JP3755605B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscope apparatus, and more particularly to an endoscope apparatus having an endoscope in which a balloon is attached to the distal end of an insertion portion and an insertion assisting tool for guiding the insertion portion of the endoscope into a body cavity.

  When inserting the insertion part of the endoscope into the deep digestive tract such as the small intestine, simply inserting the insertion part makes it difficult for force to be transmitted to the distal end of the insertion part due to the complicated bending of the intestinal tract. Have difficulty. Therefore, an insertion aid called an overtube or a sliding tube is attached to the insertion portion of the endoscope and inserted into the body cavity, and the insertion portion is guided by this insertion aid, so that the extra portion of the insertion portion is inserted. An endoscope apparatus that prevents bending and bending has been proposed (for example, Patent Document 1).

  As a conventional endoscope apparatus, there is known a double balloon type endoscope apparatus in which a balloon is provided at a distal end portion of an endoscope insertion portion and a balloon is provided at a distal end portion of an insertion assisting tool (for example, Patent Document 2 and Patent Document 3).

In the double balloon type endoscope apparatus, the insertion portion and the insertion assisting tool are inserted into the intestinal tract for a predetermined length, both the balloons are inflated, and both the balloons are brought into close contact with the intestinal wall. In some cases, the bent intestinal tract is contracted straight by pulling them together. Thereafter, by repeatedly performing the insertion operation of the insertion portion and the insertion aid and the hand pulling operation, the intestinal tract is pulled and the insertion portion is inserted into the target site. In addition, the hand pulling operation is performed by pulling the insertion assisting tool after the insertion assisting tool made of the elastic member is elastically deformed by gripping it with the hand of the operator and is brought into close contact with the insertion portion. At the same time, the insertion portion is tried to be pulled by frictional resistance generated between the insertion assisting tool and the insertion portion.
JP-A-10-248794 JP 2001-340462 A JP 2002-301019 A

  However, the conventional double-balloon type endoscope apparatus has a drawback that the insertion portion is slidable with respect to the insertion assisting tool at the time of the hand feeding operation described above, and the operability is poor.

  This invention is made | formed in view of such a situation, and it aims at providing the endoscope apparatus which can improve the operativity of the hand drag operation of an insertion part and an insertion auxiliary tool.

  In order to achieve the above object, the invention according to claim 1 is an endoscope in which a balloon is attached to a distal end portion of an insertion portion, and the insertion portion of the endoscope is inserted into a body cavity of the insertion portion. In an endoscope apparatus provided with an insertion assisting tool for assisting insertion into the inner peripheral surface of the insertion assisting tool, the inner peripheral surface of the insertion assisting tool is deformed by being pinched and deformed. It is characterized in that an engaging portion to be engaged with is formed.

  According to the first aspect of the present invention, when the insertion assisting tool is clamped and elastically deformed in the diameter-reducing direction, the insertion assisting tool is engaged with the outer peripheral surface of the insertion part, and the insertion assisting tool is relative to the insertion assisting tool. Since the engagement member for preventing slipping is formed on the inner peripheral surface of the insertion assisting tool, it is possible to prevent the insertion portion from slipping with respect to the insertion assisting tool at the time of hand feeding operation. Thereby, the operativity of the hand drag operation of an insertion part and an insertion auxiliary tool improves. Since the engaging member is engaged only when the insertion assisting tool is elastically deformed, the insertion assisting tool is not elastically deformed during the insertion / extraction operation of the insertion portion with respect to the insertion assisting tool. Therefore, the insertion / extraction operation is not adversely affected.

  According to the second aspect of the present invention, an engagement portion that is engaged with the engagement portion of the insertion assisting tool is formed on the outer peripheral surface of the insertion portion. By forming the engaged portion in the insertion portion in this way, slipping can be reliably prevented, and the operability is further improved.

  According to the endoscope apparatus according to the present invention, when the insertion assisting tool is clamped and elastically deformed, the engaging portion engaged with the outer peripheral surface of the insertion assisting tool is formed on the inner peripheral surface of the insertion assisting tool. Since it formed, it can prevent that an insertion part slips with respect to an insertion assistance tool at the time of a hand dragging operation, and this can improve the operativity of the hand dragging operation of an insertion part and an insertion assisting tool.

  Hereinafter, preferred embodiments of an endoscope apparatus according to the present invention will be described with reference to the accompanying drawings.

  FIG. 1 is a system configuration diagram of an endoscope apparatus according to an embodiment of the present invention. The endoscope apparatus shown in FIG. 1 includes an endoscope 10, an overtube (corresponding to an insertion assisting tool) 50, and a balloon control device 100.

  The endoscope 10 includes a hand operation unit 14 and an insertion unit 12 connected to the hand operation unit 14. A universal cable 15 is connected to the hand operation unit 14, and a connector (not shown) connected to a processor or a light source device (not shown) is provided at the tip of the universal cable 15.

  The hand operation unit 14 is provided with an air / water supply button 16, a suction button 18, and a shutter button 20 that are operated by an operator, and a pair of angle knobs 22, 22 and a forceps insertion unit 24 are respectively provided. It is provided in the position. Further, the hand operation unit 14 is provided with a balloon air supply port 26 for supplying air to the first balloon 30 and sucking air from the balloon 30.

  The insertion portion 12 includes a flexible portion 32, a bending portion 34, and a distal end hard portion 36. The bending portion 34 is configured by connecting a plurality of node rings so as to be able to bend, and is remotely operated by a turning operation of a pair of angle knobs 22, 22 provided on the hand operation portion 14. Thereby, the front end surface 37 of the front end portion 36 can be directed in a desired direction.

  As shown in FIG. 2, the distal end surface 37 of the distal end portion 36 is provided with an objective optical system 38, an illumination lens 40, an air / water feeding nozzle 42, a forceps port 44, and the like at predetermined positions. Further, an air supply / suction port 28 is opened on the outer peripheral surface of the distal end portion 36, and this air supply / suction port 28 is provided with an air supply tube (not shown) having an inner diameter of about 0.8 mm inserted through the insertion portion 12. 1 and communicates with the balloon air inlet 26 of FIG. Therefore, air is blown from the air supply / suction port 28 of the tip 36 by supplying air to the balloon supply port 26, and conversely, by sucking air from the balloon supply port 26, the air is sucked from the air supply / suction port 28. Air is aspirated.

  As shown in FIG. 1, a first balloon 30 made of an elastic material such as rubber is detachably attached to the distal end portion 36 of the insertion portion 12. As shown in FIG. 3, the first balloon 30 is formed of a central bulging portion 30c and attachment portions 30a and 30b at both ends thereof, and the air supply / suction port 28 is positioned inside the bulging portion 30c. It is attached to the tip 36 side. The attachment portions 30a and 30b are formed to have a diameter smaller than the diameter of the tip portion 36, and after being closely attached to the tip portion 36 with its elastic force, they are firmly fitted to the outer peripheral surface of the tip portion 36 by a ring-shaped band (not shown). Worn.

  In the first balloon 30 attached to the distal end portion 36, the bulging portion 30c is inflated into a substantially spherical shape by the air supplied from the air supply / suction port 28 shown in FIG. On the contrary, when air is sucked from the air supply / suction port 28, the bulging portion 30 c is contracted and brought into close contact with the outer peripheral surface of the distal end portion 36.

  The overtube 50 shown in FIG. 1 is formed of a tube main body 51 and a grip portion 52. The tube body 51 is formed in a cylindrical shape as shown in FIG. 4 and has an inner diameter slightly larger than the outer diameter of the insertion portion 12. The tube main body 51 is a molded product of flexible urethane resin, and the outer peripheral surface thereof is coated with a lubrication coat, and the inner peripheral surface is also coated with a lubrication coat. A soft grip 52 is fitted to the tube body 51 in a watertight manner, and the grip 52 is detachably connected to the tube body 51. The insertion portion 12 is inserted from the proximal end opening 52A of the grip portion 52 toward the tube main body 51.

  As shown in FIG. 1, a balloon air supply port 54 is provided on the proximal end side of the tube main body 51. An air supply tube 56 having an inner diameter of about 1 mm is connected to the balloon air supply port 54. This tube 56 is bonded to the outer peripheral surface of the tube body 51 and extends to the tip of the tube body 51 as shown in FIG. ing.

  The distal end portion 58 of the tube main body 51 is formed in a tapered shape to prevent the intestinal wall from being caught. A second balloon 60 made of an elastic material such as rubber is attached to the proximal end side of the distal end portion 58 of the tube main body 51. The second balloon 60 is mounted in a state where the tube main body 51 penetrates, and includes a central bulging portion 60c and attachment portions 60a and 60b at both ends thereof. The distal end side attachment portion 60a is folded inside the bulging portion 60c, and the folded attachment portion 60a is fixed to the tube main body 51 by winding the X-ray contrast yarn 62. The proximal-side attachment portion 60 b is disposed outside the second balloon 60, and is fixed to the tube body 51 by winding a thread 64.

  The bulging portion 60c is formed in a substantially spherical shape in a natural state (a state in which neither is inflated nor contracted), and its size is larger than a size in a natural state (a state in which neither is expanded nor contracted) of the first balloon 30. Largely formed. Therefore, when air is supplied to the first balloon 30 and the second balloon 60 at the same pressure, the outer diameter of the bulging portion 60c of the second balloon is larger than the outer diameter of the bulging portion 30c of the first balloon 30. . For example, the outer diameter of the second balloon 60 is configured to be φ50 mm when the outer diameter of the first balloon 30 is φ25 mm.

  The above-described tube 56 is opened inside the bulging portion 60c, and an air supply / suction port 57 is formed. Therefore, when air is supplied from the balloon air supply port 54, air is blown out from the air supply / suction port 57, and the bulging portion 60c is expanded. When air is sucked from the balloon air supply port 54, air is sucked from the air supply suction port 57, and the second balloon 60 is deflated.

  By the way, on the inner peripheral surface of the grip portion 52 of the overtube 50, a plurality of rows of engagement portions 80 having a triangular cross section, which is a non-slip member, are formed in a sawtooth shape (three rows in FIG. 4). As shown in FIG. 5, the engaging portion 80 is formed with a predetermined length in a direction orthogonal to the axial direction of the gripping portion 52, and the same applies to the surface facing the surface on which the engaging portion 80 is formed. A plurality of engaging portions 80 are formed in a sawtooth shape (three rows in FIG. 5).

  Further, at a predetermined position on the outer peripheral surface of the insertion portion 12, a plurality of engaged portions 82 having a triangular cross section as a non-slip member are formed in a sawtooth shape (four rows in FIG. 5). The engaged portion 82 is formed with a predetermined length in a direction orthogonal to the axial direction of the insertion portion 12, and is similarly engaged with a surface opposite to the surface on which the engaged portion 82 is formed. The joining portion 82 is formed in a plurality of rows (four rows in FIG. 5) in a sawtooth shape.

  As shown in FIG. 5, these engaged portions 82 are not engaged with the engaging portion 80 on the gripping portion 52 side when the gripping portion 52 is in a natural state (not elastically deformed). As shown in FIG. 4, when the gripping portion 52 is pinched in the direction indicated by the arrow and is elastically deformed in the diameter reducing direction, it engages with the engaging portion 80 on the gripping portion 52 side so as to be engaged as shown in FIG. The In other words, the diameter of the grip portion 52 and the height of the engaging portions 80 and 82 are made such that the grip portion 52 does not engage the engaging portions 80 and 82 in the natural state of FIG. The gripping part 52 is made of a soft material that engages the engaging part 80 with the engaged part 82 when elastically deformed.

  The engaged portion 82 may be formed continuously over the entire length of the insertion portion 12, or a plurality of rows may be formed as a set, and these groups may be formed at a predetermined interval. In this case, the engaged portion 82 formed at the forefront of the insertion portion 12 is a position where the balloon 30 does not contact the distal end portion 58 of the overtube 50 as shown in FIG. 4 when the engaging portion 80 is engaged. It is preferable from the viewpoint of preventing the balloon 30 from being damaged by the tip 58.

  On the other hand, the balloon control device 100 of FIG. 1 is a device that supplies and sucks fluid such as air to the first balloon 30 and supplies and sucks fluid such as air to the second balloon 60. The balloon control device 100 includes a device main body 102 having a pump, a sequencer, and the like (not shown) and a hand switch 104 for remote control.

  On the front panel of the apparatus main body 102, a power switch SW1, a stop switch SW2, a pressure gauge 106 for the first balloon 30 and a pressure gauge 108 for the second balloon 60 are provided. Further, a tube 110 that supplies and sucks air to the first balloon 30 and a tube 120 that supplies and sucks air to the second balloon 60 are attached to the front panel of the apparatus main body 102. Reservoir tanks 130 and 140 for collecting body fluids flowing back from the first balloon 30 and the second balloon 60 when the first balloon 30 and the second balloon 60 are broken are respectively provided in the middle of the tubes 110 and 120. Provided.

  On the other hand, the hand switch 104 holds the same stop switch SW3 as the stop switch SW2 on the apparatus main body 102 side, the ON / OFF switch SW4 for instructing the pressurization / decompression of the first balloon 30, and the pressure of the first balloon 30. There is provided a pause switch SW5, an ON / OFF switch SW6 for instructing pressurization / depressurization of the second balloon 60, and a pause switch SW7 for holding the pressure of the second balloon 60. The hand switch 104 is electrically connected to the apparatus main body 102 via a cable 150.

  The balloon control device 100 configured as described above supplies air to the first balloon 30 and the second balloon 60 to inflate them, and controls the air pressure to a constant value to control the first balloon 30 and the second balloon 60. Is held in an expanded state. In addition, air is sucked from the first balloon 30 and the second balloon 60 and contracted, and the air pressure is controlled to a constant value to hold the first balloon 30 and the second balloon 60 in a contracted state.

  Next, an operation method of the endoscope apparatus will be described with reference to FIGS.

  First, as illustrated in FIG. 7A, the insertion portion 12 is inserted into the intestinal tract (for example, the descending leg of the duodenum) 70 with the overtube 50 placed on the insertion portion 12. At this time, the first balloon 30 and the second balloon 60 are deflated.

  Next, as shown in FIG. 7B, the second balloon 60 is inflated by supplying air to the second balloon 60 with the distal end 58 of the overtube 50 inserted into the bent portion of the intestinal tract 70. As a result, the second balloon 60 is locked to the intestinal tract 70, and the tip 58 of the overtube 50 is fixed to the intestinal tract 70.

  Next, as shown in FIG. 7C, only the insertion part 12 of the endoscope 10 is inserted into the deep part of the intestinal tract 70. Then, as shown in FIG. 7D, air is supplied to the first balloon 30 to be inflated. Thereby, the first balloon 30 is fixed to the intestinal tract 70. At that time, since the first balloon 30 is smaller than the second balloon 60 when inflated, the burden on the intestinal tract 70 is small, and damage to the intestinal tract 70 can be prevented.

  Next, after air is sucked from the second balloon 60 to contract the second balloon 60, the overtube 50 is pushed in and inserted along the insertion portion 12 as shown in FIG. And after pushing the front-end | tip 58 of the overtube 50 to the 1st balloon 30 vicinity, as shown in FIG.7 (f), air is supplied to the 2nd balloon 60, and it is made to expand. Thereby, the second balloon 60 is fixed to the intestinal tract 70. That is, the intestinal tract 70 is grasped by the second balloon 60.

  Next, as shown in FIG.7 (g), the overtube 50 is drawn around. As a result, the intestinal tract 70 contracts substantially straight, and the excess bending or bending of the overtube 50 is eliminated.

  This operation is an operation of pulling the overtube 50 and the insertion portion 12 simultaneously. Immediately before this operation is performed, the operator grasps the grasping portion 52 as shown in FIG. 4 and moves the grasping portion 52 in the direction of the arrow in FIG. The holding portion 52 is elastically deformed in the reduced diameter direction to engage the engaging portion 80 on the grip portion 52 side with the engaged portion 82 on the insertion portion 12 side. In this engaged state, the overtube 50 is moved by hand. As a result, the insertion portion 12 is manually moved to the overtube 50 through the engagement portions 80 and 82 that are anti-slip members without slipping with respect to the overtube 50.

  Further, when the overtube 50 is pulled together, both the first balloon 30 and the second balloon 60 are locked to the intestinal tract 70, but the friction resistance of the first balloon 30 is higher than the friction resistance of the second balloon 60. Therefore, even if the first balloon 30 and the second balloon 60 move away from each other, the first balloon 30 having a small frictional resistance slides with respect to the intestinal tract 70. Therefore, the intestinal tract 70 is not pulled and damaged by both the balloons 30 and 60.

  Next, as shown in FIG. 7 (h), air is sucked from the first balloon 30 to contract the first tube 30. And the front-end | tip part 36 of the insertion part 12 is inserted in the deep part of the intestinal tract 70 as much as possible. That is, the insertion operation shown in FIG. Thereby, the front-end | tip part 36 of the insertion part 12 can be inserted in the deep part of the intestinal tract 70. FIG. When inserting the insertion portion 12 into a deeper portion, after performing a fixing operation as shown in FIG. 7D, a pushing operation as shown in FIG. ), A hand-drawing operation as shown in FIG. 7G, and an insertion operation as shown in FIG. Thereby, the insertion part 12 can be further inserted into the deep part of the intestinal tract 70.

  In the embodiment, the engaging portion 80 and the engaged portion 82, which are anti-slip members, are formed on both the overtube 50 and the insertion portion 12. However, it is necessary to form the engaging portion 80 or the engaged portion 82 in either one of them. When the frictional resistance can be obtained, it is only necessary to form a non-slip member on either one of them.

  In the embodiment, the overtube 50 having the balloon 60 at the distal end has been described as an insertion aid. However, the present invention is not limited to this, and a sliding tube (insertion aid without a balloon) used for a colonoscope is used. The anti-slip member of the embodiment may be provided in the tool.

System configuration diagram of an endoscope apparatus according to an embodiment of the present invention The perspective view which shows the front-end | tip part of the insertion part of an endoscope The perspective view which shows the front-end | tip hard part of the insertion part equipped with the 1st balloon. Side sectional view of the overtube with the insertion section inserted Main part explanatory drawing in which anti-slip members are formed on both the overtube and the insertion part Main part explanatory drawing which showed the state which both anti-slip members engaged Explanatory drawing which shows the operation method of the endoscope apparatus shown in FIG.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 26 ... Balloon air supply port, 28 ... Air supply suction port, 30 ... 1st balloon, 36 ... Tip part, 50 ... Over tube, 51 ... Tube Main body, 52 ... gripping part, 58 ... tip part, 60 ... second balloon, 80 ... engaging part, 82 ... engaged part, 100 ... balloon control device, 102 ... apparatus main body, 104 ... hand switch

Claims (2)

An endoscope apparatus comprising: an endoscope in which a balloon is attached to a distal end portion of an insertion portion; and an insertion assisting tool that inserts the insertion portion of the endoscope and assists insertion of the insertion portion into a body cavity. In
An inner peripheral surface of the insertion assisting tool is formed with an engaging portion that is engaged with the outer peripheral surface of the insertion part when the insertion assisting tool is pressed and deformed. Endoscopic device.   The endoscope apparatus according to claim 1, wherein an engaged portion that is engaged with the engaging portion of the insertion assisting tool is formed on an outer peripheral surface of the insertion portion.

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