Medical treatment endoscope

• US 20070249897A1
• Filed: 01/12/2007
• Published: 10/25/2007
• Est. Priority Date: 01/13/2006
• Status: Active Grant

• Current Assignee: Olympus Corporation
• Original Assignee: Olympus Medical Systems Corporation (Olympus Corporation)
• Inventors: Takeuchi, Saori, Yamatani, Ken, Dejima, Takumi, Kogasaka, Takahiro, Miyamoto, Manabu, Matsuno, Kiyotaka
• Granted Patent: US 8,444,547 B2
• Time in Patent Office: Days
• US Class Current: 600/104
• CPC Class Codes: A61B 1/0055 Constructional details of insertion parts, e.g. vertebral elements
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/2906 Multiple forceps
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/3447 Linked multiple cannulas

Abstract

The medical treatment endoscope according to the present invention includes a sheath having a flexibility; at least one arm member having a bending part that projects out from a front end of the sheath and performs bending actions; an open/close mechanism which directs the arm member from a direction along a central axis of the sheath to a direction deviated from the central axis of the sheath, and from a direction deviated from the central axis of the sheath to a direction along the central axis of the sheath; and a viewing device and an illuminating member that are disposed to the front end side of the sheath.

Claims

1. A medical treatment endoscope comprising:

a sheath having a flexibility;

at least one arm member having a bending part that projects out from a front end of the sheath and performs bending actions;

an open/close mechanism which directs the arm member from a direction along a central axis of the sheath to a direction deviated from the central axis of the sheath, and from a direction deviated from the central axis of the sheath to a direction along the central axis of the sheath; and

a viewing device and an illuminating member that are disposed to the front end side of the sheath.

2. The medical treatment endoscope according to claim 1, wherein the front end of the arm member is capable of relative displacement with respect to the viewing device and the illuminating member by means of at least one of a bending action of the bending part and a directional transition of the arm member by the open/close mechanism.

3. The medical treatment endoscope according to claim 2, wherein the open/close mechanism includes an open/close operating member that advance and retract with respect to the sheath, and a linking part that converts an advance/retract action of the open/close operating member into an open/close action of the arm member.

4. The medical treatment endoscope according to claim 3, including an operating part having:

a frame;

an open/close operating part for advancing and retracting the open/close operating member; and

a bending operating part to which a procedure operating part for a procedure device for performing a procedure in an organ is attachable, for bending the bending part.

5. The medical treatment endoscope according to claim 3, wherein the operating part further includes a rotation operating part that rotatably connects a base end of the sheath with respect to the frame.

6. The medical treatment endoscope according to claim 1, further comprising:

an advance/retract mechanism for advancing and retracting the arm member with respect to the sheath.

7. The medical treatment endoscope according to claim 6, wherein the operating part includes an advance/retract operating part for operating the advance/retract mechanism.

8. The medical treatment endoscope according to claim 3, wherein the open/close operating part so as to be moved freely between a first direction, in which the front end of the open/close operating part approaches the front end of the sheath, and a second direction, in which the front end of the open/close operating part moves away from the front end of the sheath, the open/close operating part being disposed approximately parallel to the direction of the central axis of the sheath;

and the linking part has one end connected to the front end of the open/close operating part and the other end connected to the arm members, the linking part spreading apart the arm members in a direction that separates them from the central axis of the sheath accompanying the movement of the open/close operating part in the first direction.

9. The medical treatment endoscope according to claim 8, wherein a plurality of the arm members project out from the front end of the sheath;

and in a cross-section along the central axis of the sheath, the open/close operating part is disposed closer to the central axis of the sheath than the position at which the plurality of arm members are disposed.

10. The medical treatment endoscope according to claim 8, wherein a connecting part for the linking part and the arm members is provided so as to be positioned between a connecting part for the open/close operating part and the linking part, and the front end of the sheath, while in a state that the linking part is caused the arm members to approach the central axis of the sheath, as a result of movement of the front end of the open/close operating part in the first direction to approach the central axis of the sheath.

11. The medical treatment endoscope according to claim 10, wherein a connecting part for the linking part and the arm members is provided so as to be positioned between a connecting part for the open/close operating part and the linking part, and the front end of the sheath, while in a state that the linking part is caused the arm members to away from the central axis of the sheath, as a result of movement of the front end of the open/close operating part in the first direction to away from the central axis of the sheath.

12. The medical treatment endoscope according to claim 10, wherein the open/close operating part is disposed to an area opposite the viewing device, between the arm members.

13. The medical treatment endoscope according to claim 8, wherein the arm members are composed of two arm members that are disposed in line with the radial direction of the sheath;

and in a cross-section along the central axis of the sheath, at least a portion of the open/close operating part is provided at a position in an area between the respective central axes of the two arm members.

14. A medical treatment endoscope comprising:

a sheath having a flexibility, in which a first lumen with an open end is formed;

at least one arm member having a second lumen with an open-end extending in the axial direction into which a procedure device for performing a procedure in an organ is insertable, and a bending part for performing bending actions, a front end of the arm member projecting out from the open end of the first lumen;

an open/close mechanism which directs the arm member projecting out from the first lumen from a direction along the central axis of the sheath to a direction deviated from the central axis of the sheath, and from a direction deviated from the central axis of the sheath to a direction along the central axis of the sheath; and

a viewing device and an illuminating member that are disposed to a front end side of the sheath.

15. The medical treatment endoscope according to claim 14, wherein the front end of the arm member is capable of relative displacement with respect to the viewing device and the illuminating member by means of at least one of a bending action of the bending part and a directional transition of the arm member by the open/close mechanism.

16. The medical treatment endoscope according to claim 15, wherein the open/close mechanism includes an open/close operating member that advances and retracts along the central axial with respect to the sheath, and a linking part that converts an axial force of the open/close operating member into a force for opening and closing the arm member with respect to the sheath.

17. The medical treatment endoscope according to claim 15, including an operating part having:

a frame;

an open/close operating part that is connected to a base end of the open/close operating member, for advancing and retracting the open/close operating member; and

a bending operating part to which a procedure operating part for the procedure device is attachable, for advancing and retracting a bending wire connected to the bending part by moving the procedure operating part.

18. The medical treatment endoscope according to claim 17, wherein the operating part further includes a rotation operating part which rotatably connect the sheath with respect to the frame.

19. The medical treatment endoscope according to claim 15, further comprising:

a guide member that extends in the direction of the central axis of the sheath and is fixed in place to the sheath; and

an advance/retract mechanism that has a sliding member that freely advances and retracts with respect to the guide member, for advancing and retracting the arm member with respect to the sheath.

20. The medical treatment endoscope according to claim 19, wherein the operating part includes an advance/retract operating part for advancing and retracting the sliding member with respect to the guide member.

21. The medical treatment endoscope according to claim 19, wherein an amount of movement of the sliding member with respect to the guide member is restricted.

22. A medical treatment endoscope comprising:

a first sheath having a flexibility and an open end;

a second sheath that is provided with a first arm member that has a front end and a base end and is inserted so that the front end area projects out from the first sheath, and that has a bending part that is freely bending through manipulation by an operator;

a third sheath provided with a second arm member that has a front end and a base end and is inserted so that the front end region projects out from the first sheath, and that has a bending part that is freely bending through manipulation by the operator;

a viewing device that is independently disposed at the front end of the first sheath from the second sheath and the third sheath, and is for viewing a target image; and

an illuminating member that is independently disposed at the front end of the first sheath from the viewing device, the second sheath and the third sheath, and is for radiating illuminating light on the target image.

23. The medical treatment endoscope according to claim 22, further comprising an open/close mechanism for respectively directing the first arm member and the second arm member from a central axis of the first sheath to a direction deviated from the central axis of the first sheath, and from a direction deviated from the central axis of the first sheath to the direction of the central axis of the first sheath, wherein the open/close mechanism includes:

an operating member that is inserted in a freely advancing and retracting manner into the first sheath;

a linking part for converting the advance/retract operation of the operating member into the open/close operation of the first arm member and the second arm member respectively; and

a support provided to the first arm member and the second arm member respectively, and connected to the linking part; and

wherein the operating member is inserted into the first sheath without interfering with the second sheath, the third sheath, the viewing device, and the illuminating member.

24. The medical treatment endoscope according to claim 22, further comprising:

an open/close mechanism for respectively directing the first arm member and the second arm member from a central axis of the first sheath to a direction that is separated from the central axis of the first sheath, and from a direction that is separated from the central axis of the first sheath to the direction of the central axis of the first sheath; and

an open/close operating part provided separately from an operating part for performing respective bending operations of the first arm member and the second arm member, for operating the open/close mechanism.

25. The medical treatment endoscope according to claim 22, wherein the open/close mechanism is fixable in place in an open state.

26. The medical treatment endoscope according to claim 22, wherein the viewing device and the illuminating member are provided to an area inside the first sheath other than areas where the second sheath and the third sheath are disposed.

27. The medical treatment endoscope according to claim 23, wherein when two areas divided by an imaginary line passing through a center in cross-section in a direction substantially perpendicular to a longitudinal direction of the first sheath are designated as a first area and a second area, then the viewing device and the illuminating member are disposed in the first area, and the operating member is disposed in the second area.

28. A medical treatment endoscope comprising:

a first sheath having pivotal joint rings attached thereto and openings at the tip thereof;

a second sheath disposed protruding from the first sheath, the second sheath having a first arm section, the first arm section having a first bending part and a second bending part, the first bending part having pivotal first joint rings attached thereto, the second bending part having a tip and a base end so that the tip end is connected to a base end of the first bending part and the base end is connected to the tip of the first sheath;

a third sheath having a second arm member having the first bending part and the second bending part, the third sheath being disposed to protrude from the first sheath;

a first operating member inserted through the first bending part and the second bending part for bending the first bending part;

a second operating member inserted through the second bending part for bending the second bending part;

a viewing device disposed at the tip of the first sheath independently from the second sheath and the third sheath for observing an object; and

an illuminating member, for illuminating light to the object, disposed at the tip of the first sheath independently from the viewing device, the second sheath, and the third sheath.

29. The medical treatment endoscope according to claim 28, wherein each second joint ring has a tip surface and a base end surface that are inclined so that the second joint rings are capable of making contact under a maximum bending condition of the second bending part, and the second joint rings are capable of separating from each other along with deformation of the second bending part to the linear state.

30. The medical treatment endoscope according to claim 28, wherein

the first operating members are disposed at positions conforming to the vertical and horizontal directions of an image observed with the viewing device;

and

the second operating members are inserted at positions rotatively offset from the first operating members by a predetermined angle.

31. The medical treatment endoscope according to claim 29, wherein

notches extending in the longitudinal directions of the first bending part and the second bending part are formed in each second joint ring, and

a coil tube is inserted through each notch.

32. The medical treatment endoscope according to claim 28, wherein

the first bending part bends in a first bending direction and a second bending direction which crosses the first bending direction, and

the second bending part passes through an objective optical system disposed to the viewing device, the second bending part is inclined relative to a plane orthogonal to an axis orthogonal to the longitudinal direction of the first sheath, and the tip of the second bending part bends in a direction away from a perspective range of the viewing device.

33. The medical treatment endoscope according to claim 28, wherein the second operating member is disposed to be inserted through the second joint rings at positions rotatively offset by approximately 45 degrees relative to pivotal positions of the second joint rings.

34. The medical treatment endoscope according to claim 28, wherein the second joint rings are pivotally attached to each other so that the second joint rings are urged in a direction where the second bending part is maintained in a linear state.

35. The medical treatment endoscope according to claim 28, wherein the central axis line of the tip surface of the second bending part is approximately parallel with the longitudinal direction of the first sheath in the maximum bending state of the second bending part.

36. The medical treatment endoscope according to claim 35, wherein a distance between a central axis line of the tip surface of the second bending part in the maximum bending state and a central axis line of the first sheath is approximately half a distance between the central axis line of the first sheath and the tip of the first bending part while the first bending part and the second bending part are in maximum bending condition in directions separate from the first sheath.

37. The medical treatment endoscope according to claim 28, wherein the second bending part includes a second base end bending part and a second tip end bending part, the second base end bending part has a base end connected to the first sheath and a tip end bending in the second direction, the second joint rings of the second bending part are pivotally attached to each other so that the second joint rings bend in a second direction separating from a first direction parallel to the longitudinal direction of the first sheath, the second tip end bending part has a base end connected to the tip of the second base end bending part and a tip connected to the base end of the first bending part, and the second joint rings of the second tip end bending part are pivotally attached to each other so that the second joint rings bend from the second direction to the first direction.

38. A medical treatment endoscope comprising:

a flexible sheath;

an arm unit protruding from a tip of the sheath for conducting bending movement;

an open/close unit for changing the direction of the arm unit from a direction in which the arm unit separates from the central axis line of the sheath to the central axis line direction;

a viewing unit for observing the tip beyond the sheath; and

an advance/retract unit for advancing and retracting the arm unit relative to the sheath.

39. A therapeutic method comprising:

a step of inserting a medical treatment endoscope in the vicinity of an affected part, the medical treatment endoscope having a sheath having a first arm member and a second arm member protruding from a tip of the sheath and bending;

a step including disposing a first endoscopic treatment instrument via the first arm member, disposing a second endoscopic treatment instrument in the vicinity of the affected part via the second arm member, and disposing a third endoscopic treatment instrument in the vicinity of the affected part via the sheath;

a step of bending the first arm member and the second arm member into different directions respectively; and

a step of conducting treatment to the affected part with the first endoscopic treatment instrument, the second endoscopic treatment instrument, and the third endoscopic treatment instrument.