JP2012024358A - Insertion device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an insertion device having a constitution capable of expanding a grasping member from a constricted condition to a specific size in a short period of time.SOLUTION: The insertion device has the insertion part 13 inserted in a subject, the grasping member 20 arranged in the outer periphery of the insertion part 13, freely expandable and contractable in the radial direction R, and fixing the position of the insertion part 13 to a wall part by abutting on the wall part in the subject when expanding to a specific size, the sealing member 20 sealing and covering the grasping member 20, the grasping member 20 is constituted of an elastic body which constricts in the radial direction R and assumes a constricted condition when the inside of the sealing member 19 is decompressed and expands in the radial direction R and is elastically restored from the constricted condition to an expanded condition expanding to the specific size by its own elastic force when the decompression inside of the sealing member 19.

Description

  The present invention relates to an insertion apparatus provided with a gripping member that is provided on the outer periphery of an insertion portion that is inserted into a subject and that can expand and contract in a radial direction.

  In recent years, an insertion device to be inserted into a subject, for example, an endoscope, has been widely used in the medical field and the industrial field. The endoscope can observe the inside of the duct by inserting an elongated insertion portion into the subject.

  In addition, an observation window for observing the inside of the pipeline and an illumination window for irradiating illumination light to the inside of the pipeline are provided on the distal end surface of the distal end portion provided on the distal end side of the insertion portion of the endoscope. It is common.

  Further, in order to improve the progress of the insertion portion of the endoscope in the conduit, first, after inserting a known overtube as an insertion device in the conduit, the insertion portion of the endoscope in the overtube There is also a well-known technique for performing endoscopic observation by allowing the insertion portion of the endoscope to advance to the site to be examined in the duct by inserting the.

  Here, when observing the test site or performing various treatments on the test site, the insertion portion is inserted into the duct until the position where the observation window faces the test site. If the tip part moves after insertion, it is difficult to observe the test site and perform various treatments.

  Even when the overtube is used, if the distal end side of the overtube moves, the advancing direction of the insertion portion of the endoscope inserted inside may be shifted from a desired direction.

  In view of such circumstances, a gripping member, such as a balloon, that can be inflated and contracted in response to air supply and exhaust of a fluid is provided on the outer periphery of the distal end portion or the overtube, and the balloon is inflated during observation. A structure is known in which the distal end portion or the distal end side of the overtube is fixed to the inner wall via a balloon by bringing the tube into contact with the inner wall of the conduit with pressure, thereby preventing the distal end portion or the distal end side of the overtube from being moved unexpectedly. It is.

  By the way, normally, when a balloon is inflated, it is common to perform gas supply from a pump through a tube communicating with the balloon to the balloon, but pressure control in the balloon is not performed. Then, there was a problem that the balloon was expanded more than necessary.

  In view of such a problem, Patent Document 1 discloses that a compressor device having a pump is provided with a pressure sensor and an electromagnetic valve for detecting the pressure in the balloon and the tube, and gas is sent from the pump to the balloon through the tube. When the pressure sensor detects that the pressure in the balloon and the tube has reached a predetermined pressure value set in advance, the balloon is prevented from being supplied into the tube using an electromagnetic valve. The structure which prevents expanding more than a regular magnitude | size is disclosed.

JP 2003-24270 A

  However, in the configuration in which the size of the balloon is inflated by detecting the pressure in the balloon and the tube using the pressure sensor, it takes time until the pressure in the balloon is stabilized at the specified pressure value. There was a problem.

  This is because the pressure in the balloon does not become the specified pressure value only by stopping the gas supply when the specified pressure value is reached, so the gas is detected while detecting the pressure little by little near the specified pressure value. This is because it is necessary to perform control to obtain a specified pressure value by repeating the air supply and exhaust.

  Furthermore, when the pressure in the balloon and the tube is detected using a pressure sensor to maintain the balloon size at a constant size, it is necessary to perform complicated pressure control.

  Therefore, there has been a demand for a configuration that can easily inflate a balloon to a specified size without using a pressure sensor and can easily maintain the size of the balloon.

  The present invention has been made in view of the above problems, and has a configuration capable of inflating a gripping member from a contracted state to a specified size in a short time and maintaining the size of an inflated balloon easily. An object of the present invention is to provide an insertion device.

  In order to achieve the above object, an insertion device according to the present invention includes an insertion portion to be inserted into a subject, and an expansion portion that is provided on an outer periphery of the insertion portion and that can expand and contract in a radial direction and expands to a predetermined size. A gripping member that fixes the position of the insertion portion with respect to the wall by contacting the wall in the subject, and a sealing member that seals and covers the gripping member. When the inside of the sealing member is depressurized, the member contracts in the radial direction and enters a contracted state, and when the decompression in the sealing member is released, the member expands in the radial direction and extends from the contracted state to the specified size. It is constituted by an elastic body that elastically returns to its expanded state by its own elastic force.

  According to the present invention, it is possible to provide an insertion device having a configuration capable of inflating a gripping member from a contracted state to a specified size in a short time and maintaining the size of the inflated balloon easily. .

The perspective view which shows the outline of a structure of the insertion apparatus which shows 1st Embodiment. 1 is a partial cross-sectional view of the overtube along the line II-II in FIG. The perspective view of the holding member of FIG. Cross section of overtube along line IV-IV in Fig. 1 Partial cross-sectional view of the overtube along line V-V in Fig. 1 2 is a partial cross-sectional view of the overtube showing a state where the gripping member of FIG. 2 is contracted Chart showing the relationship between the pressure applied to the intestinal wall by the gripping member and time The perspective view which shows the outline of a structure of the insertion apparatus which shows 2nd Embodiment. Partial cross-sectional view of the overtube and the endoscope along the line IX-IX in FIG. FIG. 8 is a partially enlarged perspective view of a part surrounded by a one-dot chain line X of the operation unit of the endoscope of FIG. The perspective view which shows the outline of a structure of the insertion apparatus which shows 3rd Embodiment. The perspective view which expands and shows the extracorporeal fixing member of FIG. 11 is a partial cross-sectional view of the overtube and the endoscope along the line XIII-XIII in FIG. The exploded view of the fixing member provided in the base end of the expansion-contraction part of the expansion-contraction apparatus of FIG. The figure which shows a mode that an endoscope is advanced in an intestinal tract using the insertion apparatus of FIG. The perspective view which shows the modification by which the hole of the porous member which comprises the holding member of an intestine holding part is partially formed The perspective view which shows the modification by which the porous member which comprises the holding member of an intestine holding part is formed in the bowl shape The perspective view which shows the modification by which the porous member which comprises the holding member of an intestine holding part is formed in the waveform. The perspective view which shows the modification which formed the holding member of the intestine holding part in the shape of a bowl from a metal strand The perspective view which shows the modification which formed the holding member of the intestine holding part in the shape which rounded the metal strand at random The partial perspective view which shows the modification in which the holding member is comprised from the several porous member The disassembled perspective view of the holding member of FIG. The figure which shows the modification by which the contact surface to the intestinal wall of the some porous member which comprises the holding member of FIG. 21 is formed in the R surface. The figure which shows the modification which varied the hardness of the holding member partially

Embodiments of the present invention will be described below with reference to the drawings.
(First embodiment)
FIG. 1 is a perspective view showing an outline of the configuration of the insertion device according to the present embodiment, FIG. 2 is a partial cross-sectional view of the overtube along the line II-II in FIG. 1, and FIG. 4 is a cross-sectional view of the overtube taken along line IV-IV in FIG. 1, and FIG. 5 is a partial cross-sectional view of the overtube taken along line VV in FIG.

  6 is a partial cross-sectional view of the overtube showing a state in which the gripping member of FIG. 2 is contracted, and FIG. 7 is a chart showing the relationship between the pressure applied to the intestinal wall by the gripping member and time. Is a chart showing a method for controlling the pressure applied to the intestinal wall when the conventional balloon is inflated, and (b) is a chart showing the pressure applied to the intestinal wall when the elastic body of FIG. 2 is inflated. is there.

  As shown in FIG. 1, the insertion device 1 includes an endoscope 2, a monitor 3, a video processor 4, a light source device 5, an air / water supply tank 6, a suction pump 7, a signal cable 8, and an insertion. The main part is comprised including the auxiliary system 9.

  The endoscope 2 includes an insertion portion 2a to be inserted into a subject, for example, an intestinal tract, an operation portion 2b positioned on the proximal end side of the insertion portion 2a, and a universal cord 2c extending from the operation portion 2b. The main portion is configured to include a connector 2d provided at the extended end of the universal cord 2c and connectable to the light source device 5.

  The video processor 4 is electrically connected to the connector 2 d of the endoscope 2 via a signal cable 8, and an image sensor (not shown) provided in the insertion portion 2 a of the endoscope 2 via the signal cable 8. In addition to performing operation control, the image signal in the intestine taken by the image sensor is processed. The image signal processed by the video processor 4 is displayed on the monitor 3 as an endoscopic image.

  The light source device 5 supplies illumination light to a known light guide (not shown) provided in the endoscope 2.

  The air / water supply tank 6 is connected to the light source device 5 through a tube, and is used when gas or liquid is supplied to a known air / water supply conduit (not shown) provided in the endoscope 2. Is.

  The suction pump 7 is connected to the connector 2d of the endoscope 2 via a tube, and the liquid or tissue in the intestinal tract is passed through a known suction conduit (not shown) provided in the endoscope 2. It is used when sucking.

  The insertion assisting system 9 includes a pump 10, a fluid supply / discharge tube 11, and an overtube 12, and a main part is configured.

  The overtube 12 includes an elongated insertion portion 13 made of a substantially cylindrical soft member, and a grip portion 14 made of a substantially cylindrical soft member provided on the proximal end side of the insertion portion 13. The part is composed.

  As shown in FIGS. 2 and 4, the insertion portion 13 has a substantially cylindrical shape, a main lumen 15 through which the endoscope 2 is inserted, and an intestinal gripping portion supply / discharge lumen (hereinafter referred to as a fluid conduit). , Simply referred to as a supply / discharge lumen) 16. Although not shown, the inner surface of the main lumen 15 is provided with a lubricating coating.

  As shown in FIG. 2, a distal tip 17 made of a soft member is fixed to the distal end of the insertion portion 13 by adhesion or welding. Further, the intestinal gripping portion 18 is fixed to the outer surface of the insertion portion 13 on the proximal end side with respect to the distal end tip 17 by adhesion or welding.

  The intestinal gripping portion 18 includes a gripping member 20 and a sealing member 19 that covers the gripping member 20 in a space between the outer surface of the insertion portion 13 and covers the main portion. The distal end side of the supply / discharge lumen 16 communicates with the inside of the sealing member 19.

  The sealing member 19 is made of a thin film such as silicon, urethane, or latex, for example, and is hermetically fixed to the outer surface of the insertion portion 13. The sealing member 19 may be provided integrally with the gripping member 20.

  The sealing member 19 is not limited to a thin film, and may be a resin or the like applied so as to cover and hold the gripping member 20 in a space between the outer surface of the insertion portion 13.

  Further, as will be described later in FIG. 2, the sealing member 19 may be fixed to the outer surface of the insertion portion 13 in a state in which the gripping member 20 is inflated. As will be described later in FIG. In a state where 20 is contracted, the insertion portion 13 may be fixed to the outer surface.

  As shown in FIG. 3, the holding member 20 is composed of a spherical elastic body having a through hole 20h through which the insertion portion 13 is inserted, for example, a porous member such as a sponge. As shown in FIG. 2, when the pressure in the sealing member 19 is reduced or released, it can expand and contract in the radial direction R, and when expanded to a specified size as shown in FIG. By abutting against the intestinal wall, the position of the insertion portion 13 is fixed with respect to the intestinal wall.

  Hereinafter, the expansion / contraction structure of the holding member 20 will be described. As shown in FIG. 5, on the outer surface of the grip portion 14 of the overtube 12, a water supply port 21 that communicates with the main lumen 15 of the overtube 12 and an intestinal gripping portion supply that communicates with the proximal end side of the supply / discharge lumen 16. A discharge port (hereinafter simply referred to as a supply / discharge port) 22 is provided.

  A water supply base 23 is provided at the opening of the water supply port 21, and a supply / discharge base 24 is provided at the opening of the supply / discharge port 22.

  As shown in FIGS. 1 and 5, the supply / discharge cap 24 is connected to the pump 10 via a fluid supply / discharge tube 11 which is a fluid conduit. The pump 10 constitutes a decompression control unit that performs decompression and release of decompression in the sealing member 19 via the fluid supply / discharge tube 11 and the supply / discharge lumen 16.

  Therefore, when the pump 10 is driven and the inside of the sealing member 19 is depressurized via the fluid supply / discharge tube 11, the supply / discharge mouthpiece 24, and the supply / discharge lumen 16, the gripping member 20 is moved into the hole of the porous member. As shown in FIG. 6, the air is contracted in the radial direction R to be in a contracted state.

  At this time, the degree of shrinkage of the porous member constituting the gripping member 20 varies depending on the coarse density of the voids of the porous member. Specifically, the porous member is more easily contracted as the degree of void is coarser. Further, when the gripping member 20 is in a contracted state, the outer diameter of the intestinal gripping portion 18 is preferably a diameter that does not interfere with the insertion of the overtube 12 into the intestine.

  On the other hand, when the driving of the pump 10 is stopped, the decompression in the sealing member 19 is released, so that the gripping member 20 immediately expands in the radial direction R as shown in FIG. It returns elastically by its own elastic force from the contracted state shown to the expanded state where it expands to a specified size.

  At this time, the degree of expansion of the porous member constituting the gripping member 20 varies depending on the coarse density of the voids of the porous member. Specifically, the denser the void degree, the easier the porous member expands. Moreover, since the holding member 20 is expanded by its own elastic force, the size after the expansion is maintained after the expansion.

  As described above, in the present embodiment, the gripping member 20 sealed in the sealing member 19 is efficiently expanded and contracted as the pump 10 is driven and stopped.

  When the grasping member 20 expands to the prescribed size shown in FIG. 2, the position of the insertion portion 13 is fixed with respect to the intestinal wall by the intestinal grasping portion 18 coming into contact with the intestinal wall. At this time, the pressure P applied to the intestinal wall from the intestinal grasping portion 18 is set to a pressure that does not damage the human body. In the inflated state, the force P (see FIG. 7) applied from the intestinal gripping portion 18 to the intestinal wall is controlled by the material and porosity of the porous member constituting the gripping member 20.

  Specifically, “the internal pressure of the balloon corresponding to the intestinal grasping portion 18 in the present embodiment is set within 6.0 kPa (about 45 mmHG) by“ Nanedo double balloon endoscope supervision / editing: Kentaro Kanno ”. Then, as the balloon is inflated, the normal intestinal tract does not perforate, and the subject does not perceive the presence of the balloon. The pressure P to be applied is set within 6.0 kPa.

  Note that the gripping force of the gripping member 20 with respect to the intestinal wall is defined by the pressure P and the contact area of the gripping member 20 with respect to the intestinal wall.

  Thus, in the present embodiment, when the pump 10 is driven and the inside of the sealing member 19 is depressurized, the gripping member 20 contracts in the radial direction R, the pump 10 is stopped, and the inside of the sealing member 19 is depressurized. It was shown that when the release is released, the gripping member 20 expands to a prescribed size in contact with the intestinal wall by its own elastic force.

  According to this, the straightening of the large intestine which has been conventionally performed by a known single balloon endoscope can be similarly performed using the overtube 12 in the present embodiment.

  Further, when the gripping member 20 shown in FIG. 6 changes from the contracted state to the inflated state of the gripping member 20 in which the gripping member 20 shown in FIG. Although it is determined by the elastic force of the porous member constituting the gripping member 20 and the contact area between the intestinal wall, the elastic force of the porous member is within 6 kPa, which is a pressure that may be applied to the intestinal wall, as described above. Therefore, the intestinal tract is not damaged with the expansion of the gripping member 20.

  Furthermore, as shown in FIG. 7 (a), in the conventional configuration, the pressure in the balloon is detected by using a pressure sensor to define the size of the balloon inflating, that is, from the balloon to the intestinal wall. In the configuration in which the pressure P is constant, the pressure in the balloon can be reduced to the specified pressure value only by controlling to stop the gas supply when the specified pressure value is reached until the pressure in the balloon is stabilized at the specified pressure value. Don't be. For this reason, it took time because it was necessary to perform control to obtain the specified pressure value by repeatedly supplying and exhausting gas while detecting the pressure in small steps near the specified pressure value. (The time to reach the conventional specified pressure P is t1).

  However, in the configuration of the present embodiment, pressure control is not required, and as shown in FIG. 7B, the gripping member 20 can be released only by stopping the pump 10 and releasing the pressure reduction in the sealing member 19. Since the pressure immediately expands to a specified size by the elastic force of the pressure and the pressure applied to the intestinal wall reaches the specified pressure P, the time t2 to reach the specified pressure P can be significantly shortened compared to the conventional case (t2 <T1) It becomes possible to quickly grasp the intestinal tract.

  In addition, since the gripping member 20 continues to maintain a predetermined size after expansion, it is not necessary to manage the expanded state of the gripping member 20 using a pressure sensor as in the past.

  As described above, it is possible to provide the insertion device 1 having a configuration capable of inflating the gripping member 20 from the contracted state to a specified size in a short time and maintaining the size of the inflated balloon easily.

(Second Embodiment)
FIG. 8 is a perspective view schematically showing the configuration of the insertion device showing the present embodiment, FIG. 9 is a partial sectional view of the overtube and the endoscope along the line IX-IX in FIG. 8, and FIG. FIG. 9 is a partially enlarged perspective view of a portion surrounded by a one-dot chain line X of the operation unit of the endoscope of FIG. 8.

  The configuration of the insertion device according to the second embodiment is different from that of the insertion device according to the first embodiment shown in FIGS. Therefore, only this difference will be described, the same reference numerals are given to the same components as those in the first embodiment, and the description thereof will be omitted.

  As shown in FIG. 8, in the present embodiment, the insertion assisting system 109 of the insertion device 101 includes a pump 10, a fluid supply / discharge tube 11, an endoscope fluid supply / discharge tube 11 a, and an overtube 12. The main part is comprised.

  Here, in the present embodiment, the intestinal gripping portion 18 is provided not only in the overtube 12 but also in the endoscope 2. Note that the intestinal gripping portion provided in the endoscope 2 is denoted by reference numeral 180.

  Specifically, the insertion portion 2a of the endoscope 2 includes a distal end portion 2as, a bending portion 2aw, and a flexible tube portion 2ak in order from the distal end side, and a main portion is configured.

  As shown in FIG. 9, like the intestine gripping part 18, the intestine gripping part 180 having the gripping member 20 and the sealing member 19 is provided so as to be covered on the outer surface of the distal end part 2as of the insertion part 2a. The distal end and the proximal end are fixed to the distal end portion 2as by a fixing ring 36 made of an elastic member.

  As shown in FIG. 9, the distal end portion 2 as includes a distal end cover 30 and a substantially cylindrical distal end body 31 that is bonded and fixed to the distal end cover 30. It should be noted that the distal end of the curved rubber 32 of the curved portion 2aw is fixed to the outer surface of the distal end body 31 by pincushion bonding.

  The distal end body 31 is provided with a connection conduit 31a that is a fluid conduit having a distal end communicating with the inside of the sealing member 19, and an intestinal gripping portion supply / exhaust that is a fluid conduit is provided at the proximal end of the connection conduit 31a. The tip of a pipe connection pipe (hereinafter simply referred to as a connection pipe) 33 is bonded and fixed.

  At the proximal end of the connection pipe 33, there is a distal end of an intestinal gripping part supply / exhaust pipe (hereinafter simply referred to as a supply / exhaust pipe) 34, which is a fluid pipe for supplying and discharging fluid to the intestinal gripping part 18. It is connected. The proximal end portion of the supply / exhaust conduit 34 is connected to an intestinal gripping portion supply / exhaust mouthpiece 35 provided on the outer surface of the endoscope operation unit 2b shown in FIG. The intestinal gripping portion supply / discharge mouthpiece 35 and the pump 10 are connected via an endoscope fluid supply / discharge tube 11a which is a fluid conduit.

  Therefore, when the pump 10 is driven and the inside of the sealing member 19 is depressurized via the endoscope fluid supply / discharge tube 11a, the supply / discharge conduit 34, and the connection tube 33, the same as the above-described intestinal grasping portion 18 of the first embodiment. When the grasping member 20 of the intestinal grasping portion 180 contracts and the decompression in the sealing member 19 is released, the grasping member 20 of the intestinal grasping portion 180 is a predetermined size, like the intestinal grasping portion 18 of the first embodiment described above. That is, it expands to a size that gives a constant pressure P to the intestinal wall.

  As described above, in the present embodiment, both the endoscope 2 and the overtube 12 are provided with the intestinal gripping portions 18 and 180 that expand due to their own elastic force when the decompression is released. Intestinal linearization can be performed in the same manner as a known double balloon endoscope in which balloons are provided on both the endoscope 2 and the overtube 12.

  Therefore, as shown in the first embodiment described above, each intestine gripping part 18, 180 is in an expanded state in which the gripping member 20 is expanded from a contracted state to a certain size that applies a prescribed pressure P to the intestinal wall. Can be inflated in a short time, and the gripping part can be changed from an inflated state to a contracted state in a short time. can do.

  In addition, since there are one intestinal gripping portions 18 and 180 respectively in both the insertion portion 2a of the endoscope 2 and the insertion portion 13 of the overtube 12, as shown in the first embodiment described above, The effect of shortening the insertion time into the intestinal tract is further increased compared to a single balloon endoscope in which the intestinal gripping portion 18 is provided only in the insertion portion 13 of the overtube 12.

  Other effects are the same as those of the first embodiment described above.

(Third embodiment)
11 is a perspective view schematically showing the configuration of the insertion device showing the present embodiment, FIG. 12 is an enlarged perspective view showing the extracorporeal fixing member of FIG. 11, and FIG. 13 is XIII-XIII in FIG. FIG. 14 is an exploded view of the fixing member provided at the base end of the expansion / contraction part of the expansion / contraction apparatus of FIG. 13.

  The configuration of the insertion device of the third embodiment is the same as that of the first embodiment shown in FIGS. 1 to 7 and the insertion device of the second embodiment shown in FIGS. The configuration of the insertion assisting system 9 is different. Therefore, only this difference will be described, the same reference numerals are given to the same components as those in the first and second embodiments, and the description thereof will be omitted.

  As shown in FIG. 11, in this embodiment, the insertion assisting system 209 of the insertion device 201 includes a pump 10, a fluid supply / discharge tube 11, an expansion / contraction device 150, and an extracorporeal fixing member 38. The part is composed.

  The expansion / contraction device 150 includes an intestinal gripping portion 280 having a gripping member 20 and a sealing member 19, and the proximal end side of the intestinal gripping portion 280, as in the intestinal gripping portions 18 and 180 of the first and second embodiments described above. The main part is comprised by the expansion-contraction part 37 located in.

  As shown in FIG. 13, the intestine gripping portion 280 includes a cylindrical member 39 that is an insertion portion, a sealing member 19, and a gripping member 20.

  The sealing member 19 is put on the outer surface of the cylindrical member 39, and the distal end and the base end of the sealing member 19 are fixed to the outer surface of the cylindrical member 39 by bonding or the like in a state where the fluid supply / discharge tube 11 is sandwiched. As a result, the tip of the fluid supply / discharge tube 11 communicates with the inside of the sealing member 19.

  The other end of the fluid supply / discharge tube 11 is connected to the pump 10 as described above. Therefore, as the pump 10 is driven and stopped, the gripping member 20 expands and contracts in the radial direction R as in the first and second embodiments described above.

  The main part of the expansion / contraction part 37 is constituted by a sheath part 40, a fixing part 41 provided on the proximal end side of the sheath part 40, and an expansion / contraction member 42 constituted by a spring or the like provided in the sheath part 40. Has been.

  The extensible member 42 has a distal end bonded and fixed to the proximal end of the cylindrical member 39. The base end of the expansion / contraction member 42 is connected to the fixing portion 41 by bonding or soldering. The fixing part 41 is a known collet chuck. As shown in FIG. 14, the head part 41 b is screwed into the screw hole 41 a of the fixing part 41 so that the fixing part 41 is inserted into the intestinal gripping part 280 and the expansion / contraction part 37. The telescopic member 37 is fixed to the insertion portion 2a of the endoscope 2 that has been made.

  As shown in FIG. 12, the extracorporeal fixing member 38 has an inverted T shape, and is fixed to the central portion of the protrusion 44 protruding from the base for fixing the fluid supply / discharge tube 11 outside the body. A groove 45 is provided.

  The fixation of the fluid supply / discharge tube 11 outside the body is not limited to the external fixation member 38, but may be performed by fixing the fluid supply / discharge tube 11 to another fixing member by a member separate from the fluid supply / discharge tube 11 such as a wire. .

  Next, the effect | action of this Embodiment is demonstrated using FIG. FIG. 15 is a diagram schematically showing how the endoscope is advanced in the intestinal tract using the insertion device of FIG. 11, and (a) is an intestinal gripping portion that is inflated and fixed to the intestinal wall. It is a figure which shows the state which pulled the endoscope to the hand side in the state, and linearized the intestinal tract, (b) is a figure which shows the state which pushed the endoscope ahead of the intestinal gripping part from (a) (C) is a figure which shows the state which moved the expansion-contraction apparatus ahead by extending an expansion-contraction part after contracting an intestine holding part.

  When the insertion device of the present embodiment is inserted into the intestinal tract, first, the insertion portion 2a of the endoscope 2 is inserted into the intestinal tract. For example, in the bent portion of the sigmoid colon, as shown in FIG. As described above, the pump 10 is stopped, the intestinal gripping portion 280 is expanded and fixed to the intestinal wall, and then the sigmoid colon is linearized by pulling the insertion portion 2a toward the hand side. At this time, the insertion portion 2 a is fixed to the expansion / contraction portion 37 by the fixing portion 41, so that the expansion / contraction member 42 of the expansion / contraction portion 37 extends together with the sheath portion 40.

  Next, as shown in FIG. 15 (b), the insertion portion 2 a is pushed forward in a state where the intestinal gripping portion 280 is fixed to the intestinal wall as it expands. As a result, the distal end of the insertion portion 2a advances before the sigmoid colon.

  At this time, since the fluid supply / discharge tube 11 is fixed to the extracorporeal fixing member 38 outside the body, the intestinal gripping portion 280 does not move forward in the intestinal tract. Further, since the insertion portion 2 a is fixed to the expansion / contraction portion 37 by the fixing portion 41, the expansion member 42 of the expansion / contraction portion 37 contracts together with the sheath portion 40 by pushing the insertion portion 2 a.

  Thereafter, as shown in FIG. 15C, when the pump 10 is driven to contract the intestinal gripping portion 280, the insertion portion 2a is fixed to the expansion / contraction portion 37 by the fixing portion 41, whereby the expansion / contraction portion Since the elastic member 42 of 37 extends forward together with the sheath portion 40 by the elastic force of the spring, the intestinal gripping portion 280 advances forward.

  Thus, the configuration of the intestinal gripping portion 280 can also be applied to the configuration in which the insertion portion 2a of the endoscope 2 is advanced in the intestinal tract.

  Therefore, if the intestinal gripping part 280 is applied to such a configuration, the endoscope 2 can be advanced while maintaining the shortening operation of the intestine and the shape of the shortened intestine, and can be easily inserted into the body cavity. Become.

  Conventionally, when inserting using an overtube, it is necessary for two people to perform the operation. One person operates the overtube, and the other person performs push-pull operation and twisting operation of the endoscope. However, in the present embodiment, only the expansion and contraction of the intestinal gripping part 280 and the operation of the insertion part 2a can be performed by the extension part 37 so that the insertion part 2a can be inserted by one person. is there.

  In addition, conventionally, the push-pull operation and the twisting operation of the endoscope are performed in the overtube, so that there is a problem that it is difficult to perform each operation due to the contact between the insertion portion of the endoscope and the inner surface of the overtube. According to the configuration of the present embodiment, since the overtube is not used, the insertion portion 2a can be easily operated.

  Hereinafter, modified examples will be described with reference to FIGS. FIG. 16 is a perspective view showing a modified example in which the holes of the porous member constituting the grasping member of the intestine grasping part are partially formed, and FIG. 17 shows the porous member constituting the grasping member of the intestine grasping part. FIG. 18 is a perspective view showing a modification in which the porous member constituting the gripping member of the intestinal gripping portion is formed in a wave shape.

  19 is a perspective view showing a modified example in which the gripping member of the intestinal gripping part is formed into a hook shape from a metal strand, and FIG. 20 is a diagram of the gripping member of the intestinal gripping part being randomly rounded with a metal strand. It is a perspective view which shows the modification formed in the shape.

  In the first to third embodiments described above, the gripping member 20 of the intestinal gripping portions 18, 180, and 280 is shown to be composed of a spherical elastic body, for example, a porous member such as a sponge.

  Here, normally, in the case of a sponge, holes (voids) are uniformly formed in the entire sphere. However, as shown in FIG. The gap density of the gaps of the gripping member 20 may be formed so as to be coarse. In this case, the degree of contraction of the gripping member 20 can be partially adjusted because it is easy to partially adjust the coarse density of the porous member simply by changing the location where the hole 20v is drilled.

  In addition, as shown in FIG. 17, the gripping member 20 is not limited to a spherical shape, and may be formed in a bowl shape in order to increase the contact area with the intestinal tract. Furthermore, as shown in FIG. 18, in order to increase the contact area with the intestinal tract, the outer peripheral surface may be formed in a shape corresponding to the buttocks of the intestinal tract, that is, in a wave shape (gourd shape). Of course, it may be formed in other shapes.

  Further, as shown in FIG. 19, the gripping member 20 is not limited to a porous member as long as it is an elastic body. For example, the gripping member 20 is made of a metal strand 25 having biocompatibility and elasticity such as nickel / titanium and molybdenum. It may be formed in a shape, or as shown in FIG. 20, the metal strand 25 may be formed in a randomly rounded shape.

  Since the metal strand 25 which comprises the shape shown in this FIG. 19, FIG. 20 is an elastic body, when it expands in an intestinal tract, it expands until it gives a fixed pressure to an intestinal wall, but the pressure is Similar to the gripping member 20 of the first to third embodiments described above, the pressure applied to the intestinal wall is set within 6.0 kPa so as not to damage the human body.

  In addition, hereinafter, modifications will be described with reference to FIGS. 21 is a partial perspective view showing a modification in which the gripping member is composed of a plurality of porous members, FIG. 22 is an exploded perspective view of the gripping member in FIG. 21, and FIG. 23 is a configuration of the gripping member in FIG. It is a figure which shows the modification by which the contact surface to the intestinal wall of the several porous member to be formed in the R surface.

  As shown in FIGS. 21 and 22, the grip member 20 formed in a spherical shape from a porous member may be formed by being divided into at least two or more on a plane perpendicular to the axial direction or a plane including the axis. I do not care. In FIGS. 21 and 22, as an example, the gripping member 20 is configured from eight porous members (20 a to 20 h).

  According to this, the expansion rate in the radial direction R is different due to the difference in the coarse density of the voids in the porous member, and the expansion rate in the radial direction R increases as the coarse density of the voids in the porous member is denser. By using the characteristics of the porous member to be described above, the porous members 20a to 20h have different coarse densities, or only a part of the porous members 20a to 20h has different coarse densities as described above. The corrugated shape shown in FIG. 18 can be easily formed, and the shape of the gripping member 20 at the time of expansion can be freely set.

  This is not limited to the case where the gripping member 20 is composed of a porous member, and the same is true when the gripping member 20 is composed of another elastic member, and the gripping member 20 is composed of a plurality of members. Thus, if the elastic modulus of the plurality of elastic members constituting the gripping member 20 is made different, the shape of the gripping member 20 at the time of expansion can be freely set.

  Moreover, as shown in FIG. 23, if the contact surface 20q to the intestinal wall 43 of each porous member 20a-20h which comprises the holding member 20 is formed in the R surface, that is, the contact surface 20q will be chamfered. In this case, when the gripping member 20 is expanded, the gripping force of the gripping member 20 on the intestinal wall 43 can be increased.

  Hereinafter, another modification will be described with reference to FIG. FIG. 24 is a diagram illustrating a modification in which the hardness of the gripping member is partially varied.

  As shown in FIG. 24, when the holding member 20 is composed of a plurality of elastic bodies 20i to 20m, the hardness of each elastic body is made different by changing the elastic coefficient of the material itself of each elastic body. Also good.

  For example, as shown in FIG. 24, when the gripping member 20 is formed in an egg shape, the hardness of the elastic body 20k constituting the portion of the gripping member 20 that comes into contact with the intestinal wall 43 is set to be elastic that is not in contact with the intestinal wall 43. You may set harder than the hardness of the bodies 20i, 20j, 20l, and 20m.

  According to this, since the hard elastic body 20k is easily caught on the intestinal wall 43, the gripping force of the gripping member 20 on the intestinal wall 43 can be improved.

  The above is the same even when the gripping member 20 is composed of a plurality of porous members, and the hardness of each porous member is changed by changing the coarse density of the voids of each porous member. May be different.

  Specifically, as described above, the porous member uses the fact that the density of voids is denser and the expansion coefficient is higher, and the fact that the density of voids is denser is to be hardened. As shown in FIG. 24, if the porous member constituting the elastic body 20k is made denser than the porous members constituting the other elastic bodies 20i, 20j, 20l, and 20m, the elastic body 20k is formed to be hard. Can do.

DESCRIPTION OF SYMBOLS 1 ... Insertion apparatus 2a ... Insertion part 10 ... Pump (pressure reduction control part)
11 ... Fluid supply / discharge tube (fluid conduit)
11a: Endoscope fluid supply / discharge tube (fluid conduit)
13 ... Insertion part 16 ... Intestinal gripping part supply / exhaust lumen (fluid conduit)
DESCRIPTION OF SYMBOLS 19 ... Sealing member 20 ... Holding member 31a ... Connection pipe line (fluid pipe line)
33 ... Intestinal gripping part supply / exhaust pipe connection pipe (fluid pipe)
34. Intestinal gripping part supply / exhaust conduit (fluid conduit)
39 ... Cylindrical member (insertion part)
101 ... Insertion device 201 ... Insertion device R ... Radial direction

Claims (8)

An insertion part to be inserted into the subject;
Provided on the outer periphery of the insertion portion, is expandable / shrinkable in the radial direction, and abuts against the wall portion in the subject when expanded to a predetermined size, whereby the insertion portion A gripping member for fixing the position;
A sealing member that seals and covers the gripping member;
A fluid conduit communicating with the sealing member;
A depressurization controller for depressurizing and releasing depressurization in the sealing member via the fluid conduit;
Comprising
The gripping member contracts in the radial direction when the inside of the sealing member is depressurized, and expands in the radial direction when the decompression in the sealing member is released. An insertion device comprising an elastic body that is elastically restored by its own elastic force to an expanded state that expands to a size.   The insertion device according to claim 1, wherein a plurality of the elastic bodies are provided in the sealing member.   The insertion device according to claim 1, wherein the elastic body is made of a porous member.   The insertion device according to claim 2, wherein the plurality of elastic bodies have different expansion rates in the radial direction. Each of the plurality of elastic bodies has a different hardness,
The insertion device according to claim 2, wherein, of the plurality of elastic bodies, the elastic body that abuts against the wall portion has a higher hardness than the elastic body that does not abut against the wall portion. The elastic body is composed of a porous member, and a plurality of the porous members are provided in the sealing member,
The expansion coefficient in the radial direction is different due to the difference in the coarse density of the voids for each porous member. The denser the coarse density of the voids in the porous member is, the larger the expansion coefficient in the radial direction is. The insertion device according to claim 4. The elastic body is composed of a porous member, and a plurality of the porous members are provided in the sealing member,
The said elastic body contact | abutted to the said wall part has the coarse density of the space | gap of the said porous member denser than the said elastic body which is not contact | abutted to the said wall part, The Claim 6 characterized by the above-mentioned. Insertion device.   The insertion device according to claim 1, wherein the gripping member is formed in a shape corresponding to a shape of the wall portion.

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