臨牀消化器内科 Vol.16 No.2(4-3)


特集名 最新の大腸内視鏡と挿入法の進歩
題名 硬度可変式大腸内視鏡の臨床 (3) 軟らかい機器による検査の実際 -- その必要性と限界
発刊年月 2001年 02月
著者 宇野 良治 弘前大学医学部第一内科
【 要旨 】 大腸内視鏡による穿孔の予防に柔軟な内視鏡が期待されている.柔軟な内視鏡のたわみやすいという欠点を克服すべく開発されたのがCF-240 AIである.硬度を変換する内視鏡の使い方には,もっとも柔軟な状態でS状結腸を通過し脾彎曲部でスコープを直線化してから硬度を上げ,再ループを防止しながら深部挿入を行う方法と,硬い状態で挿入し,有痛性のループを形成した場合に硬度を下げて挿入する方法がある.体外において最軟状態から最硬状態へ変換した場合の力は穿孔レベルに至らず,硬度変換による穿孔は理論的にありえない.しかし,将来的には最軟状態でCF-SVよりも軟らかく,硬度変換の範囲も変えることのできる内視鏡の開発が望まれる.
Theme Latest Developments in Devices Related to Colonoscopy and Progress in Insertion Techniques
Title Variable Stiffness Colonoscope
Author Yoshiharu Uno First Department of Internal Medicine, Hirosaki University School of Medicine
[ Summary ] Soft-shaft colonoscopy has been used to prevent perforation of the colon during the colonoscopic examination. In order to cover the shortcomings of the soft-shaft colonoscope, that it is too flexible, variable stiffness colonoscopes have been developed. There are two methods for using variable stiffness colonoscopes. The first method is that where, the operator passes through sigmoid colon with the scope in its most flexible condition, then straightens the scope while the tip is at the splenic flexure, and increase the stiffness to prevent loop formation and inserts it further. The second is that where, the scope is inserted with the scope in its least flexible condition. The stiffness of the scope is decreased only when a painful loop is formed. Theoretically the perforation of the colon while converting the flexibility of the scope from its least flexible condition to its most, inside the colon, will not occur, because the force for conversion of flexibility is less than the force necessary to cause perforations.
戻る