JP6261953B2 - Endoscope device - Google Patents

Description

  Embodiments described herein relate generally to an endoscope apparatus. The endoscope apparatus may be referred to as a “diagnosis system”.

  The capsule endoscope mainly includes an imaging unit (such as a CCD camera) for capturing an image inside the body cavity, an illumination unit (such as an LED) for illuminating the inside of the body cavity, and a receiving device for capturing captured image information. And a power supply (such as a silver oxide button battery) for supplying power to the transmitter. When administered orally to a subject, it moves from the esophagus to the small intestine or large intestine by taking several pictures per second, mainly by peristaltic movement of each gastrointestinal tract, just like normal food. After 10 hours, it is discharged from the anus to the outside of the body (about 8 hours until the target small intestine is photographed). The subject may be referred to as a “patient”.

  As a means for observing the small intestine that has been difficult to observe with an endoscope, there is a double balloon endoscope (for example, Non-Patent Document 1). However, since there is a slight burden on the subject in the examination with the double balloon endoscope, the flow of the screening examination with the capsule endoscope having a smaller burden is being made.

  In addition, the advantage of endoscopic examination with capsule endoscopy is that the burden on the patient is small, which is superior to conventional upper gastrointestinal endoscopy and lower gastrointestinal endoscopy. Capsule endoscopes for observing each or all of the gastrointestinal tract are also being researched and developed.

  As an example, since a capsule endoscope observes a narrow space such as the small intestine while propelling it by peristaltic motion, it is difficult to observe a wide space such as the stomach and large intestine without any difficulty. Therefore, a “self-propelled capsule endoscope” has been developed, and a conference presentation has been carried out, in which a micromachine that combines fins and fins that can be controlled with an external joystick is attached to an existing capsule endoscope. (For example, Non-Patent Document 2).

  Further, in order to solve the problem that the capsule endoscope spends wasted time until it reaches the first application site (for example, the duodenum), and the built-in battery is wasted due to imaging, transmission, etc. A technique has also been developed in which a capsule endoscope is connected to the device, guided from the mouth to the application site with a scope, and the capsule endoscope is separated when the application site is reached (for example, Patent Document 3).

US Pat. No. 5,604,531 Japanese Patent No. 3810381 Japanese Patent No. 4133074

Clinical Gastroenterology 18, 1203-1208, 2003 Sadaharu Nouda, Eiji Umegaki, Naotake Ohtsuka, Kenshiro Uesugi, et al. Observation of the Human Large Intestine With a Self-Propelling Capsule Endoscope Using a Magnetic Field by Two Different Approaches: Gastroenterology Vol. 142, Issue 5, Supplement 1, Page S -244

However, the conventional technique has the following problems.
Although the self-propelled capsule endoscope described in Non-Patent Document 2 seems to be a system that does not cause pain to the patient except that it drinks 500 ml of water at once, a large-sized device for controlling the capsule endoscope from the outside is necessary.

  Therefore, as described in Patent Document 3, a capsule endoscope is attached to the tip of an endoscope, and the scope and the duodenum are inspected by operating the scope in the same manner as a conventional endoscope. Then, it was considered that the capsule portion was separated from the scope and the digestive tract was observed from the duodenum as a normal capsule endoscope. Here, when the endoscope is inserted from the mouth, the tip of the endoscope may come into contact with the tongue base in the oropharynx, and nausea due to pharyngeal reflection may occur. Since this is a heavy burden on the patient, strong anesthesia and sedatives may be required, which is another burden on the patient, and a longer examination time also creates a burden on the medical institution side. ing.

  In order to solve the problem of pharyngeal reflex, a transnasal endoscope in which an endoscope is inserted into the stomach without passing through the pharynx has been developed and is already widely used. However, since the fiber diameter is as thin as about 6 mm compared with about 10 mm for the oral endoscope, the camera diameter is also narrowed, the field of view is narrow, the resolution of the image is low, and the visible light source is also small, so the field of view becomes dark. It is said that there is a problem that it is not suitable for close inspection. In addition, it seems that it is difficult to make the capsule endoscope attached to the tip into a size that can enter from the nose because it is necessary to mount a camera, a light source, an antenna and a power source for driving them.

  This embodiment solves the above-described problem, and reduces the burden on the subject, and further provides an endoscope apparatus capable of widening and brightening the visual field when observing the inside of a body cavity. The purpose is to provide. It is another object of the present invention to provide an endoscope apparatus for observing tissue from the stomach surface and the mucosal layer of the stomach wall to the serosa.

  In order to solve the above problems, an endoscope apparatus according to an embodiment inspects the inside of a body cavity, and includes a manipulator, a capsule endoscope, and contact / separation means. The manipulator has a multi-degree-of-freedom flexibility inserted through the nasal passage. Capsule endoscopes are introduced orally. The contacting / separating means is provided between the manipulator and the capsule endoscope, and is capable of connecting / disconnecting them.

The functional block diagram of a diagnostic system. The functional block diagram of a capsule endoscope system part. The whole figure of a manipulator. The enlarged view of the front-end | tip part of a manipulator. The block diagram of a capsule endoscope. The block diagram of the contact-and-separation means which concerns on 1st Embodiment. The figure which made the cross section of a part of contact / separation means before a connection. The partial expanded sectional view of FIG. Sectional drawing which shows the restraint member etc. of the guidance start state by a fitting hole after the mutual fitting of a convex part and a recessed part. Sectional drawing which shows the restraint member etc. of the guidance completion state by a fitting hole. Sectional drawing which shows the engaging member etc. which were engaged with the to-be-engaged part. Sectional drawing which shows the restraint member etc. which were pulled out from the fitting hole by the rod-shaped member. The functional block diagram of an approach / separation detection means. The figure which shows an endoscope apparatus when test | inspecting a stomach wall. The figure which shows the manipulator brought close to the capsule endoscope in a body cavity. The flowchart which shows a series of operation | movement when test | inspecting the inside of a body cavity with an endoscope apparatus. The figure which made a part of contact means before connection in a modification a section. Sectional drawing which shows the restraint member etc. of the guidance start state by a fitting hole after the mutual fitting of a convex part and a recessed part. The block diagram of the contact-and-separation means which concerns on 2nd Embodiment. In 2nd Embodiment, the figure which made a part of contact / separation means after being connected the cross section. The figure which made the cross section the part of contact / separation means when isolate | separated.

When observing the inside of a body cavity such as the stomach or intestine using an endoscope apparatus, a small-diameter manipulator is inserted through the nasal passage. In addition, a capsule endoscope is administered orally. The manipulator and the capsule endoscope are connected in the stomach and separated again after examination of the stomach and duodenum.
Such an endoscope apparatus requires contact / separation means for connecting / separating the manipulator and the capsule endoscope.

<First Embodiment>
Next, the configuration of the endoscope apparatus according to the first embodiment will be described with reference to the drawings. FIG. 1 is a configuration block diagram of a diagnostic system.

  As shown in FIG. 1, the diagnostic system includes a capsule endoscope system unit 1, a manipulator unit 2, a data recording unit 9, a display unit 10, a console 11, an approach / separation unit 14, an operation unit 17, and an overall control unit 18. Have

[Capsule endoscope system part 1]
FIG. 2 is a functional block diagram of the capsule endoscope system unit.
The capsule endoscope system unit 1 is installed in an examination room, for example.
As shown in FIG. 2, the capsule endoscope system unit 1 includes a capsule detection image storage device 3 and a capsule endoscope 4.

  The capsule endoscope 4 has a diameter of about 10 mm and a length of about 25 mm that can be swallowed by humans without difficulty, like a conventional capsule endoscope. In order to maintain the performance of the various devices to be mounted, it is important that the size is at least this size, and it does not enter from the nasal cavity.

  As shown in FIG. 2, the capsule detection image storage device 3 is a device that detects the position of the capsule endoscope 4 in the digestive tract and stores an image captured by the capsule endoscope 4. For example, a body surface antenna 5 that is provided on an outer garment (vest) worn by a subject and receives a position signal of the capsule endoscope 4, and a signal from the body surface antenna 5 is received and the capsule endoscope 4 A position detection unit 6 that detects position information, an image reception unit 7 that receives images captured by the capsule endoscope 4, an image storage unit 8 that stores these images, position information detected by the position detection unit 6, and A transmission unit (not shown) that transmits image information stored in the image storage unit 8 to an external data recording unit 9 and a control unit (not shown) that controls these units.

[Data recording unit 9, display unit 10, console 11]
As shown in FIGS. 1 and 2, the data recording unit 9 records the position information transmitted from the position detection unit 6 and the image information stored in the image storage unit 8.

  The display unit 10 displays position information and image information called from the data recording unit 9. The console 11 processes the information displayed on the display unit 10 and stores it again in the data recording unit 9.

[Manipulator part 2]
FIG. 3 is an overall view of the manipulator, and FIG. 4 is an enlarged view of a tip portion of the manipulator.
As shown in FIGS. 3 and 4, the manipulator unit 2 includes a manipulator 12, a tip portion 13, and an operation unit 17.

  The manipulator 12 includes a plurality of links, a joint portion where the links are rotatably connected, and an actuator (not shown) that relatively rotationally drives the links at the joint portion. Has flexibility. The manipulator may be referred to as a “multi-degree-of-freedom bending manipulator”.

  The operation unit 17 has a handle and a switch. The manipulator 12 may convert the instructions of the handle and the switch by the operator into operation signals by the control unit, and may control each main part of the distal end portion 13 based on the electrical signal, Therefore, it may be transmitted to each main part and controlled.

  Each main part controlled by the control unit in response to an instruction from the operation unit 17 includes, for example, contact / separation means 14 (engagement member 32, restraining member 34) for connecting / separating the manipulator 12 and the capsule endoscope 4. And a rod-shaped member 35) (see FIG. 6). Details of the contact / separation means 14 will be described later.

  As shown in FIG. 4, in addition to the contact / separation means 14, a camera unit 15 and a light unit 16 are disposed at the distal end portion 13. The camera unit 15 and the light unit 16 are used for confirming the position of the capsule endoscope 4 in a body cavity (for example, in the stomach).

[Details of capsule endoscope]
Next, details of the capsule endoscope 4 will be described. FIG. 5 is a configuration diagram of the capsule endoscope.

  As shown in FIG. 5, the capsule endoscope 4 has a basic configuration similar to that already commercialized, an optical system 19 for capturing an in-vivo image with a predetermined resolution, and the optical system 19 The image acquisition unit 20 that acquires the optical image information obtained by the above as an electrical signal, the image transmission unit 21 that transmits the image acquired by the image acquisition unit 20 to the outside wirelessly, and the position of the capsule endoscope 4 A position transmission unit 22 for transmitting data and the like to the outside, a light source unit 23 that illuminates an organ around the capsule endoscope 4 in conjunction with the optical system 19, and a battery 24 that supplies power to these units, And an elliptical endoscope housing 25 that accommodates them.

  In addition, the “short axis direction” and the “long axis direction” in the elliptical shape are used when indicating the direction in which the manipulator 12 and the capsule endoscope 4 are connected. In the first embodiment, the connection direction is the minor axis direction.

  The capsule endoscope 4 stores at least one of an ultrasonic device and an OCT (Optical coherence tomography) device. These apparatuses are shown as “ultrasonic / OCT apparatus 27” in FIG. At least one of an ultrasonic probe and an OCT probe is accommodated on the surface of the housing 25. These probes are indicated by “ultrasonic / OCT probe 28” in FIG. The diagnosis system is controlled by the overall control unit 18.

[Contact / separation means 14]
FIG. 6 is a configuration diagram of the contact / separation means 14.
As shown in FIG. 6, the contacting / separating means 14 is disposed between the manipulator 12 and the capsule endoscope 4. The contact / separation means 14 includes a permanent magnet 31, an engagement member 32, a biasing member 33, a restraining member 34, and a rod-shaped member 35. These are arranged at the tip 13 of the manipulator 12.

  In the capsule endoscope 4, a permanent magnet 41 and an engaged portion 42 are arranged. The manipulator 12 and the capsule endoscope 4 are connected / separated by the permanent magnet 41 and the engaged portion 42 and the contact / separation means 14.

  When the manipulator 12 and the capsule endoscope 4 are connected by the contacting / separating means 14, the capsule endoscope 4 is operated in the stomach via the manipulator 12, so that the capsule endoscope 4 is operated as a normal endoscope. Like the mirror, it comes to be pressed against the stomach wall (see FIG. 14).

[Main configuration of contact / separation means 14]
Next, an example of the contact / separation means 14 will be described with reference to FIGS.
First, the main structure of the contact / separation means 14 for connecting the capsule endoscope 4 and the manipulator 12 will be described.

  As shown in FIG. 6, the main configuration has a permanent magnet 31. On the other hand, the capsule endoscope 4 has a permanent magnet 41.

(Permanent magnet 31)
As shown in FIG. 7, the permanent magnet 31 is disposed at the distal end portion 13 of the manipulator 12. The permanent magnet 31 has a convex shape. The convex portion has an elliptical outer shape.

(Permanent magnet 41)
The permanent magnet 41 is disposed on the side surface of the capsule endoscope 4 (the side surface opposite to the side surface on which the probe is provided). The permanent magnet 41 has a concave shape. The concave portion has the same elliptical outer shape as the convex portion. By fitting convex portions and concave portions having the same elliptical outer shape, the position of the capsule endoscope 4 with respect to the manipulator 12 is determined, and the major axes and the minor axes of the elliptical shape coincide with each other. The direction of the endoscope 4 is determined. Determining the position and direction of the capsule endoscope 4 may be referred to as “positioning of the capsule endoscope 4”.

  The reason why the permanent magnet 41 is arranged on the side surface of the capsule endoscope 4 is that the area where the side surface of the capsule endoscope 4 is connected to the manipulator 12 can be made larger than that of the front end or the rear portion. This is because the capsule endoscope 4 can be stabilized, which is advantageous when the capsule endoscope 4 is pressed against the stomach wall or the like. However, this does not deny that the permanent magnet 41 is disposed at the rear of the capsule endoscope 4 or the like.

  The above is the main configuration for connecting the capsule endoscope 4 to the manipulator 12 by the magnetic force of the permanent magnets 31 and 41. Note that either one of the permanent magnets 31 and 41 may be replaced with a magnetic body, and the capsule endoscope 4 may be connected to the manipulator 12 by the magnetic force of the other permanent magnet.

  Next, an auxiliary configuration of the contacting / separating means 14 for connecting the capsule endoscope 4 to the manipulator 12 will be described.

[Auxiliary structure of the contact / separation means 14]
As shown in FIGS. 6 and 7, the auxiliary configuration includes an engaging member 32, a biasing member 33, and a restraining member 34. On the other hand, the capsule endoscope 4 includes an engaged portion 42 and a fitting hole 43.

  FIG. 8 is a cross-sectional view of a part of the contacting / separating means before connection. As shown in FIG. 8, the pair of engaging members 32 are arranged corresponding to the pair of fitting holes 43. Further, the pair of restraining members 34 are arranged corresponding to the pair of fitting holes 43. The distance between the pair of engaging members 32 is the same as the distance between the pair of fitting holes 43, and the distance between the pair of restraining members 34 is the same as the distance between the pair of fitting holes 43.

(Engagement member 32, restraint member 34)
FIG. 9 is a cross-sectional view showing a restraining member or the like in a guiding start state by a fitting hole after fitting the convex portion and the concave portion, FIG. 10 is a cross-sectional view showing a restraining member or the like in a guiding end state by the fitting hole, 11 is a cross-sectional view showing an engaging member and the like engaged with the engaged portion, and FIG. 12 is a cross-sectional view showing a restraining member and the like pulled out from the fitting hole by the rod-like member.

  As shown in FIG. 7, the engaging members 32 are disposed on both sides of the permanent magnet 31 at the distal end portion 13 of the manipulator 12. A restraining member 34 that restrains the posture of the engaging member 32 is disposed at the distal end portion 13 of the manipulator 12.

  The engaging member 32 is formed of a long, flat plate-shaped elastic material, has a restoring force, and is extended in the longitudinal direction (see FIGS. 8, 9, 10, and 12), It deform | transforms into the 2nd attitude | position (refer FIG. 11) which bent the front-end | tip part with the restoring force.

  The restraining member 34 restrains the engaging member 32 in the first posture and has a restraining groove 34a for guiding the engaging member 32 in the longitudinal direction. When the engaging member 32 protrudes with respect to the restraining groove 34a, the restraining by the restraining groove 34a is released, and the engaging member 32 is deformed to the second posture by the restoring force.

  FIG. 11 shows the engaging member 32 that is deformed to the second posture and is engaged with the engaged portion 42. In addition, since the engaging member 32 is a structure which has a restoring force, the biasing member 33 for changing the front-end | tip part to a 2nd attitude | position is not especially required. It can be said that the engaging member 32 having a restoring force includes an urging member 33. However, in a configuration in which the engaging member 32 does not have a restoring force, a biasing member 33 that deforms the engaging member 32 from the first posture to the second posture may be provided.

  In response to an instruction from the operation unit 17, the restraint member 34 is controlled by the control unit so as to protrude from the distal end portion 13 of the manipulator 12. Further, upon receiving an instruction from the operation unit 17, the control member controls the engagement member 32 so as to appear and retract relative to the restraining member 34. Thus, the engaging member 32 is guided between a protruding position protruding from one end of the restraining groove 34a and an immersing position where the engaging member 32 is immersed in the restraining groove 34a.

  As shown in FIG. 9, the restraining member 34 is fitted into the fitting hole 43 when the manipulator 12 and the capsule endoscope 4 are connected. Note that the restraining member 34 may be formed in a wedge shape to facilitate fitting.

  The restraining groove 34 a has the same groove width as the plate thickness of the engaging member 32. At one end of the restraining groove 34a (the end on the side where the engaging member 32 protrudes and protrudes), the groove wall on the side where the distal end portion of the engaging member 32 is bent has a chamfered portion 34b. The chamfered portion 34b is an inclined surface so as to smoothly connect the groove wall and the engaged portion 42. FIG. 10 shows a chamfered portion 34b that connects the groove wall of the restraining groove 34a and the engaged portion 42.

(Engaged portion 42, fitting hole 43)
The fitting hole 43 is on the side surface of the capsule endoscope (the surface facing the short axis direction) and is disposed at the left and right positions of the permanent magnet 41. The fitting hole 43 is formed in a substantially L-shaped cross-sectional shape. The fitting hole 43 includes an entrance 43a, a hole wall 45, and an engaged portion 42 that is a corner portion that is continuous with the hole wall 45 at the back of the hole and bends in a direction substantially perpendicular to the depth direction of the hole ( (See FIG. 8).

  When the permanent magnet 31 that is a convex portion is fitted into the permanent magnet 41 that is a concave portion, and the manipulator 12 and the capsule endoscope 4 are connected by the magnetic force between the permanent magnets 31 and 41, an instruction from the operation unit 17 is received. Thus, the restraining member 34 is fitted into the fitting hole 43 by causing the restraining member 34 to protrude from the distal end portion 13 of the manipulator 12 by the control unit. FIG. 9 shows the restraining member 34 in the immersion position. FIG. 10 shows the restraining member 34 that is projected by the control unit in response to an instruction from the operation unit 17 and fitted in the fitting hole 43.

  FIG. 11 shows the engaging member 32 that is projected relative to the restraining member 34 by the control unit in response to an instruction from the operation unit 17 and engages the engaged portion 42. In response to an instruction from the operation unit 17, the control unit causes the engagement member 32 to project relative to the restraining member 34, whereby the engagement member 32 is guided from the retracted position to the projecting position, and the engagement member 32 is moved to the first position. The posture is changed from the first posture to the second posture and engaged with the engaged portion 42. Thereby, the manipulator 12 and the capsule endoscope 4 are firmly fixed. This configuration is an auxiliary configuration for connecting the manipulator 12 and the capsule endoscope 4. With this configuration, even when the ultrasound / OCT probe 28 is pressed against the stomach wall, the capsule endoscope 4 is not detached from the manipulator 12. By pressing the ultrasonic / OCT probe 28 against the stomach wall, it becomes possible to observe the stomach surface and the tissue from the mucosal layer of the stomach wall to the serosa (thickness: about 8 mm). In addition, in order to suppress consumption of the battery 24 mounted on the capsule endoscope 4, power may be supplied from the manipulator 12 after connection (a power supply device is not illustrated).

  On the other hand, the control member receives the instruction from the operation unit 17 and causes the engagement member 32 to be immersed relative to the restraining member 34, whereby the engagement member 32 is guided from the projecting position to the projecting position. The member 32 is deformed from the second posture to the first posture and is detached from the engaged portion 42.

  Upon receiving an instruction from the operation unit 17, the control member causes the restraint member 34 to be immersed in the distal end portion 13 of the manipulator 12, so that the restraint member 34 is removed from the fitting hole 43. At this time, the engaging member 32 is in the immersive position in the first posture, and is controlled so as to be immersed integrally with the restraining member 34 by the control unit in response to an instruction from the operation unit 17.

  At this time, the permanent magnet 31 that is the convex portion is still fitted into the permanent magnet 41 that is the concave portion, and the manipulator 12 and the capsule endoscope 4 remain connected by the magnetic force between the permanent magnets 31 and 41.

[Configuration for Separation in Contact / Separation Means 14]
Next, an example of the contacting / separating means 14 for separating the capsule endoscope 4 and the manipulator 12 will be described.

(Bar-shaped member 35)
As shown in FIGS. 7 and 8, the rod-shaped member 35 is configured to protrude from the manipulator 12 toward the capsule endoscope 4. The rod-shaped member 35 is controlled so as to appear and disappear by the control unit in response to an instruction from the operation unit 17. The rod-shaped member 35 immersed in FIGS. 8-11 is shown. FIG. 12 shows the protruding rod-shaped member 35.

  In the state shown in FIG. 11, the permanent magnets 31 and 41 are fitted together, and the engaging member 32 is engaged with the engaged portion 42. In response to an instruction from the operation unit 17 from the state shown in FIG. 11, the control member causes the engaging member 32 to be immersed relative to the restraining member 34 to obtain the state shown in FIG. 10.

  In the state shown in FIG. 10, when the rod-shaped member 35 is projected toward the capsule endoscope 4 by the control unit in response to an instruction from the operation unit 17, the rod-shaped member 35 resists the magnetic force of the permanent magnets 31 and 41. Then, the capsule endoscope 4 is separated from the manipulator 12. Thereby, the manipulator 12 and the capsule endoscope 4 are separated.

[Other examples of contact / separation means 14]
In addition, the contact / separation means 14 mentioned above is an example, and is not limited to this. For example, in the contact / separation means 14 described above, the permanent magnets 31 and 41 are connected to each other. However, if the size problem can be cleared, the electromagnets may be connected to each other or permanent magnets may be combined with the permanent magnets. Also good. In particular, the permanent electromagnetic magnet supplies power only when the magnetic force is ON / OFF, so that power can be saved. Since these magnets can be connected or disconnected depending on the power supply state, the mechanism such as the engaging member 32 is not necessary.

[Contact / separation detecting means 50]
Next, the contact / separation detection means 50 will be described with reference to FIG.
FIG. 13 is a functional block diagram of the contact / separation detection means 50.

  As illustrated in FIG. 13, the contact / separation detection unit 50 includes a reference information storage unit 51, a comparison unit 52, and a detection unit 53.

  In the manipulator 12 inserted into the body cavity, the reflected light of the light emitted from the light unit 16 enters the camera unit 15. The detection unit 53 detects the brightness (for example, luminance) of the reflected light. The detected value (luminance value) detected is “Vd”. The reference value is “Vr”. The reference information storage unit 51 stores a reference value Vr.

  In the brightness of the reflected light detected by the detection unit 53, as the distal end portion 13 of the manipulator 12 approaches the capsule endoscope 4, the reflected light incident on the camera unit 15 increases, and the detection value Vd increases. When the manipulator 12 and the capsule endoscope 4 are connected, the distal end portion 13 of the manipulator 12 and the surface of the capsule endoscope 4 are brought into close contact with each other, so that the reflected light incident on the camera portion 15 is reduced and detected. The value Vd decreases rapidly. The contact / separation detection means 50 utilizes such a phenomenon. The detected value when the value rapidly decreases is set as a reference value Vr.

  The comparison unit 52 compares the reference value Vr with the detection value Vd, determines that the connection is before connection when the detection value Vd is higher than the reference value Vr, and connects when the detection value Vd becomes equal to or less than the reference value Vr. Judge that it was done.

The contact / separation detection means 50 is not limited to this.
For example, instead of the permanent magnet 31 provided in the manipulator 12, an electromagnet having a coil is used and current is supplied to the coil through the manipulator 12. Let Is be the current supplied to the coil.

  On the other hand, when a relative speed is generated between the electromagnet on the manipulator 12 side and the permanent magnet 41 provided in the capsule endoscope 4, a current due to the induced electromotive force flows through the coil. Here, when the two are relatively close to each other, the current flowing through the coil is defined as + Ii, and when the two are relatively distant from each other, the current flowing through the coil is defined as -Ii.

  That is, the supplied current and the current due to the induced electromotive force flow through the coil. Therefore, when a relative speed occurs between the two, the overall current flowing in the coil is Is ± Ii. When there is no relative speed between the two, the overall current flowing in the coil is Is.

  There are two cases when there is no relative speed between the two. The first case is when the manipulator 12 stops moving. The second case is when the manipulator 12 and the capsule endoscope 4 are connected because the electromagnet and the permanent magnet 41 are engaged even if the manipulator 12 can be moved, and both move together.

  The contact / separation detection means 50 utilizes such a phenomenon. The comparison unit 52 compares the reference value Ir (here, Ii) with the current value (detection value) Id flowing through the coil. When the detected value Id is not the reference value Ir, it is determined that the connection has not been made. Even if the manipulator 12 can be moved, it is determined that the connection has been made when the detected value Id becomes the reference value Ir.

[Operation]
Next, a series of operations when observing the inside of a body cavity using the endoscope apparatus will be described with reference to FIGS. FIG. 14 is a view showing an endoscope apparatus when examining the stomach wall, FIG. 15 is a view showing a manipulator brought close to a capsule endoscope in the body cavity, and FIG. It is a flowchart which shows a series of operation | movement when test | inspecting.

(S1: Oral administration of capsule endoscope)
As in the conventional capsule endoscopy, the subject starts fasting 12 hours before the examination. In addition, a drug for suppressing gastric peristalsis and a local anesthetic to the nasal cavity are administered at a predetermined time before the start of the examination. At the start of the examination, the capsule detection image storage device 3 is attached to the body surface of the subject. The surgeon operates the capsule endoscope position transmitting unit 22 with the overall control unit 18 so that the position of the capsule endoscope in the body of the subject can be grasped. In order to prevent falling into the back of the subject, the subject is placed in a supine position and a capsule endoscope is administered from the mouth.

(S2-S3: Insert the manipulator 12 from the nasal cavity into the stomach)
After confirming that the capsule endoscope 4 has reached the subject's stomach by the capsule detection image storage device 3, the operator inserts the manipulator 12 through the subject's nasal cavity. The camera unit 15 mounted on the manipulator 12 confirms that the manipulator 12 has reached the stomach.

(S4: Confirm position of capsule endoscope)
As shown in FIG. 15, the position of the capsule endoscope 4 in the stomach is confirmed by the camera unit 15 and the light unit 16 mounted on the manipulator 12, the optical system 19 mounted on the capsule endoscope, and the capsule detection image storage device 3. However, the distance between the manipulator 12 and the capsule endoscope 4 is reduced. When confirming the position of the capsule endoscope 4, an ultrasonic probe mounted on the capsule endoscope 4 may be used instead of the optical system 19 or together with the optical system 19.

(S5: Connection between the manipulator 12 and the capsule endoscope 4)
When the manipulator 12 and the capsule endoscope 4 approach each other to a predetermined arbitrary distance, the magnetic force (adsorptive force) of the permanent magnets 31 and 41 provided on both acts, and the capsule endoscope 4 is applied to the distal end portion 13 of the manipulator 12. Can be connected. At this time, the permanent magnet 31 has a convex shape, the convex portion has an elliptical outer shape, the permanent magnet 41 has a concave shape, and the concave portion has the same ellipse as the convex portion. Since the outer shape of the capsule endoscope 4 is provided, the direction in which the capsule endoscope 4 is attracted can be made constant (see FIG. 9). This is useful for aligning the positions of the restraining member 34 pushed out from the distal end portion 13 of the manipulator 12 and the fitting hole 43 provided in the capsule endoscope 4.

  Since both the permanent magnets 31 and 41 are required to have a weak magnetic force to the extent that they can be separated later by using the rod-like member 35, the magnetic force of the permanent magnets 31 and 41 alone is under examination of the stomach / duodenum. Further, it is difficult to keep the connection between the manipulator 12 and the capsule endoscope 4. Therefore, after the connection with the permanent magnets 31 and 41, the restraining member 34 is first fitted from the distal end portion 13 of the manipulator 12 to the fitting hole 43 of the capsule endoscope 4, and further passes through the restraining groove 34 a of the restraining member 34. Thus, the manipulator 12 and the capsule endoscope 4 are firmly fixed by inserting the engaging member 32 having a restoring force and bending the distal end portion of the engaging member 32 to engage with the engaged portion 42. (See FIG. 11). The restraining member 34 and the engaging member 32 can be operated by the control unit, for example, by the operator holding the manipulator 12 by receiving an instruction from the operation unit 17 provided in the manipulator 12.

(S6: Observation in the stomach)
Operate the manipulator 12 connected to the capsule endoscope 4 to check for changes in the color and shape of the gastric mucosa and stomach wall, such as bleeding, tumor, polyp, ulcer, fistula, etc., as in normal gastroscopy. Observe. If necessary, the state of the tissue inside the stomach wall may be observed by pressing the ultrasound / OCT probe 28 provided in the capsule endoscope against the stomach wall (see FIG. 14). This test is thought to be useful in the detection of Skilled gastric cancer, which is problematic because it is difficult to find in normal endoscopy and fluoroscopy.

(S7: Observation in the duodenum)
Further, the manipulator 12 connected to the capsule endoscope 4 is advanced to the back of the stomach, and the color and shape of the mucosa and intestinal wall of the duodenum, such as bleeding, tumor, polyp, ulcer, fistula, etc., as in normal duodenoscopy. Observe the presence or absence of changes. Since the duodenal wall is thin, it seems that it is not as necessary as the stomach wall, but if necessary, the ultrasound / OCT probe 28 provided in the capsule endoscope is pressed against the duodenal wall to examine the state of the tissue in the duodenal wall (See FIG. 14).

(S8: Separation of the manipulator 12 and the capsule endoscope 4)
When the observation of the stomach / duodenum is completed, the manipulator 12 is advanced to the vicinity of the end point of the duodenum, and the capsule endoscope 4 is separated from the manipulator 12.

  When the examination of the stomach / duodenum is completed and the capsule endoscope 4 is separated from the manipulator 12 at the end point of the duodenum or at an arbitrary point, the engaging member 32 is detached from the engaged portion 42 and the restraining member 34. Is removed from the fitting hole 43, and finally, the rod-shaped member 35 is pushed out from the distal end portion 13 of the manipulator 12, and both permanent magnets 31 and 41 are separated. Similarly to the restraining member 34 and the like, the rod-shaped member 35 can be controlled by the control unit, for example, by the operator who holds the manipulator 12 by receiving an instruction from the operation unit 17.

  The surgeon uses the manipulator 12 or the camera provided in the capsule endoscope 4 to confirm that the separation has been performed reliably.

(S9: Capsule endoscopy of the small intestine)
The capsule endoscope 4 that has been confirmed to be separated from the manipulator 12 starts an examination as the capsule endoscope 4 after a predetermined procedure such as a signal to start an examination by the operator. When electric power is supplied from the manipulator 12, switching is performed so that the battery 24 mounted on the capsule endoscope 4 is driven at this timing. Like the normal capsule endoscope 4, it is carried from the small intestine to the large intestine by peristaltic movement, and the small intestine is inspected by the capsule endoscope 4 during this period.

  By the above method, it becomes possible to perform a gastro / duodenal examination with a high-resolution, wide-angle and bright endoscope using a scope without a pharyngeal reflex, and a disease detection rate is expected to be high.

[Variation 1 of the first embodiment]
Next, Modification 1 of the configuration for positioning the capsule endoscope 4 will be described with reference to FIGS. 17 and 18. FIG. 17 is a cross-sectional view of a part of the contacting / separating means before connection in a modified example, and FIG. 18 is a cross-sectional view showing a restraint member and the like in a guidance start state by a fitting hole after the convex portion and the concave portion are fitted to each other. FIG.

  In the first embodiment, the capsule endoscope 4 is positioned by the permanent magnet 31 that is a convex portion (elliptical outer shape) and the permanent magnet 41 that is a concave portion (elliptical outer shape). The entire distal end portion 13 may be formed as a convex portion (elliptical outer shape), and the side surface of the capsule endoscope 4 may be formed as a concave portion (elliptical outer shape) correspondingly. The positioning accuracy of the capsule endoscope 4 can be increased by the amount of the convex portion and the concave portion.

[Modification 2 of the first embodiment]
Next, a second modification of the configuration for positioning the capsule endoscope 4 will be described.
In the first embodiment, the main configuration of the contact / separation means 14 for connecting the capsule endoscope 4 to the manipulator 12 is such that, for example, the N pole of the permanent magnet 31 and the S pole of the permanent magnet 41 are opposed to each other. However, the present invention is not limited to this.

  For example, as the permanent magnet 31, an N pole and an S pole are arranged along the surface of the distal end portion 13 of the manipulator 12. Further, as the permanent magnet 41, an N pole and an S pole are arranged along the surface of the capsule endoscope 4. As a result, the N pole of the permanent magnet 31 and the S pole of the permanent magnet 41 are attracted, and the S pole of the permanent magnet 31 and the N pole of the permanent magnet 41 are attracted, so that the permanent magnets 31 and 41 are attracted to each other. The position and direction of the moment are determined. Thereby, the position and direction of the capsule endoscope 4 with respect to the manipulator 12 can be determined.

Second Embodiment
Next, a second embodiment of the apparatus will be described with reference to FIGS. 19 is a configuration diagram of the contact / separation means, FIG. 20 is a cross-sectional view of a part of the contact / separation means after being connected, and FIG. 21 is a cross-sectional view of a part of the contact / separation means when separated. It is. Note that in the second embodiment, the same components as those in the first embodiment are denoted by the same reference numerals, description thereof is omitted, and different components are mainly described.

[Contact / separation means 14]
As the main configuration of the contact / separation means 14 for connecting the manipulator 12 and the capsule endoscope 4, the first embodiment has the permanent magnets 31 and 41. In the second embodiment, the permanent magnet is provided. Instead of 31 and 41, a suction device 36, a nozzle 37, a chamber 38, a tube 39 and a valve 39a are provided. In addition, it is the same as that of 1st Embodiment that the engaging member 32, the biasing member 33, and the restraining member 34 are provided as an auxiliary structure for connecting (refer FIG. 19).

  In the first embodiment, the direction in which the manipulator 12 and the capsule endoscope 4 are connected is the short axis direction. On the other hand, in 2nd Embodiment, let a connection direction be a major axis direction.

(Suction device 36)
As shown in FIGS. 19 and 20, a suction device 36 is disposed at the proximal end portion of the manipulator 12. A nozzle 37 is disposed at the distal end portion 13 of the manipulator 12. The nozzle 37 has an oval cross-sectional outer shape. The nozzle 37 is connected to the suction device 36 through a chamber 38, a chamber 38, a tube 39, and a valve 39a. Through the valve 39a, the nozzle 37 communicates with the suction device 36 and communicates with the outside air.

  The suction device 36 operates under the control of the control unit in response to an instruction from the operation unit 17. The nozzle 37 is connected to the suction device 36 side by the valve 39a, the suction device 36 is operated, the gas in the body cavity is sucked from the nozzle 37, and the inside of the nozzle 37 is lower than the pressure of the gas in the body cavity (negative pressure) To. On the other hand, by making the nozzle 37 communicate with the outside air by the valve 39a, the inside of the nozzle 37 is brought into a state (positive pressure) equal to or higher than the pressure of the gas in the body cavity. The suction device 36 can be controlled by the control unit in response to an instruction from the operation unit 17, for example, by the operator holding the manipulator 12.

(Engaged portion 42, target 44)
As shown in FIG. 20, the engaged portion 42 is disposed on the side surface (the surface facing the long axis direction) of the capsule endoscope 4. The engaged portion 42 has the same elliptical hole as the outer shape of the nozzle 37. In the capsule endoscope 4, a target 44 is disposed behind the engaged portion 42 (in the long axis direction).

  The nozzle 37 is fitted into the engaged portion 42, the tip of the nozzle 37 is brought into contact with the target 44 (see FIG. 20), and the suction device 36 is operated to make the nozzle 37 have a negative pressure. Thereby, the target 44 is sucked by the nozzle 37. Thereby, the manipulator 12 and the capsule endoscope 4 are connected. The configuration including the suction device 36, the nozzle 37, the chamber 38, the tube 39, and the valve 39a is the main configuration of the contacting / separating means 14 for connecting the manipulator 12 and the capsule endoscope 4.

  By making the inside of the nozzle 37 communicate with the outside air by the valve 39a, the inside of the nozzle 37 becomes a positive pressure, the target 44 is not sucked, and the target 44 is separated from the nozzle 37. Thereby, the manipulator 12 and the capsule endoscope 4 are separated.

(Engagement member 32, biasing member 33, restraining member 34)
As shown in FIGS. 20 and 21, the nozzle 37 is provided with a pair of engaging members 32. The pair of engaging members 32 are configured to be openable and closable in a closed state so that the outer surfaces thereof are smoothly continuous with the peripheral surface of the nozzle 37 and an open state separated from the peripheral surface of the nozzle 37. FIG. 20 shows a pair of engaging members 32 that are open in a V shape. FIG. 21 shows a pair of engaging members 32 in a closed state.

  The biasing member 33 is a compression coil spring. The biasing member 33 biases the pair of engaging members 32 in the opening direction.

  The pair of engaging members 32 can be inserted into and removed from the engaged portion 42 in a closed state. The pair of engaging members 32 engage with the engaged portion 42 in an open state. Each engagement member 32 is configured to open and close the other end portion (upper end portion in FIG. 20) around one end portion (lower end portion in FIG. 20). The engaged portion 42 is configured such that the pair of engaging members 32 can be opened and the pair of engaging members 32 are engaged in the opened state. Therefore, the engaged portion 42 may be formed along the movement locus when the other end portion of the engaging member 32 is opened and closed.

  When the engaging member 32 is opened and engaged with the engaged portion 42, the manipulator 12 and the capsule endoscope 4 are not separated. When the engaging member 32 is closed and separated from the engaged portion 42, the manipulator 12 and the capsule endoscope 4 can be separated (in order to be actually separated, the target 44 is provided by the nozzle 37). Must not be sucked in.)

  As shown in FIGS. 20 and 21, one end of the restraining member 34 is connected to the engaging member 32. Here, the restraining member 34 is a control wire and is pulled along the nozzle 37, and its distal end is extended to the proximal end of the manipulator 12. The restraining member 34 is retracted / retracted under the control of the control unit in response to an instruction from the operation unit 17. When the restraining member 34 is retracted against the biased force, the pair of engaging members 32 are closed (see FIG. 21). When the restraining member 34 is extended by the biased force, the pair of engaging members 32 are opened (see FIG. 20). The configuration by the engaging member 32, the urging member 33, and the restraining member 34 is an auxiliary configuration of the contacting / separating means 14 for connecting the manipulator 12 and the capsule endoscope 4.

[Operation]
Next, a series of operations when observing the inside of a body cavity using an endoscope apparatus will be described. In the series of operations, the second embodiment is different from the first embodiment in that in the series of operations shown in FIG. 16, the connection (S5) between the manipulator 12 and the capsule endoscope 4, the manipulator 12 and the capsule endoscope. This is the separation of the mirror 4 (S8).
Hereinafter, these different operations will be described.

(S5: Connection between the manipulator 12 and the capsule endoscope 4)
The manipulator 12 is moved closer to the capsule endoscope 4 and the nozzle 37 is inserted into the engaged portion 42. At this time, since the outer shape of the nozzle 37 and the shape of the engaged portion 42 are the same elliptical shape, the suction direction of the capsule endoscope 4 can be made constant. At this time, the restraining member 34 is retracted against the urging force of the urging member 33, and the engaging member 32 is closed (see FIG. 21).

  Further, the nozzle 37 is inserted, and the tip of the nozzle 37 is brought into contact with the target 44 (see FIG. 20). Next, upon receiving an instruction from the operation unit 17, the suction unit 36 is operated by the control unit, and the gas in the body cavity is sucked through the nozzle 37. As a result, the nozzle 37 has a negative pressure, the target 44 is attracted to the nozzle 37, and the manipulator 12 and the capsule endoscope 4 are connected.

  Next, the restraining member 34 is extended by the urging force of the urging member 33, and the engagement member 32 is opened in a V shape (see FIG. 20). Thereby, the engaging member 32 is engaged with the engaged portion 42. Thereby, the capsule endoscope 4 is firmly fixed to the manipulator 12.

(S8: Separation of the manipulator 12 and the capsule endoscope 4)
When the observation of the stomach / duodenum is completed, the manipulator 12 is advanced to the vicinity of the end point of the duodenum, and the capsule endoscope 4 is separated from the manipulator 12.

  When the examination of the stomach / duodenum is completed and the capsule endoscope 4 is separated from the manipulator 12 at the end of the duodenum or at an arbitrary point, the nozzle 37 is communicated with the outside air by the valve 39a. A positive pressure is sufficient. Thereby, the target 44 is not attracted to the nozzle 37. Furthermore, the engaging member is closed by retracting the restraining member 34 (see FIG. 21). Thereby, the engaging member 32 is detached from the engaged portion 42. As described above, the manipulator 12 and the capsule endoscope 4 are separated.

  Since the target 44 is not attracted to the nozzle 37 only by making the inside of the nozzle 37 positive, the rod-shaped member 35 according to the first embodiment becomes unnecessary.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

DESCRIPTION OF SYMBOLS 1 Capsule endoscope system part 2 Manipulator part 3 Capsule detection image storage apparatus 4 Capsule endoscope 5 Body surface antenna 6 Position detection part 7 Image receiving part 8 Image storage part 9 Data recording part 10 Display part 11 Console 12 Manipulator 13 Tip Unit 14 contact / separation means 15 camera unit 16 light unit 17 operation unit 18 overall control unit 19 optical system 20 image acquisition unit 21 image transmission unit 22 position transmission unit 23 light source unit 24 battery 25 casing 27 ultrasonic wave / OCT apparatus 28 ultrasonic wave / OCT probe 31 Permanent magnet 32 Engaging member 33 Energizing member 34 Restraining member 34a Restraining groove 34b Chamfered portion 35 Bar-shaped member 36 Suction device 37 Nozzle 38 Chamber 39 Tube 39a Valve 41 Permanent magnet 42 Engaged portion 43 Fitting hole 43a Entrance 44 Target 45 Hole wall 50 Contact / separation detection means 51 Reference information Part 52 comparison unit 53 detector

Claims (10)

In an endoscopic device for examining the inside of a body cavity,
A manipulator having a multi-degree-of-freedom flexibility inserted through the nose;
A capsule endoscope to be introduced orally;
Contact / separation means provided between the manipulator and the capsule endoscope and capable of connecting / separating them;
An endoscope apparatus characterized by comprising: The contacting / separating means has a magnet disposed on one of the manipulator and the capsule endoscope and a magnet or a magnetic body disposed on the other, and connects the capsule endoscope by magnetic force. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is configured as follows. The magnet disposed on the one side has one of a convex part or a concave part,
The magnet or magnetic body disposed on the other side has the other of the convex portion or the concave portion,
The endoscope apparatus according to claim 2, wherein the convex portion and the concave portion are configured to be fitted to each other to position the capsule endoscope with respect to the manipulator. The convex part and the concave part have the same elliptical outer shape,
The endoscope apparatus according to claim 3. The contacting / separating means includes a nozzle disposed at a distal end portion of the manipulator, and a suction means disposed at a proximal end portion of the manipulator,
The capsule endoscope is configured to be connected by bringing the nozzle into contact with the capsule endoscope and applying a negative pressure in the nozzle by the suction means. The endoscope apparatus described in 1. An engaged portion is provided on the surface of the capsule endoscope,
The contacting / separating means has an engaging member and a restraining member,
The restraining member allows the engaging member to be inserted into the engaged portion by restraining the engaging member in a first posture, releases the engaging member inserted into the engaged portion, and then releases the restraint. The endoscope apparatus according to any one of claims 1 to 5, wherein the engaging member is engaged with the engaged portion by changing to the posture. The engaging member is biased to change from the first posture to the second posture;
The endoscope apparatus according to claim 6. The contacting / separating means further includes a rod-shaped member, and projects the rod-shaped member from the manipulator toward the capsule endoscope so as to separate the capsule endoscope from the manipulator against the magnetic force. The endoscope apparatus according to any one of claims 2 to 4, wherein the endoscope apparatus is characterized in that: A tip of the manipulator is provided with a light source and an optical system on which reflected light of light emitted from the light source is incident,
The contact / separation detection unit configured to be able to determine whether or not the capsule endoscope is connected based on the brightness of reflected light incident on the optical system. The endoscope apparatus according to any one of the above. The magnet disposed in the manipulator is an electromagnet having a coil to which a current is supplied through the manipulator,
Wherein said electromagnet manipulator side, the or capsule endoscope permanent magnets arranged on the mirror side in the process of approaching relatively and a magnetic material elements, based on a change of the current flowing in the coil, the capsule endoscope The endoscope apparatus according to claim 2, further comprising contact / separation detection means configured to be able to determine whether or not is connected.

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