JP2017099810A - Treatment instrument insertion tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment instrument insertion tool having a structure that enables a replacement work of a treatment instrument to be easily performed.SOLUTION: A treatment instrument insertion tool 20 is to be attached to an endoscope 1, which is to be inserted in a subject, and used to insert treatment instruments 31-34 to be used for treating the subject into the subject. The treatment instrument insertion tool 20 includes a tube 21 that guides the treatment instruments 31-34 into the subject, a guide part body 22 attachable to a portion 2z of an insertion part 2, which is positioned outside of the subject when the insertion part 2 of the endoscope 1 is inserted in the subject, the guide part body 22 being provided at one end of the tube 21 so as to serve as an insertion port through which the treatment instruments 31-34 are inserted into the tube 21, and sliders 41-44 to be attached to the treatment instruments 31-34 so as to be attachable to the guide part body 22.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a treatment instrument insertion tool that is attached to an insertion device that is inserted into a subject and inserts a treatment tool for treating the subject into the subject.

  In recent years, an insertion device inserted into a subject, for example, an endoscope, has been widely used in the medical field.

  An endoscope used in the medical field observes an organ in a body cavity by inserting a long and thin insertion portion into a body cavity as a subject, and in a treatment instrument insertion path provided in the endoscope as necessary. Various treatments can be performed on a target site of an organ in a body cavity (hereinafter referred to as a treatment target site) using the inserted treatment tool.

  When observing the body cavity, the operator, for example, grasps the insertion portion of the endoscope with the right hand and performs various operations of the insertion portion while observing the endoscope image, A technique for performing various operations on the operation unit of the mirror is common.

  In addition, when performing treatment on a treatment target site in a body cavity, the operator once removes the right hand from the insertion portion, and then grasps the treatment tool with the right hand and inserts the treatment tool insertion passage provided in the operation portion. Generally, a procedure is performed in which a treatment tool is inserted into the treatment tool insertion passage through the mouth, and the treatment tool is protruded into the subject from the distal end opening of the treatment tool insertion passage formed at the distal end of the insertion portion. It is.

  Here, when performing various treatments on the treatment target site in the body cavity using the treatment tool, the operator inserts the treatment target site while observing the endoscopic image in order to perform appropriate treatment. This necessitates fine adjustment of the distal end position of the section and the distal end position of the treatment instrument.

  However, as described above, the surgeon selectively performs various operations on the insertion portion and various operations on the treatment tool with the right hand, so that the distal end position of the insertion portion and the distal end position of the treatment tool with respect to the treatment target site are minute. There was a problem that it was difficult to make adjustments at the same time.

  In addition, as described above, since the operator must perform various operations of the treatment tool performed with the right hand while moving the right hand away from the insertion portion, the operator performs fine adjustment of the distal end position of the treatment tool with respect to the treatment target site. There is also a problem that the position of the distal end of the insertion portion with respect to the treatment target site is shifted.

  In view of such a problem, Patent Literature 1 discloses a tube-shaped treatment instrument guide portion whose one end is detachable at an insertion port of a treatment instrument insertion path provided in an operation portion, and an other end of the treatment instrument guide portion. There is disclosed a treatment instrument insertion tool that is provided and includes a guide body that is detachable from a portion of the insertion section that is located outside the subject, and that inserts a treatment instrument into the subject.

  In the treatment instrument insertion tool disclosed in Patent Document 1, the guide unit main body is attached to a portion of the insertion part located outside the subject, and one end of the treatment tool guide part is attached to the insertion opening of the treatment instrument insertion path. In the state, the treatment instrument is inserted into the treatment instrument insertion path via the guide part main body and the treatment instrument guide part, and in a state where the treatment tool protrudes into the subject from the distal end opening at the distal end of the insertion part, the operator inserts the insertion part with the right hand Since the position of the treatment tool can be adjusted using a treatment tool operation unit such as a slider fixed to the guide unit body with the right hand while holding the handle, the distal end position of the insertion portion with respect to the treatment target site and the treatment tool can be adjusted with only the right hand. Fine adjustment of the tip position can be performed simultaneously.

International Application Publication No. WO2013 / 065509

  By the way, when a treatment target site is treated using the treatment instrument insertion tool disclosed in Patent Document 1, a plurality of treatment instruments can be selectively inserted into and removed from the treatment instrument insertion path and the treatment instrument insertion tool. One treatment tool may be inserted and removed several times. That is, there is a case where a treatment tool replacement operation occurs.

  However, in the treatment instrument insertion tool disclosed in Patent Document 1, the treatment instrument operation unit fixed to the guide body is fixed to the treatment instrument with a ratchet, a chuck, or the like. When inserting / removing a tool selectively, or when inserting / removing one treatment tool, there is a need for a separate operation for attaching / detaching the treatment tool operation unit from the treatment tool, and there is a problem that the replacement work of the treatment tool is complicated. .

  The present invention has been made in view of the above problems, and an object of the present invention is to provide a treatment instrument insertion tool having a configuration capable of easily performing a treatment tool replacement operation.

  In order to achieve the above object, a treatment instrument insertion tool according to an aspect of the present invention is attached to an insertion device that is inserted into a subject, and the treatment instrument insertion tool that inserts a treatment tool for treating the subject into the subject. A treatment instrument guide for guiding the treatment instrument into the subject and an insertion portion of the insertion device positioned outside the subject when the insertion device is inserted into the subject. A guide body that is detachably attached to a part, is provided on one end side of the treatment instrument guide section and serves as an insertion port for the treatment instrument to the treatment instrument guide section, and is attached to the treatment instrument, and the guide section A treatment instrument operating section that is detachable from the main body.

  ADVANTAGE OF THE INVENTION According to this invention, the treatment tool penetration tool which comprises the structure which can perform the replacement | exchange operation | work of a treatment tool easily can be provided.

The figure which shows the treatment tool penetration tool of 1st Embodiment with an endoscope The figure which shows the cross section of a part of treatment tool insertion tool of FIG. 1 with a part of treatment tool with which the treatment tool operation part was attached. The fragmentary sectional view which shows the modification by which the film | membrane was provided between the treatment tool guide part and the guide part main body in the treatment tool insertion part of FIG. The figure which shows a part of treatment tool insertion tool of 2nd Embodiment with a part of treatment tool with which the treatment tool operation part was attached. 4 is a side view of a part of the treatment instrument insertion tool in FIG. 4 viewed from the V direction in FIG. The figure which shows the modification of the shape of the processus | protrusion of FIG. 4 with a treatment tool operation part. The figure which shows some cross sections of the treatment tool penetration tool of 3rd Embodiment with a part of treatment tool to which the treatment tool operation part was attached. The figure which shows a part of treatment tool penetration tool of 4th Embodiment with a part of treatment tool with which the treatment tool operation part was attached. FIG. 8 shows a modification in which the second engagement portion is formed of a slit and a plurality of convex portions formed in the slit. The modification of the treatment instrument to which a part of the treatment instrument insertion instrument and the treatment instrument operation unit are attached is provided. Figure shown with part FIG. 8 shows a modification in which the second engaging portion is formed of a slit and a single convex portion formed in the slit, and a part of the treatment tool insertion tool and a treatment tool to which the treatment tool operation portion is attached. Figure shown with part The figure which shows the modification of the shape of the slit of FIG. 8 with a part of treatment instrument insertion tool. The figure which shows the modification of the shape of the protrusion of the slider which can be inserted in the slit of FIG.

  Embodiments of the present invention will be described below with reference to the drawings. In the embodiment described below, the insertion device will be described using an endoscope as an example.

(First embodiment)
FIG. 1 is a diagram showing a treatment instrument insertion tool of the present embodiment together with an endoscope, and FIG. 2 is a partial cross-section of the treatment instrument insertion tool of FIG. 3 and FIG. 3 are partial sectional views showing a modification in which a film is provided between the treatment instrument guide section and the guide section main body in the treatment instrument insertion section of FIG.

  As shown in FIG. 1, an endoscope 1 that is an insertion device includes an insertion section 2 that is inserted into a subject, an operation section 3 that is connected to the proximal end side of the insertion section 2, and the operation section. 3 comprises a universal cord 8 extended from 3 and a connector 9 provided at the extended end of the universal cord 8 to constitute a main part. Note that the endoscope 1 is electrically connected to an external device such as a control device or a lighting device via the connector 9.

  The operation section 3 is provided with an up / down bending operation knob 4 for bending the bending section 2w of the insertion section 2 in the up / down direction and a left / right bending operation knob 6 for bending the bending section 2w in the left / right direction.

  Further, the operation unit 3 is provided with a fixed lever 5 that fixes the rotation position of the up / down bending operation knob 4 and a fixed knob 7 that fixes the rotation position of the left / right bending operation knob 6. The operation unit 3 is provided with various known operation switches.

  The various knobs 4, 6, 7, lever 5, various switches and the like provided in the operation unit 3 are operated by the left hand of the operator, for example.

  The insertion portion 2 includes a distal end portion 2s, a bending portion 2w, and a flexible tube portion 2k in order from the distal end side, and is formed in an elongated shape. The insertion unit 2 is operated by, for example, the operator's right hand.

  Contrary to the above, various operations of the insertion unit 2 may be performed with the left hand of the operator and various operations of the operation unit 3 may be performed with the right hand of the operator.

  The bending portion 2w is bent in, for example, four directions, up, down, left, and right, by a turning operation of the up / down bending operation knob 4 or the left / right bending operation knob 6, so that an imaging unit (not shown) provided in the distal end portion 2s is provided. The observation direction can be changed, or the insertability of the tip 2s in the subject can be improved. Furthermore, the flexible tube portion 2k is connected to the proximal end side of the bending portion 2w.

  Further, a treatment instrument insertion passage 10 is provided in the insertion portion 2 and the operation portion 3. One end of the treatment instrument insertion path 10 is opened as a distal end opening 10a at the distal end surface of the distal end portion 2s, and the other end is opened as an insertion opening 10b in the operation unit 3.

  In addition, since the structure of the other endoscope 1 is the same as the structure of a general endoscope, the detailed description is abbreviate | omitted.

  The treatment tool insertion tool 20 is attached to the endoscope 1 and inserts any of the treatment tools 31 to 34 for treating the inside of the subject into the subject.

  In the present embodiment, the case where there are four treatment tools is shown as an example, but the number of treatment tools may be one or a plurality other than four.

  The treatment instrument insertion tool 20 includes a tube 21 that is a treatment instrument guide section, a guide section main body 22, and any one of sliders 41 to 44 that are treatment instrument operation sections.

  The tube 21 guides any of the treatment tools 31 to 34 into the subject, and is made of a resin such as Teflon (registered trademark).

  Specifically, the other end of the tube 21 can be freely connected to the insertion port 10b of the treatment instrument insertion passage 10 provided in the endoscope 1, and after the connection, the tube 21 is inserted into the tube 21 from the guide portion main body 22. Any one of the treatment tools 31 to 34 is guided through the treatment tool insertion passage 10 into the subject through the distal end opening 10a.

  As shown in FIGS. 1 to 3, the guide body 22 is provided on one end side of the tube 21, and the treatment tools 31 to 34 pass through the guide 21 and any of the sliders 41 to 44 is attached. A space 22i communicating with the space 21i inside the tube 21 is provided, and the base end of the space 22i constitutes an insertion port 22p of any of the treatment tools 31 to 34 into the space 21i.

  In addition, as shown in FIG. 3, even if the film | membrane 50 which has the hole 50h through which any of the treatment tools 31-34 passes in the boundary of the space 21i of the tube 21 and the space 22i of the guide part main body 22 is provided. Good.

  The membrane 50 tries to discharge the liquid in the subject toward the outside of the body when the pressure in the subject is higher than the atmospheric pressure in a state where any of the treatment tools 31 to 34 is passed through the hole 50h. Along with this, the liquid is prevented from moving from the space 21 i to the space 22 i via the treatment instrument insertion passage 10.

  According to this, as will be described later, any one of the sliders 41 to 44 provided in the treatment tools 31 to 34 is operated to finely adjust the distal end position of the treatment tools 31 to 34 or to the treatment. When replacing the device, the membrane 50 can prevent the liquid in the subject from leaking out of the body through the insertion port 20p.

  Therefore, the diameter of the hole 50 h needs to be smaller than the outer diameter of any of the treatment tools 31 to 34. As a result, the membrane 50 is in close contact with any one of the outer peripheral surfaces of the treatment tools 31 to 34 to maintain liquid tightness. That is, the film 50 functions as a liquid-tight member.

  In addition, as shown in FIG. 1, the guide body 22 is, for example, a one-dot chain line located outside the subject in the flexible tube portion 2 k of the insertion portion 2 when the insertion portion 2 is inserted into the subject. The enclosed part 2z is detachable. The guide unit main body 22 is configured not to be displaced from the part 2z after being attached to the part 2z located outside the subject.

  Further, as shown in FIG. 2, a slit 22 s that is a second engaging portion communicating with the insertion port 22 p and the space 22 i is formed in the guide portion main body 22. The slit 22s is formed along the longitudinal direction N in which the tube 21 guides any of the treatment instruments 31 to 34 with respect to the guide body 22.

  As shown in FIG. 1, the sliders 41 to 44 are attached in advance to the treatment instruments 31 to 34, respectively, and are detachable from the space 22 i of the guide body 22.

  The sliders 41 to 44 may be detachable from the treatment tools 31 to 34, respectively. Hereinafter, the structure of the sliders 41 to 44 will be described by taking the slider 41 as an example. Furthermore, the treatment tools 31 to 34 will be described using the treatment tool 31 as an example. Therefore, the structure of the slider 41 is also applied to the structures of the sliders 42 to 44, and the structure of the treatment instrument 31 is also applied to the treatment instruments 32 to 34.

  Specifically, as shown in FIG. 2, the slider 41 is provided with a protrusion 41t as a first engaging portion on the outer surface 41g, and the protrusion 41t can be freely fitted into the slit 22s, so that the treatment tool is provided. It is detachably attached to the space 22 i of the guide portion main body 22 in a state of being attached to the guide 31 in advance.

  In the state where the slider 41 is mounted on the guide portion main body 22, the treatment instrument 31 is inserted into the space 21i and the space 22i, the slider 41 is inserted into the space 22i, and the protrusion 41t is inserted into the slit 22s. In this state, as shown in FIG. 1, the distal end 31s of the treatment instrument 31 protrudes from the distal end opening 10a into the subject.

  In this state, the surgeon moves the projection 41t back and forth within the slit 22s with the right hand along the longitudinal direction N while observing the endoscopic image while holding the insertion portion 2 with the right hand, for example. The position of the distal end side of the treatment instrument 31 protruding into the subject can be finely adjusted. Further, at the same time, the operator can finely adjust the position of the distal end portion 2s of the insertion portion 2 with the right hand while observing the endoscopic image.

  In addition, with respect to the guide part main body 22, the sliders 41-44 each attached to the some treatment tools 31-34 are selectively removable.

  That is, the protrusions 41t to 44t respectively provided on the sliders 41 to 44 can be selectively inserted into the slit 22s.

  In addition, since the structure of the other treatment tool insertion tool 20 is the same as the past, the description is abbreviate | omitted.

  Thus, in this Embodiment, it showed that the sliders 41-44 were previously attached to the treatment tools 31-34, respectively.

  The sliders 41 to 44 can be attached to and detached from the guide portion main body 22 when any of the treatment tools 31 to 34 is inserted into and removed from the space 21i and the space 22i. These are shown to be freely inserted into the slits 22s.

  Further, while holding the insertion portion 2 with the right hand, that is, in a state where the tip position of the tip portion 2s of the insertion portion 2 can be finely adjusted or with the tip position fixed, any of the protrusions 41t to 44t is slit 22s. It was shown that the tip position of any of the treatment tools 31 to 34 can be finely adjusted by operating the front and rear with the right hand along the longitudinal direction N.

  According to this, in the treatment instrument insertion tool 20 having a configuration in which fine adjustment of the distal end position of the treatment instruments 31 to 34 can be performed with the right hand while holding the insertion portion 2 with the right hand, the space 21i, the space 22i, and the treatment instrument insertion When exchanging the treatment instrument inserted in the passage 10, the sliders 41 to 44 are fixed to the treatment instruments 31 to 34 in advance, and the sliders 41 to 44 are configured to be detachable from the guide body 22. Therefore, it is not necessary to fix or remove the slider with a ratchet or chuck, etc., every time the treatment tool is replaced or inserted / removed as in the past. It can be done easily.

  From the above, it is possible to provide the treatment instrument insertion tool 20 having a configuration capable of easily performing treatment tool replacement work.

(Second Embodiment)
FIG. 4 is a diagram showing a part of the treatment instrument insertion tool of the present embodiment together with a part of the treatment instrument to which the treatment instrument operation unit is attached, and FIG. 5 is a part of the treatment instrument insertion tool in FIG. FIG. 5 is a side view as seen from the V direction in FIG. 4.

  The configuration of the treatment instrument insertion tool of the second embodiment is the shape of the slit formed in the guide body as compared with the treatment instrument insertion tool of the first embodiment shown in FIGS. Is different.

  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 FIGS. 4 and 5, in the present embodiment, the slit 22 s includes first slits 22 s 1 and 22 s 3 extending along the longitudinal direction N, and the longitudinal direction continuous to the first slit 22 s 1. The main portion is configured to include a second slit 22 s 2 having an angle with respect to N.

  The width N1 in the longitudinal direction N of the second slit 22s2 is set to be larger than the width N2 in the longitudinal direction N of the protrusion 41t (N2 <N1).

  In addition, the structure of the other treatment tool insertion tool 20 is the same as 1st Embodiment mentioned above. Also in the present embodiment, the structure of the sliders 41 to 44 will be described using the slider 41 as an example, and the structure of the treatment tools 31 to 34 will be described using the treatment tool 31 as an example. Therefore, the structure of the slider 41 is also applied to the structures of the sliders 42 to 44, and the structure of the treatment instrument 31 is also applied to the structures of the treatment instruments 32-34.

  In such a configuration, when inserting the protrusion 41 t of the slider 41 into the slit 22 s, the operator first inserts the slider 41 into the space 22 i from the rear in the longitudinal direction N of the guide portion main body 22. The protrusion 41t is inserted into the slit 22s3 and advanced forward in the longitudinal direction N. Thereafter, the slider 41 is rotated to advance the protrusion 41t within the second slit 22s2, and the protrusion 41t is inserted into the first slit 22s1. .

  In this state, the distal end position of the treatment instrument 31 is finely adjusted by moving the protrusion 41t between the distal end 22s1a and the proximal end 22s1b of the first slit 21s1 before and after the longitudinal direction N in the first slit 21s1. I do. When the projection 41t is withdrawn from the slit 22s, the operator performs an operation opposite to that described above.

  Therefore, in the first embodiment described above, since the slit 22s communicates with the insertion port 22p, there is a possibility that the projection 41t may come off from the slit 22s due to the rearward movement operation of the projection 41t in the longitudinal direction N. there were. On the other hand, in the present embodiment, since the slit 22s has the second slit 22s2, it is not intended due to the movement operation of the protrusion 41t in the first slit 22s1 along the longitudinal direction N. It is possible to reliably prevent the protrusion 41t from coming off from the first slit 22s1.

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

  Hereinafter, a modification will be described with reference to FIG. FIG. 6 is a view showing a modified example of the shape of the protrusion of FIG. 4 together with the treatment instrument operation unit.

  In the present embodiment described above, the width N1 in the longitudinal direction N of the slit 22s is shown to be set larger than the width N2 in the longitudinal direction N of the protrusion 41t. That is, the width N2 of the protrusion 41t is set to be smaller than the width N1 of the slit 22s.

  Not limited to this, as shown in FIG. 6, the protrusion 41t is composed of a shaft 41tb and a contact portion 41ta provided at the upper end of the shaft 41tb, so that only the shaft 41tb can advance the slit 22s in the longitudinal direction. Of course, the width N3 of N may be set smaller than the width N1 of the slit 22s (N3 <N1).

(Third embodiment)
FIG. 7 is a view showing a cross section of a part of the treatment instrument insertion tool of the present embodiment together with a part of the treatment instrument to which the treatment instrument operation unit is attached.

  The configuration of the treatment instrument insertion tool of the third embodiment is the same as that of the treatment instrument insertion tool of the first embodiment shown in FIGS. 1 to 3 and the second embodiment shown in FIGS. Compared with the treatment instrument insertion tool, the shape of the slit formed in the guide body and the point that at least a part of the protrusion is elastically deformed are 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. 7, in the present embodiment, the slit 22s is formed in a hole shape along the longitudinal direction N so as to have a distal end 22sa and a proximal end 22sb.

  Further, the protrusion 41t of the slider 41 is configured to be fitted into the slit 22s by elastically deforming at least a part thereof.

  In addition, the structure of the other treatment tool insertion tool 20 is the same as 1st, 2nd embodiment mentioned above. Also in the present embodiment, the structure of the sliders 41 to 44 will be described using the slider 41 as an example, and the structure of the treatment tools 31 to 34 will be described using the treatment tool 31 as an example. Therefore, the structure of the slider 41 is also applied to the structures of the sliders 42 to 44, and the structure of the treatment instrument 31 is also applied to the treatment instruments 32 to 34.

  In such a configuration, when inserting the protrusion 41 t of the slider 41 into the slit 22 s, the surgeon first moves the slider 44 from the rear in the longitudinal direction N of the guide body 22 to the space 22 i of the guide body 22. And inserted through the insertion port 22p. At this time, in a state where the protrusion 41t is elastically deformed and compressed in the direction of the treatment instrument 31, the slider 41 is advanced forward, and then the protrusion 41t is fitted into the slit 22s. At this time, the protrusion 41t is released from the state compressed by the slit 22s and returns to the original state.

  In a state where the projection 41t is fitted in the slit 22s, the distal end position of the treatment instrument 31 is moved by moving the projection 41t back and forth in the longitudinal direction N between the distal end 22sa and the base end 22sb of the slit 22s in the slit 22s. Make fine adjustments. When the projection 41t is withdrawn from the slit 22s, the operator performs an operation opposite to that described above.

  Even in such a configuration, it is possible to reliably prevent the projection 41t from unintentionally coming out of the slit 22s due to the movement operation of the projection 41t in the slit 22s.

  The other effects are the same as those of the first and second embodiments described above.

(Fourth embodiment)
FIG. 8 is a view showing a part of the treatment instrument insertion tool of the present embodiment together with a part of the treatment instrument to which the treatment instrument operation unit is attached.

  The configuration of the treatment instrument insertion tool of the fourth embodiment is the same as that of the treatment instrument insertion tool of the first embodiment shown in FIGS. 1 to 3 and the second embodiment shown in FIGS. Compared with the treatment instrument insertion tool and the treatment instrument insertion tool of the third embodiment shown in FIG. 7, the shape of the slit formed in the guide body and the shape of the protrusion provided on the slider are different.

  Therefore, only this difference is demonstrated, the same code | symbol is attached | subjected to the structure similar to 1st-3rd embodiment, and the description is abbreviate | omitted.

  As shown in FIG. 8, in the present embodiment, the second engaging portion includes a slit 22 s extending along the longitudinal direction N, and a plurality of slits 22 s formed along the longitudinal direction N. It is comprised from the groove | channel 22m.

  Further, the protrusion 41t provided on the slider 41 has a convex portion 41td that can be fitted into the slit 22s and can be freely engaged with and disengaged from any one of the grooves 22m.

  In addition, the structure of the other treatment tool insertion tool 20 is the same as the 1st-3rd embodiment mentioned above. Also in the present embodiment, the structure of the sliders 41 to 44 will be described using the slider 41 as an example, and the structure of the treatment tools 31 to 34 will be described using the treatment tool 31 as an example. Therefore, the structure of the slider 41 is also applied to the structures of the sliders 42 to 44, and the structure of the treatment instrument 31 is also applied to the structures of the treatment instruments 32-34.

  According to such a configuration, when the projection 41t is inserted into the slit 22s, the position of the distal end of the treatment instrument 31 is determined in advance, for example, by engaging the convex portion 41td with any one of the grooves 22m. Can be adjusted easily with different pitches. That is, the advance / retreat amount of the treatment tool 31 can be quantitatively controlled.

  The other effects are the same as those of the first to third embodiments described above.

  Further, in the present embodiment, it has been shown that the distal end of the treatment instrument 31 is positioned by engaging / disengaging the convex portion 41td with respect to any of the plurality of grooves 22m. Even in a configuration in which a plurality of grooves along the longitudinal direction N are provided on the inner peripheral surface facing 22i, and a convex portion provided on the outer surface 41g of the slider 41 is freely detachable in any of the grooves, the above-described book The same effect as the embodiment can be obtained.

  Furthermore, not only the engagement / disengagement of the groove and the protrusion, but also using a known ratchet mechanism, the same effects as those of the above-described embodiment can be obtained.

  Moreover, the configuration shown in FIGS. 9 to 12 is conceivable as the configuration in which the slider 41 is attached to and detached from the guide portion main body 22 without being limited to the configurations of the second to fourth embodiments described above.

  9 to 12, the structure of the sliders 41 to 44 will be described using the slider 41 as an example, and the structure of the treatment tools 31 to 34 will be described using the treatment tool 31 as an example. . Therefore, the structure of the slider 41 is also applied to the structures of the sliders 42 to 44, and the structure of the treatment instrument 31 is also applied to the structures of the treatment instruments 32-34.

  FIG. 9 shows a modification in which the second engaging portion of FIG. 8 is composed of a slit and a plurality of convex portions formed in the slit, and a part of the treatment instrument insertion tool and the treatment instrument operation portion are attached. It is a figure shown with some treatment tools.

  As shown in FIG. 9, the second engaging portion provided in the guide body 22 includes a slit 22 s extending along the longitudinal direction N, and a plurality of slits 22 s formed along the longitudinal direction N. You may be comprised from the convex part 22t.

  According to such a configuration, when the protrusion 41t is inserted into the slit 22s, the distal end of the treatment instrument 31 every time the protrusion 41td provided on the protrusion 41t of the slider 41 gets over any one protrusion 22t. Can be easily positioned. That is, the advance / retreat amount of the treatment tool 31 can be quantitatively controlled.

  FIG. 10 shows a modification in which the second engaging portion of FIG. 8 is configured by a slit and one convex portion formed in the slit, and a part of the treatment instrument insertion tool and the treatment instrument operation portion are attached. It is a figure shown with some treatment tools.

  As shown in FIG. 10, the second engagement portion provided in the guide portion main body 22 includes a slit 22 s extending along the longitudinal direction N and a single convex portion 22 d formed in the slit 22 s. It does not matter. Further, in FIG. 10, a protrusion 41d is provided on the slider 41 itself.

  According to such a configuration, when the projection 41 t is fitted into the slit 22 s and the projection 41 d gets over the projection 22 d, the mounting and fixing configuration of the slider 44 with respect to the guide body 22 can be easily realized. .

  11 is a view showing a modification of the shape of the slit of FIG. 8 together with a part of the treatment instrument insertion tool, and FIG. 12 is a view showing a modification of the shape of the protrusion of the slider that can be fitted into the slit of FIG. is there.

  As shown in FIG. 11, the slit 22 s formed in the guide body 22 is continuous with the large-diameter slit 22 sf and the proximal end of the slit 22 sf and has a small diameter formed up to the proximal end of the guide body 22. You may be comprised from slit 22sg.

  As shown in FIG. 12, the protrusion 41t that can be fitted into the slit 22s may be configured to be extendable and contractable from a small-diameter shaft 41td and a large-diameter shaft 41te that is continuous with the upper end of the small-diameter shaft 41td. I do not care.

  According to such a configuration, when the slider 41 is mounted on the guide portion main body 22, the protrusion 41t is lifted from the rear of the guide portion main body 22 with respect to the small diameter slit 22sg and passes through the small diameter shaft 41td. If the projection 41t is pushed down after the small-diameter shaft 41td is fitted into the large-diameter slit 22sf, the large-diameter shaft 41te and the small-diameter shaft are interposed between the distal end 22sf1 and the base end 22sf2 of the large-diameter slit 22sa. 41td can move back and forth.

  Even with such a configuration, the projection 41t is unintentionally removed from the slit 22s due to the movement operation of the large-diameter shaft 41te and the small-diameter shaft 41td in the large-diameter slit 22sf along the longitudinal direction N. It can be surely prevented.

  In the first to fourth embodiments described above, the insertion device has been described using the endoscope 1 as an example. However, the insertion device is not limited to this, and the insertion device includes a treatment instrument insertion passage other than the endoscope. Needless to say, the present invention can also be applied to devices.

  In the first to fourth embodiments described above, the other end of the tube 21 is connected to the insertion port 10b. However, the present invention is not limited to this, and the tube 21 is fixed to the outer periphery of the insertion portion 2. Of course, the tube 21 may guide the treatment tool 31 to 34 directly into the subject.

1 ... Endoscope (insertion device)
DESCRIPTION OF SYMBOLS 2 ... Insertion part 2z ... The part located outside the subject of an insertion part 10 ... Treatment tool insertion path 20 ... Treatment tool insertion tool 21 ... Tube (treatment tool guide part)
22 ... Guide body 22m ... Groove (second engaging part)
22p: Insertion hole of guide body 22s: Slit (second engaging portion)
22s1 ... 1st slit 22s2 ... 2nd slit 22s3 ... 1st slit 31-34 ... Treatment tool 41-44 ... Slider (treatment tool operation part)
41g ... Outer surface of treatment instrument operation part 41t-44t ... Protrusion (first engaging part)
41td ... projection 50 ... film 50h ... hole N ... longitudinal direction

Claims (9)

A treatment instrument insertion tool that is attached to an insertion device that is inserted into a subject and that inserts a treatment tool for treating the subject into the subject,
A treatment instrument guide for guiding the treatment instrument into the subject;
When the insertion portion of the insertion device is inserted into the subject, the treatment device is detachable from a portion of the insertion portion located outside the subject and is provided on one end side of the treatment instrument guide portion. A guide part body serving as an insertion port for the treatment instrument to the guide part;
A treatment instrument operating section that is attached to the treatment instrument and is detachable from the guide body;
A treatment instrument insertion tool characterized by comprising:   The treatment instrument insertion tool according to claim 1, wherein the treatment tool operation parts respectively attached to the plurality of treatment instruments are selectively detachable with respect to the guide part main body.   The treatment instrument according to claim 1, wherein the treatment instrument operation unit is detachable from the treatment instrument and is detachable from the guide unit main body in a state of being attached to the treatment instrument. Insertion tool. A first engagement portion is provided on an outer surface of the treatment instrument operation portion;
The treatment instrument insertion tool according to claim 1, wherein a second engagement portion into which the first engagement portion can be fitted is provided in the guide portion main body. The first engagement portion is a protrusion provided on the outer surface of the treatment instrument operation portion,
The second engaging portion includes a first slit provided in the guide portion main body and extending along a longitudinal direction in which the treatment instrument guide portion guides the treatment instrument, and the first slit. The treatment instrument insertion tool according to claim 4, further comprising a second slit which is continuous and has an angle with respect to the longitudinal direction. The second engagement part is a slit provided in the guide part body and a plurality of grooves formed in the slit,
The first engagement portion is a protrusion that can be fitted into the slit provided on the outer surface of the treatment instrument operation portion and can be fitted into any one of the grooves. 5. A treatment instrument insertion tool according to 4. The second engagement portion is a slit provided in the guide portion main body,
The said 1st engaging part is a processus | protrusion provided in the said outer surface of the said treatment tool operation part which can be inserted in the said slit by at least one part elastically deforming. Treatment tool insertion tool. The treatment instrument guide portion is a tube whose other end is connected to the treatment instrument insertion path of the insertion device,
The treatment instrument insertion tool according to claim 1, wherein the tube guides the treatment instrument into the subject through the treatment instrument insertion passage.   A film that has a hole through which the treatment tool passes and that suppresses liquid from moving from the treatment tool guide portion to the guide portion body is provided inside the boundary between the treatment tool guide portion and the guide portion body. The treatment instrument insertion tool according to claim 1, wherein the treatment instrument insertion tool is provided.

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