JPH0376129B2 - - Google Patents

Description

TECHNICAL FIELD The present invention relates to a cleaning control device for a human body cavity (cavity) and a tubular organ, and in particular to an endoscope device. , having at least one conduit for injecting irrigation fluid, either intermittently or continuously, into the body cavity and/or canal, referred to as the interference region, to provide interference with continuous and continuous irrigation. The present invention relates to a urinary endoscope device.

The device comprises a tank containing the cleaning fluid, a connecting conduit connecting the tank to the pipe, a supply pump attached to the connecting conduit for supplying cleaning fluid to the pipe, and downstream of the pump the first pressure sensing means connected to the connecting conduit, said first pressure sensing means measuring the instantaneous pressure present in said conduit at the level of these pressure sensing means and generating a measurement signal representative of said pressure; and means for determining a maximum allowable pressure within said interference region.

In certain procedures in endoscopy, even if they are only examination procedures and even in surgical procedures, it is known that the presence of an aqueous fluid in the interference region is generally necessary. The foregoing applies in particular to urinary endoscopes, ie to the bladder, ureter, urethra, prostate or kidney viewing end. More commonly, however, this is also required for pathological cavities which have to be examined or treated, for example by excision or by irrigation alone.

When performing endoscopy in an artificial fluid environment, continuous or intermittent irrigation with or without fluid flow is applied.

As a first example, the fluid is injected through a conduit of an endoscope and expelled through another conduit of the endoscope or by other means such as a catheter. As a second example, one and the same conduit of the endoscope is responsible for injecting and draining liquid.

Today, both continuous and intermittent flushing utilizes a reservoir of fluid whose operating position is at a higher level than the endoscope for gravity injection. In this configuration, the pressure of fluid injected into the interference region is primarily determined by the height of the fluid column between the endoscope and the fluid level of the tank.

In the case of intermittent flushing, fluid evacuation is currently done manually by the physician, who opens a drain stop or similar attached to the cover of the endoscope. ,
Alternatively, the operating element set having the telescoping portion is pulled out from the cover of the endoscope. This method is not a good evacuation method because it requires completely emptying the examination or surgical field.

In the case of continuous irrigation, liquid drainage is currently carried out by an outlet tube when using a two-way endoscope and by a catheter when using a single-way endoscope. In either case, the evacuation is accomplished either by gravity of the fluid to be ejected or by a pump with a selected constant flow rate.

The first problem arises when the level of fluid being injected from the tank changes over time due to fluid consumption. This means that adaptation to pressure changes,
or installing the tank at an appropriately high level.

The second problem arises in the case of continuous cleaning,
This is because good regulation of fluid evacuation is not always easy. Over-draining reduces the pressure in the interference region, whereas under-draining carries the risk of a dangerous overpressure building up in said region.

The pressure value within the interference region is directly related to the filling of this region, ie the volume of fluid it contains. Incomplete filling adversely affects the quality of the examination and jeopardizes the surgical cycle, whereas overfilling, or excessive pressure, can endanger the patient, especially in the case of surgery. Also, if the discharge flow exceeds or exceeds the injection flow, the interference region will be incompletely filled and the first discharge will occur. Conversely, if the discharge flow rate is less than or becomes less than the injection flow rate, the interference region becomes overfilled and this creates excessive pressure in the interference region, causing the second discharge will be carried out.

As a result, the clinician must be careful to avoid excessively high or low fluid pressure by simultaneously monitoring the injection and drainage of irrigation fluid. These monitors impose an arduous task on the physician that requires constant and meticulous attention, which is always required for proper endoscopic operation. Furthermore, with conventional irrigation devices, the physician has very limited, even uncertain, knowledge of the instantaneous flow rate of the volume of fluid injected as well as the volume of fluid expelled; has been a substantial hindrance to accurately monitoring all of these various parameters.

The purpose of the present invention is to provide a constant cleaning process in continuous cleaning.
All of the above disadvantages are obviated by the cleaning control device according to the invention, which is capable of operating at the lowest possible pressure and, in intermittent cleaning, at incremental but limited pressures that are within a threshold that cannot be exceeded. That's true.

Said object is achieved by a device according to the invention, which device comprises: (i) a pressure drop between said pressure sensing means and said interference region on the one hand and a pressure drop between said pressure sensing means and said interference region on the other hand; (ii) correction means adapted to equalize said measurement signal indicative of pressure by a level difference in said interference region and to determine the value of the instantaneous pressure at the level of said interference region; The cleaning fluid is characterized by comprising means for controlling the injection of the cleaning fluid so that the pressure is equal to or less than the maximum pressure at any moment.

According to the object of the invention, said means for equalizing the signal due to said pressure drop are constituted by a correction circuit coupled to a controllable correction circuit having a control element, said control element being controlled by said element. The correction circuit is configured to send separate signals corresponding to different hydraulic equivalent cross-sections of the selected endoscope internal tube to the correction circuit.

In a preferred embodiment, the means for equalizing the signal by means of pressure drop receives command signals representing different hydraulic equivalent cross-sections of the internal tube of the endoscope, which are sent by a selection circuit having an adjustment element; (a) receiving a flow signal transmitted by a device actuated by fluid displaced from the pump; and (b) transmitting a correction signal to the correction circuit in accordance with the infusion flow rate measured and adjusted by the flow command signal. and a signal processing device configured to provide a signal.

In the preferred embodiment of the device according to the invention, the means for equalizing the signal due to the pressure drop comprises a circuit consisting of a regulating element for regulating and preselecting the injection flow rate. The circuit and the adjustment element are configured to send separate signals to a controller of the feed pump corresponding to different values of fluid injected into the interference region indicated by the element.

In this preferred embodiment, the means for equalizing the signal by means of level differences comprises a correction circuit coupled to a variable control correction circuit consisting of an adjustment element.
The variable control correction circuit and the adjustment element are configured to send separate signals to the correction circuit, each corresponding to a separate level difference between the pressure sensing means and the interference region indicated by the element. .

In a preferred embodiment of the device according to the invention, the means for determining the maximum permissible pressure in the interference region have a control circuit with a regulating element. The circuit and the adjustment element are configured to send separate signals to a first input of the comparator, each corresponding to different values of the maximum allowable pressure within the interference region indicated by the element. There is.

In a particularly preferred embodiment, the device according to the invention includes:
various visual display devices configured to visualize the instantaneous pressure within the interference region, the instantaneous pressure measured by the first pressure sensing means, and the instantaneous pressure within the internal tube of the endoscope; is equipped.

Additionally, the device according to the invention includes a device configured to emit a signal indicating the flow rate of the injected fluid and at least one volume counter for counting the volume of fluid delivered by the pump. and a processing device connected to the correction circuit.

In a preferred embodiment, the device according to the invention includes: (c) in intermittent cleaning, a first counter configured to measure the volume of fluid delivered since the start of the current cycle; and (d) a mode of cleaning. Regardless, two counters are provided, a second counter configured to measure the volume of fluid delivered since the start of operation.

In a particularly preferred embodiment, the device according to the invention includes:
A preselection circuit consisting of a regulating element is provided, the preselection circuit emitting signals corresponding to the volumes of the various fluids to be delivered during operation, i.e. during the current cycle, selected by said regulating element. It is configured to transmit relatively.

In this case, the comparator includes: (e) a first input for the signal corresponding to the volume of the various fluids sent from the preselection circuit, and (f) by the first counter. A second input for the emitted signal may also be provided.

Preferably, each of the first and second counters is associated with a first and second visual display device, respectively.

In order to stop the injection of fluid within the interference region when a predetermined volume of fluid has been injected, the apparatus according to the preferred embodiment is equipped with first and second zero reset devices, said reset devices comprising: , respectively associated with the first counter and the second counter, and the first zero reset device is configured to operate a comparator coupled to a command device of an electric valve inserted into the conduit. has been done.

In order to couple the injection device of the cleaning device according to the invention with an active discharge control device, two matching circuits are arranged to respectively amplify and adjust signals indicative of the flow rate and the instantaneous pressure in the interference region, and Two connections are provided for connecting the two matching circuits.

In one embodiment of particular interest, a cleaning device according to the invention is equipped with said active discharge control device, said discharge control device comprising: (a) a conduit for discharging fluid from the interference region; ) an evacuation pump attached to said conduit; and (c) second pressure sensing means connected to said conduit below said interference region; on the other hand, due to the pressure drop present between the second pressure sensing means and the interference region, and on the other hand, due to the level difference present between the second pressure sensing stage and the interference region, the signal emitted by the second pressure sensing means is Correction means for equalizing the measurement signal and means for controlling the discharge of the cleaning fluid such that the pressure in the interference region is at any instant less than or equal to the maximum pressure may be provided. It is a characteristic.

In this case, the correction means for equalizing the measurement signal emitted by the second pressure sensing means due to the pressure loss may be equipped with a comparison processing device and a correction circuit with an adjustment element. desirable.
The circuit and the adjustment element are configured to send different signals to the comparison processing device, each corresponding to different hydraulic equivalent cross-sections of the outlet conduit selected by the element.

In this case as well, it is desirable that the means for equalizing the signal due to the pressure loss is equipped with a correction circuit including a preset element, but in that case the correction circuit and the preset element are removed from the interference region. and is configured to select a predetermined flow rate of the fluid. They are likewise provided with a connection for connection to a correction circuit with a regulating element, said regulating element being configured to take into account a signal indicating the instantaneous flow rate of the injection device.

In this case, it is desirable that at least the means for equalizing the signal based on the level difference is equipped with a controllable correction circuit having a preset element.
It is arranged to send separate signals to the correction circuit, each corresponding to a separate level difference between said second pressure sensing means and interference regions selected by said element.

In order to make the invention easier to understand, the invention will be described by way of example with reference to the accompanying drawings.

FIG. 1 is a diagram showing a preferred embodiment of the injection device of the cleaning device according to the present invention, and FIG. 2 is a diagram showing a preferred embodiment of the discharge device of the cleaning device according to the present invention.

FIG. 1 shows the injection device of the cleaning device according to the invention, which device is used for examining and/or surgically treating the hollow organ 2, i.e. the bladder, of a patient lying on a table 3. Useful endoscope 1
It is composed of. As mentioned above, for this kind of interference it is necessary to fill the bladder cavity with irrigation fluid 4, which is initially contained in a tank 5 and is passed through a conduit 7 with a filter 8. It is inserted into the bladder through the internal conduit 6 of the endoscope.

During intervention, irrigation fluid 4 can be delivered to the endoscope and thus injected into the organ 2 in either a continuous or intermittent manner.

This injection is carried out by a pump 9, such as a magnet-driven gear pump, which is mounted on the conduit 7 between the endoscope and the filter, and which pumps the fluid into the endoscope in a controlled manner. It is constructed to be carried to a mirror. The conduit 7 between the endoscope and the pump is provided with a pressure gauge 10 and a safety pressure gauge 12, which pressure gauge 10 is separated from the fluid 4 by means of a diaphragm or similar type of isolation means 11. Preferably, the safety pressure gauge 12 is isolated, and the safety pressure gauge 12 is connected to the switch 13 when the maximum safe pressure is exceeded.
It has a variable calibration means for blocking.

The pressure gauge 10 is equipped to measure the instantaneous pressure at that level in the conduit 7 and to emit an appropriate measurement signal, whereas the pressure gauge 12 is equipped to measure the instantaneous pressure at that level in the conduit 7, while the pressure gauge 12 is equipped to measure the instantaneous pressure at that level in the conduit 7 and to emit an appropriate measurement signal. The switch 13 is configured to be connected as long as the following conditions exist.

Additionally, the injection device is equipped with a processing device 14A, which is configured to shape the measurement signal emitted by the pressure gauge 10. The output signal is on the one hand a visual display device 1 configured to indicate to the doctor the instantaneous pressure at the level of the manometer 10;
6A and on the other hand to a correction circuit 14B configured to emit a correction signal by means of a variable control correction circuit 22 having a slide 23. By using this variable control correction circuit, the physician can adjust the magnitude of the correction signal sent to the correction circuit 14B, which is determined by the pressure gauge 10 and the organ 2. Specifically, it represents the level difference h between the determined interference region and the tip of the endoscope 1. For example, it can be seen that the variable control correction circuit is intended to provide seven separate correction values corresponding to level differences over 0-30 cm.

The output signal of the correction circuit 14B is directed on the one hand to a visual display device 16B configured to indicate to the physician the instantaneous pressure in the conduit 7 at the level of the endoscope, and on the other hand to a correction circuit 14C. The correction circuit 14C receives a first correction signal from a variable control correction circuit 22A, for example in the form of a slide 23A, intended to allow the physician to adjust the magnitude of the correction signal transmitted to the circuit; The magnitude of the correction signal represents the cross section of the internal tube 6 of the endoscope. For example, variable control correction circuit 2
2A is configured to be able to transmit three separate correction values corresponding to hydraulic equivalent cross-sectional measurements of 3, 5 and 7 mm ² . In addition, the correction circuit 14C:
configured to receive a second correction signal from device 32 via line 59, said device 32 comprising:
This device generates a signal corresponding to the injection flow rate via the line 59, and will be explained in more detail later.

As a result, in the circuit 14C, the pressure measurement signal, which has already been corrected according to the level difference between the measurement point and the endoscope, is thus
and the injection flow rate. In other words, the pressure measurement signal is corrected according to the pressure loss resulting from these two factors.

The output signal of the correction circuit 14C is directed on the one hand to a visual display device 16C designed to allow the physician to display the pressure thus equalized, and on the other hand to one input 17 of the comparison circuit 18. ,
The other input 19 of the comparator circuit 18 receives a reference signal from the control circuit 20 . The control circuit 2
0 allows the physician to adjust the maximum permissible pressure within the interference region defined by the organ 2 during the procedure, such as by the slide 21, and thus to change the characteristics of the signal directed to the input 19. for example,
Twelve separate values can be provided which adjust the maximum allowable pressure within the interference region over a water column of 5 to 60 cm. Alternatively, knowing the operation of the comparator circuit 18 allows the flow rate to be adjusted so that the pressure within the interference region does not exceed a predetermined value selected by the physician. To that effect, the doctor selects said pressure by means of the control circuit 20 with the aid of the slide 21.

The display device 16C is very useful to the doctor since it allows him to monitor the actual pressure within the organ 2. Furthermore, display device 16A
and 16B can constantly monitor the equalization associated with the predetermined level difference h , thus providing a very effective monitoring means for the doctor.

Due to the level difference h between the pressure gauge and the endoscope and the corrections associated with the endoscope inlet cross-section and also with the injection flow rate, the doctor can detect organs 2 that may not be detected.
You can change the height of the operation as needed, without any concern about possible pressure changes within the
Endoscopes can be replaced and/or flow rates can be changed. Similarly, these corrections can be made without making any calculations or modifying the endoscope by equipping it with a pressure sensor.
By measuring the external pressure of the organ 2, the actual pressure within the organ 2 can be determined with reasonable accuracy.

The comparison signal appearing at the output 24 of the comparator 18 is
Via line 25 it is sent to a control device 26 of the pump and optionally to audible signal means 27 and/or visual signal means 28 . These signaling means are arranged to issue a signal when a preselected maximum pressure is achieved. The control device 26 controls the supply line 29 of the pump 9, and the pump 9 is equipped with a switch 13. If necessary, additional compensation means 60 may be provided, which compensation means are then related to the temperature of the pressure sensing means due to the ambient temperature, i.e. the temperature of the fluid and the temperature of the pressure gauge 12.

The control device 26 includes a device (preset device) 57 that adjusts the injection flow rate and also preselects the flow rate.
is connected to. This adjustment circuit includes slide 5
8 can be installed. The slide allows the clinician to control the magnitude of the control signal, which magnitude corresponds to the most appropriate flow rate for a given intervention. Different values for adjusting the flow rate are obtained, for example over 0 to 700 cm ³ .

In operation, as long as the pressure in the conduit 7 at the level of the endoscope and in the organ 2 due to the above corrections is below the maximum reference pressure indicated in the control circuit 20, the pump will operate and pump fluid into the endoscope. Send it to the mirror and inject it into the organ. As soon as the maximum reference pressure is reached, the comparator circuit 18 controls the device 26 which shuts off the pump and thus stops the fluid supply to the endoscope. If for some reason the pressure in the conduit 7 reaches the maximum safe value that can be measured by the pressure gauge 12, the pump 9 is cut off and stopped by the switch 13.

An advantage of the above device is that it is further provided with additional means configured to measure the volume of fluid injected in progress since the start of the interference. These additional means are particularly effective when carried out in an intermittent cleaning method. In this embodiment, said additional means are controlled by an element 30 mounted in series in the conduit 7 downstream of the pump 9. The element 30 is
It is actuated by fluid delivered by a pump and emits a signal, e.g. a pulse, representative of the flow rate, the frequency of said pulses being proportional to the flow rate. Further, the element 30 may be configured in a gear type or may be integrated with the pump 9. The pulses emitted by elements 30, each representing a volume, are sent via line 31 to a signal processing device 32. The signal processing device 32 includes an EL diode,
or a similar type of visual display 33, which displays the instantaneous flow rate to the clinician. The signal processing device 32 connects the first and second counters 3 via its output line 34.
5 and 36 are also controlled. Each counter 35 and 36
are connected to visual display devices 37 and 38, respectively, which display the volume calculated by counting the pulses emitted by element 30 and formed by device 32. It is configured so that it can be displayed by a doctor.

In intermittent cleaning, the first counter 35
Used to measure the volume of fluid released since the current cycle started. Same counter 3
5 also controls an element 54 intended to transmit, by means of an audio device 55, an audio signal of the following types, for example: That is, when the manual switch 51 that controls the element 54 is in the "volume limit" position, from 0 cm ³ to 200 cm ³ there is 1 audible signal / 10 cm ³ ) From 200 cm ³ to 300 cm ³ there is 2 audible signals / 10 cm ³ ) bass From ^300cm3 to ^400cm3 : 3 / ^10cm3 ) From ^400cm3 to ^500cm3 : 1 audible signal / ^10cm3 ) High temperature From ^500cm3 to ^600cm3 : 2 / ^10cm3 ) b Switch 51 is "No volume limit" , one audible signal is generated per 10 cm ³ .

The counter 36 is intended to measure the fluid released since the start of operation, irrespective of the cleaning method, i.e. intermittent or continuous cleaning.

The result of the counter 35 is communicated via line 39 to one input 40 of a comparator circuit 41, the other input of which receives a reference signal coming from an adjustment circuit 43. This adjustment circuit allows the physician to adjust the volume of fluid that is to be released during operation, ie, during the current cycle, such as by slide 44. for example
It can be assumed that the area ranges from 150 to 600 ^cm3 .

The signal triggered by the comparator circuit is on line 45
via a device 46 which controls a supply line 47 of an electric valve 48 mounted on the conduit 7. As long as the volume measured by the counter 35 is less than or equal to the volume determined by the regulating circuit 43, the comparison signal keeps the electric valve 48 open. However, in contrast, as soon as the measured volume equals this preselected volume, closure of the electric valve 48 is commanded, thus cutting off the fluid supply to the endoscope. The comparison signal sent via line 45 can control audible alarm means 49 or visual alarm means 50, said alarm means emitting a signal the moment a preselected maximum volume is reached.

In a preferred embodiment, controllers 26 and 4
6 can be combined to control pumps and electric valves simultaneously.

Naturally, this comparison of the supplied volume to the reference volume is only significant for intermittent cleaning methods. Therefore, for continuous cleaning methods, switch 51
a is provided, which switch 51a is connected to a manual switch 51 and (a) constantly controls the device 46 via the comparator 41 in one of its two positions corresponding to continuous cleaning. actuates and controls electric valve 48 to keep it open and (b) causes comparator 41 to control device 46 in the other position corresponding to intermittent flushing.

Each counter 35 and 36 is provided with zero reset means 52 and 53, respectively, by means of which the infusion device can be connected and activated automatically or manually activated by the physician. can. a preselected maximum volume of the volume released after the preceding zero reset;
For example, fluid is injected as long as it is below 400 cm ³ .
As soon as this volume reaches this value, in this example 400 cm ³ , the injection is automatically stopped and can only be resumed after another zero reset via the pushbutton 52 after the interference area has been emptied. can. Furthermore, the physician can stop the infusion at any moment before the volume reaches this value.

As a result of the above, the device allows preselection of a maximum pressure in the interference region, provides visual and/or audible monitoring of the instantaneous pressure in the interference region, and adjusts this maximum pressure during operation. This also enables automatic operation of the supply pump, which the doctor can do by himself without any assistance.

Further, in said preferred embodiment having means for measuring the volume of fluid released, said injection device (c) presets the volume to be released in one cycle in the case of intermittent flushing; (d) constant visual and/or audible monitoring of released volume and flow rate; (e) adjustment of a reference volume during operation; and (f) automatic shutoff of fluid flow when the reference volume is reached. It will be done.

In said modification, the pump 9 can be operated continuously and the electric valve 48 can be installed in the form of a three-way valve with a return path to the tank 5. Such a three-way valve is also a device 26
controlled by

All suitable devices, passive or active, regulated or unregulated, can be used for continuous or intermittent irrigation to drain fluid from the organ 2. However, considerable safety is added by utilizing active emission control means, which will be described in more detail below. The device thus includes an adaptation circuit configured to respectively amplify and adapt one of the signals from the device 32 representative of the flow rate and the instantaneous pressure information in the interference region sent from the circuit 14C. 32B and 32D are provided, but these means are adapted to provide connections 32C and 32E to take this information into account.

The discharge device of the cleaning device having the injection device as described above will be explained in more detail with reference to FIG.

In this embodiment, the evacuation device is constituted by an evacuation conduit 107 that connects with the second internal tube 106 of the endoscope 1 . However, in some cases,
Said drainage tube 107 can be connected to a catheter (not shown) having an opening into the organ 2.

In addition, the device is equipped with a pump 108, for example of the peristaltic type, which is attached to the conduit 107. In fact, an intermediate tank 109 is inserted into the conduit 107 upstream of the pump 108, and two branch pipes 107a and 1
07b (forming the inlet and outlet branches of the conduit 107, respectively) with the plug 110 of this tank. Although the tip of the inlet branch pipe 107a is preferably placed above the level of the fluid 111, the tip of the outlet branch pipe 107a is preferably placed above the level of the fluid 111.
The tip of b is placed in the upper region of this fluid, thereby forming a tank.

A pressure gauge 112 hydraulically isolated from the cleaning fluid by isolation means 113, for example in the form of a diaphragm.
are attached to the conduit 107 in parallel between the endoscope 1 and the intermediate tank 109. This pressure gauge 1
12 is configured to measure the instantaneous pressure present in the discharge conduit 107 at that level.

According to a particularly preferred embodiment of the evacuation device, the signal emitted by the pressure gauge 112 indicating the pressure present in the conduit 107 at the level of the pressure gauge 112 accurately indicates the pressure present in the organ 2. It will be corrected as follows. The device according to the invention is thus equipped with a correction circuit 114, such as a subtracter, which corrects the correction signal sent from a variable control correction circuit 115, for example of the potentiometer type, to the pressure gauge 112.
is configured to subtract from the measurement signal transmitted by the correction circuit 1, whereby the doctor
The magnitude of the correction signal transmitted to 14 can be adjusted with the aid of slide 116 or the like. The magnitude of this correction signal represents the level difference h' between the endoscope 1 and the pressure gauge 112. For example, a correction scale can be constructed with seven separate values corresponding to level differences over 100-130 cm.

As in the case of the infusion device described in the description with respect to FIG. 1, the physician can change the height of the operation as necessary without worrying about possible pressure changes within the organ 2. This results in a change in operating height. This characteristic of the device according to the invention is that
Furthermore, by measuring the external pressure in the organ 2 and making appropriate corrections, it is possible to recognize the actual pressure in the organ 2 with appropriate accuracy without having to make calculations or modify the endoscope by equipping it with a pressure detector. In other words, physicians can use a common endoscope in their operations and benefit from real improvements and greater accuracy at the same time.

The output signal of the correction circuit 114 is sent via line 117 to a comparison, correction and processing device 118. This device also connects to the control circuit 1 via an inlet line 119.
By using said control circuit, the doctor can control the intravesical pressure allowed into the interfering organ 2 with the aid of the slide 121 etc. can. For example, a correction can be made such that the actual pressure in the interference region corresponds to a maximum value over a water injection of 5 to 60 cm.

The comparison signal applied to the outlet line 122 of the post-process comparison device 118 controls the controller 124 of the pump 108 via an optoelectronic coupling device 123 . An advantage of this pump control device 124 is that it can be equipped with a push button 126 for controlling the purification. A visual display device 140, for example in the form of a galvanometer, may be attached to the output of pressure gauge 112 or subtractor 114 to indicate to the physician the actual pressure being measured.

Due to the good characteristics of the ejector, line 117
The measurement signal of the instantaneous pressure appearing on line 117 is corrected to take into account the cross-section of the discharge conduit, i.e. the hydraulic equivalent cross-section of pipe 106, and the discharge flow rate, these two parameters being added to the measurement signal on line 117. It causes functional decline.

The correction signal is added to the additional input line 127 of the comparator 118.
appears in Said line 127 comes from a correction circuit 129 which takes into account the cross-sectional area of the tube 106. The circuit 129 is equipped with a control element 134, such as a slide, which moves between terminals corresponding to various cross sections. Correction circuit 1
29 is the switch 12 appearing on its input line 135.
Controlled by signals from 8. This switch is connected in two positions, namely via a connection 132 to the injection control device described in connection with FIG. a first
and a second position connected to the slide 131 of the correction circuit 130.
The 30 terminals correspond to various injection volumes selected by the physician according to the actual flow rate, and when injecting fluid only by gravity, the flow rate can indicate the height of the tank containing the irrigation fluid. Displayed by. The fluid level in this tank is kept constant, for example by suspending the tank with the aid of a suitable selected spring.

As already explained in connection with the drawings, the evacuation device of this embodiment can also be equipped with an additional correction circuit 133 which takes into account the temperature of the pressure sensing means, which temperature is therefore the ambient temperature; This is due to the temperature of the fluid, the temperature of the pressure gauge, etc.

Although the evacuation device can be used separately from the injection device, i.e. in combination with the injection device by gravity, the preferred use of this device ensures that the pressure and flushing flow rate are controlled and constant. Interfering with continuous cleaning. In operation,
is measured by the pressure gauge 112 and the circuit 1
15, 129, 133 and 130 or 120
As long as the pressure corrected by is less than or equal to the operating pressure indicated by the physician on circuit 120, pump 108 is stopped. Conversely, when this pressure is reached or exceeded, pump 108 is activated.

If the evacuation device is used with a gravity passive injection device, the device constitutes a regulator by constant control of the pressure. In this case, comparison device 11
8 advantageously includes a flow sensing means 14 attached to the conduit 107 upstream of the intermediate tank 109.
The flow rate information conveyed by 1 can be utilized. By means of the flow information transmitted by said means 141, known per se, via line 142 and by the pressure information transmitted by device 114 via line 117, comparator device 118 determines the interference region. The discharge flow rate can be corrected so that the pressure within remains at a constant value selected by slide 121 of control circuit 120.

If this emission control device is utilized in conjunction with an injection control device, said device provides additional safety to the latter. In this case, the usefulness of comparator 118 is to utilize the pressure information within the interference region transmitted by the injector of connection 132A to maintain this pressure at a constant value selected by the injector. Therefore, the discharge flow rate must be adjusted.

Finally, the device according to the invention can also be used for interference with intermittent irrigation when using a single-channel endoscope with an outlet stop, i.e. with two stops (e.g. with a central valve in the case). be able to. In this case, the emission control is carried out by means of a comparison device 118, which ensures the role of the safety element.

Injections performed while interfering with the urinary tract with an endoscope are
Until now, knowledge of and familiarity with fluid parameters such as volume, flow rate, and pressure has been approximate, even dangerous, as it has been done by gravity; however, as described above, active discharge control The above limitations and dangers can be removed by having an accurate and complete knowledge of the hydraulic parameters and being thoroughly familiar with them at all times by utilizing electronically regulated injection methods that can be achieved by . The result is safety for the patient by eliminating all excess pressure and complexity, as well as significantly improved operating conditions for the surgeon with maximum visible gain and instantaneous irrigation control within the interference area. It will be. In particular, visibility within the interference region is improved, thus reducing surgical discomfort. Freed from control and coordination problems, the surgeon is able to focus his time during the surgery on the more important surgery itself, and is able to perform interventions more reliably and effectively.

In summary, electronically regulated injection utilized for intermittent flushing allows for all endoscopic interventions to: That is, 1. Selection of injection water pressure parameters: (a) Maximum pressure of the fluid in the interference region; (b) Instantaneous flow rate of the injected fluid; (c) Maximum volume of the fluid to be injected per cycle.

Continuous instantaneous visual and/or audible indication of these parameters: (a) instantaneous pressure within the interference area; (b) instantaneous flow rate of fluid injected; (c) instantaneous flow rate of fluid injected since the start of the cycle and since the start of the interference. volume.

3 Instantaneous pedal control of fluid injection and electrical operating current.

4. Correction of the height of the operating table, i.e. equalization of the height change determined by the physician of the operating table, ie of the organ to be operated on.

The same results are obtained with electronically regulated injection devices used for continuous cleaning. Whereas in intermittent cleaning the appropriate intervention takes place only during the fluid injection cycle, in continuous cleaning the operations are carried out throughout the cleaning. In that case, the emissions are
a special conduit for an endoscope or a trocar for the bladder,
This is done through either of the following.

Electronically regulated emissions make it possible to: Namely: 1. Pressure selection in the interference region, especially interference under low pressure.

2. Automatic adjustment of suction water pressure parameters: (a) Constant pressure in the interference area; (b) Equalization of suction flow rate and infusion flow rate for the total value of the infusion flow rate; (c) Constant bladder volume; 3. Instantaneous value of suction Always displayed.

4 Correction of operating table height.

The invention is not limited to the above-described implementation forms and to the forms shown in the accompanying drawings, but can be realized with various modifications and variations known to those skilled in the prior art.

Claims (1)

[Claims] 1. A cleaning control device for human body cavities and tubular organs;
In particular, an endoscopic device, more particularly an urinary endoscopic device, which injects irrigation fluid either intermittently or continuously into a body cavity and/or duct, referred to as an interference region. said apparatus for controlling the cleaning of human body cavities and tubular vessels for intermittent and continuous cleaning interventions, said apparatus comprising: (a) a tank containing a cleaning fluid; (b) a junction conduit connecting the tank to said tube; (c) a supply pump attached to said junction conduit for supplying cleaning fluid to said tube; and (d) downstream of said pump and said junction. first pressure sensing means connected to the conduit for measuring the instantaneous pressure present in the conduit at the level of the means and for emitting a measurement signal representative of said instantaneous pressure;
and (e) means for determining a maximum permissible pressure in said interference region, and (f) on the other hand, due to the pressure drop between said pressure sensing means and said interference region. on the other hand, said pressure sensing means and correction means for equalizing said measurement signal indicative of the pressure due to the level difference existing between the interference region and determining the value of the instantaneous pressure at the level of the interference region; and (g) of the cleaning fluid. and control means for controlling the injection so that the pressure in the interference region is less than or equal to the maximum pressure. cleaning control device. 2. In the device according to claim 1,
The correction means for equalizing the signal due to the pressure loss is a variable control correction circuit 2 equipped with a control element 23A.
2A, and the variable control correction circuit and the control element respectively correspond to various hydraulic equivalent cross sections of the endoscope internal tube 6 selected by the control element. The apparatus for controlling cleaning of human body cavities and tubular organs, characterized in that it is configured to transmit a separate signal to the correction circuit 14C. 3. In the device according to claim 2,
The correction means for equalizing the signal due to the pressure loss are arranged to receive command signals representing different hydraulic equivalent cross sections of the endoscope internal tube, which are sent by a selection device 57 with an adjustment element 58. (h) receiving a flow signal transmitted from the element 30 actuated by the fluid displaced by the pump 9; and (i) injecting a measured and adjusted flow rate in accordance with said flow control signal; The apparatus for controlling cleaning of human body cavities and tubular organs, characterized in that it comprises a signal processing device 32 configured to issue a corresponding correction signal to the correction circuit 14C. 4. In the device according to claim 1,
The correction means for equalizing the signal due to the level difference is a variable control correction circuit 2 equipped with a control element 23.
2, said variable control correction circuit and said control element respectively corresponding to the discrete level differences between said pressure sensing means 10 and said interference region indicated by said control element. The cleaning control apparatus for human body cavities and tubular organs as described above, characterized in that the apparatus is adapted to transmit a separate signal to the correction circuit 14B for the purpose of cleaning the body cavity and tubular organs. 5. In the device according to claim 1,
The means for determining the maximum permissible pressure in said interference region comprises a control circuit 20 equipped with a control element 21, said control circuit and said control element controlling said pressure in said interference region selected by said control element. A control device for cleaning human body cavities and tubular organs as described above, characterized in that it is adapted to issue separate signals corresponding to different values of the maximum permissible pressure to the first input of the comparator 18. . 6. In the device according to claim 1,
The device includes at least one optical display device 16C configured to visualize the instantaneous pressure within the interference region.
The above-mentioned human body cavity and tubular organ cleaning control device, comprising: 7. In the device according to claim 1,
The device includes an optical display 16 for visualizing the instantaneous pressure measured by the first pressure sensing means 10.
The cleaning control device for human body cavities and tubular organs as described above, comprising: A. 8. In the device according to claim 1,
Device for controlling cleaning of human body cavities and tubular organs, characterized in that said device is equipped with an optical display device 16B for visualizing the instantaneous pressure in the conduit 7. 9. In the device according to claim 3,
The element 30 is adapted to emit a signal indicative of the flow rate of the injected fluid, and the processing device 32 is adapted to provide at least one counter for counting the volume of fluid delivered by the pump 9 to the correction circuit 14C. The above-mentioned human body cavity and tubular organ cleaning control device, characterized in that: 10. The apparatus of claim 9, wherein the apparatus comprises: a first counter 35 configured to measure the volume of fluid delivered since the start of the current cycle in an intermittent wash; and whatever the wash mode is. A control device for cleaning human body cavities and tubular organs as described above, characterized in that it comprises two counters: a second counter 36 adapted to measure the volume of fluid delivered since the start of the intervention. 11. The device of claim 1, wherein the device sends signals to the comparator 41 selected by the control element 44 and corresponding to the volumes of the various fluids that have to be sent during the interference cycle, i.e. the current cycle. Device for controlling cleaning of human body cavities and tubular organs as described above, characterized in that it is equipped with a preselection device 43 having said control element 44 adapted to transmit signals to the human body. 12. Apparatus according to claims 10 and 11, wherein the comparator 41 has a first input 42 for the signals corresponding to the volumes of the various fluids sent from the preselection device 43; , and a second input 40 for the signal emitted by the first counter 35. 13. In the device according to claim 10, each counter of the first and second counters 35, 36 is connected to the first and second visual display device 3.
7 and 38, respectively. 14. The apparatus of claim 10, wherein the apparatus comprises a first zero reset device 52 and a second zero reset device 53 associated with the first counter 35 and the second counter 36, respectively. and the first zero reset device 5
2 actuates a comparator 41 coupled to a control device 46 of an electric valve 48 inserted in the conduit 7 to stop the injection of fluid when a predetermined volume has been injected into the interference region. The above-mentioned human body cavity and tubular organ cleaning control device characterized by: 15. The apparatus of claim 9, comprising two adaptation circuits 32B and 32D configured to respectively amplify and adapt signals indicative of flow rate and instantaneous pressure within the interference region; A device for controlling cleaning of human body cavities and tubular organs as described above, characterized in that it comprises connections 32C and 32E for connecting the compatible circuit to an emission control device. 16. The device according to claim 15, wherein the active discharge control device includes: (a) a conduit 107 for discharging fluid in the interference region; and (b) a discharge pump 108 attached to the conduit.
and (c) a second pressure sensing means connected to the conduit above the interference region, while causing a pressure drop within the second pressure sensing means and the interference region;
on the other hand, said second pressure sensing means and correction means for equalizing the measurement signal emitted by said second pressure sensing means due to a level difference between said interference regions; and said A device for controlling the cleaning of human body cavities and tubular organs, characterized in that it comprises evacuation control means for ensuring that the pressure in the interference region is at any moment less than or equal to the maximum pressure. 17. In the device according to claim 16, the correction means for equalizing the measurement signal transmitted by the second pressure sensing means due to the pressure loss is a correction circuit 1 having a comparison processing device 118 and a control element 134.
29, and the correction circuit and the control element control the tube 106 selected in advance by the element.
A device for controlling cleaning of human body cavities and tubular organs, characterized in that the device is adapted to transmit various signals to the device 118, respectively corresponding to various hydraulic equivalent cross sections of the body. 18. The device according to claim 16, wherein the means for equalizing the signal due to the pressure drop comprises a correction circuit 130 with a preselection element 131, the correction circuit and element being separated from the interference region. The control device for cleaning human body cavities and tubular organs as described above, characterized in that the flow rate of the fluid to be discharged is preselected. 19. The device according to claim 16, wherein the means for equalizing the signal due to the pressure drop is connected to a correction circuit 129 having a control element configured to take into account a signal representative of the instantaneous flow rate of the injection device. The cleaning control device for human body cavities and tubular organs as described above, characterized in that it comprises a connecting part 132. 20 In the device according to claim 16, the means for equalizing the signal due to the level difference is a variable control correction circuit 115 having a preselection element 116.
, wherein the correction circuit and the preselection element generate separate signals corresponding respectively to the separate level differences between the second pressure sensing means 112 and the interference region displayed by the correction circuit 114 . The cleaning control device for human body cavities and tubular organs as described above, characterized in that the device is adapted to send out a signal to the human body cavity and tubular organs.