DE102017103818A1 - Endoscope with a controllable movable intermediate section proximal to the bending section - Google Patents

Abstract

The invention relates to an endoscope with an endoscope control body (1) with control elements (11, 12), a flexible insertion tube (2) on the distal side of the endoscope control body (1), and a bending section (4) at the distal end of the endoscope. Proximally from the bending section (4), a controllable movable intermediate section (3) is provided as a section of the flexible insertion tube (2).

Description

The invention relates to an endoscope with an endoscope control body with controls, a flexible insertion tube on the distal side of the endoscope control body, and a bending section at the distal end of the endoscope.

Such an endoscope can be used to examine e.g. of the intestine or esophagus or even the duodenum, the bile duct, the bile, the pancreatic duct, the pancreas, etc., are applied.

Such an endoscope is inserted into a body tract (intestine, esophagus, etc.) of the patient and inserted to the site of the desired examination. It is hardly avoidable that the outer wall of the endoscope touches the inner wall of the body during advancement of the endoscope. Should the pressure of the endoscope on the inner wall of the body tract become too great, if the inner wall of the body tract has a pre-injury, or if the same point on the inner wall of the body tract is repeatedly pushed through the endoscope, the inner wall of the body tract can be injured.

The present invention has an object to provide an endoscope in which to reduce the risk of injury to an inner wall of the Körpertrakts, in which the endoscope is inserted.

This object is achieved by an endoscope with the features of claim 1.

Advantageous developments are the subject of the dependent claims.

In the invention, an endoscope has an endoscope control body with controls, a flexible insertion tube on the distal side of the endoscope control body, and a bending section on the distal end of the endoscope. Proximally from the bending portion, a controllable movable intermediate portion is provided as a portion of the flexible insertion tube.

The controllable intermediate movable section allows for actively controllably moving the flexible introducer tube to assist insertion of the flexible introducer tube into a body tract. As a result, obstacles resulting from the shape of the specific body tract can be better overcome by repeated active controllable movement of the flexible insertion tube. The risk of injury to the inner wall of the Körpertrakts is lowered.

The controllable movable intermediate section may adjoin the bending section. Thus, the controllable intermediate movable section is as distal as possible. The distal portion of the flexible introducer tube is first inserted into the body tract. The more proximal areas of the flexible introducer tube follow the movement of the distal portion of the flexible introducer tube in the body tract.

In a wall region of the intermediate section, at least one pull cable can be extended, which can be controlled from the proximal side, in order to bring about a curvature of the intermediate section as a controlled movement. Thus, the active control of the movement of the movable intermediate portion is realized by a particularly simple and easy to handle manner.

The at least one pull rope can run in a spiral manner in the extension direction of the intermediate section. The spiral shape brings a particularly simple but effective controllable movement of the movable intermediate section with it.

In a wall region of the intermediate portion, a plurality of tension cables can be provided. The many pull ropes can be operated alternately.

The pull rope or pull ropes may or may be independent of one or more pull ropes of the bend section at the distal end of the endoscope. Thus, the intermediate section has its own separate control, which has only the operation of the movement of the intermediate section to the task.

In the endoscope control body can be provided at least one control for the Zugseilsteuerung. Thus, it is easy for the user to control the movement of the intermediate section. He is used to finding the controls in the endoscope control body.

The control for the Zugseilsteuerung can be manually operated.

Alternatively, the control for the Zugseilsteuerung have a drive device.

The drive means may be a motor which rhythmically controls a respective tightening and releasing of the respective puller wires in a pulsating manner. As a result, a rhythmically pulsating movement of the intermediate section can be achieved.

The wall portion of the intermediate portion may be an elastic rubber hose in which Longitudinal spiral channels are formed for the respective tension cables. The tension cables thus do not increase the thickness of the flexible insertion tube. The spiral shape is clearly and permanently predefined.

Alternatively it can be provided in the intermediate portion, a hinge system consisting of mutually relatively pivotable hinged joint members, on the outer surfaces of the puller wires are anchored spirally extending in the longitudinal direction of the intermediate portion.

At least in the intermediate section, a support element can extend axially centrally. Thereby, the controlled movement of the intermediate section can be supported. An already existing element, e.g. a working channel, a flushing channel, etc. can be taken as such a support element.

The endoscope may be a duodenoscope, a colonoscope, a gastroscope or a bronchoscope. The endoscope can also be any other endoscope.

The above-explained aspects of the present invention can be suitably combined.

list of figures

• 1 shows a schematic perspective view of an endoscope of an embodiment of the present invention.
• 2 shows a schematic perspective view of a controllable movable intermediate portion of the present invention.
• 3 shows a schematic perspective view of the controllable movable intermediate portion of the present invention, wherein the outer shell of the better understanding is shown because of transparent.
• 4 shows a schematic perspective view of the controllable movable intermediate portion of the present invention, wherein the outer shell of the better understanding is shown because of transparent and a pull rope is pulled.
• 5 shows a schematic external perspective view of the controllable movable intermediate portion of the present invention, wherein a first pull rope is pulled.
• 6 shows a schematic perspective external view of the controllable movable intermediate portion of the present invention, wherein a second pull rope is pulled.
• 7 shows a schematic view of an intermediate portion of another embodiment of the present invention.
• 8th shows a schematic view of a colon when using an endoscope of the present invention.
• 9 shows a schematic view of the colon of 8th , wherein the endoscope in the same insertion position as in 8th is and by pulling the traction cables a wave motion of the endoscope tube is generated.
• 10 shows a schematic view of the colon of 8th and 9 wherein the endoscope of the present invention over the location of 9 is slightly pushed further and by pulling the traction cables a wave motion of the endoscope tube is still generated.

Hereinafter, the present invention will be described in detail with reference to the drawings by way of embodiments.

First embodiment

1 shows a schematic perspective view of an endoscope of an embodiment of the present invention.

The endoscope according to the invention has an endoscope control body 1 and to the endoscope control body 1 distal then a flexible insertion tube 2 , the endoscope tube. The endoscope tube 2 has a controllable movable intermediate section 3 on, attached to the section of the conventional flexible insertion tube 2 connects distally. At the distal end of the endoscope, a bending section 4 is provided. The bending section 4 is distal to the controllable intermediate movable section 3 intended.

The bending section 4 has an endoscope head on its distal side 5 , The bending section 4 is by control wires, not shown, by a on Endoskopkontrollkörper 1 attached control such as a steering wheel 11 and a steering wheel 12 actuated. The control wires, not shown, extend through the endoscope, that is through the endoscope control body 1 , the flexible insertion tube 2 and the controllable movable intermediate section 3 , For example, there can be four control wires for the bending section 4 be provided. In particular, by pressing the control (turning the steering wheel 11 ) the control wires for the bending section 4 so tense or relieved that the bending section 4 makes a bend in the desired direction. At the distal end of the bending section 4 is an endoscope head 5 arranged.

The endoscope control body 1 is over a cable 10 connected to an endoscope plug.

Below is the controllable movable intermediate section 3 more precisely.

The controllable movable intermediate section 3 forms part of the endoscope tube 2 , More precisely, the intermediate section forms 3 a distal portion of the endoscope tube 2 and adjoins the bending section 4 at.

The endoscope tube 2 is formed as a jacket element (hollow tube), through which necessary facilities for bending section 4 and to the endoscope head 5 extend, such as a working channel, the traction cables (Bowden cables) for the bending section 4 , Signal lines for a camera and a lighting device, and other endoscope supply lines, etc. As a material of the endoscope tube 2 Rubber or plastic is used.

The controllable movable intermediate section 3 thus has a jacket made of rubber or plastic. In this coat Zugseilkanäle are designed exclusively for traction cables 31 . 32 . 33 . 34 of the intermediate section 3 are provided. These Zugseilkanäle each extend spirally along the longitudinal direction of the intermediate portion 3 , There are four Zugseilkanäle for each of the traction cables in the embodiment 31 . 32 . 33 . 34 intended. The Zugseilkanäle each have the same spiral shape to each other and are arranged offset by 90 degrees in the circumferential direction to each other.

The controllable movable intermediate section 3 has a ring element on the distal side 30 , On the ring element 30 are the distal ends of the traction cables 31 . 32 , 33, 34 anchored and open into their respective Zugseilkanal and extend spirally in the proximal direction.

At the proximal end of the intermediate section 3 end the Zugseilkanäle. From the proximal end of the intermediate section 3 extend the pull ropes 31 . 32 , 33, 34 preferably straight up to its control described below.

2 shows the intermediate section 3 and the bending section 4 from the outside, being the location of an imaginary generatrix 3A at the intermediate section 3 is indicated.

3 shows the intermediate section 3 and the bending section 4 in the same position as in 2 , wherein the respective outer shell of the better understanding is shown because of transparent. The spiral-like course of the traction cables 31 , 32, 33, 34 in the intermediate section 3 is clearly visible. Furthermore, in 3 to recognize, like theirs in the intermediate section 3 trained Zugseilkanal leaving traction cables 31 . 32 . 33 . 34 extending straight in the proximal direction.

In the middle of the intermediate section seen in cross-section 3 extends in the axial direction a (not shown) supporting element. This support element extends at least in the intermediate section 3 along the central axis of the intermediate section 3 , As such a support member, a working channel or other element present in the endoscope can function.

In the 2 and 3 are the pull ropes 31 . 32 . 33 . 34 in non-actuated position. In other words, none of the pull ropes 31 . 32 . 33 . 34 drawn.

4 shows a situation starting from the location in 3 one of the pull ropes 31 . 32 . 33 . 34 namely the pull rope 31 pulled in the proximal direction, see arrow F. The pulling of the pull rope is carried out by the below-mentioned control device (not shown).

How out 4 can be seen, the pull rope depends 31 when pulled out, just go out. Thus, the pulled pull rope exercises 31 on the channel wall of its Zugseilkanals a force from the spiral shape of the Zugseilkanals in the elastic jacket of the intermediate section 3 stretches. In other words, the traction cable channel of the tow rope that has been pulled is shortened 31 elastic. The mean length of the intermediate section 3 stays the same (constant). As a result, the intermediate section deforms 3 spirally.

The generatrix 3A by pulling the first pull rope 31 spirally deformed intermediate section 3 is in 5 recognizable.

Thus, by pulling a pull rope in the intermediate section 3 generates a wave motion.

Will the pulled first pull rope 31 relieved again and a second pull rope 32 pulled, thus changes the waveform of the intermediate section 3 to another spiral, where the Zugseilkanal the tow rope pulled 32 stretched, see 6 ,

In other words, by successively pulling the various traction cables shifts 31 . 32 . 33 . 34 and relieving the previously pulled haul rope the position of the bends in the intermediate section 3 , In this case, a spiral shape alternates with another spiral shape. Be the pull ropes 31 . 32 . 33 . 34 pulled in sequential order of attachment, changing a spiral shape with another by 90 degrees in the cross section of the intermediate section 3 offset spiral shape.

The ropes 31 . 32 . 33 . 34 can by a at the endoscope control body 1 arranged control can be alternately pulled and relieved.

Second embodiment

7 shows a schematic view of an intermediate section 3 a second embodiment of the present invention.

In the first embodiment, the traction cables 31 . 32 . 33 . 34 arranged in their spiral-shaped Zugseilkanälen formed in the shell of the intermediate section 3.

The second embodiment differs from the first embodiment in that the intermediate portion 3 not designed as an elastic hose but in a kind of link chain.

As in 7 shown, the intermediate section 3 a link chain as a joint system adjacent to the distal ring 30 on.

The link chain is made of individual mutually articulated intermediate section elements 35 formed, which act as link chain links or joint rings. Each of these link chain links 35 is ring-shaped. The ring shape of the link chain link 35 has a front side as a first side and opposite to the first side a second side. Each of the link chain links 35 has two opposite radially extending hinge projections 36 on. The joint projections 36 are on the first side of the ring shape of the link chain link 35 intended. On the second side has the link chain link 35 two opposite hinge flanges extending axially away from the ring mold 37 , Each hinge flange 37 has a passage opening in the radial direction. At the respective link chain link 35 are the joint flanges 37 relative to the joint projections 36 arranged not only on opposite sides but also rotated by 90 degrees in the circumferential direction. The joint projections 36 stand with the openings of the joint flanges 37 of the adjacent link chain link 35 engaged. Thus, the link chain links 35 with each other via the joint projections 36 and joint flanges 37 connected to a long chain and hinged to each other.

Each link chain link 35 has four eyelets on its outer peripheral surface 38 equally spaced on the same circumferential line. The openings of the eyelets 38 are aligned in the proximal / distal direction.

towing ropes 31 . 32 . 33 . 34 extend through the eyelets 38 each spirally along the longitudinal direction of the intermediate section 3 like this in 7 is shown.

Thus, every pull rope is 31 . 32 . 33 . 34 on the outer circumference of each link chain link 35 so supported and guided that results in a total along the longitudinal direction of the intermediate portion, the spiral shape. The leadership of the traction cables 31, 32, 33, 34 takes place through the eyelets 38 , Alternative to the eyelets 38 It is also possible to use projections on the outer circumference of each link chain link 35 are arranged radially extending.

About the link chain members 35 connected together to form a long chain is an in 7 not shown elastic protective tube arranged.

The function is otherwise as in the first embodiment.

It should also be noted that other joint systems are applicable in an intermediate section according to the invention.

Control and drive

The ropes 31 . 32 . 33 . 34 can in all embodiments by a on Endoskopkontrollkörper 1 arranged control can be alternately pulled and relieved.

The control of the traction cables 31 . 32 . 33 . 34 can be done manually.

For example, in the endoscope control body 1 an eccentric are arranged, on which the four traction cables 31 . 32 . 33 . 34 attack each offset at 90 ° to each other. This eccentric may be formed as an eccentric pin on which the four traction cables 31 . 32 . 33 . 34 are hung in different directions.

Alternatively, a crankshaft may be used that is perpendicular to the axis of the endoscope control body 1 extends. The crankshaft has in the longitudinal direction four mutually eccentric shaft sections (multiple cranked). On each shaft portion a disc is rotatably mounted. On the outer circumference of each disc is the proximal end of one of the pull ropes 31 . 32 . 33 . 34 anchored. Turning the crankshaft causes the respective discs to move alternately in the proximal and distal directions. Due to the mutually eccentric shaft sections are the discs and thus the proximal ends of the respective Zugseile 31 . 32 . 33 . 34 alternately moved in the proximal and distal directions.

Alternatively, a swash plate can be applied, in which all four traction cables 31 . 32 . 33 . 34 can be arranged parallel to each other.

A camshaft can be used.

Any mechanism requiring an oscillating linear (translational) movement on the tow ropes 31 . 32 . 33 . 34 can be used.

Particularly advantageous here is the resulting alternating periodic actuation of the traction cables 31 . 32 . 33 . 34 ,

As a drive of the eccentric or the swash plate, crankshaft, etc., a crank for manual operation can be applied.

In a preferred variant, the control of the traction cables takes place 31 . 32 . 33 . 34 about a motor. In this case, the direction of rotation, ie forward / reverse, the speed and possibly the amplitude via switch or regulator on the handle of the endoscope control body 1 Thus, the tension cables can 31 . 32 . 33 . 34 be controlled so that there is a manual or motor drive, in which the traction cables 31 . 32 . 33 . 34 periodically out of phase and relieved.

This allows the pull ropes 31 . 32 . 33 . 34 be pulled periodically successively in a predetermined direction of rotation and relieved, resulting in a wave motion of the intermediate section 3 results. This wave motion of the intermediate section 3 is not a propulsion but an oscillating motion, in which a helix seems to turn around its axis. This wave motion of the intermediate section 3 is similar to a writhing worm.

The drive can be designed so that it is switched on when needed. When not using the drive are the traction cables 31 . 32 . 33 . 34 relaxed. In this position, the endoscope according to the invention behaves like a conventional endoscope.

Frequency and amplitude of the drive mechanism can be controllable.

The direction of rotation of the drive mechanism can be reversible.

application

The 8th - 10 show an example of an application of the endoscope according to the invention in the colon 100 ,

In 8th is the endoscope according to the invention through the rectum 101 and the descending colon 102 in the Quercolon 103 of the colon 100 been advanced. Relatively strong changes of direction such as at the transition from descending colon 102 to Quercolon 103 complicate the advancement of the endoscope.

In the situation of 8th has the bending section 4 and the distal portion of the intermediate section 3 the direction changes at the transition from descending colon 102 to Quercolon 103 already happened. In this situation, due to an unfavorable relative position between the colon inner wall and the intermediate section 3 the endoscope further advancement of the endoscope to be difficult.

In the situation of 8th By alternately, preferably rhythmically pulsating, pulling the traction cables a wave motion in the intermediate section 3 generated. As a result, the relative position between the colon inner wall and the intermediate section changes permanently 3 of the endoscope. 9 shows the same insertion position of the endoscope as in 8th However, by pulling the traction cables and thereby effected a wave motion of the endoscope tube, but the relative position between the colon inner wall and the intermediate section 3 has changed. The arrow W indicates the displacement of the shaft position of the intermediate section 3 at.

In this permanent change in the relative position results in each case a relative position between colon inner wall and intermediate section 3 in which advancing the endoscope is easier. The wave motion of the intermediate section 3 For a while, it finds a good match with the bowing of the bowel. 10 shows a schematic view of the colon of 8th and 9 where the endoscope is relative to 9 is slightly pushed further and by pulling the traction cables, the wave motion of the endoscope tube is still generated. The arrow S shows the advancing of the endoscope.

Advantages of the invention

The user can thus pull the traction cables alternately, preferably rhythmically pulsating, and wait for those moments in which an advancing of the endoscope is easy.

The progressive waveform facilitates sliding of the endoscope in the insertion direction. The endoscope can wind itself like a worm and run past obstacles, thus overcoming them.

Not only the advancement of the endoscope is facilitated by the present invention. Because when advancing the endoscope of the intermediate section 3 not repeatedly pressing in the same place of the large intestine inner wall, also a risk of injury of the large intestine inner wall can be diminished.

Thus, the risk of injury to an inner wall of the body tract into which the endoscope is inserted is alleviated.

Other alternatives

In the exemplary embodiments, the controllable movable intermediate section forms 3 a part of the endoscope tube 2 , In addition, the intermediate section forms 3 a distal portion of the endoscope tube 2 and adjoins the bending section 4 at. Alternatively, between the intermediate section 3 and the bending section 4 another section of the endoscope tube 2 predetermined (short) length, which is not with the tension cables 31 - 34 is provided. In this alternative, the intermediate section 3 and bending section 4 (slightly) spaced.

In another alternative, the one with the ropes 31 - 34 provided intermediate section 3 over the entire length of the endoscope tube 2 extend.

In the embodiments, the four traction cables 31 . 32 . 33 . 34 intended. Alternatively, two, three, five or more pull ropes may be provided.

In the first embodiment, the Zugseilkanäle each have the same spiral shape to each other. The invention is not limited thereto. The Zugseilkanäle may have a mutually different spiral shape. As a result, although the shape of the winding movement of the intermediate section 3 with changing pulling the ropes uneven. Nevertheless, there is a wave motion of the intermediate section 3 which supports advancing the endoscope.

In the first embodiment, the Zugseilkanäle (and thus the traction cables) are arranged offset from one another by 90 degrees, considering the cross section. The invention is not limited thereto. The Zugseilkanäle and Zugseile can be arranged offset from one another at a distance which differs from 90 degrees.

The endoscope according to the invention can be applied to any part of the body.

LIST OF REFERENCE NUMBERS

1

Endoscope control body

2

flexible insertion tube

3

controllable movable intermediate section

3A

imaginary generatrix

4

bending section

5

endoscope head

10

Cable to the endoscope plug

11

Steering wheel

12

Steering wheel

30

ring element

31

rope

32

rope

33

rope

34

rope

35

Link chain link

36

joint projection

37

Joint flange with opening

38

eyelet

100

colon

101

rectum

102

descending colon

103

transverse colon

Claims (13)

Endoscope comprising an endoscope control body (1) with control elements (11, 12), a flexible insertion tube (2) on the distal side of the endoscope control body (1), and a bending section (4) at the distal end of the endoscope, characterized in that proximally of the bending section (4) a controllable movable intermediate portion (3) is provided as a portion of the flexible insertion tube (2). Endoscope according to Claim 1 wherein the controllable movable intermediate section (3) adjoins the bending section (4). Endoscope according to Claim 1 or 2 in which in a wall region of the intermediate section (3) extends at least one traction cable (31-34) which is controllable from the proximal side in order to cause a curvature of the intermediate section (3) as a controlled movement. Endoscope according to Claim 3 , wherein the at least one traction cable (31-34) spirally extends in the extension direction of the intermediate section (3). Endoscope according to one of Claims 1 to 4 , wherein in a wall region of the intermediate portion (3) a plurality of tension cables (31-34) is provided. Endoscope according to one of Claims 3 to 5 wherein the traction cable or traction cables (31-34) are or are independent of one or more traction cables of the bending section (4) at the distal end of the endoscope. Endoscope according to one of Claims 3 to 6 , wherein in the endoscope control body (1) at least one control element for the Zugseilsteuerung the intermediate portion (3) is provided. Endoscope according to Claim 7 , wherein the control for the Zugseilsteuerung is manually operated. Endoscope according to Claim 7 wherein the control for the Zugseilsteuerung has a drive device. Endoscope according to Claim 9 wherein the drive means is a motor which rhythmically pulsates a respective cocking and unloading of the respective pull ropes (31-34). Endoscope according to one of Claims 1 to 10 wherein the wall portion of the intermediate portion (3) is an elastic rubber hose in which spiral channels for the respective tension cables (31-34) are formed in the longitudinal direction. Endoscope according to one of Claims 1 to 10 , wherein in the intermediate portion (3) a joint system is provided, which consists of mutually relatively pivotable hinged joint members, on the outer surfaces of the tension cables (31 - 34) in the longitudinal direction of the intermediate portion (3) are anchored displaced spirally extending. Endoscope according to one of Claims 1 to 12 , wherein at least in the intermediate section (3) centrally a support member extends axially.

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