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WO2017109987A1 - Appareil d'insertion de tube flexible - Google Patents

Appareil d'insertion de tube flexible Download PDF

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Publication number
WO2017109987A1
WO2017109987A1 PCT/JP2015/086393 JP2015086393W WO2017109987A1 WO 2017109987 A1 WO2017109987 A1 WO 2017109987A1 JP 2015086393 W JP2015086393 W JP 2015086393W WO 2017109987 A1 WO2017109987 A1 WO 2017109987A1
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WO
WIPO (PCT)
Prior art keywords
rigidity
stiffness
variable
bent
bending
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2015/086393
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English (en)
Japanese (ja)
Inventor
池田　裕一
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Olympus Corp
Original Assignee
Olympus Corp
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Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2015/086393 priority Critical patent/WO2017109987A1/fr
Publication of WO2017109987A1 publication Critical patent/WO2017109987A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor

Definitions

  • the present invention relates to a flexible tube insertion device.
  • the flexible tube insertion device which is an endoscope device has an endoscope.
  • the insertion portion of the endoscope is inserted into the inside of the conduit portion, and further inserted from the inside of the conduit portion toward the deep portion of the conduit portion.
  • the deep part here refers to a position ahead of the current position in the insertion direction of the insertion part.
  • the conduit portion is a conduit portion that can move according to the insertion operation of the insertion portion, has elasticity, and is bent.
  • Such a conduit portion refers to, for example, the large intestine. Hereinafter, description will be made using the large intestine.
  • the push-in operation is performed excessively, the bending portion may be overextended by the push-in operation, and the patient will be pained by the overextension. If the pulling-out operation is performed early to avoid overextension, the insertion part will come out of the large intestine before the large intestine changes to a substantially straight state. For this reason, the operator cannot perform a substantially linear procedure, and the large intestine does not change to a substantially linear state.
  • the endoscope system disclosed in Patent Document 1 includes a passive bending portion that is passively bent by an external force of a bending portion during a pushing operation of the insertion portion, and an insertion portion having a passive bending portion.
  • the insertion portion is inserted toward the deep portion along the bent portion by the passive bending portion.
  • an overtube covering the passive bending portion is used. The overtube prevents the passive bending portion from being bent by an external force, increases the bending rigidity of the insertion portion, and changes the bending portion into a substantially linear state.
  • the insertion part of the endoscope apparatus disclosed in Patent Document 2 has a plurality of curved parts.
  • Each of the bending portions is connected in series and is bent in the opposite direction with respect to each other.
  • the bundle type fiber sensor disclosed in Patent Document 3 detects the shape of the insertion portion with an optical fiber.
  • Patent Document 1 the outer diameter of the insertion portion is increased by the overtube, which increases the burden on the patient. In order to reduce the burden on the patient, it is conceivable not to use an overtube. However, in this case, the insertability of the insertion portion into the deep portion is degraded.
  • Patent Document 2 since the insertion portion does not change the pipe portion into a substantially straight line state, the insertion property of the insertion portion into the deep portion is deteriorated.
  • Patent Document 3 does not specifically disclose improvement in insertability of the insertion portion into the deep portion.
  • Patent Documents 1, 2, and 3 the insertion portion cannot correspond to various bent portions, and it is difficult to insert (forwardly move) toward the deep portion in the duct portion. Under this circumstance, when the operator's hand side force is transmitted to the insertion part, buckling may occur in the insertion part, and the insertion into the deep part will be further deteriorated.
  • the present invention has been made in view of these circumstances, and an object of the present invention is to provide a flexible tube insertion device capable of improving insertion into a deep portion in a pipeline portion.
  • An aspect of the flexible tube insertion device includes an insertion portion that is inserted into a conduit portion having a bending portion, and a rigidity that is disposed in the insertion portion and varies, and the bending portion of the insertion portion is bent by the rigidity.
  • a stiffness variable portion that varies stiffness, a state information of the insertion portion, a detection unit that detects state information of the duct portion based on the state information of the insertion portion, and the bending according to the insertion of the insertion portion
  • a control unit that performs control to gradually increase the rigidity of the rigidity variable part passing through the bent part based on the detection result of the detection unit so that the part is substantially linear.
  • FIG. 1 is a schematic view of a flexible tube insertion device according to an embodiment of the present invention.
  • FIG. 2A is a diagram illustrating a state where the insertion portion of the flexible tube insertion device moves forward toward the first bent portion.
  • FIG. 2B is a diagram illustrating a state in which the leading rigidity variable portion has reached the entrance of the first bent portion.
  • FIG. 2C is a diagram illustrating a state in which the leading rigidity variable portion has reached the bent reaching portion.
  • FIG. 2D is a diagram illustrating a state in which the leading rigidity variable portion has reached the passage site.
  • FIG. 2E is a diagram for explaining a change in stiffness of the stiffness variable portion in the first bent portion.
  • FIG. 2A is a diagram illustrating a state where the insertion portion of the flexible tube insertion device moves forward toward the first bent portion.
  • FIG. 2B is a diagram illustrating a state in which the leading rigidity variable portion has reached the entrance of the first bent portion.
  • FIG. 2F is a diagram illustrating a change in stiffness of the stiffness variable portion in the second bent portion.
  • FIG. 2G is a diagram showing that the insertion portion and the conduit portion are in a substantially straight line state.
  • FIG. 3A is a diagram illustrating a state in which the stiffness variable portion has reached the entrance arrival site.
  • FIG. 3B is a diagram illustrating a state in which the stiffness variable portion has reached the bend reaching portion.
  • FIG. 3C is a diagram illustrating a state in which the rigidity variable portion has reached the bending reaching portion and the passing portion.
  • FIG. 3D is a diagram illustrating a state in which the stiffness variable portion has reached the passage site.
  • the deep portion indicates a position ahead of the current position in the insertion direction of the insertion portion 40.
  • the distal end portion of the insertion portion 40 is moved from the inlet of the conduit portion 301 (hereinafter referred to as the conduit inlet 301a) to the inside of the conduit portion 301.
  • the operator holds an arbitrary position of the insertion portion 40 exposed to the outside from the conduit portion 301.
  • the pushing operation indicates that the insertion unit 40 is pushed by the pushing force applied to the insertion unit 40 by the operator from the gripped part.
  • tip part of the insertion part 40 is pushed toward the deep part which exists ahead of the pipe-line entrance 301a, and moves forward toward a deep part.
  • the pulling-out operation refers to pulling out the insertion portion 40 by the pulling force applied to the insertion portion 40 by the operator from the gripped part.
  • the distal end portion of the insertion portion 40 is pulled out from the deep portion toward the front, and moves backward toward the conduit inlet 301a.
  • the conduit portion 301 has a first bent portion 303a and a second bent portion 303b, and the bent portions 303a and 303b have inlets 305a and 305b, respectively.
  • the second bent portion 303b is located deeper than the first bent portion 303a.
  • the positions of the bent portions 303a and 303b and the inlets 305a and 305b with respect to the pipe inlet 301a may be stored as stored information in, for example, an internal memory (not shown) in advance. This position may be specified in advance by, for example, a training model or the like, or may be specified in advance by the conduit unit 301.
  • An insertion apparatus 10 that is an endoscope apparatus as shown in FIG. 1 is provided in an operating room or examination room, for example.
  • the insertion device 10 includes a medical endoscope 20 and an insertion control device 120 connected to the endoscope 20.
  • the insertion device 10 includes a light source device (not shown) connected to the endoscope 20, an image control device (not shown) connected to the endoscope 20, a display device (not shown) connected to the image control device, and an image control device. And an input device not shown.
  • the endoscope 20 is an example of an insertion device that is inserted into an inserted body 300 having a duct portion 301 such as a large intestine.
  • the endoscope 20 images the inside of the conduit section 301 by an imaging unit of an imaging unit (not shown).
  • a light source device (not shown) emits light so that the imaging unit can capture an image.
  • the light is guided to a lighting unit of a lighting unit (not shown) by a light guide member of a lighting unit (not shown) provided inside the endoscope 20.
  • Light is emitted from the illumination unit to the outside as illumination light.
  • the image picked up by the image pickup unit is output from the image pickup unit to an image control device (not shown) via a signal line of an image pickup unit provided inside the endoscope 20.
  • An image control device (not shown) performs signal processing so that an image taken by the imaging unit is displayed on a display device (not shown).
  • the insertion control device 120 controls the bending rigidity of the insertion portion 40 disposed in the endoscope 20.
  • the endoscope 20 is described as a medical flexible endoscope, for example, it is not necessary to be limited to this.
  • the endoscope 20 only needs to have a flexible insertion portion 40 that is inserted into the inserted body 300, such as an industrial flexible endoscope, a catheter, or a treatment instrument.
  • the inserted body 300 is not limited to a person, but may be an animal or another structure.
  • the endoscope 20 may be a direct-view type endoscope 20 or a side-view type endoscope 20.
  • the endoscope 20 includes an operation unit 30 that is gripped by an operator, and an insertion unit 40 that is inserted into the duct portion 301 of the insertion target 300.
  • the operation unit 30 is connected to the proximal end portion of the insertion unit 40.
  • the operation unit 30 includes a bending operation unit (not shown) that operates a bending unit 43 described later, and a switch unit (not illustrated) that operates each unit such as an imaging unit.
  • the operation unit 30 further includes a universal cord 35, and is connected to the light source device (not shown), the image control device (not shown), and the insertion control device 120 via the universal cord 35.
  • the insertion portion 40 is tubular, elongated and flexible.
  • the insertion part 40 moves forward and backward in the pipe part 301 with respect to the pipe part 301.
  • the insertion part 40 can be bent according to the shape of the pipe line part 301.
  • the insertion portion 40 has a distal end hard portion 41, a bending portion 43, and a flexible tube portion 45 in order from the distal end portion of the insertion portion 40 toward the proximal end portion of the insertion portion 40.
  • the proximal end portion of the distal end rigid portion 41 is connected to the distal end portion of the bending portion 43, the proximal end portion of the bending portion 43 is connected to the distal end portion of the flexible tube portion 45, and the proximal end portion of the flexible tube portion 45 is operated. It is connected to the part 30.
  • the imaging unit and the illumination unit described above are provided inside the distal end hard portion 41.
  • the flexible tube portion 45 of the insertion portion 40 is divided into a plurality of segments 47 arranged in a line along the axial direction of the insertion portion 40.
  • the segment 47 may function as a virtual region that does not exist or may function as a structure that actually exists.
  • the distal end hard portion 41 and the bending portion 43 are shorter than the flexible tube portion 45. For this reason, in this embodiment, the distal end hard portion 41, the bending portion 43, and the distal end portion of the flexible tube portion 45 are regarded as the distal end portion of the insertion portion 40.
  • the bending stiffness of each segment 47 can be changed independently by control of a stiffness control unit (hereinafter referred to as control unit 121) arranged in the insertion control device 120. Therefore, the bending stiffness of the flexible tube portion 45 can be partially changed by the bending stiffness of each segment 47 that is independently controlled by the control unit 121.
  • control unit 121 a stiffness control unit arranged in the insertion control device 120. Therefore, the bending stiffness of the flexible tube portion 45 can be partially changed by the bending stiffness of each segment 47 that is independently controlled by the control unit 121.
  • control unit 121 a stiffness control unit
  • the insertion device 10 has one or more stiffness variable portions 55 arranged in the insertion portion 40. Specifically, the stiffness variable portion 55 is built in the insertion portion 40. The rigidity variable part 55 should just be incorporated in the flexible tube part 45 at least. Moreover, the rigidity variable part 55 should just be arrange
  • the rigidity variable portion 55 has variable rigidity, and changes the bending rigidity of the insertion portion 40 according to the rigidity.
  • the stiffness variable portion 55 is built in each segment 47.
  • the stiffness variable portion 55 may be built in all the segments 47 or may be built only in some of the segments 47.
  • a portion where the variable stiffness portion 55 is provided may function as at least the segment 47.
  • One rigidity variable portion 55 may be incorporated across the plurality of segments 47.
  • the stiffness variable portions 55 may be arranged in one row along the axial direction of the insertion portion 40 or may be arranged in a plurality of rows.
  • the stiffness variable portions 55 When the stiffness variable portions 55 are arranged in a plurality of rows, the stiffness variable portions 55 may be provided at the same position so that the stiffness variable portions 55 are adjacent to each other in the circumferential direction of the flexible tube portion 45, The insertion portion 40 may be provided so as to be shifted in the axial direction. The stiffness variable portion 55 only needs to be able to vary the bending stiffness of the insertion portion 40 in units of segments 47 by the stiffness of the stiffness variable portion 55.
  • the stiffness variable portion 55 is, for example, a coil pipe formed of a metal wire, and an electroconductive polymer artificial muscle (hereinafter referred to as EPAM) enclosed in the coil pipe.
  • the central axis of the coil pipe is provided to coincide with or parallel to the central axis of the insertion portion 40.
  • the coil pipe has electrodes provided at both ends of the coil pipe.
  • Each of the electrodes of the stiffness varying unit 55 is connected to the insertion control device 120 via a signal cable 57 built in the endoscope 20, and power is supplied from the insertion control device 120.
  • the EPAM tends to expand and contract along the central axis of the coil pipe.
  • the rigidity of the rigidity variable portion 55 changes.
  • the rigidity of the rigidity variable portion 55 increases as the value of the applied voltage increases.
  • the stiffness of the stiffness varying portion 55 changes, the bending stiffness of the segment 47 incorporating the stiffness varying portion 55 also changes accordingly. Electric power is supplied to each electrode independently.
  • the rigidity of each of the rigidity variable portions 55 changes independently, and the bending rigidity of each of the segments 47 also changes independently.
  • the stiffness varying unit 55 changes the bending stiffness of the segment 47 due to the stiffness change of the stiffness varying portion 55, and partially changes the bending stiffness of the flexible tube portion 45 due to the stiffness change of the segment 47.
  • the rigidity variable portion 55 may use a shape memory alloy instead of EPAM.
  • the insertion device 10 includes a detection unit 60 that detects the state information of the insertion unit 40 and the state information of the conduit unit 301 based on the state information of the insertion unit 40.
  • a detection operation start instruction (a detection start instruction and a calculation start instruction described later) is input from the input device, the detection unit 60 starts detection and always detects it.
  • the detection timing may be performed every time a fixed time elapses, and is not particularly limited.
  • the detection unit 60 includes a state detection unit 61 disposed inside the insertion unit 40 and a state calculation unit 63 disposed in the insertion control device 120.
  • the state detection unit 61 is arranged side by side with the stiffness variable unit 55.
  • the state detection unit 61 detects state information of the insertion unit 40 including shape information, twist information, and position information of the insertion unit 40.
  • the shape information of the insertion portion 40 indicates, for example, the shape of the insertion portion 40 in the axial direction of the insertion portion 40.
  • the state detection unit 61 includes, for example, at least one of a coil, an optical fiber sensor, an acceleration sensor, and an absorption member.
  • the coil generates a magnetic field corresponding to the state of the insertion portion 40 such as the shape of the insertion portion 40.
  • the optical fiber sensor the light transmittance changes according to the state of the insertion portion 40.
  • the acceleration sensor measures acceleration.
  • the absorbing member absorbs X-rays corresponding to the state of the insertion portion 40.
  • the state detection unit 61 always detects (operates) after the detection start instruction output from the input device is input to the state detection unit 61. Note that the detection timing may be performed every time a fixed time elapses, and is not particularly limited.
  • the state detection unit 61 is connected to the state calculation unit 63 by, for example, wired or wireless, and outputs a detection result detected by the state detection unit 61 to the state calculation unit 63.
  • the state calculation unit 63 calculates the state information of the insertion unit 40 and the state information of the pipeline unit 301 based on the detection result of the state detection unit 61.
  • the state information of the insertion unit 40 calculated by the state calculation unit 63 includes, for example, shape information, twist information, and position information of the insertion unit 40.
  • the state information of the pipe line part 301 includes, for example, shape information of the pipe line part 301 and position information of the first bent part 303a and the second bent part 303b in the pipe line part 301.
  • the state information of the pipeline section 301 is calculated by the state calculation section 63 based on the state information of the insertion section 40.
  • the state calculation unit 63 is configured by a hardware circuit including an ASIC, for example.
  • the state calculation unit 63 may be configured by a processor.
  • a program code for causing the processor to function as the state calculation unit 63 when the processor executes is stored in an internal memory or an external memory (not shown) accessible by the processor. Keep it.
  • the state calculation unit 63 always calculates (operates) after the calculation start instruction output from the input device is input to the state calculation unit 63 in a state where the detection result of the state detection unit 61 is input. Note that the calculation timing may be performed every time a fixed time elapses, and is not particularly limited.
  • the state calculation unit 63 outputs the calculation result to the control unit 121 through a signal line (not shown).
  • the state calculation unit 63 calculates the current state information of the insertion unit 40 in the pipeline unit 301 based on the calculation result calculated by the state calculation unit 63.
  • the state calculation unit 63 is connected to the display device, and outputs the current state information of the insertion unit 40 in the pipe line unit 301 to the display device. Then, the display device displays the current state information of the insertion unit 40 in the pipe line part 301.
  • the current state information of the insertion unit 40 in the pipe line part 301 is, for example, information in which the state information of the insertion part 40 is matched with the state information of the pipe line part 301.
  • the display is performed by, for example, three dimensions. The operator can monitor the position and state of the insertion section 40 in the pipe section 301 based on the state information of the insertion section 40 displayed on the display device.
  • the insertion device 10 has a control unit 121 arranged in the insertion control device 120.
  • the control unit 121 is configured by a hardware circuit including, for example, an ASIC.
  • the control unit 121 may be configured by a processor.
  • program code for causing the processor to function as the control unit 121 when the processor executes is stored in an internal memory (not shown) or an external memory that is accessible by the processor. .
  • the control unit 121 individually controls the stiffness of each of the stiffness variable units 55 via the signal cable 57.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55 to an arbitrary height.
  • the height of the rigidity may be changed, for example, in stages, or may change continuously.
  • the height of rigidity is adjusted as desired according to the pipe line part 301.
  • the rigidity variable portion 55 having low rigidity is illustrated in white, and the rigidity variable portion 55 having high rigidity is illustrated in black.
  • the stiffness variable portion 55 having intermediate stiffness is indicated by a black line.
  • low rigidity, medium rigidity, and high rigidity are described, but the rigidity is not limited to three stages of low, medium, and high.
  • the low rigidity is a rigidity that allows the insertion portion 40 to bend along the shape of the duct portion 301, and is a rigidity that enables the insertion portion 40 to be passively bent by an external force or the like.
  • the external force indicates, for example, a force applied to the insertion portion 40 from an arbitrary angle with respect to the central axis of the insertion portion 40.
  • the insertion portion 40 functions as a low stiffness portion that can be passively bent by receiving an external force.
  • Low rigidity represents the rigidity with which the insertion portion 40 is released from a substantially linear state.
  • the low rigidity is, for example, a minimum rigidity or a rigidity close to the minimum rigidity with respect to the rigidity controlled by the control unit 121.
  • the low stiffness may be the initial stiffness before the stiffness change is performed. Therefore, the low rigidity may be set to a desired value as long as it is lower than the medium rigidity.
  • the control unit 121 may end the rigidity control without controlling the rigidity to be low.
  • High rigidity indicates a substantially linear rigidity in which the first and second bent portions 203a and 203b (see FIG. 2E) of the insertion portion 40 are substantially linearized.
  • the first and second bent portions 203a and 203b are a portion of the insertion portion 40 that passes through the first and second bent portions 303a and 303b of the conduit portion 301.
  • the high rigidity is such that the first and second bent portions 203a and 203b are changed to the first and second substantially straight portions 207a and 207b (see FIG. 2G), and the external force is applied to the first and second substantially straight portions 207a and 207b. 1, 2
  • the rigidity which keeps a substantially straight state without bending the substantially straight parts 207a and 207b.
  • the high rigidity is, for example, the maximum rigidity or a rigidity close to the maximum rigidity with respect to the rigidity controlled by the control unit 121.
  • the first and second substantially straight parts 207a and 207b are harder than the parts controlled with medium rigidity or low rigidity.
  • the first and second substantially straight portions 207a and 207b function as high-rigidity portions that are not bent even when an external force is applied and maintain a substantially straight state.
  • the medium rigidity indicates, for example, an intermediate rigidity between the low rigidity and the high rigidity, or a rigidity between the low rigidity and the high rigidity.
  • the timing at which the control unit 121 controls the stiffness of the stiffness varying unit 55 will be described.
  • the first bending portion 303a is used and seven stiffness variable portions 55 are arranged, and the stiffness variable portions 55a, 55b, 55c, 55d, 55e, 55f, and 55g are arranged in order from the top.
  • the segment 47 is not shown in FIGS. 2A to 2G.
  • the detection unit 60 outputs the current state information of the insertion unit 40 in the pipeline unit 301 to the control unit 121.
  • the state information of the insertion part 40 also includes position information of the insertion part 40 with respect to the pipeline inlet 301a.
  • the control unit 121 grasps the position of the inlet 305a with respect to the pipeline inlet 301a based on the state information of the insertion unit 40 or based on stored information stored in an internal memory (not shown).
  • the control unit 121 determines that the rigidity variable portion 55a is the first based on the position information.
  • the stiffness of the stiffness variable portions 55a to 55g is controlled to a high stiffness, which is the standard stiffness, until reaching the entrance 305a of the one bent portion 303a.
  • the control unit 121 when the distal end portion of the flexible tube portion 45 reaches the inlet 305a, the control unit 121 is arranged at the inlet 305a, for example, based on the position information output from the detection unit 60, or The rigidity of the rigidity variable portion 55a arranged at the entrance 305a and the front of the entrance 305a is controlled from the high rigidity, which is the standard rigidity, to the middle rigidity. Specifically, the control unit 121 controls the rigidity of the segment 47 disposed at the inlet 305a or the rigidity variable unit 55a corresponding to the segment 47 disposed before the inlet 305a and the inlet 305a.
  • the front range is substantially the same as the length of one segment 47, for example.
  • the control unit 121 reaches the inside of the first bent portion 303a based on the position information output from the detection unit 60.
  • the rigidity of the rigidity variable portion 55a is controlled from medium rigidity to low rigidity. Specifically, the control unit 121 controls the stiffness of the stiffness varying unit 55a corresponding to the segment 47 that has reached the inside of the first bent portion 303a.
  • the control unit 121 Based on the detection result of the detection unit 60, the control unit 121 increases the rigidity of the rigidity variable unit 55 that passes through the first bending part 303a so that the first bending part 303a is substantially linearized as the insertion part 40 is inserted.
  • the control unit 121 displays the position information output from the detection unit 60 as shown in FIGS. 2D and 2E. Based on this, the stiffness of the stiffness variable portion 55d passing through the first bent portion 303a is maintained at medium stiffness. Thereafter, as shown in FIG. 2F, the control unit 121 controls the stiffness of the stiffness varying unit 55d from medium stiffness to high stiffness.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55d corresponding to the segment 47 passing through the first bent portion 303a. Further, for example, as shown in FIGS. 2D, 2E, 2F, and 2G, it is assumed that the rigidity variable portions 55c and 55d are arranged in the first bent portion 203a passing through the first bent portion 303a. In this case, the control unit 121 controls the stiffness of the stiffness varying unit 55c to a low stiffness, and controls the stiffness varying portion 55d to a high stiffness after maintaining the stiffness of the stiffness varying unit 55d to a medium stiffness. That is, the control unit 121 gradually increases the rigidity of the rigidity variable parts 55c and 55d in the first bent portion 203a from low rigidity to high rigidity through medium rigidity.
  • the control unit 121 determines that the stiffness of the stiffness variable portion 55d that passes through the first bent portion 303a. Maintain high rigidity.
  • control part 121 controls rigidity similarly to the 1st bending part 303a also about the 2nd bending part 303b.
  • the control unit 121 controls the radius of curvature of the insert portion 40 by controlling the rigidity of the rigidity variable portion 55. Will be expanded.
  • An input device (not shown) outputs a detection operation start instruction (detection start instruction and calculation start instruction) for starting the operation of the detection unit 60 to the detection unit 60, and issues a control start instruction for starting the operation of the control unit 121. Output to.
  • the input device may output the detection operation start instruction and the control start instruction simultaneously or individually.
  • the input device is a general input device, for example, a button switch or a dial.
  • One portion of the insertion portion 40 that has reached the inlets 305a and 305b of the first and second bent portions 303a and 303b and the front of the inlets 305a and 305b is referred to as an inlet reaching portion 251a and 251b (see FIGS. 2B and 2D).
  • the entrance reaching portions 251a and 251b may refer only to the portions reaching the entrances 305a and 305b.
  • One part of the insertion portion 40 that has not reached the front is referred to as an inlet non-reaching part 253a, 253b (see FIGS. 2A and 2D).
  • One portion of the insertion portion 40 that has reached the inside of the first and second bent portions 303a and 303b is referred to as a bent reaching portion 255a and 255b (see FIG. 2D).
  • One portion of the insertion portion 40 that has passed through the first and second bent portions 303a and 303b and that has passed through the first and second bent portions 303a and 303b is referred to as a passing portion 257a and 257b (see FIG. 2D).
  • the large intestine will be described as an example of the conduit portion 301.
  • the operator holds the insertion portion 40 and inserts the insertion portion 40 into the large intestine from the duct entrance 301a (anus).
  • the operator grasps an arbitrary position of the insertion portion 40 exposed to the outside from the large intestine, and pushes the insertion portion 40 from the grasped portion. Accordingly, the insertion portion 40 is pushed toward the first bent portion 303a in the sigmoid colon of the large intestine existing in front of the duct entrance 301a, and moves forward toward the first bent portion 303a.
  • the detection unit 60 detects the state information of the insertion unit 40 and outputs, for example, position information included in the state information to the control unit 121. In the following description, it is assumed that the detection unit 60 constantly detects the state information of the insertion unit 40 and further outputs it to the control unit 121.
  • the stiffness variable portions 55a, 55b, 55c, 55d, 55e, 55f, and 55g are arranged in the entrance non-reaching portion 253a.
  • the control unit 121 increases the rigidity of the rigidity variable parts 55a, 55b, 55c, 55d, 55e, 55f, and 55g until the rigidity variable parts 55a, 55b, 55c, 55d, 55e, 55f, and 55g reach the front of the inlet 305a. Control to high rigidity, which is the standard rigidity.
  • control unit 121 controls the stiffness of the stiffness variable portions 55a, 55b, 55c, 55d, 55e, 55f, and 55g at the entrance unreached portion 253a to a high stiffness that is a reference stiffness. Thereby, the bending rigidity of the insertion part 40 is maintained in a high state.
  • the insertion portion 40 is further inserted toward the deep portion.
  • the distal end portion of the flexible tube portion 45 reaches the inlet 305a and the front of the inlet 305a.
  • the stiffness variable portion 55a is disposed at the entrance reaching portion 251a.
  • the stiffness variable portions 55b, 55c, 55d, 55e, 55f, and 55g are disposed in the entrance unreached portion 253a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55a from the high stiffness that is the standard stiffness to the middle stiffness.
  • control unit 121 maintains the rigidity of the rigidity variable parts 55b, 55c, 55d, 55e, 55f, and 55g at a high rigidity. Therefore, the bending rigidity of the inlet reaching part 251a is lower than the bending rigidity of the inlet non-reaching part 253a. The bending rigidity of the entrance unreached portion 253a is maintained in a high state.
  • the entrance unreached portion 253a and the entrance reach portion 251a are hard substantially straight portions.
  • the force on the hand side of the operator who pushes in the insertion portion 40 is efficiently transmitted from the grasping portion to the distal end portion of the insertion portion 40. For this reason, even if external force is applied to the insertion part 40 from the pipe line part 301, a substantially linear site
  • the insertion part 40 is further inserted toward the deep part as shown in FIG. 2C.
  • the stiffness variable portion 55a is disposed at the bend reaching portion 255a.
  • the stiffness variable portion 55b is disposed at the entrance reaching portion 251a.
  • the stiffness variable portions 55c, 55d, 55e, 55f, and 55g are disposed in the entrance non-reaching portion 253a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55a that has reached the inside of the first bent portion 303a from medium stiffness to low stiffness.
  • the bending rigidity of the bent reaching part 255a is lower than the bending rigidity of the inlet reaching part 251a. Therefore, the radius of curvature of the bent reaching portion 255a can be substantially the same as the radius of curvature of the first bent portion 303a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55b from the high stiffness that is the standard stiffness to the middle stiffness. The control unit 121 maintains the rigidity of the rigidity variable parts 55c, 55d, 55e, 55f, and 55g at a high rigidity. Therefore, the bending rigidity of the inlet reaching part 251a is lower than the bending rigidity of the inlet non-reaching part 253a.
  • the bending rigidity of the entrance unreached portion 253a is maintained in a high state.
  • the entrance unreached portion 253a and the entrance reach portion 251a are hard substantially straight portions.
  • the bent reaching portion 255a can be bent along the shape of the first bent portion 303a due to low rigidity, and acts on the bent reaching portion 255a from the first bent portion 303a. It can be passively bent by external force. For this reason, even if pushing operation with respect to the insertion part 40 is implemented excessively, the 1st bending part 303a is suppressed overextension and a patient's pain is reduced. Moreover, the passability of the insertion part 40 improves. As in the state shown in FIG. 2A, when a pushing operation is performed, the hand side force is efficiently transmitted from the grasping portion to the distal end portion of the insertion portion 40.
  • the insertion part 40 is inserted toward the deep part, the rigidity variable part 55a is disposed at the passage part 257a, the rigidity variable part 55b is disposed at the bending arrival part 255a, and the rigidity variable part 55c is disposed at the inlet arrival part.
  • the rigidity variable portions 55d, 55e, 55f, and 55g are arranged at the entrance non-reaching portion 253a.
  • the rigidity of the rigidity variable portion 55a is controlled to be low
  • the rigidity of the rigidity variable portion 55b is controlled to be low.
  • the rigidity of the rigidity variable portion 55c is controlled to medium rigidity
  • the rigidity of the rigidity variable portions 55d, 55e, 55f, and 55g is controlled to high rigidity.
  • variable stiffness portions 55a and 55b are disposed in the passage portion 257a.
  • the stiffness variable portion 55c is disposed at the bending reaching portion 255a and the passing portion 257a.
  • the stiffness variable portion 55d is disposed at the entrance reaching portion 251a.
  • the stiffness variable portions 55e, 55f, and 55g are disposed in the entrance non-reaching portion 253a.
  • the control unit 121 maintains the rigidity of the rigidity variable parts 55a and 55b at a low rigidity.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55c from medium stiffness to low stiffness. As a result, the bending rigidity of the bent reaching part 255a is lower than the bending rigidity of the inlet reaching part 251a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55d from high stiffness to medium stiffness.
  • the control unit 121 maintains the rigidity of the rigidity variable parts 55e, 55f, and 55g at a high rigidity. Therefore, the bending rigidity of the inlet reaching part 251a is lower than the bending rigidity of the inlet non-reaching part 253a.
  • the bending rigidity of the entrance unreached portion 253a is maintained in a high state.
  • the entrance unreached portion 253a and the entrance reach portion 251a are hard substantially straight portions.
  • the pushing operation in the state shown in FIG. 2D is substantially the same as the pushing operation in the state shown in FIG.
  • the insertion portion 40 is inserted toward the deep portion.
  • the first bent portion 303a is continuous with the second bent portion 303b, or the distance between the first bent portion 303a and the second bent portion 303b is short. For this reason, the rigidity of the rigidity variable parts 55a and 55b is controlled to be low between the first bent part 303a and the second bent part 303b.
  • the rigidity variable part 55a is arrange
  • the rigidity variable part 55b is arrange
  • the rigidity of the rigidity variable part 55a is controlled to medium rigidity
  • the rigidity of the rigidity variable part 55b is controlled to high rigidity.
  • the insertion part 40 is inserted toward the deep part, the rigidity variable part 55a is disposed at the bending reaching part 255b, and the rigidity variable part 55b is disposed at the inlet reaching part 251b.
  • the stiffness of the stiffness varying portion 55a is controlled to a low stiffness
  • the stiffness of the stiffness varying portion 55b is controlled to a medium stiffness.
  • the insertion part 40 is further inserted toward the deep part as shown in FIG. 2E.
  • the stiffness variable portion 55a is disposed at the passage portion 257b.
  • the stiffness variable portion 55b is disposed at the bending reaching portion 255b and the passage portion 257b.
  • the stiffness variable portion 55c is disposed at the entrance reaching portion 251b.
  • the stiffness variable portion 55d is disposed at the bend reaching portion 255a and the passage portion 257a.
  • the stiffness variable portion 55e is disposed at the entrance reaching portion 251a.
  • the stiffness variable portions 55f and 55g are arranged at the entrance non-reaching portion 253a.
  • the control unit 121 maintains the rigidity of the rigidity variable parts 55a, 55b, and 55c at a low rigidity. Thereby, the bending rigidity of the passage part 257b, the bending reaching part 255b, and the inlet reaching part 251b maintains the lowered state.
  • the control unit 121 maintains the rigidity of the rigidity variable parts 55e, 55f, and 55g at a high rigidity.
  • the bending rigidity of the entrance unreached portion 253a is maintained in a high state.
  • the entrance reaching portion 251a and the entrance non-arrival portion 253a are hard substantially straight portions. As shown in FIG.
  • the control unit 121 determines that the rigidity of the stiffness varying unit 55d disposed in the first bent portion 303a from the inlet reaching portion 251a (the state shown in FIG. 2D) to the bent reaching portion 255a (the state shown in FIG. 2E) is medium. Maintain rigidity.
  • the stiffness variable portion 55d is disposed from the bent reaching portion 255a to the passing portion 257a.
  • the control part 121 controls the rigidity of the rigidity variable part 55d arrange
  • the control portion 121 controls the rigidity variable portion 55d arrange
  • the stiffness variable portions 55a and 55b are disposed at the passage portion 257b.
  • the stiffness variable portion 55c is disposed at the bending reaching portion 255b.
  • the stiffness variable portion 55d is disposed at the passage portion 257a.
  • the stiffness variable portion 55e is disposed at the first bent portion 203a (the bent reaching portion 255a and the passing portion 257a).
  • the control unit 121 maintains the rigidity of the rigidity variable parts 55a and 55b at a low rigidity in preparation for insertion into the next bent part (not shown).
  • the control unit 121 controls the stiffness of the stiffness varying unit 55c inserted into the second bent portion 303b from medium stiffness to low stiffness, and then controls the stiffness to medium stiffness as shown in FIG. 2F. As shown in FIG. 2F, the control unit 121 controls the stiffness of the stiffness varying unit 55d to be high stiffness. The control unit 121 maintains the rigidity of the rigidity variable parts 55e, 55f, and 55g at a high rigidity.
  • the bending rigidity of the bending reaching portion 255b shown in FIG. 2F is higher than the bending rigidity of the bending reaching portion 255b shown in FIG. 2E.
  • the radius of curvature of the second bent portion 203b further expands, and the second bent portion 203b approaches a substantially straight portion.
  • the radius of curvature of the second bent portion 303b also increases, and the second bent portion 303b approaches a substantially straight portion.
  • the bending rigidity of the bending reaching part 255a shown in FIG. 2F is higher than the bending rigidity of the bending reaching part 255a shown in FIG. 2E, and the passing part 257a shown in FIG. Is higher than the bending rigidity of the passing portion 257a shown in FIG. 2E.
  • the curvature radius of the 1st bending part 303a further expands, and the 1st bending part 303a approaches a substantially linear part.
  • the radius of curvature of the first bent portion 303a also increases, and the first bent portion 303a approaches a substantially straight portion.
  • the control unit 121 controls the rigidity of the rigidity variable parts 55c, 55d, 55e, 55f, and 55g to be high rigidity.
  • the bending rigidity of the insertion portion 40 is higher than the bending rigidity of the insertion portion 40 shown in FIG. 2F.
  • the radius of curvature of the insertion portion 40 further increases, the first and second bent portions 203a and 203b change to the first and second substantially linear portions 207a and 207b, and the insertion portion 40 changes to a substantially linear state.
  • the radii of curvature of the first and second bent portions 303a and 303b are also enlarged, and the first and second bent portions 303a and 303b are changed to substantially straight portions.
  • the insertion portion 40 is hard and is in a substantially straight state, and the large intestine is also in a substantially straight state. Therefore, the hand side force is efficiently transmitted from the grasping portion to the distal end portion of the insertion portion 40. For this reason, a substantially straight site
  • part is not bent and the insertion property of the insertion part 40 to a deep part improves. In addition, the occurrence of buckling is suppressed by efficient transmission of force and a hard substantially straight portion.
  • the rigidity of the rigidity variable portion 55 does not increase, and the first bending portion 203a tries to pass through the first bending portion 303a while being bent. In this case, the proximal force is hardly transmitted to the distal end portion of the insertion portion 40 by the first bent portion 203a, and buckling may occur in the insertion portion 40. Even if the insertion portion 40 passes through the first bent portion 303a, buckling may occur if the bending rigidity of the insertion portion 40 is low.
  • the portion of the insertion portion 40 including the first and second bent portions 203a and 203b is surely changed to the substantially straight portions 207a and 207b, and the large intestine portion including the first bent portion 303a is the substantially straight portion.
  • 207a and 207b it changes to a substantially linear part reliably.
  • the bending rigidity of the substantially linear portions 207 a and 207 b is hard due to the rigidity change of the rigidity variable portion 55. For this reason, the bending of the substantially straight portions 207a and 207b is prevented, the force on the hand side is efficiently transmitted from the grip portion to the distal end portion of the insertion portion 40, and the insertion portion 40 is easily inserted toward the deep portion. The insertability of the portion 40 is improved. Further, since the force on the hand side is efficiently transmitted from the gripping portion to the distal end portion of the insertion portion 40, occurrence of buckling is prevented, and the insertability of the insertion portion 40 into the deep portion is improved.
  • the insertion part 40 may easily move in the abdominal cavity due to the forward movement. For example, when the distal end portion of the insertion portion 40 is pushed in while passing through the first bent portion 303a of the large intestine, the large intestine may move due to the pushing. Then, the force on the operator's hand side that pushes in the insertion portion 40 becomes difficult to be transmitted to the distal end portion of the insertion portion 40, and the insertion portion 40 may be buckled.
  • the force on the hand side is less likely to be transmitted to the distal end portion of the insertion portion 40 due to buckling, and the distal end portion may not be easily inserted (moved forward) toward the deep portion.
  • the insertion part 40 will be in a stack state in which the propulsive force is lost, in other words, the insertability may be reduced.
  • In order to insert the insertion portion 40 easily there is a substantially straight line technique for changing the large intestine to a substantially straight state by operating the insertion portion 40. Long training is required to acquire this straight line technique.
  • the rigidity of the stiffness variable portion 55c is determined. Is controlled to a low rigidity, and the rigidity of the rigidity variable portion 55d is controlled to a high rigidity after maintaining the medium rigidity. That is, the bending rigidity of the first bent portion 203a gradually increases from low rigidity to high rigidity through medium rigidity.
  • the portion of the insertion portion 40 including the first bent portion 203a changes from a curved state to a substantially linear state, and along with this change, the portion of the duct portion 301 including the first bent portion 303a also changes to a substantially straight portion.
  • the insertion portion 40 in the substantially straight state can be easily inserted toward the deep portion of the pipe portion 301 in the substantially straight state by pushing the insertion portion 40 in the substantially straight state.
  • the insertion property of 40 can be improved.
  • the insertion portion 40 is hard and is in a substantially straight state, and the conduit portion 301 is also in a substantially straight state. Therefore, the hand side force for pushing the insertion portion 40 is easily transmitted to the distal end portion of the insertion portion 40. For this reason, buckling of the insertion part 40 can be prevented and the insertion property of the insertion part 40 to the deep part in the pipe line part 301 can be improved.
  • the operator can make adjustment of the bending rigidity of the insertion portion 40 unnecessary, and can concentrate on the pushing operation of the insertion portion 40. Therefore, in this embodiment, when inserting the insertion part 40 in the deep part in the pipe line part 301, operativity can be improved. In this embodiment, since the overtube is not used, it is possible to prevent the outer diameter of the insertion portion 40 from increasing, and to reduce patient pain and burden on the patient.
  • the rigidity of the rigidity variable portion 55 arranged at the inlet reaching portion 251a is controlled to a medium rigidity
  • the rigidity of the rigidity variable portion 55 arranged at the inlet non-reaching portion 253a is controlled to a high rigidity.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55 to the high stiffness that is the reference stiffness until the stiffness varying unit 55 reaches the near side. Further, the control unit 121 controls the stiffness of the stiffness varying unit 55 that reaches the entrance 305a and the near side from the high stiffness that is the standard stiffness to the middle stiffness.
  • the operator can efficiently transmit the hand side force from the grasping portion to the distal end portion of the insertion portion 40 until the insertion portion 40 reaches the first bent portion 303a. For this reason, generation
  • the stiffness of the stiffness varying portion 55 arranged at the bend reaching portion 255a is controlled from medium stiffness to low stiffness. Therefore, the bent reaching portion 255a can be bent along the shape of the first bent portion 303a due to low rigidity, and can be passively bent by an external force acting on the bent reaching portion 255a from the first bent portion 303a. . For example, even if the pushing operation with respect to the insertion part 40 is performed excessively, the excessive extension of the 1st bending part 303a can be suppressed and a patient's pain can be reduced. Moreover, the passability of the insertion part 40 can be improved.
  • the stiffness of the stiffness variable portion 55c is low.
  • the rigidity of the rigidity variable portion 55d is controlled to a medium rigidity and then to a high rigidity. That is, the bending rigidity of the first bent portion 203a gradually increases from low rigidity to high rigidity through medium rigidity. For this reason, the 1st bending part 203a changes to a substantially straight part, and the 1st bending part 303a changes to a substantially straight part.
  • part 203a and the 1st bending part 303a is also expanded. Therefore, the insertion property of the insertion part 40 in the deep part can be improved.
  • control unit 121 controls the rigidity of the rigidity variable unit 55 to be high rigidity, and the bending reaching portion 255a is changed to a substantially linear portion, the control unit 121 Maintain high rigidity. For this reason, a substantially linear site
  • control unit 121 includes the variable stiffness portion 55 corresponding to the segments disposed at the inlet reaching portions 251a and 251b, the inlet non-reaching portions 253a and 253b, the bent reaching portions 255a and 255b, and the passage portions 257a and 257b. To control the stiffness. For this reason, the bending rigidity of the insertion portion 40 can be precisely controlled.
  • FIG. 3A corresponds to FIG. 2B.
  • the stiffness variable portion 55 is disposed at the entrance reaching portion 251a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55 from the high stiffness, which is the standard stiffness, to the middle stiffness.
  • the insertion portion 40 is provided for passage through the first bent portion 303a having a small radius of curvature R1.
  • FIG. 3B corresponds to FIG. 2C.
  • the stiffness variable portion 55 is disposed at the bending reaching portion 255a.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55 that has reached the inside of the first bent portion 303a from medium stiffness to low stiffness.
  • the bending rigidity of the bent reaching portion 255a is lower than the bending rigidity of the inlet reaching portion 251a.
  • the radius of curvature R2 of the bent reaching portion 255a can be substantially the same as the radius of curvature R1 of the first bent portion 303a.
  • the bent reaching portion 255a can be bent along the shape of the first bent portion 303a due to low rigidity, and can be passively bent by an external force acting on the bent reaching portion 255a from the first bent portion 303a. Even if the pushing operation with respect to the insertion part 40 is performed excessively, the first bending part 303a is restrained from overextension and the patient's pain is reduced. Moreover, the passability of the insertion part 40 improves. Generation
  • FIG. 3C corresponds to FIG. 2E.
  • the stiffness variable portion 55 is disposed at the first bent portion 203a (the bent reaching portion 255a and the passing portion 257a).
  • the control unit 121 controls the rigidity of the rigidity variable unit 55 from low rigidity to medium rigidity. Accordingly, the radius of curvature of the first bent portion 203a is larger than the radius of curvature R2 of the bent reaching portion 255a. And the curvature radius R3 of the 1st bending part 303a becomes larger than the curvature radius R1.
  • FIG. 3D corresponds to FIG. 2G.
  • the control unit 121 controls the stiffness of the stiffness varying unit 55 arranged at the passage site 257a from medium stiffness to high stiffness.
  • the bending rigidity of the passage part 257a is higher than the bending rigidity of the passage part 257a shown in FIG.
  • the radius of curvature of the passage portion 257a is larger than the curvature radius of the passage portion 257a shown in FIG. 3C, and the passage portion 257a changes to a substantially linear portion.
  • the radius of curvature R4 of the first bent portion 303a becomes larger than the radius of curvature R3, and the first bent portion 303a changes to a substantially linear portion. Thereafter, the same control is performed on the second bent portion 303b.
  • the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Moreover, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment.

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Abstract

L'invention concerne un appareil d'insertion de tube flexible (10) présentant : une partie d'insertion (40) ; au moins une partie à rigidité variable (55) présente sur la partie d'insertion (40), dotée d'une rigidité variable, et permettant à la rigidité à la flexion de la partie d'insertion (40) de varier en fonction de la rigidité de la partie à rigidité variable (55) ; et une unité de détection (60). L'appareil d'insertion de tube flexible (10) est équipé d'une unité de commande (121) qui réalise une commande de manière à augmenter progressivement la rigidité de la partie à rigidité variable (55) en passant par des sections courbées (303a, 303b), de sorte que les sections courbées (303a, 303b) deviennent sensiblement linéaires à mesure que la partie d'insertion (40) est insérée à travers ces dernières.
PCT/JP2015/086393 2015-12-25 2015-12-25 Appareil d'insertion de tube flexible Ceased WO2017109987A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2015/086393 WO2017109987A1 (fr) 2015-12-25 2015-12-25 Appareil d'insertion de tube flexible

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2015/086393 WO2017109987A1 (fr) 2015-12-25 2015-12-25 Appareil d'insertion de tube flexible

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WO2017109987A1 true WO2017109987A1 (fr) 2017-06-29

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PCT/JP2015/086393 Ceased WO2017109987A1 (fr) 2015-12-25 2015-12-25 Appareil d'insertion de tube flexible

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WO (1) WO2017109987A1 (fr)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06181882A (ja) * 1992-12-17 1994-07-05 Toshiba Corp 内視鏡装置用スコープ
JPH10295629A (ja) * 1997-05-01 1998-11-10 Koji Ikuta 剛性可変型索状体
JP2005304780A (ja) * 2004-04-21 2005-11-04 Olympus Corp 医療用ベッド
JP2007054125A (ja) * 2005-08-22 2007-03-08 Olympus Medical Systems Corp 内視鏡

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH06181882A (ja) * 1992-12-17 1994-07-05 Toshiba Corp 内視鏡装置用スコープ
JPH10295629A (ja) * 1997-05-01 1998-11-10 Koji Ikuta 剛性可変型索状体
JP2005304780A (ja) * 2004-04-21 2005-11-04 Olympus Corp 医療用ベッド
JP2007054125A (ja) * 2005-08-22 2007-03-08 Olympus Medical Systems Corp 内視鏡

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