Endoscope is a kind of medical instrument with the purpose of observation. It is an optical device, which can go deep into the natural cavity of human body or through the opening of the hole for examination, diagnosis or treatment.

　　內(nèi)窺鏡主要由三大系統(tǒng)組成，分別為窺鏡系統(tǒng)、圖像顯示系統(tǒng)、照明系統(tǒng)。以目前較為常用的電子內(nèi)窺鏡為例，窺鏡系統(tǒng)包括手柄和鏡體，鏡體伸入患者體內(nèi)，鏡體內(nèi)部并列多個管道，包括照明光纖、傳像光纖（電子內(nèi)窺鏡中是CCD視頻線）、傳氣通道、傳水通道、器械通道等。

　　Endoscope is mainly composed of three systems, which are endoscope system, image display system and lighting system. Taking the electronic endoscope as an example, the endoscope system includes a handle and a mirror body, the mirror body extends into the patient's body, and there are several parallel pipes in the mirror body, including lighting optical fiber, image transmission optical fiber (CCD video cable in the electronic endoscope), gas transmission channel, water transmission channel, device channel, etc.

　　一、內(nèi)窺鏡發(fā)展情況及運用場景

　　1、 Development and application of endoscope

　　1、發(fā)展史

　　1. History of development

　　內(nèi)窺鏡的發(fā)展經(jīng)歷了硬管式內(nèi)窺鏡（1806-1932）、半曲式內(nèi)窺鏡（1932-1957）到纖維內(nèi)窺鏡（1957以后）、電子內(nèi)窺鏡（1983年以后）四個階段。按其成像構(gòu)造分類：可大體分為3大類：硬管式內(nèi)窺鏡、光學纖維（可分為軟鏡和硬鏡）內(nèi)窺鏡和電子內(nèi)窺鏡（可分為軟鏡和硬鏡）。

　　The development of endoscope has gone through four stages: hard tube endoscope (1806-1932), half curved endoscope (1932-1957), fiber endoscope (after 1957) and electronic endoscope (after 1983). According to its imaging structure, it can be roughly divided into three categories: hard tube endoscope, optical fiber (soft mirror and hard mirror) endoscope and electronic endoscope (soft mirror and hard mirror).

　　2、內(nèi)窺鏡運用場景

　　2. Endoscope application scene

　　二、內(nèi)窺鏡分類介紹

　　2、 Classification of endoscopes

　　1、硬管式內(nèi)窺鏡

　　1. Rigid tube endoscope

　　硬管內(nèi)窺鏡，主要用于人體表淺及淺層部位自然腔道和通過穿刺開口腔道的病灶診斷和(或)，如膀胱鏡、腹腔鏡，在操作中不可彎曲。硬管內(nèi)窺鏡主要由光學成像系統(tǒng)和照明系統(tǒng)組成：光學部分外觀看是一個細長的金屬管子，而里面裝著一個由許多透鏡組成的完整的光學系統(tǒng)。光學成像系統(tǒng)由物鏡系統(tǒng)、轉(zhuǎn)像系統(tǒng)、目鏡系統(tǒng)三大系統(tǒng)組成。

　　Hard tube endoscopy is mainly used for the diagnosis and / or treatment of the lesions in the natural lumen of the superficial and shallow parts of the human body and through the puncture of the open lumen, such as cystoscope and laparoscope, which cannot be bent during the operation. The hard tube endoscope is mainly composed of optical imaging system and lighting system: the optical part is a long and thin metal tube, and there is a complete optical system composed of many lenses inside. The optical imaging system is composed of objective system, image rotation system and eyepiece system.

　　2、纖維內(nèi)窺鏡

　　2. Fiberscope

　　纖維內(nèi)窺鏡一般由目鏡、手輪（軟性或半硬性）、鉗道口、導光束接口、導像束、導光束組成，有些產(chǎn)品還包括送水（氣）孔、閉孔器等。纖維內(nèi)窺鏡由光學觀察系統(tǒng)、照明傳輸系統(tǒng)和支架構(gòu)件組成。光學觀察系統(tǒng)由聚焦成像的物鏡組、傳輸物鏡組像的傳/轉(zhuǎn)像組和目視觀察用的目鏡或CCD轉(zhuǎn)接鏡構(gòu)成；照明傳輸系統(tǒng)由混編排列的多束導光纖維構(gòu)成；支架構(gòu)件由支承并包裹前述系統(tǒng)并開有手術(shù)或沖洗孔道的醫(yī)用金屬或有機材料構(gòu)成。

　　Fiber endoscope is generally composed of eyepiece, hand wheel (soft or semi-rigid), Tongdao port, light guide interface, image guide beam and light guide beam. Some products also include water (air) supply hole, hole closers, etc. The fiber endoscope consists of an optical observation system, a lighting transmission system and a bracket component. The optical observation system is composed of a focus imaging objective lens group, a transmission / conversion group for transmitting the objective lens group image and an eyepiece or CCD adapter for visual observation; the lighting transmission system is composed of a mixed arrangement of multi beam light guide fibers; the bracket component is composed of medical metal or organic materials supporting and wrapping the above system and opening an operation or washing channel.

　　纖維內(nèi)窺鏡按用途分為：上消化道內(nèi)窺鏡、下消化道內(nèi)窺鏡、呼吸道內(nèi)窺鏡。

　　Fiberscope can be divided into upper digestive tract endoscope, lower digestive tract endoscope and respiratory tract endoscope according to its application.

　　按光學視向角分為：前視型、斜視型、側(cè)視型三種。

　　According to the optical viewing angle, it can be divided into three types: forward viewing type, squint viewing type and side viewing type.

　　按功能分為：具有手術(shù)功能（帶手術(shù)和/或沖洗孔道）和不具有手術(shù)功能（檢查用）兩種。

　　According to the function, it can be divided into two types: with operation function (with operation and / or flushing hole) and without operation function (for examination).

　　3、電子內(nèi)窺鏡

　　3. Electronic endoscope

　　電子內(nèi)窺鏡主要由內(nèi)鏡、電視信息系統(tǒng)中心和電視監(jiān)視器三個主要部分組成，另外還配備一些輔助裝置，如錄像機、照相機、吸引器以及用來輸入各種信息的鍵盤和診斷所用的各種處置器具等。

　　The electronic endoscope is mainly composed of three main parts: endoscope, TV information system center and TV monitor. In addition, it is also equipped with some auxiliary devices, such as video recorder, camera, attractor, keyboard for inputting various information and various disposal devices for diagnosis and treatment.

　　4、超聲內(nèi)鏡

　　4. Endoscopic ultrasonography

　　將微型高頻超聲探頭安置在內(nèi)鏡前端，在內(nèi)鏡直接觀察腔內(nèi)形態(tài)的同時，又可進行實時超聲掃描，以獲得管道壁各層次的組織學特征及周圍鄰近臟器的超聲圖像。

　　The micro high-frequency ultrasound probe is placed in the front of the endoscope. When the endoscope directly observes the shape of the cavity, it can also carry out real-time ultrasound scanning, so as to obtain the histological characteristics of the various layers of the pipe wall and the ultrasound images of the surrounding organs.

　　5、膠囊內(nèi)鏡

　　5. Capsule endoscopy

　　膠囊內(nèi)鏡早由以色列科學家于 2000 年研發(fā)，膠囊內(nèi)鏡可以對全小腸進行拍照觀察（胃鏡和腸鏡只能看到胃部和大腸，無法看到中間小腸這一段），彌補了胃鏡和腸鏡看不到的地方，大大提高了消化道疾病診斷檢出率。

　　Capsule endoscopy was first developed by Israeli scientists in 2000. Capsule endoscopy can take photos of the whole small intestine (gastroscope and enteroscope can only see the stomach and large intestine, but can't see the middle small intestine). It makes up for the places that gastroscope and enteroscope can't see, and greatly improves the detection rate of digestive tract disease diagnosis.

　　膠囊胃鏡需實現(xiàn)對膠囊的主動控制，目前主要有兩種方式實現(xiàn)主動控制：內(nèi)部驅(qū)動和外部驅(qū)動。內(nèi)部驅(qū)動模式暫時缺乏可行性，外部驅(qū)動的主流方式是依靠體外磁場控制。目前主要有三大類磁控方法：手柄式、磁共振（MRI）線圈式和機器臂式磁控，目前僅機器臂式磁控獲批用于臨床胃部檢查。根據(jù)磁控的類型，主要分為電磁體、永磁體和磁共振。

　　Capsule gastroscope needs to realize the active control of capsule. At present, there are two main ways to achieve the active control: internal drive and external drive. The internal driving mode is temporarily lack of feasibility, and the main way of external driving is to rely on external magnetic field control. At present, there are three main types of magnetic control methods: handle type, magnetic resonance (MRI) coil type and machine arm type. At present, only machine arm type magnetic control has been approved for clinical gastric examination. According to the type of magnetic control, it is mainly divided into electromagnet, permanent magnet and magnetic resonance.

　　三、內(nèi)窺鏡市場與技術(shù)

　　3、 Endoscope market and technology

　　1、內(nèi)窺鏡市場

　　1. Endoscope Market

　　2015 年全球內(nèi)窺鏡市場規(guī)模已經(jīng)達到 302 億美元，2011 年-2015 年復合增長率為 7.2%。2017 年國內(nèi)市場規(guī)模約為 246 億人民幣，其中軟性內(nèi)窺鏡的市場規(guī)模大約 33-35 億人民幣。從全球看軟鏡技術(shù)基本被日本主要幾家企業(yè)壟斷。奧林巴斯、賓得、富士合計占據(jù) 90%以上的市場份額，其中奧林巴斯市場份額超過 65%。我國硬鏡市場一梯隊為 Karl Storz 和奧林巴斯，二梯隊為史塞克和狼牌，合計占據(jù) 85%以上的市場份額。國產(chǎn)硬鏡的主要廠家包括沈陽沈大、好克和天松等，國產(chǎn)企業(yè)合計市場份額 5%左右。

　　In 2015, the global endoscope market has reached 30.2 billion US dollars, with a compound growth rate of 7.2% from 2011 to 2015. In 2017, the domestic market size was about 24.6 billion yuan, including 3.3-3.5 billion yuan for soft endoscopes. From a global perspective, soft mirror technology is basically monopolized by several major Japanese enterprises. Olympus, Pentax and Fuji together account for more than 90% of the market share, of which Olympus accounts for more than 65%. The first echelon of China's hard mirror market is Karl Storz and Olympus, and the second echelon is Stryker and wolf, accounting for more than 85% of the total market share. The main manufacturers of domestic hard mirror include Shenyang Shenda, Haoke and Tiansong. The total market share of domestic enterprises is about 5%.

　　2、內(nèi)窺鏡技術(shù)方向

　　2. Technical direction of endoscope

　　目前電子內(nèi)窺鏡的發(fā)展趨勢為兩方面：1、高清分辨率，目前已經(jīng)達到百萬像素；2、探頭微型化。探頭的大小直接影響創(chuàng)傷的嚴重程度，微型探頭化可以減輕患者痛苦和不適度。

　　At present, the development trend of electronic endoscope is two aspects: 1. High resolution, which has reached one million pixels; 2. Probe miniaturization. The size of the probe has a direct impact on the severity of the trauma. Miniaturization of the probe can reduce the pain and discomfort of patients.