Source: http://www.google.com/patents/US20030135091?dq=7,546,338
Timestamp: 2017-10-17 07:56:58
Document Index: 499347896

Matched Legal Cases: ['Application No. 2002', 'art 28', 'art 28', 'art 28', 'art 28', 'art 28', 'art 28', 'art 28', 'art 28', 'art 28']

Patent US20030135091 - Medical treatment method and apparatus - Google Patents
A medical treatment method comprises orally inserting a first endoscope having a first treatment tool provided thereto into a body cavity, inserting a first insertion member insertion support tool from at least one of abdominal and transdermal cavities into the body cavity, inserting a second endoscope...http://www.google.com/patents/US20030135091?utm_source=gb-gplus-sharePatent US20030135091 - Medical treatment method and apparatus
Publication number US20030135091 A1
Application number US 10/334,462
Also published as US6991602
Publication number 10334462, 334462, US 2003/0135091 A1, US 2003/135091 A1, US 20030135091 A1, US 20030135091A1, US 2003135091 A1, US 2003135091A1, US-A1-20030135091, US-A1-2003135091, US2003/0135091A1, US2003/135091A1, US20030135091 A1, US20030135091A1, US2003135091 A1, US2003135091A1
Inventors Masaaki Nakazawa, Toshio Nakamura, Hidenobu Kimura, Tatsuya Furukawa, Koji Yamaya, Nobuyuki Matsuura, Hisao Yabe
Original Assignee Masaaki Nakazawa, Toshio Nakamura, Hidenobu Kimura, Tatsuya Furukawa, Koji Yamaya, Nobuyuki Matsuura, Hisao Yabe
Patent Citations (4), Referenced by (116), Classifications (33), Legal Events (6)
US 20030135091 A1
A medical treatment method comprises orally inserting a first endoscope having a first treatment tool provided thereto into a body cavity, inserting a first insertion member insertion support tool from at least one of abdominal and transdermal cavities into the body cavity, inserting a second endoscope having a second treatment tool provided thereto into the body cavity through the first insertion member insertion support tool, grasping a lesioned part by the second treatment tool inserted into the body cavity by the second endoscope, cutting the lesioned part by the first treatment tool inserted into the body cavity by the first endoscope, and collecting the lesioned part.
inserting the second insertion member insertion support tool from at least one of abdominal and transdermal cavities into the body cavity;
inserting the third treatment tool into the body cavity through the second insertion member insertion support tool; and
20. A fluid control apparatus for an insertion member insertion support tool, comprising:
a main body having a hole through which an insertion member is inserted into a body cavity, an inside diameter of the hole being larger than an outside diameter of the insertion member, a seal member which seals a gap formed between the insertion member and the hole with the insertion member being inserted, and closes the body cavity and a duct communicating with the hole;
a fluid supply mechanism which supplies a fluid to the duct; and
a control mechanism which controls a quantity of fluid supplied to the duct by the fluid supply mechanism and controls a frictional force between the insertion member and the hole.
21. The fluid control apparatus according to claim 20, wherein the control mechanism includes, between the fluid lead-in duct and the fluid supply mechanism, a pressure detection mechanism that detects a pressure in an organ, and an operation control mechanism that controls an operation of the fluid supply mechanism by the pressure detected by the pressure detection mechanism.
22. The fluid control apparatus according to claim 20, wherein an insertion member insertion support tool which connects the inside of the organ and the outside of the body with at least one of abdominal and transdermal cavities is provided between the main body and the organ, and the main body is connected to the insertion member insertion support tool.
23. A fluid control apparatus for an insertion member insertion support tool which inserts at least one of an endoscope and a treatment tool from at least one of abdominal and transdermal cavities into an organ, comprising:
a main body which is caused to communicate with the inside of an organ and includes a through hole having a larger diameter than an outside diameter of the endoscope and an insertion portion of the treatment tool, a seal member which receives the insertion portion in the through hole and seals the atmosphere in the organ, and an air lead-in duct which communicates with the through hole; and
an air supply pump which supplies air to the air lead-in duct between the insertion portion and the through hole and inflates the organ by reducing a coefficient of friction between the insertion portion and the through hole and causing the air to flow into the organ.
24. The fluid control apparatus according to claim 23, further comprising, between the air lead-in duct and the air supply pump, a pressure control valve having a pressure detection mechanism which detects a pressure in the organ and an operation control mechanism which controls an operation of the air supply pump by the detected pressure.
25. The fluid control apparatus according to claim 23, further comprising, between the main body and the organ, an insertion member insertion support tool that connects the inside of the organ and the outside of the body with at least one of abdominal and transdermal cavities, the main body being connected to the insertion member insertion support tool.
26. A fluid control apparatus for an insertion member insertion support tool of an insertion member having an elongated insertion portion which is inserted from at least one of abdominal and transdermal cavities into an organ, comprising:
a main body which communicates with the inside of an organ and includes a through hole having a larger diameter than an outside diameter of the insertion portion, a seal member which receives the insertion portion in the through hole and seals the inside of the organ, and a fluid lead-in duct which communicates with the through hole; and
a fluid feed mechanism which causes a fluid to flow through the fluid lead-in duct and lowers a coefficient of friction between the insertion portion and the through hole by causing the fluid to flow between the insertion portion and the through hole.
27. The fluid control apparatus according to claim 26, further comprising, between the fluid lead-in duct and the fluid supply mechanism, a pressure control mechanism having a pressure detection mechanism which detects a pressure in the organ and an operation control mechanism which controls an operation of the fluid supply mechanism.
28. The fluid control apparatus according to claim 26, further comprising an insertion member insertion support tool which is provided between the main body and the organ, connects the inside of the organ and the outside of the body with at least one of abdominal and transdermal cavities, and is connected to the main body.
29. The fluid control apparatus according to claim 27, further comprising an insertion member insertion support tool which is provided between the main body and the organ, and which connects the inside of the organ and the outside of the body with at least one of abdominal and transdermal cavities, and is connected to the main body.
30. A medical treatment apparatus capable of giving a treatment to a lesioned part in an organ, comprising:
a first flexible endoscope having an insertion portion which is orally inserted into the organ; and
a second flexible endoscope which has an insertion portion which is inserted from at least one of abdominal and transdermal cavities into the organ and gives a medical treatment to the lesioned part in cooperation with the first flexible endoscope.
31. The medical treatment apparatus according to claim 30, further comprising a third flexible endoscope which has an insertion portion which is inserted from at least one of abdominal and transdermal cavities into the organ and gives a medical treatment to the lesioned part in cooperation with the first and second flexible endoscope.
32. The medical treatment apparatus according to claim 30, wherein an observation optical system is eliminated from the insertion portion of the second flexible endoscope.
33. The medical treatment apparatus according to claim 31, wherein an observation optical system is eliminated from the insertion portion of the second flexible endoscope.
34. The medical treatment apparatus according to claim 30, wherein the organ is a stomach.
35. The medical treatment apparatus according to claim 34, wherein there is provided a first insertion member insertion support tool which connects the inside of the stomach and the outside of the living body with at lest one of abdominal and transdermal cavities.
36. The medical treatment apparatus according to claim 35, wherein a catheter that the second flexible endoscope is inserted into the stomach through an inner hole of the catheter is provided to the first insertion member insertion support tool.
37. The medical treatment apparatus according to claim 36, wherein the catheter is formed of any of a chloroethene material, a PTFE-based material and a silicon material.
38. The medical treatment apparatus according to claim 37, wherein a treatment tool is provided in the catheter of the first insertion member insertion support tool.
39. The medical treatment apparatus according to claim 38, wherein there is provided a holding portion which is provided so as to protrude from the insertion portion of the second flexible endoscope and holds the treatment tool.
40. The medical treatment apparatus according to claim 35, wherein there is provided a second insertion member insertion support tool which causes the inside of the organ to communicate with the outside of the living body with at least one of abdominal and transdermal cavities and is provided at a position different from that of the first insertion member insertion support tool.
41. The medical treatment apparatus according to claim 40, wherein a catheter that at least one of the third flexible endoscope and the treatment tool is inserted into the stomach through an inner hole of the catheter is provided to the second insertion member insertion support tool.
42. The medical treatment apparatus according to claim 41, wherein at least one of the third flexible endoscope and the vicinity of an end of the insertion portion of the treatment tool includes at least one grasping portion which is held by a treatment tool provided to the first flexible endoscope.
43. The medical treatment apparatus according to claim 41, wherein the treatment tool includes at least two polyarticular arms, grasping portions provided at end portions of the polyarticular arms, and an operation portion which operates the polyarticular arms and the grasping portions.
44. The medical treatment apparatus according to claim 36, wherein an opening of at least one of the insertion portion of the second flexible endoscope and the treatment tool includes a seal member which seals the inside of the organ at an end portion of the catheter outside the body.
45. The medical treatment apparatus according to claim 44, wherein an air supply path is caused to communicate with a lead-in duct of at least one of the flexible endoscope and the treatment tool at the end portion of the catheter outside the body, and an insertion member insertion support tool having a seal member is detachably provided on the front side.
46. The medical treatment apparatus according to claim 36, further comprising a holding mechanism which is inserted into the stomach through the catheter and can hold the first flexible endoscope.
47. The medical treatment apparatus according to claim 45, further comprising a holding mechanism which is inserted into the organ through the catheter and can hold the first flexible endoscope.
48. The medical treatment apparatus according to claim 30, wherein at least one of the first and second flexible endoscopes includes a first curved portion which is bent in two directions and a second flexible portion which is bent in at least two directions.
49. The medical treatment apparatus according to claim 30, wherein a direction identification label which is observed by the first flexible endoscope and lead the curved portions of the second flexible endoscope to a desired direction is provided on an outer surface in the vicinity of the end portion of the insertion portion of the second flexible endoscope.
50. The medical treatment apparatus according to claim 30, wherein the insertion portion of at least one of the first and second flexible endoscopes has a treatment tool which protrudes from the end of the insertion portion and whose end is bent.
51. The medical treatment apparatus according to claim 50, wherein a direction identification label which is observed by the first flexible endoscope and lead the curved portion of the second treatment tool to a desired direction is provided on the outer surface in the vicinity of the end portion of the insertion portion of the treatment tool.
52. A medical treatment apparatus capable of giving a medical treatment to a lesioned part in an organ, comprising:
a first endoscope having a flexible insertion portion which is orally inserted into an organ in a living body;
at least one insertion member having an insertion portion which is inserted from at least one of abdominal and transdermal cavities into the organ; and
at least one second endoscope which has a flexible insertion portion which is inserted from at least one of abdominal and transdermal cavities into the organ and gives a medical treatment to a lesioned part in the organ in cooperation with the first endoscope and the insertion member.
53. The medical treatment apparatus according to claim 52, wherein the insertion member is formed of any of an endoscope having a flexible insertion portion, a treatment tool having a flexible insertion portion and a treatment tool having a rigid insertion portion.
54. The medical treatment apparatus according to claim 52, wherein a treatment tool which gives a medical treatment to the lesioned part along the insertion portion is provided to at least one of the first and second endoscopes.
55. A medical treatment method for a lesioned part existing in an organ of a living body, comprising:
56. The medical treatment method according to claim 55, wherein an insertion portion of a first flexible endoscope is inserted from at least one of abdominal and transdermal cavities into the organ.
57. The medical treatment method according to claim 55, wherein a medical treatment is given to the inside of the organ by endoscopic mucosal resection (EMR).
58. The medical treatment method according to claim 56, wherein a medical treatment is given to the inside of the organ by endoscopic mucosal resection.
59. The medical treatment method according to claim 55, wherein the lesioned part is lifted up by the second flexible endoscope and the lesioned part is cut by the first flexible endoscope.
60. The medical treatment method according to claim 55, wherein the lesioned part is lifted up by the second and third flexible endoscopes, and the lesioned part is cut by the first flexible endoscope.
61. The medical treatment method according to claim 55, wherein the second flexible endoscope, an observation optical system of which has been eliminated from an insertion portion thereof, is led to a desired position by the first flexible endoscope.
62. The medical treatment method according to claim 55, wherein the organ is a stomach.
63. The medical treatment method according to claim 62, wherein the second flexible endoscope is inserted through a first insertion member insertion support tool which connects the stomach and the outside of the body.
64. The medical treatment method according to claim 63, wherein the first insertion member insertion support tool is formed by percutaneous endoscopic gastrostomy (PEG).
65. The medical treatment method according to claim 64, wherein a catheter is set in an inner hole of the first insertion member insertion support tool and the second flexible endoscope is inserted through this catheter.
66. The medical treatment method according to claim 64, wherein a treatment tool is inserted through a second insertion member insertion support tool provided at a position different from that of the first insertion member insertion support tool.
67. The medical treatment method according to claim 55, wherein the first flexible endoscope orally inserted into the organ is used to observe the lesioned part, and
68. The medical treatment method according to claim 56, wherein the first flexible endoscope orally inserted into the organ is used to observe the lesioned part, and
This application is based upon and claims the benefit of priority from the prior Japanese Patent Application No. 2002-005106, filed Jan. 11, 2002, the entire contents of which are incorporated herein by reference.
The present invention provides a medical treatment method for treating a lesioned part of an organ, and an apparatus using this method.
[0012]FIG. 1 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a first embodiment;
[0013]FIG. 2A is a schematic view showing a procedure to keep a gastric fistula formation tube on a body wall;
[0014]FIG. 2B is a schematic view showing a procedure following that illustrated in FIG. 2B to keep the gastric fistula formation tube on the body wall;
[0015]FIG. 2C is a schematic view showing a procedure following that illustrated in FIG. 2B to keep the gastric fistula formation tube on the body wall;
[0016]FIG. 2D is a schematic view showing a procedure following that depicted in FIG. 2C to keep the gastric fistula formation tube on the body wall;
[0017]FIG. 2E is a schematic view showing a procedure following that depicted in FIG. 2D to keep the gastric fistula formation tube on the body wall;
[0018]FIG. 3 is a schematic cross-sectional view showing a modification of a treatment apparatus according to the first embodiment;
[0019]FIG. 4A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a second embodiment;
[0020]FIG. 4B is a schematic view showing a state that a protrusion portion is provided at an end portion of an insertion portion of the second endoscope, a hole is formed along this insertion portion and a grasping forceps is arranged in this hole;
[0021]FIG. 4C is a schematic view showing a state that a hook portion is provided to the protrusion portion depicted in FIG. 4B;
[0022]FIG. 4D is a schematic view showing that a cylindrical member which can be fitted is provided at the end portion of the second endoscope and a protrusion portion similar to that depicted in FIG. 4B is provided to this cylindrical member;
[0023]FIG. 4E is a schematic view showing a state that a guide tube is arranged in the hole illustrated in FIG. 4D;
[0024]FIG. 4F is a schematic view showing a state that the guide tube is arranged along the insertion portion of the second flexible endoscope by using surgical tape;
[0025]FIG. 5A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a third embodiment;
[0026]FIG. 5B is a schematic view showing the vicinity of a curved portion of the second endoscope by the first flexible endoscope;
[0027]FIG. 6 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a fourth embodiment;
[0028]FIG. 7 is a cross-sectional view showing a mouth ring fitted to the gastric fistula formation tube illustrated in FIG. 6;
[0029]FIG. 8A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a fifth embodiment;
[0030]FIG. 8B is a schematic view showing that a holding portion which can be held by using the grasping forceps protruding from the insertion portion of the first flexile endoscope is provided at the end portion of the second endoscope;
[0031]FIG. 8C is a schematic view showing that a blade is arranged at the curved portion of the second endoscope;
[0032]FIG. 9 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a sixth embodiment;
[0033]FIG. 10A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a seventh embodiment;
[0034]FIG. 10B is a schematic view showing an end portion of the insertion portion of the first flexible endoscope;
[0035]FIG. 11A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope and a rigid grasping forceps into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes and the rigid grasping forceps according to an eighth embodiment;
[0036]FIG. 11B is a schematic view showing that the curved portion can be led in a desired direction by grasping the first flexible endoscope by the rigid grasping forceps;
[0037]FIG. 12 is a schematic cross sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a ninth embodiment;
[0038]FIG. 13 is a schematic cross-sectional view showing a modification of the treatment apparatus according to the ninth embodiment;
[0039]FIG. 14 is a schematic cross-sectional view showing the modification of the treatment apparatus according to the ninth embodiment;
[0040]FIG. 15A is a schematic view showing a state that a cover tube is put on the second flexible endoscope according to a tenth embodiment;
[0041]FIG. 15B is a schematic view showing a structure of an end portion of the cover tube illustrated in FIG. 15A;
[0042]FIG. 15C is a schematic view showing a state that the lesioned part is sucked into the cover tube;
[0043]FIG. 15D is a schematic view showing that the lesioned part is collected by using the first flexible endoscope after cutting the lesioned part by using a high-frequency snare illustrated in FIGS. 15A to 15C;
[0044]FIG. 16 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ by using a curved gastric fistula formation tube in the stomach and gives a medical treatment to a lesioned part existing on the abdominal wall side by using these two flexible endoscopes according to an 11th embodiment;
[0045]FIG. 17 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ by using a curved gastric fistula formation tube in the stomach and gives a medical treatment to a lesioned part existing on the abdominal wall side by using these two flexible endoscopes according to a 12th embodiment;
[0046]FIG. 18 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ through an insertion support tool provided at the upper end of a gastric fistula formation tube and gives a medical treatment to a lesioned part by using these two flexible endoscopes according to a 13th embodiment;
[0047]FIG. 19A is a schematic cross-sectional view showing the insertion support tool of the endoscope provided at the upper end portion of the gastric fistula formation tube illustrated in FIG. 18;
[0048]FIG. 19B is a block diagram showing structures of an excessive pressure rise prevention valve and an air supply pump illustrated in FIG. 19A;
[0049]FIG. 20 is a schematic cross-sectional view which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads second and third flexible endoscopes into the organ and gives a medical treatment to a lesioned part by using these three flexible endoscopes according to a 14th embodiment;
[0050]FIG. 21 is a schematic cross-sectional view showing a modification of the treatment apparatus according to the 14th embodiment;
[0051]FIG. 22 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads second and third flexible endoscopes into the organ and gives a medical treatment to a lesioned part by using these three flexible endoscopes according to a 15th embodiment;
[0052]FIG. 23 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a treatment tool into the organ from another abdominal wall, and gives a medical treatment to a lesioned part by using these two flexible endoscopes and one treatment tool according to a 16th embodiment;
[0053]FIG. 24A is a schematic cross-sectional view showing a treatment apparatus which grasps an end portion of a treatment tool abdominally or transdermally led into an organ by using a first flexible endoscope orally led into the organ, and gives a medical treatment in the organ in cooperation with a second flexible endoscope abdominally or transdermally led into the organ according to a 17th embodiment;
[0054]FIG. 24B is a schematic view showing that an end portion of the above-described treatment tool has a holding portion;
[0055]FIG. 24C is a schematic view showing that the end portion of the above-described treatment tool has a flange member;
[0056]FIG. 25A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a treatment tool into the organ from another abdominal wall, and can maintain a state that a lesioned part is grasped and lifted up by using the treatment tool according to an 18th embodiment;
[0057]FIG. 25B is a schematic view showing a clip provided at the upper end portion of the gastric fistula formation tube in order to maintain the state illustrated in FIG. 25A;
[0058]FIG. 26A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a treatment tool from another abdominal wall, and gives a medical treatment to a lesioned part according to a 19th embodiment;
[0059]FIG. 26B is a schematic view showing an end portion of the insertion portion of the first flexible endoscope;
[0060]FIG. 27A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a treatment tool from another abdominal wall, and gives a medical treatment to a lesioned part according to a 20th embodiment;
[0061]FIG. 27B is a schematic view showing that the first flexible endoscope can be grasped by a rigid grasping forceps and a curved portion can be led in a desired direction;
[0062]FIG. 28A is a schematic view showing a state that a clip with a thread provided in the second endoscope is hooked by a collection treatment tool for collecting the clip with a thread which is led from another gastric fistula formation tube according to a 21st treatment;
[0063]FIG. 28B is a schematic view showing a state that the clip with a thread is taken out of a body from the gastric fistula formation tube having the collection treatment tool arranged thereto, the grasping forceps is taken out from the second flexible endoscope and a lesioned part is grasped;
[0064]FIG. 28C is a schematic view showing a state that a lesioned part is cut by using the first flexible endoscope, the clip with a thread is pulled and a cut piece is taken out of the body;
[0065]FIG. 29 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads an ultrasonic treatment tool into the organ from another abdominal wall, a and gives a medical treatment to a lesioned part by using these two flexible endoscopes and one ultrasonic treatment tool according to a 22nd embodiment;
[0066]FIG. 30 is a schematic cross-sectional view showing a modification of a treatment apparatus according to the 22nd embodiment;
[0067]FIG. 31 is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a suction device into the organ from another abdominal cavity, and gives a medical treatment to a lesioned part by using these two flexible endoscopes and one suction device according to a 23rd embodiment;
[0068]FIG. 32A is a schematic cross-sectional view showing a treatment apparatus which orally leads a first flexible endoscope into an organ, abdominally or transdermally leads a second flexible endoscope into the organ, abdominally or transdermally leads a multi-lumen treatment tube into the organ from another abdominal wall, and gives a medical treatment to a lesioned part by using these two flexible endoscopes and one multi-lumen treatment tube according to a 24th embodiment; and
[0069]FIG. 32B is a schematic view showing the multi-lumen treatment tube illustrated in FIG. 32A, as seen from a direction indicated by an arrow B.
By using the flexible endoscope 11 and 22, not only when the lesioned part exists on the back side but also when the lesioned part 28 exists in the vicinity of the abdominal cavity (insertion support tool), this lesioned part 28 can be likewise cut off by operating the insertion portions 11 a and 22 a.
The technique can be further assuredly carried out by selecting and using the cutting treatment tool such as the high-frequency snare 26 or the needle-shaped scalpel 30 according to depth, size or infiltration degree of the lesioned part 28.
As shown in FIG. 5A, in a treatment apparatus according to this embodiment, the first and second flexible endoscopes 11 and 22 are inserted into the stomach 2. In addition, as shown in FIG. 5B, four identification labels 50 are provided in the vicinity of the base end portion of the curved portion 22 b of the second flexible endoscope 22. Assuming that the circumferential direction of the second flexible endoscope 22 is divided into four directions, i.e., an up (U) direction 50 a, a down (D) direction 50 b, a right (R) direction (not shown), and a left (L) direction 50 c every 90°, the identification labels 50 are separated by colors, e.g., red, blue, yellow, green or the like. By observing such identification labels 50 by using the first flexible endoscope 11, an operator of the first flexible endoscope 11 can readily instruct an operator of the second flexible endoscope 22 of the direction in which the curved portion 22 b of the second flexible endoscope 22 should be moved.
Furthermore, as shown in FIG. 10B, an object lens 90 is provided at the central part of the insertion portion 11 a of the first endoscope 11. A pair of light guides 92 are provided on the sides of the object lens 90. Moreover, an air supply/water supply nozzle 94 is provided to the insertion portion 11 a. Then, a treatment tool guide groove 96 is formed between each light guide 92 and the air supply/water supply nozzle 94. In addition, the treatment tool guide grooves 96 are also provided at positions which are symmetrical to the object lens 90 at the center. For example, a high-frequency snare 26 or a needle-shaped scalpel 30 is provided in each of these treatment tool guide grooves 96. The high-frequency snare 26 or the needle-shaped scalpel 30 is selectively led out and used from the groove portion opening portion 97 toward the direction of the end of the insertion portion 11 a.
It is to be noted that the curved portions 22 b′ and 22 b″ which can be bent in four directions are provided to the curved portion 22 b of the second flexible endoscope 22 in this embodiment but the present invention is not restricted to such a curved portion 22 b. For example, as shown in FIG. 13, curved portions 11 b′ and 11 b″ which can be bent in four directions may be respectively provided to the curved portion 11 b of the first flexible endoscope 11 and operation portions 11 c′ and 11 c″ which respectively operate the curved portions 11 b′ and 11 b″ in the main body of the endoscope 11 may be provided. Additionally, for example, as shown in FIG. 14, curved portions 11 b′, 11 b″, 22 b and 22 b″ which can be bent in four directions may be respectively provided to the curved portions 11 b and 22 b of the first and second endoscopes 11 and 22, and two operation portions llc′, llc″ and 22 c′ and 22 c″ may be provided to the main bodies of the endoscopes 11 and 22.
Therefore, the following can be said with respect to this embodiment. Although description has been given as to the case where the lesioned part 28 on the back side is treated in this embodiment, a desired treatment can be readily given to the lesioned part 28 in the vicinity of the abdominal cavity, where the treatment is hardly carried out, by providing a plurality of curved portions 22 b′ and 22 b″.
A 10th embodiment will now be described with reference to FIGS. 15A to 15D. This embodiment is a modification of the first embodiment, and like reference numerals denote like or corresponding parts, thereby omitting the detailed explanation.
Further, an air supply mouth ring 130 as an air lead-in duct having a hole communicating with the through hole 122 is provided preferably in a direction orthogonal to the through hole 122 of the main body 121. An excessive pressure rise prevention valve (pressure control valve) 134 is provided by the air supply mouth ring 130 via an air supply hose 132 a, and an air supply pump 136 is provided to the excessive pressure rise prevention valve 134 via an air supply hose 132 b.
Furthermore, as shown in FIG. 19B, the excessive pressure rise prevention valve 134 includes a valve 134 a, a pressure detection circuit 134 b and an operation control circuit 134 c. The pressure detection circuit 134 b detects the pressure in the stomach 2 and pressure of air supplied from the air supply pump 136 through the valve 134 a at predetermined intervals of, e.g. 0.5 seconds. Moreover, the operation control circuit 134 c controls opening/closing of the valve 134 a and the operation of the air supply pump 136 by using the pressure detected by the pressure detection circuit 134 b. Therefore, when the inside of the stomach 2 reaches a predetermined pressure, the operation control circuit 134 c acts to stop the operation of the air supply pump 136 and close the valve 134 a. When supplying air into the stomach 2, the pressure on the stomach 2 side is detected. When the inside of the stomach 2 is yet to reach a predetermined pressure, the air supply pump 136 is actuated, the valve 134 a is opened, and air is supplied into the stomach 2. In this manner, a fluid supply mechanism is formed.
It is to be noted that description has been given as to the case where a treatment is given by inserting the grasping forceps 144 having flexibility into the second gastric fistula formation tube 4′ in this embodiment, but a rigid treatment tool, such a rigid grasping forceps, may be used. In addition, the present invention is not restricted to the grasping forceps 144, and a high-frequency snare or a needle-shaped scalpel may be provided instead. Therefore, the following can be said with respect to this embodiment. In the case of inserting the grasping forceps 144 into the stomach 2, it does not have to be inserted through the forceps channel or the like of the second flexible endoscope 22, and hence there is used a treatment tool which is hard to be inserted into the forceps channel of the endoscope 22 such as a treatment tool with a large diameter or a treatment tool with a large end.
As shown in FIG. 24, in a treatment apparatus according to this embodiment, the first and second flexible endoscopes 11 and 22 are inserted into the stomach 2. Further, in this treatment apparatus, a grasping forceps 144 having flexibility is provided to the second gastric fistula formation tube 4′. As shown in FIG. 24B, this grasping forceps 144 has a plate type tab 146 which extends in a longitudinal direction provided in the vicinity of the end of the insertion portion 144 a.
When the lesioned part 28 exists on the gastric mucosa in the stomach 2 on the back side, this lesioned part 28 is treated by the two flexible endoscopes 11 and 22 and the grasping forceps 144 as follows.
As shown in FIG. 31, in a treatment apparatus according to this embodiment, the first and second flexible endoscopes 11 and 22 are inserted into the stomach 2. For example, a suction device 166 as a treatment tool (insertion member) is provided to the second gastric fistula formation tube 4′. This suction device 166 includes a drain tube 166 a which can be inserted into the stomach 2 through the second gastric fistula formation tube 4′. An end portion of an aspirator 166 b is provided at a base end portion of this drain tube 166 a. Therefore, a stored liquid 168 such as sordes in the stomach can be sucked and discharged to the outside of the body by driving and operating the aspirator 166 b.
When the lesioned part 28 exists on the gastric mucosa in the stomach 2 on the back side, the lesioned part 28 is treated by these two flexible endoscopes 11 and 22 and the suction device 166 as follows.
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U.S. Classification 600/113, 600/101
International Classification A61B19/00, A61B17/34, A61B1/313, A61B1/00, A61B1/01, A61B1/31, A61B18/14, A61B17/00, A61B1/018
Cooperative Classification A61B90/50, A61B1/00149, A61B1/015, A61B1/00154, A61B1/0014, A61B2018/1407, A61B2017/00269, A61B1/31, A61B17/3415, A61B2017/3445, A61B1/313, A61B1/00073, A61B2017/00296, A61B17/3421, A61B1/01, A61B1/018
European Classification A61B1/00E4B, A61B1/00P3, A61B17/34G4, A61B17/34E, A61B1/01, A61B1/313
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Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:OLYMPUS OPTICAL CO., LTD.;REEL/FRAME:016986/0422