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WO2019087254A1 - Systѐme d'endoscope - Google Patents

Systѐme d'endoscope Download PDF

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Publication number
WO2019087254A1
WO2019087254A1 PCT/JP2017/039143 JP2017039143W WO2019087254A1 WO 2019087254 A1 WO2019087254 A1 WO 2019087254A1 JP 2017039143 W JP2017039143 W JP 2017039143W WO 2019087254 A1 WO2019087254 A1 WO 2019087254A1
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
sheath
distal end
balloon
insertion portion
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/JP2017/039143
Other languages
English (en)
Japanese (ja)
Inventor
和敏 熊谷
尚也 杉本
善朗 岡崎
俊二 武井
祐介 野村
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2017/039143 priority Critical patent/WO2019087254A1/fr
Publication of WO2019087254A1 publication Critical patent/WO2019087254A1/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
    • A61B1/005—Flexible endoscopes
    • A61B1/01—Guiding arrangements therefore
    • 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
    • A61B1/012—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 characterised by internal passages or accessories therefor
    • A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments

Definitions

  • the present invention relates to an endoscope system, and more particularly to an endoscope system for a pericardium.
  • the present invention has been made in view of the above-described circumstances, and holds the tip of the endoscope at a position away from the heart in the pericardial cavity, and secures a space around the tip of the endoscope. It is an object of the present invention to provide an endoscope system that can
  • One aspect of the present invention is an endoscope, an elongated medical device disposed in parallel with the endoscope and inserted into a body cavity with the endoscope, a distal end portion of the endoscope, and the medical device And an expansion member, which is expandable between the endoscope and the medical instrument in a parallel direction.
  • the dilation member expanding between the endoscope and the medical instrument juxtaposed to each other maintains a space in the parallel direction between the distal end portion of the endoscope and the medical instrument. Therefore, the distal end portion of the endoscope is pushed away from the heart while pushing up the pericardium by expanding the expandable member in a state where the distal end portion of the endoscope is arranged on the pericardial side and the expandable member is arranged on the cardiac side It is lifted and held away from the heart. Thereby, a space can be reliably secured around the tip of the endoscope.
  • the medical device is a tubular sheath into which the endoscope can be inserted in the longitudinal direction, and the expansion member is inserted into the inner surface of the sheath and the sheath. It may be disposed between the outer surface, and at least a distal end of the sheath may be configured to allow the parallel movement of the distal end of the endoscope by the expanding member.
  • the expansion member in the sheath is expanded in a state where it is disposed between the distal end of the endoscope and the heart, thereby moving the endoscope in the direction away from the heart in the sheath, and the distal end of the endoscope Can be lifted away from the heart.
  • the expansion member is fixed to the outer surface of the distal end portion of the endoscope, the distal end of the endoscope protrudes longitudinally from the distal end of the sheath, and the expansion member is inserted into the sheath
  • a positioning portion may be provided to position the sheath and the endoscope in the longitudinal direction.
  • the sheath may have an inner diameter that allows the distal end portion of the endoscope and the expansion member in a contracted state to move radially.
  • the distal end of the sheath may be radially expandable by the expanding member.
  • the medical instrument is a treatment instrument disposed outside the endoscope, and the expansion member is disposed between the outer surface of the treatment instrument and the outer surface of the distal end portion of the endoscope. It may be done. With the treatment tool on the heart side and the endoscope on the pericardial side, the dilation member is expanded to keep the tip of the endoscope away from the heart while being placed near the heart The treatment tool can treat the heart.
  • the treatment tool may have a flexible portion that can be bent in a direction intersecting in the longitudinal direction by the expanding member at the tip.
  • the dilation member is expanded in a state where it is disposed between the distal end of the endoscope and the soft part of the treatment tool, thereby curving the soft part toward the heart side and placing the tip of the treatment tool closer to the heart can do.
  • the expansion member may be a balloon. In this way, expansion and contraction of the balloon can be controlled by a simple operation of adjusting the amount of fluid in the balloon.
  • the expandable member can be deformed from an contracted shape extending in a direction along the longitudinal direction of the endoscope to an expanded shape having a larger dimension in the parallel direction than the contracted shape by an elastic restoring force It may be By doing so, the expansion member can be self-expanded by the elastic recovery force.
  • the endoscope includes a bending portion which can be bent downward corresponding to the downward direction of the endoscopic image acquired by the endoscope, and the expansion member is closer to the bending portion than the bending portion.
  • the proximal end side may be disposed below the endoscope.
  • the bending portion may be bendable in the upward direction opposite to the downward direction, and the expansion member may be disposed on the upper side of the endoscope.
  • the upper expansion member With the heart placed on the lower side of the endoscope, the upper expansion member is expanded to hold the tip of the endoscope away from the pericardium and subsequently bend the bending portion upward.
  • the tip of the endoscope is directed to the pericardium side and the pericardium is looked up.
  • the present invention it is possible to hold the tip of the endoscope at a position away from the heart in the pericardial cavity, and to secure the space around the tip of the endoscope.
  • FIG. 1A is a figure which shows the state which expanded the balloon. It is a side view which shows the structure of the sheath in the other modification of the endoscope system of FIG. 1A. It is a side view which shows the whole structure of the endoscope system which concerns on the 2nd Embodiment of this invention. It is a side view which shows the state which expanded the balloon of the endoscope system of FIG. 6A. It is a schematic front view which looked at the endoscope system of FIG. 6A in the longitudinal direction from the front end side. It is a side view which shows the whole structure of the modification of the endoscope system of FIG. 6A. It is a schematic front view which looked at the other modification of the endoscope system of FIG.
  • an endoscope system 100 includes a circular tubular elongated sheath (medical device) 1 inserted into a pericardial space, and a sheath within the sheath 1. 1, an elongated endoscope 2 disposed in parallel with 1, a balloon (expansion member) 3 disposed between the inner surface of the sheath 1 and the outer surface of the endoscope 2, and the sheath 1 and the endoscope 2 And a positioning portion 4 for mutually positioning in the longitudinal direction.
  • a circular tubular elongated sheath (medical device) 1 inserted into a pericardial space
  • a sheath within the sheath 1.
  • an elongated endoscope 2 disposed in parallel with 1
  • a balloon (expansion member) 3 disposed between the inner surface of the sheath 1 and the outer surface of the endoscope 2
  • a positioning portion 4 for mutually positioning in the longitudinal direction.
  • the sheath 1 has a lumen 5 which is open at the distal end surface and the proximal end surface and penetrates in the longitudinal direction.
  • the sheath 1 can maintain its shape against the radially outward force received from the balloon 3 expanded in the lumen 5 while having flexibility capable of being curved along the shape of tissue in the body It has rigidity.
  • the endoscope 2 is a direct-view type that acquires an endoscopic image of the field of view in front of the distal end surface.
  • the endoscope 2 includes a long insertion portion 6 to be inserted into the body, and an operation portion 7 connected to the proximal end of the insertion portion 6.
  • the insertion portion 6 has flexibility that can be curved along the shape of tissue in the body.
  • the distal end portion of the insertion portion 6 is provided with an optical member (specifically, an illumination lens and an objective lens) for observing the heart A, and a curved portion 8 positioned on the proximal side of the optical member There is.
  • the insertion portion 6 has a vertical direction corresponding to the vertical direction of the endoscopic image, which is a direction perpendicular to the longitudinal direction.
  • the bending portion 8 can be bent at least downward by the operation of a handle (not shown) provided on the operation portion 7.
  • the insertion portion 6 is longer than the sheath 1 and has a length such that the entire curved portion 8 can be protruded from the distal end of the sheath 1.
  • the balloon 3 is fixed to the outer surface of the distal end portion of the insertion portion 6 at a position proximal to the bending portion 8.
  • the insertion portion 6 has a connection port 6a to which an air supply device such as an air tube or a syringe connected to a pump can be connected, and an air lumen (not shown) communicating the inside of the balloon 3 with the connection port 6a. It is provided.
  • the connection port 6 a is provided at the proximal end of the insertion portion 6 which is disposed on the proximal side of the sheath 1.
  • the operator can expand the balloon 3 by supplying air into the balloon 3 through the air lumen by the air supply device, and exhaust air from inside the balloon 3 through the air lumen by the air supply device. And the balloon 3 can be deflated.
  • the balloon 3 is provided only on the lower side of the insertion portion 6 and expands and contracts at least in the vertical direction of the insertion portion 6 by the supply and discharge of air.
  • the lumen 5 is a total of the insertion portion 6 in the vertical direction and the balloon 3 in a contracted state so that a space is formed between the outer surface of the insertion portion 6 and the inner surface of the lumen 5 in a contracted state. It has an inner diameter larger than its dimensions. Therefore, the insertion portion 6 is movable in the longitudinal direction in the lumen 5 in the deflated state of the balloon 3, and the vertical movement of the insertion portion 6 and the deflated balloon 3 in the lumen 5 is permitted. It has become.
  • the expansion of the balloon 3 causes the insertion portion 6 to abut on the inner surface of the lumen 5 in the sheath 1. It is lifted upward and held at the top in the lumen 5. In this state, the insertion portion 6 is pressed against the inner surface of the lumen 5 by the balloon 3 so as to be fixed in the lumen 5 in the longitudinal and radial directions.
  • the positioning portion 4 has a longitudinal position of the insertion portion 6 in the lumen 5 such that the entire curved portion 8 protrudes outward from the tip of the sheath 1 and at least a portion of the balloon 3 is disposed in the sheath 1 regulate.
  • the positioning portion 4 shown in FIG. 1A is a flange-like stopper that is provided at the proximal end of the insertion portion 6 and protrudes radially outward from the side surface of the insertion portion 6.
  • the stopper has a diameter larger than the diameter of the opening of the lumen 5 at the proximal end surface of the sheath 1, and the stopper abuts on the proximal end surface of the sheath 1 so that the sheath 1 and the insertion portion 6 can be positioned relative to each other. There is.
  • FIG. 2 shows another example of the positioning unit 4.
  • the positioning portion 4 shown in FIG. 2 is a scale provided on the side surface of the proximal end of the insertion portion 6 and indicating the amount of insertion of the insertion portion 6 into the lumen 5.
  • the operator inserts into the lumen 5 based on the scale so that the entire curved portion 8 protrudes outward from the distal end of the sheath 1 and at least a part of the balloon 3 is disposed in the sheath 1 Control the insertion amount of 6.
  • the sheath 1 is inserted from under the xiphoid process to the pericardial cavity.
  • the sheath 1 disposed in the body is restricted by the adjacent skin, pericardium B, mediastinal tissue, etc., thereby restricting longitudinal movement and rotation around the longitudinal axis.
  • the insertion portion 6 is inserted into the pericardial cavity via the lumen 5.
  • the posture around the longitudinal axis of the insertion portion 6 in the lumen 5 is adjusted so that the balloon 3 is disposed on the heart A side.
  • the positioning portion 4 positions the sheath 1 and the insertion portion 6 with each other such that the entire curved portion 8 protrudes outward from the distal end of the sheath 1 and at least a portion of the balloon 3 is disposed in the sheath 1 .
  • the balloon 3 is expanded by supplying air into the balloon 3 using an air supply device connected to the connection port 6a.
  • the expanded balloon 3 moves the insertion portion 6 to the pericardium B side in the lumen 5.
  • the distal end portion of the insertion portion 6 located outside the sheath 1 is lifted in a direction away from the heart A while pushing up the pericardium B, and held at a position away from the heart A. Therefore, a space S is secured between the distal end of the insertion portion 6 and the heart A in front of the distal end of the sheath 1.
  • the heart A can be observed by curving the bending portion 8 downward so that the distal end surface of the insertion portion 6 faces the heart A.
  • the pressing force toward the heart A is achieved by the balloon 3 expanding in the parallel direction of the sheath 1 and the insertion portion 6 between the inner surface of the sheath 1 and the outer surface of the distal end of the insertion portion 6 Even in a situation where the force acts from the pericardium B to the tip of the insertion portion 6, the tip of the insertion portion 6 can be held at a position away from the heart A against the force from the pericardium B.
  • This has the advantage that the space S necessary for observation of the heart A can be reliably secured between the tip of the insertion portion 6 and the heart A.
  • the insertion portion 6 is pressed against the inner surface of the lumen 5, thereby restricting the longitudinal movement and rotation around the longitudinal axis of the insertion portion 6 in the lumen 5. Position and posture of the tip of the Therefore, there is an advantage that observation of the heart A can be performed stably.
  • the operator can easily control the distance between the tip of the insertion portion 6 and the heart A. There is.
  • the balloon 3 is fixed to the insertion portion 6, but instead, the balloon 3 may be fixed to the inner surface of the distal end portion of the lumen 5, and the insertion portion 6 and It may be separate from the sheath 1. Even in this case, the distal end portion of the insertion portion 6 can be lifted upward in the lumen 5 by expanding the balloon 3 in a state where the balloon 3 is disposed below the distal end portion of the insertion portion 6.
  • the sheath 1 is not deformed by the expansion of the balloon 3. Instead, as shown in FIGS. 3A and 3B, the distal end of the sheath 1 is expanded from the expanded balloon 3. It may be configured to expand radially by an applied radial outward force.
  • slits 9 extending in the longitudinal direction from the distal end are formed at two places spaced in the circumferential direction, and the distal end of the sheath 1 is circumferentially divided by the slits 9 It is divided into portions 1a and 1b. When the width of the slit 9 is expanded, the distal end of the sheath 1 is expanded in the radial direction.
  • the insertion portion 6 By expanding the balloon 3 in a state in which the slits 9 are disposed on the left and right sides of the insertion portion 6, the insertion portion 6 can be lifted upward while expanding the distal end portion of the sheath 1 in the vertical direction of the insertion portion 6. .
  • the insertion portion 6 can be lifted to a position further away from the heart A as compared with the case where the sheath 1 whose diameter of the distal end portion is fixed is used. Further, since the pericardium B is pushed up to a position further away from the heart A by the portion 1a positioned above the insertion portion 6, a wider space S can be secured.
  • the balloon 3 is provided both on the lower side and on the upper side of the insertion part 6.
  • the upper balloon 3 and the lower balloon 3 may be integral so as to simultaneously expand and contract, or separate so as to expand and contract independently of each other.
  • the relative rigidity of the two portions 1a and 1b and the position of the slit 9 are designed such that one of the two portions 1a and 1b divided by the slits 9 is preferentially deformed by the expanded balloon 3. May be
  • the bending portion 8 is preferably bendable in the upward direction. By doing in this way, looking up at the pericardium B by curving the bending portion 8 upward in a state where the distal end portion of the insertion portion 6 is held at a position separated from the pericardium B by the expanded upper balloon 3 As can be observed.
  • the balloon 3 When using the sheath 1 having the slit 9, the balloon 3 may be provided only on the lower side of the insertion portion 6 as shown in FIG. 4. Thus, when the balloon 3 is provided only on the lower side of the insertion portion 6, the insertion portion 6 is compared with the case where the balloon 3 is provided on both the lower side and the upper side. Can be lifted further away from the
  • the distal end portion of the sheath 1 may be configured to be expanded in the radial direction by the expansion of the balloon 3 by being formed of an elastic material that can expand and contract in the circumferential direction.
  • the insertion portion 6 and the balloon 3 in the contracted state do not necessarily have to be movable in the vertical direction in the lumen 5. It is sufficient that the insertion portion 6 and the balloon 3 in the contracted state have a minimum inner diameter that can move in the longitudinal direction.
  • one of the two portions 1a and 1b divided by the slit 9 may be shorter than the other.
  • An endoscope system 200 according to a second embodiment of the present invention will be described with reference to the drawings.
  • An endoscope system 200 according to the present embodiment includes a treatment tool 12 disposed outside the endoscope 2 as shown in FIGS. 6A and 6B, and the balloon 3 includes an insertion portion 6 and the treatment tool 12.
  • the balloon 3 includes an insertion portion 6 and the treatment tool 12.
  • the endoscope system 200 includes a sheath 1, an endoscope 2, a long treatment tool 12 disposed in parallel with the endoscope 2 in the sheath 1, and a balloon 3.
  • the treatment instrument 12 includes an elongated trunk 13 inserted into the body, and an end effector 14 connected to the tip of the trunk 13 for treating the heart A.
  • the body portion 13 has flexibility higher than that of the insertion portion 6 while having flexibility capable of being bent along the shape of tissue in the body.
  • the end effector 14 is, for example, a forceps or a ligation tool.
  • the total dimension of the vertical outer diameter of the insertion portion 6 and the balloon 3 in the contracted state and the outer diameter of the trunk portion 13 is smaller than the inner diameter of the lumen 5 of the sheath 1. That is, the insertion portion 6, the balloon 3 in the contracted state and the trunk portion 13 can be simultaneously disposed in the lumen 5, and in the contracted state of the balloon 3, the insertion portion 6 and the trunk portion 13 move longitudinally in the lumen 5 can do.
  • the balloon 3 disposed between the insertion portion 6 and the trunk portion 13 expands in the vertical direction
  • vertical force is applied to the insertion portion 6 and the body portion 13 in a direction away from each other.
  • the force from the balloon 3 lifts the insertion portion 6 upward to a position abutted against the inner surface of the lumen 5, and the body 13 is pushed downward to a position abutted against the inner surface of the lumen 5.
  • the insertion portion 6 having a rigidity lower than that of the body portion 13 is preferentially bent upward.
  • the sheath 1 is inserted from under the xiphoid process into the pericardial space.
  • the lumens are arranged such that the insertion portion 6 is disposed on the pericardium B side and the trunk portion 13 on the heart A side, and the balloon 3 is disposed between the insertion portion 6 and the trunk portion 13.
  • the insertion portion 6 and the body portion 13 are inserted into the pericardial cavity via the 5, and the bending portion 8, the balloon 3 and the end effector 14 are protruded outward from the distal end of the sheath 1.
  • the balloon 3 is expanded by supplying air into the balloon 3 using an air supply device connected to the connection port 6a.
  • the distal end of the insertion portion 6 is lifted to the side of the pericardium B by the expanded balloon 3 and held at a position away from the heart A, and the distal end of the trunk 13 is pushed downward to the heart A and located near the heart A Will be held by
  • the portion of the insertion portion 6 between the bending portion 8 and the tip of the sheath 1 is bent upward, and the tips of the bending portion 8 and the insertion portion 6 are further separated from the heart A.
  • a space S is secured between the distal end of the insertion portion 6 and the heart A in front of the distal end of the sheath 1.
  • the heart A can be observed by curving the bending portion 8 downward so that the distal end surface of the insertion portion 6 faces the heart A.
  • the balloon 3 expanded by air is elastically deformable, even when the body 13 is pressed toward the heart A by the expanded balloon 3, the longitudinal advancing and retracting of the body 13 and the rotation around the longitudinal axis are It is possible.
  • the operator advances and retracts and rotates the treatment tool 12 and treats the heart A with the end effector 14 as needed.
  • the pressing force from the pericardium B toward the heart A is expanded by the balloon 3 expanded in the parallel direction of the insertion portion 6 and the trunk portion 13 between the insertion portion 6 and the trunk portion 13.
  • the tip of the insertion portion 6 can be held at a position away from the heart A against the force from the pericardium B.
  • the tip of the insertion portion 6 is lifted to a position further away from the heart A as compared with the first embodiment in which the balloon 3 is expanded inside the sheath 1.
  • a larger space S can be secured.
  • the operator can easily control the distance between the tip of the insertion portion 6 and the heart A. There is.
  • the balloon 3 may have a flat shape in which the dimension in the left-right direction is larger than the dimension in the vertical direction in the contracted state.
  • FIG. 7 simply shows the arrangement of the sheath 1, the insertion portion 6, the body portion 13 and the balloon 3.
  • the relative position of the insertion portion 6 and the trunk portion 13 may be shifted in the left-right direction.
  • the trunk portion 13 has higher rigidity than the insertion portion 6 so that the trunk portion 13 is not bent by the expanded balloon 3, but instead, as shown in FIG.
  • the flexible portion 15 may be provided at the distal end portion of the body portion 13 so that both the body portion 13 and the insertion portion 6 are curved by the expanded balloon 3.
  • the flexible portion 15 is lower than the rigidity of the other portion of the body portion 13 and has substantially the same rigidity as the rigidity of the insertion portion 6.
  • the body portion 13 is formed of a coil sheath formed by spirally winding a metal thin wire
  • a coil sheath having different rigidity in the flexible portion 15 and other portions is used.
  • the distal end of the insertion portion 6 is positioned away from the heart A and the end effector 14 is positioned closer to the heart A as the insertion portion 6 is bent upward and the soft portion 15 is curved downward by the expanded balloon 3. , Each held. Thereby, the heart A can be easily treated by the end effector 14 disposed in the vicinity of the heart A.
  • FIG. 9 simply shows the arrangement of the sheath 1, the balloon 3 and the treatment instruments 12A and 12B.
  • the insertion portion 6 and the two trunks 13 are disposed in the lumen 5 so that the trunks 13 of the two treatment instruments 12A and 12B are aligned in the left-right direction on the lower side of the insertion portion 6.
  • the balloon 3 is disposed between the insertion portion 6 and the two trunks 13 so as to press the two trunks 13 downward simultaneously. Therefore, as in the case of the balloon 3 shown in FIG. 7, the balloon 3 is preferably wide in the left-right direction. As described above, the insertion portion 6 can be lifted more stably upward by pressing the two trunks 13 aligned in the left and right direction with the expanded balloon 3.
  • the expanding member is the balloon 3, but the expanding member may be a member other than the balloon 3. 10 and 11 show another example of the expanding member 3.
  • the expanding members 31 and 32 in FIGS. 10 and 11 are constituted by the tip of the wire longitudinally movably disposed in the wire lumen (not shown) formed longitudinally in the insertion portion 6 There is.
  • the wire is made of a shape memory material such as nickel titanium and has flexibility.
  • the wire lumen opens on the side surface of the distal end of the insertion portion 6 on the proximal side of the curved portion 8, and the distal end portions 31 and 32 of the wire are disposed outside the insertion portion 6 via the opening 6 b.
  • the distal end portions 31 and 32 of the wires have an expanded shape that spreads in a U-shape or a loop in a plane in the vertical direction of the insertion portion 6 below the insertion portion 6.
  • the proximal end of the wire is drawn outward from the proximal end of the insertion portion 6.
  • the distal end portions 31 and 32 of the wire are accommodated in the wire lumen while being elastically deformed into a contracted shape extending linearly along the longitudinal direction of the insertion portion 6 It has become.
  • the distal end portions 31 and 32 of the wire are configured to protrude downward to the outside of the insertion portion 6 while being deformed into the expanded shape by elastic restoring force. .
  • the use of the wire self-expanding in the expanded shape as the expanding members 31 and 32 allows the expansion of the expanding members 31 and 32 and the expansion and contraction of the expansion members 31 and 32 as compared with the case of using the balloon 3
  • the contraction can be performed more simply.
  • the endoscope 2 is a direct view type, but may be a perspective view type or a side view type instead. In the case of the perspective view type or side view type endoscope 2, the bending portion 8 may not be provided.
  • endoscope system 100, 200 endoscope system 1 sheath (medical device) 2 Endoscope 3 Balloon (expansion member) 31, 32 wire (expansion member) Reference Signs List 4 positioning unit 5 lumen 6 insertion unit 6a connection port 7 operation unit 8 bending unit 9 slit 12, 12A, 12B treatment tool (medical device) 13 body part 14 end effector 15 soft part A heart B pericardium S space

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Abstract

La présente invention concerne un système d'endoscope (100) qui comprend : un endoscope (2) ; un dispositif médical allongé (1) qui est agencé parallèlement à l'endoscope (2) et inséré dans une cavité corporelle conjointement avec l'endoscope (2) ; et un élément de dilatation (3) qui est disposé entre une partie d'extrémité distale de l'endoscope (2) et le dispositif médical (1) et est apte à se dilater dans la direction dans laquelle l'endoscope (2) et le dispositif médical (1) sont agencés parallèlement.
PCT/JP2017/039143 2017-10-30 2017-10-30 Systѐme d'endoscope Ceased WO2019087254A1 (fr)

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WO2019087254A1 true WO2019087254A1 (fr) 2019-05-09

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Cited By (1)

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US12279809B2 (en) 2019-11-18 2025-04-22 Circa Scientific, Inc. System with instrument port for epicardial ablation

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