal end of the image transmission means, and an insertion portion including an illumination means, and a gripping portion provided on a proximal end side of the insertion portion,
The insertion portion includes a first bending portion and a second bending portion that are bent at a predetermined angle, a tip portion where the objective lens is located, a first straight portion connected to the grip portion, and the tip And a second straight part located between the first straight part and the first straight part,
The first curved portion is formed at a connection portion between the tip portion and the second straight portion, and the second curved portion is a connection between the second straight portion and the first straight portion. Formed in the part,
The first curved portion and the second curved portion are curved in the same direction with respect to the first straight portion ,
The angle of the second curved portion, which is an angle formed by the first straight portion and the second straight portion, is the first curve, which is an angle formed by the tip portion and the second straight portion. Lacrimal endoscope characterized by being larger than the angle of the part .

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