JP4243977B2 - Endoscope anchor guidance system - Google Patents

Description

[0001]
【Technical field】
The present invention relates to an endoscope anchor guidance system used when excising a lesion under endoscopic observation.
[0002]
[Prior art and its problems]
Conventionally, when excising a lesion inside a human body in a normal operation, the distance between the lesion and the adjacent normal tissue is widened by lifting the lesion using a grasping forceps, and the lesion and the normal tissue are in that state. It is excised between. However, for example, in endoscopic mucosal resection (EMR), since only one endoscope can be inserted into the body, the lesion cannot be lifted, and physiological saline is placed on the normal mucosa around the lesion with an injection needle. Water or the like was injected to raise the lesion, and in that state, a high-frequency knife or snare was used to perform excision between the lesion and the normal mucous membrane.
[0003]
However, in such a conventional method, the lesioned part could not be lifted to a sufficient position, and thus a sufficient excision part at the boundary between the lesioned part and the normal tissue could not be secured.
In addition, when the lesioned part has a flat shape, it may not be possible to create an excised part.
[0004]
Further, during the excision work, the already excised lesioned part may fall on the normal tissue, thereby obstructing the field of view by the endoscope, particularly when the lesioned part is large. For this reason, the excised part cannot be seen, and in order to remove it blindly, the normal part is damaged and complications such as perforation occur, blood vessels are damaged and major bleeding occurs. Since it could not be confirmed and hemostasis could not be achieved, serious complications could occur, and a safer device and treatment method were required.
[0005]
Therefore, in order to solve these problems, the present applicant generates a magnetic field by arranging a clip for grasping a lesion in the human body, a magnetic anchor made of a magnetic body connected to the clip, and an external body. And a magnetic anchor guiding device that powers the magnetic anchor, and the magnetic anchor is powered by a magnetic field generated by the magnetic anchor guiding device to lift the lesion gripped by the clip. A guidance system has been proposed and a patent application has been filed (Japanese Patent Application No. 2002-268239).
[0006]
As described above, in the invention of the present patent application, the gripping force by the clip is not so strong. Therefore, when the power applied to the magnetic anchor is large, the clip may be detached from the lesion. If the clip is detached from the lesioned part in this way, it becomes necessary to grip the clip again on the lesioned part, so that it takes a long time to treat the lesioned part, which increases the burden on the operator and the patient. End up.
[0007]
OBJECT OF THE INVENTION
An object of the present invention is to use an endoscope guidance system for an endoscope and an anchor guidance system that enable a fastening member linked to an anchor to be attached to a target portion inside a target object in a state of being securely removed. It is to provide a treatment method using an endoscope.
[0008]
Summary of the Invention
An endoscope anchor guidance system according to the present invention includes an attachment member attached to a target portion inside an object, a magnetic anchor made of a magnetic body connected to the attachment member, and an outside of the object. And a magnetic anchor guiding device that generates a magnetic field and moves the magnetic anchor in a predetermined direction by a magnetic force generated from the magnetic field, wherein the anchoring member includes: A penetrating shaft portion that can penetrate the target portion, and a large-diameter retaining portion that is provided at one end of the penetrating shaft portion and has a larger cross-sectional shape than the penetrating shaft portion. The vicinity of the end portion on the opposite side of the diameter retaining portion forms a planned bending portion that can be bent and maintains the shape after bending.
[0009]
The magnetic anchor guide device generates a magnetic force by a generated magnetic field, and moves the magnetic anchor in a predetermined direction by the magnetic force, and a U-shape in which the magnetic guide member is arranged in a specific plane. It is practical to have an in-plane moving mechanism that moves along the frame member and a unidirectional moving mechanism that relatively moves the U-shaped frame member in a direction perpendicular to the one plane.
[0010]
Furthermore, it is practical to connect the magnetic anchor and the brazing member with a flexible connecting string.
[0011]
According to another aspect, the anchor guiding system for an endoscope of the present invention is a non-magnetic member that is attached to a target portion inside the object and that is connected to the attachment member and moves according to gravity. An endoscope anchor guidance system comprising a body and a gravity anchor, wherein the attachment member is provided at a penetrating shaft portion that can penetrate the target site, and at one end of the penetrating shaft portion. A large-diameter retaining portion having a larger cross-sectional shape than the through-shaft portion, and the through-shaft portion has a post-bending shape that can be bent at least near the end opposite to the large-diameter retaining portion. It is characterized by the fact that the planned folding portion is maintained.
[0012]
Also in this aspect, it is practical to connect the magnetic anchor and the attachment member with a flexible connection string.
[0013]
In any aspect, the holding member that holds the large-diameter retaining portion of the attachment member, and the bending that bends the planned folding portion in a state where the large-diameter retaining portion is held by the holding member. It is preferable to provide a holding and deforming tool that can be inserted into and removed from the forceps channel of the endoscope.
[0014]
Further, the holding member and the bending member are pivotally mounted by a pin so as to be openable and closable, and a holding opening and closing piece and a folding opening and closing piece that can be opened and closed by an operation wire are provided, and the holding member is attached to the holding opening and closing piece. Forming a holding groove for the large-diameter retaining portion, and when the folding opening / closing piece is closed with respect to the holding opening / closing piece, the fastening member held by the holding opening / closing piece is It is practical to bend the folding part.
[0015]
Further, it is practical that the holding member of the holding and deforming tool can be released from the holding of the large-diameter retaining portion after the bending portion is bent.
[0023]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. The anchor guiding system according to the present embodiment includes a magnetic anchor device 10 (magnetic anchor 11, a fastening member 12, and a connecting string 15), an endoscope 20, and a sticking operation on a lesion X of the magnetic anchor device 10. And a magnetic anchor guiding device 40 that controls the magnetic anchor device 10 to be attracted outside the body (applies a magnetic force to the magnetic anchor 11).
[0024]
First, the configuration of the magnetic anchor device 10 will be described with reference to FIGS. 1 to 3.
The magnetic anchor 11 is composed of a main body portion 11a and a projection portion 11b having a substantially cylindrical shape, and is entirely formed of a ferromagnetic material. Specific examples of the magnetic material include magnets such as platinum magnets, rare earth magnets, terbium / dysprosium / iron alloys, in addition to pure iron and iron alloys.
[0025]
The hook-shaped attachment member 12 includes a head (large diameter retaining portion) 13 having a substantially circular shape when viewed from the front, and a rod-shaped through shaft portion 14 protruding from the center of the head 13. The tip end portion 14 is a planned bending portion 14a that can be plastically deformed.
One end of a flexible connecting string 15 is fixed to the protrusion 11 b of the magnetic anchor 11, and the other end of the connecting string 15 is firmly connected to the penetrating shaft portion 14 of the attachment member 12. The fastening member 12 and the magnetic anchor 11 are connected via a connecting string 15. As the connecting string 15, for example, a surgical suture, a fishing line, or a metal wire can be used.
[0026]
FIG. 4 shows an endoscope 20 used to perform a resection using an anchor guidance system.
Since the structure of the endoscope 20 is well known, detailed description thereof is omitted. However, an air / water supply nozzle (not shown) for sending air and cleaning water to the distal end surface 22 of the insertion portion 21 to be inserted into the body, an excision portion. And an illumination window for illuminating the periphery thereof (not shown), an observation window (not shown) in which an objective lens is disposed immediately after observing the excision and the periphery thereof, and an outlet 23 of the forceps channel C (not shown) (See FIG. 10 and the like). The forceps channel C is formed in the insertion portion 21, and the inlet 24 a is formed on the end surface of the forceps opening 24.
[0027]
The holding and deforming tool 30 shown in FIGS. 5 to 7 is inserted into the forceps channel C of the endoscope 20.
The holding and deforming tool 30 has the following structure.
A mounting piece 32 whose tip protrudes forward of the tube 31 is fixed to the inner peripheral surface of the tip of the tube 31 made of a flexible material. An intermediate portion between the holding opening / closing piece (holding member) 34 and the folding opening / closing piece (folding member) 35 is pivotally mounted around the pin 33. The distal ends of a pair of operation wires 36 and 37 that pass through the tube 31 are fixed to the proximal ends of the holding opening / closing piece 34 and the bending opening / closing piece 35, respectively. Both the operation wires 36 and 37 are movable relative to the tube 31 in the axial direction of the tube 31, and by operating an operation portion (not shown) provided at the proximal end portion of the tube 31, It moves in the axial direction of the tube 31. When the operation wires 36 and 37 move in the axial direction of the tube 31, the holding opening / closing piece 34 and the folding opening / closing piece 35 open and close.
As shown in FIGS. 5 and 7, the front end surface 34 a of the holding opening / closing piece 34 is provided with a first holding groove (holding groove) 38 a facing the longitudinal direction of the holding opening / closing piece 34. The first holding groove 38 a penetrates the holding opening / closing piece 34 in a direction parallel to the pin 33, and can fit and hold the head 13.
Further, the base of the penetrating shaft portion 14 that is orthogonal to and communicates with the first holding groove 38a and opens at the front surface 34a and the surface facing the folding opening / closing piece 35. A second holding groove 38b capable of fitting and holding the end portion is provided.
Furthermore, a bending planned portion 14 a of the through shaft portion 14 that opens on the front surface 35 a of the folding opening / closing piece 35 and the holding opening / closing piece 34 is fitted to the tip of the folding opening / closing piece 35. A bendable groove 39 is provided.
[0028]
Next, the configuration of the magnetic anchor guidance device 40 that controls the magnetic anchor 11 outside the body of the patient A will be described with reference to FIGS. 8 and 9.
A pair of XY stages (one-way moving mechanisms) 42 and 42 are disposed on both sides of the bed 41 having a floor plate 41a on which the patient A is placed. The pair of XY stages 42 reciprocate linearly along the longitudinal direction of the bed 41 so that the longitudinal positions of the both 42 and 42 are always the same. Further, above the bed 41, a frame / rail (two-plane moving mechanism) composed of two rails 44 and 45 that are substantially U-shaped in front view and are parallel to each other in a plane orthogonal to the longitudinal direction of the bed 41. 43, and both ends of the frame / rail 43 are fixed to the left and right XY stages 42, respectively. The inner rail 44 is slidably mounted with a magnetic induction member 46 that controls the magnetic anchor 11 of the magnetic anchor device 10 to be attracted outside the body (which exerts a magnetic force on the magnetic anchor 11). The XY stage 42 can be moved along the rail 45. The magnetic induction member 46 is obtained by fixing an electromagnet 47 having a structure in which a coil is wound around an iron core on a base 48, and the electromagnet 47 is always directed to the patient A side (see FIG. 8). The magnetic induction member 46 may be a combination of a permanent magnet and an electromagnet, or a combination of two or more permanent magnets and electromagnets.
[0029]
A counterweight 49 for maintaining the weight balance of the entire frame / rail 43 is slidably mounted on the rail 45 on the rail 45 outside the frame / rail 43. The counterweight 49 changes its position according to the position of the magnetic induction member 46. For example, when the magnetic guide member 46 is located on the front side of the patient A, the counterweight 49 is located on the back side of the patient A, and when the magnetic guide member 46 is on the back side of the patient A, the counterweight 49 is Located on the front side of the patient A, the entire frame / rail 43 is balanced in weight.
The magnetic guide member 40, the XY stage 42, and the frame / rail 43 described above constitute the magnetic anchor guide device 40.
[0030]
Next, the excision procedure for the lesion X using the anchor guidance system will be described. Prior to performing the resection using the anchor guidance system, first, as shown in FIGS. 8 and 9, the patient A subjected to local anesthesia is laid on the floor plate 41 a of the bed 41. At this time, the XY stage 42 is operated so that the longitudinal direction position of the bed 41 of the frame / rail 43 is substantially the same position as the head A1 of the patient A, and the magnetic induction member 46 and the counterweight 49 are set to a predetermined position. Keep it in the place.
Next, the XY stage 42 is operated to place the frame / rail 43 on the front side of the patient A, and the magnetic guiding device 46 is moved along the frame / rail 43 to start excision of the magnetic guiding member 46. It is located at the hour position (see FIG. 9).
[0031]
Next, a flexible overtube (not shown) is inserted into the body from the mouth of the patient A, and the distal end of the overtube is brought close to the lesion X in the organ B (see FIG. 13 and the like). Then, the endoscope 20 is inserted into the overtube, the distal end portion of the insertion portion 21 is projected from the distal end of the overtube, and is brought close to the lesioned portion X (not shown). As described above, when the distal end of the insertion portion 21 of the endoscope 20 is inserted into the organ B, an observation image in the organ B obtained from the observation window of the endoscope 20 is displayed on a television monitor (not shown). .
[0032]
Next, a tube-shaped treatment tool (not shown) having an injection needle at the distal end is inserted from the inlet 24a of the forceps port 24, and the injection needle is protruded from the outlet 23 of the insertion portion 21, thereby causing the injection needle to become a lesion. A physiological saline solution is injected from the periphery of the part X into the submucosal layer B1 of the organ wall, and the lesioned part X is lifted from the proper muscle layer B2 (see FIG. 13, FIG. 14, etc.).
[0033]
Next, the endoscope 20 is taken out from the body of the patient A, and the holding / deforming tool 30 and the magnetic anchor device 10 are attached to the endoscope 20 outside the body of the patient A in the following procedure.
[0034]
First, the operation part of the holding and deforming tool 30 is operated in advance to keep the holding opening / closing piece 34 and the folding opening / closing piece 35 in the fully closed state, and while maintaining the fully closed state, the entrance 24a of the forceps port 24a. Then, the holding / deforming tool 30 is inserted into the forceps channel C, and the holding opening / closing piece 34 and the folding opening / closing piece 35 are projected from the distal end surface 22 of the endoscope 20 as shown in FIG.
[0035]
Next, from the front of the endoscope 20, the attachment member 12 is brought close to the front end surfaces 34 a and 35 a of the holding opening / closing piece 34 and the bending opening / closing piece 35, and the head 13 and the through shaft portion 14 are held. The first holding groove 38a and the second holding groove 38b of the opening / closing piece 34 are fitted to each other, and the planned folding portion 14a is fitted to the folding groove 39 of the folding opening / closing piece 35 (FIG. 11). reference).
In this way, when the attachment member 12 is held by the holding and deforming tool 30, the proximal end portion (not shown) of the holding and deforming tool 30 protruding rearward from the forceps port 24 is pulled rearward to hold it. The opening / closing piece 34, the folding opening / closing piece 35, the attachment member 12, and the connecting string 15 are completely stored in the forceps channel C, and the protrusion 11b of the magnetic anchor 11 is stored in the forceps channel C. The portion 11a is brought into contact with the distal end surface 22 of the insertion portion 21, and the endoscope 20, the magnetic anchor device 10, and the holding / deforming tool 30 are integrated (see FIG. 12).
[0036]
Next, the endoscope 20 in such a state is inserted again into the organ B, the distal end portion of the insertion portion 21 is brought close to the lesioned portion X, and then the holding and deforming tool 30 is moved with respect to the endoscope 20. The holding opening / closing piece 34 and the folding opening / closing piece 35 are fully opened by relatively moving forward and operating the operating portion. If it does in this way, the bending plan part 14a will escape from the groove 39 for bending of the opening / closing piece 35 for bending, and the adhesion member 12 will be hold | maintained only by the opening / closing piece 34 for holding (refer FIG. 13).
Furthermore, the lesioned part X is positioned between the holding opening / closing piece 34 and the folding opening / closing piece 35 in the fully opened state by operating the endoscope 20 (see FIG. 13).
[0037]
In this state, the holding opening / closing piece 34 and the folding opening / closing piece 35 are fully closed by operating the operating portion of the holding and deforming tool 30. Then, as shown in FIG. 14, the penetrating shaft portion 14 of the attachment member 12 penetrates the lesioned portion X, and the bending planned portion 14 a is pressed against the bending groove 39 of the folding opening / closing piece 35. The bent portion 14a is bent in a direction substantially orthogonal to the penetrating shaft portion 14 (plastically deformed). In this way, the penetrating shaft portion 14 is completely prevented from coming off the lesioned portion X by the head 13 and the planned bending portion 14a, and the lesioned portion X and the attachment member 12 are integrated.
[0038]
Subsequently, when the operation opening / closing piece 34 and the folding opening / closing piece 35 are opened by operating the operation unit, the folding scheduled portion is formed from the folding groove 39 of the folding opening / closing piece 35 as shown in FIG. 14a comes out. Further, when the endoscope 20 is moved away from the lesion X in a direction parallel to the first holding groove 38a, as shown in FIG. 15, the first holding groove 38a of the holding opening / closing piece 34 and The head portion 13 and the through shaft portion 14 escape from the second holding groove 38b.
Thereafter, the operation part of the holding / deforming tool 30 is operated to return the holding opening / closing piece 34 and the folding opening / closing piece 35 to the fully closed state, and the holding / deforming tool 30 is removed from the forceps channel C of the endoscope 20. Pull out completely (not shown).
[0039]
Subsequently, as shown in FIG. 16, when the magnetic anchor 11 is attracted to the upper side of FIG. 16 by increasing the magnetic field generated by the magnetic guiding member 46 arranged outside the body of the patient A, the entire connecting string 15 is obtained. As the tension member 10 is tensioned, the attachment member 12 moves in the direction of magnetic force (upward in FIG. 16), and the lesioned part X integrated with the attachment member 12 also moves reliably by a sufficient distance in the same direction.
[0040]
Thus, when the lesioned part X is moved in the desired direction by a desired distance, a sufficiently large excision part is formed at the boundary between the lesioned part X and the normal tissue. As shown in FIG. An incision tool such as a high-frequency knife 50 is inserted into the organ B using the forceps channel C of the endoscope 20 (not shown in FIG. 16), and the lesioned part X is excised together with the mucous membrane from one end side.
When the lesioned part X is excised from one end side to the opposite end side, the entire lesioned part X is eventually completely excised (not shown).
At the time of excision work with the high-frequency knife 50, the position of the tip 50a of the high-frequency knife 50 becomes easier to confirm as the excision area is expanded.
[0041]
When the excision work is completed as described above, the lesioned part X separated from the normal tissue is maintained in an integrated state with the attachment member 12 (magnetic anchor device 10), so that the lesioned part X is prevented from being lost. . In order to collect the excised lesioned part X, grasping forceps (not shown) are inserted into the forceps channel C of the endoscope 20, the magnetic anchor device 10 is grasped by the grasping forceps, and the endoscope is left as it is. 20 is removed from the body, and the lesion X is taken out of the body together with the magnetic anchor device 10. After that, treatments such as suturing and disinfection of the excised part are performed.
[0042]
As described above, if the anchor guiding system of the present embodiment is used, it is possible to attach the attachment member 12 that forms a part of the magnetic anchor device 10 to the lesioned part X in a state in which the attachment is reliably prevented. Even if the magnetic force applied to the magnetic anchor 11 is large, the attachment member 12 does not come out of the lesion X. For this reason, compared with the case where the lesioned part X is hold | gripped with a clip conventionally, the burden of an operator and a patient can be reduced.
[0043]
Further, since the lesioned part X can be moved in a desired direction by a sufficient distance, the excision part at the boundary between the lesioned part X and the normal tissue can be easily and reliably secured with a sufficient size. Even if the lesioned part X has a flat shape, a sufficiently large excision part can be created, so that the lesioned part X can be easily excised.
[0044]
Furthermore, since the lesioned part X is lifted by the attachment member 12, the excised part can be sufficiently secured, and the already excised lesioned part X can be prevented from falling on the proper muscle layer B2.
Moreover, since the adhesion member 12 can be arrange | positioned in arbitrary positions, the visual field of the endoscope 20 is not prevented by the excised lesioned part X.
[0045]
Next, a second embodiment of the present invention will be described with reference to FIGS.
The same members as those in the first embodiment are designated by the same reference numerals, and detailed description thereof is omitted.
[0046]
The anchor guiding system of the present embodiment includes a gravity anchor device 60 (consisting of a gravity anchor 61, a fastening member 12, and a connecting string 15), an endoscope 20, and a holding and deforming tool 30.
The outer shape of the gravity anchor 61 is the same as that of the magnetic anchor 11, and includes a main body 61a and a protrusion 61b. The entire gravity anchor 61 is formed of a non-magnetic material, and specific examples of the non-magnetic material include gold, copper, aluminum, stainless steel (austenite), brass, ceramic, glass, and the like.
[0047]
The gravity anchor device 60 is inserted into the organ B while being attached to the endoscope 20 in the same manner as in the first embodiment, and then attached to the lesioned part X by the holding and deforming tool 30. , Separated from the holding and deforming tool 30.
As shown in FIG. 18, since the gravity anchor 61 moves according to the gravity P, when the posture of the patient A is changed and the gravity anchor 61 is moved in a desired direction, the string portion 15 is tensioned, and the attachment member 12 is moved. The lesioned part X to which is attached moves downward in the direction of gravity. For this reason, a sufficiently large excision part is formed at the boundary between the lesion X and normal tissue, so the lesion X is excised with the high-frequency knife 50 or the like.
[0048]
As described above, also in the anchor guiding system of the present embodiment, the attachment member 12 that forms a part of the gravity anchor device 60 is securely removed from the lesion X as in the first embodiment. Therefore, even if the mass of the gravity anchor 61 is large, the attachment member 12 does not come out of the lesion X. For this reason, compared with the case where the lesioned part X is hold | gripped with a clip conventionally, the burden of an operator and a patient can be reduced.
Furthermore, in this embodiment, the magnetic anchor guiding device 40, which is an expensive device necessary in the first embodiment, is not necessary, which is advantageous in terms of cost compared to the first embodiment.
[0049]
Although the present invention has been described with reference to the above embodiment, the present invention is not limited to the above embodiment, and can be improved or changed within the scope of the purpose of the improvement or the idea of the present invention.
[0050]
【The invention's effect】
As described above, according to the present invention, the attachment member linked to the anchor can be attached to the target portion inside the object in a state in which the attachment member is securely detached.
[Brief description of the drawings]
FIG. 1 is an overall view of a magnetic anchor device according to a first embodiment of the present invention.
FIG. 2 is a side view of a fastening member.
FIG. 3 is a front view of a fastening member.
FIG. 4 is an overall view of an endoscope.
FIG. 5 is a side view showing the distal end portion of the holding and deforming tool with the tube broken.
6 is a view of the distal end portion of the holding and deforming tool as viewed from the direction of the arrow VI in FIG.
FIG. 7 is a view of the holding opening / closing piece of the holding / deforming tool as seen from the direction of the arrow VII in FIG. 5;
FIG. 8 is a view of a bed on which a patient whose lesion is to be excised and a magnetic anchor guide device are viewed from the patient's head side.
FIG. 9 is a side view of a bed on which a patient is placed and a magnetic anchor guiding device.
FIG. 10 is a view showing a distal end portion of an endoscope to which a holding and deforming tool is attached and a magnetic anchor device in a sectional view of the endoscope.
FIG. 11 is a cross-sectional view of the endoscope, showing a state in which the magnetic anchor device is attached to the holding and deforming tool attached to the endoscope.
FIG. 12 is a cross-sectional view of the endoscope showing a state in which the holding and deforming tool is completely stored in the forceps channel of the endoscope and a magnetic anchor is attached to the distal end of the endoscope. is there.
FIG. 13 is a cross-sectional view of the endoscope showing a state in which the magnetic anchor device protrudes from the distal end of the endoscope and the holding and deforming tool is fully opened in the organ.
FIG. 14 is a cross-sectional view of an endoscope showing a state in which the holding and deforming tool is fully closed in the organ and a sticking member is inserted into a lesioned portion. .
FIG. 15 is a cross-sectional view of an endoscope showing a state in which the holding and deforming tool is fully opened and separated from the attachment member.
FIG. 16 is a view showing a state in which a lesioned part is moved by using a magnetic anchor guiding device after attaching a sticking member to the lesioned part.
FIG. 17 is an overall view of a gravity anchor device according to a second embodiment of the present invention.
FIG. 18 is a diagram showing a state in which a lesioned part is moved by moving a gravity anchor in the direction of gravity after the attachment member is attached to the lesioned part.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Magnetic anchor apparatus 11 Magnetic anchor 11a Main part 11b Protrusion part 12 Attachment member 13 Head (Large diameter retaining part)
14 Penetrating shaft portion 14a Bending scheduled portion 15 Connecting string 20 Endoscope 21 Inserting portion 22 Tip surface 23 Forceps channel outlet 24 Forceps port 24a Inlet 30 Holding / deforming tool 31 Tube 32 Mounting piece 33 Pin 34 Holding opening / closing piece ( Holding member)
35 Opening and closing pieces for bending (bending members)
36 37 Operation wire 38a First holding groove (holding groove)
38b Second holding groove 39 Bending groove 40 Magnetic anchor guiding device 41 Bed 41a Floor plate 42 XY stage (one-way moving mechanism)
43 Frame / rail (moving mechanism in one plane)
44 Rail 45 Rail 46 Magnetic induction member 47 Electromagnet 48 Base 49 Counterweight 50 High-frequency knife 50a Tip 60 Gravity anchor device 61 Gravity anchor 61a Main body 61b Protrusion A Patient (object)
A1 head B organ B1 submucosa B2 proper muscle layer C forceps channel X lesion (target site)

Claims (8)

An adhesive member attached to an object part inside the object;
A magnetic anchor made of a magnetic material connected to the adhesive member;
A magnetic anchor guiding device that is arranged outside the object, generates a magnetic field, and moves the magnetic anchor in a predetermined direction by a magnetic force generated from the magnetic field;
An endoscope anchor guidance system comprising:
The adhesive member is
A penetrating shaft that can penetrate the target site;
A large diameter retaining portion provided at one end of the penetrating shaft portion and having a larger cross-sectional shape than the penetrating shaft portion;
An endoscope anchor guidance system for an endoscope, wherein the penetrating shaft portion forms a planned bending portion that can be bent at least in the vicinity of the end opposite to the large-diameter retaining portion and maintains a shape after bending. . The endoscope anchor guidance system according to claim 1, wherein
The magnetic anchor guiding device is
A magnetic induction member that generates a magnetic force by a generated magnetic field and moves the magnetic anchor in a predetermined direction by the magnetic force;
An in-plane movement mechanism for moving the magnetic induction member along a U-shaped frame member arranged in a specific plane;
A one-way moving mechanism for relatively moving the U-shaped frame member in a direction orthogonal to the one plane;
An anchor guide system for an endoscope. The endoscope anchor guidance system according to claim 1 or 2, wherein the magnetic anchor and the attachment member are connected by a flexible connecting string. An adhesive member attached to an object part inside the object;
A gravity anchor made of a non-magnetic material that is connected to the attachment member and moves according to gravity;
An endoscope anchor guidance system comprising:
The adhesive member is
A penetrating shaft that can penetrate the target site;
A large diameter retaining portion provided at one end of the penetrating shaft portion and having a larger cross-sectional shape than the penetrating shaft portion;
An endoscope anchor guidance system for an endoscope, wherein the penetrating shaft portion forms a planned bending portion that can be bent at least in the vicinity of the end opposite to the large-diameter retaining portion and maintains a shape after bending. . The endoscope anchor guidance system according to claim 4, wherein the magnetic anchor and the attachment member are connected by a flexible connecting string. The endoscope anchor guidance system according to any one of claims 1 to 5,
And a holding member that holds the large-diameter retaining portion of the attachment member, and a bending member that bends the planned bending portion while holding the large-diameter retaining portion on the holding member. An anchor guide system for an endoscope comprising a holding and deforming tool that can be inserted into and removed from the forceps channel of the endoscope. The endoscope anchor guidance system according to claim 6, wherein
The holding member and the bending member are pivotably mounted by a pin so as to be opened and closed, and are a holding opening / closing piece and a bending opening / closing piece that can be opened and closed by an operation wire. The holding member of the large-diameter retaining portion is formed, and when the folding opening / closing piece is closed with respect to the holding opening / closing piece, the attachment member held by the holding opening / closing piece An endoscope anchor guiding system for bending the bending portion of the endoscope. The endoscope anchor guidance system according to claim 6 or 7,
An endoscope anchor guidance system for an endoscope in which the holding member of the holding and deforming tool is capable of releasing the holding of the large-diameter retaining portion after the bending portion is bent.

Images