DE202009009342U1 - endoscope - Google Patents

Abstract

Endoscope (1) comprising a flexible endoscope shaft (2) with an essentially cylindrical basic contour extending in an axial direction (a), characterized in that the endoscope (1) has an inflatable tube (3) extending in the axial direction (a). comprising the endoscope shaft (2) over a part of its circumference (U).

Description

The The invention relates to an endoscope that moves in an axial direction extending, flexible endoscope shaft having a substantially cylindrical basic contour includes.

For Diagnostic and therapeutic interventions become flexible endoscopes used of the aforementioned type, which are sufficient in the prior art are known. They are introduced rectally and to the examined Position or pushed along the area to be examined, z. B. in the area of the colon. Analog endoscopes are synonymous for the Gastroscopy used and introduced orally in this case.

The direction control of the movable endoscope tip in two planes is carried out mechanically by means of two control wheels on the endoscope handle in order to minimize lumenzentriert and gently pretend the intestinal wall or optimally set a target region. According to a very preferred procedure, an electric drive is used for the endoscope for its movement in the axial direction. Such a solution is in the DE 10 2005 002 461 B3 described.

there The following problem arises: As a rule, the colon (colon) after a first linear course from the rectum from a loop or arch-like course on, the so-called sigma loop (Colon sigmoideum). The sigma loop provides for insertion of the Endoscopes in the colon is an obstacle, especially the strong curved rectosigmoid transition zone from the rectum to the sigmoid colon. The endoscope must be in the area of the sigma loop learn a bend to follow the further course of the colon to be able to. The required bending moment is transmitted by force transmission of the distal end of the endoscope applied on contact with the intestinal wall, which in turn means that the intestinal wall in this area of a (counter) force through the Endoscope is exposed, which can bulge the intestinal wall. This Again, it is uncomfortable or even painful for the patient.

Of the Invention is therefore based on the object, an endoscope of the above so educate that in this regard remedy is created. Accordingly, the endoscope should be so be equipped that even when passing the sigma loop of the colon did not exert high forces on the intestinal wall but the endoscope gently through the said region of the colon can be performed, then continue in the colon to be pushed forward.

The Solution of this problem by the invention is characterized in that that the endoscope has an inflatable extending in the axial direction Has tube that the endoscope shaft only one Part of its circumference wrapped.

Of the Endoscope shaft is preferred relative to the hose in the axial direction displaced. In this case, agents are preferably present, with the relative position between endoscope shaft and tube can be adjusted in the axial direction and / or controlled.

These Means may according to a first preferred embodiment the invention comprise a flexible push rod, in the axial direction of the endoscope shaft and with the one axial end of the Hose can be moved relative to the endoscope shaft.

To In an alternative solution, the means comprise a pull rope, which runs in the axial direction of the endoscope shaft and with an axial end of the tube are pulled relative to the endoscope shaft can.

A another alternative provides that the means comprise a cap, which is placed on a distal end of the endoscope shaft and to which an axial end of the hose is connected, the cap provided with unlocking means with which the relative mobility of the endoscope shaft can be released to the tube.

A In turn, another alternative provides that the means as an unlocking element are executed by a counter to the insertion direction of the Endoscope can be activated return movement, whereby the relative axial mobility between the endoscope shaft and hose is releasable.

The An axial end of the tube is preferably by means of a linear bearing stored on the endoscope shaft. The linear bearing can be a retaining ring form for the hose. The linear bearing can be a ball bearing be.

Of the Hose preferably surrounds the endoscope shaft via a Circumferential angle of at most 270 °.

The hose can consist of two or more sub-hoses. In this case, at least two partial tubes can run parallel to one another in the axial direction of the endoscope. The partial hoses can be formed from one another by a weld running in the hose in the axial direction. Furthermore, there may be a fluidic connection between the partial tubes. The fluidic connection is preferably in the axial end of the Partial hoses arranged.

Of the Hose is preferably over with an air pump An air line in communication with the air pump outside the area of the endoscope is arranged when used as intended is introduced into the body. The air pump is preferably hand-operated.

Of the Hose is preferably designed as a disposable item, d. H. it is used only once.

Of the Hose is still preferably made of a material with less Elasticity. Accordingly, the splint function especially strong when inflating the tube.

The proposed embodiment of an endoscope thus helps that in particular the area of the sigma loop of the colon is gentle on the endoscope is overcome. The proposed hose is interchangeably arranged on the endoscope and is disposable used.

The Endoscope equipped according to the invention a support function or a splint for the Endoscope available, allowing a bulging of the intestinal wall prevented or at least significantly reduced. The inflated Hose, which can be addressed as a support hose, also has a straightening function around the sigma loop. Thus is an improved, internally supported propulsion of the endoscope possible at the colonoscopy.

He becomes a more even distribution of forces reached on the intestinal wall, in particular during the bending of the endoscope in the area of the sigma loop, occur. This will not happen anymore to a strong bulging of the intestinal wall by the endoscope Passing the Sigma Loop. Thus, a gentler investigation or treatment of the patient. This is the probability of occurrence reduces that, especially in the motorized endoscope this taken from the drive system and more sensitive must be advanced by hand. Furthermore, the probability of occurrence it reduces the sedated patient if necessary with the help of other helpers on the back must be turned to the endoscope about the critical Get away from the sigma loop.

Of the Hose is not circular in this case (completely around the circumference) formed to the desired Straightening function on the side of the endoscope facing the intestinal wall to create without narrowing the lumen of the colon in other places.

In the drawing embodiments of the invention are illustrated. Show it:

1 schematically an inserted into the colon of a patient endoscope during a first examination phase,

2 schematically the endoscope introduced into the colon during a second, later examination phase,

3 schematically shows the endoscope inserted into the colon during a third, even later investigation phase,

4 an endoscope with a flexible push rod for relative axial displacement of a tube to an endoscope shaft,

5 an endoscope with a pull rope for the relative axial displacement of the tube to the endoscope shaft,

6 the section AB according to 3 through the endoscope according to a first embodiment of the endoscope,

7 the section AB according to 3 through the endoscope according to a second embodiment of the endoscope,

8a an endoscope provided with an unlocking element in a further embodiment of the endoscope in a still locked phase,

8b the endoscope according to 8a during an unlocking operation and

8c the endoscope according to 8a in the unlocked state.

In 1 is an endoscope 1 to see with which a colonoscopy is to be made. For this purpose, it is already a first piece largely linear in the rectum 13 inserted by a patient. The endoscope 1 has in the usual way an endoscope shaft 2 with a distal end 6 on; at the distal end 6 are the required elements (camera, treatment equipment) arranged, which are needed for a colonoscopy or surgery of the colon. The endoscope shaft 2 has a substantially cylindrical basic contour and extends in an axial direction a.

The endoscope 1 further comprises an axially extending a inflatable hose 3 on top of the endoscope 2 wrapped over part of its circumference (s. 6 and 7 ). The hose 3 is in 1 not inflated yet outlined in a condition. He is over an air line 11 with an air pump 10 (Hand pump, as it is known, for example, from blood pressure monitors), with which he can be sensitively inflated.

The hose 3 is with an axial end 5 relative to the endoscope shaft 2 slidably arranged in the axial direction a, wherein the displacement possibility, as will be seen, can be blocked. For low-friction and tilt-free displacement of the axial end 5 of the hose 3 is a linear bearing 7 provided, which can be designed as a plain bearing element or as a rolling bearing (ball bearing). It has a retaining ring 8th on, on which the hose 3 is attached. The retaining ring 8th is preferably closed annularly; but this is not mandatory.

Will the endoscope 1 from the in 1 outlined position without the proposed inventions proposed further advanced into the colon, there is a course for the endoscope 2 , as indicated by dashed lines. After concerns on the intestinal wall 14 in the area of the rectosigmoid transition zone 15 presses the endoscope tip against the intestinal wall 14 and accordingly the intestinal wall 14 against the endoscope, so that it is bent and follows the course of the colon. This leads to a bulging of the intestinal wall 14 , as indicated by a dot-dash line (see reference numeral 14 ' ).

To prevent this, will - like it 2 shows - in the area of the rectosigmoid transition zone 15 by means of the hand pump 10 the hose 3 inflated, so that he, as in 2 sketched, gently to the intestinal wall 14 applies and the endoscope 2 during further propulsion into the colon is supported. The increased burden of the intestinal wall 14 is avoided.

Is the rectosigmoid transition zone 15 overcome in this way becomes the endoscope 2 advanced into the colon, with the tube 3 remains stationary in the intestine. For this purpose, a relative axial displacement between the endoscope shaft 2 and the hose 3 accomplished or approved. For this are means 4 for adjusting or controlling the axial relative position between the endoscope shaft 2 and the hose 3 intended.

In the 4 and 5 Possible solutions are shown.

To 4 can the endoscope shaft 2 relative to the hose 3 thereby make an axial relative movement that the retaining ring 8th to which the hose 3 is arranged with a flexible push rod 4 ' connected is. The push rod 4 ' runs in the axial direction a parallel to the endoscope shaft 2 in a page area. Shall the hose 3 not further advanced axially in the colon, the retaining ring 8th with the push rod 4 ' held stationary while the endoscope shaft is advanced further.

In this solution, it is by an angled handle 16 at the end of the push rod 4 ' possible to also perform a rotation of the arrangement about the longitudinal axis.

In the solution according to 5 is provided that in a working channel (see reference numerals 12 in 8th ) a pull rope 4 '' runs, that at the distal end 6 of the endoscope shaft 2 is deflected and with the retaining ring 8th can be pulled if necessary or by relieving the pull rope 4 '' during further advancement of the endoscope shaft 2 can stay behind.

In the 6 and 7 you can see that the hose 3 only over a defined circumferential angle α over the circumference U of the endoscope shaft 2 around, which is desirable for the illustrated function of supporting the endoscope at a portion of the intestinal wall.

At the solution after 6 is only a single hose element 3 provided, which extends over a circumferential angle α of slightly more than 180 ° in the circumferential direction U and the endoscope shaft 2 envelops or surrounds. At the solution after 7 is the hose 3 from two partial hoses 3 ' and 3 '' , each covering a peripheral portion, but overall cover about the same circumferential angle α, as at 6 , The training of the hose 3 in the form of several partial hoses can be made by manufacturing technology that welds are introduced into the tube, which extend in the axial direction a and thus divide the tube into individual sections. An air exchange between the individual sub-hoses 3 ' . 3 '' , ... can through a fluidic connection 9 done as they are in 7 is shown schematically.

By a fluidic connection, it is possible, the individual chambers of the hose, ie the partial hoses 3 ' . 3 '' , with a single hand pump 10 inflate. Alternatively, however, it is also conceivable that a separate hand pump is used for each partial hose, which would allow it to inflate the hose in segments in order to specifically activate the support function on the intestinal wall.

In both cases ( 6 and 7 ) is the endoscope shaft 2 safely abge on one side supports, so that the desired splinting or support of the endoscope shaft is secured to the intestinal wall.

Another possible solution of the unlocking of the endoscope shaft 2 from the hose 3 is in 8th outlined. Again, it is about the unlocking, which allows the endoscope from the in 2 sketched position, leaving the tube behind can be further advanced into the colon, as in 3 is illustrated. In the solution according to 8th is on the retaining ring 8th an unlocking element 4 ''' attached, when inserting the endoscope 1 into the intestine with a hook-like end in the working channel 12 of the endoscope shaft 2 intervenes. Thus, when advancing the endoscope shaft 2 the hose 3 over the retaining ring 8th pulled along or taken away. This is in 8a outlined.

Should be in the in 2 sketched position of the endoscope shaft 2 from the hose 3 be disconnected, since the tube during further advancement of the endoscope shaft 2 should be left behind - as it is in 8b is shown - the endoscope shaft 2 pulled back slightly (by about 5 mm) (see arrow in 8b ). Then the hose 3 inflated. The hose 3 lies down between the inner circumference of the retaining ring 8th and the outer periphery of the endoscope shaft 2 and presses the retaining ring 8th - Since the circumferential angle α of the hose extension (s. 6 and 7 ) is less than 360 ° - radially from the endoscope shaft 2 off, as it is in 8c you can see. As a result, the unlocking element 4 ''' disengaged so that upon further advancement of the endoscope shaft 2 according to 8c endoscope shaft 2 and hose 3 are decoupled.

Another possibility, not shown, is the retaining ring 8th as a cap (transparent, so the camera can see through) form on the distal end 6 of the endoscope shaft is placed. The cap has a passage opening for the endoscope shaft 2 , which is initially blocked by a blocking element. Accordingly, the endoscope shaft can initially only be advanced together with the tube. When the desired end position for the hose 3 is reached, the blocking element can be withdrawn, for example, by inflating the tube, so that the passage opening is released for the endoscope shaft; Accordingly, the endoscope shaft can now be advanced further into the colon when the tube is left behind.

The Freeing the endoscope shaft, d. H. the abolition of the effect of Locking elements can also be used separately and independently of inflation the hose is made by a suitable pulling or pushing element, which is guided in or at the endoscope. That's it also possible, the said release or blocking reversible execute, z. B. by using an actuating element in the manner of a Bowden cable.

Yet another and simple way of locking the connection between the retaining ring and the tip of the endoscope shaft and the targeted solution of this locking is the following configuration: The retaining ring is in turn formed as a cap and has a circular opening for the passage of the endoscope shaft. On the retaining ring, which is made somewhat oval, a mandrel extending in the axial direction "downward" is arranged, which is positioned so that in the working channel ( 12 , s. 8th ) arrives for locking, so that the retaining ring and thus the hose is taken along with the advancement of the endoscope shaft.

Should the catch is released at the relevant point in the colon be, the endoscope shaft is slightly withdrawn (z. B. by 2 cm), so that the mandrel slips out of the working channel and the tip of the endoscope shaft when pushing on the spine sideways over and through the circular opening emerges from the cap-like retaining ring, so that the endoscope shaft can be pushed further into the colon.

After completion of the examination or treatment, the air is removed from the hose 3 drained again and removed the endoscope and tube from the colon.

It It goes without saying that the retaining ring or the other said elements must be carried out in such a way that there are no sharp edges to a violation of the Prevent intestinal wall.

If an electromotive drive is used for the endoscope, a guide channel is preferably provided on this, so that the hose 3 along the inside of the device can be fed without kinking in the intestine.

Although the filling of the hose 3 is preferred with air, in principle, another fluid can be used for this purpose, for. B. water. This has the advantage that the stabilizing effect of the hose is higher than in the case of filling with air or another gas.

1

endoscope

2

endoscope shaft

3

tube

3 '

part hose

3 ''

part hose

4

medium for setting / controlling the axial relative position

4 '

flexible push rod

4 ''

rope

4 '' '

unlocking

5

axial End of the hose

6

distal End of the endoscope shaft

7

linear bearings

8th

retaining ring

9

fluidic connection

10

air pump

11

air line

12

working channel

13

rectum

14

intestinal wall

14 '

baggy intestinal wall

15

rectosigmoid transition zone

16

handle

a

axially

U

scope

α

circumferential angle

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• DE 102005002461 B3 [0003]

Claims (20)

Endoscope ( 1 ), which has a flexible endoscope shaft extending in an axial direction (a) ( 2 ) having a substantially cylindrical basic contour, characterized in that the endoscope ( 1 ) in the axial direction (a) extending inflatable tube ( 3 ), the endoscope shaft ( 2 ) over a part of its circumference (U) wrapped. Endoscope according to claim 1, characterized in that the endoscope shaft ( 2 ) relative to the hose ( 3 ) in the axial direction (a) is displaceable. Endoscope according to claim 2, characterized in that means ( 4 ), with which the relative position between the endoscope shaft ( 2 ) and hose ( 3 ) in the axial direction (a) and / or can be controlled. Endoscope according to claim 3, characterized in that the means ( 4 ) a flexible push rod ( 4 ' ), which in the axial direction (a) of the endoscope shaft ( 2 ) and with the one axial end ( 5 ) of the hose ( 3 ) relative to the endoscope shaft ( 2 ) can be moved. Endoscope according to claim 3, characterized in that the means ( 4 ) a pull rope ( 4 '' ), which in the axial direction (a) of the endoscope shaft ( 2 ) and with the one axial end ( 5 ) of the hose ( 3 ) relative to the endoscope shaft ( 2 ) can be pulled. Endoscope according to claim 3, characterized in that the means ( 4 ) comprise a cap which extends onto a distal end ( 6 ) of the endoscope shaft ( 2 ) is placed and with the one axial end ( 5 ) of the hose ( 3 ), wherein the cap is provided with unlocking means with which the relative mobility of the endoscope shaft ( 2 ) to the hose ( 3 ) can be released. Endoscope according to claim 3, characterized in that the means ( 4 ) as unlocking element ( 4 ''' ) are executed by a counter to the direction of insertion of the endoscope ( 1 ) can be activated, whereby the relative axial mobility between the endoscope shaft ( 2 ) and hose ( 3 ) is releasable. Endoscope according to one of claims 2 to 7, characterized in that the one axial end ( 5 ) of the hose ( 3 ) by means of a linear bearing ( 7 ) on the endoscope shaft ( 2 ) is stored. Endoscope according to claim 8, characterized in that the linear bearing ( 7 ) a retaining ring ( 8th ) for the hose ( 3 ). Endoscope according to claim 8 or 9, characterized in that the linear bearing ( 7 ) is a ball bearing. Endoscope according to one of claims 1 to 10, characterized in that the hose ( 3 ) the endoscope shaft ( 2 ) over a circumferential angle (α) of at most 270 ° surrounds. Endoscope according to one of claims 1 to 11, characterized in that the hose ( 3 ) from two or more sub-hoses ( 3 ' . 3 '' ) consists. Endoscope according to claim 12, characterized in that at least two partial tubes ( 3 ' . 3 '' ) parallel to one another in the axial direction (a) of the endoscope ( 1 ). Endoscope according to claim 12 or 13, characterized in that the partial hoses ( 3 ' . 3 '' ) from each other through one in the hose ( 3 ) are formed in the axial direction (a) extending weld. Endoscope according to one of claims 12 to 14, characterized in that a fluidic connection ( 9 ) between the sub-hoses ( 3 ' . 3 '' ) consists. Endoscope according to claim 15, characterized in that the fluidic connection ( 9 ) in the axial end region of the partial tubes ( 3 ' . 3 '' ) is arranged. Endoscope according to one of claims 1 to 16, characterized in that the hose ( 3 ) with an air pump ( 10 ) via an air line ( 11 ), the air pump ( 10 ) outside the area of the endoscope ( 1 ), which is introduced into the body when used as intended. Endoscope according to claim 17, characterized in that the air pump ( 10 ) is manually operated. Endoscope according to one of claims 1 to 18, characterized in that the hose ( 3 ) is designed as a disposable item. Endoscope according to one of claims 1 to 19, characterized in that the hose ( 3 ) consists of a material with low elasticity.