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WO2023277141A1 - Laryngoscope - Google Patents

Laryngoscope Download PDF

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Publication number
WO2023277141A1
WO2023277141A1 PCT/JP2022/026266 JP2022026266W WO2023277141A1 WO 2023277141 A1 WO2023277141 A1 WO 2023277141A1 JP 2022026266 W JP2022026266 W JP 2022026266W WO 2023277141 A1 WO2023277141 A1 WO 2023277141A1
Authority
WO
WIPO (PCT)
Prior art keywords
bending
curved
section
bending portion
curved 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/JP2022/026266
Other languages
English (en)
Japanese (ja)
Inventor
玄 戸原
圭吾 柳澤
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.)
Nipro Corp
Tokyo Medical and Dental University NUC
Original Assignee
Nipro Corp
Tokyo Medical and Dental University NUC
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 Nipro Corp, Tokyo Medical and Dental University NUC filed Critical Nipro Corp
Priority to JP2023532061A priority Critical patent/JPWO2023277141A1/ja
Publication of WO2023277141A1 publication Critical patent/WO2023277141A1/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
    • 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
    • A61B1/267—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 for the respiratory tract, e.g. laryngoscopes, bronchoscopes

Definitions

  • the present invention relates to a laryngeal endoscope used for swallowing endoscopy.
  • transnasal endoscopy for example, Patent Document 1
  • Patent Document 1 transnasal endoscopy
  • the subject's larynx specifically, the epiglottis, tracheal wall, vocal cords, esophageal entrance, etc.
  • the subject swallows thick food jelly, etc. It is possible to check the state of mastication, presence or absence of residue, and presence or absence of inflow into the trachea.
  • FIG. 1 shows the positional relationship between the laryngeal region and the endoscope insertion portion ES when observing the laryngeal region with such a conventional transnasal endoscope.
  • FIG. 1 schematically shows a cross-section from the lower half of the face to the throat of the human body, including nasal cavity NC, oral cavity MC, tongue S, epiglottis KG, trachea T, tracheal anterior wall TF, tracheal posterior wall TB, and esophagus. E, etc. are shown. Also, the dotted line in the drawing virtually indicates the field of view of the endoscope.
  • the trachea anterior wall TF of the trachea T can be easily visually recognized according to the orientation of the tip of the endoscope insertion portion ES. ), the endoscope must be inserted along the epiglottis KG.
  • a vomiting reflex occurs, which not only makes the examination impossible but also causes great pain to the subject.
  • the tracheal posterior wall TB cannot be visually recognized, and if there is a residue on the tracheal posterior wall TB, there is a risk of overlooking it. I had a problem.
  • the present invention was invented in view of the above circumstances, and aims to provide an endoscope that allows visual confirmation of the posterior wall of the trachea during swallowing endoscopy.
  • a laryngeal endoscope for use in swallowing endoscopy comprising an insertion section formed in a tubular shape and inserted into a human body, and a grasping section arranged on the proximal end side of the insertion section,
  • the insertion section is a tip comprising at least an objective lens; a first bending portion positioned closer to the proximal end than the distal end portion and bending in a direction perpendicular to the central axis of the insertion portion; a second curved portion positioned closer to the proximal end than the first curved portion and curved in a direction opposite to the first curved portion around the central axis; a tubular flexible tube portion having flexibility located on the proximal end side of the second bending portion,
  • the grip portion includes an operation portion for deforming at least one of the first bending portion and the second bending portion into the bending shape.
  • the distal end of the endoscope is inserted near the larynx, the second bending portion is bent toward the epiglottis, and the first bending portion is bent toward the posterior wall of the trachea.
  • the position so that it is in a flat state, it becomes possible to visually recognize the posterior wall of the trachea without inserting the endoscope deep into the larynx (into the trachea).
  • the swallowing endoscopy if there is a residue on the posterior wall of the trachea, it can be prevented from being overlooked, and a more accurate swallowing endoscopy can be performed.
  • the first curved portion may be curved at a predetermined angle in advance, and the operation portion may deform the second curved portion into the curved shape.
  • the laryngoscope includes a first operating section for deforming the first bending section into the bending shape, and a second operating section for deforming the second bending section into the bending shape. , may be used.
  • a series of operations such as insertion of the endoscope and positioning with respect to the inspection site can be performed along the shape of the subject's nasal cavity, larynx, etc. It becomes possible to flexibly carry out the examination, and the burden on the subject can be reduced.
  • first curved portion is formed so as to be curved and deformable at an angle of ⁇ 20 degrees or more and ⁇ 50 degrees or less with respect to the central axis
  • second curved portion is formed with respect to the central axis. It may be formed so as to be curved and deformable at an angle of ⁇ 130 degrees or less in the direction opposite to the one curved portion.
  • Such a configuration is suitable for observing the posterior wall of the trachea by bending the second bending portion toward the epiglottis side and bending the first bending portion toward the posterior wall of the trachea.
  • first curved portion may be formed shorter than the second curved portion, and the length of the first curved portion is 3 mm or more and 13 mm or less, and the length of the second curved portion is 10 mm. 30 mm or less.
  • Such a configuration is suitable for observing the posterior wall of the trachea without bringing the endoscope into contact with the epiglottis.
  • the above means can be used in combination as much as possible.
  • an endoscope that allows visual confirmation of the posterior wall of the trachea in swallowing endoscopy.
  • FIG. 1 is a diagram for explaining the positional relationship of the insertion portion and the observation field when observing the vicinity of the larynx using a conventional endoscope.
  • FIG. 2A is a front view showing a schematic configuration of the laryngoscope according to Embodiment 1 of the present invention.
  • 2B is a top view showing a schematic configuration of the laryngoscope according to Embodiment 1 of the present invention;
  • FIG. 3A is a first diagram illustrating a mode of a bending portion of the laryngoscope according to Embodiment 1 of the present invention.
  • FIG. 3B is a second diagram illustrating the aspect of the bending portion of the laryngoscope according to the first embodiment of the present invention;
  • FIG. 1 is a diagram for explaining the positional relationship of the insertion portion and the observation field when observing the vicinity of the larynx using a conventional endoscope.
  • FIG. 2A is a front view showing a schematic configuration of the laryngoscope according
  • FIG. 3C is a third diagram illustrating the aspect of the bending portion of the laryngoscope according to the first embodiment of the present invention
  • FIG. 3D is a fourth diagram illustrating the aspect of the bending portion of the laryngoscope according to the first embodiment of the present invention.
  • 4A and 4B are diagrams for explaining the positional relationship and observation field of the insertion section when observing the vicinity of the larynx using the laryngoscope according to the first embodiment.
  • FIG. 5 is a diagram illustrating a schematic configuration of a laryngoscope according to Embodiment 2 of the present invention.
  • FIGS. 2A and 2B are diagrams showing an outline of the structure of the laryngoscope 1 according to the present embodiment, FIG. 2A being a front view of the laryngoscope 1, and FIG.
  • the laryngeal endoscope 1 generally has an insertion section 11 and a grasping section 12 .
  • the insertion portion 11 is formed in a tubular shape and is a portion to be inserted into the human body.
  • first bending portion 111 positioned, a second bending portion 112 positioned on the proximal side of the first bending portion 111, and a flexible tube portion 113 positioned on the proximal side of the second bending portion 112. doing.
  • each portion constituting the insertion portion 11 may be made of different materials.
  • the tip portion 110 may be made of stainless steel
  • the first bending portion 111 and the second bending portion 112 may be made of fluororubber
  • the flexible tube portion 113 may be made of polyurethane resin.
  • an image guide fiber optical glass fiber
  • a light guide fiber a first bending mechanism for bending the first bending portion 111
  • a second bending portion 112 a second bending mechanism for bending is built in.
  • the first bending mechanism and the second bending mechanism can adopt desired known techniques and may have any configuration. By connecting with a wire, pulling one of the wires and relaxing the other, it is possible to make a structure that bends toward the side of the pulled wire.
  • the grip part 12 has a substantially rectangular parallelepiped housing, and has a first bending part operation lever 121 , a second bending part operation knob 122 , a light source connection part 123 and an eyepiece 124 .
  • the first bending portion operating lever 121 is connected to the first bending mechanism, and by sliding the first bending portion operating lever 121 forward and backward, the first bending mechanism is operated to bend the first bending portion 111 . be able to.
  • the second bending portion operating knob 122 is connected to the second bending mechanism, and by rotating the second bending portion operating knob 122, the second bending mechanism is operated to bend the second bending portion 112. be able to.
  • the first bending portion operating lever 121 and the second bending portion operating knob 122 are provided on different surfaces of the housing of the grip portion 12, respectively.
  • the first bending portion operating lever 121 can be operated with the thumb
  • the second bending portion operating knob 122 can be operated with the index finger (or middle finger). That is, it becomes possible to grip the grip portion 12 and operate the first bending portion operating lever 121 and the second bending portion operating knob 122 with only one hand.
  • one operating portion is an operating lever and the other operating portion is an operating knob. It is possible to prevent operation errors such as putting away.
  • the light source connection part 123 is connected to a light source device (not shown) by a light guide cord (not shown) or the like. Since the light source connecting portion 123 and the light guide of the distal end portion 110 are connected by a light guide fiber, the light emitted from the light source device is transmitted to the light guide of the distal end portion 110 via the light guide fiber. This makes it possible to illuminate the observation site.
  • the eyepiece 124 is connected to the objective lens of the distal end portion 110 via an image guide fiber, and the image formed on the objective lens is transmitted to the eyepiece 124 by the image guide fiber.
  • FIGS. 3A and 3B are diagrams for explaining bending modes of the first bending portion 111 and the second bending portion 112 of the laryngeal endoscope 1 according to the present embodiment.
  • FIG. 3A is a diagram showing the vicinity of the distal end portion 110 of the laryngoscope 1 when neither the first bending portion 111 nor the second bending portion 112 is bent. Note that the dashed-dotted line in the drawing indicates the central axis A1 of the tubular insertion portion 11 .
  • the first curved portion 111 is formed shorter than the second curved portion 112.
  • the length of the first curved portion 111 is 3 mm to 13 mm, preferably 6 mm to 10 mm, and the length of the second curved portion 112 can be 10 mm to 30 mm, preferably 15 mm to 25 mm.
  • FIG. 3B is a diagram showing a state in which the first bending portion 111 is bent. As shown in FIG. 3B, the first bending portion 111 is in a state of being bent in a direction orthogonal to the central axis A1 of the insertion portion 11 (the direction of the white arrow in the drawing). The first bending portion 111 is configured to be bendable at an angle of ⁇ 20 degrees or more and ⁇ 50 degrees or less with respect to the central axis A1.
  • FIG. 3C is a diagram showing a state in which the second bending portion 112 is bent.
  • the second bending portion 112 is bent in a direction opposite to the bending direction of the first bending portion 111 (the direction of the black arrow) with respect to the center axis A1 of the insertion portion 11. It has become.
  • the second bending portion 112 is configured to be bendable at an angle of ⁇ 130 degrees or less in the opposite direction to the first bending portion 111 with respect to the central axis A1.
  • it may be configured to be bendable at an angle of ⁇ 20 degrees or more and ⁇ 50 degrees or less with respect to the central axis A1.
  • FIG. 3D shows the vicinity of the distal end portion 110 of the laryngoscope 1 with both the first bending portion 111 and the second bending portion 112 bent. As shown in FIG. 3D, when both the first bending portion 111 and the second bending portion 112 are bent, the bending portions as a whole draw a substantially S-shaped line.
  • FIG. 4 shows a state in which both the first bending section 111 and the second bending section 112 are bent after the insertion portion 11 of the laryngoscope 1 is inserted to the vicinity of the larynx.
  • the insertion portion 11 is inserted to the vicinity of the larynx
  • the second bending portion 112 is bent toward the epiglottis KG
  • the second bending portion 112 is bent toward the epiglottis KG.
  • the laryngeal endoscope 1 according to the first embodiment has a variable configuration in which both the first bending section 111 and the second bending section 112 are changed into a curved shape by operating the bending mechanism with the operation section.
  • the present invention is not necessarily applied only to such embodiments. Other embodiments of the present invention are described below.
  • FIG. 5 is a front view showing the outline of the structure of the laryngeal endoscope 2 according to the second embodiment of the present invention.
  • the laryngeal endoscope 2 is generally configured to have an insertion section 21 and a grasping section 22, similar to the laryngeal endoscope 1.
  • the insertion section 21 includes a distal end portion 210, a first bending portion 211, a second bending portion 212, and a flexible tube portion 213 is generally the same as the laryngeal endoscope 1 according to the first embodiment. However, it differs from the insertion section 11 of the laryngoscope 1 in that the first bending section 211 is formed in a pre-curved shape.
  • the grip portion 22 of the laryngoscope 2 includes a second bending portion operation knob 222 and an eyepiece lens 224, and a light source connection portion is also provided at the same position as the laryngoscope 1, although not shown. there is However, it differs from the laryngeal endoscope 1 in that it does not have a configuration corresponding to the first bending section operating lever.
  • the first bending portion 211 is formed in a pre-curved state, and only the second bending portion 212 can be changed by operating the second bending portion operation knob 222. It has a configuration that curves into the In addition, the second bending portion 212 can bend at least in a direction opposite to the bending direction of the first bending portion 211 . As a result, by bending and deforming only the second bending portion 212, the entire bending portion can be formed into a substantially S-shaped shape, and a laryngeal endoscope capable of visually recognizing the posterior wall of the trachea can be provided. .
  • the operation unit for bending the bending portion and the bending mechanism can be made into one (single system) as in the conventional art. It is possible to reduce the burden associated with the operation of the operator. In addition, since the bending mechanism can be integrated into one system, it is possible to contribute to the reduction in the diameter of the insertion portion and the enhancement of the function of the optical system (each fiber).
  • the imaging means and image display means may be connected to a laryngeal endoscope, and the endoscopy may be performed while checking the image on the image display means.
  • the image guide fiber in the insertion portion may be omitted, and an imaging element (CCD, CMOS, etc.) may be arranged at the tip portion.
  • the light emitted from the light source device is transmitted to the light guide at the tip through the light guide fiber.
  • first bending portion operating lever 121 and the second bending portion operating knob 122 are provided on different surfaces of the housing of the grip portion 12, but this configuration is not necessarily required.
  • both the first bending portion 111 and the second bending portion 112, in which the operation knobs are provided doubly on the same surface of the housing, are configured to be bent by the operation knobs connected thereto. good too.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Physiology (AREA)
  • Pulmonology (AREA)
  • Endoscopes (AREA)

Abstract

Laryngoscope utilisé pour un examen endoscopique de la déglutition et comprenant : une partie d'insertion de forme tubulaire qui est introduite dans le corps humain ; et une partie de préhension disposée sur le côté d'extrémité proximale de la partie d'insertion. La partie d'insertion comprend : une section d'extrémité distale comportant au moins une lentille d'objectif ; une première section incurvée qui est située plus loin en direction de l'extrémité proximale que la section d'extrémité distale, et qui est incurvée dans une direction perpendiculaire à l'axe central de la partie d'insertion ; une seconde section incurvée qui est située plus loin en direction de l'extrémité proximale que la première section incurvée, et qui est incurvée autour de l'axe central dans une direction opposée à la première section incurvée ; et une section de tube souple tubulaire qui est souple et située plus loin en direction de l'extrémité proximale que la seconde section incurvée. La partie de préhension comprend une section de fonctionnement permettant de déformer la première section incurvée et/ou la seconde section incurvée dans la forme incurvée.
PCT/JP2022/026266 2021-07-01 2022-06-30 Laryngoscope Ceased WO2023277141A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2023532061A JPWO2023277141A1 (fr) 2021-07-01 2022-06-30

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
JP2021110357 2021-07-01
JP2021-110357 2021-07-01

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WO2023277141A1 true WO2023277141A1 (fr) 2023-01-05

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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002177202A (ja) * 2000-10-02 2002-06-25 Olympus Optical Co Ltd 内視鏡
US6494828B1 (en) * 2001-07-23 2002-12-17 Jonathan Berall Laryngoscope
JP2008228783A (ja) * 2007-03-16 2008-10-02 Nippon Medical School 喉頭鏡
JP2010528820A (ja) * 2007-06-12 2010-08-26 エーブイエヌ・メディカル・テクノロジーズ，エルエルシー 気道管理
JP2016515842A (ja) * 2013-02-28 2016-06-02 クック・メディカル・テクノロジーズ・リミテッド・ライアビリティ・カンパニーＣｏｏｋ Ｍｅｄｉｃａｌ Ｔｅｃｈｎｏｌｏｇｉｅｓ Ｌｌｃ 体内通路の視覚化および治療のための医療デバイス、システムおよび方法
US20180085545A1 (en) * 2016-09-27 2018-03-29 Andrew Maslow Intubating endoscopic device
CN209951215U (zh) * 2018-12-29 2020-01-17 上海交通大学医学院附属第九人民医院 一种咽喉部内镜手术装置
US20210353888A1 (en) * 2020-05-12 2021-11-18 Samuel Wilson Endotracheal Tube with Fulcrum

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002177202A (ja) * 2000-10-02 2002-06-25 Olympus Optical Co Ltd 内視鏡
US6494828B1 (en) * 2001-07-23 2002-12-17 Jonathan Berall Laryngoscope
JP2008228783A (ja) * 2007-03-16 2008-10-02 Nippon Medical School 喉頭鏡
JP2010528820A (ja) * 2007-06-12 2010-08-26 エーブイエヌ・メディカル・テクノロジーズ，エルエルシー 気道管理
JP2016515842A (ja) * 2013-02-28 2016-06-02 クック・メディカル・テクノロジーズ・リミテッド・ライアビリティ・カンパニーＣｏｏｋ Ｍｅｄｉｃａｌ Ｔｅｃｈｎｏｌｏｇｉｅｓ Ｌｌｃ 体内通路の視覚化および治療のための医療デバイス、システムおよび方法
US20180085545A1 (en) * 2016-09-27 2018-03-29 Andrew Maslow Intubating endoscopic device
CN209951215U (zh) * 2018-12-29 2020-01-17 上海交通大学医学院附属第九人民医院 一种咽喉部内镜手术装置
US20210353888A1 (en) * 2020-05-12 2021-11-18 Samuel Wilson Endotracheal Tube with Fulcrum

Also Published As

Publication number Publication date
JPWO2023277141A1 (fr) 2023-01-05

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