JPH0477567B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Technical Field of the Invention] The present invention relates to an advancement/retraction guiding device for an endoscope or the like that can be smoothly inserted into a curved body cavity such as the large intestine.

[Technical background of the invention and its problems]

In recent years, endoscopes have been widely used for medical and industrial purposes.

Some of these endoscopes have a hard insertion section and are inserted into the abdominal cavity while being guided through a puncture such as a trocar, and others have a soft insertion section that does not require the above puncture and are inserted into the oral cavity or anus. There are soft types that can be inserted into the target site via a curved intrabody cavity route.

When inserting the above-mentioned flexible endoscope from the anus into the large intestine, the operation of inserting it deep into the body cavity through a curved path such as the S-shaped section requires a highly skilled technique, and requires a highly skilled person. If I wasn't the operator, I would have been in a situation where the patient would have been in great pain.

For this reason, various conventional examples have been disclosed in which a means for propelling the insertion section is provided on the distal end side of the insertion section of the endoscope, thereby making it possible to insert the endoscope deep into the insertion section.

For example, as disclosed in Japanese Unexamined Patent Application Publication No. 54-160083, a screw-shaped propulsion ring is attached to the distal end of the insertion section, and the rotation of the propulsion ring is remotely controlled on the proximal side. There is a conventional example in which the insertion portions are propelled together by the screwing motion of the ring.
This conventional example has the risk of twisting and damaging the intestinal wall etc. when screwing in.

For this reason, the conventional example disclosed in Japanese Patent Application Laid-Open No. 55-45426 has a structure in which the propellers are rotated in opposite directions to each other in order to eliminate the drawbacks of the conventional example. However, even in this conventional example, rotation in opposite directions creates parts where the folds of the intestinal wall are separated, and if this condition progresses further,
Propulsion function is reduced and there is a risk of damaging the intestinal wall.

In addition, there is a conventional example in which a balloon for propulsion is attached to the distal end side of the insertion portion, and the balloon is inflated or deflated to cause propulsion. This conventional example has the disadvantage that it takes time to insert it to the required depth because the amount of movement propelled by expansion and contraction for propulsion cannot be increased very much.

In addition, in these conventional examples, the outer diameter of the insertion portion is increased, which causes great pain to the patient during insertion.

In addition, do not attach anything to the insertion part of the endoscope.
There is a conventional example in which the endoscope insertion section is inserted into the insertion section by giving a simple back-and-forth movement or a simple rotational movement to the outside of the insertion port, but the simple operation described above does not allow the insertion of the endoscope into the insertion section. It was difficult to insert.

[Purpose of the invention]

The present invention has been made in view of the above-mentioned points, and by making it possible to automatically perform insertion and withdrawal operations similar to those performed by the most skilled surgeon, it is possible to easily advance and withdraw. It is an object of the present invention to provide an advancement/retraction guidance device for an endoscope or the like that causes less pain to the patient.

[Summary of the invention]

The present invention provides a main body that holds a tubular section such as an insertion section of an endoscope with at least one of a drive system that allows the insertion section to move back and forth and a drive system that provides rotational motion. A control device section is provided to control the system.

[Embodiments of the invention]

Hereinafter, the present invention will be specifically explained with reference to the drawings.

1 to 6 relate to one embodiment of the present invention, and FIG. 1 shows the embodiment in use,
2 shows the structure of the first embodiment in cross section, FIG. 3 shows the front view of FIG. 2 with a part cut away, FIG. 4 shows the configuration of the control device section of the first embodiment, and FIG. The figure shows a temporal change in the rotational angle in an example in which the longitudinal motion roller is driven, and FIG. 6 shows a temporal change in the rotation angle in one example in which the rotational motion roller is driven.

As shown in FIG. 1, an advancement/retraction guiding device (hereinafter simply referred to as an advancing/retracting (guiding) device) 1 for an endoscope or the like according to an embodiment has a flexible (soft) insertion portion 3 of an endoscope 2. It is composed of a main body part 4 of the advancing/retreating guidance device that holds the main body 4, and a control device part 5 that controls the main body 4 (of the advancing/retreating guiding device) and is provided with a driving power source.

The endoscope 2 emits illumination light supplied from an external light source 6 from the distal end side of the insertion section via a light guide cable 7 and a light guide inserted through the flexible insertion section 3. An illumination optical system and an objective lens form an image of the illuminated object, and the flexible image guide inserted through the insertion section 3 transmits the image to the operation section 8 side, where it is observed from behind the eyepiece section 9. An observation optical system that can be used is formed.

On the other hand, the main body part 4 attached to the outer periphery of the insertion part 3 has a structure shown enlarged in FIGS. 2 and 3.

That is, two recesses are formed in the axial direction at four locations on the inner periphery of the hollow annular first bearing 12, which is slightly larger than the outer diameter of the insertion portion 3, and each recess is provided with a longitudinally moving roller. 13,13,...1
3 is rotatably housed in the insertion portion 3 in the axial direction.

A second bearing loosely fitted around the outer periphery of the first bearing 12 is also provided.
The inner peripheral surface of the bearing 14 is also formed with concave portions extending over two stages, for example, at four locations, and in each of these concave portions, rotary rollers 15, 15, . . . It is housed so as to be rotatably supported around its axial direction (indicated by arrow A).

As shown in FIG. 3, one of the longitudinally moving rollers 13, 13, . In order to detect
is attached, and the main body of the variable resistor 17 is fixed in a recess formed in the first bearing 12.

Further, one of the rollers 13, 13, . By rotating the roller 13 in the forward or reverse direction, the roller 13 attached to the motor 18 is rotated, and the insertion section 3 is set to be able to be moved forward or backward.

Similarly, rotating rollers 15, 15, ..., 1
5 is the roller 1 as shown in FIG.
5, the first roller that comes into contact with the roller 15
A shaft 21A of a variable resistor 21 is attached to the rotation shaft of the roller 15 as rotation detection means so that the rotation angle of the bearing 12 (or the insertion portion 3 rotating together with the first bearing 12) can be detected. .

Further, one of the rollers 15, 15, .
The rotation of the motor 22 can be controlled in the forward or reverse direction by an electric signal supplied through the motor, and the rotation of the motor 22 (of the rotating shaft 22A) rotates the roller 15 connected to the motor 22. , the insertion portion 3 is rotated together with the first bearing 12 relative to the second bearing 14 .

In addition, each rotating shaft 18 of the motors 18 and 22
The rollers 13 and 15 attached to A and 22A are
These motors 18 and 22 are designed to rotate smoothly when they are not being driven. Further, each variable resistor 17 for detecting the longitudinal movement and rotational movement,
21 is connected to the control device section 5 via a signal line (not shown) in the signal cable 24, as shown in FIG.
By measuring each resistance value that varies depending on the rotation of each shaft 17A, 21A, each roller 1
3 and 15, that is, the amount of movement (rotation angle) of the longitudinal and rotational movements of the insertion section and their positions can be detected.

By the way, each of the above-mentioned motors 18 and 22 is a motor that can be rotated by an arbitrary angle in the forward direction or in the reverse direction by electric signals supplied from the control device section 5 via cables 19 and 23, respectively.

The control device section 5 is configured as shown in FIG. 4, for example. That is, a constant voltage source 31 housed in the control device section 5 supplies a constant voltage to both ends of each variable resistor 17, 21 via a signal line (not shown), and controls the rotation of each shaft 17A, 21A. Therefore, variable resistance terminals whose resistance is varied are respectively connected to input terminals of voltage controlled oscillators (voltage frequency converters) 32 and 33.

The voltage controlled oscillators (VCO) 32 and 33 are
The oscillation frequency of the output signal changes depending on the potential applied to the input terminal, and the outputs of these oscillators 32 and 33 are sent to the recording and reproducing head via amplifiers 34 and 35 and interlocking switches 36 and 37, respectively. 38 and 39, the information is simultaneously recorded on a tape 40 that moves at a constant speed.

Also, during playback, the amplifiers 41 and 42 pass through the interlocking switches 36 and 37, respectively.
phase comparison for inputting, comparing and outputting each regenerated electrical signal that has been sufficiently amplified by the amplifiers 34 and 35 (which detected the actual driving state); The signals are input to devices 43 and 44, respectively. The output of each phase comparator 43, 44 controls the rotation of each motor 18, 22 via a low pass filter 45, 46, respectively.

That is, if the electric signal in the state in which the motors 18 and 22 are actually being driven does not match the regenerated signal from the output of each phase comparator 43 and 44, the motors 18 and 22 will respond in the direction of the deviation. A signal is output, and this output is passed through low-pass filters 45 and 46 to control each motor 18 and 22 so that the deviation is reduced. In other words, the motors 18 and 22 are driven so as to quickly match the positions of the variable resistors 17 and 21 corresponding to the reproduced signals, and when they match, the state is maintained. In other words, each motor 18, 22 is controlled so as to reproduce the same state as during recording.

The operation of one embodiment configured in this manner will be described below.

When inserting using the above-mentioned first embodiment, after setting as shown in FIG. 1, each motor 18, 22 is not operated and the insertion operation is actually performed by a surgeon who is extremely proficient in the insertion operation. get. in this case,
The forward/backward movement and rotational movement performed by the operator are separately detected by variable resistors 17 and 21, respectively, sufficiently amplified through VCOs 32 and 33, and recorded on tape 40.

Therefore, once you record the above insert operation,
Thereafter, the signal recorded on the tape 40 is reproduced, and if the positions of the variable resistors 17 and 21 corresponding to the reproduced signal differ from the actual positions, each phase comparator 43 , 44 and filter 45,
The output through 46 is positive or negative, and the positive or negative output drives each motor 18, 22 to quickly match. In other words, each motor 18, 2
In step 2, the insertion section 3 is inserted while moving back and forth and rotating so as to match the recorded signal, so that the insertion operation can be performed by a skilled surgeon. If the tape 40 is used as a cassette tape, it can be replaced and used depending on the insertion site.

Incidentally, the insertion operation performed by the skilled surgeon is as shown in FIGS. 5 and 6, for example.

In other words, the longitudinal motion rollers 13, 13, ..., 1
3, in addition to the insertion operation, for example, as shown in Fig. 5, the period T is
is vibrated back and forth at 0.1 [sec] to 2 [sec],
As shown in FIG.
It is performed while rotating and vibrating at an amplitude C of 10 [degrees].
By applying such fine vibrations, the friction between the insertion section 3 and the body cavity wall can be reduced, and the endoscope insertion section 3 can be inserted smoothly.

In addition, since the angle of rotation in the above is generally not so large, the variable resistor 17 attached to the first bearing 12 and the cable 19 connected to the motor 18, which are rotated together with the insertion section 3, are rotated to some extent. Although it is sufficient to arrange it with some allowance, it is also possible to use a brush or the like to transmit the signal like in the structure of a normal motor or the like.

Note that if the variable resistors 17 and 21 mentioned above are of helical rotation type (multi-rotation type), the number of rotations can also be detected. In addition, even if it is a one-turn type and has a structure that returns to the original angle (position) after one rotation, the variable resistors 17 and 2 may be used as necessary.
Means for detecting the rotation angle of 1 may also be provided. This can be recorded simultaneously on different parts of the tape 40, or it can be multiplexed as in a video tape recorder (the signals for longitudinal motion and rotational motion can also be multiplexed in the same way). .

Incidentally, the tape 40 may be a cassette tape or the like, or a continuous tape may be used if the recording signal is repetitive. Furthermore, if the repetition period is short, a semiconductor recording device can also be used.

In the first embodiment, the frequency is converted and recorded, but it is also possible to use an analog-to-digital (AD) converter to record it as a digital amount on the tape 40 or a magnetic disk. In the case of time or repetition, semiconductor devices can be used. RAM
Alternatively, in the case of the above-mentioned semiconductor device such as ROM, a counter or the like is used that specifies and reads an address when outputting a recorded signal. Furthermore, a floppy disk widely used as a recording (reproducing) device for microcomputers and the like can also be used.

Further, the control device section 5 is not limited to the one described above, and may be formed using or combining other known means.

Note that, instead of using the phase comparators 43 and 44, a counter and a digital comparator may be used as a means for controlling each motor 18, 22 to be in a state corresponding to the reproduced signal. In other words, count each signal within a (short) fixed time,
The outputs are compared in magnitude using each digital comparator, and based on the comparison output, each motor 1
8 and 22 should be controlled. When using this digital comparator, each variable resistor 17, 2
The output of motor 1 can be AD converted and recorded, or input to a digital comparator and output from each motor 1 as shown above.
It can also be configured to control 8 and 22.

The control device section 5 houses a function generator, which generates signals of various waveforms, records the signals on a tape 40, etc., and reproduces the signals to control the motor. 18 and 22 can also be configured.

The longitudinal drive motor 18 or the rotary drive motor 22 described above may have an appropriate torque (or less) so as not to cause pain to the patient due to excessive force during the insertion operation. This can also be applied to the rollers 13 and 15 side. In other words, it is possible to prevent rotation when the load exceeds a certain value. In these cases, the phase difference or frequency difference input to the phase comparator 43 or 44 becomes large, so
It is also possible to use a display to inform the operator when the difference exceeds a certain value, or when the difference exceeds a certain value and continues for a predetermined period of time.

In the present invention, a drive source for longitudinal motion and a drive source for rotational motion are required, but it is of course preferable to have detection means for them using variable resistors 17, 21, etc. It's not essential. (If the detection means is not used, the drive source is directly controlled by an appropriate signal.) In the above embodiment, the variable resistor 17, etc. and the motor 18, etc. are mounted on separate rollers. Although it is attached, it may also be connected to the same roller.

Further, the present invention can be applied not only to flexible endoscopes but also to rigid endoscopes, and can be applied not only to medical endoscopes but also to industrial endoscopes. Furthermore, it can also be applied to insertion of tubular parts in medical instruments such as probes and catheters. Furthermore, it can be applied not only to guiding when inserting the device, but also to withdrawing the inserted object.

The drive motors 18 and 22 are configured to be controlled by electric signals output from the control device section 5. .) and
The load on the motors 18 and 22, which are driven while being controlled by the electric signal, is detected, and at each time, an electric signal that gives a (micro) vibration is superimposed on the electric signal, and the load in the insertion direction is reduced. It is also possible to select and insert smaller (microscopic) vibrations (by changing the signal of the function generator within a certain range, and selecting the most appropriate one within that range). By repeating this process, it is possible to gradually generate more appropriate insertion operation signals, and the pain caused to the patient can be significantly alleviated.

Note that the roller 1 attached to the first bearing 12
3, 13, ..., 13 are installed so that each shaft is pressed inward with a constant force, these rollers 1
3, 13, . . . , 13, which is moved forward and backward in contact with the tubular portions such as the insertion portion 3, which has some irregularities or has a different outer diameter. For each roller 13 to which the variable resistor 17 or motor 21 is attached, the attachment portion of the variable resistor 17 or the like may be biased inward.

Further, the first bearing 12 can be attached and detached from the second bearing 14 so that it is possible to cope with tubular portions having greatly different outer diameters. Furthermore, the tubular portion is not limited to a cylindrical shape, but can also be applied to a prismatic shape.

Incidentally, a drive system in which only one side is formed also falls within the scope of the present invention.

〔Effect of the invention〕

As described above, according to the present invention, the device for inserting the endoscope is configured to be able to appropriately control the drive sources for forward and backward movement and rotational movement, so even if the insertion site is different, the endoscope can be easily inserted and withdrawn. It has the advantage that it can be used with less pain to the patient. Furthermore, since the insertion portion does not have a large diameter, it can be inserted into narrow areas. moreover,
The present invention has the advantage that it can also be applied to conventional general endoscopes. In addition, appropriate insertion operations can be performed depending on the insertion site, and the device can be applied to a wide range of insertion applications.

[Brief explanation of the drawing]

1 to 6 relate to one embodiment of the present invention, FIG. 1 is a schematic perspective view showing how the first embodiment is actually used, and FIG. 2 shows the main body of the advancement/retraction device of the first embodiment. 3 is a partially cutaway front view showing the advancing/retracting device main body in one embodiment, FIG. 4 is a block diagram showing the configuration of the control device in one embodiment, and FIG. FIG. 6 is an explanatory diagram showing temporal changes when the back-and-forth motion roller is driven back and forth, and FIG. 6 is an explanatory diagram showing temporal changes when the rotational motion roller is rotationally driven in the insertion operation. 1... Advance/retreat (guidance) device, 2... Endoscope, 3...
...insertion part, 4...advancement/retraction device main body part, 5...control device part, 6...light source, 12...first bearing, 13...
... (For longitudinal motion) roller, 14 ... Second bearing, 1
5... (Rotating motion) roller, 17, 21... Variable resistor, 18, 22... Motor, 19, 23...
Cable, 31... Constant voltage source, 32, 33... Voltage controlled oscillator, 34, 35... Amplifier, 38, 3
9... Head, 40... Tape, 41, 42...
Amplifier, 43, 44...Phase comparator, 45, 46
...(Low pass) filter.

Claims (1)

[Scope of Claims] 1. An advancement/retraction guiding device for advancing and retracting a tubular portion of a device or instrument such as an endoscope inserted into a body cavity or a lumen, the tubular portion being attached to a main body portion that holds the tubular portion; At least one of a drive system that is movable back and forth along the longitudinal direction and a drive system that rotates around the longitudinal direction is provided, and the drive system can be operated in a correct manner, either integrally or separately from the main body. 1. An advancement/retraction guidance device for an endoscope, etc., characterized in that it is provided with a control section that can be controlled by drive signals in the direction and in the reverse direction. 2. The advancement/retraction guidance device for an endoscope or the like according to claim 1, wherein the control section has means for outputting the signal. 3. The advancement/retraction guidance device for an endoscope or the like according to claim 1, wherein the control section has means for forming the signal. 4. The advancement/retraction guidance device for an endoscope or the like according to claim 1, wherein the main body portion or the control portion is provided with means for detecting at least one of an amount of longitudinal and rotational drive. 5. The advancement/retraction guidance device for an endoscope or the like according to claim 2, wherein the signal output means is formed by reading out or reproducing a recorded signal. 6. The means for forming the signal is such that when the advancing/retreating guidance device is attached to a device or instrument such as an endoscope and the device or instrument is operated to advance or retreat, a signal corresponding to the operation is recorded. The advancement/retraction guidance device for an endoscope or the like according to claim 3, characterized in that it is formed by: 7. The advancement/retraction guidance device for an endoscope or the like according to claim 3, wherein the means for forming the signal is formed from a signal from a function generator.