JP2006158840A - Endoscope attachment and endoscopic system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope attachment capable of accurately guiding a hypodermic needle catheter as a treatment instrument to near the centesis target position, and an endoscopic system equipped with it capable of giving a precise medical treatment to an inner wall inside the body cavity. <P>SOLUTION: An endoscope 1 is provided with an observation window 11 for observing an esophageal varix, and a channel port 12 for projecting a hypodermic needle catheter 3, both of which are placed on a front end face 10. An endoscope attachment 2, which is integrally fitted on the front end face 10 side of the endoscope 1 when attached to the endoscope 1, is provided with a hood section 4 in a cylindrical shape which covers the front end face 10 by projecting forward from the front end face 10, and a guide section 5 which guides the hypodermic needle catheter 3 to face a prescribed way while the catheter is being projected out of the channel port 12. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an endoscope attachment attached to an endoscope for performing treatment on, for example, esophageal varices and an endoscope system including the same.

  A large-scale surgical operation is required as a method for treating esophageal varices, but esophageal varices sclerotherapy (EIS) has been widely implemented in recent years for the purpose of reducing the burden on patients. It has become like this. This EIS is a method of treating a varicose blood vessel by injecting a drug solution such as a sclerosing agent into an esophageal varices using an endoscope system equipped with an injection needle catheter or a hood.

  An example of an endoscope system used for such an EIS is shown in FIG. The endoscope system 100 includes an endoscope 101, a hood 102 attached to the front end face 110 side of the endoscope 101, and an injection needle catheter 103 as a treatment tool. The injection needle catheter 103 is inserted into the channel of the endoscope 101, and the distal end side thereof, that is, the puncture needle 103 n side, protrudes from the channel port 112 of the front end face 110 to the inside of the hood 102. Although not shown, the front end surface 110 is provided with various structures such as an observation window, a light source, and a liquid feed port for cleaning the observation window in addition to the channel port 112.

When injecting into the esophageal varices V generated in the esophagus E as the inner wall of the body cavity, the front end side of the hood 102 is brought into contact with the esophageal varices V and the endoscope system 100 is positioned and fixed, and then the needle catheter 103 Is pushed forward, the puncture needle 103n is punctured at the puncture target position (treatment target position) of the esophageal varices V, and the drug solution is injected.
Japanese Patent Laid-Open No. 54-086881 Japanese Patent Laid-Open No. 54-081690 JP 61-191333 A

  In such an endoscope system 100, the injection needle catheter 103 protruding from the channel port 112 is in an unsupported state inside the hood 102 and can be bent in the horizontal direction (vertical direction and horizontal direction). ing. For this reason, for example, when the patient (living body) moves unexpectedly or the tissue around the esophageal varices V peristally moves, vibration occurs during the procedure, and the needle catheter 3 is shaken or displaced. There was a risk of it. The occurrence of such vibration or the angle of the endoscope system 100 makes it difficult to accurately match the puncture position of the puncture needle 103n with the puncture target position, making it difficult to perform a stable procedure. there were.

  Further, if the puncture is performed with the puncture needle 103n bent downward, the needle projectable range d1 to the esophageal varices V is necessarily narrowed as shown in FIG. If the needle protrusion allowable range d1 is exceeded, the puncture needle 103n penetrates the esophageal varices V, and the medical solution cannot be accurately injected into the affected area. For this reason, the protruding length of the puncture needle 103n must be accurately controlled, and a high degree of skill is required for a technician who performs the procedure.

  A device for changing the direction of a biopsy tool or a distal end positioning device for an endoscope is disclosed in Patent Documents 1 to 3. However, in the configurations described in these documents, the above-described problems are accurately solved. It was something that could not be solved.

  The present invention has been made in view of the above circumstances, and includes an attachment for an endoscope that can accurately guide an injection needle catheter as a treatment instrument to the vicinity of a puncture target position, and an endoscope attachment that is accurately provided on an inner wall of a body cavity. It is an object of the present invention to provide an endoscope system capable of performing treatment on the endoscope.

  According to the first aspect of the present invention, the distal end portion of an endoscope having an observation window for observing the inner wall of the body cavity and a channel port for projecting a treatment tool for performing treatment on the inner wall of the body cavity at the distal end portion. An endoscope attachment that is integrally attached to the side, and covers the distal end portion by protruding forward from the distal end portion of the endoscope in a substantially cylindrical shape when attached to the endoscope. A hood part and a guide part for guiding the injection needle catheter as the treatment tool protruding from the channel port so as to face in a predetermined direction are provided.

  Since such a guide portion is provided so that the injection needle catheter protruding from the channel port is directed in a predetermined direction, the injection needle catheter is accurately positioned to a predetermined position on the inner wall of the body cavity, that is, near the puncture target position. Guide and accurately puncture the position.

  A second aspect of the present invention is the endoscope attachment according to the first aspect, wherein the guide portion extends forward from a position continuous with the channel port, and the injection needle catheter is disposed along the guide portion. And a guide rail is formed to guide the vicinity of a predetermined position of the inner wall of the body cavity.

  Since such a guide rail is formed, the injection needle catheter can be fixed along the axial direction, and not only the puncture target position but also the puncture angle can be appropriately maintained. Further, a simple configuration can be adopted, and the field of view from the observation window is hardly blocked.

  The invention according to claim 3 is the attachment for endoscope according to claim 1 or 2, further comprising a positioning fixing portion for fixing the vicinity of the treatment target position on the inner wall of the body cavity in the hood portion. It is characterized by.

  Since such a positioning and fixing part is provided, the vicinity of the treatment target position on the inner wall of the body cavity can be positioned in the hood part, and can be fixed to the part, and a predetermined part of the inner wall of the body cavity captured in the hood part. It is possible to accurately suppress the occurrence of deviation and perform observation and puncture with an endoscope more accurately.

  The invention according to claim 4 is the attachment for endoscope according to claim 10, wherein the positioning fixing portion is formed by cutting out a part of the substantially cylindrical shape. It is made into the deformation | transformation part of this food | hood part formed in this.

  Since the positioning and fixing means is such a deformed portion of the hood portion, the positioning and fixing portion can be provided integrally with the hood portion, and the configuration can be simplified without providing a separate member. Then, by pressing the positioning and fixing portion against the raised portion of the inner wall of the body cavity such as a varicose vein, the inner wall of the body cavity is elastically deformed and fitted into the positioning and fixing portion. It can be fixed in the hood.

  The invention according to claim 5 is an endoscope system having an observation window for observing the inner wall of the body cavity and a channel port for projecting a treatment tool for performing treatment on the inner wall of the body cavity at the distal end portion. An endoscope, an attachment for an endoscope according to any one of claims 1 to 4 attached to a distal end side of the endoscope, and an injection needle catheter as the treatment instrument are provided. It is characterized by that.

  Since the endoscope system has such a configuration, it is possible to accurately treat the inner wall of the body cavity.

In the endoscope attachment and the endoscope system according to the present invention, the injection needle catheter as the treatment instrument can be accurately guided to the vicinity of the puncture target position. Therefore, it is possible to suppress the possibility of blurring and displacement of the injection needle catheter, to accurately match the puncture position of the puncture needle with the puncture target position, and to perform the procedure stably. .
Moreover, it becomes easy to keep the puncture angle at a constant shallow angle. Therefore, since the range in which the needle can protrude from the inner wall of the body cavity can be increased, the limitation of the puncture depth can be relaxed, the procedure can be simplified, and an appropriate procedure can always be performed.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

[First Embodiment]
First, a basic form of an endoscope attachment and an endoscope system according to the present invention will be described as a first embodiment. As shown in FIGS. 1 and 2, the endoscope system S is mainly used in esophageal varices sclerotherapy (EIS), and observes and treats esophageal varices (inner wall, aneurysm). The endoscope 1 is configured to include an endoscope attachment 2 attached to the front end face (tip portion) 10 side of the endoscope 1 and an injection needle catheter (treatment tool) 3.

  The proximal end side of the endoscope 1 is connected to an operation unit (not shown) located outside the body, and various operations of the endoscope 1 can be performed from this operation unit. An observation window 11, a channel port 12, a light source 13, and a liquid feed port 14 for cleaning the observation window 11 are provided on the front end surface 10 which is the distal end portion of the endoscope 1. In FIG. 2, illustration of the observation window 11, the light source 13, and the liquid feeding port 14 is omitted.

  The channel port 12 is for projecting a treatment tool for performing treatment on esophageal varices, and is a portion where a channel 1 h formed in the endoscope 1 is opened in the front end face 10. The other end side of the channel 1h reaches the operation part, and a syringe catheter 3 having a puncture needle 3n on the distal end side is inserted into the channel 1h so as to be detachable from the operation part. 12 protrudes inside the hood part 4. Note that the treatment instrument that can be inserted into the channel 1h includes not only the injection needle catheter 3, but also various treatment instruments such as a biopsy forceps, an acupuncture forceps, a snare, and a coagulator.

  The endoscope attachment 2 is composed of various parts such as a hood part 4, a guide part 5, and a positioning and fixing part 7. The endoscope attachment 2 is detachably attached to the front end face 10 side of the endoscope 1, and is entirely made of a resin-made transparent member such as acrylic, polycarbonate, polyolefin elastomer, or the like. Is formed. The reason why the transparent member is used in this way is to secure a good field of view from the observation window 11.

  The hood portion 4 is a portion that constitutes the base of the endoscope attachment 2 and protrudes forward from the front end surface 10 of the endoscope 1 in a substantially cylindrical shape when attached to the endoscope 1. The front end face 10 is covered. The hood portion 4 has a substantially cylindrical shape and is detachably attached to the distal end portion side of the endoscope 1. The front-side hard portion 4a and the rear-side soft portion 4c are integrally joined. It is set as the structure. This is because, in order to firmly fix the esophageal varices V in the hood portion 4, the hood portion 4 is preferably made of a hard member, and corresponds to the endoscope 1 having various outer diameters. This is because the attachment portion to the endoscope 1 is preferably made of a soft member. And the front edge part 4f of the hood part 4 has comprised the end surface formed so that it might be substantially orthogonal to the axial direction of the hood part 4. FIG.

  The guide unit 5 guides the injection needle catheter 3 protruding from the channel port 12 so as to face a predetermined direction. Here, the upper part of the block body 4 b that stands up from the lower part on the inner peripheral side of the hood part 4 is illustrated as the guide part 5. That is, the injection needle catheter 3 can be placed on the guide portion 5 and the direction of the puncture needle 3n can be changed to guide the injection needle catheter 3 at a predetermined angle to a predetermined position of the esophageal varices.

  The positioning and fixing portion 7 is for capturing and fixing the vicinity of the puncture target position (treatment target position) of the esophageal varices into the hood portion 4. Here, a deformed portion of the hood portion 4 formed in the hood portion 4 so as to have a shape in which a part of a substantially cylindrical shape is cut out is illustrated as the positioning fixing portion 7. By pressing the positioning and fixing portion 7 to a predetermined position of the esophageal varices, the aneurysm is elastically deformed and fitted into the positioning and fixing portion 7, so that the hood portion 4 can be positioned at the position. Can be firmly fixed. Further, since the knob taken into the positioning and fixing portion 7 is elastically deformed, it is raised to the inside of the hood portion 4. Therefore, the distance between the front end side of the guide part 5 and the aneurysm can be shortened, and the injection needle catheter 3 can be more accurately guided to the puncture target position.

  FIG. 3 shows a state in which such an endoscope system S is used for injection into the esophageal varices V generated in the esophagus E. As shown in this figure, first, the front edge portion side of the hood portion 4 of the endoscope attachment 2 is brought into contact, and the endoscope system S is positioned and fixed at a predetermined position of the esophageal varices V by the positioning fixing portion. To do. In this manner, the injection needle catheter 3 is pushed forward, the puncture needle 3n is punctured at the puncture target position (treatment target position) of the esophageal varices V, and the sclerosing agent is injected. At this time, since the injection needle catheter 3 protruding from the channel port 12 is directed in a predetermined guide direction by the guide portion 5, the puncture needle 3n is accurately punctured at a puncture target position at a predetermined puncture angle. Further, by setting the guide direction by the guide portion 5 to a predetermined value, the needle projectable range d2 to the esophageal varices V can be made larger than the conventional needle projectable range d1 shown in FIG.

  In addition, regarding the guide portion 5 and the positioning and fixing portion 7, the inventors of the present application have invented various modifications in addition to those exemplified above. These modifications will be described later as other embodiments.

In the endoscope attachment 2 according to the present embodiment, a hood portion 4 that forms a substantially cylindrical shape from the front end surface 10 of the endoscope 1 and protrudes forward to cover the distal end portion when attached to the endoscope 1. And a guide portion 5 for guiding the injection needle catheter 3 protruding from the channel port 12 in a predetermined direction. Therefore, the needle catheter 3 can be accurately guided to the vicinity of the puncture target position of the esophageal varices V, and puncture can be performed at the position. This suppresses the possibility that the injection needle catheter 3 is shaken or misaligned, makes it possible to accurately match the puncture position of the puncture needle 3n with the puncture target position, and to perform a stable procedure. Possible.
In addition, since the needle projectable range d2 to the esophageal varices V can be made large, the restriction of the puncture depth can be relaxed, the procedure can be simplified, and an appropriate procedure can always be performed. .

  Moreover, since the positioning fixing part 7 which positions and fixes the esophageal varices V at a predetermined position in the hood part 4 is provided, the esophageal varices V is positioned at a predetermined position in the hood part 4 and at the position. It can be firmly fixed, and it is possible to accurately suppress the occurrence of positional deviation of the endoscope 1 and to perform observation and puncture with the endoscope 1 more accurately.

As described above, the injection needle catheter 3 protruding from the channel port 12 is bent at a predetermined angle by the guide portion 5. Assuming that the angle changed at this time is α, as shown in FIGS. 4 and 5, it is appropriate that the angle α is within the range of 0 (°) to X (°) (0 <α <X). is there.
First, X will be described. As shown in FIG. 4, let A be a straight line that connects the upper end point t of the channel port 12 serving as a fulcrum for bending the syringe catheter 3 upward and the one point s of the upper end of the front edge portion 4 f of the hood portion 4. A straight line extending in parallel with the axis of the channel 1h from the upper end point t, that is, a straight line orthogonal to the front edge portion 4f is defined as B. An angle formed by the straight line A and the straight line B is X.

Next, α will be described. As shown in FIG. 5, when the injection catheter 3 protruding from the channel port 12 is supported and protruded by the support point ht of the guide portion 5, the angle formed with the axis of the channel 1h is α. Here, the inner diameter of the channel 1h is C, the outer diameter of the injection needle catheter 3 is D, and the distance in the straight line B direction (the axial direction of the channel 1h) between the upper end point t and the support point gt is supported from L1 and the straight line B2. Let h be the height to point gt. The straight line B2 is a straight line extending in parallel with the axis of the channel 1h from the lower end point b of the channel port 12, that is, a straight line parallel to the straight line B closest to the outer peripheral side of the endoscope 1 in the channel 1h. These C, D, L1, h and α have the relationship shown in the following (Formula 1).

tan α = (h− (C−D / cos α)) / L1 (Formula 1)

In this way, by appropriately setting the values of C, D, L1, and h in the endoscope attachment 2, the needle catheter 3 can be advanced toward the aneurysm at an angle α.

  FIG. 6A shows a case where α is an inappropriate value (α ≧ X), and FIG. 6B shows a case where α is an appropriate value (0 <α <X). Show. Specifically, the angle α is preferably in the range of 0 ° to 10 °.

  If the length of the inner surface of the hood portion 4 is L and the length of the aneurysm that enters the hood portion 4 when the esophageal varices V is fixed is Lv, the length of the guide portion 5 is L as shown in FIG. -Lv or less is preferable. For example, when the length L of the inner surface of the hood portion 4 is 10 mm and the length Lv into which the knob enters the hood portion 4 is 5 mm, the length of the guide portion 5 is set to 5 mm or less.

  Further, as shown in FIGS. 4 and 5, the guide portion 5 is arranged such that its proximal end gb is located on the outer peripheral side of the channel port 12, that is, below the lower end point b of the channel port 12. It is preferable to arrange so as to be located on the side. In this way, the guide portion can be prevented from blocking the channel opening, and the injection needle catheter can be easily protruded into the hood portion.

[Second Embodiment]
Next, a modified example of the guide portion 5 of the endoscope attachment 2 shown in the first embodiment will be described as a second embodiment with reference to FIGS. In addition, in this embodiment and each embodiment mentioned later, illustration or description of the positioning fixing | fixed part 7 may be abbreviate | omitted suitably.

  In the example shown in FIG. 7, as in the example shown in FIG. 1, the upper part 51 of the solid block body 41 that stands up from the lower part on the inner peripheral side of the hood part 4 is used as the guide part. The upper part 51 as the guide part is adjusted to a predetermined inclination angle. The guide portion is formed with a guide rail that extends forward from a position continuous with the channel port 12 and guides the injection needle catheter 3 to the puncture target position of the esophageal varices.

Examples of such guide rails are shown in FIGS.
The guide rails 51a and 51b shown in FIGS. 9A and 9B are both deep grooves having a width wider than the outer diameter of the injection needle catheter 3 and having a depth equal to or greater than the radius of the injection needle catheter 3. The guide rail 51a is a substantially U-shaped groove in a sectional view, and the guide rail 51b is a substantially U-shaped groove in a sectional view. In such guide rails 51a and 51b, the possibility that the injection needle catheter 3 is detached from the guide rails 51a and 51b can be almost eliminated, so that the injection needle catheter 3 is guided to the puncture target position of the esophageal varices very accurately. be able to.

  Also, the guide rails 51c, 51d, 51e shown in FIGS. 10 (a) to 10 (c) are both shallow groove portions that are set so that there are two points of contact with the injection needle catheter 3 when viewed in cross section. Has been. The guide rail 51c is a substantially V-shaped groove in a sectional view, the guide rail 51d is a substantially U-shaped groove in a sectional view, and the guide rail 51e is a substantially V-shaped groove in a sectional view. Such guide rails 51c, 51d, and 51e can be made narrow, and it is not necessary to dig deeply into the groove. Therefore, the block body 41 and the guide rails 51c, 51d, and 51e can be downsized. Therefore, a good field of view from the observation window 11 can be ensured. Since the needle catheter 3 is supported at two points, that is, stress is concentrated at these two points, the needle catheter 3 can be accurately placed, and the needle catheter 3 is attached to the esophageal vein. It is possible to accurately guide to the target position of the puncture of the aneurysm.

  As shown in FIG. 10B, when the width W of the block body 41 is equal to or smaller than the outer diameter D of the injection needle catheter 3, the visual field of the endoscope is not obstructed by the guide rail 51d, and a good visual field is obtained. Can be secured. For example, when the outer diameter D of the injection needle catheter 3 is 2 mm, the width W of the block body 41 is preferably set to about 1.8 mm.

  Further, the guide rail 51f shown in FIG. 11 is a wide shallow groove portion having a substantially U shape in cross section, which is set so that the diameter is much larger than the outer diameter of the injection needle catheter 3. The guide rail 51f and the injection needle catheter 3 have approximately one point of contact when viewed in cross section. In such a guide rail 51f, the width of the block body 41 can be kept low because it is not necessary to dig deeply into the groove, although a wide width is required. Therefore, a good field of view from the observation window 11 can be ensured, and since the width is wide, the injection needle catheter 3 can be accurately aligned, and the injection needle catheter 3 can be used as a puncture target for esophageal varices. Can guide accurately to the position.

  Next, in the example shown in FIG. 8, the upper part of the solid block body 42 that stands up from the lower part on the inner peripheral side of the hood part 4 is used as the guide part. The guide portion is adjusted to a predetermined inclination angle, extends forward from a position connected to the channel port 12, and guides the needle catheter 3 to the puncture target position of the esophageal varices by inserting the needle catheter 3. Has been. In this guide pipe 52, since the injection needle catheter 3 is inserted into the insertion hole 52h, for example, the patient (living body) moves unexpectedly, or the peripheral tissue of the esophageal varices is peristally moved. Even if vibration in the lateral direction (vertical direction and horizontal direction) occurs unexpectedly, the injection needle catheter 3 does not come off the guide portion. In other words, there is almost no blurring or displacement of the injection needle catheter 3, so that the injection needle catheter 3 can be accurately guided to the puncture target position of the esophageal varices.

  Next, in the example shown in FIGS. 12A and 12B, the upper part of the solid block body 43 that rises like a hill from the lower part on the inner peripheral side of the hood part 4 is used as the guide part. A guide slope that is set at a predetermined inclination angle and extends in a fan shape forward from a position continuous with the channel port 12 and guides the injection needle catheter 3 to the puncture target position of the esophageal varices 53. In this guide slope 53, the injection needle catheter 3 is always placed on the guide slope 53 and does not come off. And the guide direction of the injection needle catheter 3 can be changed by changing the angle of the guide slope 53 by changing the attachment angle to the endoscope 1 suitably. Therefore, the needle catheter 3 can be accurately guided to the puncture target position of the esophageal varices while appropriately fine-tuning the guide direction.

  In addition, as shown in FIG.12 (c), you may make it combine a guide slope and a guide rail. In this example, a guide slope 54 and a guide rail 54r formed as a shallow groove portion are formed on the upper portion of the block body 43 serving as a guide portion. In this way, it is possible to obtain both the advantages of the guide rail 51e and the like and the advantages of the guide slope 53 and the like as described above.

  Next, in the example shown in FIG. 13A, the upper part of the thin plate-like plate body 55 that is set at a predetermined inclination angle so as to protrude in a hill shape and is attached to the lower part on the inner peripheral side of the hood part 4. Is used as a guide part. In this guide portion, a guide slope 55 is formed which extends in a fan shape forward from a position connected to the channel port 12 and guides the injection needle catheter 3 to the puncture target position of the esophageal varices. The guide slope 55 is provided with scales 55 s formed vertically and horizontally as means for detecting the position and direction of the injection needle catheter 3. The scale 55s is provided on the guide slope 55 at a position at least visible from the observation window 11 of the endoscope 1, as shown in FIG.

  In the guide slope 55, as in the guide slope 53, the injection needle catheter 3 can be accurately guided to the puncture target position of the esophageal varices while appropriately fine-tuning the guide direction. Since the scale 55s is provided so that the position and direction of the injection catheter 3 can be observed and detected from the observation window 11, the distance and angle between the injection catheter 3 and the puncture target position can be objectively known. be able to. Therefore, the operation of the injection needle catheter and the like from the outside of the body can be performed easily and accurately.

  The solid block bodies 41, 42, 43 described above are preferably manufactured by integral molding with the hood portion 4 from the viewpoint of simplifying the manufacturing process or increasing the accuracy of the finished product. It may be manufactured by separate molding. Conversely, the plate body 45 may be manufactured by integral molding with the hood portion 4 as long as the scale 55s can be accurately formed.

  In the example shown in FIG. 14, the endoscope attachment 2 is applicable to an outer channel type endoscope. The endoscope used here is composed of an endoscope main body 1A and an outer channel 1B, and the injection needle catheter 3 is inserted into the outer channel 1B. As the endoscope main body 1A, it is preferable to secure a channel 1h for a treatment instrument other than the injection needle catheter 3 (for example, for forceps) using the same configuration as the endoscope 1 described above.

  In this example, a long hole 56 as a guide portion is formed below the hood portion 4 and is continuous with the channel port 12B of the outer channel 12. By setting the length or position of the long hole 56 to a predetermined value, the guide direction of the injection needle catheter 3 protruding from the channel port 12B through the long hole 56 to the inside of the hood portion 4 can be set to a predetermined value. Specifically, as shown in FIG. 16, the puncture needle 3n can be punctured shallowly from the root side of the esophageal varices V. Thereby, it becomes possible to deal with a small aneurysm.

[Third Embodiment]
Next, a modification of the guide portion 5 of the endoscope attachment 2 shown in the first embodiment will be described as a third embodiment with reference to FIGS. 15 and 17 to 19. This embodiment relates to an example in which the guide portion 5 is a direction variable guide portion capable of arbitrarily changing the guide direction of the injection needle catheter 3. Here, two examples of the direction variable guide part will be described.

First, a first example is shown in FIG.
The variable direction guide portion 60 includes a slide rail 62 formed at the lower portion on the inner peripheral side of the hood portion 4 and a block member (pressing member) 61 attached to the slide rail 62. .

  The slide rail 62 is formed below the injection needle catheter 3 on the inner peripheral surface of the hood portion 4 so as to extend in the front-rear direction. The block member 61 is attached to the slide rail 62 so as to be slidable in the front-rear direction and not movable in the lateral direction (vertical direction, left-right direction), and the upper surface side thereof is in contact with the injection needle catheter 3. That is, when the block member 61 is slid on the slide rail 62, the contact position between the injection needle catheter 3 and the block member 61 changes. For this reason, when the block member 61 is moved from the front to the rear, the injection needle catheter 3 is pressed upward, and the puncture needle 3n is directed upward. Thus, the guide direction of the injection needle catheter 3 can be changed by sliding the block member 62 in the front-rear direction.

  A wire 63 is attached to the block member 61. The wire 63 extends to the outside of the hood portion 4 and is led out to the operation portion outside the body by the outer channel 63C. That is, the slide amount of the block member 61 can be remotely controlled by operating the wire 63 from outside the body. Although the wire 63 is led out by the outer channel here, it may be led out by using the channel 1h of the endoscope 1.

  Next, a second example is shown in FIG. The variable direction guide portion 65 includes a balloon 66 attached to the inner peripheral side of the hood portion 4 so as to be able to expand and contract, and an intake / exhaust channel 67 for performing intake / exhaust in the balloon 66. ing.

  The balloon 66 is disposed below the injection needle catheter 3 on the inner peripheral side of the hood portion 4. That is, when the degree of expansion of the balloon 66 is reduced, the puncture needle 3n is directed downward, but when the degree of expansion of the balloon 66 is increased, the injection needle catheter 3 is pressed upward, and the puncture needle 3n comes to face upward. Thus, the guide direction of the injection needle catheter 3 can be changed by changing the degree of expansion of the balloon 66.

  An intake / exhaust channel 67 is connected to the balloon 66. The intake / exhaust channel 67 is extended to the outside of the hood portion 4 and led out to the operation portion outside the body. That is, by performing intake / exhaust to the intake / exhaust channel 67 from outside the body, the degree of expansion of the balloon 66 can be remotely controlled. Although the intake / exhaust channel 67 is an outer channel here, it may be arranged in the channel 1h of the endoscope 1.

  FIG. 18 and FIG. 19 show a direction variable guide portion 65A having a plurality of such balloons 66 and a plurality of intake / exhaust channels 67, respectively. As shown in these drawings, the direction variable guide portion 65 includes balloons 66a, 66b, 66c attached to the inner peripheral side of the hood portion 4 so as to be able to expand and contract, and intake and exhaust air in the balloons 66a, 66b, 66c, respectively. Intake and exhaust channels 67a, 67b, 67c for performing the above.

  As shown in FIG. 18 (a), the balloon 66b is disposed below the injection needle catheter 3 on the inner peripheral side of the hood portion 4, and the balloon 66a is disposed on the right side of the injection needle catheter 3 (in FIG. 18). On the left side, the balloons 66c are arranged on the left side (right side in FIG. 18) of the injection needle catheter 3, respectively. These balloons 66a, 66b, and 66c are connected to intake and exhaust channels 67a, 67b, and 67c, respectively, and can individually be expanded and contracted. For example, as shown in FIG. 18B, if the degree of expansion of the balloon 66a is increased, the injection needle catheter 3 is pushed and moved in the left direction. Further, as shown in FIG. 18C, if the degree of expansion of the balloon 66b and the balloon 66c is increased, the injection needle catheter 3 is pushed and moved in the upper right direction. As described above, the guide direction of the injection needle catheter 3 can be changed not only in the vertical direction but also in the horizontal direction.

  As shown in FIG. 19, the intake / exhaust channels 67a, 67b, and 67c are respectively connected to a balloon control device 68 provided on the operation unit side outside the body. In this balloon control device 68, by operating a joystick 68j, the amount of air supplied to and exhausted from the exhaust channels 67a, 67b, 67c can be individually controlled. That is, the degree of expansion of the balloons 66a, 66b, 66c can be remotely controlled from outside the body.

As described above, the direction variable guide portion 65 is attached to the inner peripheral side of the hood portion 4 so as to be able to expand and contract, and includes a balloon 66 that presses the injection needle catheter 3 in the lateral direction during expansion. Therefore, by changing the expansion degree of the balloon 66, the pressing degree of the injection needle catheter 3 can be continuously changed, and the guide direction can be continuously changed. Thereby, the guide direction of the injection needle catheter 3 can be changed quickly and accurately by a simple operation.
Further, if a plurality of balloons are provided so that they can be individually inflated and contracted as in the balloons 66a, 66b, 66c, the guide directions of the injection needle catheter can be set in various ways, so that the procedure can be performed more easily. be able to.

[Fourth Embodiment]
Next, a modification of the positioning and fixing portion 7 of the endoscope attachment 2 shown in the first embodiment will be described as a fourth embodiment with reference to FIGS. Each example of the positioning and fixing portion shown in the present embodiment is a deformed portion of the hood portion 4 that is formed in the hood portion 4 so as to have a shape in which a part of the substantially cylindrical shape is cut out. Therefore, in each figure, illustration of components other than the hood part 4 and the positioning fixing part is omitted.

As an example of such a deformed portion of the hood portion 4, a description will be given below of an example in which a portion of the hood portion 4 in the vicinity of the front edge portion 4 f is cut into a predetermined slit.
A slit portion 71 shown in FIG. 20 has a shape in which a part thereof is cut out in a substantially U shape from the front edge portion 4 f of the hood portion 4 toward the rear. Moreover, the slit part 72 shown in FIG. 21 is made into the shape which cut out a part in the substantially V shape toward the back from the front edge part 4f of the food | hood part 4. As shown in FIG. Further, the slit portion 73 shown in FIG. 22 has a shape in which a part thereof is cut out in a substantially U shape from the front edge portion 4 f of the hood portion 4 toward the rear. Thus, by appropriately selecting the shape of the slit portion according to the shape of the esophageal varices V, the esophageal varices V can be accurately taken into the hood portion 4.

  Further, the slit portion 74 shown in FIG. 23 has a shape in which a part thereof is cut out in a substantially Ω shape from the front edge portion 4 f of the hood portion 4 toward the rear. Thus, when it is made into a substantially Ω-shape, when the esophageal varices are pressed, the back side of the captured aneurysm, that is, the front edge portion 4f side is narrowed, so that the once-acquired aneurysm can hardly be removed.

  Furthermore, FIG. 24 shows an example in which a part of the hood part 4 in the vicinity of the front edge part 4f is cut into a substantially square shape as a deformed part of the hood part 4 as a window part. The window portion 75 has a shape in which the front edge portion 4f of the hood portion 4 is left as it is, and a part of the hood portion 4 is cut out by a predetermined distance from the front edge portion 4f. If it does in this way, at the time of press to an esophageal varices, it can make it difficult to remove the once taken-in aneurysm.

  In addition, it is preferable that these slit parts are arrange | positioned in the front of a guide part and the circumferential direction substantially the same position as a guide part. In this way, the slit portion and the central axis of the injection needle catheter can be positioned on substantially the same axis, and the blood vessel in the esophageal varices can be accurately punctured at the approximate center. .

  Moreover, when forming such a slit part in the food | hood part 4, it is set as the side view curve shape as shown to Fig.26 (a), and the side view linear shape as shown to Fig.27 (a). There are cases. In the former case, as shown in FIG. 26 (b), the contact angle can be arbitrarily set, and can be appropriately selected according to the shape of the esophagus E, the position of the esophageal varices V, and the like. Become. On the other hand, in the latter case, the contact can be made at a constant angle θ, and a constant fixed state can always be maintained.

  Further, as a deformed portion of the hood portion 4, as shown in FIG. 25, the front edge portion of the hood portion 4 may be inclined. With such an inclined front edge portion 76, the opening area of the front edge of the hood portion 4 can be made wider than in the case of the front edge portion 4f. Therefore, if the inclination angle is set to a predetermined value, esophageal varices It can be made to contact so as to cover a predetermined position of V. And if it suck | inhales using the endoscope which has a suction capability, the wide range of esophageal varices V can be raised to the food | hood part 4 inner side.

  Further, such slit portions may be formed at a plurality of locations in the circumferential direction of the hood portion 4. FIGS. 28A and 28B show an example in which slit portions are formed at two upper and lower portions of the hood portion 4. In this example, the substantially U-shaped slit portion 73d is formed on the lower side, and the substantially U-shaped slit portion 73u is formed on the upper side. In this way, the hood portion 4 can be more firmly fixed to the esophageal varices V, and the area of the raised portion inside the hood portion 4 can be further secured.

[Fifth Embodiment]
Next, a fifth embodiment will be described with reference to FIGS. The present embodiment relates to an example in which the hood portion 4 of the endoscope attachment 2 shown in the first embodiment is provided with alignment means for aligning the position in the circumferential direction with the endoscope. . In addition, in each figure, illustration of the guide part 5 and the positioning fixing | fixed part 7 may be abbreviate | omitted suitably.

  In the example shown in FIG. 29, a marker 81 as an alignment means is formed on the rear side on the hood portion 4 so that alignment with the endoscope 1 in the circumferential direction can be easily performed. FIG. 30 shows a modification of the example shown in FIG. 29. A marker 81a is formed on the rear side of the hood portion 4, and a marker 81b is formed on the outer peripheral side of the endoscope 1. Thus, the mutual alignment can be performed more easily and accurately. Thus, when the endoscope attachment 2 is attached to the endoscope 1, the mutual alignment can be accurately performed. And even if positional deviation in the circumferential direction occurs at the time of use, that is, after mounting, it can be quickly restored.

  Further, in the example shown in FIG. 31, as an alignment unit, a marker 82 similar to the marker 81 is formed at a position visible from the observation window 11 when attached to the endoscope 1. Here, the visible position is formed at the position of the front edge portion 4 f on the hood portion 4. Therefore, as a simple configuration, it is possible to easily visually recognize whether or not the endoscope attachment 2 and the endoscope 1 are positioned in the circumferential direction by using the endoscope 1. it can. Therefore, even when the endoscope 1 is inserted into the body cavity, the positional deviation of the endoscope attachment 2 can be recognized.

  Further, in the example shown in FIGS. 32A and 32B, a protrusion 83 as an alignment means is provided on the inner peripheral side of the hood portion 4. The protrusion 83 protrudes inward from the inner peripheral side of the hood 4, and comes into contact with a part of the front end surface 10 of the endoscope 1 when attached to the endoscope 1. Here, “a part of the front end face 10” refers to a portion excluding the observation window 11, the channel port 12, the light source 13, the front surface of the liquid feeding port 14, and the inner peripheral side thereof. In other words, the shape of the protrusion 83 is adapted to the arrangement of each structure provided on the front end surface 10 of the endoscope 1, and the protrusion 83 has an outer periphery than the position of each structure. The front end surface 10 on the side can be contacted.

In this way, the protrusion 83 is shaped so as to come into contact with a part of the front end surface 10 excluding these front surfaces in accordance with the arrangement of the structures on the front end surface 10. Therefore, it can be mounted without obstructing various operations by the endoscope 1 such as observation and treatment, and it can be very easily determined whether or not the position is correct by an appearance inspection or the like.
Further, for example, if the projection 83 can be visually recognized by observing with the endoscope 1, it can be determined that the positional deviation has occurred, so that the positional deviation can be easily recognized by observation from outside the body. Can do.

  Here, the protrusion 83 is prevented from projecting to the inner peripheral side of the position of each structure on the front end face 10, but such a configuration is not necessarily required unless various operations by the endoscope 1 are hindered. Does not have to be adopted. However, it is necessary to set the contact position of the protruding portion 83 with at least the observation window 11 and the front surface of the channel port 12 excluded so as not to obstruct observation and treatment.

  Further, in the example shown in FIG. 33, a cylindrical portion 84 as an alignment means is provided inside the hood portion 4. The cylindrical portion 84 is integrally attached on a block-like pedestal 48 erected from the lower portion on the inner peripheral side of the hood portion 4, and protrudes rearward at a position corresponding to the channel port 12. When the endoscope 1 is mounted, it is inserted into the channel port 12 and is fitted. The tube portion 84 is formed with a through hole 84h. When the tube 84 is attached to the endoscope 1, the syringe catheter 3 in the channel port 12 passes through the through hole 84h and the hood portion 4 is inserted. Can project inward.

  Further, in the example shown in FIG. 34, a half cylinder part 85 as an alignment means is provided inside the hood part 4. The semi-cylindrical portion 85 is obtained by forming the above-described cylindrical portion 84 into a semi-cylindrical shape, and is integrally attached on a block-shaped pedestal 48 that stands up from the lower portion on the inner peripheral side of the hood portion 4. And protrudes rearward at the corresponding position. When the endoscope 1 is mounted, it is inserted into the channel port 12 and is fitted. When attached to the endoscope 1, the injection needle catheter 3 in the channel port 12 can protrude to the inside of the hood portion 4 through the upper side of the half tube portion 85.

  Since the cylindrical portion 84 or the semi-cylindrical portion 85 is inserted and fitted into the channel port 12, the circumferential direction of the endoscope attachment 2 is attached to the endoscope 1 after the attachment. It is possible to accurately prevent the positional deviation from occurring. And since it fits in the channel port 12, the possibility that the attachment 2 for endoscopes will detach | leave after attachment to the endoscope 1 can be suppressed exactly.

  In each of the above-described embodiments, the case where an injection needle catheter is used as the treatment instrument has been described. However, the present invention can be appropriately applied to treatment instruments other than the injection needle catheter.

(Additional item 1)
2. The guide pipe according to claim 1, wherein the guide portion is a guide pipe that extends forward of the channel port and guides the injection needle catheter to the vicinity of a treatment target position on the inner wall of the body cavity. The endoscope attachment described.

  Since such a guide pipe is used, for example, even when the living body moves unexpectedly, the injection needle catheter does not come off the guide portion. That is, it is possible to guide the injection needle catheter to the vicinity of the puncture target position on the inner wall of the body cavity and to puncture the position very accurately even for an unexpected movement during the treatment.

(Appendix 2)
2. The inner side according to claim 1, wherein the guide portion is a guide slope that expands in front of the channel port and guides the injection needle catheter to a vicinity of a predetermined position on the inner wall of the body cavity. Attachment for endoscope.

  Since such a guide slope is used, the injection needle catheter is always placed on the guide portion and does not come off. And the angle of a guide part can be changed by changing the attachment position and attachment angle to an endoscope suitably, and the guide direction of an injection needle catheter can be changed. For this reason, for example, even when it is necessary to change the puncture target position depending on the result of observation by an endoscope, the guide direction is accurately guided to the vicinity of the puncture target position while finely adjusting the guide direction, and the position is extremely accurate. Can be punctured.

(Additional Item 3)
The attachment for an endoscope according to appendix 1 or appendix 2, wherein the guide portion is provided with detection means for detecting the position and direction of the injection needle catheter.

  Since the position and direction of the injection needle catheter can be detected by such detection means, the distance and angle between the injection needle catheter and the puncture target position can be objectively known, and from the outside of the body. These operations can be performed easily and accurately.

(Appendix 4)
The endoscope attachment according to appendix 3, wherein the detecting means is a scale formed vertically and horizontally at a position that can be visually recognized from the observation window when the detector is attached to the endoscope.

  Since the detection means has such a scale, the position and direction of the injection needle catheter can be accurately detected by visual recognition using an endoscope as a simple configuration.

(Appendix 5)
The endoscope attachment according to any one of appendices 1 to 4, wherein the guide portion is a direction variable guide portion capable of arbitrarily changing a guide direction of the injection needle catheter. .

  Since such a direction variable guide portion is used, the puncture target position can be quickly and accurately adjusted after the endoscope and the hood portion are fixed in the vicinity of the treatment target position. Therefore, even if the puncture target position is moved, the injection needle catheter can be caused to follow it, so that the position can be accurately punctured.

(Appendix 6)
The supplementary item 5 is characterized in that the direction variable guide portion is provided with a pressing member that is slidably attached to the inner peripheral side of the hood portion and that presses the injection needle catheter in a lateral direction. The endoscope attachment described.

  Since the direction variable guide portion has such a configuration, by sliding the pressing member, the pressing position of the injection needle catheter can be continuously changed in the front-rear direction, and the guide direction can be continuously changed. Therefore, as a simple configuration, the guide direction of the injection needle catheter can be accurately changed.

(Appendix 7)
The supplementary item 5 is characterized in that the direction-variable guide part is provided with a balloon that is slidably attached to the inner peripheral side of the hood part and that presses the injection needle catheter in the lateral direction when inflated. The endoscope attachment described.

  Since the direction variable guide portion has such a configuration, the guide direction can be changed continuously by changing the degree of inflation of the balloon to continuously change the degree of pressing of the injection needle catheter. Therefore, the guide direction of the injection needle catheter can be quickly and accurately changed by a simple operation. Further, if a plurality of balloons are provided so that they can be individually inflated and contracted, the guide direction of the injection needle catheter can be set variously in the vertical and horizontal directions.

(Appendix 8)
The deformed portion of the hood portion is a slit portion having a shape obtained by cutting a part of the position in the vicinity of the front edge of the hood portion into a substantially U shape, a substantially U shape, a substantially V shape, or a substantially Ω shape. The endoscope attachment according to claim 4, wherein the attachment is an endoscope.

  Since the positioning and fixing part is such a slit part, for example, by pressing this slit part against the raised part of the body cavity inner wall such as varicose veins, the body cavity inner wall taken into the slit part is elastically deformed, and the inside of the hood part Fixed to. And by appropriately setting the shape of the slit part to be substantially U-shaped, substantially U-shaped, substantially V-shaped, or substantially Ω-shaped, according to the shape of the portion fixed in the hood part And can be selected as appropriate.

(Appendix 9)
4. The inner portion according to claim 3, wherein the deformed portion of the hood portion is a window portion having a shape obtained by cutting out a part of the vicinity of the front edge portion of the hood portion into a substantially square shape. Attachment for endoscope.

  Since the positioning and fixing portion is such a window portion, the aneurysm can be fixed in the window portion by pressing the window portion against the raised portion of the body cavity inner wall such as a varicose vein. Moreover, since the front edge part side of the hood part is not open, there is almost no possibility that the knob once fixed will come off.

(Appendix 10)
The endoscope attachment according to appendix 8 or appendix 9, wherein the positioning and fixing portions are formed at a plurality of locations in the circumferential direction of the hood portion.

  In this way, because it is formed in multiple places, for example, even in the bulge part of the body cavity inner wall like an elongated varicose vein, these slit parts are pressed and fitted to fix the aneurysm in the hood part can do.

(Appendix 11)
5. The positioning device according to claim 1, wherein the hood portion is provided with positioning means for aligning a position in a circumferential direction with the endoscope when the hood portion is attached to the endoscope. Attachment for endoscope as described in 1.

  Since such an alignment means is provided, mutual alignment can be performed accurately when the endoscope attachment is mounted on the endoscope. And after mounting | wearing with an endoscope, it can return to the original state quickly so that it may not generate | occur | produce the position shift to the circumferential direction of each other, or it generate | occur | produces.

(Appendix 12)
The endoscope attachment according to appendix 11, wherein the positioning means is a marker formed at a position that is visible from the observation window when mounted on the endoscope.

  Since such a marker is formed as an alignment means, it is easy to observe whether or not the endoscope attachment and the endoscope are aligned in the circumferential direction using the endoscope. Can be visually recognized.

(Appendix 13)
The alignment means protrudes inward from the hood portion, and when attached to the endoscope, at least a part of the distal end portion of the endoscope excluding the front surface of the observation window and the channel port; The attachment for an endoscope according to Additional Item 11, wherein the attachment is a projecting portion that abuts.

As the positioning means, it is provided with such a protrusion, so that it can be mounted without obstructing various operations by the endoscope such as observation and treatment, and whether it is aligned by visual inspection etc. It can be determined very easily.
Further, for example, if the projection can be visually recognized by observing with an endoscope, it can be determined that the positional deviation has occurred, so the positional deviation can be easily recognized even by observation from outside the body. .

(Appendix 14)
The alignment means is provided on the inner side of the hood so as to protrude rearward at a position corresponding to the channel opening, and when fitted to the endoscope, a cylindrical portion that is inserted into and fitted into the channel opening. Or the endoscope attachment of Additional remark 11 characterized by being made into a half cylinder part.

  Since such a cylindrical portion or a semi-cylindrical portion is provided as the alignment means, it is possible to accurately detect that the positional displacement in the circumferential direction occurs after the attachment of the endoscope attachment to the endoscope. In addition, it is possible to prevent the possibility of detachment after mounting.

(Appendix 15)
The endoscope for endoscope according to any one of claims 10 to 18, wherein the positioning and fixing portion is disposed in front of the guide portion and at a substantially same position in the circumferential direction as the guide portion. attachment.

  Thus, the positioning and fixing portion and the central axis of the injection needle catheter can be positioned on substantially the same axis, and the approximate center of the blood vessel in the raised portion of the inner wall of the body cavity such as varicose veins Can be punctured accurately.

(Appendix 16)
The endoscope attachment according to any one of claims 1 to 19, wherein the guide portion is disposed such that a proximal end portion thereof is positioned on an outer peripheral side with respect to the channel port. .

  Since it does in this way, it can prevent that a guide part obstruct | occludes a channel opening, and can make an injection needle catheter protrude easily in a hood part.

1 is a schematic perspective view of an endoscope system according to an embodiment of the present invention. It is a schematic sectional side view of the endoscope system shown in FIG. It is a schematic sectional side view which shows the state which has performed treatment to the esophageal varices using the endoscope system shown in FIG. It is a schematic sectional side view of the endoscope system which concerns on one Embodiment of this invention. It is a schematic sectional side view which shows the endoscope system shown in FIG. 4 in detail. In the endoscope system shown in FIG. 5, (a) is a schematic side sectional view showing when the angle α is an inappropriate value, and (b) is a schematic side sectional view showing when the angle α is an appropriate value. . It is a schematic perspective view of the endoscope system which shows the modification of a guide part. It is a schematic perspective view of the endoscope system which shows the modification of a guide part. It is a longitudinal cross-sectional view which shows an example of a guide rail. It is a longitudinal cross-sectional view which shows the other example of a guide rail. It is a longitudinal cross-sectional view which shows another example of a guide rail. It is a figure which shows the modification of a guide part, Comprising: (a) is a schematic perspective view of an endoscope system, (b) is the longitudinal cross-sectional view, (c) is a longitudinal cross-sectional view which shows the modification of (b). is there. It is a figure which shows the modification of a guide part, Comprising: (a) is a schematic perspective view of an endoscope system, (b) is an endoscopic image from an observation window. It is a schematic immediate cross-sectional view of an endoscope system showing a modification of a guide part. It is a schematic sectional drawing of the endoscope system which shows the 1st example of the direction variable guide part as a modification of a guide part. It is a schematic sectional side view which shows the state which has performed treatment to the esophageal varices using the endoscope system shown in FIG. It is a schematic sectional drawing of the endoscope system which shows the 2nd example of the direction variable guide part as a modification of a guide part. It is a longitudinal cross-sectional view of the endoscope system which shows the modification of the direction variable guide part shown in FIG. It is a schematic block diagram which shows the control system of the direction variable guide part shown in FIG. It is an expanded view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is an expanded view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is an expanded view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is an expanded view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is an expanded view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is a schematic sectional side view which shows the modification of the positioning fixing | fixed part formed in the food | hood part. It is a figure which shows the modification of the positioning fixing | fixed part formed in the food | hood part, Comprising: (a) is a schematic sectional side view, (b) is a schematic sectional side view which shows the state which is treating the esophageal varices . It is a figure which shows the modification of the positioning fixing | fixed part formed in the food | hood part, Comprising: (a) is a schematic sectional side view, (b) is a schematic sectional side view which shows the state which has performed treatment to an esophageal varices . It is a figure which shows the modification of the positioning fixing | fixed part formed in the food | hood part, Comprising: (a) is a schematic perspective view, (b) is a sectional side view. It is a schematic perspective view of an endoscope system showing an example of an alignment means. FIG. 30 is a schematic perspective view of an endoscope system showing a modification of the alignment means shown in FIG. 29. It is a schematic perspective view of the endoscope system which shows the other example of the alignment means. It is a figure which shows the further another example of an alignment means, Comprising: (a) is a schematic perspective view of an endoscope system, (b) is a longitudinal cross-sectional view. It is a schematic perspective view of the endoscope system which shows the further another example of the alignment means. It is a schematic perspective view of the endoscope system which shows the further another example of the alignment means. It is a schematic sectional side view which shows the state which has performed treatment to the esophageal varices using the endoscope system of a prior art example.

Explanation of symbols

S Endoscope System 1 Endoscope 1A Endoscope Body (Endoscope)
1B Outer channel (endoscope)
2 Endoscope attachment 3 Injection needle catheter (treatment tool)
4 Hood part 4f Front edge part 5 Guide part 7 Positioning fixing part 10 Front end surface (tip part)
11 Observation window 12 Channel port 51a, 51b, 51c, 51d, 51e, 51f Guide rail (guide part)
52 Guide pipe (guide part)
53, 54 Guide slope (guide part)
60 direction variable guide (guide)
61 Block member (pressing member, direction variable guide)
62 Slide rail (Direction variable guide)
65, 65A direction variable guide part (guide part)
66, 66a, 66b, 66c Balloon (Direction variable guide)
67, 67a, 67b, 67c Intake / exhaust channel (direction variable guide section)
71, 72, 73, 74 Slit part (positioning and fixing part, deformation part of hood part)
73d, 73u Slit part (positioning and fixing part, deformation part of hood part)
75 Window (positioning / fixing part, hood part deformation part)
76 Inclined front edge (positioning and fixing part, deformed part of hood part)
81, 81a, 81b, 82 Marker (Positioning means)
83 Projection (Positioning means)
84 Tube (Positioning means)
85 Half cylinder (alignment means)
V Esophageal varices (inner wall of body cavity)

Claims (5)

An endoscope that has an observation window for observing the inner wall of a body cavity and a channel port for projecting a treatment tool for performing a treatment on the inner wall of the body cavity that is detachably mounted on the distal end side. An endoscope attachment,
A hood portion that protrudes forward from the distal end portion of the endoscope and covers the distal end portion when attached to the endoscope; and
A guide portion for guiding the injection needle catheter as the treatment tool protruding from the channel port so as to face a predetermined direction;
An endoscope attachment characterized by comprising:   2. The guide portion according to claim 1, wherein the guide portion is a guide rail that extends forward of the channel opening and guides the injection needle catheter to a position near a treatment target position on the inner wall of the body cavity. The endoscope attachment described.   The endoscope attachment according to claim 1 or 2, further comprising a positioning fixing portion that fixes a vicinity of a treatment target position on the inner wall of the body cavity in the hood portion.   The said positioning fixing | fixed part is made into the deformation | transformation part of this hood part formed in the said hood part so that it may become the shape which notched a part of said substantially cylindrical shape, The Claim 3 characterized by the above-mentioned. The endoscope attachment described. An endoscope having an observation window for observing the inner wall of the body cavity and a channel port for projecting a treatment tool for performing treatment on the inner wall of the body cavity at the distal end;
The endoscope attachment according to any one of claims 1 to 4, which is attached to a distal end side of the endoscope;
A needle catheter as the treatment instrument;
An endoscope system comprising:

Images