Untitled record

Method and device for examining organs not accessible to immediate observation, in particular the digestive organs X-ray examination using contrast agents, in particular the gastrointestinal tract, has the disadvantage of providing only silhouetted images and also of a relief of the stomach does not make the organ itself visible. This disadvantage is overcome by the well-known method of gastric mirroring, which permits observation of the digestive organs to the extent that a diagnostic error is impossible for the area covered by the eye. However, the value of this method, which can be used in a technical-diagnostic sense, is considerably reduced by the risk of injury to the test person and the delivery organs (such as a tear of the esophagus) that is readily apparent in his application, so that the majority of physicians completely reduce the gastric level. and, at the most, resort to him as the ultimate means. In addition, the examination of the intestine with the gastric mirrors built to date, and the so-called mobile gastric mirrors, is not possible, and only the last 3o to 40 cm of the colon can be detected by rectoscopy; in other words, with help Gastroscopy and rectoscopy of the small intestine, especially the very important duodenum, can not be observed with the excretory ducts of the liver and the pancreas. All of these disadvantages are eliminated by the method of the present invention. It consists essentially in the fact that the imaging of the organs, in particular of the digestive organs, which are not accessible to direct observation, takes place by image telegraphy, in such a way that the image telemetering device, together with the optics required for it, is introduced into the organ to be examined. where he scans the interior of this organ by a beam of light and this causes the electrical current fluctuations caused thereby in a photosensitive cell to an outside of the body of the examinee arranged receiver and makes it visible again.

An embodiment of a working according to the new method and suitable for the examination of the digestive organs device is illustrated in the drawing with various embodiments of the encoder.

The receiver (fig. R) consists of a rotating roller a. Which moves in the direction of its axis and which is surrounded in the usual way by a film to be exposed. The light of a uniform light source b is controlled by, for example, a Kerr cell c, and then concentrated on a point of the film via a condenser lens d by means of a mirror e, so that all points of the film are successively exposed due to the rotation and travel of the roller a. The Kerr cell c is fed with the givers controlled, via the cable f1, f2 (see Fig. A, which represents a section along the line: 2-z of Fig. I) supplied to an amplifier g currents. Depending on the voltage of the supplied currents results in a more or less: large shading of the transmitted light.

The roller a is there by a screw. with an electric motor i, to which one feeds current through a cable h, or a movement u. Like. Coupled such that the motor i bearing frame l and with it the roller a gradually moves up or down. The frame L is connected to a light-tight box m, which can be adjusted in height by a counterweight n.

A flexible shaft o connects to the motor shaft (see Fig. 2), which, together with the cable f1, f2 and the cable p1, p2 leading to the light source of the transmitter, is enclosed by a tube q (approximately the thickness of a duodenal probe) is and ends in the donor r.

As far as the education of the donor is concerned, the following generally should be said: The stomach is a (slowly) moving organ, so that only snapshots are possible. In x-ray photography you can still get good gastric images with exposures of half a second. The exposure time could be, without having to accelerate the mechanical process accordingly, abschnürzen except for a fraction of a second through the Schlitzblendenv abbreviated, which is known to forego the fact that one waives the simultaneous capture of the entire object in favor of image sharpness and exposed individual strips of the image successively. The scanning of the object on a picture-telegraphic path now basically represents a similar process and brings the desired effect particularly well into effect insofar as the exposed strips have the smallest possible width. If, according to the new method, the scanning of the organ in the direction of the peristaltic wave may even proceed at the same speed, a stationary object would be permanently exposed. Of course, in the changing circumstances in the healthy and even in the diseased stomach such a meeting can never be the result of a calculation and must be left to chance. It is therefore always to be expected with a moving stomach wall (the average course of the stomach movement is zo to 30 seconds), even if especially with empty stomach longer periods of peristaltic rest occur and you through fat and oil administration, the movement of the stomach for some time completely can turn off.

When scanning the image, the encoder or its optics must either be advanced or retracted. The retraction would certainly ensure uniform movement, but has the disadvantage that the peristalsis runs counter to the exposure process.

A further problem is the guidance of the free end of the tube q. Since the observation instrument is movable, the examiner has no influence on the position of the optics at the moment of insertion of the instrument. In order to get a good picture, the optics must now as possible lie in the middle line of the organ (gas cylinder). Such guidance can be achieved, for example, by providing the tube tip with a duodenal probe, which must be passed through the stomach outlet prior to exposure, and attaching inflatable rubber balloons t1, t2 in front of and behind the transducer Instrument over the giver and protect it from contamination, in the stomach but by supplying air with the help of a conventional air blower u through the channel v to inflate spherically, so that the right-sided distance from the gastric mucosa is maintained (see Fig. 7). It is also possible (see Fig. 8) to obtain x influence on the position of the tube tip by means of cord tubes running inside the tube q.

The distortions resulting from the incongruence between the gas cylinder and the film roller and between the displacement of the tube tip and the displacement of the roller can easily be accepted since such distortions from gastric mirroring and X-ray photography are known and can be evaluated.

In Fig. 3 to 6 different embodiments of the encoder r are shown.

According to Fig. 3, at the end of the flexible shaft o, a plane or convex mirror i is mounted at an angle of about q.5 °, opposite to which a photocell z and a light source 3 lie. The light from the light source e is collimated by the lens mirror system q, 1 and thrown by means of the rotating mirror i through the glass wall of the instrument onto corresponding points on the stomach wall. The reflected light from this passes directly to the photocell a and causes Sfromschwankungen that are transmitted on the way via the cable f1, f = on the Kerrzelle c.

The introduction of the donor into the stomach must of course not be more difficult than that of the stomach tube and the situation does not cause more discomfort than the duodenal probe, which is known to be in the intestine for hours, even weeks, without causing disturbances. Accordingly, the size of the encoder should be selected (about 1 cm in diameter and 3 to d cm in length).

The device according to Fig.3 is used for seamless sampling of the stomach entrance to the stomach outlet and the subsequent intestinal parts. With the help of the spindle h, the roller a downwards or upwards and at the same time (in case of calm attitude of the patient) the tube q in the stomach before or. moved back. As with gastric mirroring, the stomach can be unfolded by blowing in air (channel y is used for this purpose).

In Fig. D. a second embodiment of the transmitter is shown, in which the photocell a is disposed behind the mirror i and rotates with this, but otherwise has no egg-lovely modifications compared to the first embodiment.

In Fig. 5 and 6, two further embodiments are shown, which allow a symmetrical beam path and a considerable space savings.

According to Fig. 3, this is achieved by the fact that the convex mirror i is mounted on the anode 8 of a rotating alkaline cell 9. In Fig. 6, the photocell into two fixed parts 2a, from decomposed, one of which is arranged in front of the other, behind the mirror i and arranged in front of the mirror part is formed as a hollow cylinder. If you assign a cable pair to each part and if you color the glass wall (red and green), you can achieve a colored reproduction with a corresponding doubling of the receiver (with three photocells a three-color photograph would be possible).

It is to be understood that the embodiments illustrated in the drawings are only examples, and that any other configuration of the transmitter and the receiver is possible in accordance with the art of image telegraphy.