Appendix

Structure and Components of Endoscopes
Outline of Gastrointestinal Endoscopy System

1

Current gastrointestinal endoscopes for examining the esophagus, stomach,and large and small intestines are mostly videoscopes. Videoscopes have anelectronic image sensor attached to the distal tip of the instrument. A
videoscope system consists of the following equipments.

1

LCD monitor

2
Videoscope

Main body : LCD monitor
Video system center

Endoscope1

The video system center converts the electrical signals from an image sensor
at the tip of a videoscope into video signals and displays them on an LCDmonitor.
In addition to high-definition vision, the system supports various types ofimage processing including color enhancement and Narrow Band Imaging(NBI). The latest units are integrated with a light source and come equippedwith an LED with a long life span. To improve color reproductivity, the system
has adopted five-color LEDs supporting violet, blue, green, amber, and red. It
also has an automatic dimming feature (automatically adjusts the brightness)
and a pump that transmits water and air.

2MainbodyVideo systemcenter with abuilt-in lightsource

Main
body

EndoscopeThe endoscope has three parts: the control section, the insertion section, and the connector section.
● Control Section

The angulation knob on the control section is connected to the tip of theendoscope by a series of wires. By turning the angulation knob, the bending
section at the distal end bends horizontally and vertically allowing for easierinsertion into the body and the ability to view 360 degrees within body
cavities.
The endoscope also contains buttons (valves) for feeding air or waterand for applying suction. Covering the opening in the air/water valve will feed
air into the organ being observed and will gently expand it for a better view.
Depressing this valve will feed water through the endoscope to wash theviewing lens. Depressing the suction valve will allow the doctor to use theendoscope to suction any fluids which are obscuring a good view of thetissue. Endotherapy devices can be passed through the instrument channel
for performing endoscopic biopsy and other treatments.
● Insertion Section

On the tip of the insertion section, there are four main parts: 1. Objective lensand image sensor, 2. Light guides that bring light from the light source throughthe endoscope, 3. Instrument channel outlet where endotherapy devices canbe pushed in and out (also has a suction opening), 4. Nozzle for feeding waterand air.
The objective lens is typically a super-wide-angle lens in order tovisualize a large area of tissue at one time. In order to view tumor tissue in amore detailed manner, some endoscopes have an optical zoom feature. They
also support high-definition video displays.
Light guide fiber bundles conduct light from the external light source
through the endoscope to illuminate body cavities. Endotherapy devices arepushed in and out of the instrument channel for harvesting tissue (biopsy),removing tumors, cauterizing bleeding lesions, etc. The nozzle on the distal tip
is used to clean the lens with water and expand body cavities by insufflatingthem with air.

Control Section

Suction button

Air/water button

Universal cord
Angulation control knob
Grip section
Instrument channel

Insertion
SectionDistal End

Insertion section
Insertion
tube

Distal end
Bendingsection

Instrument
Objective lenschanneloutletAir/water nozzle(can clean lens surface)

Light guide

Connector Section
SectionSuction port
port
Suction

Ventilation port
port
Ventilation

Electrical contact
contact
Light guide
guide● Connector Section

The connector section connects the endoscope with the video system center through the universal cord. Supply of air andwater is also performed through this connection.

3●Peripheral

Imaging Management Hub

Imaging management hub simplifies the process of recording, managing, andediting high-resolution endoscopic images (video and still images).

Imaging management hub35

Appendix

Appendix

TrocarOutline of Surgical Endoscopy System●The following instruments are used in endoscopic surgery. As open surgery is
gradually being replaced by endoscopic surgery, the sophistication ofendosurgical device has increased.

Trocars are used to create an opening (portal) for passing endoscopic
instrumentation into the body. The endoscope, forceps, electrosurgical knives,
hemostatic/suturing equipment, etc., are then inserted through the trocar asneeded for surgery. Olympus offers various types of trocars, such as ones thatare available in diameters ranging from 5-15mm, ones that have an anti-slip
balloon, and a threaded type. Currently, the most common trocars come witha sheath and are single-use.

1LCD monitor

Main body3

1

Insufflator

Main body : LCD monitor
Video system center
Xenon light source for IR imaging

Peripheral

1
Video systemcenter with abuilt-in lightsourceSurgical endoscopy systems include models that are compatible with 3D
endoscopes, which make it easier to grasp depth, and models equipped with 4K
monitors, which provide clear, high-definition images with greater detail. The video
system center with a built-in light source serves as a processor that converts theelectrical signals from the videoscope into video signals to display on an LCD
monitor and functions as a light source that supplies light to the scope tip via thelight guide cable. Some xenon light source devices enable infra-red (IR)observation.

Main body

●11mm

12mm

15mm

TrocarForceps

There are various kinds of forceps—such as grasping forceps that hold tissue andneedles, dissecting forceps that mechanically separates tissue, scissor forceps
for cutting tissue, etc.

Xenon lightsource for IRimaging

5mmForceps

2Videoscope/Rigidendoscope(Telescope)

Endoscope

3
Imaging management hub2
●Peripheral

Tip of grasping forceps

EndoscopeVideoscope●In general, videoscopes have a diameter of 5-10mm and a length of 300-370mm.
Their tips contain a lens, a CCD image sensor, and light guide fiber bundles forbringing illumination into the body. Some models are straight, others havedeflectable tips. The CCDs in Olympus endoscopes support high-definition
imaging. Focusing is unnecessary due to their broad depth of field.

Tip of dissecting forceps

Hemostasis Clip

In endoscopic surgery, clips are often used to quickly close a blood vessel andstop bleeding that cannot be controlled by other means. The clips are held in apistol-shaped clip applier. Clips are applied repeatedly like a stapler.
Surgical videoscope
Hemostatic clip (image)●Rigid Endoscope (Telescope)

A wide variety of telescopes are used for various types of diagnosis andtreatment. Uses in urology include transurethral prostatectomy and nephrectomy(kidney removal). Uses in ear, nose, and throat include viewing, diagnosing, andtreating the eardrum, nasal cavity, and vocal cords, which is performed using athin rigid endoscope. Rigid endoscopes are also used for myomectomy ingynecology and for viewing, diagnosing, and treating inside joint cavities inorthopedics.

●

Ultrasonic devices for coagulation and cutting by converting electricity into
ultrasonic vibrations. The heat is generated when the tip of the device (scissors)
contacts the tissue and then cuts the tissue and causes coagulation (hemostasis).

●●）による社内机上試験

血管サイズ

Ultrasonic energy device
Rigid endoscope (Telescope)High-Frequency Electrosurgical Device (Electrode)Olympus has commercialized electrosurgical knives that use high-frequency
currents as an energy source. These devices come in two types, monopolar with
one electrode and bipolar with two electrodes. Bipolar knives in particular arecapable of ablation for small lesions, for example. This minimizes the risk ofthermal damage to surrounding tissue.

Peripherals

Insufflator

The insufflator feeds carbon dioxide gas into the abdominal cavity in order toexpand it and create a working space to perform surgery. A special insufflationneedle (Veress needle) delivers the carbon dioxide gas to the peritoneal cavity.
The insufflator monitors the pressure of the peritoneal cavity and automaticallypumps in additional gas as needed to make up for gas that naturally leaks out
during surgery.

血管封止力

生体モデルの腸間膜（血管耐圧

出力レベル

●

3Ultrasonic Energy Device●Insufflator

Imaging Management Hub

High-frequency electrosurgical device (Electrode)

Fully-Integrated Bipolar / Ultrasonic Energy Devices

Combining the excellent hemostatic capabilities (controlling bleeding) ofbipolar high-frequency energy with precise dissection of ultrasonic energy, theenergy device can perform multiple tasks of vessel sealing, hemostasis,coagulation, incision, and dissection in one unit. The device meets surgeon ’s
demands for superior medical effectiveness.
Bipolar & ultrasonic energy devices

Imaging management hub simplifies the process of recording, managing, andediting high-resolution endoscopic images (video and still images).

Imaging management hub3637