Source: https://patents.google.com/patent/US8021293B2/en
Timestamp: 2019-06-26 23:27:45
Document Index: 590967448

Matched Legal Cases: ['arts 15', 'art 15', 'art 7', 'art 3', 'art 3', 'art 15', 'art 15', 'art 15', 'art 15', 'art) 31', 'art 31', 'art 36', 'art 36', 'art 36', 'art 36', 'art 46', 'art 47', 'art 46', 'art 47', 'art 50', 'art 57', 'art 56', 'art 57', 'art 71', 'art 71', 'art 48', 'art 46', 'art 47', 'art 50', 'art 36', 'art 36', 'art 36', 'art 36', 'art 36', 'art 15', 'art 58', 'art 51', 'art 51', 'art 36']

US8021293B2 - Medical treatment endoscope - Google Patents
US8021293B2
US8021293B2 US11/809,488 US80948807A US8021293B2 US 8021293 B2 US8021293 B2 US 8021293B2 US 80948807 A US80948807 A US 80948807A US 8021293 B2 US8021293 B2 US 8021293B2
US11/809,488
US20080051631A1 (en
2006-01-13 Priority to US11/331,963 priority Critical patent/US8092371B2/en
2006-05-16 Priority to US11/435,183 priority patent/US8617054B2/en
2007-01-12 Priority to US11/652,880 priority patent/US8444547B2/en
2007-06-01 Application filed by Olympus Medical Systems Corp filed Critical Olympus Medical Systems Corp
2007-06-01 Priority to US11/809,488 priority patent/US8021293B2/en
2007-11-13 Assigned to OLYMPUS MEDICAL SYSTEMS CORP. reassignment OLYMPUS MEDICAL SYSTEMS CORP. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DEJIMA, TAKUMI, MATSUNO, KIYOTAKA, TAKEMOTO, SHOTARO
2008-02-01 Priority claimed from US12/024,704 external-priority patent/US9308049B2/en
2008-02-22 Priority claimed from US12/035,535 external-priority patent/US9289112B2/en
2008-02-28 Publication of US20080051631A1 publication Critical patent/US20080051631A1/en
2008-03-28 Priority claimed from US12/058,029 external-priority patent/US8556805B2/en
2008-03-28 Priority claimed from US12/057,990 external-priority patent/US9173550B2/en
2008-05-27 Priority claimed from US12/127,449 external-priority patent/US8439828B2/en
2011-09-20 Publication of US8021293B2 publication Critical patent/US8021293B2/en
This is a Continuation In-part Application (CIP) based on U.S. patent application Ser. No. 11/652,880, titled “MEDICAL TREATMENT ENDOSCOPE”, filed Jan. 12, 2007, which is a CIP based on U.S. patent application Ser. No. 11/435,183, titled “MEDICAL TREATMENT ENDOSCOPE”, filed May 16, 2006, which is a CIP based on U.S. patent application Ser. No. 11/331,963, titled “MEDICAL TREATMENT ENDOSCOPE”, filed Jan. 13, 2006.
FIG. 53 shows an initial state of the arm member of the medical treatment endoscope in cross-sectional view.
FIG. 54 shows a bending state of the arm member of the medical treatment endoscope in cross-sectional view.
FIG. 55 shows an initial state of the arm member of the medical treatment endoscope in cross-sectional view.
FIG. 56 shows the arm member of the medical treatment endoscope in cross-sectional view.
FIG. 59 is a cross-sectional view along the line in FIG. 53.
FIG. 72 is a perspective view showing a medical treatment endoscope according to a fifth embodiment.
FIG. 73 is an enlarged view of an operation section.
FIG. 74 is a view taken along the line A-A in FIG. 73 in parallel with an axial direction of a first operation section.
FIG. 75 is a view on arrow AB in FIG. 74.
FIG. 76 is a cross-sectional view along the line AC-AC in FIG. 75.
FIG. 77 is a cross-sectional view along the line AD-AD in FIG. 75.
FIG. 78 is an exploded view for a rotational axis.
FIG. 79 is a perspective view for the other rotational axis, a support chip, and a bending wire.
FIG. 80 is a cross-sectional view along the line AE-AE in FIG. 79.
FIG. 81 is a plan view illustrating a first operation stick and a procedure instrument.
FIG. 82 is a cross-sectional view along the line AF-AF in FIG. 81 illustrating a pre-insertion state of the procedure instrument.
FIG. 83 is a perspective view for a piston.
FIG. 84 is a cross-sectional view showing an enlarged state of a first operation stick illustrated in FIG. 77.
FIG. 85 shows an enlarged state of a channel illustrated in FIG. 84.
FIG. 86 is a plan view illustrating a procedure instrument.
FIG. 87 is a cross-sectional view along the line AG-AG in FIG. 86.
FIG. 88 describes how to attach a protection member to a ring.
FIG. 89 describes a post-attached protection member disposed to the ring.
FIGS. 90A and 90B illustrate a cam in a perspective view.
FIG. 91 is a view on arrow AH in FIG. 90.
FIG. 92 is a cross-sectional view along the line AI-AI in FIG. 86.
FIG. 93 is a cross-sectional view along the line AJ-AJ in FIG. 86.
FIG. 94 illustrates motions provided by a cam, a piston, and a connection plate when the procedure instrument is inserted into the first operation stick.
FIG. 95 illustrates the piston pushed up by the cam.
FIG. 96 illustrates a retractable state of the connection plate.
FIG. 97 illustrates the cam disposed between two grooves of the connection plate.
FIG. 98 illustrates an engaged state of the cam to a second groove.
FIG. 99 illustrates the cam pushing up the piston when removing the procedure instrument.
FIG. 100 illustrates the piston pushed up by rotating the cam.
FIG. 101 illustrates a base having an operation section joined to a second bending slider disposed on a side of a base.
FIG. 102 is a cross-sectional view illustrating a mechanism for joining the second bending slider to the operation section in the configuration shown in FIG. 101.
FIG. 103 is a view showing a modified example of the cam.
FIG. 104 illustrates a feed operation for the procedure instrument.
FIG. 105 illustrates a feed operation for the procedure instrument.
FIG. 106 illustrates a combined use of the medical treatment endoscope and an overtube.
FIG. 107 is an external view for the procedure instrument.
FIG. 108 is a cross-sectional view for the procedure instrument.
FIG. 109 is a cross-sectional view along the line AK-AK in FIG. 108.
FIG. 110 is a cross-sectional view along the line AL-AL in FIG. 108.
FIG. 111 illustrates a pusher wire protruding from a needle.
FIG. 112 illustrates a retainer embedded in tissue of an inner wall of a body cavity.
FIG. 113 illustrates a disposition of the operation section having an overcoat tube enclosing a needle.
FIG. 114 is a view showing the overcoat tube enclosing the needle.
FIG. 115 illustrates a main body of the operation section pushed into the overcoat tube.
FIG. 116 illustrates the needle protruding into the inner wall of the body cavity.
FIG. 117 illustrates the protruding stabbing into the inner wall of the body cavity.
FIG. 118 illustrates a forwarded state of a slider.
FIG. 119 illustrates an anchor extruded from the needle.
As shown in FIGS. 1 and 2, rigid front end parts 15 are disposed at the front ends of the first arm member 8A and the second arm member 8B. A bumper 15 a is provided at the front end part 15 for limiting movement in the forward direction when gripping forceps 5 or the like are inserted from the base end side of the instrument insertion channel 6.
Bending wires 17A and 17B, and bending wires 17C and 17D are paired respectively, and positioned so as to be symmetrical about the center of bending part 7. Each bending wire 17A, 17B, 17C, and 17D is inserted into a bending wire coil 18 within the first sheath 3. A video cable 20, which is connected to a viewing device 12 which includes an image pick-up unit 11 and an objective lens (optical member for viewing) 23, and two light guides (illuminating members) 21A and 21B which emit illuminating light onto illuminating lenses (illuminating optical members) 21 a, which are structural components of the illuminating members and are for lighting the object to be illuminated by forming the illuminating light bundles into a desired light bundle profile, are inserted into the first sheath 3 so as not to interfere with the second sheath 9A, the third sheath 9B and the various bending wires. A rigid sheath front end part 3A is disposed to the front end of the first sheath 3. An objective lens 23, and illuminating lenses 21 a which are on either side of the objective lens so as to interpose the objective lens 23 therebetween, are disposed to the sheath front end part 3A. In other words, the illuminating members are disposed on either side of the viewing device. As shown in FIG. 7A, a plurality of markings 22, for understanding the length of the inserted portion when the endoscope is inserted into the patient, are provided at predetermined intervals along the surface of the first sheath 3 on the hand-held side thereof.
As shown in FIGS. 2A and 2B, this gripping forceps 5 is fixed in place via a first connecting member 30A, a second connecting member 30B and a third connecting member 30C to the second arm member 8B to enable free rotation. The first connecting member 30A is tubular, with its inner peripheral surface fixed in place near the front end of the gripping forceps 5 by a screw, adhesive agent or the like. The second connecting member 30B is in the form of a short pipe, and is interposed between the bumper 15 a of the front end part 15 and the first connecting member 30A. The third connecting member 30C is in the form of a short pipe, and is formed so that the base end projects inward in the radial direction. This third connecting member 30C engages with the front end part 15, and pushes the first connecting member 30A in the forward direction. As a result, the second connecting member 30B is pushed further forward than the first connecting member 30A, coming into contact with the bumper 15 a of the front end part 15, thereby restricting movement of the gripping forceps 5 in the advancing or retracting direction. On the other hand, the gripping forceps 5 are attached in a freely rotating manner with respect to the instrument insertion channel 6. Note that the third connecting member 30C may also be attached to the front end part 15 by screwing, or by an adhesive agent or the like.
The gripping forceps 5 are provided with a forceps operating part (procedure operating part) 31. The forceps operating part 31 is provided with a forceps operating part main body 32 to which the coil sheath 25 a is connected, and a forceps handle 33 to which a forceps manipulating wire 27 is connected and which is disposed in a freely retracting and advancing manner with respect to the forceps operating part main body 32.
The linking part 36 is formed extending in the form of a long plate, and one end 36 a is axially supported by a guide member 42 of the first sheath 3, explained below, to enable rotation. Note that in the case of the second arm member 8B, one end 36 a of the linking part 36 is axially supported by a sliding member 43, explained below, that can advance and retract along the central axis C1.
The support 37 is supported by another end 36 b of the linking part 36 via a support axis 38, to enable rotation thereof, or alternatively, is connected so that rotation is not possible. The other end 36 b of the linking part 36 is formed in the shape of a disk centered about the position of attachment to the support axis 38, with bending opening/closing wires 35 supported by the periphery thereof. The bending opening/closing wires 35 are disposed inside the first sheath 3, inserted into respective bending opening/closing wire coils 41.
The frame 45 is provided with a moving frame 45A where the open/close operating part 46 and the bending operating part 47 of the arm member 8A are disposed; and a fixed frame 45B where the open/close operating part 46 and the bending operating part 47 of the arm member 8B, and the rotation operating part 50 of the first sheath 3, are disposed. Arm clamps 52 for supporting the first arm member 8A and the second arm member 8B projecting from the base end of the first sheath 3 farther toward the hand-held side are respectively disposed along the central axis C3 to moving frame 45A and fixed frame 45B. In addition to the first arm member 8A and the second arm member 8B, the light guides 21A and 21B and the video cable 20 project out from the base end of the first sheath 3, and are connected respectively to a light source device L and a controller C. A fixing screw 45 a for connecting and fixing in place a scope holder 86, explained below, is disposed to the bottom of the fixed frame 45B. Note that with respect to fixing with the scope holder 86, it is also acceptable to enable free sliding so that it is possible to adjust the position of the front end of the medical treatment endoscope 1 inside the body cavity by advancing and retracting the entire operating part.
The horizontal bending operating part 57 is provided with the same construction as the vertical bending operating part 56. In other words, the horizontal bending operating part 57 is equipped with a pair of rod-shaped second bending guides 70A and 70B in which the longitudinal ends of the second movement restricting member 61 are engaged in a manner to enable sliding, in order to cause parallel displacement of the second movement restricting member 61 in the horizontal direction; a second die part 71 that is connected to the end 61 a of the second movement restricting member 61, and moves along the second bending guide 70A; a second belt member 72, in which both ends are connected with respect to the second die part 71 so as to be in opposition to one another from the direction along the second bending guide 70A; adjusting wheels 66 for adjusting the tension by winding the second belt member 72; a second chain belt, not shown in the figures, in which the bases of the bending wires 17C and 17D are connected at either end; and a second gear 75 in which the second chain belt engages and around which the second belt member 72 is wound.
The advance/retract operating part 48 is provided with a slide rail 76 for moving the moving frame 45A, to which the open/close operating part 46 and the bending operating part 47 connected to the aim member 8A are disposed, with respect to the fixed frame 45B; and a base 77 which is disposed to the moving frame 45A and engages in a sliding manner with the slide rail 76. An advance/retract restricting member 78 is disposed to the front end side of the slide rail 76. The amount of sliding of the moving frame 45A is restricted to a predetermined range as a result of the base 77 coming into contact with this advance/retract restricting member 78. This advance/retract restricting member 78 is positioned at a predetermined location so that the sliding member 43 of the advance/retract mechanism 13 does not come free from the guide member 42.
The rotation operating part 50 is disposed further toward the front end side of the frame 45 than the arm clamp 52, and is provided with a sheath connector 82, to which a rotation knob 81 is disposed and the base end of the first sheath 3 is connected; and a rotation support 83 for supporting the sheath connector 82 in a manner to enable rotation. A screw hole 83 a is formed in the rotation support 83, and a through-hole 82 a is formed in the sheath connector 82. The rotation of the sheath connector 82 with respect to the rotation support 83 is restricted as a result of the engagement of a stopping screw or the like at the position where the screw hole 83 a and the through-hole 82 a are overlapped. The amount of rotation is preferably on the order of 180 degrees to either side. Note that a through-hole 83 b is disposed to the rotation support 83 for insertion of the light guides 21A and 21B and the video cable 20.
When opening the first arm member 8A and the second arm member 8B with respect to the first sheath 3 from the starting state shown in FIGS. 5A and 7A, the open/close handle 55 is slid with respect to the open/close operating part main body 53 a predetermined distance toward the hand-held side. The bending opening/closing wire 35 is thus retracted with respect to the first sheath 3 toward the hand-held side. Accompanying this, the other end 36 b of the linking part 36 receives a rotational torque toward the base end side of the first sheath 3. The other end 36 b side of the linking part 36 is rotated about the one end 36 a by a predetermined angle in the direction away from the central axis C1 of the first sheath 3. As shown in FIGS. 6A and 8A, the support 37 rotates with respect to the first sheath 3, and opens. In this case, the position of the open/close handle 55 is fixed in place by the rack 53A of open/close operating part main body 53, and the position of the bending opening/closing wire 35 is thus fixed in place with respect to the first sheath 3.
When closing the first arm member 8A and the second arm member 8B with respect to the first sheath 3, the open/close handle 55 is advanced forward with respect to the open/close operating part main body 53, while pressing on the release button 55A of the open/close handle 55. At this time, the bending opening/closing wire 35 is advanced forward with respect to the front end side of the first sheath 3. Accompanying this, the rotational torque applied on the linking part 36 is released, and the other end 36 b of the linking part 36 is rotated about the one end 36 a of the linking part 36 in a direction toward the central axis C1 of the first sheath 3. As a result, the support 37 rotates with respect to the first sheath 3 and closes, i.e., resumes the starting state.
As an example here, the case will be explained where a high-frequency knife 85 is inserted into the second sheath 9A and the first arm member 8A. First, the high-frequency knife 85 is inserted into the instrument insertion channel 6, and the front end of the high-frequency knife 85 comes into contact with the bumper 15 a that is provided at the front end part 15 of the first arm member 8A. The front end of the high-frequency knife 85 is urged toward the bumper 15 a by pushing the high-frequency knife 85 further in from the base end side, so that the knife operating part, not shown, of the high-frequency knife attaches into the attachment part 58 of the operating part 51. In this way, advancing and retracting of the high-frequency knife 85 with respect to the first arm member 8A is restricted. Note that the high-frequency knife 85 is supported to enable free rotation with respect to the first arm member 8A and the operating part 51.
After the abdominal cavity having been treated is suitably irrigated, the medical treatment endoscope 1 is retracted into the stomach ST via the wall of the opening SO. After releasing the pressure applied to the abdominal cavity AC, the medical treatment endoscope 1 is taken out of the mouth M of the patient PT.
In this case, the axial force generated by advancing and retracting the bending opening/closing wire 35 with respect to the first sheath 3 can be converted through the linking part 36 of the open/close mechanism 10 into the force for opening and closing the first arm member 8A and the second arm member 8B. As a result, the first arm member 8A and the second arm member 8B