JP2002330918A - Hood for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a hood for an endoscope which maintains the sniping property of details even in a curving section, opens a cut opened mucosa and assures the operation field. SOLUTION: This hood has an endoscope wearing section 12 which is made wearable at a distal end 18 of the endoscope 16 and a convergently cylindrical hood section 14 which projects to the forward of the endoscope 16 from the endoscope wearing section 12 and has an aperture 20 of a diameter finer than the diameter of the endoscope wearing section 12 at its distal end.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

The present invention relates to an endoscope hood, and more particularly to an endoscope hood suitable for use in endoscopic procedures such as mucosal resection.

[0002]

BACKGROUND OF THE INVENTION In general,
For securing visual field and retaining mucous membrane during endoscopic mucosal resection,
Grasping forceps are often used.

In this case, it is necessary to use a two-channel endoscope or two endoscopes in order to perform mucosal incision and snare after grasping the mucous membrane with grasping forceps.

[0004] In addition, when attempting to resect a relatively large flat mucosal tumor of 2 cm or more endoscopically, it is difficult to perform a lump resection with a snare.

[0005] In particular, when the size exceeds 4 cm, it is very difficult to apply a snare and cut all at once, and there is a risk of perforation.

In order to collectively resect such a large lesion, it is necessary to incise the submucosal layer.

As a method for incising the submucosal layer, there is a report that attempts to incise the mucous membrane with a grasping forceps and then incise the needle with a needle knife. Has not been obtained.

When a two-channel endoscope is used, the grasping forceps and the needle knife move at the same time, so that the operability is limited. When two endoscopes are used, operation by one person is not possible. It is impossible, and cooperative operation is difficult if performed by two people.

Accordingly, the present inventor has previously proposed a forceps for incising a mucous membrane (Japanese Patent Application No. 10-225158) and a transparent hood with a flat tip for an endoscope (Japanese Patent Application No. 11-205141).

When this forceps is used, first, the mucous membrane to be incised is sandwiched between the forceps, and after confirming that the incised portion is appropriate, the incision can be performed by applying a high-frequency current.

By using the forceps, the incision position,
The depth can be determined properly, and if the pinch is made in an inappropriate position, it can be re-pinched before the high-frequency current flows, preventing improper incision and preventing And safe mucosal incision is possible.

This also applies to the incision of the submucosa.

At this time, a transparent hood such as a flat end-type endoscope is used in combination with a purpose of securing the visual field of the treatment section and keeping the opening direction of the forceps constant.

However, in the transparent hood having a flat distal end for an endoscope, since the hood is wide and wide, it is difficult to operate in a fine portion, and there is a problem in particular in the aimability of treatment in a bent portion.

It is also conceivable to use a conventional cylindrical hood together with a needle knife for the same purpose, but in this case, the tip diameter is too large and it is difficult to open a fine incision. There is still a problem with sniper measures in detail.

An object of the present invention is to provide a hood for an endoscope which can maintain a sharp aiming property even at a bent portion, open an incision mucosa, and secure an operation field.

[0017]

In order to achieve the above object, an endoscope hood according to the present invention comprises: a tubular endoscope mounting portion which can be mounted on a distal end portion of an endoscope; The endoscope further includes a tubular hood portion that protrudes toward the endoscope from the endoscope mounting portion and has an opening having a smaller diameter than the endoscope mounting portion at the distal end.

According to the present invention, the endoscope mounting portion is mounted on the distal end portion of the endoscope, and the tapered cylindrical hood portion having an opening having a smaller diameter than the mounting portion is projected toward the endoscope. Since the hood portion has a smaller diameter than the mounting portion, the operation at the small portion is easy, and particularly, the sniper of the treatment at the bent portion is good, and the mucosal incision portion can be easily opened.

That is, when the incision wound is opened by lifting the mucous membrane that has been peeled off by incising the submucosal layer with the hood, the wound can be observed endoscopically through the hood.

Further, a treatment tool such as a needle knife can be taken out from the opening at the tip of the hood, and a treatment such as incision can be performed using a high-frequency current or the like. Can be kept good.

In addition, since the length of the treatment tool such as a needle knife which is protruded from the tip of the hood can be finely adjusted, it is possible to prevent the treatment tool such as a needle knife from being cut too deeply and safe to operate. Can be used for

In the present invention, the hood has a length of 3
-20 mm, and the diameter of the opening at the tip can be 2-9 mm.

That is, as the diameter of the opening at the tip of the hood becomes smaller, the sniper property increases, but the field of view becomes worse and the operation becomes difficult.

The longer the hood is, the easier it is to open the incision. However, if it is too long, the field of view becomes worse.

Therefore, an appropriate opening diameter and a length of the hood for obtaining a good visual field while maintaining a sufficient sniper property are desirable. As a result of studying various opening diameters and hood lengths, the opening diameter at the tip is 2 mm. ~ 9mm, preferably 4 ~ 7mm, particularly preferably 5 ~ 6mm, the length of the hood part is 3 ~ 20m
m, preferably 4 to 10 mm, particularly preferably 5 to 8 m
At the time of m, it was acquired that the intended purpose could be achieved.

In the present invention, by forming at least the hood portion with a transparent material, a better visual field can be secured.

In the present invention, the opening at the tip is formed obliquely, that is, the length to the opening on one side of the hood is longer than that on the opposite side.
Making the incision easier to open while securing a sufficient field of view,
Operability can be improved.

In the present invention, by forming a drain port near the endoscope mounting portion of the hood, the liquid can be prevented from being stored in the hood, and the suction operation can be performed efficiently, so that the visual field can be more effectively viewed. Can be secured and more efficient use is possible.

[0029]

Embodiments of the present invention will be described below with reference to the drawings.

FIG. 1 is a diagram showing an endoscope hood according to one embodiment of the present invention.

The endoscope hood 10 has an endoscope mounting section 12 and a hood section 14.

The endoscope mounting section 12 is formed in a cylindrical shape having an inner diameter substantially corresponding to the outer shape of the endoscope 16, and a distal end portion 18 of the endoscope 16 is inserted inside the endoscope mounting section 12, thereby forming the endoscope. It can be attached to the tip portion 18 of 16.

The hood portion 14 is formed in a tapered cylindrical shape which projects forward of the endoscope 16 from the endoscope mounting portion 12 and has an opening 20 at the tip end, which has a smaller diameter than the endoscope mounting portion 12. .

The hood portion 14 is formed of a transparent material so that a better visual field can be secured.

The length of the hood 14 is 3 to 20 m.
m, preferably 4 to 10 mm, particularly preferably 5 to 8 m
m, and the aperture 20 has a diameter of 2 to 9 mm, preferably 4 to 7 mm, and particularly preferably 5 to 6 mm, so that a good visual field can be obtained while maintaining sufficient sniper property.

The opening 20 is formed diagonally, that is, the length to the opening 20 on one side of the hood portion 14 is longer than that on the opposite side.
Making the incision easier to open while securing a sufficient field of view,
Operability is improved.

Further, the endoscope mounting section 12 of the hood section 14
A plurality of, for example, four drain ports 22 are provided in the vicinity to prevent the liquid from being stored in the hood portion 14, perform the suction operation efficiently, secure the field of view more effectively, and enable efficient use. .

Next, the case of performing endoscopic mucosal resection of a superficial tumor by using such an endoscope hood 10 will be described.

First, an expected incision line is assumed on the mucosa around the mucosal tumor to be resected, and marking is performed using a high-frequency current or the like.

Thereafter, a liquid such as physiological saline is injected into the submucosa below the mucosa to be incised, the mucosa is raised, and then the mucosa is incised using a needle knife.

At this time, it is often not necessary to use the endoscope hood 10 in many cases. However, if it is difficult to secure the visual field due to the location of the tumor, the endoscope hood 10 is used to cut the mucous membrane. It will be easier.

When the incision around the tumor is made, the incision layer is opened at the tip of the hood portion 14 to expose the fibers of the submucosal layer,
The incision is advanced with a needle knife.

In this case, the exfoliated mucous membrane is lifted by the tip of the hood portion 14 so that not only the surgical field can be easily secured, but also the depth of the fiber incision by the needle knife can be reduced.
By adjusting the length of the tip of the needle knife that protrudes from the opening 20 at the tip of No. 4, it is possible to easily adjust the length, and the incision can be safely advanced.

When proceeding the treatment while looking at the tumor mucous membrane below the visual field, if the long side up to the opening 20 at the tip is used up, the exfoliated mucosa can be easily lifted, and Can be easily secured.

When it is necessary to repeatedly perform washing and suctioning due to bleeding on the way, the drainage port 22 provided near the endoscope mounting portion 12 of the hood portion 14 prevents the liquid from being stored in the hood portion 14. The suction operation can also be performed efficiently, the visual field can be more effectively secured, and the treatment can be easily performed.

The submucosa may be incised so that the tumor mucous membrane is completely removed, but if the detachment progresses considerably and the snare can be easily applied, the last step is to use a snare to cut it off. Separation can be performed easily.

As described above, as long as the lesion remains in the mucosa, the lumpectomy can be safely performed regardless of the size.

As described above, it is effective for endoscopic mucosal resection of flat mucosal tumors occurring in the gastrointestinal tract such as the esophagus, stomach, and large intestine, and in particular, en bloc resection of large tumors of 2 to 3 cm or more.

Further, by using such an endoscope hood 10, a one-channel ordinary endoscope 1 without anesthesia can be used.
Endoscopic mucosal resection can be easily performed using this book.Large mucosal tumor lesions that were previously treated using laparotomy or laparoscopic assisted surgery can be performed with less invasive endoscopic procedures. It becomes treatable.

The present invention is not limited to the above embodiment, but can be modified into various forms within the scope of the present invention.

For example, in the above embodiment, only the hood portion is formed of a transparent material, but the hood portion and the endoscope mounting portion may be integrally formed of a transparent material.

In the above embodiment, the case where the endoscope hood is used for endoscopic mucosal resection of a superficial tumor has been described. However, the present invention is not limited to this example, and endoscopic procedures other than mucosal resection may be used. For example, it can be applied to endoscopic hemostasis, etc.When stopping the bleeding, secure the visual field while peeling the clot at the tip of the hood, and check the bleeding point, and then stop the bleeding from the opening of the hood. It is possible to take out the probe for use and to surely aim at the bleeding point to perform the hemostatic treatment.

[Brief description of the drawings]

FIG. 1 is an external perspective view showing an endoscope hood according to an embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Endoscope hood 12 Endoscope mounting part 14 Hood part 16 Endoscope 18 Tip part 20 Opening 22 Drainage port

Claims (5)

[Claims] 1. A tubular endoscope mounting portion capable of being mounted on a distal end portion of an endoscope, protruding beyond the endoscope from the endoscope mounting portion, and having a distal end from the endoscope mounting portion. A hood portion having a cylindrical shape at the end having a small-diameter opening. 2. The hood for an endoscope according to claim 1, wherein the hood has a length of 3 to 20 mm and a diameter of an opening at a distal end of 2 to 9 mm. 3. The endoscope hood according to claim 1, wherein at least the hood portion is formed of a transparent material. 4. The hood for an endoscope according to claim 1, wherein the opening at the tip is formed obliquely. 5. The hood for an endoscope according to claim 1, wherein a drain port is formed near the endoscope mounting portion of the hood portion.