US20070080962A1

US20070080962A1 - Insertion apparatus

Info

Publication number: US20070080962A1
Application number: US11/599,548
Authority: US
Inventors: Yasuhito Kura; Takahiro Kishi; Akira Suzuki; Akira Taniguchi; Makoto Abe; Katsutaka Adachi
Original assignee: Olympus Corp
Current assignee: Olympus Corp
Priority date: 2004-05-14
Filing date: 2006-11-14
Publication date: 2007-04-12
Also published as: JP4436833B2; JPWO2005110195A1; CN1950021A; US20070060790A1; WO2005110197A1; US20070059956A1; WO2005110195A1; JPWO2005110196A1; CN100455251C; JPWO2005110197A1; US7862504B2; US7938772B2; WO2005110196A1

Abstract

An insertion apparatus includes a tubular member equipped with a propulsion power generating portion, a rotating portion for rotating the tubular member around the longitudinal axis of the tubular member, a distal end which can be slidingly moved with respect to a rotation of the tubular member rotated by the rotating portion and is equipped with an observation portion for observing a body to be examined, and a propulsion power receiving portion for receiving propulsion power generated by the propulsion power generating portion equipped in the tubular member.

Description

CROSS REFERENCE TO RELATED APPLICATION

This application is a continuation application of PCT/JP2005/008916 filed on May 16, 2005 and claims benefit of Japanese Application No. 2004-145694 filed in Japan on May 14, 2004, the entire contents of which are incorporated herein by this reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention
The present invention relates to an insertion apparatus for improving insertability of a medical apparatus having an observation section into an intracavital region.
2. Description of the Related Art
Recently, an endoscope equipped with an elongated insertion portion having flexibility has been utilized in inspection, treatment, or the like in the medical field. With the endoscope, not only observation of an intracavital organ and the like may be performed without incision by inserting the insertion portion into an intracavital region, but also a variety of therapies and treatments may be performed by introducing an accessory into an intracavital region through a treatment device insertion channel provided in the insertion portion as needed. In the endoscope, a bending section is provided at the distal side of the insertion portion. The bending section can be made to bend in, for example, up and down directions, left and right directions, or the like by performing forward/backward movements of a manipulation wire connected with bending parts constituting the bending section. The manipulation wire is to be moved forward/backward by rotating manipulation of, for example, a bending knob provided at a manipulation section.
When performing endoscopy, the insertion portion must be inserted into an intricately structured intracavital region. When the insertion portion is inserted into a intricately structured lumer, for example, a colon or the like which describes 360 degree loop, an operator manipulates the bending knob to bend the bending section, and performs hand manipulation such as twist manipulation of the insertion portion to move the distal end of the insertion portion toward a target portion to be observed.
However, a skill is required to be able to introduce the insertion portion to the deepest part of the intricately structured colon smoothly in a short time without giving pain to a patient. In other words, there exists a risk that loss of the intended insertion direction may occur when inserting the insertion portion into a deep portion, and a change in shape of the intestine may be caused when inserting the insertion portion into a deep portion of the intestine. Accordingly, various proposals for improving insertability of the insertion portion have been made.
There is disclosed a propulsion device for a medical device which enables easy introduction of the medical device into a deep portion of a live body duct with low invasibility, for example, in Japanese Patent Application Laid-Open Publication No. H10-113396. In the propulsion device, a rib declining relative to the axial direction of a rotating member is provided at the rotating member. Accordingly, rotating power of the rotating member is converted to propulsion power by the rib by rotation of the rotating member and the medical device connected to the propulsion device is moved in a direction toward the deep portion by the propulsion power.

SUMMARY OF THE INVENTION

An insertion apparatus of the present invention includes a tubular member equipped with a propulsion power generating portion, a rotating portion for rotating the tubular member around the longitudinal axis of the tubular member, a distal portion which can be slidingly moved with respect to a rotation of the tubular member rotated by the rotating portion and equipped with an observation portion for observing a body to be examined, and a propulsion power receiving portion for receiving propulsion power generated by the propulsion power generating portion equipped in the tubular member.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagram illustrating a construction of an insertion apparatus;
FIG. 2 is a diagram illustrating a construction of an introducing duct including a partial cross-section diagram;
FIG. 3 is a cross-section diagram taken on line III-III of FIG. 2;
FIG. 4 is a diagram illustrating a construction of a distal side portion of a handling portion in which a proximal portion body constituting the introducing duct is disposed;
FIG. 5 is a diagram illustrating a relation between the introducing duct and an endoscope inserted into an insertion portion cover of the introducing duct;
FIG. 6 is a diagram illustrating a construction of a rotating mechanism portion;
FIG. 7 is a diagram showing a state where the introducing duct in which an insertion portion of the endoscope is inserted to be disposed is inserted from the anus;
FIG. 8 is a diagram showing a state where a distal portion body of the introducing duct in which the insertion portion of the endoscope is inserted to be disposed is inserted near the cecum portion;
FIG. 9 is a perspective view illustrating another exemplary construction of the distal side portion of the handling portion;
FIG. 10 is a side view of the distal side portion of the handling portion and a partial cross-section diagram thereof shown in FIG. 9;
FIG. 11 is a diagram illustrating a proximal portion body provided with eyemarks for informing disposed positions of convex stopping portions;
FIG. 12 is a diagram illustrating an introducing duct of another construction;
FIG. 13 is an enlarged diagram illustrating a construction near the distal portion of the introducing duct;
FIG. 14 is a diagram illustrating another exemplary construction of the distal portion body constituting the introducing duct;
FIG. 15 is a diagram illustrating other exemplary construction of the distal portion body constituting the introducing duct;
FIG. 16 is a diagram illustrating stop grooves formed at the distal portion of the endoscope and the distal side portion of the handling portion;
FIG. 17 is a diagram illustrating a construction of the introducing duct in which a cover member is adhered to the insertion portion of the endoscope;
FIG. 18 a perspective view illustrating another construction of the introducing duct;
FIG. 19 is a longitudinal direction cross-section diagram illustrating the construction of the introducing duct in FIG. 18;
FIG. 20 is a diagram illustrating an introducing duct equipped with an electromagnetic valve for carrying out supply control of fluid;
FIG. 21 is a diagram illustrating an exemplary operation of the electromagnetic valve;
FIG. 22 a diagram illustrating another construction of switches carrying out fluid control;
FIG. 23 is a perspective view illustrating an introducing duct in which the insertion portion of the endoscope is disposed between an air and water supply nozzle and an aperture of an aspiration channel;
FIG. 24 is a diagram illustrating an exemplary construction of the introducing duct characterized in the construction of the spiral duct;
FIG. 25 is a diagram illustrating another exemplary construction of the introducing duct characterized in the construction of the spiral duct;
FIG. 26 is a diagram illustrating another construction of the introducing duct;
FIG. 27 is a diagram illustrating an exemplary construction of an insertion portion distal portion of the endoscope provided in the introducing duct shown in FIG. 26;
FIG. 28 is a diagram illustrating another exemplary construction of the insertion portion distal portion of the endoscope disposed in the introducing duct shown in FIG. 26;
FIG. 29 is a diagram illustrating an insertion portion having an aperture of the insertion duct line disposed in the introducing duct shown in FIG. 26;
FIG. 30 is a diagram illustrating a construction of the insertion apparatus and external devices provided with the insertion apparatus;
FIG. 31 a diagram illustrating an endoscopic medical device in which an spiral duct is disposed in a rotatable manner;
FIG. 32 is a diagram illustrating a construction of the rotating mechanism portion;
FIG. 33 is a diagram showing a state where the endoscopic medical device is inserted form the anus; and
FIG. 34 is a diagram showing a state where the distal portion of the endoscopic medical device is inserted near the cecum.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
A first embodiment of the present invention will be described with reference to FIG. 1 to FIG. 11.
As shown in FIG. 1, an insertion apparatus 1 of the embodiment includes an endoscope 2 which is a medical device and is equipped with an observation portion, and an endoscope insertion ancillary device 3.
The endoscope 2 comprises an insertion portion (see reference numeral 11 in FIG. 2), a handling portion 12 provided at the proximal side of the insertion portion 11, and an universal cord 13 extending from a side portion of the handling portion 12. An accessory inlet 14 and the like are provided at a distal side portion of the handling portion 12 of the endoscope 2. The accessory inlet 14 communicates with an accessory insertion channel (not shown) for introducing an accessory into an intracavital region.
For the endoscope 2, a light source device 4, a video processor 5, and a monitor 6 are provided as external devices. The light source device 4 provides illumination light to the endoscope 2. The video processor 5 includes a controlling circuit for carrying out various controlling operations, a signal processing circuit, and the like. The video processor 5 provides a driving signal for driving, for example, an image pick up device, which is constituted by an observation portion (not shown) provided in the endoscope 2 and generates an image signal from an electric signal photoelectrically converted in the image pickup device and transmitted therefrom to output to the monitor 6. On the image screen of the monitor 6, an endoscope image is displayed by receiving the image signal output from the video processor 5.
The endoscope insertion ancillary device 3 includes an introducing duct 20 and a rotating device 40.
As shown in FIGS. 2 and 3, the introducing duct 20 comprises a distal portion body 21 and a proximal portion body 22, a cover member 23, and a spiral duct 24. The distal portion body 21, the proximal portion body 22, and the cover member 23 constitute an insertion portion cover 10 as insertion portion covering means. The spiral duct 24 is a member for generating propulsion power as described below.
The spiral duct 24 is a tubular member formed by coiling a metal wire 24 a having a predetermined diameter made of, for example, stainless in spiral state to have a predetermined flexibility. Therefore, a spiral portion 24 b which is a propulsion power generating portion formed by the surface of the metal wire 24 a is provided on the outer surface of the spiral duct 24.
The cover member 23 constituting the insertion portion cover 10 is formed by an elongated tube of flexible resin having a small frictional resistance, for example, Teflon (trademark). The distal portion body 21 constituting the insertion portion cover 10 is cylindrical. Moreover, the distal portion body 21 is formed of a transparent resin member having an optical property, for example, polycarbonate. The distal face of the distal portion body 21 is constituted by a closing window portion 21 a. In the distal portion body 21, a distal portion 15 constituting the insertion portion 11 of the endoscope 2 is disposed covered by the distal portion body 21. The inner diameter of the distal portion body 21 is larger than the outer diameter of the distal portion 15 so that a predetermined space is formed between the inner circumferential surface of the distal portion body 21 and the outer circumferential surface of the distal portion 15.
A first shoulder 21 b and a second shoulder 21 c are formed in this order from the proximal side on the outer circumferential surface of the proximal portion side which is an aperture side of the distal portion body 21. One end of the cover member 23 is coated to be disposed in a water-tight manner by, for example, adhesion at the first shoulder 21 b. One end of the spiral duct 24 is integrally fixed by adhesion or the like at the second shoulder 21 c. That is, one end of the cover member 23 and one end of the spiral duct 24 are respectively integrally fixed at the corresponding first shoulder 21 b and second shoulder 21 c in the distal portion body 21.
On the other hand, the proximal portion body 22 constituting the insertion portion cover 10 is tubular. The proximal portion body 22 is formed of a resin member having a good tribological property, such as polyacetal. The proximal portion body 22 includes a rotating fix portion 25 and a connecting fix portion 26. The rotating fix portion 25 is arranged near a break stop (see reference numeral 12 a in FIG. 2 and FIG. 5) constituting the distal end side of the handling portion 12. Four convex stopping portions 25 a, for example, forming an inclined plane are provided at an even interval in the circumferential direction on the proximal side of the inner circumferential surface of the rotating fix portion 25. The connecting fix portion 26 is constituted so that another end of the cover member 23 and another end of the spiral duct 24 are fixed. Specifically, a connecting groove portion 26 a is formed in the connecting fix portion 26. Another end of the cover member 23 is coated to be disposed and another end of the spiral duct 24 is disposed in the connecting groove portion 26 a. Then in the arrangement, adhesion bond is applied to another end of the cover member 23 and the spiral duct 24. Thereby, another end of the cover member 23 is integrally fixed to the proximal portion body 22 in a water-tight manner and another end of the spiral duct 24 is integrally fixed to the proximal portion body 22.
Therefore, the insertion portion cover 10 in which the cover member 23 is fixed to the distal portion body 21 and the proximal portion body 22 in a water-tight manner and having an elongated inner space is constituted. Then, the distal portion 15 of the insertion portion 11 of the endoscope 2 is inserted from the aperture of the proximal portion body 22 into the inner space, and then the distal portion 15 is passed through the cover member 23 to be disposed at the inner circumferential surface side of the distal portion body 21. By doing so, the distal portion 15, a bending section 16, and a flexible duct portion 17 constituting the insertion portion 11 are covered by the insertion portion cover 10.
Note that the spiral duct 24 is not limited to the single strip constitution but may be formed by winding many strips (for example, two strips, four strips, or the like). Besides, when the metal wire 24 a is wound in a spiral state, properties of the spiral duct 24 can be variously set by changing the degree of adhesion between portions of the metal wire 24 a and by variously changing the angle of the spiral.
As shown in FIG. 4, a circumferential groove portion (hereinafter, abbreviated as circumferential groove) 31 and a stop groove 32 to be stopping portion are provided in this order from the insertion portion 11 side at the distal side portion of the handling portion 12. The convex stopping portions 25 a formed on the inner circumferential surface of the rotating fix portion 25 are freely disposed in the circumferential groove 31. The convex stopping portions 25 a are engageably inserted to be arranged at the stop groove 32.
The width W1 of the circumferential groove 31 is formed larger than the width of the convex stopping portions 25 a so that the convex stopping portion 25 a can be rotationally moved smoothly along the circumferential groove 31. On the other hand, the width W2 of the stop groove 32 is formed to be the same as the width of the convex stopping portions 25 a and is formed at a predetermined position.
Therefore, the convex stopping portions 25 a formed at the rotating fix portion 25 are disposed at the circumferential groove 31 under the state where the insertion portion 11 of the endoscope 2 is disposed in the inner space of the insertion portion cover 10 constituting the introducing duct 20 as shown in the lower half of the drawing of FIG. 5. Consequently, a space 33 is formed between the back surface 21 d of the closing window portion 21 a and the distal surface of the distal portion 15. On the other hand, the convex stopping portions 25 a are engageably inserted to be disposed at the stop groove 32 under the state where the insertion portion 11 of the endoscope 2 is disposed in the inner space of the insertion portion cover 10 as shown in the upper half of the drawing of FIG. 5. Consequently, the distal portion body 21 is moved to the distal end side of the distal portion 15 and the back surface of the closing window portion 21 a is adhered with the distal surface of the distal portion 15 equipped with a lens cover constituting the observation portion. Thereby, observation by the endoscope may favorably be performed where light for forming an optical image passed through the closing window portion 21 a and the lens cover is focused on the image pick up device in the endoscope 2.
On the other hand, a rotating device 40 constituting the endoscope insertion ancillary device 3 includes, for example, an arm portion 41 and a rotating mechanism portion 42. One end of the arm portion 41 is placed at the seal of an inspecting room. The arm portion 41 includes a plurality of arm members 41 a, for example, having different lengths, and joint portions 41 b for connecting adjacent arm members 41 a in a rotatable manner. The rotating mechanism portion 42 is placed at another end of the arm portion 41. Thereby, the rotating mechanism portion 42 may be moved to any position with a slight force.
As shown in FIG. 6, the rotating mechanism portion 42 includes a rotating portion body 43, a motor 44, a rotating power transmission member 45 which is a rotating portion, and a guidance duct holding portion 46. The motor 44 generates the driving power for rotating the spiral duct 24 in the predetermined direction of the spiral duct longitudinal axis rotation (hereinafter, abbreviated as axis rotation). The motor 44 is fixedly provided at, for example, a side wall of the rotating portion body 43.
The rotating power transmission member 45 is integrally fixed to the motor axis 44 a of the motor 44. The rotating power transmission member 45 is formed by a resin member, a rubber member, or the like having elasticity. The guidance duct holding portion 46 is disposed at the position opposing the rotating power transmission member 45 fixed to the motor axis 44 a. The guidance duct holding portion 46 is fixed, for example, at the bottom of the rotating portion body 43. A curved surface (not shown) or a concave portion of hemispherical shape (not shown) which approximately matches the outline shape of the spiral duct 24 or the proximal portion body 22 is formed on the surface portion of the guidance duct holding portion 46 opposing the rotating power transmission member 45. The spiral duct 24 constituting the introducing duct 20 is to be disposed between the rotating power transmission member 45 and the concave portion of the guidance duct holding portion 46 as shown in the drawing.
In the state where convex stopping portions 25 a are disposed at the circumferential groove 31 as shown in FIG. 5, the spiral duct 24 constituting the introducing duct 20 in which the insertion portion 11 of the endoscope 2 is disposed is to be disposed between the rotating power transmission member 45 and the guidance duct holding portion 46. Then, the motor 44 is driven. Consequently, the rotating power transmission member 45 integrally fixed to the motor axis 44 a is rotated, and the rotation force is transmitted to the spiral duct 24. Here, the introducing duct 20 is smoothly rotated relative to the axis rotation with respect to the insertion portion 11 of the endoscope 2 by respectively integrally fixing both end portions of the spiral duct 24 to the distal portion body 21 and the proximal portion body 22, by integrally providing the cover member 23 to the bodies 21 and 22, and by providing the space 33 between the back surface 21 d of the closing window portion 21 a and the distal surface of the of the distal portion 15.
An operation of the insertion device 1 constructed as described above will be described.
First, a medical personnel (abbreviated as staff) prepares the endoscope 2 and the introducing duct 20 constituting and the endoscope insertion ancillary device 3. Moreover, the rotating mechanism portion 42 is disposed at the predetermined position by moving the arm portion 41 of the rotating device 40 constituting the endoscope insertion ancillary device 3.
Next, the desired site, for example, the proximal portion side of the spiral duct 24 constituting the introducing duct 20 is disposed between the guidance duct holding portion 46 and the rotating power transmission member 45 constituting the rotating mechanism portion 42. Thereby the proximal portion side of the introducing duct 20 is held by the rotating mechanism portion 42. Then, the distal portion side of the introducing duct 20 is disposed, for example, on a bed 7.
Next, the insertion portion 11 of the endoscope 2 is inserted into the inner portion of the introducing duct 20 from the aperture of the proximal portion body 22 constituting the introducing duct 20. Then, convex stopping portions 25 a provided at the proximal portion body 22 are disposed at the circumferential groove 31. Thereby, the insertion portion 11 of the endoscope 2 is covered by the insertion portion cover 10 provided at the introducing duct 20 and the preparation for introducing the endoscope 2 into the colon is completed. At this time, the space 33 is formed between the proximal surface of the distal portion body 21 and the distal surface of the distal portion 15 as shown in the lower half of the drawing of FIG. 5. Note that the light source device 4, the video processor 5, and the monitor 6 which are peripheral device are also prepared with preparation of the endoscope 2, the introducing duct 20, and the rotating device 40.
A procedure for inserting the endoscope 2 covered by the introducing duct 20 into the colon will be described.
At first, an operator (not shown) holds the distal side of the introducing duct 20. Then, the distal portion of the introducing duct 20 is inserted into the anus of the patient 8 lying on the bed 7. Consequently, the spiral portion 24 b formed on the outer surface of the spiral duct 24 provided at the introducing duct 20 is made to contact the bowel wall. At this time, the contact state of the spiral portion 24 b and the bowel wall resembles that of male and female screws. Moreover, an endoscope image captured by image pickup device of the endoscope 2 through the closing window portion 21 a is displayed on the screen of the monitor 6.
In the state where the spiral portion 24 b and the bowel wall are made to contact each other, the motor 44 of the rotating mechanism portion 42 is rotatably driven. Consequently, the rotating power transmission member 45 is rotated to transmit the rotating power to the spiral duct 24 disposed between the rotating power transmission member 45 and the guidance duct holding portion 46 as described above. Thereby, the introducing duct 20 is rotated in the axis rotation direction as shown by the arrow in FIG. 7.
In the rotation state, a force such as that for moving a male screw with respect to a female screw is generated at the contact portion between the spiral portion 24 b of the spiral duct 24 constituting the rotated introducing duct 20 and the bowel wall, and a propulsion power for advancing the introducing duct 20 is generated. That is, the introducing duct 20 is advanced into the colon in the depth direction by the propulsion power. Consequently, the convex stopping portions 25 a provided at the proximal portion body 22 constituting the introducing duct 20 contact the distal side wall 31 a of the circumferential groove 31 and the propulsion power generated at the introducing duct 20 is transmitted to the endoscope 2. That is, the distal side wall 31 a is to be a propulsion power receiving portion that transmit the received propulsion power generated at the introducing duct 20 to the endoscope 2.
Thereby, the insertion portion 11 of the endscope 2 can be introduced toward the deep portion of the colon by the propulsion power with the introducing duct held by the operator. Here, the introducing duct 20 in which the insertion portion 11 is disposed is introduced toward the intracavital deep portion by a slight force by performing a hand operation for advancing the introducing duct 20.
That is, the introducing duct 20 in which the insertion portion 11 of the endoscope 2 is inserted to be disposed inserted from an anus 71 is advanced toward the sigmoid colon 73 from the rectum 72 by the propulsion power and by hand manipulation and bending manipulation and the like performed by the operator. Then, the introducing duct 20 in the rotating state passes through the sigmoid colon 73, and after that, reaches, for example, near the cecum portion 79 which is the observation target portion as shown in FIG. 8 by passing through the bending portion which is the bend between the sigmoid colon 73 and the descending colon 74 which is difficult to move through, the splenic flexure 76 which is the bend between the descending colon 74 and the transverse colon 75 which is easy to move through, and the liver curvature 77 which is the bend between the transverse colon 75 and the ascending colon 78.
When the operator judges that the distal portion body 21 of the introducing duct 20 has reached near the cecum portion 79 from the endoscope image displayed on the screen of the monitor 6, the driving of the motor 44 is stopped by, for example, instruction to the staff. Then, convex stopping portions 25 a are engageably inserted to be disposed from the circumferential groove 31 to the stop groove 32 by moving the proximal portion body 22. Thereby, the back surface 21 d of the closing window portion 21 a enters an adherent state with the distal surface of the distal portion 15, and a good-quality endoscope image desired by the operator is displayed on the screen of the monitor 6. Here, the operator draws back the insertion portion 11 to perform endoscope inspection in the colon.
Then, after finishing the inspection, the insertion portion 11 of the endoscope 2 is withdrawn from the introducing duct 20 and the introducing duct 20 is discarded whereas the insertion portion 11 of the endoscope 2 is inserted into a new introducing duct 20 not yet used. This makes it possible to carry out the next inspection without the need for cleaning and disinfection of the endoscope 2.
In this manner, the introducing duct is constituted by integrally fixing end portions of the spiral duct and the cover member to the distal portion body and proximal portion body, and the stop convex portions provided at the proximal portion body of the introducing duct are freely disposed at the circumferential groove provided at the handling portion of the endoscope. Then, the rotating power of the rotating power transmission member rotated by the motor provided at the rotating mechanism portion is transmitted to the spiral duct to rotate the introducing duct. Consequently the propulsion power for moving the introducing duct toward the deep portion of the colon can be obtained, and the introducing duct is moved by the propulsion power. At this time, the propulsion power generated at the introducing duct is transmitted to the endoscope as the convex stopping portions contact the distal side wall of the circumferential groove, so that introduction toward the deep portion of the colon can be performed by the propulsion power generated at the spiral duct constituting the introducing duct without rotating the insertion portion of the endoscope.
Further, end portions of the cover member disposed at the inner circumferential surface side of the spiral duct provided at the introducing duct are adherently disposed to the distal portion body and the proximal portion body in a water-tight manner to constitute the insertion portion cover. Thereby, insertion portion can surely be prevented from directly contacting body walls and the like during inspection by inserting and disposing the insertion portion of the endoscope into the insertion portion cover provided at the insertion tube.
Therefore, after finishing the inspection, the insertion portion of the endoscope is withdrawn from the introducing duct and the introducing duct is discarded whereas the withdrawn endoscope is combined with a new introducing duct to be reused without implementing cleaning and disinfection, so that the staff is relieved from troublesome cleaning and disinfection of the endoscope and the introducing duct at the end of inspection.
Note that in the embodiment, a colon is described as an example of a lumer in which the insertion portion 11 of the endoscope 2 covered with the introducing duct 20 is inserted. However, a lumer to which the insertion portion 11 is inserted is not limited to a colon and may be a lumer and the like such as from an oral cavity, an esophagus, a stomach, to a small bowel and the like.
In addition, a rotating direction of the introducing duct 20 in the embodiment may be only one direction which is an advancing direction, but the rotating direction may be switched between the advancing direction and retreating direction at a constant cycle or random timing. In this manner, by combining the rotations performed in the advancing and the retreating operations, in the event that the distal end of the introducing duct 20 becomes stuck in a small concave section or the like of a wall of the bowel when advancing, it can be released by performing a retreating operation. Then, when advancing again, the introducing duct is smoothly advanced without becoming stuck again because the portions of the bowel and the introducing duct 20 are delicately shifted.
Further, the stopping portion may be constituted by concave stopping portions 34 as shown in FIG. 9 instead of forming the stop groove 32. Thereby, the proximal portion side of the introducing duct 20 may be prevented from moving in the circumferential direction in the state where the proximal surface of the distal portion body 21 contacts the distal surface of the distal portion 15.
When forming the concave stopping portions 34, inclined surfaces 35 are provided whose outer diameter increases toward the concave stopping portions 34 from the circumferential groove 31 between the circumferential groove 31 and the concave stopping portions 34. Thereby, convex stopping portions 25 a can be smoothly moved from the circumferential groove 31 to the stop groove 32 with a slight force.
In addition, eyemarks 27 are provided for informing an operator or a staff of the position of the convex stopping portions 25 a at the outer circumferential surface of the proximal portion body 22 constituting the introducing duct 20 as shown in FIG. 11. Thereby, the convex stopping portions 25 a can be surely moved from the circumferential groove 31 to the concave stopping portions 34 at one time by carrying out a shifting operation for shifting the proximal portion body 22 to the proximal side in the state where the eyemarks 27 and the concave stopping portion 34 have the same position.
A construction and operation of another construction of the introducing duct having an insertion portion cover will be described with reference to FIG. 12 to FIG. 17.
As shown in FIG. 12, the introducing duct 20A of the embodiment comprises an insertion portion cover 10A as insertion portion covering means and a spiral duct 24. The insertion portion cover 10A includes a distal portion body 21, a proximal portion body 22, and a cover member 23, and the spiral duct 24 is disposed in a rotatable manner with respect to the distal portion body 21 and a proximal portion body 51.
The proximal portion body 51 is tubular and is formed by a resin member. An O ring providing circumferential groove 51 a in which an O ring 53 is disposed on the proximal side inner circumferential surface of the proximal portion body 51 is formed. The O ring 53 is fix menas for integrally fixedly providing the proximal portion body 51 at a predetermined position of a crack stop 12 a, and is disposed in a water-tight and adherent manner by a predetermined bias power with respect to the outer circumferential surface of the crack stop 12 a.
A first shoulder 51 b and a second shoulder 51 c are formed in this order from the distal side on the distal side outer circumferential surface of the proximal portion body 51. Another end of the cover member 23 is fixed in a water-tight manner by, for example, adhesion at the first shoulder 51 b. Thereby, an insertion portion cover 10A in which the cover member 23 is fixed to the distal portion body 21 and the proximal portion body 51 in a water-tight manner and having an elongated inner space is constituted.
A circular member 52 is a hard member, for example, stainless-steel and is formed to have a predetermined thickness. The circular member 52 is integrally fixedly provided by, for example, adhesion so as to be attached firmly to the wall surface formed at the second shoulder 21 c of the distal portion body 21. Note that the distal surface of the circular member 52 is a propulsion power receiving portion for receiving the propulsion power generated at the spiral duct 24.
Each end portion of the spiral duct 24 of the embodiment is disposed at the second shoulder 21 c of the distal portion body 21 and at the second shoulder 51 c of the proximal portion body 51 in a rotatable manner. Consequently, in the embodiment, the spiral duct 24 constituting the introducing duct 20A is constituted to rotate with respect to the distal portion body 21 and the proximal portion body 51 in place of the rotation of the introducing duct 20.
In addition, in the spiral duct 24 of the embodiment, for example, a space t having a predetermined size is formed at least between one end surface of the spiral duct 24 and the end surface of the circular member 52 fixedly provided at the second shoulder 21 c of the distal portion body 21 or between another end surface of the spiral duct 24 and the wall surface formed at the second shoulder 51 c of the proximal portion body 51.
The other constructions are the same as in the embodiment describe above, so that the same reference numerals are applied to the same members to skip the description.
An operation of the insertion apparatus 1 equipped with the introducing duct 20A constructed as described above will be described.
First, a staff prepares an endoscope 2 and an introducing duct 20A and disposing a rotating mechanism portion 42 at a desired position by moving the arm portion 41 of the rotating device 40.
Next, a desired portion, for example, the proximal portion side of the spiral duct 24 constituting the introducing duct 20A is disposed between the guidance duct holding portion 46 and the rotating power transmission member 45 constituting the rotating mechanism portion 42. Thereby, the proximal portion side of the introducing duct 20A is held by the rotating mechanism portion 42.
Then, the insertion portion 11 of the endoscope 2 is inserted into the introducing duct 20 from the aperture of the proximal portion body 51 constituting the introducing duct 20A. Then, the O ring 53 provided at the proximal portion body 51 is attached firmly to the crack stop 12 a provided at the endoscope 2 and a water-tight state is held.
Thereby, the proximal portion body 51 is integrally fixed to the proximal portion body 51 by the bias power of the O ring 53. In the fixedly provided state, the insertion portion 11 of the endoscope 2 is covered by the insertion portion cover 10A provided at the introducing duct 20A and the preparation for introducing the endoscope 2 into, for example, a colon is finished. At this time, the proximal surface of the distal portion body 21 and the distal surface of the distal portion 15 is attached firmly as shown in upper half portion of the drawing of FIG. 5. Note that a light source device 4, a video processor 5, and a monitor 6 which are peripheral device are also prepared with preparation of the endoscope 2, the introducing duct 20, and the rotating device 40.
Here, a procedure for inserting the endoscope 2 covered by the introducing duct 20A into a colon will be described.
First, an operator (not shown) holds the distal side of the introducing duct 20A. Then, the distal portion of the introducing duct 20A is inserted into the anus of the patient 8 lying on the bed 7. Consequently, the spiral portion 24 b formed on the outer surface the spiral duct 24 provided at the introducing duct 20 is made to contact the bowel wall. At this time, the contact state of the spiral portion 24 b and the bowel wall resembles that of male and female screws. Moreover, a good-quality endoscope image captured by image pickup device of the endoscope 2 through the closing window portion 21 a is displayed on the screen of the monitor 6.
In the state where the spiral portion 24 b and the bowel wall are made to contact each other, the motor 44 of the rotating mechanism portion 42 is rotatably driven. Consequently, the rotating power transmission member 45 is rotated to transmit the rotating power to the spiral duct 24 disposed between the rotating power transmission member 45 and the guidance duct holding portion 46. Thereby, only the spiral duct 24 constituting the introducing duct 20 is rotated around the axis as shown by the arrow in the FIG. 7. Consequently, the propulsion power is generated at the contact portion between the spiral portion 24 b of the rotated spiral duct 24 and bowel wall. Thereby, the spiral duct 24 is moved toward the direction of the circular member 52 as shown in the arrow in FIG. 13.
Then, the propulsion power generated at the spiral duct 24 is transmitted to the introducing duct 20A through the distal portion body 21 by the contact of the distal end of the spiral duct 24 and the circular member 52, and the introducing duct 20A is moved into the intracavital deep direction by the propulsion power. In this state, as the introducing duct 20A is integrally provided with respect to the insertion portion 11 of the endoscope 2, the insertion portion 11 is also introduced toward the deep direction with the introducing duct 20A moved toward the intracavital deep portion by the propulsion power. Therefore, the introducing duct 20A in which the insertion portion 11 of the endoscope 2 is integrally disposed is introduced toward the intracavital deep portion by a slight force by performing a hand operation for advancing the introducing duct 20A by the operator.
In this manner, each end portion of the spiral duct 24 constituting the introducing duct integrally provided with respect to the insertion portion of the endoscope is provided in a rotatable manner at the distal portion body and the proximal portion body. Then, the rotating power of the rotating power transmitting member rotated by the motor provided in the rotating mechanism portion is transmitted to the spiral duct 24. Consequently, the spiral duct becomes a rotating state with respect to the distal portion body and the proximal portion body constituting the introducing duct to be able to obtain the propulsion power for pushing the introducing duct toward the deep portion. Subsequently, the spiral duct in the rotating state moved by the propulsion power contacts the circular member fixedly provided at the distal portion body. Thereby, the propulsion power generated at the spiral duct can be transmitted to the introducing duct through the distal portion body without decrement. The other operations and effects are the same as in the embodiment described above.
Note that the distal portion body 55 may be constituted by a distal member 56 and a closing window member 57 as the introducing duct 20B shown in FIG. 14. The distal member 56 is tubular and a first shoulder 21 b and a second shoulder 21 c are provided at the outer circumferential surface proximal portion side of the distal member 56. The closing window member 57 is an optical member made of, for example, a resin constituting a closing window and provided at the distal surface of the distal member 56.
Thereby, the distal member 56 can be formed not of a resin member having optical property but commodity type resin member. In this construction, the insertion portion cover 10B is fixed to the distal portion body 55 equipped with the closing window member 57 and the proximal portion body 51 with the cover member 23 in a water-tight manner to constitute an elongated inner space. The other construction and operation/effect are the same as in the embodiment described above.
Further, an O ring providing circumferential groove 56 a may be formed on the inner circumferential surface of the distal portion member 56 for the distal portion body 55 to provide an O ring 58 having approximately the same operation as the O ring 53, that is, having a predetermined bias power.
Thereby, the O ring 58 is integrally press-disposed with respect to the outer circumferential surface of the distal portion 15 of the insertion portion 11 provided at the inner portion of the distal portion body 55 by the elastic force. Accordingly, the distal portion body 55 is also fixed with respect to the insertion portion 11 in addition to the proximal portion body 51, so that the introducing duct 20B can more surely integrally be fixed at the insertion portion 11 of the endoscope 2. The other constructions and operations/effects are the same as in the embodiment described above.
Further, the distal portion body 55 may be constituted by a distal member 59 and a closing window member 57 as the introducing duct 20C shown in FIG. 15. The distal member 59 also serves as fixing means and is formed in a tubular shape of an elastic member. A first shoulder 21 b and a second shoulder 21 c are provided at the outer circumferential surface proximal portion side of the distal member 59. The trough-hole of the distal member 59 is constituted by a tapered surface 59 a for forming a distal side and a guide surface 59 b for forming a proximal side. Inner diameter of the tapered surface 59 a is gradually narrowed by a predetermined amount than outer diameter of the distal portion 15 toward from the closing window member 57 side to the proximal side. The inner diameter of the proximal side of the guide surface 59 b is somewhat lager than the outer diameter of the distal portion 15 and the inner diameter is gradually narrowed toward the distal side.
Therefore, the distal portion body 55 and insertion portion 11 of the distal portion 15 can be integrally fixed by the elastic force by disposing the distal portion 15 of the insertion portion 11 at a predetermined position against the elastic force of the distal portion body 55. The other constructions and operations/effects are the same as in the embodiment described above.
Moreover, stopping grooves 15 a and 12 c for preventing the distal portion body (not shown) and the proximal portion body (not shown) to be displaced or rotated in the circumference direction may be formed at the distal portion 15 of the endoscope 2 and the distal side portion 12 b of the handling portion 12 as fixing means or displace preventing means as shown in FIG. 16. When forming the stopping grooves 15 a and 12 c, convex portions engageably inserted to be disposed at the stopping grooves 15 a and 12 c are respectively provided at the distal portion body and the proximal portion body not shown.
Further, for the introducing duct 20D shown in FIG. 17, a continuous hole 51 d for communicating the outer portion of the body portion and the inner hole of the body portion is provided at the distal portion body 51 as shown in FIG. 4. A cap portion 60 is provided at the continuous hole 51 d, and an aspiration tube 62 extended from an aspiration pump 61 is connected to the cap portion 60.
Then, the air between the insertion portion 11 and the cover member 23 is aspirated by the aspiration pump 61 in the state where the insertion portion 11 of the endoscope 2 is inserted to be disposed in the insertion cover 10B constituting the introducing duct 20D. Consequently, the cover member 23 adheres to the insertion portion 11 of the endoscope 2.
Thereby, the spiral duct 24 rotated by the motor 44 in the rotating mechanism portion 42 is prevented from contacting the cover member 23 and the occurrence of defects such as a perforation, a tear and the like can be surly prevented. The other constructions and operations/effects are the same as in the embodiment described above.
Constructions and operations of another construction of the introducing duct having an insertion portion cover will be described with reference to FIG. 18 to FIG. 23.
An insertion portion cover 10C which is insertion portion covering means is constituted by an elastic cover tube 81 and a proximal portion constituting member 82 for the introducing duct 20E of the embodiment as shown in FIG. 18 and FIG. 19. In addition, a spiral duct 24 is provided in a rotatable manner on the outer circumferential surface of the elastic cover tube 81.
The elastic cover tube 81 is formed by, for example, an elongated and flexible Teflon (trademark) resin having a small friction resistance. A first through-hole 81 a, a second through-hole 81 b, and a third through-hole 81 c are provided in the elastic cover tube 81. A flange portion 81 d is provided at the distal portion of the elastic cover tube 81.
The first through-hole 81 a is a through-hole for inserting the insertion portion 11 of the endoscope 2. Accordingly, a closing window member 57 for sealing the distal side aperture of the first through-hole 81 a is fixed at the distal surface of the flange portion 81 d of the elastic cover tube 81 so that a water-tight state is ensured.
The second through-hole 81 b is an air and water supply channel. Accordingly, an air and water supply nozzle 83 is fixedly provided at the distal portion of the second through-hole 81 b. The aperture of the air and water supply 83 is opposing the closing window member 57. Accordingly, when, for example, carrion and the like are attached to the closing window member 57, the attached carrion can be flushed away by ejecting, for example, water as shown in the arrow from the aperture of the air and water supply nozzle 83. Further, drop of water and the like attached to the surface of the closing window member 57 can be removed by, for example, ejecting air from the aperture of the air and water supply nozzle 83.
Then, the third through-hole 81 c is an aspiration channel.
The spiral tube 24 is provided at the outer circumferential surface of the elastic cover tube 81 in a rotatable manner. Dropout of the spiral tube 24 is prevented by providing the flange portion 81 d at the distal portion of the elastic cover tube 81, and the wall surface of the flange portion 81 d is to be a propulsion power receiving portion. Note that the circular member 52 may also be provided at the wall surface of the distal side formed by the flange portion 81 d in the embodiment.
On the other hand, the proximal portion constituting member 82 is formed by a tubular resin member and the proximal surface of the spiral duct 24 contacts the distal surface side of the proximal portion constituting member 82. A first concave portion 82 a in which the proximal portion of the elastic cover tube 81 is engageably inserted to be disposed is provided at the distal side portion of the proximal portion constituting member 82. On the other hand, a second concave portion 82 b in which the distal side portion of the handling portion 12 of the endoscope 2 is provided is provided at the proximal side portion of the proximal portion constituting member 82. The first concave portion 82 a and the second concave portion 82 b are communicated by a penetration hole 82 c having an inner diameter where the insertion portion 11 can pass through.
In addition, an air and water supply hole 82 d which is a continuous hole communicated with the second through-hole 81 b provided at the elastic cover tube 81 and a hole for aspiration (not shown) which is a continuous hole communicated with the third through-hole 81 c at predetermined positions of the proximal portion constituting member 82. Duct line connecting members 84 are respectively provided at end of the air and water supply hole 82 d and the aspiration hole.
An air and water supply duct line 85 a extended from the air and water supply device 85 is connected with the duct line connecting member 84 provided at the hole for the air and water supply 82 d. On the other hand, an aspiration duct line (not shown) extended from an aspiration device (not shown) is connected with the duct line connecting member (not shown) provided at the hole for aspiration.
The air and water supply device 85 and the aspiration device are electrically connected with, for example, the video processor 5 in the embodiment. Moreover, an air and water supply push-button switch (hereinafter, abbreviated as first switch) 87 and an aspiration push-button switch (hereinafter, abbreviated as second switch) 88 are provided at the handling portion 12 of the endoscope 2.
The first switch 87 includes a button portion 87 b having a detecting portion 87 a and sensors 87 c and 87 d for detecting the detecting portion 87 a. Correspondingly, the second switch 88 includes a button portion 88 b having a detecting portion 88 a and sensor 88 c for detecting the detecting portion 88 a. Note that reference numeral 89 a refers to a spring for biasing the button portions 87 c and 88 b to the position in the drawing. Reference numeral 89 b refers to signal lines extended from each sensor 87 c, 87 d, and 88 c and are electrically connected to the video processor 5.
Thereby, the air and water supply device 85 becomes air supply state when, for example, the button portion 87 b of the first switch 87 is push operated and the position of the detecting portion 87 a is detected by the sensor 87 c. Then, the air and water supply device 85 is to be shifted from air supply state to water supply state when the button portion 87 b is push operated and the position of the detecting portion 87 a is detected by the sensors 87 d. On the other hand, the aspiration device becomes aspiration state when, for example, the button portion 88 b of the second switch 88 is push operated and the detecting portion 88 a is detected by the sensor 88 c.
In this manner, the diameter of the introducing portion can be reduced by providing only a closing window 18 constituting an observation optical system and an illumination window 19 constituting an illumination optical system at the distal surface of the insertion portion 11 in the endoscope 2A of the embodiment which is inserted to be disposed in the first through-hole 81 a of the elastic cover tube 81 by providing the second through-hole 81 b for air and water supply and the third through-hole 81 c for aspiration at the elastic cover tube.
Note that an electromagnetic valve 90 may be provided at a half way portion of an air supply duct line 85 b and a water supply duct line 85 c extended from, for example, the air and water supply device 85 and an aspiration duct line 85 d extended from the aspiration device (not shown), at the same time, an air supplying touch censer 91, a water supplying touch censer 92 a, and an aspirating touch censer 91 a may be provided at switch portions 91, 92, and 93 provided at, for example, the handling portion 12 as shown in FIG. 20 and FIG. 21. Thereby, air supply, water supply, and aspiration can be carried out by changing the duct line corresponding to the operated touch sensor to open state. Water supply is performed by operating the water supplying touch censer 92 a to shift an air supplying piston 91 b and a water supplying piston 92 b to open the air duct line 85 b and water duct line 85 c in FIG. 21.
Sensors provided at the switch portions 91, 92, and 93 are not limited to the touch censers 91 a, 92 a, and 93 a and may be photo censers or the like. Further, the switch portions 91, 92, and 93 may be a dial switch 94 equipped with a rotatable dial as shown in the arrow in FIG. 22. In the dial switch, positions of each piston 91 b, 92 b, and 93 b are changed in accordance with a rotation position of the dial. Accordingly, adjustment of ejecting amount and adjustment of aspiration amount may be performed during water and air supply by shifting a rotation position of the dial switch 94.
In addition, a second through-hole 81 b, and a third through-hole 81 c may be provided to sandwich a first through-hole 81 a in which the insertion portion 11 of the endoscope 2 is inserted to be provided as the introducing duct 20F shown in FIG. 23. Thereby, the balance of the flexibility of the introducing duct 20F is approximately maintained at comparable level in up and down directions as well as in left and right directions as compared to the constitution of the introducing duct 20E in which the air and water supply channel and the aspiration channel are provided at one side of the distal surface of the insertion portion 11 as shown in FIG. 18. In this construction, a through-hole or tube communicated with the second through-hole 81 b and a through-hole or tube communicated with the third through-hole 81 c are disposed inside of the spiral duct 24.
A construction and an operation thereof of the introducing duct having characteristics in the constitution of the spiral duct will be described with reference to FIG. 24.
A constitution of the spiral duct 100 disposed at outer circumferential surface side of the cover member 23 is different from the embodiments described above for the introducing duct 20G of the embodiment as shown in FIG. 24. The spiral duct 100 includes a single layer portion 101 having good flexibility and a plural layers portion 102 having a predetermined flexibility although harder than the single layer portion 101. The single layer portion 101 is constituted by winding a single metal wire in the spiral manner and the plural layers portion 102 is constituted by winding two metal wires in the spiral manner.
Moreover, the single layer portion 101 is disposed to cover the bending section 16 of the insertion portion 11 and the vicinity thereof. Accordingly, when the bending section 16 is bent, the desired bending operation is performed without losing bending property of the bending section 16 by providing the single layer portion 101 to the bending section 16. Correspondingly, the plural layers portion 102 is disposed to cover the flexible duct portion 17 at the proximal side than the bending section 16. Therefore, the rotation power of the rotating power transmission member 45 is effectively transmitted to the spiral duct 100 by disposing the rotating power transmission member 45 rotated by the motor 44 provided in the rotating mechanism portion 42 to the plural layers portion 102.
Note that the distal portion body 103 includes a tubular distal duct member 104 provided with a first shoulder 104 a, a second shoulder 104 b, and a retaining 104 c at the proximal portion side and a closing window member 57 provided at the distal surface of the distal duct member 104 in the embodiment. Thereby, the single layer portion 101 is disposed at the second shoulder 104 b with covered state by the retaining 104 c provided at the distal duct member 104. Therefore the single layer portion 101 can surely be prevented from dropping off from the distal duct member 104.
Another construction and operation thereof of the introducing duct having characteristics in the constitution of the spiral duct will be described with reference to FIG. 25.
The insertion portion cover 10D comprises a first cover portion 111 and a second cover portion 112 for the introducing duct 20H of the embodiment as shown in FIG. 20. The first cover portion 111 covers the bending section 16 and the vicinity thereof of the insertion portion 11. The second cover portion 112 covers the flexible duct portion 17 at the proximal side than the bending section 16.
The first cover portion 111 includes a tubular distal duct member 113, a closing window member 57, a tubular half way portion duct member 114, and a first cover member 23 a. The distal portion body includes the distal duct member 113 and the closing window member 57. The ends of the first cover member 23 a are fixed to the distal duct member 113 and the halfway portion duct member 114 in a water-tight manner. Accordingly, a shoulder 113 a and a shoulder 114 a in which the first cover member 23 a is fixed in a water-tight manner are respectively provided on the proximal portion outer circumferential surface of the distal duct member 113 and the distal portion outer circumferential surface of the halfway portion duct member 114.
On the other hand, the second cover portion 112 includes a half way portion duct member 114, a proximal portion body 51 not shown, and a second cover member 23 b. The ends of the second cover member 23 b are fixed to the half way portion duct member 114 and the proximal portion body 51 in a water-tight manner. Moreover, a spiral duct 24 is to be formed at the outer circumferential side of the second cover member 23 b. A first shoulder 114 b and a second shoulder 114 c are provided on the proximal portion outer circumferential surface of the half way portion duct member 114. The second cover member 23 b is fixed at the first shoulder 114 b in a water-tight manner. The spiral duct 24 is provided in a rotatable manner at the second shoulder 114 c.
Note that the half way portion duct member 114 is to be integrally provided at the distal side portion of the flexible duct portion 17 by, for example, elastic force. Thereby, the bending section 16 covered with the first cover portion 111 is bent without losing bending property.
Constructions and operations of still another construction of the introducing duct having an insertion portion cover will be described with reference to FIG. 26 to FIG. 29.
An insertion portion cover 10E which is insertion portion covering means includes a distal portion body 121, a proximal portion body 51, and a cover member 123 for the introducing duct 20K of the embodiment as shown in FIG. 26. The spiral duct 24 is disposed in a rotatable manner with respect to the distal portion body 121 and the proximal portion body 51. In addition, the circular member 52 is fixedly provided at a predetermined position of the distal portion body 121.
The cover member 123 is an elongated and thin-walled elastic member having optical transparency and one end is constituted as a pouched portion 123 a and another end is constituted as an aperture.
The distal portion body 121 is tubular and formed by a resin member. A shoulder 121 a in which the spiral duct 24 is disposed in a rotatable manner is formed on the proximal portion side outer circumferential surface of the cover member 123. A predetermined position of the cover member 123 is integrally adherently fixed by, for example, adhesion on the inner circumferential surface of the distal portion body 121. Thereby, the pouched portion 123 a of the cover member 123 projects a predetermined amount from the distal surface of the distal portion body 121. The distal portion aperture of the cover member 123 is fixed to the first shoulder portion 51 b of the proximal portion body 51 in a water-tight manner by, for example, adhesion.
Each ends of the spiral duct 24 are disposed at the shoulder 121 a of the distal portion body 21 and the second shoulder 51 c of the proximal portion body 51 in a rotatable manner. The circular member 52 is integrally fixedly provided to a wall face formed at the shoulder 121 a of the distal portion body 121 by, for example, adhesion. The other constructions are the same as in the embodiment describe above, so that the same reference numerals are applied to the same members to skip the description.
Accordingly, when the insertion portion 133 of the endoscope 132 in which the distal surface 131 is constituted by a plane surface as shown in FIG. 27 or the insertion portion 136 of the endoscope 135 in which the distal surface 134 is constituted by, for example, a curved surface as shown in FIG. 28 is inserted into the insertion portion cover 10E of the introducing duct 20K of the embodiment, the pouched portion 123 a is deformed to be adherently disposed so as to fit with the distal surface shape. Reference numeral 137 refers to a lens for observation and reference numeral 138 refers to a lens for illumination.
In this manner, the cover member constituting the insertion portion cover provided at the introducing duct is formed by the elastic member and the pouched portion is provided at one end portion. Then, the distal portion of the insertion portion is covered to be disposed at the pouched portion. Thereby, the thin-walled insertion portion cover can be adherently disposed at the distal portion of the insertion portion regardless of the insertion portion distal shape of the endoscope inserted to be disposed in the insertion portion cover. The other operations and effects are the same as in the embodiment described above.
Note that a stopping groove (not shown) may be formed at the distal portion of the endoscope 132 (not shown) and the distal side portion of the handling portion (not shown) as displacement preventing means for preventing displacement of the proximal portion body 51 in the circumferential direction. Convex portions engageably inserted to be disposed at the stopping groove are respectively provided at the insertion portion body and the distal portion body when forming the stopping groove.
In the case where the aperture 141 which doubles an aspiration duct and a treatment device insertion channel is included on the distal surface 140 of the endoscope 139 as shown in FIG. 29, the aperture 141 is operated as an aspiration duct in the state where the insertion portion 142 is disposed in the insertion portion cover 10E. Thereby, the pouched portion 123 a of the insertion portion cover 42 can be surely adhered to the distal surface 140 to surely prevent displacement and the like of the insertion portion cover 123 under inspection.
A second embodiment of the present invention will be described with reference to FIG. 30 to FIG. 34.
As shown in FIG. 30, an insertion apparatus 1A of the embodiment includes a distal portion 150 equipped with a closing window for observing a body to be examined, a spiral duct 170 which is a tubular member equipped with a propulsion power generating portion for advancing the distal portion 150 toward the intracavital deep portion, and a rotating mechanism portion 180 equipped with a rotating portion for rotating the spiral duct 170 around the longitudinal axis. A propulsion power controlling device 201, an air and water supply device 202, an aspiration device 203, a video processor 204, and a monitor 205 are provided as external devices.
The spiral duct 170 and the rotating mechanism portion 180 are a distal portion insertion ancillary device corresponding to the endoscope insertion ancillary device of the first embodiment. A foot switch 206 may be connected to the propulsion power controlling device 201. The foot switch 206 is a driving switch 207 for handling on/off state of, for example, the motor described below. Reference numeral 208 refers to a switch such as, for example, a rotation direction changeover switch for changing over rotation direction of a motor, a switch for emergency stop, or the like.
The distal portion 150 includes a distal portion body 151 made of, for example, a resin, and a spiral duct striking member (hereinafter, abbreviated as striking member) 160 as shown in FIG. 31. The distal portion body 151 is approximately columnar and is provided with, for example, an aspiration aperture 152 a, an air and water supply aperture 153 a, an illumination portion hole 154 a, and an observation portion hole 155 a. A convex portion 151 a in which the distal aperture described below of the striking member 160 is outfitted to be disposed is provided at the proximal side of the distal portion body 151.
An optical lens 156 a and an image pick up device 156 b such as CCD or the like constituting an observation portion are provided at the observation portion hole 155 a. An optical lens 157 a and a light emitting device 157 b such as LED or the like constituting an illumination portion are provided at the illumination portion hole 154 a. The air and water supply aperture 153 a is one end side aperture of the air and water supply hole 153 constituting an air and water supply channel, and a nozzle 209 which is bend at approximately L character shape is provided at the air and water supply aperture 153 a side so that at least a fluid jet nozzle opposes the optical lens 156 a of the observation portion. The aspiration aperture 152 a is one end side aperture of the aspiration hole 152 constituting an aspiration channel.
A signal line hole 155 b is communicated with an observation portion hole 155 a and a signal line 156 c extended from the image pickup device 156 b is inserted in the signal line hole 155 b. A lead wire hole 154 b is communicated with a illumination portion hole 154 a and a lead wire 157 c extended from the light emitting device 157 b is inserted therein.
Note that reference numeral 158 a refers to an air and water supply mouth ring and provided in such a way that a predetermined amount is projecting from another end side aperture of the air and water supply hole 153. One end portion of an elongated and flexible air and water supply tube 159 a constituting the air and water supply channel is fixedly provided at the air and water supply mouth ring 158 a. Reference numeral 158 b refers to an aspiration mouth ring and provided in such a way that a predetermined amount is projecting from another end side aperture of the aspiration hole 152. One end portion of an elongated and flexible aspiration tube 159 b constituting an aspiration channel is fixedly provided at the aspiration mouth ring 158 b. Connecting mouth rings 159 c and 159 d are respectively provided at another end portion of the air and water supply tube 159 a and another end portion of the aspiration tube 159 b.
The striking member 160 comprises a thick diameter portion 161 and a thin diameter portion 162. A concave portion 161 a of a predetermined shape constituting an inner space is provided at the thick diameter portion 161. A hole portion 162 a communicating with the concave portion 161 a is provided at the thin diameter portion 162. The distal aperture 161 b of the thick diameter portion 161 is outfitted to be disposed at the convex portion 151 a of the distal portion body 151 and the striking member 160 and the distal portion body 151 is integrally fixed by, for example, adhesion. One end portion of the protection tube 163 which is a tube body constituting an insertion portion to be inserted into an elongated and flexible intracavital region is fixed at the thin diameter portion 162. In this manner, so-called endoscopic medical device 164 is constructed with the distal portion 150 and the protection tube 163 by fixedly providing the protection tube 163 at the thin diameter portion 162 of the striking member 160 constituting the distal portion 150.
The outer diameter of the thick diameter portion 161 of the striking member 160 is larger than the outer diameter of the spiral duct 170, and in particular, the distal portion of the spiral duct 170 is made to contact the wall surface 161 c of the thick diameter portion 161 in constitution. Moreover, the protection tube 163 is longer and thinner than the spiral duct 170 and the protection tube 163 is freely disposed in the spiral duct 170. The proximal side of the protection tube 163 is extended by a predetermined amount from the end surface of the spiral duct 170. A signal cable 173 in which a signal wire 156 c and a lead wire 157 c are, for example, wrapped in one, an air and water supply tube 159 a, and an aspiration tube 159 b are inserted in the protection tube 163. Then, the proximal side of the signal cable 173 and the proximal side of each tube 159 a and 159 b are extended by a predetermined amount from the end surface of the protection tube 163.
The spiral duct 170 is formed in tubular shape by coiling a metal wire 171 having a predetermined diameter made of, for example, stainless in spiral manner to have a predetermined flexibility. Therefore, a spiral portion 172 which is a propulsion power generating portion formed by the surface of the metal wire 171 is provided on the outer surface of the spiral duct 170. The spiral duct 170 is not limited to the single strip constitution but may be formed by winding numbers of strips (for example, two strips, four strips, or the like). Besides, when the metal wire 171 is wound in the spiral manner, properties of the spiral duct 170 may be variously set by changing the degree of adhesion between portions of the metal wire 171 and by variously changing the angle of the spiral.
A rotating mechanism portion 180 includes a rotating portion body 181 which is a steel case and a handling portion body 182 constituting a handling portion integrally provided at the rotating portion body 181 as shown in FIG. 30 and FIG. 32. The rotating portion body 181 includes a motor 183, a rotating power transmitting member 184 which is a rotation portion, and a guidance duct holding portion 185. The motor 183 generates driving power for rotating the spiral duct 170 in a predetermined direction around the axis. The motor 183 is fixedly provided, for example, at the side wall of the rotating portion body 181.
The rotating power transmission member 184 is integrally fixed to the motor axis 186 of the motor 183. The rotating power transmission member 184 is formed by a resin member, a rubber member, or the like having elasticity. The guidance duct holding portion 185 is disposed at the position opposing the rotating power transmission member 184 fixed to the motor axis 186. The guidance duct holding portion 185 is fixedly provided, for example, at the bottom of the rotating portion body 181. On the surface portion of the guidance duct holding portion 185 opposing the rotating power transmission member 184, a curved surface (not shown) or a concave portion of hemispherical shape (not shown) which approximately matches the spiral duct 170 in outline shape is formed. The spiral duct 170 is to be disposed between the rotating power transmission member 184 and the concave portion of the guidance duct holding portion 185 as shown in the drawing.
On the other hand, operation buttons 187 and 188, a connector portion 189, a communicate portion 189, switches 191, 192, 193, and 194 are provided at the handling portion body 182. The operation button 187 is an air and water supply button and indicates on/off of air supply function and on/off of water supply function. The operation button 188 is an aspiration button and indicates on/off of aspiration function. A connector 174 provided at the proximal portion of the signal cable 173 is connected at the connector portion 189 in a detachable manner. An air and water supply opening 190 a and an aspiration opening 190 b are provided at the communicating portion 190. A connecting mouth ring 159 c is communicated at the air and water supply opening 190 a in a detachable manner. A connecting mouth ring 159 d is communicated at the aspiration opening 190 b in a detachable manner. Switches 191, 192, 193, and 194 are remote switches for outputting an indicator signal to the video processor 204. The first switch 191 lets an observation image into a still state or release the still state displayed, for example, on the screen of the monitor 205. The second switch 192, for example, indicates to record an observation image. The third switch 193, for example, switches over photometry. The forth switch 194, for example, performs switching over of enlargement factor of an observation image.
A universal cord 195 is extending from the back end side portion of the handling portion body 182. Signal wires extended from the switch 191, 192 193, and 194 (not shown), signal wires extended from the connector portion 189 (not shown), an air and water supply tube constituting the air and water supply channel communicated with the air and water supply opening 190 a (not shown), and an aspiration tube constituting the aspiration channel communicated with the aspiration opening 190 b (not shown), are inserted to be disposed in the universal cord 195.
A connector body 196 is provided at the proximal end of the universal cord 195. A propulsion power connector portion 196 a connected through the propulsion power controlling device 201 and the first electric cable 197 a, an air and water supply connector portion 196 b equipped with an air and water supply mouth ring (not shown), for example, directly connected with the air and water supply device 202, an aspiration connector portion 196 c connected through the aspiration device 203 and the aspiration tube 198, and a processor connector portion 196 d connected through the video processor 204 and the second electric cable 197 b are provided at the connector body 196. The video processor 204 and the monitor 205 are connected with the third electric cable 197 c.
The propulsion power controlling device 201 is a control unit for variously controlling the motor 183. A switch for controlling drive/stop of the motor 183, a switch for changing number of rotations of the motor 183, a switch for changing rotation direction of the motor 183, a switch for quickly stopping the motor 183 and the like are provided at the propulsion power controlling device 201. Therefore, the spiral duct 170 may be rotated in the state desired by a user by performing timely switching operation by the user.
An air supply pump and a water supply bottle not shown are equipped with the air and water supply device 202. A liquid, for example, water or a gas, for example, air can be blown out from the nozzle 209 by performing timely operation of the air and water supply button 187 by a user. An aspiration pump and an aspiration bottle not shown are equipped with the aspiration device 203. Collection of, for example, water, liquid, and the like blown out from the nozzle 209 through the aspiration aperture 152 a can be carried out by timely operating the aspiration button 188 by a user.
The video processor 204 includes a controlling circuit for carrying out various controlling, a signal processing circuit, and the like. The video processor 204 provides a driving signal for driving the image pickup device 156 b provided at the distal portion body 151 and generates an image signal from the electric signal photoelectrically converted in the image pickup device and transmitted to output to the monitor 205. Thereby, an observed inner image is displayed on the image screen of the monitor 205 by receiving the image signal outputted from the video processor 5.
It should be noted here that the image pickup device may be C-MOS (abbreviated name of Complementary Metal-Oxide Semiconductor) image sensor.
An operation of the insertion apparatus 1A constructed as describe above will be described.
At first, a staff prepares the insertion apparatus 1A. Then the desired position, for example, the proximal portion side of the spiral duct 170 is disposed between the guidance duct holding portion 185 and the rotating power transmission member 184 constituting the rotating mechanism portion 180. Then, the distal portion side 150 disposed at the distal side of the spiral duct 170 is disposed, for example, on the bed 7.
Next, an operator (not shown) holds the distal side of the introducing duct 170. Then, the distal portion body 151 constituting the distal portion 150 provided at the distal side than the spiral duct 170 is inserted into the anus of the patient 8 lying on the bed 7. Consequently, the spiral portion 172 formed on the outer surface of the spiral duct is made to contact the bowel wall. At this time, the contact state of the spiral portion 172 and the bowel wall resembles that of male and female screws. Moreover, an observation image captured by image pickup device 156 b through the optical lens 156 a is displayed on the screen of the monitor 205.
In the state where the spiral portion 172 and the bowel wall are made to contact each other, the motor 183 provided in the rotating mechanism portion 180 is rotatably driven by operating the switch for controlling drive/stop provided in the propulsion power controlling device 201. Consequently, the rotating power transmission member 184 is rotated to transmit the rotating power to the spiral duct 170 disposed between the rotating power transmission member 184 and the guidance duct holding portion 185. Thereby, the spiral duct 170 is rotated in the axis rotation direction as shown by the arrow in FIG. 33.
In the rotation state, a force such as that for moving a male screw with respect to a female screw at the contact portion between the spiral portion 172 of the spiral duct 170 and the bowel wall is generated, that is, a propulsion power for advancing the spiral duct 170 is generated. Consequently, the spiral duct 170 is advanced toward into the deep direction of the colon by the propulsion power. At this time, the propulsion power generated at the spiral duct 170 is transmitted to the distal portion 150 in the case where the wall surface 161 c which is the proximal surface of the thick diameter portion 161 and the propulsion power receiving portion contacts the distal end of the spiral duct 170. On the other hand, in the case where the wall surface 161 c is apart from the distal end of the spiral duct 170, the distal end of the spiral duct 170 contacts the wall surface 161 c after the spiral duct 170 is moved, and the propulsion power generated at the spiral duct 170 is transmitted to the distal portion 150.
Thereby, the distal portion 150 disposed at the distal side of the spiral duct 170 held by the operator and the protection tube 163 fixedly provided at the thin diameter portion 162 of the striking member 160 constituting the distal portion 150 are moved in the deep portion direction in the colon. At this time, the distal portion 150 and the protection tube 163 are smoothly introduced toward the intracavital deep portion by a slight force with the operator's timely hand operation for advancing the spiral duct 170. At this time, the protection tube 163 and the distal portion 150 are not rotated and only the spiral duct 170 is rotated because the spiral duct 170 is slidingly movable with respect to the protection tube 163 and the thin diameter portion 162. Therefore, the observation image displayed on the screen of the monitor 205 is prevented from rotating.
Note that in the case where carrion and the like are adhered to the optical lens 156 a to cause a trouble in the observation image displayed on the screen of the monitor 205, the air and water supply button 187 is timely operated. Consequently, cleaning water is blown out from the nozzle 209 to flush away the carrion and the like adhered to the optical lens 156 a. Subsequently, drop of water adhered to the optical lens 156 a is removed by blowing out air from the nozzle 209 to obtain a satisfactory observation image. Further, in the case where carrion and the like needs to be aspirated, the operation button 188 is timely operated to aspirate the carrion.
Further, when it is recognized that the distal portion body 151 constituting the distal portion 150 of the introducing duct 20 becomes stuck in a small concave or the like of the wall of the bowel by the observation image displayed on the screen of the monitor 205, rotation of the motor 183 is stopped by, for example, operating the driving switch 207, and after that, the protection tube 163 positioned at the hand side is pulled to remove the stuck. After that, the driving switch 207 is operated to again rotate the motor 183 to advance.
In this manner, the distal portion 150, having the distal portion body 151 in which protection tube 163 is inserted in the spiral tube 170 and the image pickup device 156 b and the light emitting device 157 b are provided at the distal side and inserted from the anus, is advanced toward the sigmoid colon 73 from the rectum 72 by the propulsion power generated at the spiral tube 170, by hand manipulation performed by the operator, and the like. Then, the spiral tube 170 in the rotating state passes through the sigmoid colon 73, and after that, reaches, for example, near the cecum portion 79 which is the observation target portion as shown in FIG. 34 by passing through the bending portion which is the bend between the sigmoid colon 73 and the descending colon 74 which is difficult to move through, the splenic flexure 76 which is the bend between the descending colon 74 and the transverse colon 75 which is easy to move through, and the liver curvature 77 which is the bend between transverse colon 75 and ascending colon 78.
When the operator judges that the distal portion 150 has reached near the cecum portion 79 from the endoscope image displayed on the screen of the monitor 205, the driving of the motor 183 is stopped by, for example, instruction to the staff or operating the driving switch 207 of the foot switch 206. Then, the operator draws back the distal portion 150 to perform the inspection in order to carry out the endoscopy in the colon.
Then, after finishing the inspection, the connecting mouth ring 159 c is taken out from the air and water supply opening 190 a, the connecting mouth ring 159 d is taken out from the aspiration opening 190 b, and the connector 174 is taken out from the connector portion 189. Thereafter, the spiral duct 170 is withdrawn from the protection tube 163 and the spiral duct 170 is discard. On the other hand, the handling portion body 182 and the universal cord 195, and the distal portion 150 and the protection tube 163 are respectively separately washed.
To be more specific, as for the handling portion body 182 and the universal cord 195, cleaning of the inside of the air and water supply tube constituting the air and water supply channel and cleaning of the inside of the aspiration tube constituting the aspiration channel inserted to be disposed at the inside portion are carried out. On the other hand, as for the distal portion 150 and protection tube 163, in addition to cleaning the air and water supply tube 159 a constituting the air and water supply channel and cleaning the aspiration tube 159 b constituting the aspiration channel inserted to be disposed at the inside portion, the outer surface of the distal portion 150 and the protection tube 163 is carried out. Note that the spiral duct 170 may be sterilized and disinfected without being discarded.
In this manner, so-called endoscopic medical device is constituted by providing an image pickup device and a light emitting device at the distal portion body constituting the distal portion and by fixedly providing a protection tube at the thin diameter portion of the striking member constituting the distal portion, and a spiral duct provided with a spiral portion on the outer circumferential side of the protecting cube is disposed in a slidingly movable manner. Then, the rotation power of the rotating power transmission member rotated by the motor provided at the rotating mechanism portion is transmitted to the spiral duct and the spiral duct is rotated. Consequently, the propulsion power for moving the spiral duct toward the deep portion of the colon can be obtained. When the spiral duct is moved by the propulsion power, the distal surface of the spiral duct contacts the wall surface of the thick diameter portion. Thereby, the propulsion power generated at the spiral duct is transmitted to the distal portion and introduction toward the deep portion can be performed by the propulsion power generated at the spiral duct without rotating the distal portion integrated with the protection tube. Further, downsizing of the diameter of the endoscopic medical device equipped with the spiral duct which generates the propulsion power can be realized.
Further, after finishing the inspection, each connecting mouth ring is taken out from the air and water supply opening and the aspiration opening, and the connector is taken out from the connector portion to withdraw the spiral duct from the protection tube in the state. Thereby, the spiral duct, the handling portion body and the universal cord, and the distal end and the protection tube can be separated to respectively individually set and perform the aftertreatment after the inspection is finished. In other words, as for the spiral duct, selection of either discard or autoclave sterilization is possible. The handling portion body and the universal cord can be reused, by cleaning the tube constituting the channel. The distal portion and the protection tube can be reused, by cleaning the outer surface and the tube. In this case, as for the tube constituting the channel, the length of the channel can be shorten to implement cleaning and disinfection at short times, easily, and surely by dividing the channel into two portions.
Note that the present invention is not limited to only the embodiments described above and various different embodiments may be available without departing from the gist of the present invention.

Claims

1. An insertion apparatus comprising:

a tubular member equipped with a propulsion power generating portion;

a rotating portion for rotating the tubular member around the longitudinal axis of the tubular member;

a distal portion which can be slidingly moved with respect to the tubular member rotated by the rotating portion and is equipped with an observation portion for observing a body to be examined; and

a propulsion power receiving portion for receiving propulsion power generated by the propulsion power generating portion equipped in the tubular member.

2. The insertion apparatus according to claim 1, wherein the propulsion power receiving portion is a distal side wall of a circumferential groove portion in which is placed a convex stopping portion that is formed on an inner circumferential surface of a rotating fix portion constituting a proximal portion body of an insertion cover.

3. The insertion apparatus according to claim 1, wherein the propulsion power receiving portion is circular member adherently and fixedly provided on a wall surface constituting a shoulder in which the tubular member formed at a distal portion body of an insertion portion cover is disposed.

4. The insertion apparatus according to claim 1, wherein the propulsion power receiving portion is a wall surface formed at a distal portion body of an insertion portion cover and contacting a distal end of the tubular member.

5. The insertion apparatus according to claim 1, wherein the propulsion power generating portion is a spiral-shaped portion.

6. The insertion apparatus according to claim 1, wherein the propulsion power receiving portion is a wall surface provided at the distal portion contacting a distal end of the tubular member.

7. An insertion apparatus comprising:

a tubular member equipped with a propulsion power generating portion;

a rotating portion for rotating the tubular member around the longitudinal axis of the tubular member; and

a distal portion provided at a distal side of the tubular member, the distal portion being slidingly movable with respect to the tubular member rotated by the rotating portion, and the distal portion being equipped with an observation portion for observing a body to be examined, and with a propulsion power receiving portion for receiving propulsion power generated by the propulsion power generating portion equipped to the tubular member.

8. The insertion apparatus according to claim 7, wherein the propulsion power generating portion is a spiral-shaped portion.