Endoscopy method and endoscope

• US 8,900,123 B2
• Filed: 03/01/2010
• Issued: 12/02/2014
• Est. Priority Date: 03/02/2009
• Status: Active Grant

• Current Assignee: Olympus Corporation
• Original Assignee: Olympus Corporation
• Inventors: Okazaki, Yoshiro, Sugahara, Michihiro
• Primary Examiner(s): Laballe, Clayton E
• Assistant Examiner(s): Smith, Linda B
• Application Number:
  US12/714,827
• Publication Number:
  US 20100240952A1
• Time in Patent Office: 1,737 Days
• Field of Search: 600/102, 600/174
• US Class Current: 600/102
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00177 for 90 degrees side-viewing
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/0243 for immobilizing local areas of the heart, e.g. while it beats trocars attached to inner organs or inner body tissue A61B2017/3488
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61M 2025/1047 having centering means, e.g. balloons having an appropriate shape
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

With an endoscope including a long, thin inserted portion that is inserted into the body of a patient, securing means for securing the inserted portion to tissue inside the body, the securing means being provided at least at a distal-end portion of the inserted portion, an observation optical system that is provided at the inserted portion and that acquires an image of the tissue, and observation-distance adjusting means for adjusting the distance between the observation optical system and a surface of the tissue, it is possible to attain a stable field of view without having to stop the pulsation or the like of the heart or other tissue.

Claims

1. An endoscopy method comprising:

an inserting step of inserting an inserted portion of an endoscope into a body;

a securing step of securing a distal-end portion of the inserted portion to a surface of a heart inside the body such that an observation window, which is provided on one of a side face of the inserted portion or on the distal-end portion, faces toward the surface of the heart; and

an observation-distance adjusting step of adjusting the distance between the observation window and the surface of the heart by inflating a balloon provided on a portion of the inserted portion, where the balloon is provided on less than a full circumference of the inserted portion, and the portion includes a side that the observation window faces.

2. An endoscopy method according to claim 1,

wherein in the inserting step, the inserted portion is inserted into a gap between the heart and the pericardium, and

wherein the endoscopy method further includes a space forming step of forming an observation space for the endoscope by widening the gap between the heart and the pericardium.

3. An endoscopy method according to claim 1,

wherein in the securing step, the inserted portion is secured to the heart at positions on both sides, along a lengthwise direction, of a curving portion provided at the inserted portion, and

wherein in the observation-distance adjusting step, the curving portion is curved.

4. An endoscopy method according to claim 1,

wherein in the inserting step, the inserted portion is inserted, which is pretrained into a shape curved at a predetermined curvature, in such a state that the inserted portion is extended to have a curvature smaller than the predetermined curvature, and

wherein in the observation-distance adjusting step, the inserted portion is released from the extended state to the predetermined curvature.

5. An endoscopy method according to claim 1, wherein in the observation-distance adjusting step, an elastic member is pressed in a lengthwise direction from a proximal-end of the inserted portion, the elastic member being disposed on a side face of the inserted portion along the lengthwise direction and fixed at a distal end of the inserted portion, thereby projecting the elastic member in a radial direction.

6. An endoscopy method according to claim 1, wherein in the observation-distance adjusting step, one end of a plurality of link members is moved in a lengthwise direction of the inserted portion, the plurality of link members being coupled so as to pivot with each other, thereby moving a joint portion in a radial direction.

7. An endoscopy method according to claim 1,

wherein in the securing step, the inserted portion is secured to the tissue by using a magnetic force, and

wherein in the observation-distance adjusting step, the magnetic force is adjusted to adjust a magnetic repelling force between the magnetic force and another magnetic force generated from the adjacent tissue.

8. An endoscopy method according to claim 1,

wherein in the securing step, the inserted portion is secured to the tissue by using a fluid jet, and

wherein in the observation-distance adjusting step, the flow velocity of the fluid jet is adjusted.

9. An endoscopy method according to claim 1, wherein in the inserting step, the inserted portion is inserted from under the xiphoid process into the gap between the heart and the pericardium.

10. An endoscopy method according to claim 1, wherein the inserted portion is operated under X-ray radiography.

11. An endoscopy method according to claim 1, wherein in the inserting step, the inserted portion is inserted between organs adhering to each other.

12. An endoscopy method according to claim 1, wherein, in the securing step, the distal-end portion of the inserted portion is attached to the heart by using a negative pressure.

13. An endoscopy method according to claim 9,

wherein in the securing step, the distal-end portion is secured to the heart or the pericardium, and

wherein in the observation-distance adjusting step, the gap between the heart and the pericardium is widened by freeing from the heart the distal-end portion secured to the heart or the pericardium.

14. An endoscope comprising:

a long, thin inserted portion that is inserted into the body of a patient;

securing means for securing the inserted portion to a tissue inside the body, the securing means being provided at least at a distal-end portion of the inserted portion;

an observation optical system that is provided at the inserted portion and that acquires an image of the tissue or adjacent tissue adjacent to the tissue; and

observation-distance adjusting means for adjusting the distance between the observation optical system and one of a surface of the tissue or a surface of the adjacent tissue,

wherein an observation window is provided on one of a side face of the inserted portion or on the distal-end portion, and

wherein the observation-distance adjusting means is provided on a portion of the inserted portion and the observation-distance adjusting means is provided on less than a full circumference of the inserted portion, where the portion includes a side that the observation window faces.

15. An endoscope according to claim 14, wherein the securing means includes an attachment unit that attaches to the tissue by using a negative pressure.

16. An endoscope according to claim 14, wherein the securing means includes one or more hook members that are hooked to the tissue.

17. An endoscope according to claim 14, wherein the securing means includes a balloon member that is inflated so as to be engaged with a recess of the tissue.

18. An endoscope according to claim 14, wherein the securing means includes forceps for holding the tissue.

19. An endoscope according to claim 14, wherein the observation-distance adjusting means is implemented by a balloon that is disposed between the tissue or the adjacent tissue and the inserted portion and that is inflated or deflated to adjust the distance between the observation optical system and a surface of the tissue or a surface of the adjacent tissue.

20. An endoscope according to claim 14,

wherein a plurality of the securing means are provided at intervals along a lengthwise direction of the inserted portion, and

wherein the observation-distance adjusting means is implemented by a curving portion that is disposed between the securing means and that curves the inserted portion.

21. An endoscope according to claim 14, wherein the observation-distance adjusting means is implemented by training the inserted portion into a curved shape.

22. An endoscope according to claim 14, wherein the observation-distance adjusting means is implemented by an elastic member that is disposed on a side face of the inserted portion along a lengthwise direction, that is fixed at a distal end of the inserted portion, and that is projected in a radial direction by being pushed in the lengthwise direction from a proximal end of the inserted portion.

23. An endoscope according to claim 14, wherein the observation-distance adjusting means is a link mechanism that includes a plurality of link members coupled so as to pivot with each other and that moves a joint portion in a radial direction when one end thereof is moved in a lengthwise direction of the inserted portion.

24. An endoscope according to claim 14, wherein the inserted portion has a channel for passing various instruments in accordance with procedures performed on the tissue or the adjacent tissue.

25. An endoscope according to claim 14, wherein the securing means is magnetic-force generating means for securing the inserted portion to the tissue by using a magnetic force.

26. An endoscope according to claim 14, wherein the securing means is fluid jetting means for securing the inserted portion to the tissue by using a fluid jet.

27. An endoscope according to claim 14, wherein the observation-distance adjusting means observes the tissue to which the inserted portion is secured by the securing means or a tissue in proximity to the tissue to which the inserted portion is secured.

28. An endoscope according to claim 15, wherein the attachment unit has an attachment surface for attachment to the tissue such that the angle of the attachment surface relative to the inserted portion is changeable.

29. An endoscope according to claim 15, wherein the attachment unit has a suction hole provided on a side face of the inserted portion.

30. An endoscope according to claim 15,

wherein a plurality of the attachment units are provided at intervals along a lengthwise direction, and

wherein the observation optical system is provided between a pair of the attachment units.

31. An endoscope according to claim 21, wherein the observation-distance adjusting means includes a guide sheath that accommodates the inserted portion in an extended state such that the inserted portion is projectable and retractable from a distal end of the guide sheath.

32. An endoscope according to claim 22, wherein the elastic member has a cross-sectional shape extending in a circumferential direction of the inserted portion.

33. An endoscope according to claim 22, wherein the elastic member is formed of a bundle of wires arrayed in the circumferential direction of the inserted portion.

34. An endoscope according to claim 24,

wherein the observation optical system is provided on a side face of the inserted portion, and

wherein the channel has an exit provided at a circumferential position substantially corresponding to the observation optical system.

35. An endoscope according to claim 24, wherein the channel has an exit provided so that an instrument projected from the exit passes through a field of view of the observation optical system.

36. An endoscope according to claim 25, wherein the observation-distance adjusting means includes magnetic-force adjusting means for adjusting the magnetic force generated by the magnetic-force generating means to adjust a magnetic repelling force between the magnetic-force generating means and another magnetic-force generating means provided in the adjacent tissue.

37. An endoscope according to claim 26, wherein the observation-distance adjusting means is flow-velocity adjusting means for adjusting the flow velocity of the fluid jetted by the fluid jetting means.

38. An endoscope according to claim 28, wherein the attachment unit includes an attachment pad having the attachment surface and a joint that joins the attachment pad with the inserted portion so that the attachment pad is pivotable about an axis perpendicular to a lengthwise axis of the inserted portion.

39. An endoscope according to claim 38, wherein the joint is a flexible tubular member that conveys a negative pressure to the attachment pad.

40. An endoscope according to claim 39, wherein the tubular member is bellows.