JP3466012B2 - Endoscope - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention adjusts the flexibility of an insertion portion.
The present invention relates to an endoscope that can be adjusted. 2. Description of the Related Art Conventionally, for example, in an endoscope used for the large intestine,
Push the insertion part into a meandering place like the sigmoid colon
Insert in such a case.
However, those that are relatively soft are suitable. But soft
If it is an insertion part, try to go deeper than the sigmoid colon
Then, the insertion part bends in the middle, and from the hand
If the pushing force is difficult to transmit to the tip of the insertion section
There was a drawback. [0003] Therefore, when the sigmoid colon is crossed, treatment with an endoscope is performed.
In the tool insertion channel, a stainless steel called a stylet
Wire with a long waist made of wire, etc.
To the deeper part by hardening the insertion part
Attempts to insert were sometimes made. [0004] (Problems of the Related Art) [0004] However, a treatment tool insertion chamber for an endoscope
In the method of putting a separate stylet in the channel, the following
There were such drawbacks. (1) Suction performed through a treatment tool insertion channel
Intestinal water cannot be removed quickly because
Long entry time. (2) Attach a separate stylet to the endoscope insertion channel.
The removal work is troublesome and the handling is complicated. (3) Stylets also need to be cleaned and disinfected for each inspection.
Time and effort in the work and management,
Handling is complicated. (Object of the Invention) The object of the present invention is to
Without reducing the suction function performed through the communication channel,
Easy handling and endoscope with flexible insertion section
To provide a mirror. According to the present invention, there is provided a flexible member.
An endoscope having an inserted portion and an operating portion,
Accommodates an elongated hard member inside the
Operate the means to move the member axially in the insertion section
Section. By doing so, the tip of the stylet
Harden or soften the insertion area in the moving range
Can be The stylet is stored inside the endoscope
The need for removal and cleaning, and disinfection
You. <First Embodiment> Referring to FIGS. 1 and 2, a first embodiment of the present invention will be described.
One embodiment will be described. (Configuration) FIG. 1A shows an endoscope 1 and the endoscope 1 is inserted.
Mainly unit 2, operation unit 3, and universal cord 4
It is configured. The insertion part 2 has a tip part 5, a curved part 6, softness
The parts 7 are arranged in a line from the tip in that order.
An observation window with an objective lens built in the tip 5
An image sensor device for imaging a visual field observed through a window;
There is a bright window, channel opening, nozzle for the observation window, etc.
However, it is omitted here and not shown. Bending part 6
Is a bending operation by an operation knob (not shown) provided on the operation unit 3.
The bending operation is performed via the operation wire. Is flexible part 7 a flexible tube?
It has a relatively flexible configuration. In the insertion portion 2, a lamp connected to the illumination window is provided.
Light guide, imaging signal connected to the image sensor device
Line, treatment instrument channel connected to said channel opening
Tube, air supply / water supply tube connected to the nozzle
, The built-in objects such as the bending operation wire are arranged,
Here, it is omitted and not shown. On the other hand, a conduit 8a is formed in the flexible portion 7.
A first guide tube 8 is disposed. First
The tip side of the guide tube 8 is on the way near the tip of the flexible portion 7
It extends to the free state. The first
Connect the distal end of the guide tube 8 to the bending section 6 and the flexible section 7
May be fixed to the main member of the insertion section 2 in the vicinity of the section.
No. The distal end of the first guide tube 8 is connected to the sealing member 10.
Sealed. The proximal end side of the first guide tube 8 is
It is led into the operation unit 3. Of the first guide tube 8
A second side having a pipe 9a further rearward than the proximal end
Are connected. 1st guide
The tube 8 and the second guide tube 9 are each a flexible tube.
Is formed. The rear end of the first guide tube 8 and the second
The distal end of the guide tube 9 is open at both of the conduits 8a, 9a.
Each end is operated with the mouths coaxially arranged
It is attached and fixed to the support frame member 11 of the part 3. No.
The rear end portion of the guide tube 9 at hand is
It is guided and arranged in the monkey cord 4. The rear end of the first guide tube 8 and the second
A space 12 is formed between the distal end of the
In this space 12, stylet moving means is provided.
Is placed. The stylet moving means is a first guide
Penetrated through the tube 8 and the second guide tube 9
Transfer rollers 1 sandwiching the stylet 13
4 are provided. Fewer two transfer rollers 14
One is rotated by a motor 15
You. The motor 15 is connected to a control device via an electric wire 16.
17. This control device 17
The endoscope may be provided at the distal end of the
In addition to 1, for example, it is incorporated in a light source device (not shown).
It may be provided or may be provided separately and separately.
Also, a switch 18 for controlling the motor 15 is operated by an operation unit.
3. This switch 18 connects an electric wire 19
The control device 17 is connected to the control device 17 via the control unit 17. The switch 18 is, for example, as shown in FIG.
It is a seesaw shape, and press the mountain above (in front of)
The roller 14 rotates in the direction in which the stylet 13 advances.
The motor 15 can be driven to push the lower (rear) mountain
In this case, the roller 14 moves in the direction of retracting the stylet 13.
The motor 15 can be driven to rotate. Of course, the switch 18 is not a seesaw type
Alternatively, separate switches may be used for forward and reverse.
The driving style of the motor 15 for driving the roller 14 is electric.
Magnetic, piezoelectric, or whatever
An actuator may be used. The outermost circumference of roller 15 is shown
As shown in black in (a), a rubber-based resin
Treated to minimize lips. The stylet 13 has rigidity in the insertion portion 2.
It is a hard member to be applied. And the stylet
13 is a tip portion (for example, 5 cm) as shown in FIG.
About) the flexible part 21 and the part closer to it (for example,
About 75cm) to the hard part 22, and further to the hand side
The minute (for example, about 55 cm) is composed of the rear soft part 23.
I have. Of course, the length of each part is
There are various patterns depending on the specifications of the mirror 1. The flexible portion 21 and the flexible portion 23 are, for example,
It is made of oil pipe and is softer than the hard part 22
No. The hard portion 22 is made of stainless steel, brass, aluminum or the like.
Solid line or pipe made of metal such as metal, titanium, super elastic alloy, etc.
And its outer diameter is about 0.5-2 mm. Also,
Although it may be resin, super-elastic alloys are not easily plastically deformed
Therefore, it is hard to bend and is very desirable. In addition, in the case of resin, the same rigidity is obtained.
Tend to be larger in diameter than metals. Hard part 22 and after
The outer diameters of the flexible portions 23 are substantially the same, and
It is possible to go in and out while rare. The tip of the flexible portion 21
The rear end of the rear flexible portion 23 is connected to the conduit 8 of the first guide tube 8.
a and the inner surface of the conduit 9a of the second guide tube 9
Finished by providing a round, for example, spherical tip 24
There is. The distal end of the conduit 8a of the first guide tube 8
Since the opening is sealed by the sealing member 10,
That the tip of the let 13 moves further forward
Regulating. Similarly, the conduit 9 of the second guide tube 9
a rear end opening is not shown, but it is closed
Restricts further movement of the back of the inlet 13
You. The style in the position shown in FIG.
FIG. 1 shows a case in which
The stylet 13 at the position shown in FIG.
Shows the case where it is moved to. Second guide tube
Where 9 moves from the operation unit 3 to the universal cord 4
Form a relatively steep curve 26. Therefore, FIG.
In the stylet 13 (the rearmost position) in FIG.
The rear end of the sex part 22 is not shown, but before the curve 26.
It is located so that the uni
The rear flexible portion 23 is accommodated in the portion of the versal cord 4.
You. This makes it possible to move within the curve 26.
Is the second flexible portion 23 of the stylet 13, so the second guide
The pipe line 9a of the tube 9 is not damaged. Rice cake
This is only an example, and the sealing member 10 is
If it is near the connecting part of the flexible part 7, it is flexible from the tip of the soft part 7.
Can be varied, and various other patterns
Can be considered. The flexible portion 21 is also provided in front of the rigid portion 22.
The flexible part 7 of the insertion part 2 is bent to some extent
When the stylet 13 is moved at the time of
Does not hurt. Further, also in the hard part 22, in the longitudinal direction,
Do not make the front side slightly softer than the back side
However, there may be a change in hardness
Me. There are also user preferences. ). The first guide tube 8 is not provided.
Both have the basic function of moving the stylet 13
However, the moving stylet 13 is
In the flexible tube 7a, which damages the storage or the cylindrical body of the flexible portion 7,
In order not to catch on the surface, the guide tube 8
Something is desirable. Also, the tip of the first guide tube 8
It is desirable that the end does not extend into the curved portion 6. At least
It is preferable that the connecting portion between the curved portion 6 and the cylindrical body 6a be as small as possible. In general, the endoscope 1 has a curved portion rather than the flexible portion 7.
Because the space inside 6 is narrow, the first
When the guide tube 8 is inserted into the curved portion 6, the diameter becomes large.
Design. Also, the hard portion 2 of the stylet 13
2 is bent with a small bending radius in the bending section 6
When this is done, the rigid part 22 strongly presses other built-in components and damages them.
There is a risk of damaging or damaging the curved portion 6 itself. Is
Therefore, the rigid portion 22 of the stylet 13 is particularly
Should be able to move only to the near side
You. (Operation) By pressing the switch 18, the mode
By driving the roller 15 and turning the roller 14, the stylet 1
3 can be moved back and forth in the axial direction. Switch 18
The finger of the hand holding the operation unit 3 is located at a position where it can be easily reached.
The switch 18 can be easily operated with one hand. At the position of the stylet 13 in FIG.
Is the tip of the stylet 13 from the tip of the tip 5
It is assumed that it is about 75 cm, and as shown in FIG.
The tip of the stylet 13 at that time is the tip
Assuming that the position is about 20 cm from the tip surface of the part 5, the movement amount
d is about 55cm. Stylet 13
Assuming that the flexible portion 21 is about 5 cm,
Flexible part 7 from 25cm to 80cm from the tip of mirror 1
Is a variable flexibility. However, the second guide tube 9 (especially
If the hard tube is made of a hard tube, the hard portion 22
Since it is put in the monkey cord 4, the tip of the rigid portion 22
It can be completely stored in the operation unit 3, and the total length of the flexible unit 7 is extremely large.
Can be soft. Next, the endoscope 1 is inserted into the large intestine 31 with reference to FIG.
An example of a procedure to be inserted will be described. First, stylet 13
Is the most rearward with respect to the endoscope 1 as shown in FIG.
Keep it in the position. Soft except for stylet 13
The sex part 7 has very flexible flexibility. Stylet
The tip of the rigid portion 22 of the end 13 is 80 cm from the end of the endoscope 1.
The insertion part 2 is 80cm from the tip
It is very soft now, and the hand side is considerably more
It is hard. As shown in FIG. 2A, the sigmoid colon 32 of the large intestine
Is winding, but the insertion part 2 is 80cm from the tip
Very soft, so insert it along its curved shape.
If you push the entrance 2 slowly, there will be no pain for the patient
It is possible to easily cross the sigmoid colon 32. In this manner, the distal end of the insertion portion 2 is
Inserted into the body to reach around the splenic curvature 34 beyond 32
The amount applied is usually less than 70 cm. Therefore, the style
The rearmost position of the rigid portion 22 of the kit 13 is appropriate. Next, from the state of FIG.
When the insertion portion 2 is pulled so that the end does not come off, FIG.
And the insertion portion 2 becomes substantially straight,
The sigmoid colon 32 is also folded, almost straight
Be in a state. Here, press the switch 18 and press the stylet
13 is moved to the distal end side (the state of FIG. 1B). So
Then, the insertion part 2 is about 1cm from 25cm from the tip
The soft portion 7 becomes hard (the hard portion 22 is 75
cm). As a result, the sigmoid colon 32
And the bending of the transverse colon 35
Without losing (the hard part 22 is not only hard,
Is highly resilient to return immediately
It can be inserted while releasing the deflection), transverse colon 35, liver
2, over the bend 37, over the ascending colon 36 to the cecum 38.
Insert easily and quickly while drawing a loose curve as shown in (c)
Can be At this time, the amount inserted into the body
Since it is usually 80 cm or less from the tip, the above-described hard portion 22
The length of is considered reasonable. As described above, the stylet 13 is completely
Since it is housed inside the endoscope 1 and is built in,
Through the treatment instrument insertion channel to change the flexibility of the
There is no need to insert a stylet. Therefore, treatment
Sacrifice the suction function through the tool insertion channel.
And not. The stylet 13 is placed inside the endoscope 1.
It is stored and clean, so only the endoscope 1 is cleaned after inspection.
You only have to disinfect. (Effect) Through the tube for the treatment instrument channel
Easy handling without sacrificing the original suction function
By changing the flexibility of the insertion section, the insertability of the endoscope 1 can be improved.
Wear. <Second Embodiment> Referring to FIG.
A second embodiment will be described. (Configuration) This embodiment is basically similar to the above-described embodiment.
Almost the same, but different here. sand
That is, the movement of the stylet 13 is not electric, but manually.
It is something that can be done. Operation knob 41 on operation unit 3
So that the operation knob 41 drives the roller 14.
It has become. In the present embodiment, the stylet of the operation unit 3
A transparent window 42 is provided in a part of
The stylet 13 is visible from the outside
You. Stylet 13 is color-coded in its axial direction.
Or with a scale. (Function) Rotating the operation knob 41
Then, the stylet 13 can be moved forward and backward. The embodiment
It is better to operate the switch 18 electrically as in
The operation itself is easy because it is performed with the switch, but as in this embodiment
By manually setting the motor 15, switch 18,
The endoscope 1 and the endoscope 1
The system configuration can be simplified. Further, the stylet 1 is transmitted through the transparent window 42.
By looking at the color and scale of 3, the axis of the stylet 13
Direction, that is, where the insertion section 2 is hard
Can be recognized. The transparent window 42 is a casing of the operation unit 3
May be adhered to
May be integrally formed by a two-color molding method or the like. (Effects) The endoscope 1 and the
The system can be simple. Also, the insertion section 2
Is visible. <Third Embodiment> Referring to FIG.
The third embodiment will be described. (Structure) FIG. 4 shows a universe in the endoscope of this embodiment.
The connector 45 provided at the rear end of the monkey 4
Show. The basic configuration of the endoscope 1 is the first embodiment described above.
And the same as those of the second embodiment. Here, the second gas
Id tube 9 and a style inserted through its conduit 9a
Of the flexible part 23 to the connector 45
Prolonged. The connector 45 has the second guide tube.
Mounted on the opening of the hole 46 communicating with the conduit 9a of the valve 9
A cap 47 is provided. Cap 47 is a seal
Watertightly attached and detachable with ring 48
So that it is usually screwed. In the cap 47
The rear end of the stylet 13
Is to be delivered. The stylet 13 of FIG.
The position is closest when the stylet 13 is at the rearmost position.
It is a place. The connector 45 is connected to a light guide.
A light guide tube 49 is provided. (Function) Rear hard part 23 of stylet 13
The hardness varies depending on the user. Also, the same
Bend while using tilet 13 for many inspections
Habits can follow. At such time, the cap 47 is removed and
Pull out the stylet 13 and select your favorite stylet 13
Or replace it with a new stylet 13
Easy to do. Note that the stylet 13 is connected to the connector 45.
For those made, the row shown in the first embodiment is used.
The motor 14 and the motor 15 are provided in the connector 45,
May be moved, and the operation unit 3 may be moved from the first embodiment.
Can be lightened. (Effect) According to this embodiment, the style
Unit 13 can be easily replaced, and the user's preferences and changes over time
Can respond to. <Fourth Embodiment> Referring to FIG.
A fourth embodiment will be described. (Configuration) The basic principle of this embodiment is also the first and second embodiments.
Is the same as However, in the present embodiment, the stylet 1
3 is not inside the universal cord 4.
No. When the stylet 13 is located at the rearmost position,
Of the stylet 13 near the rear end of the operation unit 3
Opening 5 provided at the rear end of the operation unit 3
Located within 1. A rubber cap 52 is made of water in the opening 51.
Closely attached. Rubber cap 52 is quite strong
It is attached so that it will not come out unless you pull it out with force
You. And usually, the rear end of the stylet 13 is rubber
It is inserted into the cap 52. As in the case of the second embodiment, the operation
Turn the operation knob 41 provided in the section 3 to turn the stylet 13
It can be moved forward and backward manually. (Operation) As in the case of the second embodiment, the operation knob 41 is
The stylet 13 can be moved by turning it.
The rear part of the stylet 13 is a universal cord
Since it is not in 4, the movement amount is generally small
You. However, when the rubber cap 52 is removed, the stylet
12 can be easily removed and replaced. From the fourth embodiment
However, since the overall length of the stylet 12 is short, no replacement work is required.
Cheap. In addition, stylet in universal cord 4
13 and its guide tube are not included.
The versal code 4 can be thinned. (Effect) According to this embodiment, the style
The replacement work of the unit 13 is easy and the universal cord 4
Can be made thinner. In the present embodiment, the rear end of the stylet 13
The part is not inside the universal cord 4. Follow
Thus, the stylet 13 may be the hard portion 22 to the rear. <Fifth Embodiment> Referring to FIG.
A fifth embodiment will be described. (Configuration) In the present embodiment, the endoscope described above is used.
A specific example of the soft part is shown. Figure 6 shows the crossing of the soft part
FIG. The tubular body 55 constituting the exterior of the flexible portion is an outer layer
56 and an inner layer 57. The outer layer 56 is further divided into a plurality of layers.
The outermost layer is made of resin (including surface coating)
The braided tube on which it is placed
Tube made of stainless steel or other fine wire)
Have been. The inner layer 57 may be a single layer or a plurality of layers.
It consists of a spiral tube of stainless steel or other metal. Of the inner layer 57
A groove 58 is formed partially along the axial direction. This
The lumen 59 formed between the groove 58 and the outer layer 56 is utilized.
To guide the stylet 13 as described above.
I'm trying. Here, the gas described above is placed in the lumen 59.
The guide tube 8 is installed, and inside this guide tube 8
The stylet 13 is inserted and stored in the insertion section 2.
You. The groove 58 forms a gap between the outer layer 56 and the outer layer 56.
Since the lumen 59 is formed, the guide 59 is not necessarily a separate member.
Do not need the tube 8
Since the stylet 13 can move smoothly,
No. In the tubular portion 55 of the flexible portion, there is another built-in member.
Treatment instrument channel tube 61, air supply tube 6
2. Water supply pipe tube 63, light guide 64, image signal
No. 65 and angle wire / coil 66
You. (Function) The rigid portion 22 of the stylet 13
If the flexible portion 7 is in the flexible portion 7 of the insertion portion 2, the flexible portion 7 is bent.
When the rigid part 22 presses other built-in parts when
May damage the light guide 64, for example.
However, in this embodiment, the groove 58 of the inner layer 57
Since the tilet 13 is separated from other internal components,
You can not press on the built-in. (Effect) The stylet 13 is placed in the soft portion 7.
Even if there is a rigid portion 22, it damages other internal components
do not do. <Sixth Embodiment> This embodiment has been described so far.
In the embodiment described above, the stylet 12 is moved.
It is a modification of the moving force amount of the means. Predetermined amount of force for moving stylet 13
An example in which the power is set to is described. As described in FIG.
Basically moving the stylet 13 from back to front.
Is when the flexible part 7 is in a state close to a straight state.
You. However, by mistake, the flexible part 7 has a steep loop
When the stylet 13 is forcibly advanced in the state of
Buckling of the guide tube 8 or conduit 8a of
The steep loop has increased rigidity with the stylet 13.
The tip 5 is jumped up due to sudden release, and the living body wall
May be damaged. Therefore, as in the first embodiment, the motor 15
When moving the stylet 13 with the
The power to be applied is set to a predetermined power. For example, the soft part
Pipeline when 7 is looping smaller than the specified bending radius
8a and stylet 13
What is necessary is just to make it smaller. Alternatively, as in the second embodiment, the operation
When turning the roller 41 and the roller 14,
When the frictional force of the burette 13 is such that the soft part 7
When looping, between line 8a and stylet 13
It should be smaller than the generated frictional resistance. That is,
Try to slip. The amount of force to move the stylet 13
May be set as follows. It is stylet 13
The leading or trailing end of the pipe 8a abuts the leading end of the conduit 8a, or
Rear end of conduit 9a (or rear end wall of caps 47, 52)
When hitting the butt, the butt was broken
The pipes 8a and 9a are plastically deformed by applying a large tension.
Generation of the motor 15 so that the
Set the amount of force and the frictional force between the roller 14 and the stylet 13
I do. (Effect) The part accompanying the movement of the stylet 13
It prevents damage to products and living body walls. [Supplementary notes] (1) For an endoscope having an insertion section provided with a flexible section and an operation section
In the above, an elongated hard member is housed inside the soft part.
At the same time, the rigid member is moved in the axial direction of the insertion portion.
An endoscope wherein means is provided in an operation unit. (2) In the above (1), a tip portion or a rear portion of the hard member.
At least one of the ends is a soft part. (3) In the above (1), the rigid member is a bay.
It is close to the music. (4) In the above (1), the rigid member is replaceable.
You. (5) In the above (4), the replacement of the hard member is performed by using a universal member.
This is performed at the connector at the end of the monkey cord. (6) In the above (4), the replacement of the rigid member is performed after the operation section.
Perform at the edge. (7) In the above (1), the hard portion in the soft portion
The flexible member is in a conduit provided in the flexible part, and the conduit is inserted.
Formed by a guide tube inserted into the inlet,
Or, it is formed on the outer cylindrical member of the insertion portion. (8) In the above (7), the end of the pipeline is closed.
I am (9) In (7) above, the end of the pipe is closer to the curved part than the curved part.
On the side. (10) In the above (1), the hand side of the rigid member is
It is in the versal code. (11) In the above (10), the hand side of the rigid member is
It is in a pipeline provided in the universal cord. (12) In the above (11), the rear end of the pipeline is closed.
You. (13) In the above (1), the moving means is an electric motor.
It depends on the drive mechanism and the switches that control it. (14) In the above (13), the electric drive mechanism is an operation unit.
Is within. (15) In the above (13), electric drive
The mechanism is in the connector. (16) In the above (1), the means for moving is manual.
Depends on the operation knob. (17) In (1) above, the position of the rigid member is visually approved.
Functioned. (18) In (17) above, the visual recognition is provided on the operation unit.
Depends on the transparent window and the display on the stylet. (19) In the above (1), the hard member is a hard part outer wall.
Housed inside. (20) In the above (19), the hard member is outside the soft part.
It was installed in a pipe housed in a wall. (21) In the above (1), the rigid member is
The moving force was set to a predetermined force or less. (22) In the above (21), the predetermined amount of force is
When the rigid member moves in a predetermined loop shape,
Is the frictional resistance experienced by (23) In the above (21), the predetermined force is a rigid part.
Break other members when the material moves to the front or the rear
Competence. (24) In the above (21), the setting is such that the hard member is
This is because the driving force for dynamic driving is determined. (25) In the above (21), the setting is
Determine the frictional force between the contact part that sends the hard member and the hard member.
According to. (26) In the above (1), the hard member is a superelastic alloy.
Formed. (27) In the above (1), the rigid member is located rearmost.
When the rigid member tip is closer than 70 cm from the endoscope tip
On the side. (28) In the above (1), the rigid member is located at the frontmost position.
When the hard member is at the rear end, it is closer than 80 cm from the endoscope end.
On the side. As described above, according to the present invention, the absorption
Easy handling without dropping the pulling function
By changing the flexibility, the insertability of the endoscope can be improved.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an explanatory diagram of an endoscope according to a first embodiment. FIG. 2 is an explanatory view of the use of the endoscope. FIG. 3 is an explanatory diagram of an operation unit of an endoscope according to a second embodiment. FIG. 4 is an explanatory diagram of a connector section of an endoscope according to a third embodiment. FIG. 5 is an explanatory diagram of an operation unit of an endoscope according to a fourth embodiment. FIG. 6 is a cross-sectional view of a flexible portion of the endoscope. [Description of Signs] 1 endoscope 2 insertion section 3 operation section 4 universal cord 5 distal end section 6 bending section 7 flexible section 8 first guide tube 8a pipe line 9 second Guide tube 9a ... Pipe line 12 ... Space 13 ... Stylet 14 ... Transfer roller 15 ... Motor 16 ... Electric wire 17 ... Control device 18 ... Switch 41 ... Operation knob 47 ... Cap 52 ... Cap 55 ... Cylindrical body 58 ... Groove 59 ... lumen

Continuation of front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61B 1/00-1/32

Claims (1)

(57) An endoscope having an insertion portion provided with a flexible portion and an operation portion, wherein an elongated hard member is housed inside the endoscope and the hard member is provided. An endoscope, wherein means for moving the member in the insertion section in the axial direction is provided in the operation section.