JP2002330928A - Endoscope system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope system as a main purpose with which curving of a curving part never becomes difficult, the fixing force to a tip guide part never decreases and the tip guide part is easily fitted to the tip part of an insertion part of the endoscope. SOLUTION: A treatment tool guide 15 is provided with the tip guide part 16 provided with a through hole 24 through which a treating tool 14 is penetrated and a wire fixing tool 17 for abutting and fixing the part 16 to the tip end of the insertion part 2 of the endoscope by drawing a wire 22 fixed to the guide part 16 through the inside of a channel 10 of the endoscope.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope in which a treatment tool guide for supporting a treatment tool is provided along the outer peripheral surface of an insertion portion of the endoscope and fixed to the endoscope. About the system.

[0002]

2. Description of the Related Art Generally, when performing treatment on a living tissue in a body cavity under an endoscope, a treatment instrument is inserted into an endoscope channel provided in the endoscope, and the treatment instrument is inserted into the endoscope. It has been performed to guide the patient into a body cavity through an endoscope channel to perform a procedure. Here, when it is desired to use a treatment tool having an outer diameter larger than the inner diameter of the endoscope channel, a tube through which the large-diameter treatment tool can be inserted is inserted into the endoscope using a medical tape, a rubber band, or the like. There is a method in which a treatment instrument having a large diameter is guided from the base end to the distal end of the part in an external state, guided through a tube into a body cavity, and treated.

In Japanese Patent Application Laid-Open No. Hei 5-307143, a distal end guide is provided at a position forward of a curved portion at a distal end portion of an insertion portion of an endoscope, and a guide tube of a treatment tool is provided for the endoscope. An endoscope system including a treatment tool guide configured to be movable in an axial direction along an outer peripheral surface of an insertion portion is disclosed. Here, when guiding the treatment instrument to the distal end portion of the insertion section of the endoscope, the distal end of the treatment instrument guide tube is brought into contact with the distal end guide of the insertion section of the endoscope. In this state, by inserting the treatment tool into the guide tube, the treatment tool can be guided to the distal end of the insertion portion of the endoscope. Further, when the bending portion is bent, the guide tube can be switched to a state in which the guide tube does not cover the bending portion by retracting the guide tube to the proximal end side.

[0004]

In an endoscope having a curved portion at the distal end of the insertion portion of the endoscope, the treatment instrument insertion tube is connected to a base of the insertion portion of the endoscope using a medical tape, a rubber band, or the like. If the tube is attached from the end to the tip in a fixed state, the bending portion and the tube become integral with each other, so that the bending portion becomes hard and it is difficult to bend.

Further, in the endoscope system having the above-mentioned conventional configuration disclosed in Japanese Patent Application Laid-Open No. Hei 5-307143, the method of fixing the distal end guide to the distal end of the insertion section of the endoscope is as follows. There is a method in which the distal end guide is merely slightly press-fitted onto the portion, or a method of fixing the distal end guide by providing a fixing mechanism at the distal end of the insertion portion of the endoscope.

However, in the method of fitting the distal end guide to the distal end portion of the insertion portion of the endoscope, the distal end guide is inserted when the endoscope is inserted into the body of the patient or when the endoscope is operated. There is a possibility that the sticking force of the resin decreases and loosening occurs.

In the method of providing a fixing mechanism at the distal end portion of the insertion section of the endoscope and fixing the endoscope, it is difficult to provide such a special fixing mechanism in an endoscope whose diameter has been reduced. Very difficult. Further, there is a problem that the versatility is lacking in that an external treatment tool can be attached only to an endoscope provided with the fixing mechanism as described above.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has as its object to prevent the bending of the bending portion from being difficult to be performed, to prevent the fixing force of the front guide portion from decreasing, and to reduce the front guide portion. It is an object of the present invention to provide an endoscope system that can be easily attached to a distal end portion of an insertion section of an endoscope.

[0009]

Means for Solving the Problems To achieve the above object, an invention according to claim 1 includes an endoscope having a channel in an insertion portion inserted into a lumen, and fixed to the endoscope,
A treatment tool guide that supports the treatment tool along with the outer peripheral surface side of the insertion section and supports the treatment tool, wherein a through hole through which the treatment tool can be inserted into the treatment tool guide is provided. Providing the provided distal guide portion, the distal portion is inserted through the channel from the distal opening of the channel of the endoscope to the proximal opening of the channel through the channel from the distal opening of the channel of the endoscope. The endoscope system is characterized in that fixing means for fixing the distal end guide portion to the distal end surface of the insertion portion of the endoscope by pulling the pulling member in the retracted state is provided. In the endoscope system according to the first aspect of the present invention, the proximal end of the traction member having the distal end portion fixed to the distal end guide portion is inserted through the distal end side opening of the endoscope channel into the endoscope channel. By pulling and fixing the traction member in a state of being inserted to the base end side opening of the endoscope channel, the distal end guide portion is fixedly abutted on the distal end surface of the insertion portion of the endoscope. In this state, the treatment tool is inserted through the through-hole of the distal end guide portion, and the treatment tool is inserted into the visual field of the endoscope to perform treatment on the affected part.

According to a second aspect of the present invention, the endoscope is provided with a traction member fixing portion for removably fixing the traction member at a base end side opening of the channel.
2. The endoscope system according to item 1. According to the second aspect of the present invention, the traction member is detachably fixed to the traction member fixing portion at the base end side opening of the endoscope channel.

According to a third aspect of the present invention, in the endoscope according to any one of the first and second aspects, the distal end guide portion is formed with an observation window which does not hinder observation of the endoscope. System. According to the third aspect of the present invention, the endoscope can be observed through the observation window of the distal end guide portion.

According to a fourth aspect of the present invention, the distal end guide has a concave portion into which the distal end of the insertion portion of the endoscope can be fitted, and the distal end of the endoscope is fitted into the concave portion. The endoscope system according to claim 3, wherein a fixing means for firmly fixing the distal end guide portion is formed at the distal end portion of the endoscope. And Claim 4
According to the invention, the distal end portion of the insertion portion of the endoscope is fitted into the concave portion of the distal end guide portion, whereby the distal end guide portion is firmly fixed to the distal end portion of the endoscope.

According to a fifth aspect of the present invention, the traction member is formed of a tube, and the distal end guide portion is formed with an opening of the tube. Endoscope system. According to the fifth aspect of the present invention, by connecting the tube of the traction member to the opening of the tube of the distal guide, suction, water supply, air supply, and the like are performed from the opening of the distal guide through the tube of the traction member. It is something that can be done.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows an endoscope system according to the present embodiment, and 1 is a main body of the endoscope. The endoscope main body 1 is provided with an elongated insertion portion 2 to be inserted into a lumen, and an operation portion 3 on a hand side connected to a base end of the insertion portion 2.

Further, the insertion section 2 of the endoscope includes an elongated and flexible flexible tube 4, a bending portion 5 provided continuously at the tip of the flexible tube 4, and a bending portion 5. And a front end portion 6 connected to the front end.

As shown in FIG. 2, a distal end surface 7 of the distal end portion 6 of the insertion section 2 has an observation window 8 of an observation optical system, an illumination window 9 provided with an illumination lens, and The distal end side opening 10a of the endoscope channel 10 formed therein is provided. Further, an endoscope channel 1 serving as an insertion passage for a treatment tool or a passage for liquid or the like is provided inside the insertion portion 2.
0, an image guide fiber, a light guide fiber, and the like are incorporated. Here, the tip of the image guide fiber is disposed on the inner side of the observation window 8, and the tip of the light guide fiber is disposed opposite to the inner side of the illumination lens of the illumination window 9.

A channel opening 11 communicating with the base end of the endoscope channel 10 protrudes from the operation section 3 on the proximal side of the endoscope. The channel opening 11 is provided with a proximal opening 10 b of the endoscope channel 10. Further, the operation section 3 is provided with a bending lever 12 for performing a bending operation of the bending section 5, and one end of a universal cord 13 is connected thereto. A connector detachably connected to a light source device (not shown) is connected to the other end of the universal cord 13.

In the endoscope system according to the present embodiment, a treatment tool 14 externally attached to the insertion section 2 of the endoscope main body 1 is provided along the outer peripheral surface of the insertion section 2. There is provided a treatment tool guide 15 which is supported by. The treatment tool guide 15 includes a distal end guide portion 16, a tubular wire fixing tool (fixing means) 17, a plurality of, in this embodiment, two channel fixing tools 18, and a channel tube 19.

As shown in FIG. 3 (B), the distal guide 16 is provided with a substantially gourd-shaped base member 20 in which two circular portions 20a and 20b are arranged and joined. As shown in FIG. 3A, a concave portion 21 that can be fitted to the distal end portion 6 of the insertion portion 2 is formed on the inner surface side of the one circular portion 20a of the base member 20. Then, by fitting the concave portion 21 of the base member 20 to the distal end portion 6 of the insertion portion 2 of the endoscope, the distal end guide portion 16 can be fixed to the distal end portion 6 of the insertion portion 2 of the endoscope. It has become.

Further, the endoscope channel 1 on the distal end surface 7 of the endoscope is provided at the inner bottom of the concave portion 21 of the distal end guide portion 16.
The distal end of the wire (traction member) 22 is fixed at a position corresponding to the distal end side opening 10a. This wire 22
Is set to a length longer than the length of the insertion section 2 of the endoscope, for example. Further, the concave portion 2 of the tip guide portion 16
A distal end window 23 is provided on the inner bottom of the endoscope 1 at a position corresponding to the observation window 8 and the illumination window 9 on the distal end surface 7 of the endoscope. When the distal end guide portion 16 is brought into contact with the distal end surface 7 of the endoscope, the observation window 8 and the illumination window 9 of the distal end surface 7 are arranged to face the distal end window 23 of the distal end guide portion 16, and
The observation window 8 and the illumination window 9 are not shielded by the base member 20. The tip window 23 may be formed of a transparent cover glass or the like, or may be a through hole.

The other circular portion 20 of the base member 20
A distal end through-hole 24 having a diameter larger than the outer diameter of the treatment tool 14 is formed in b. And, this tip guide portion 16
The distal end portion of the treatment instrument 14 can be inserted through the distal end portion through hole 24.

As shown in FIG. 4, the wire fixing member 17 is provided with a mounting screw portion 26 at one end of a tubular support shaft portion 25 and a wire fixing portion 27 at the other end.
The distal end guide portion 16 is provided in the pipe of the wire fixture 17.
Of the wire 22 can be inserted.

Further, the mounting screw portion 2 of the wire fixture 17
Reference numeral 6 denotes a thin tubular support tube 28 screwed to one end of the support shaft portion 25, and a substantially cylindrical large-diameter support rotatably and axially movable on the support tube 28. Rotating member 2
9 are provided. On the inner peripheral surface of the distal end portion of the rotating member 29, a female screw portion 30 to be screwed to the channel opening 11 in the operation portion 3 on the hand side of the endoscope is formed. Here, a male screw portion is formed at the peripheral portion of the base end side opening portion 10b of the endoscope channel 10 in the channel mouth 11 of the operation portion 3 of the endoscope. And channel mouth 11
By screwing the female screw portion 30 of the rotating member 29 into the male screw portion of the endoscope, the mounting screw portion 26 is attached to the channel opening 11 of the operation portion 3 and can be attached to the proximal opening 10b of the endoscope channel 10. It has become.

The wire fixing part 2 of the wire fixing tool 17
7 is provided with a cylindrical fixing rubber 31, a cylindrical holding member 32 for holding the fixing rubber 31, and a tightening operation member 33 for tightening the rubber 31. Here, a female screw portion 33 a that is screwed to a male screw portion 32 a formed on the base outer peripheral surface of the holding member 32 is formed on the inner peripheral surface of the proximal end portion of the tightening operation member 33. Further, a pressing portion 33 b for pressing the fixing rubber 31 against the holding member 32 is formed at the tip of the tightening operation member 33. Then, by rotating the tightening operation member 33, the pressing portion 33 of the tightening operation member 33 is rotated.
By means of b, it is possible to switch between a tightening position where the fixing rubber 31 is tightened and a tightening release position where the tightening of the fixing rubber 31 is released. Here, in a state where the tightening operation member 33 is held at the tightening release position, the wire 2 is inserted into the tube of the wire fixing tool 17 along the axial direction.
2 can be inserted. Then, when the tightening operation member 33 is rotated in the tightening direction, the rubber 31 inside the tightening operation member 33 is tightened, and the wire 22 can be fixed.

The channel fixture 18 is provided with a locking ring 34 that is removably locked to the outer peripheral surface of the insertion section 2. The inner diameter of the locking ring portion 34 is set to be substantially the same as the outer diameter of the insertion section 2 of the endoscope.
Further, a retaining ring 35 for retaining the channel tube 19 protrudes from an outer peripheral surface of the retaining ring portion 34. Here, the holding ring 35 protrudes to the side of the locking ring portion 34 in a direction orthogonal to the axial direction of the insertion portion 2.

The holding ring 35 is provided with a tube insertion hole 36 having a diameter large enough for the channel tube 19 to move in the axial direction. And
As shown in FIG. 1, when a plurality of channel fixing devices 18 are engaged with the insertion portion 2, the most advanced channel fixing device 18 is used.
Is fixed to the front (hand side) of the bending portion 5.

The channel tube 19 is provided with a tube body 37 through which the treatment tool 14 can be inserted, and a base 38 provided at the tip of the tube body 37. Furthermore, the base 38 of the channel tube 19
Is formed with a flange 38a having a diameter larger than the inner diameter of the tube insertion hole 36 of the holding ring 35 of the channel fixture 18. The channel tube 19 is attached to the insertion portion 2 while being inserted into the holding rings 35 of the plurality of channel fixtures 18. At this time, the channel tube 19 is connected to the flange 38 of the base 38 of the channel tube 19 as shown by a solid line in FIG.
a between a retracted position where the front end of the channel fixture 18 is abutted against the front end of the channel fixture 18 and a forward position where the flange 38a of the base 38 abuts on the distal end guide portion 16 as shown by an imaginary line in FIG. It is slidably supported.

The treatment tool 14 has a wire-like, elongated, highly flexible shaft portion 39, a treatment portion 40 such as a grasping forceps provided at the distal end of the shaft portion 39, and a shaft portion 39. An operation handle portion 41 on the hand side provided at the base end portion is provided. The operation handle 41 is provided with a slider 42 that can slide in the axial direction. The treatment section 40 is opened and closed in accordance with the sliding operation of the slider 42.

Next, the operation of the endoscope system having the above configuration will be described. When using the treatment tool 14 having an outer diameter larger than the inner diameter of the endoscope channel 10 when using the endoscope system of the present embodiment, first, as shown in FIG. The fixture 18 is attached by engaging with the outer peripheral surface of the insertion section 2. At that time, the leading-edge channel fixture 18 is fixed in a state of being arranged before the bending portion 5.

Subsequently, the base end side of the channel tube 19 is inserted into the tube insertion hole 36 of the holding ring 35 of the channel fixture 18 at the foremost end, and further the tube insertion hole of the holding ring 35 of the channel fixture 18 at the rear position. 36 is set. At this time, the channel tube 19 is slidably supported by the plurality of channel fixtures 18.

Thereafter, the distal end guide section 16 is attached to the distal end section 6 of the insertion section 2 of the endoscope. At this time, the tip guide 1
6, the base end of the wire 22 is inserted into the endoscope channel 10 through the distal opening 10a of the endoscope channel 10,
The endoscope is extended to the operation unit 3 near the hand of the endoscope. further,
The extending end of the wire 22 is extended from the proximal opening 10b of the endoscope channel 10 to the outside through the inside of the tube of the wire fixing tool 17. At this time, the fastening operation member 33 of the wire fixing tool 17 is held at the fastening release position.

In this state, by pulling the extending end of the wire 22, the base member 20 of the distal guide 16 is brought into contact with the distal end 6 of the insertion section 2 of the endoscope. The recess 21 is fitted to the distal end 6 of the insertion section 2 of the endoscope. Thereafter, the fixing portion 27 of the wire fixing member 17 attached to the channel opening 11 of the operation portion 3 on the hand side of the endoscope.
Is rotated in the tightening direction. At this time, when the tightening operation member 33 is rotated in the tightening direction, the rubber 3 inside the tightening operation member 33 is rotated.
1 is pressed in the axial direction and tightened, and elastically deforms in a direction in which the inner diameter of the rubber 31 decreases. Then, the inner peripheral portion of the rubber 31 is pressed against the wire 22 so that the wire 22 is fixed so as not to move in the axial direction. Thus, the distal guide 16 is fixed to the distal end 6 of the insertion section 2 of the endoscope via the wire 22.

Thereafter, the channel tube 19 is inserted into the tube insertion hole 36 of the holding ring 35 of the channel fixture 18.
And is slidably attached to the insertion section 2. At this time, the base 38 of the channel tube 19 is set so as to be located in front of the channel fixture 18 at the most distal position. In this state, the treatment tool 14 is inserted into the channel tube 19.

At the time of inserting the treatment tool 14, the treatment tool 1
Before the insertion of 4, the channel tube 19 is slid forward in advance. As a result, the flange 38a of the base 38 is moved to the forward position where the flange 38a abuts on the distal end guide 16 as indicated by a virtual line in FIG. In this state, the treatment tool 1
4 into the channel tube 19, and
The treatment section 40 at the distal end of No. 4 is extended forward from the base 38 of the channel tube 19 through the distal end through hole 24 of the distal end guide section 16. Then, in a state where the treatment section 40 at the distal end of the treatment instrument 14 is positioned within the visual field of the endoscope, the treatment section 40 at the distal end of the treatment instrument 14 is guided to the affected part, and the operation of the treatment instrument 14 at the hand side is performed. The treatment section 40 at the distal end of the treatment instrument 14 is operated by the handle section 41.

Further, when the bending section 5 of the endoscope needs to be bent after the treatment section 40 at the distal end of the treatment tool 14 is guided into the endoscope field of view, the channel tube 19 is moved to the near side. The pulling operation is performed to move the flange 38a of the base 38 of the channel tube 19 to the retracted position where the flange 38a of the base 38 abuts on the front end of the channel fixture 18 at the foremost position as shown by the solid line in FIG. With the channel tube 19 retracted from the bending range of the bending portion 5 by this operation, the bending operation of the bending portion 5 of the endoscope is performed as shown in FIG.

When the treatment tool 14 is replaced, first, the channel tube 19 is pushed forward along the treatment tool 14 so that the flange 38a of the base 38 is moved to the distal end guide portion as shown by the imaginary line in FIG. Move to the advancing position where it abuts 16. In this state, after the treatment tool 14 in the channel tube 19 is pulled out to the outside, the replacement of the treatment tool 14 for inserting another treatment tool 14 into the channel tube 19 is performed.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the wire 22 of the distal end guide portion 16 that guides the movement of the treatment tool 14 is pulled toward the hand side through the endoscope channel 10 and the wire 22 cannot be moved in the axial direction by the wire fixing tool 17. By fixing the distal end guide portion 16 to the distal end portion 6 of the insertion section 2 of the endoscope via the wire 22, the distal end side guide portion 16 can be fixed. Therefore, when the endoscope is inserted into the body of the patient or when the endoscope is operated, there is no possibility that the fixing force of the distal end guide portion 16 is reduced or loosened.

Further, at the time of attaching the distal end guide portion 16 to the distal end portion 6 of the endoscope insertion portion 2, the concave portion 21 of the base member 20 of the distal end guide portion 16 is inserted into the distal end portion 6 of the endoscope insertion portion 2. After fitting the wire 2
2 is pulled toward the hand side through the endoscope channel 10,
By fixing the wire 22 so as to be immovable in the axial direction with the wire fixing tool 17, the distal end side guide portion 16 is fixed to the distal end portion 6 of the insertion section 2 of the endoscope via the wire 22. As a result, the distal-side guide portion 16 can be easily attached to the distal end portion 6 of the endoscope.

In the bending operation of the bending portion 5 of the endoscope, the channel tube 19 is pulled toward the hand side so that the flange 38a of the base 38 of the channel tube 19 is positioned at the most distal position as shown by a solid line in FIG. Is moved to the retracted position where it abuts against the front end of the channel fixture 18.
With this operation, the bending operation of the bending portion 5 of the endoscope can be performed in a state where the channel tube 19 is retracted from the bending range of the bending portion 5, as shown in FIG. Does not become difficult to be curved.

FIGS. 7 and 8A and 8B show a second embodiment of the present invention. In the present embodiment, the configuration of the distal end guide portion 16 of the treatment tool guide 15 in the endoscope system of the first embodiment (see FIGS. 1 to 6) is changed as follows.

That is, the treatment tool guide 1 of the present embodiment.
5, the wire 2 of the distal end guide portion 16 of the first embodiment
As shown in FIGS. 8A and 8B, a pulling member of the distal end guide portion 16 is formed by the channel tube 51 instead of 2. Further, the base member 2 of the tip guide portion 16
0 has a channel tube opening 52 communicating with the channel tube 51. The outer diameter of the channel tube 51 is smaller than the inner diameter of the endoscope channel 10.

Further, a tube 53 connected to a device (not shown) for performing suction, water supply, air supply, etc., is connected to the base end side of the channel tube 51. Then, suction, water supply, air supply, and the like are performed from the tube 53 to the channel tube 51.

Next, the operation of the present embodiment having the above configuration will be described. In the present embodiment, the same operation as that of the endoscope system of the above-described first embodiment is performed, and in addition, the tube 53 connected to a device that performs suction, water supply, air supply, or the like is connected. Endoscope channel tube 51
Suction, water supply, air supply, and the like are performed through the endoscope channel tube 51.

Therefore, in the present embodiment, a tube 53 extending from a device for performing suction, water supply, air supply, or the like is connected to the base end of the endoscope channel tube 51, and is connected through the endoscope channel tube 51. It is possible to perform treatment while performing suction, water supply, air supply, and the like. For this reason, there is an effect that the safety and the operability of the endoscopic procedure are improved, and the applicable cases can be further expanded.

FIG. 9 (A) shows a stereoscopic rigid endoscope 61,
9 shows an endoscope system 64 used in combination with the treatment tools 62 and 63. The stereoscopic rigid endoscope 61 is provided with a substantially straight tubular insertion portion 65. As shown in FIG. 9C, a hard pipe 66 formed by arranging two cylindrical bodies 66a and 66b in parallel and forming a substantially figure-eight shape is disposed at least near the distal end of the insertion portion 65. I have.

Further, the stereoscopic rigid mirror 61 is provided with independent left and right objective optical systems 67 and 68. These two objective optical systems 67 and 68 have exactly the same configuration. The left objective optical system 67 is connected to the left cylindrical body 6.
6a, the right objective optical system 68 is housed in the right cylindrical body 66b, respectively. In addition, this hard pipe 66
It may be a hollow rigid pipe integrally formed in the shape of a figure 8, or may be one in which two cylindrical bodies 66a and 66b are arranged side by side and fixed with solder or an adhesive.

Around the objective optical systems 67 and 68, a ring-shaped light guide fiber 6 is formed.
9, 70 are densely arranged. Further, at the base end of the insertion portion 65, a grip portion 7 having a CCD camera head (not shown) for photographing images of the objective optical systems 67 and 68 is incorporated.
1 are connected.

Further, an electric wire (not shown) for transmitting an electric image signal and a cable 72 for extending the light guide fibers 69 and 70 are connected to the grip portion 71. A light guide connector (not shown) and a camera connector (not shown) having the same configuration as that of a normal endoscope are connected to the rear end of the cable 72, and a light source device, a TV camera device, a monitor, etc. Observation is possible in combination with

At the foremost portion of the hard pipe 66, a thin plate-shaped hard ring member 73 is provided which surrounds the side surface of the concave portion of the hard pipe 66 in a substantially annular shape. The ring member 73 is fixed to the hard pipe 66 by soldering or bonding. Thereby, treatment instrument insertion holes 74 and 75 are formed between the concave portion of the hard pipe 66 and the ring member 73. Then, as shown in FIG. 9 (A), the treatment tools 62 and 63 can be inserted into the respective treatment tool insertion holes 74 and 75 and used.

The ring member 73 may be formed by bending a round bar into a circular shape, or may be provided so as to surround only one side surface of the concave portion of the hard pipe 66 in a semicircular shape.

Next, the operation of the endoscope system 64 having the above configuration will be described. When the endoscope system 64 having the above configuration is used, for example, when performing an operation under an endoscope in neurosurgery or the like, as shown in FIG.
The treatment tools 62 and 63 have a deep hole-shaped surgical site H with an open body surface.
Insert and use. At this time, the treatment tools 62 and 63 are inserted into the treatment tool insertion holes 74 and 75 between the concave portion of the rigid pipe 66 at the distal end of the insertion portion 65 and the ring member 73. In this state, the treatment tools 62 and 63 are operated. Therefore, when operating each of the treatment tools 62 and 63, the ring member 7
3 serves as a fulcrum, and the treatment tools 62 and 63 can be inserted obliquely with respect to the axial direction of the insertion section 65.

Therefore, the endoscope system 64 having the above configuration has the following effects. That is, when the stereoscopic rigid endoscope 61 having the above configuration is used, the treatment tools 62 and 63 are inserted into the treatment tool insertion holes 74 and 75 between the concave portion of the rigid pipe 66 at the distal end of the insertion portion 65 and the ring member 73. Used when inserted. At this time, when operating each of the treatment tools 62 and 63, the ring member 73 becomes a fulcrum, and the treatment tools 62 and 63 can be inserted obliquely with respect to the axial direction of the insertion portion 65. Although the degree of freedom of the operation is large, the operation is easy and it is possible to guide the treatment tools 62 and 63 to a target location.

The treatment tools 62 and 63 are formed by the ring member 73.
The treatment tools 62 and 63 do not separate from the stereoscopic rigid endoscope 61, and the treatment tools 62 and 63 are safely held.
Can be operated, and the treatment tools 62 and 63 are lost (cannot be seen from the endoscope image of the stereoscopic rigid endoscope 61)
Not even.

Further, unnecessary space (dead space which has not been used conventionally) is provided in the left and right objective optical systems 67 and 68 of the stereoscopic rigid endoscope 61.
Therefore, there is an effect that a space-saving operation under an endoscope can be performed.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) The endoscope having an endoscope channel in an endoscope insertion portion, and a treatment tool fixed to the endoscope and arranged along the outer peripheral side of the endoscope insertion portion. In an endoscope system having a treatment tool guide that can be attached to a mirror insertion portion, the treatment tool guide extends from a distal end guide portion provided with a through hole through which the treatment device can be inserted, and the distal end guide portion. A distal end opening of the endoscope channel formed on the distal end surface of the endoscope insertion portion, and a proximal end opening of the endoscope channel via the endoscope channel. An endoscope system wherein the distal end guide abuts and is fixed to the distal end surface of the endoscope insertion portion by pulling and fixing the wire in a state where the distal end guide is inserted through the end guide.

(Additional Item 2) The endoscope system according to Additional Item 1, wherein the wire is fixed to a proximal end opening of the endoscope channel.

(Additional Item 3) The endoscope system according to additional items 1 and 2, wherein an observation window which does not hinder observation of the endoscope is formed in the distal end guide.

(Additional Item 4) The distal end guide is formed with a concave portion into which the distal end portion of the endoscope can be fitted, and the concave portion is fitted with the distal end portion of the endoscope, so that the inner end can be more firmly inserted. The endoscope system according to claim 3, wherein a distal end guide can be fixed to a distal end portion of the endoscope.

(Appendix 5) Instead of the wire, a tube extends from the distal end guide, and the distal end guide has
5. The endoscope system according to claim 1, wherein an opening of the tube is formed.

(Additional Item 6) In a stereoscopic rigid endoscope having two objective optical systems, at least the vicinity of the distal end of the insertion portion is formed into a shape in which two cylinders are arranged in parallel, and the side of the insertion portion is formed at the foremost end. A stereoscopic rigid endoscope comprising: a ring member on a thin plate that surrounds a substantially annular shape; and a space for inserting a treatment tool is provided between a concave portion of an insertion portion and the ring member.

(Conventional Techniques of Supplementary Items 1 to 5) In general, when performing a treatment under an endoscope, the treatment is performed by inserting a treatment tool into an endoscope channel provided in the endoscope. However, if it is desired to use a treatment tool having an outer diameter larger than the inner diameter of the endoscope channel, a tube through which the treatment tool can be inserted is inserted from the base end of the endoscope insertion section using a medical tape or rubber band. A method has been performed in which the treatment is performed through the inside of the tube. However, in an endoscope having a curved portion, when the above-described tube is attached to the endoscope insertion portion, the curved portion and the tube are integrated, so that it is difficult to bend. There was a problem.

As a means for solving the problem, as described in Japanese Patent Application Laid-Open No. Hei 5-307143, when a treatment tool is guided to the distal end of the endoscope, the distal end provided at the distal end of the endoscope is used. When the distal end of the tube is brought into contact with the guide, the treatment tool can be guided to the distal end of the endoscope, and when bending the bending portion,
An endoscope system including a treatment instrument guide capable of retracting a tube to a proximal end side so that the tube does not cover a curved portion is disclosed.

(Problems to be Solved by Additional Items 1 to 5)
The method of fixing the distal end guide to the distal end portion of the endoscope in the endoscope system as disclosed in Japanese Patent Application Laid-Open No. Hei 5-307143 merely involves slightly press-fitting the distal end portion of the endoscope into the distal end portion. Alternatively, a method of fixing the distal end guide by providing a fixing mechanism at the distal end portion of the endoscope has been adopted. In the method of fitting and fixing the end guide, it is considered that when the endoscope is inserted into the patient's body and when the endoscope is operated, the fixing force of the distal end guide is reduced and looseness may occur. Also, in the method of providing a fixing mechanism at the end of the endoscope and fixing the endoscope, it is very difficult to provide such a mechanism in an endoscope whose diameter is progressing further. There is a problem that it lacks versatility because it can be attached only to an endoscope provided with a mechanism.

(Objects of Supplementary Items 1 to 5) The present invention has been made in view of the above circumstances, and there is no decrease in the fixing force of the distal guide, and the distal guide is easily attached to the distal end of the endoscope. It is an object of the present invention to provide an endoscope system provided with a treatment tool guide capable of performing an operation.

(Function of Supplementary Items 1 to 5) In order to achieve the above object, the endoscope system according to the present invention firstly attaches the proximal end of the wire extending from the distal end guide to the distal end surface of the endoscope insertion section. In a state where the wire is pulled from the distal end opening of the endoscope channel formed through the endoscope channel to the proximal end opening of the endoscope channel, the wire is pulled and fixed, so that the distal end guide can be viewed inside. It is fixed to the mirror tip surface. In this state, the treatment instrument is inserted into the distal end through hole provided in the distal end guide, and the affected part is treated while the treatment instrument is positioned in the endoscope visual field.

(Effects of Supplementary Items 1 to 5) According to the present invention, there is no decrease in the fixing force of the distal end guide, the safety of the endoscopic procedure can be improved, and the distal end guide can be viewed through the endoscope. It can be easily attached to the mirror tip.

(Prior Art of Appendix 6) In recent years, surgery performed remotely using a treatment tool while observing an observation image of an endoscope has become widespread. In order to use endoscopic images for surgery, perspective of the images is important, and it is necessary to obtain the same sensation as seen directly with human eyes, so endoscopes capable of stereoscopic viewing have also been developed. . There are various methods for obtaining a stereoscopic image, but, similarly to the case where a human performs a stereoscopic vision with the left and right eyes, two objective optical systems for the endoscope are provided independently for the left and right, and the endoscope is obtained from each optical system. The most popular method is to process the obtained image to obtain a stereoscopic image.

(Problem to be Solved by Supplementary Item 6) When performing an operation under an endoscope in neurosurgery or the like, the endoscope or the treatment tool is inserted into a deep hole-shaped operation portion having an open body surface. When used, careless movement of the treatment tool may cause the endoscope to fall out of the field of view or damage tissues such as the brain. In a conventional stereoscopic rigid endoscope, no treatment instrument insertion conduit is provided at all, or the treatment instrument insertion conduit is built in over the entire length of the insertion portion. If the treatment instrument insertion conduit is not provided, the operation is very troublesome because there is no fulcrum for supporting the treatment instrument, and the treatment instrument suddenly moves greatly and it is difficult to guide to the target place. there were. Also, the burden on the finger was heavy. On the other hand, when the treatment instrument insertion conduit is built in, the safety is high, but since the treatment instrument can only protrude straight forward along the longitudinal axis of the insertion portion, there is a limit in the treatment ability.

(Purpose of Supplementary Item 6) Provided is a stereoscopic rigid endoscope which is highly safe when used in combination with a treatment instrument and does not impair the operability of the treatment instrument.

(Function of Supplementary Item 6) The treatment tool is inserted into the space between the concave portion of the insertion portion and the ring member to operate the treatment tool. The ring member serves as a fulcrum, and the treatment instrument can be inserted obliquely to the longitudinal axis of the insertion section. The treatment tool does not leave the distal end.

(Effect of Supplementary Item 6) Since the ring member serves as a fulcrum and the treatment tool can be inserted obliquely with respect to the longitudinal axis of the insertion portion, the operation can be performed despite the high degree of freedom of operation of the treatment tool. It is possible to guide the treatment tool to a target place as desired. Further, since the distal end of the treatment tool is held by the ring member, the treatment tool does not separate from the endoscope,
The treatment tool can be safely operated, and the treatment tool is not lost (cannot be seen from the endoscope image).

Since the space unnecessary for the optical system of the stereoscopic rigid endoscope (dead space which has not been conventionally used) is used as the space for inserting the treatment tool, the space-saving operation under the endoscope is possible. is there.

[0073]

According to the first aspect of the present invention, the treatment instrument guide is provided with a tip guide portion provided with a through hole through which the treatment tool can be inserted, and the traction member having the tip portion fixed to the tip guide portion is provided inside the treatment tool guide. With the endoscope channel inserted from the distal opening to the proximal opening of the channel through the inside of the channel,
A securing means is provided for abutting and fixing the distal end guide portion to the distal end surface of the insertion portion of the endoscope by towing the traction member, so that the fixing force of the distal end guide does not decrease, and the safety of the endoscopic procedure is reduced. The end guide can be easily attached to the end portion of the endoscope.

According to the second aspect of the present invention, the traction member can be detachably fixed by the traction member fixing portion at the base end side opening of the endoscope channel.

According to the third aspect of the present invention, the endoscope can be observed through the observation window of the distal end guide portion.

According to the fourth aspect of the present invention, the distal end of the insertion portion of the endoscope is fitted into the concave portion of the distal end guide, thereby firmly fixing the distal end guide to the distal end of the endoscope. Can be.

According to the fifth aspect of the present invention, the tube of the traction member communicates with the opening of the tube of the distal guide portion, so that suction, water supply, and air supply are performed through the tube of the traction member from the opening of the distal guide portion. And so on.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a state in which a treatment tool is inserted through a treatment tool guide attached to an endoscope main body in an endoscope system according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing a distal end portion of an insertion section of the endoscope in the endoscope system according to the first embodiment.

FIG. 3A is a vertical cross-sectional view illustrating a main configuration of a distal end guide unit in the endoscope system according to the first embodiment;
(B) is a front view of the tip guide portion.

FIG. 4 is a side view of a main part of the endoscope system according to the first embodiment in which a part of a wire fixing tool is shown in cross section;

FIG. 5 is a side view of a main part showing a state in which a treatment tool is inserted through a treatment tool guide in the endoscope system according to the first embodiment, with a partial cross section.

FIG. 6 is an exemplary perspective view for explaining a state in which a bending portion of the endoscope in the endoscope system according to the first embodiment is curved;

FIG. 7 is a perspective view showing a state in which a treatment tool is inserted through a treatment tool guide attached to an endoscope main body in the endoscope system according to the second embodiment of the present invention.

FIG. 8A is a vertical cross-sectional view illustrating a configuration of a main part of a distal end guide unit in an endoscope system according to a second embodiment;
(B) is a front view of the tip guide portion.

9 shows an endoscope system using a combination of a stereoscopic rigid endoscope and a treatment tool, wherein (A) is a side view showing a use state of the endoscope system, and (B) is a stereoscopic rigid endoscope. (C) is a sectional view taken along line 9C-9C of (B).

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Endoscope main body 2 Insertion part 10 Channel 14 Treatment tool 15 Treatment tool guide 16 Tip guide part 17 Wire fixing tool (fixing means) 22 Wire (traction member) 24 Tip through hole

Claims (5)

[Claims] 1. An endoscope having a channel in an insertion portion to be inserted into a lumen, and a state in which a treatment tool is fixed to the endoscope and is provided along the outer peripheral surface of the insertion portion. An endoscope system comprising: a treatment tool guide supported by a treatment tool guide; wherein the treatment tool guide is provided with a tip guide portion provided with a through hole through which the treatment tool can be inserted, and a tip portion is fixed to the tip guide portion. By pulling the towing member from the distal end opening of the channel of the endoscope through the channel to the base end opening of the channel, by towing the towing member, An endoscope system comprising a fixing means for abutting and fixing to a distal end surface of an insertion portion of the endoscope. 2. The endoscope according to claim 1, wherein the endoscope is provided with a traction member fixing portion for removably fixing the traction member at a base end side opening of the channel. system. 3. The endoscope system according to claim 1, wherein an observation window that does not hinder observation of the endoscope is formed in the distal end guide portion. 4. The end guide is formed with a concave portion into which a distal end portion of an insertion portion of the endoscope can be fitted, and the distal end portion of the endoscope is fitted into the concave portion so as to perform the endoscope. The endoscope system according to claim 3, wherein a fixing means for firmly fixing the distal end guide portion is formed at a distal end portion of the mirror. 5. The endoscope system according to claim 1, wherein the traction member is formed by a tube, and the distal end guide portion is formed with an opening of the tube. .