JP3787724B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscope apparatus, and more particularly to an endoscope apparatus that inserts an insertion portion of an endoscope into a body cavity using an insertion assisting tool.

  When inserting the insertion part of the endoscope into the deep digestive tract such as the small intestine, simply pushing 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. For example, if excessive bending or bending occurs in the insertion portion, the insertion portion cannot be inserted further deeper. Therefore, a method for preventing excessive bending and bending of the insertion portion by covering the insertion portion of the endoscope with an insertion aid such as a sliding tube and inserting it into the body cavity and guiding the insertion portion with this insertion aid. Has been proposed.

Patent Document 1 describes an endoscope apparatus in which a sheath is put on an insertion portion of an endoscope and a balloon is provided at a distal end portion of the sheath. According to this endoscope apparatus, the sheath is fixed in the body cavity by inflating the balloon. Therefore, the insertion portion can be fixed in the body cavity via the sheath.
JP 2003-144378 A

  However, Patent Document 1 has a problem in that the insertion portion cannot be inserted into and removed from the sheath because the sheath is fixed to the insertion portion. Therefore, there is a problem that it is not easy to pull out only the insertion portion of the endoscope while the sheath is inserted into the body cavity.

  In addition, Patent Document 1 has a problem in that since the sheath is covered on the entire insertion portion of the endoscope, when the bending portion is bent, the sheath becomes a resistance and the bending operability is lowered. .

  The present invention has been made in view of such circumstances. An endoscope that can fix and insert / remove an insertion portion of an endoscope to / from an insertion assisting tool as necessary, and has excellent bending operability. An object is to provide an apparatus.

  In order to achieve the above object, the invention according to claim 1 includes an endoscope having a bending portion in an insertion portion provided continuously with a hand operation portion, and a cylindrical insertion assisting tool that covers the insertion portion. In the endoscope apparatus provided, a first balloon is attached to the insertion portion closer to the hand operation portion than the bending portion, and the insertion portion is expanded by inflating the first balloon in the insertion aid. Is fixed to the insertion aid, and the first balloon is contracted to allow the insertion portion to be inserted into and removed from the insertion aid, and a second balloon is attached to the distal end portion of the insertion aid. The distal end portion of the insertion assisting tool is fixed in the body cavity by inflating the second balloon.

  According to the first aspect of the present invention, the insertion portion is fixed to the insertion aid by inflating the first balloon in the insertion aid, and the insertion portion can be inserted into and removed from the insertion aid by contracting the first balloon. Therefore, the insertion portion can be fixed to the insertion aid or inserted / removed as necessary. Therefore, the insertion part is fixed to the insertion assisting tool for observation and various treatments, or the insertion assisting tool is left in the body cavity and only the insertion part is pulled out to insert another treatment tool into the insertion assisting tool. Can be used and is very convenient.

  According to the first aspect of the invention, the insertion portion is fixed to the insertion aid by inflating the first balloon, and the insertion aid is secured in the body cavity by inflating the second balloon. The part can be firmly fixed in the body cavity via the insertion aid.

  Further, according to the first aspect of the invention, since the first balloon is arranged closer to the hand operating portion than the bending portion of the insertion portion, the insertion portion is inserted into the insertion portion with the bending portion protruding from the insertion assisting tool. Can be fixed to the tool. Therefore, it can prevent that a bending part contacts an insertion auxiliary tool at the time of bending operation, and can improve bending operativity.

  According to the endoscope apparatus according to the present invention, the first balloon for fixing the insertion portion to the insertion assisting tool is attached to the insertion portion, so that the insertion portion can be inserted and aided by inflating or deflating the first balloon. It can be fixed to the tool or inserted / removed. According to the present invention, since the second balloon for fixing the insertion aid in the body cavity is attached to the insertion aid, the insertion portion is inserted into the insertion aid by inflating the first balloon and the second balloon. Can be firmly fixed in the body cavity. Furthermore, according to the present invention, since the first balloon is provided closer to the hand operating portion than the bending portion of the insertion portion, it is possible to improve the bending operability when the insertion portion is fixed to the insertion aid.

  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 the present invention.

  As shown in FIG. 1, the endoscope apparatus according to the present invention mainly includes an endoscope 10, a light source device 20, a processor 30, and an insertion assisting tool 70.

  The endoscope 10 includes an insertion portion 12 that is inserted into a body cavity, and a hand operation portion 14 that is connected to the insertion portion 12, and a universal cable 16 is connected to the hand operation portion 14. An LG connector 18 is provided at the tip of the universal cable 16, and the LG connector 18 is connected to the light source device 20. In addition, an electrical connector 24 is connected to the LG connector 18 via a cable 22, and the electrical connector 24 is coupled to the processor 30. The LG connector 18 is connected to an air / water supply tube 26 that supplies air and water, and a suction tube 28 that sucks air.

  The hand operation unit 14 is provided with an air / water supply button 32, a suction button 34, and a shutter button 36, and a pair of angle knobs 38 and 38 and a forceps insertion unit 40. Further, the hand operation unit 14 is provided with a supply / suction port 44 for supplying a fluid to a first balloon 42 to be described later and for sucking a fluid from the first balloon 42. Hereinafter, although an example using air as a fluid will be described, other fluids such as an inert gas or water may be used.

  The insertion portion 12 includes a distal end portion 46, a bending portion 48, and a flexible portion 50. The bending portion 48 is remotely controlled by rotating a pair of angle knobs 38, 38 provided on the hand operating portion 14. Bending operation. Thereby, the front end surface 47 of the front end portion 46 can be directed in a desired direction.

  As shown in FIG. 2, an observation optical system 52, illumination optical systems 54 and 54, an air / water supply nozzle 56, a forceps port 58, and the like are provided on the distal end surface 47 of the distal end portion 46. A CCD (not shown) is disposed behind the observation optical system 52, and a signal cable (not shown) is connected to a substrate that supports the CCD. The signal cable is inserted into the insertion portion 12, the hand operating portion 14, and the universal cable 16 of FIG. 1, extends to the LG connector 18, and is connected to the processor 30. Therefore, the observation image captured by the observation optical system 52 is formed on the light receiving surface of the CCD and converted into an electric signal, and this electric signal is output to the processor 30 via the signal cable and converted into a video signal. Is done. As a result, the observation image is displayed on the monitor 60 connected to the processor 30.

  As shown in FIG. 2, a first balloon 42 made of an elastic body such as rubber is detachably attached to the flexible portion 50 immediately on the proximal end side of the bending portion 48. The first balloon 42 is formed in a cylindrical shape with both ends narrowed, and both ends of the first balloon 42 are fixed to the flexible portion 50 in a state where the insertion portion 12 is inserted through the first balloon 42. It is attached by. A method for fixing both ends of the first balloon 42 is performed, for example, by winding a thread (not shown) around both ends of the first balloon 42 and bringing the first balloon 42 into close contact with the outer peripheral surface of the flexible portion 50 over the entire circumference. Is called. Instead of winding the thread, a fixing ring (not shown) may be fixed by fitting the both ends of the first balloon 42.

  A vent hole 62 is formed on the outer peripheral surface of the flexible portion 50 at the position of the first balloon 42. The vent 62 communicates with the supply / suction port 44 via a tube (not shown) inserted into the insertion portion 12 of FIG. A tube 64 is connected to the supply / suction port 44, and this tube 64 is connected to an air pressure control unit 66. The air pressure control unit 66 supplies air to the tube 64 or sucks air from the tube 64 and controls the air pressure at that time, and operates an operation button 68 provided on the front surface. It is operated by doing. Accordingly, by operating the air pressure control unit 66, air can be supplied to the first balloon 42 via the tube 64, or air can be sucked from the first balloon 42 via the tube 64. The first balloon 42 is fixed to the intestinal tract in the body cavity by inflating outside the insertion assisting tool 70, and is fixed to the insertion assisting tool 70 by inflating inside the insertion assisting tool 70. Yes. Further, the first balloon 42 is contracted by sucking air so as to stick to the outer peripheral surface of the soft portion 50, whereby the soft portion 50 can be inserted into the insertion assisting tool 70.

  On the other hand, the insertion assisting tool 70 is configured by covering the outer side of a resin tube made of urethane or the like with a chemical-resistant coat and protecting the inner side with a lubricating coat, and exerts a restoring force when an external force is applied from the outer peripheral surface. It is like that. Further, the inner diameter of the insertion assisting tool 70 is formed larger than the outer diameter of the insertion part 12 of the endoscope 10 so that the insertion part 12 can be inserted into the insertion assisting tool 70.

  A ring (not shown) made of an X-ray opaque member such as metal is provided at the distal end portion of the insertion assisting tool 70, and the distal end position of the insertion assisting tool 70 can be grasped when observed through X-ray fluoroscopy. It is like that. A second balloon 72 made of an elastic material such as rubber is attached to the outer periphery of the distal end of the insertion assisting tool 70. The second balloon 72 is formed in a cylindrical shape with both ends narrowed, and both ends of the second balloon 72 are fixed to the insertion assisting tool 70 with the insertion assisting tool 70 inserted through the second balloon 72. It is attached by doing. At that time, it is preferable that the tip portion of the second balloon 72 is folded and fixed inside the second balloon 72. A tube 76 attached to the outer surface of the insertion assisting tool 70 is communicated with the second balloon 72, and the tube 76 is connected to the tube 80 via a connector 78. The distal end of the tube 80 is connected to the air pressure control unit 66 described above, and the air pressure control unit 66 supplies air to the tube 80, sucks air from the tube 80, and air pressure at that time. Can be controlled. Thereby, air can be supplied to the second balloon 72 to inflate the second balloon 72, or air can be sucked from the second balloon 72 to contract the second balloon 72. The second balloon 72 is inflated into a substantially spherical shape by supplying air and is fixed in the body cavity. Further, the second balloon 72 is contracted by sucking air so as to stick to the outer peripheral surface of the insertion assisting tool 70.

  A hard grip 74 is provided at the proximal end of the insertion assisting tool 70. When inserting the insertion assisting tool 70 into the body cavity, the gripping portion 74 is gripped. The gripper 74 is provided with a lubricant supply port 84. A lubricant such as water is supplied from the lubricant supply port 84 between the insertion assisting tool 70 and the insertion portion 12. Therefore, the friction between the insertion portion 12 and the insertion assisting tool 70 is resisted, and the insertion assisting tool 70 can be smoothly inserted along the insertion portion 12.

  Next, an operation method of the endoscope apparatus configured as described above will be described.

  First, the insertion part 12 of the endoscope 10 is inserted into the insertion assisting tool 70 in advance, and the insertion assisting tool 70 is pulled toward the hand operating part 14 side of the endoscope 10. Further, the first balloon 42 and the second balloon 72 are deflated. In this state, the insertion portion 12 of the endoscope 10 is inserted into the body cavity of the subject. Then, after inserting a predetermined amount of the insertion part 12 into the intestinal tract in the body cavity, the first balloon 42 is inflated, and the flexible part 50 of the insertion part 12 is fixed to the intestinal tract by the first balloon 42.

  Next, the insertion assisting tool 70 is inserted along the insertion portion 12 while confirming the distal end position of the insertion assisting tool 70 by X-ray fluoroscopy. When the distal end position of the insertion assisting tool 70 reaches the vicinity of the first balloon 42, the insertion operation of the insertion assisting tool 70 is stopped. Then, the second balloon 72 is inflated, and the distal end of the insertion assisting tool 70 is fixed to the intestinal tract. In this state, the insertion assisting tool 70 is pulled forward. As a result, the intestinal tract is contracted, and excess bending or bending of the insertion assisting tool 70 is eliminated.

  Then, after the first balloon 42 is deflated, the insertion portion 12 is further inserted into the deep portion. At this time, since the insertion assisting tool 70 is not excessively bent or bent, the insertion portion 12 can be easily inserted. Then, after inserting a predetermined amount, the above-described operation is repeated. Thereby, the insertion part 12 can be easily inserted even to the deep part of an intestinal tract.

  After the distal end portion 46 of the insertion portion 12 reaches a predetermined position, observation and various treatments are performed. At that time, as shown in FIG. 3, the second balloon 72 is inflated to fix the insertion assisting tool 70 to the intestinal tract, and the first balloon 42 is inflated within the distal end of the insertion assisting tool 70 to insert the insertion section 12. It fixes to the auxiliary tool 70. Thereby, the insertion part 12 is fixed to the intestinal tract via the insertion assisting tool 70. At that time, the insertion portion 12 is fixed more firmly than when the first balloon 42 is directly fixed to the intestinal tract. Therefore, when the bending portion 48 is bent, the position of the distal end surface 47 can be accurately operated with respect to the intestinal tract, and the distal end surface 47 can be reliably directed to a desired position of the intestinal tract. Further, since the first balloon 42 is inflated at the distal end portion of the insertion assisting tool 70, the insertion section 12 is fixed in a state where the bending portion 48 protrudes from the insertion assisting tool 70. Therefore, even if the bending portion 48 is bent in this state, there is no possibility that the bending portion 48 or the distal end portion 46 contacts the insertion assisting tool 70. Thereby, bending operability can be improved.

  As described above, according to the present embodiment, the first balloon 42 is attached to the flexible portion 50 of the insertion portion 12, and the first balloon 42 is inflated at the distal end portion of the insertion assisting tool 70. The insertion portion 12 can be firmly fixed to the intestinal tract via the tool 70, and the distal end surface 47 can be accurately directed to a desired position of the intestinal tract. In addition, since the bending portion 48 protrudes from the insertion assisting tool 70 during the bending operation, the bending operability can be improved.

  Further, according to the present embodiment, it is possible to pull out only the insertion portion 12 of the endoscope 10 while the insertion assisting tool 70 is inserted into the body cavity. That is, by deflating the first balloon 42 from the state of FIG. 3, the insertion portion 12 can be inserted into and removed from the insertion assisting tool 70, so that only the insertion portion 12 can be pulled out. Therefore, the insertion assisting tool 70 can be used as it is inserted into the intestinal tract, and a treatment instrument such as forceps or another endoscope insertion part can be quickly inserted through the insertion assisting tool 70. .

  In the embodiment described above, the first balloon 42 combines the means for fixing the insertion portion 12 to the intestine and the means for fixing the insertion portion 12 to the insertion assisting tool 70. However, the present invention is not limited to this. However, a separate balloon may be provided. That is, a dedicated balloon for fixing the insertion portion 12 to the insertion assisting tool 70 and a dedicated balloon for fixing the insertion portion 12 in the body cavity may be attached to the insertion portion 12.

  Further, when a dedicated balloon for fixing the insertion portion 12 to the insertion assisting tool 70 is used, a small diameter portion having a small inner diameter is provided at the distal end portion of the insertion assisting tool 70 and is fixed only by this small diameter portion. Such a balloon may be used.

  In addition, the insertion assistance tool in this invention should just be used in the state which covered the insertion part 12 of the endoscope 10, and assists insertion of the insertion part 12, and is generally called a sliding tube or an overtube. Can be applied to things.

System configuration diagram of an endoscope apparatus according to the present invention The perspective view which shows the insertion part of an endoscope Sectional view showing the action of the balloon

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 16 ... Universal cable, 18 ... LG connector, 20 ... Light source device, 22 ... Cable, 24 ... Electric connector, 26 ... Air supply / water supply tube, 28 ... suction tube, 30 ... processor, 32 ... air / water feed button, 34 ... suction button, 36 ... shutter button, 38 ... angle knob, 40 ... forceps insertion part, 42 ... first balloon, 44 ... supply / suction port, 46 ... tip part, 47 ... tip surface, 48 ... curved part, 50 ... soft part, 52 ... observation optical system, 54 ... illumination optical system, 56 ... air / water feed nozzle, 58 ... forceps port, 60 ... monitor, 62 ... vent hole, 64 ... tube, 66 ... air pressure control unit, 68 ... operation button, 70 ... insertion aid, 72 ... second balloon, 74 ... gripping part, 76 ... tube, 78 ... connector, 80 ... Breakfast, 84 ... lubricant supply port

Claims (1)

In an endoscope apparatus including an endoscope having a bending portion in an insertion portion provided continuously to a hand operation portion, and a cylindrical insertion assisting tool that covers the insertion portion,
A first balloon is attached to the insertion portion closer to the hand operation portion than the bending portion, and the insertion portion is fixed to the insertion aid by inflating the first balloon in the insertion aid. The insertion portion can be freely inserted into and removed from the insertion aid by deflating the first balloon,
An endoscope apparatus, wherein a second balloon is attached to a distal end portion of the insertion assisting tool, and the distal end portion of the insertion assisting tool is fixed in a body cavity by inflating the second balloon. .

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