JPH0638787B2 - Internal cavity pressure regulator for endoscope - Google Patents

Description

Description: [Industrial field of use] The present invention relates to an intracorporeal pressure adjusting device for an endoscope, which is used for an endoscope and adjusts the intracavity pressure during observation.

[Prior Art] Since internal organs such as the gastrointestinal tract generally have a self-contractile behavior, when the inside of the body cavity is inspected using an endoscope, an external air is sent through an air supply duct incorporated in the endoscope. Air, etc. is sent from the inside, and the pressure is used to inflate the inner wall of the body cavity for observation.

However, if the pressure inside the body cavity becomes too high due to excessive air supply due to the cleaning of the objective lens surface or due to the operator's carelessness, etc., the inner wall of the body cavity can be overextended and minute changes in the mucous membrane can be observed. In addition to disappearing, it may cause discomfort to the patient and, in some cases, cause accidents such as damage to the inner wall of the body cavity. In addition, when performing endoscopic laser treatment or the like, since air is generally continuously supplied into the body cavity, there is a similar risk.

Therefore, conventionally, a pressure detector for detecting the pressure in the suction pipe of the endoscope is provided, the pressure in the body cavity is detected through the suction pipe, and the pressure is displayed on an indicator and connected to the suction pipe. The suction device thus operated is operated by an output signal from the pressure detector to perform suction for a short time (for example, 0.5 seconds) to automatically reduce the pressure inside the body cavity.

[Problems to be Solved by the Invention] Since the above-mentioned conventional body cavity internal pressure adjusting device for an endoscope always displays the pressure detected by the pressure detector as it is, when the suction device operates, the suction operation is performed. The pressure in the suction pipe that had dropped due to was displayed as it was. That is, the display device does not display the internal pressure of the body cavity, but displays the internal pressure of the suction conduit as it is, which may mislead the user and cause confusion in operation.

SUMMARY OF THE INVENTION It is an object of the present invention to solve the above-mentioned conventional drawbacks and to provide a body cavity internal pressure adjusting device for an endoscope, which does not display a pressure display far from the body cavity internal pressure on a display during a suction operation.

[Means for Solving Problems] An internal cavity pressure adjusting device for an endoscope according to the present invention for solving the above problems has an opening at an insertion portion 1 of the endoscope, as shown in FIG. Suction means 15 connected in communication with the suction pipeline 14, a pressure detection means 16 for detecting the pressure in the suction pipeline, and a pressure display means 23 for displaying the detected pressure detected by the pressure detection means. The pressure detecting means 1
A suction control means for controlling the operation of the suction means 15 by an output signal from the pressure sensor 6, and a pressure value detected by the pressure detection means 16 immediately before the start of the operation of the suction means 15 until the end of the suction operation. And a display lock means for displaying.

[Operation] The pressure detecting means detects the pressure in the suction pipe line. As a result, in the normal state, the pressure inside the body cavity is detected via the suction conduit. The suction control means controls the operation of the suction means in accordance with the detected pressure, and the body cavity pressure is adjusted.

Then, during the operation of the suction means, the display lock means locks the pressure value detected immediately before the start of the suction operation, and the pressure display means continues to display the pressure value until the end of the suction operation.

[Embodiment] An embodiment of the present invention will be described with reference to the drawings.

1 is an insertion portion of an endoscope to be inserted into a body cavity, 2 is an operation portion,
Reference numeral 3 denotes a connector that is connected to an external light source device 4. Inside the light source device 4, an illumination lamp 5 and an air supply pump that is an air supply means 6 are provided. Then, the illumination light enters the illumination light guide 7 of the endoscope from the illumination lamp 5, and a gas such as air is sent from the air sending means 6 to the air sending conduit 8 inserted in the endoscope. The air supply conduit 8 is opened from the connector 3 through the operation portion 2 and the insertion portion 1 to the tip of the insertion portion, and the switching valve 9 is provided so as to project from the operation portion 2 in the middle thereof.

Although this switching valve 9 is well known, detailed description thereof will be omitted. Normally, the air feeding conduit 8 communicates with the outside air, and the air sent from the air feeding means 6 is discharged to the outside. When pushed with a fingertip, the space between the outside air and the outside air is closed and the air is sent into the body cavity through the opening at the tip of the insertion section 1. It should be noted that an electric switch or the like may be provided instead of such a switching valve, and as the air supply means, one that continuously supplies air or one that automatically controls the air supply operation is used. Good.

Reference numeral 11 denotes a forceps channel through which a treatment tool or the like is inserted, the tip end of which is opened to the tip end of the insertion portion 1 and the base end is communicated with a forceps insertion port 12 formed in the lower portion of the operation portion 2. 14
Is a suction tube made of, for example, polyurethane resin or silicone resin, and is detachably connected to the forceps insertion opening 12 of the endoscope through a connection mouthpiece 13 connected to the mouth of the suction tube. Reference numeral 10 is a known forceps plug provided in the connection mouth ring 13, for example, a structure in which a slit is formed in a rubber plug, from which treatment instruments can be inserted into the forceps channel 11, and the treatment instruments can be inserted. If not, it is sealed.

The suction tube 14 is connected to an external suction means 15, and by the forceps channel 11 and the suction tube 14,
A suction conduit that opens at the tip of the insertion portion 1 is formed.
The suction means 15 includes a suction pump 15a, a suction tank 15b for storing a suctioned object, first and second electromagnetic opening / closing valves 15c,
It consists of 15d. The first electromagnetic on-off valve 15c is a normally closed type, the second electromagnetic on-off valve 15d is a normally open type electromagnetic valve, and the first electromagnetic on-off valve 15c is provided with an opening / closing counter 34 for counting the number of times of opening and closing. ing. The first solenoid on-off valve 15c is interposed in the middle of the suction tube 14,
A second electromagnetic opening / closing valve 15d is provided in the middle of a ventilation pipe 15e which is branched from a conduit in the middle of the first electromagnetic opening / closing valve 15c and the suction tank 15b and opened to the outside air.

Therefore, in the present embodiment, the suction pump 15a is always operated, and the first electromagnetic opening / closing valve 15c is closed and the second electromagnetic opening / closing valve 15d is opened to open the ventilation pipe 1
The outside air is sucked from 5e, and conversely, the first solenoid opening / closing valve 15
By opening c and closing the second electromagnetic on-off valve 15e, suction is performed only from the suction tube 14, and thus the first and second electromagnetic on-off valves 15c and 15d are interlocked with each other to perform the suction operation. Controlled.

Branch pipe line 14a is connected to the middle of the suction tube 14
Is formed, a pressure detector 16 for detecting the pressure in the suction tube 14 is provided at the end of the branch pipeline 14a, and if each pipeline is not blocked, the suction pipeline (suction tube 14, The body cavity pressure is detected via the forceps channel 11) and the branch duct 14a. A indicates a branch portion.
A second air supply unit 17 for supplying air into the suction tube 14 is provided near the pressure detector 16 and in the middle of the branch pipe line 14a. This second air supply means 1
7 is, for example, a small air supply pump, and a suction tube 14
A small amount (for example, 30 to 70 m / min) of air is continuously or intermittently supplied.

Further, in the vicinity of the branch portion A of the branch pipe line 14a, a normally open third electromagnetic on-off valve 18 for opening and closing the pipe line is provided, and between the electromagnetic on-off valve 18 and the pressure detector 16, A three-way electromagnetic on-off valve 19 for switching the pipeline is provided. A water passage tube 21 that communicates with a water tank 20 that stores cleaning water and the like is connected to the three-way electromagnetic on-off valve 19. By switching the three-way electromagnetic on-off valve 19, suction is performed via the branch pipe line 14a. The pipe line 11 and the pressure detector 16 communicate with each other, or the suction pipe line 11 and the water passage tube 21 communicate with each other.

Reference numeral 22 is a setting means for setting the internal pressure of the body cavity or a mode for adjusting the internal pressure desired by the operator, 23 is a pressure display means for displaying the detected internal pressure of the body cavity, and 24 is an alarm for issuing an alarm when an abnormality occurs. Means, which will be described with reference to FIG. 3 showing the appearance of the apparatus.

In FIG. 3, reference numeral 22a denotes a pressure setting switch for setting the pressure inside the body cavity desired by the operator. When one of the two buttons is pressed, the set pressure becomes high, and when the other button is pressed, the set pressure becomes low.
A switch having the same function as the pressure switch 22a may be provided as a foot-operated foot switch (not shown). The set pressure set here is the set pressure display 22b.
Is displayed in.

Reference numeral 22c is a switch for turning on and off the function of automatically adjusting the pressure inside the body cavity. If the switch 22c is turned on, the pressure inside the body cavity is automatically adjusted. If the switch is turned off, the pressure inside the body cavity is not automatically adjusted. Only the pressure is displayed. Two
Reference numeral 2d is a suction mode setting switch for setting one suction time for adjusting the pressure inside the body cavity, and the setting contents (low, auto, high) are displayed on the mode display lamp 22e. Reference numeral 22f is a suction switch that switches the three-way electromagnetic on-off valve 19 and selects the suction state from the water passage tube 21. The setting means 22 is configured by these switches and the like 22a to 22f.

Reference numerals 23a and 23b are pressure display means 23 for displaying the pressure and the like detected by the pressure detector 16, 23a is a digital display for digital display, and 23b is a bar graph for analog display. Reference numeral 24a is an alarm lamp, and an alarm buzzer (not shown) that operates in conjunction with the lamp 24a is built in the device.

In FIG. 1, reference numeral 25 is a microcomputer including an input / output interface 25a and a central processing unit (CPU) 25b.
And a memory 25c. The input terminal of the input / output interface 25a is connected to the output line of the setting means 22, the output line of the pressure detector 16 through the A / D converter 26, and the output line of the opening / closing counter 34. In addition, the output terminals of the input / output interface 25a are connected to the respective solenoid opening / closing valves 1 through the drive circuits 27-30.
5c, 15d, 18 and 19 are connected, and the air supply means 17 and the pressure display means 23 are provided via the drive circuits 31 to 33.
And the alarm means 24 is connected.

Next, the operation of the above embodiment will be described.

After the insertion portion 1 of the endoscope is inserted into the body cavity of the patient, the switching valve 9 of the operation portion 2 is manually operated to send air into the body cavity from the air supply means 6 in the light source device 4. , The pressure inside the body cavity rises.

In order to automatically control the internal pressure of the body cavity to be equal to or lower than an arbitrary set pressure, the connection mouth ring 13 of the internal pressure adjusting device is connected to the forceps insertion port 12 of the endoscope. Even in this state, the treatment tool can be freely inserted into the forceps channel 11 through the forceps plug 10. And ON-OFF switch 2 for automatic adjustment
2c is set to ON, and the pressure most appropriate for the inspection is set by the pressure setting switch 22a. The pressure is displayed on the set pressure display 22b.

Then, in a normal state where the suction switch 22f is OFF, the first electromagnetic opening / closing valve 15c is closed, the second electromagnetic opening / closing valve 15d and the third electromagnetic opening / closing valve 18 are open, and the three-way electromagnetic opening / closing valve 19 is opened. Connects the branch line 14a to the pressure detector 16. Therefore, the pressure detector 16 detects the pressure inside the body cavity through the suction tube 14 and the like, and the output signal thereof is converted into a digital signal through the A / D converter 26 and input to the input / output interface 25a. The output signal from the output interface 25a is transmitted via the drive circuit 32 to the display means 23 (digital display 23a and bar graph 23).
The pressure in the body cavity is displayed in b). The display of the digital display 23a normally displays the detected pressure detected by the pressure detector 16 in real time, and when the microcomputer 25 performs an interrupt prohibition process, the display state immediately before that is maintained. It Further, since the first electromagnetic on-off valve 15c is normally closed, the suction means 1
5 does not communicate with the suction tube 14,
Only the atmosphere is sucked in through e. Second air supply means 1
Reference numeral 7 supplies a small amount of air into the branch conduit 14a.

The CPU 25b compares the set pressure set by the setting means 22 with the detected pressure detected by the pressure detector 16, and when the detected pressure becomes higher than the set pressure, the output signal of the input / output interface 25a is digitally displayed. 23
The display of “a” is prohibited and fixed to the display value immediately before that, the air supply of the second air supply means 17 is stopped, and the second and third electromagnetic on-off valves 15d, 18 are closed. The first solenoid opening / closing valve 15c is opened. Then, after a certain period of time, everything is returned to the original normal state.

Therefore, during the fixed time, the suction tube 14 communicates with the suction means 15, and the air in the body cavity is sucked through the forceps channel 11 to reduce the pressure. This suction (decompression)
A certain time during which the operation is performed is stored in the memory 25c of the microcomputer, and the suction mode setting switch 2
The suction operation time differs depending on the input signal from 2d to the input / output interface 25a. That is, when the suction mode setting is high mode, the pressure reducing operation is performed for 1 second, and when the suction mode setting is low mode, the pressure reducing operation is performed for 0.2 second. In the auto mode, the setting pressure is less than 10 mmHg for 0.3 seconds, and the setting pressure is 10 mmHg. The pressure reducing operation is performed for 0.5 seconds in the range from 1 to 15 mmHg, and for 0.7 seconds when the set pressure exceeds 15 mmHg. In this way, the most appropriate mode can be selected according to the situation of the endoscopy.

When mucus, dirt, or the like is clogged in the forceps channel 11 or the suction tube 14, the pressure detector 16 does not detect the pressure inside the body cavity. However, when the suction tube 14 or the like is clogged, the internal pressure of the pipe increases due to the minute amount of air discharged from the second air supply unit 17 into the branch pipe line 14a, so that the pressure is detected by the pressure detector 16. The above suction (decompression)
The operation is performed, and the mucus and the like clogged in the suction tube 14 is sucked and removed by the suction means 15.

However, as shown in FIG. 4, mucus or the like accumulates in the portion where the suction tube 14 is bent downward, and suction (pressure reduction) is performed once.
In operation, mucus cannot escape from the bent part of the tube,
When the suction operation ends, the mucus may return to the bottom of the bent portion of the tube again. In such a case, immediately after the suction operation is completed, the pressure detector 16 detects the atmospheric pressure (0
mmHg) or lower pressure is detected. At that time, the digital display 23a of the display means gives a display irrelevant to the pressure value (for example, "EE") by the output signal from the input / output interface 25a of the microcomputer, and the displayed value is not the intracavity pressure. Show. Then, the suction operation is repeated due to the rise in the pipe pressure due to the air supply from the second air supply means 17, and while the suction operation is repeated three times, the atmospheric pressure or lower pressure is continuously applied in the pressure detector 16. If detected, the suction operation is continuously performed for a long time (for example, 1.5 seconds) by an output signal from the input / output interface 25a of the microcomputer, and the clogged mucus or the like is suctioned and discharged. If the detected pressure exceeds atmospheric pressure,
Both the display and suction operation time return to the normal state.

When excessive air is supplied into the body cavity and the suction operation of the present apparatus does not reduce the pressure in between, an alarm is issued.
That is, when the pressure detected by the pressure detecting means 16 exceeds a predetermined pressure (for example, 20 mmHg) for a predetermined number of times (for example, 3 times), the alarm lamp 24a is turned on by an output signal from the input / output interface 25a of the microcomputer. The alarm buzzer sounds at the same time. If the detected pressure falls below a predetermined pressure, the alarm will stop. The automatic adjustment switch 22c
When is OFF, an alarm is issued when the detected pressure exceeds a predetermined pressure continuously for, for example, 2 seconds or more.

When the inside of the suction tube 14 and the inside of the branch conduit 14a are cleaned after the endoscopic examination is completed, the suction tube connection mouthpiece 1
3 is removed from the forceps insertion opening 12 of the endoscope and put in the cleaning liquid in the water tank 20, and the tip of the water passage tube 21 is also in the water tank 2.
Put in 0 wash solution. And the suction switch 22f
When turned on, the output from the input / output interface 25a causes the digital display 23a to switch to a display such as "-", and the first and third solenoid on-off valves 15
c and 18 are opened, and the second solenoid on-off valve 15d is closed. Then, the three-way solenoid on-off valve 19 is, for example, 0.5
The suction tube 14 and the water passage tube 21 are switched to the side of the water passage tube 21 only twice at an interval of 2 seconds, and the suction tube 14 and the water passage tube 21 are branched to the branch line 14a.
To communicate via. Then, since the suction tube 14 is longer than the water passage tube 21 and the resistance in the tube is large,
While the three-way electromagnetic on-off valve 19 is open to the water passage tube 21 side, the washing liquid in the water tank 20 is sucked from the water passage tube 21 to wash the inside of the branch pipe line 14a. When the water passage tube 21 side is closed, the cleaning liquid is sucked from the suction tube 14 and the inside of the suction tube 14 is cleaned.

In addition, since the suction tube 14 and the tubes in the vicinity of each electromagnetic opening / closing valve of the branch conduit 14a are deteriorated due to repeated suction operations, that is, repeated opening / closing operations of the electromagnetic valve, in the present embodiment, the replacement time is notified by an alarm. It is supposed to inform. That is, the output signal from the open / close counter 34 is the input / output interface 25a of the microcomputer.
When the opening / closing operation of the first electromagnetic opening / closing valve 15c reaches 200,000 times, the input / output interface 25
The alarm lamp 24a is turned on by the output signal from a.

5 to 8 are flowcharts showing the programs stored in the memory 25c of the microcomputer 25, and s in the drawings indicates steps.

FIG. 5 to FIG. 7 are programs executed when the suction switch is OFF, and when suction does not operate midway, about 1000 cycles are executed per second on average.

First, in s1, the counters m and n and the flag f are initialized, for example, m = 2000, n = 3, and f = 0. Next, in s2, the detected pressure (P) from the pressure detector is read, in s3, the detected pressure is displayed on a bar graph, and s4
Then, allow the digital display to interrupt the display.

Then, in s5, the opening / closing counter of the first electromagnetic opening / closing valve is read, and in s6, it is determined whether or not the number of times of opening / closing counter has reached the tube replacement count (for example, 200,000 times), and the replacement count is reached. If it is, the alarm lamp is turned on in s7 and the process proceeds to s9. If the open / close counter does not reach the tube replacement count in s6, s8
Then, the alarm lamp is turned off, and the process proceeds to s9.

Next, in s9, it is judged whether or not the detected pressure P exceeds 20 mmHg. When it exceeds 20 mmHg, the overpressure detection counter m is set to m = m-1 in s10, and in s11, m
If = 0, the alarm lamp and alarm buzzer are turned on in s12.
Set to N and proceed to s15. Unless m = 0 in s11, the process directly proceeds to s15. When the detected pressure does not exceed 20 mmHg in s9, the alarm lamp and the alarm buzzer are turned off in s13, and the overpressure detection counter m and the overpressure detection counter flag f are initialized to the initial values (m = 200) in s14.
0, f = 0) and the process proceeds to s15.

At s15, the states of the pressure setting switch and other switches are read, at s16 the state of the automatic adjustment switch is determined, and when the automatic adjustment is OFF, the process returns to s2. When the automatic adjustment is ON, it is determined whether a detected pressure P is the set pressure P ₀ the following s17, when the detected pressure P is not less than the set pressure P ₀ is the s18, split the display of the digital display The display state is locked as a lock prohibition, and in s19, the suction operation time according to the states of the mode setting switch and the pressure setting switch is selected from the table stored in the memory (ROM).

FIG. 9 shows the table, and the suction time is given by the set pressure and the setting mode. In this table, 1 second in high mode and 0.
Given a constant suction time of 2 seconds, in auto mode,
When the set pressure is less than 10 mmHg, the suction time is 0.3 seconds, when it exceeds 15 mmHg, the suction time is 0.7 seconds, and when the set pressure is 10 to 15 mmHg, the suction time is 0.5 seconds.

Next, at s20, the first to third electromagnetic on-off valves are set to the suction (pressure reduction) state. That is, the first electromagnetic on-off valve is opened and the second and third electromagnetic on-off valves are closed. And s21
If the remaining suction operation time is not 0 in s22, the process returns to s21. If the remaining suction operation time is 0 in s22, the first to third solenoid on-off valves are turned on in s23. The original normal state is restored, the display interrupt prohibition of the digital display is released in s24, and the process proceeds to s25.

At s25, the overpressure detection counter flag f is set to f = 0.
If so, the overpressure detection counter m is set to m = 3 in s26, a flag is set in s27 (f = 1), and s2
Go to 8. When the detected pressure P is equal to or lower than the set pressure P ₀ in s17, the process directly proceeds from s17 to s28.

At s28, the detected pressure P from the pressure detector is read,
At s29, it is determined whether the detected pressure P is 0 mmHg or less. When the detected pressure P is 0 mmHg or less, s
At 30, the display on the digital display is set to "EE" to lock the display state, and at s31, the detection counter n is set to n.
= N−1, if n = 0 in s32, the process returns to s2, and if n = 0, the first to third electromagnetic on-off valves are switched to the suction (pressure reduction) state for 1.5 seconds in s33. And s3
At n, n is reset to n = 3 and the process returns to s2. Also, s
When the detected pressure is not 0 mmHg or less in 29, n is reset to n = 3 in s35, the display interrupt prohibition of the digital display is released in s36, and the process returns to s2.

FIG. 8 is a flowchart showing a program executed when the suction switch is ON. First, in s51, the counter i is initialized and i = 2. Then s52
Then, the display of the digital display is set to, for example, "---" and the display state is locked. Then, if i = 0 is not obtained in s54,
At s55, open the 3-way solenoid on-off valve to the water passage tube side for 0.5 seconds to connect the water passage tube and the suction tube, and after 0.5 seconds, return the 3-way solenoid on-off valve to its original state. Then, in s56, the counter i is set to i = i−1, and s5
Wait for 0.5 seconds at 7 and return to s54. When i = 0 in s54, the process directly proceeds to s57 and returns to s54 again.

FIG. 10 is a graph showing data obtained by measuring the state of body cavity pressure by clinically using the device of this example.

(A), (b), and (c) in FIG. 10 show the state of the intracavity pressure when the set pressure is set to 10, 15, and 20 mmHg, respectively. Shows that the internal pressure of the body cavity is momentarily increased. As can be seen from this data, the apparatus of the present embodiment can maintain the pressure inside the body cavity extremely accurately at the time of endoscopic examination.

EFFECTS OF THE INVENTION According to the body cavity pressure adjusting device for an endoscope of the present invention, the pressure value detected immediately before the start of the suction operation is displayed during the operation of the suction means until the end of the suction operation. It has an excellent effect that an internal examination is smoothly performed without displaying a pressure that is far from the internal pressure of the body cavity and thus causing no unnecessary confusion in operation.

[Brief description of drawings]

FIG. 1 is a block diagram showing the configuration of the present invention, FIG. 2 is a block diagram of an embodiment of the present invention, FIG. 3 is an external perspective view of the apparatus of that embodiment, and FIG. FIG. 5 to FIG. 8 are flowcharts showing programs stored in the memory of the microcomputer, FIG. 9 is a diagram showing a table also stored in the memory, and FIG. It is a graph which shows the experimental result which measured the adjustment state of the internal pressure of the body cavity by the Example apparatus.

Claims (1)

[Claims] Claims: 1. A suction means communicating with and connected to a suction pipeline that opens to an insertion portion of an endoscope, a pressure detection means for detecting the pressure in the suction pipeline, and a detection detected by the pressure detection means. A pressure display means for displaying the pressure, a suction control means for controlling the operation of the suction means by an output signal from the pressure detection means, and a pressure value detected by the pressure detection means immediately before the start of the operation of the suction means. A body cavity internal pressure adjusting device for an endoscope, comprising: display lock means for displaying the pressure on the pressure display means until the end of the operation.