JP4009350B2

JP4009350B2 - Endoscope system

Info

Publication number: JP4009350B2
Application number: JP21213397A
Authority: JP
Inventors: 石川　　正宏; 秀樹下中; 晃一川島; 孝之鈴木; 浩司神原; 哲也山本
Original assignee: Olympus Corp
Current assignee: Olympus Corp
Priority date: 1997-08-06
Filing date: 1997-08-06
Publication date: 2007-11-14
Anticipated expiration: 2017-08-06
Also published as: JPH1147079A

Description

【０００１】
【発明の属する技術分野】
本発明は、内視鏡検査や内視鏡下手術において使用する内視鏡と、処置用の器材とを備えた内視鏡システムに関する。
【０００２】
【従来の技術】
従来より、細長の挿入部を体腔内に挿入することにより、体腔内臓器などを観察したり、必要に応じて処置用チャンネル内に挿通した処置用の器材（処置具とも記載する）を用いて各種治療処置のできる医療用の内視鏡が広く利用されている。
【０００３】
前記処置用の器材は、内視鏡の処置具用チャンネルの直径寸法が細径（３ｍｍ程度）で長尺（２ｍ程度）な管腔内に挿通可能なように細長な構造になっている。このため、この細長な処置用の器材を内視鏡の処置用チャンネルに挿入する際、折れたり、破損したりするおそれがあるので、医療者は処置用の器材を処置用チャンネルに挿入するために細心の注意を払わなければならなかった。
【０００４】
例えば、特開昭６４−８０３３５号公報には前記処置具の挿入時の破損を防止するため、処置用の器材に適度な弾力性を有する部材を用いたり、先端形状を滑らかにすることで挿入性を向上させるようにした内視鏡が示されている。
【０００５】
また、経内視鏡的に処置を行う場合、内視鏡と処置具とが独立しているため、医療者は両手を用いて、複雑な内視鏡の操作と処置具の操作とを行ったり、介添え者を含む数人で内視鏡と処置具との操作を行わなければならないので、熟練した操作技術を必要にしていた。このため、内視鏡と処置用の器材との操作を容易化するため、内視鏡操作部に処置用の器材の操作部を連結固定するようにしたものがある。
【０００６】
【発明が解決しようとする課題】
しかしながら、前記特開昭６４−８０３３５号公報に示されているように材料的な改善や形状を曲面にすることでは根本的な解決にならず、特に特殊な材料を使用する場合には材料の入手が困難なことや製造方法が複雑になって大量生産するには不向きで、処置具が高価になるなどといった問題があった。
【０００７】
また、内視鏡と処置具との操作を容易化するために、内視鏡と処置具とを連結固定するものでは内視鏡の操作部と処置具の操作部とが干渉するため操作性が悪化するという問題があった。
【０００８】
さらに、処置後に、細長な処置用の器材の洗滌、消毒などの後処理を行う際、洗滌し難く、後処理に時間がかかるという問題があると共に、後処理後に処置具を保管、管理をする際、処置具が細長であるため保管スペースが大きくなるという問題があった。
【０００９】
本発明は上記事情に鑑みてなされたものであり、チャンネルに挿入する際に発生していた処置具の破損を防止し、内視鏡下での操作が容易で、より小さなスペースで保管が可能な内視鏡システムを提供することを目的にしている。
【００１０】
【課題を解決するための手段】
本発明の内視鏡システムは、生体組織に対して処置を行うためのそれぞれが異なる処置手段をそれぞれの本体部に備える複数種類の内視鏡用モジュールと、前記複数種類の内視鏡モジュールがそれぞれ内視鏡挿入部に取り付けられる内視鏡とを具備する内視鏡システムであって、
前記内視鏡は、前記内視鏡挿入部の先端部に設けられ、前記内視鏡用モジュールが着脱自在な着脱手段となる先端突出部と、前記内視鏡挿入部に連設する操作部に設けられ、前記内視鏡挿入部に取り付けられた前記内視鏡用モジュールの処置手段を遠隔操作する操作ハンドルと、前記操作ハンドルに一端部が固定される、他端部に着脱手段及び操作力伝達手段を兼ねる、ネジ部を有する第１の連結部材を備える、伝達ワイヤと、前記内視鏡挿入部に設けられ、前記伝達ワイヤが挿通される送気・送液用チャンネルを兼ねるワイヤ用チャンネルとを具備し、
前記内視鏡用モジュールは前記本体部に、前記内視鏡挿入部の先端突出部が嵌入配置される着脱手段となる配置用孔と、前記ワイヤ用チャンネルの先端側の開口に対向して連通配置される開口を備える孔部と、前記孔部を介して前記内視鏡側に延出され、端部に、前記伝達ワイヤに備えられた前記第１連結部材に着脱自在な着脱手段及び操作力伝達手段を兼ねる、前記第１の連結部材のネジ部が螺合するネジ部を備える第２連結部材を有する前記処置手段を操作するための操作ワイヤとを具備する。
【００１１】
この構成によれば、処置手段を有する内視鏡用モジュールを内視鏡挿入部の先端部に取り付けることによって内視鏡的処置が行え、内視鏡用モジュールを内視鏡挿入部から取り外した状態で保管が可能である。
【００１２】
【発明の実施の形態】
以下、図面を参照して本発明の実施の形態を説明する。
図１ないし図８は本発明の第１実施例に係り、図１は内視鏡システムを構成する内視鏡の先端部及びこの内視鏡に取り付けられる内視鏡用モジュールの１例である結紮用モジュールの構成を説明する断面図、図２は内視鏡の操作部の構成を示す説明図、図３は他の内視鏡用モジュールの例である把持用モジュールと内視鏡の先端部の構成を示す説明図、図４は内視鏡の先端部に結紮用モジュールを取り付けた状態を示す説明図、図５は結紮用モジュールを取り付けた内視鏡の作用を説明する図、図６は引き続き患部に弾性リングを装着するときの使用状態を説明する図、図７は内視鏡の先端部に把持用モジュールを取り付けた状態を示す説明図、図８は把持用モジュールを取り付けた内視鏡の作用を示す説明図である。
【００１３】
図１に示すように本実施形態の内視鏡システム１は、内視鏡２と、この内視鏡２の先端部２１に着脱自在な内視鏡用モジュールの１つである結紮用モジュール３とで構成されている。
【００１４】
前記内視鏡１の先端部２１は、結紮用モジュール３を着脱可能にするための着脱手段を兼ねる先端突出部２２及び係止用孔部２３ａを有する固定着脱用孔２３と、操作力を伝達する伝達ワイヤ４が進退自在に挿通されるワイヤ用チャンネル２４とを有して構成されている。前記伝達ワイヤ４の先端部には筒状で、着脱手段及び操作力伝達手段となる第１連結部材４１が固設されるようになっており、この第１連結部材４１の内周面には雌ネジ４２が形成されている。
【００１５】
前記結紮用モジュール３は、硬質で透明な樹脂部材で略凸字形状に形成されており、細径で前記内視鏡２の先端部２１に対峙して着脱部となる連結部３１及び前記連結部３１よりやや太径なキャップ部３２を備える本体部３０と、前記キャップ部３２の外周面に配置される結紮用の弾性リング３４及びリング操作ワイヤ３５を備える処置手段となる結紮具３３とで構成されている。前記リング操作ワイヤ３５の基端部には略円柱状で着脱手段と操作力伝達手段となる第２連結部材３７が固設されるようになっており、この第２連結部材３７の先端部には前記第１連結部材４１の雌ネジ４２に噛合する雄ネジ３８が形成されている。
【００１６】
前記結紮用モジュール３の本体部３０のキャップ部３２には先端側に開口部３２ａ有して患部を配置することが可能な処置用空洞部３２ｂが形成されている。また、前記連結部３１には前記先端部２１の先端突出部２２が嵌入配置される突出部配置用孔３１ａ及び前記固定着脱用孔２３に係入される着脱手段となる係止爪部３６ａを先端部に設けた着脱用突起部３６と、前記リング操作ワイヤ３５が進退自在に挿通されるワイヤ挿通孔３１ｂが形成されている。このワイヤ挿通孔３１ｂは、前記処置用空洞部３２ｂに連通しており、前記突出部配置用孔３１ａは前記処置用空洞部３２ｂに連絡孔３２ｃを介して連通している。
【００１７】
前記リング操作ワイヤ３５は、複数のワイヤ線３５ａ，３５ｂを撚り合わせて形成したものであり、前記ワイヤ挿通孔３１ｂ内を通過したリング操作ワイヤ３５が処置用空洞部３２ｂ内でワイヤ線３５ａ，３５ｂに分かれている。この処置用空洞部３２ｂ内で分かれたワイヤ線３５ａ，３５ｂの先端部は前記キャップ部３２の外周面に配置されるように延出している。
【００１８】
前記ワイヤ線３５ａ，３５ｂの先端部にはそれぞれ複数の誘導部３５ｃが等間隔に設けられており、これら誘導部３５ｃを備えた先端部をキャップ部３２の外周面上に配置した状態で、前記誘導部３５ｃに対して前記弾性リング３４を所定の位置に配置している。
【００１９】
図２に示すように前記先端部２１に形成したワイヤ用チャンネル２４は、前記内視鏡１の操作部５まで形成されており、このワイヤ用チャンネル２４内を挿通する伝達ワイヤ４の基端部が操作部５内に設けられている内視鏡用モジュールの処置手段を操作する操作力を発生させるための回転操作ハンドル５１の回動自在な軸部５１ａに固定されている。このことによって、前記回転操作ハンドル５１を回動操作することによって、前記伝達ワイヤ４が進退動作する。
【００２０】
前記ワイヤ用チャンネル２４は、このチャンネル２４の中途部で操作部５の側部に開口を有する送気・送液用チャンネル５３に連通している。前記開口部端５２にはパッキン５４を内部に設けた口金５５が配設されており、この口金５５、前記送気・送液用チャンネル５３及びワイヤ用チャンネル２４によって液体や気体を導く送気・送液用チャンネルを形成している。
【００２１】
なお、前記内視鏡１は、図示しない光学レンズ、この光学レンズを通過して入力された光学像を内視鏡手元側で観察可能にする光伝達手段、先端部を所望の方向に湾曲させるための湾曲部を備え、前記操作部５には湾曲部を湾曲操作する操作ノブ（不図示）が前記回転操作ハンドル５１の近傍に設けられている。
【００２２】
また、前記内視鏡用モジュールの他の形態としては結紮用モジュール３に限定されるものではなく、例えば図３に示すような把持用モジュール６がある。この把持用モジュール６は、硬質な樹脂部材で略パイプ形状に形成された前記結紮用モジュール３の本体部３０の連結部３１と略同形状のモジュール本体６１と例えば３つの把持部６３ａ，６３ｂ，６３ｃを備える処置手段である把持具６２とで構成されている。
【００２３】
前記モジュール本体６１には、前記内視鏡の先端部２１に対峙する着脱部となる前記先端部２１の先端突出部２２が嵌入配置される突出部配置用孔３１ａ及び前記固定着脱用孔２３に係入される係止爪部３６ａを先端に設けた着脱用突起部３６と、前記把持部６３ａ，６３ｂ，６３ｃを凸没させる把持部操作ワイヤ６３が進退自在に挿通されるワイヤ挿通孔３１ｂが形成されている。このワイヤ挿通孔３１ｂは貫通孔であり、前記突出部配置用孔３１ａは連通孔６４によって外部に連通している。前記把持部操作ワイヤ６３の基端部には前記リング操作ワイヤ３５の基端部に設けられているものと同様の着脱手段である略円柱状の第２連結部材３７が固設されている。なお、内視鏡の構成及びその他の構成は、前記図１で示した内視鏡システムと同様であり、同部材には同符号を付して説明を省略する。
【００２４】
上述のように構成した内視鏡システム１の作用を説明する。
まず、内視鏡１を体腔内に挿入する前に、保管箱に保管されている内視鏡モジュールの中から内視鏡１の先端部２１に装着する結紮用モジュール３を取り出す。そして、内視鏡１の伝達ワイヤ４の先端部に固設されている第１連結部材４１の雌ネジ４２と結紮用モジュール３の操作ワイヤ３５の基端部に固設されている第２連結部材３７の雄ネジ３８とを螺合固定し、続いて、本体部３０の着脱用突起部３６を固定着脱用孔２３に配置すると共に、先端突出部２２と突出部配置用孔３１ａとの位置合わせを行って、結紮用モジュール３と内視鏡２とが近づく方向に移動していく。すると、前記先端突出部２２が突出部配置用孔３１ａに嵌入して所定位置に配置されると共に、係止爪部３６ａが係止用孔部２３ａに係入して、図４に示すように結紮用モジュール３を内視鏡２の先端部２２に一体的に固定する。
【００２５】
次に、結紮用モジュール３を先端部２１に一体的に固定した内視鏡１を体腔内の検査部位近傍まで挿入して、結紮用モジュール３のキャップ部３２の先端側に設けられている開口部３２ａを体腔内の患部１０に対峙するまで移動させる。
【００２６】
次いで、内視鏡１の操作部５の開口部端５２に設けられている口金５５を介して図示しない吸引装置によって吸引をかける。すると、この口金５５、前記送気・送液用チャンネル５３及びワイヤ用チャンネル２４によって形成されている送気・送液用チャンネルを介して体腔内の空気が吸引されることによって、キャップ部３２の処置用空洞部３２ｂ内に患部１０が吸い込まれる。
【００２７】
ここで、内視鏡１の操作部５に設けた回転操作ハンドル５１を操作して、伝達ワイヤ４を巻き取っていく。このことによって、前記伝達ワイヤ４が進退すると共に、この伝達ワイヤ４に連結されているリング操作ワイヤ３５が手元側に移動することで、先端部に設けられている誘導部３５ｃが移動して、キャップ部３２の外周面に配置された弾性リング３４が前記誘導部３５ｃに押されて徐々に移動していく。そして、図５に示すように前記弾性リング３４が本体部３０の前方から脱落して収縮することによって、処置用空洞部３２ｂ内に吸引された患部１０の根元部を、自らの弾性力によって結紮する。
【００２８】
続いて、図６に示すように内視鏡１を体外に抜去することなく矢印に示すように移動させて上記操作を繰り返し行うことによって、複数の箇所に弾性リング３４を結紮することが可能である。
【００２９】
また、引き続いて結紮以外の処置を行う場合には内視鏡２を体腔内から抜去する。そして、前記固定着脱用孔２３の係止用孔部２３ａに係入している係止爪部３６ａを押し込みながら結紮用モジュール３と内視鏡１の先端部２１とを引き離す方向に移動させていくことによって結紮用モジュール３を内視鏡１の先端部２１から分離する。
【００３０】
次いで、前記図３に示した把持用モジュール６のような他の内視鏡用モジュールを、前記結紮用モジュール３を内視鏡２先端部２１に取り付けたときと同様に、伝達ワイヤ４の先端の雌ネジ４２と把持用モジュール６の把持部操作ワイヤ６３の基端部に固設されている第２連結部材３７の雄ネジ３８とを螺合固定し、続いて、モジュール本体６１の着脱用突起部３６を固定着脱用孔２３に配置すると共に、先端突出部２２と突出部配置用孔３１ａとの位置合わせを行って、把持用モジュール６と内視鏡２とが近づく方向に移動していく。すると、前記先端突出部２２が突出部配置用孔３１ａに嵌入して所定位置に配置されると共に、係止爪部３６ａが係止用孔部２３ａに係入して、図７に示すように把持用モジュール６を内視鏡２の先端部２１に一体的に固定する。
【００３１】
続いて、内視鏡１の操作部５の回転操作ハンドル５１を操作して把持用モジュール６の把持部６３ａ，６３ｂ，６３ｃをワイヤ挿通孔３１ｂ及びワイヤ用チャンネル内に収納した状態にして体腔内に挿入し目的部位まで移動させる。
【００３２】
そして、回転操作ハンドル５１を操作して伝達ワイヤ４を進退させることで、この伝達ワイヤ４に連結されている把持部操作ワイヤ６３が進退操作されることによって把持部６３ａ，６３ｂ，６３ｃが凸没して、図８に示すように患部１０ａを把持部６３ａ，６３ｂ，６３ｃで把持することができる。そして、患部１０ａを把持した後、体腔内から内視鏡２を抜去して処置を終了する。
【００３３】
このように、細長な処置具を内視鏡の処置用チャンネルに挿入する代わりに、処置手段を有する小型の内視鏡用モジュールを内視鏡の先端部に着脱自在な構成にすると共に、内視鏡内を挿通する伝達ワイヤと各モジュールに設けられている処置手段を操作する操作手段とを接続固定する連結手段を設けたことによって、処置具をチャンネルに挿入する際に発生していた処置具の破損をなくすことができると共に、内視鏡用モジュールの保管スペースを小さくすることができる。このことによって、処置具の管理が大幅に改善される。
【００３４】
また、内視鏡の操作部に設けられている操作ノブ等の近傍に、予め内視鏡モジュールの処置手段を操作する操作ハンドルを設けているので、内視鏡の操作及び内視鏡用モジュールに設けられている処置手段の操作を容易に行うことができる。
【００３５】
図９ないし図１１は本発明の第２実施形態に係り、図９は内視鏡用モジュールの別の構成である生検用モジュールと内視鏡の先端の構成を示す説明図、図１０は内視鏡の先端部に生検用モジュールを取り付けた状態を示す説明図、図１１は生検用ジュールを取り付けた内視鏡の作用を示す説明図である。
【００３６】
図９に示すように内視鏡用モジュールの別の構成である生検用モジュール７は、硬質な樹脂部材で略パイプ形状に形成されたモジュール本体７１と例えば一対の生検鉗子７２，７２を備える処置手段である生検鉗子具７３とで構成されている。
【００３７】
前記モジュール本体７１には、前記内視鏡２の着脱部となる前記先端突出部２２を含む先端部２１が嵌入配置される先端部配置用孔７４と、前記生検鉗子７２，７２を開閉操作する鉗子操作用ワイヤ７５が進退自在に挿通されるワイヤ挿通孔７６が形成されている。前記モジュール本体７１の外周面には前記先端部配置用孔７４に連通するネジ用孔７１ａが設けられており、このネジ用孔７１ａに着脱手段になる固定ネジ７７が配置されるようになっている。
【００３８】
前記ワイヤ挿通孔７６は前記先端部配置用孔７４に連通しており、この先端部配置用孔７４は連絡孔７８によって外部に連通している。また、前記鉗子操作用ワイヤ７５の基端部には前記リング操作ワイヤ３５及び把持部操作ワイヤ６３の基端部に設けたものと同様の着脱手段である略円柱状の第２連結部材３７が固設されている。なお、その他の構成及び内視鏡に固定着脱用孔を形成していないこと以外は前記第１実施形態と同様であり、同部材には同符号を付して説明を省略する。
【００３９】
図１０に示すように内視鏡１の伝達ワイヤ４の先端部に固設されている第１連結部材４１の雌ネジ４２と生検用モジュール７の鉗子操作用ワイヤ７５の基端部に固設されている第２連結部材３７の雄ネジ３８とを螺合固定し、続いて、モジュール本体７１の先端部配置用孔７４に内視鏡２の先端部２１を挿入した後、固定ネジ７７でこの生検用モジュール７を内視鏡２の先端部２１に一体的に固定する。そして、前記第１実施形態と同様に、生検用モジュール７の生検鉗子７２を閉じた状態にして内視鏡２を体腔内に導入する。
【００４０】
図１１に示すように内視鏡１の操作部５に設けられている回転操作ハンドル５１を操作して伝達ワイヤ４を進退させることで、この伝達ワイヤ４に連結されている鉗子操作用ワイヤ７５が進退操作されて生検鉗子７２が開閉動作して患部１０ｂの生検が行われる。
【００４１】
このように、本実施形態においては内視鏡用モジュールと内視鏡との固定をネジによって行っているので、着脱が容易でかつ、前記第１実施形態で実施した場合よりも強力に内視鏡と内視鏡用モジュールとを接続固定することができる。なお、その他の作用及び効果は前記第１実施形態と同様である。
【００４２】
図１２ないし図１４は本発明の第３実施形態に係り、図１２は内視鏡用モジュールのまた他の構成である拡張用モジュールと内視鏡の先端の構成を示す説明図、図１３は内視鏡の先端部に拡張用モジュールを取り付けた状態を示す説明図、図１４は拡張用ジュールを取り付けた内視鏡の作用を示す説明図である。
【００４３】
図１２に示すように内視鏡用モジュールのまた他の構成である拡張用モジュール８は、硬質な樹脂部材で略パイプ形状に形成されたモジュール本体８１と、このモジュール本体８１の外周面に被覆配置される弾力性を有する部材で形成されたバルーン８２とで構成されている。なお、前記モジュール本体８１の基端部には雄ネジを形成した凸部８１ａが設けられており、この雄ネジに略パイプ形状の接合部材８３の先端部に形成した雌ネジが噛合するようになっている。前記接合部材８３を凸部８１ａに螺合して、この接合部材８３を締め込む方向に回転させていくことによって、凸部８１ａの内径寸法が徐々に小径になるようにモジュール本体８１が構成されている。また、前記バルーン８２は糸巻き接着部８２ａによってモジュール本体８１に固定されている。
【００４４】
また、前記モジュール本体８１には、前記内視鏡２の着脱部となる前記先端突出部２２を含む先端部２１が嵌入配置される先端部配置用孔８４と、前記バルーン８２を拡張させるための気体や液体などが送られる送気・送液通路８５と、先端部に開口を有する先端側空洞部８６とが形成されている。
【００４５】
前記送気・送液通路８５の一端部は、モジュール本体８１のバルーン８２が配置されている外周面に開口を有し、他端部は前記先端部配置用孔８４に連通している。また、この先端部配置用孔８４は連絡孔８４ａによって先端側空洞部８６に連通している。さらに、前記送気・送液通路８５の他端部には着脱手段と送気・送液通路形成手段とを兼用する中空で弾力性を有する部材で形成された略ニップル形状の接続部材８７が配設されている。この接続部材８７は、内視鏡２に設けられているワイヤ用チャンネル２４内に挿抜自在になっている。
【００４６】
なお、前記接続部材８７は、シリコーンや天然ゴム、イソプレンゴム、ネオプレンゴムなどの密着性がよく、液洩れや空気洩れの生じない部材で形成されている。その他の構成及び内視鏡に固定着脱用孔を形成していないこと以外は上述した実施形態と同様であり、同部材には同符号を付して説明を省略する。
【００４７】
内視鏡１の操作部５に設けられている回転操作ハンドル５１を回転操作して伝達ワイヤ４の先端部に固設されている第１連結部材４１をワイヤ用チャンネル２４内に配置する。この状態で、接合部材８３の貫通孔を介してモジュール本体８１の先端部配置用孔８４に内視鏡２の先端部２１を挿入すると共に、前記ワイヤ用チャンネル２４内に接続部材８７を押し込んでいく。このことによって、拡張用モジュール８と内視鏡２とが仮固定される。
【００４８】
次いで、前記接合部材８３を閉め込む方向に回転させて凸部８１ａの内径寸法を徐々に小径にして凸部８１ａの内周面を内視鏡２の先端部２１の外周面に締め付けていくことによって、図１３に示すように拡張用モジュール８と内視鏡２とを一体的に固定する。
【００４９】
拡張用モジュール８を先端部２１に取り付けた内視鏡２を体腔内に挿通し、手元側操作部の口金５５に例えば図示しないシリンジを連結してシリンジ内の液体を送気・送液用チャンネル５３内に注入していく。すると、シリンジから注入された液体が、内視鏡１のワイヤ用チャンネル２４、接続部材８７、送気・送液通路８５を通じてバルーン８２内に注入されて、図１４に示すようにバルーン８２が拡張する。この拡張したバルーン８２によって、患部１０ｃを拡張及び圧迫して、体腔内の狭窄した患部の解除及び患部の圧迫止血を行う。
【００５０】
このように、拡張用モジュールと内視鏡とをワイヤ用チャンネルに押し込まれる接続部材及び接合部材を閉め込むことによって内径寸法が小径にして凸部の内周面を内視鏡先端部の外周面に締め付けてモジュール本体と内視鏡とを一体的に固定することによって、前記実施形態１に比べて簡単で、かつ強固に内視鏡用モジュールを内視鏡に装着固定することができる。
【００５１】
図１５ないし図１９は本発明の第４実施形態に係り、図１５は内視鏡用モジュールのまた別の構成である切開用モジュールと内視鏡の先端の構成を示す説明図、図１６は内視鏡の操作部を示す説明図、図１７は内視鏡の先端部に切開用モジュールを取り付けた状態を示す説明図、図１８は体腔内の患部に切開部を配置している状態を示す説明図、図１９は切開部で患部を切開する様子を示す説明図である。
【００５２】
図１５に示すように内視鏡用モジュールのまた他の構成である切開用モジュール９は、硬質な樹脂部材で略パイプ形状に形成されたモジュール本体９１及びこのモジュール本体９１の基端部に固定されて着脱手段となる略パイプ形状の第１磁石９２と、例えば切開部９３ａを備えた処置手段である切開具９３とで構成されている。
【００５３】
前記モジュール本体９１には先端側に開口部９１ａ有して患部を配置することが可能な処置用空洞部９１ｂが形成されている。前記切開具９３は、略輪形状の切開部９３ａを形成するスネア９４と、このスネア９４が挿通されモジュール本体９１に対して進退自在に配置され、前記伝達ワイヤ４の進退動作が伝達される切開具操作用チューブ９５と、この切開具操作用チューブ９５の手元側に設けられる圧入部材９６とで構成されている。また、前記内視鏡２の先端部２１には着脱手段となる第２磁石９７がこの先端部２１の外周上を回転可能に設けられている。また、前記ワイヤ用チャンネル２４内には操作チューブ９８が進退自在に挿通され、この操作チューブ９８内を伝達ワイヤ４が挿通している。
【００５４】
図１６に示すように内視鏡１の操作部５には、前記伝達ワイヤ４の端部が接続された第１の操作力用の第１操作ハンドル９９ａと前記操作チューブ９８の手元側端部が接続された第２の操作力用の第２操作ハンドル９９ｂとが設けられており、これら第１ハンドル９９ａ及び第２ハンドル９９ｂをそれぞれ進退動作させることによって、前記伝達ワイヤ４及び操作チューブ９８をそれぞれ進退させることができるようになっている。なお、その他、内視鏡に固定着脱用孔を形成していないこと以外は上述した実施形態と同様であり、同部材には同符号を付して説明を省略する。
【００５５】
上述のように構成した切開用モジュール９と内視鏡２とを備える内視鏡システム１の作用を説明する。
まず、内視鏡１を体腔内に挿入する前に、内視鏡１の先端に切開用モジュール９を装着する。このとき、内視鏡１の第１連結部材４１の雌ネジ４２と、切開具９３の第２連結部材３７の雄ネジ３８とを螺合固定して伝達ワイヤ４とスネア９４とを接続する。
【００５６】
続いて、内視鏡１のワイヤ用チャンネル２４内を挿通している操作チューブ９８の先端部を前記切開具９３の圧入部材９６の手元側から圧入して、操作チューブ９８と切開具操作用チューブ９５とを接続した後、切開用モジュール９の第１磁石９２の貫通穴内に、内視鏡１の先端部２１に配置されている第２磁石９７を係入して、各々の磁石９２，９７の磁力によって、図１７に示すように内視鏡１と切開用モジュール９とを一体的に固定する。
【００５７】
続いて、前述の第１実施形態と同様に体腔内に内視鏡１を配置した後、図１８に示すように吸引力によって患部１０ｄを処置用空洞部９１ｂ内に引き込む。このとき、スネア９４をモジュール本体９１の開口部９１ａに沿わせてリング状の切開部９３ａを形成しておくことによって、吸引された患部１０ｄが切開部９３ａに巻かれた状態になる。
【００５８】
次に、操作部５の第２ハンドル９９ｂを前進させる。すると、切開具操作用チューブ９５が前方に押し出されることによって、スネア９４は相対的に切開具操作用チューブ９５に引き込まれ、患部１０ｄの根元をスネア９４が１次緊縛される。
【００５９】
次いで、第１ハンドル９９ａを手元側に後退させる。このことによって、前記スネア９４が切開具操作用チューブ９５内に大きく引き込まれて２次緊縛されると共に、この状態でスネア９４に高周波を付与することによって患部１０ｄの切除が完了する。
【００６０】
処置が終了して内視鏡を体腔内から抜去した後、切開用モジュール９を取り外す場合には、内視鏡１の先端部２１に設けられている第２磁石９７を回転させる。このことにより、内視鏡用モジュール側の第１磁石９２と内視鏡１側の第２磁石９７とが各々の磁石により反発して、切開用モジュール９と内視鏡１とが分離される。
【００６１】
このように、切開用モジュールを構成するスネアと、切開具操作用チューブをそれぞれ独立して操作することができる。このことにより、切開などの複雑な操作を行うことが可能になる。
【００６２】
また、切開用モジュールと内視鏡とを磁力によって脱着にしているため、脱着を繰り返し行っても内視鏡やモジュール側に負荷がかかって破損することを防止することができる。
【００６３】
なお、本発明は、以上述べた実施形態のみに限定されるものではなく、発明の要旨を逸脱しない範囲で種々変形実施可能である。
【００６４】
［付記］
以上詳述したような本発明の上記実施形態によれば、以下の如き構成を得ることができる。
【００６５】
（１）内視鏡挿入部の先端部に、少なくとも１つ以上の処置手段を有する内視鏡用モジュールを、着脱手段を介して取付け可能である内視鏡システム。
【００６６】
（２）前記内視鏡鏡は、前記内視鏡用モジュールの処置手段を遠隔操作する操作部を有する付記１記載の内視鏡システム。
【００６７】
（３）前記操作部からの操作力を、前記処置手段へ伝達する操作力伝達手段を有する付記２記載の内視鏡システム。連結部材
（４）前記内視鏡用モジュールは、前記操作部からの第１の操作力を伝達する第１操作力伝達手段と、前記操作部からの第２の操作力を伝達する第２操作力伝達手段とを有する付記２記載の内視鏡システム。
【００６８】
【発明の効果】
以上説明したように本発明によれば、処置具の破損を防止し、内視鏡下での操作が容易で、小さなスペースで保管が可能な内視鏡システムを提供することができる。
【図面の簡単な説明】
【図１】図１ないし図８は本発明の第１実施例に係り、図１は
内視鏡システムを構成する内視鏡の先端部及びこの内視鏡に取り付けられる内視鏡用モジュールの１例である結紮用モジュールの構成を説明する断面図
【図２】内視鏡の操作部の構成を示す説明図
【図３】他の内視鏡用モジュールの例である把持用モジュールと内視鏡の先端部の構成を示す説明図
【図４】内視鏡の先端部に結紮用モジュールを取り付けた状態を示す説明図
【図５】結紮用モジュールを取り付けた内視鏡の作用を説明する図
【図６】引き続き患部に弾性リングを装着するときの使用状態を説明する図
【図７】内視鏡の先端部に把持用モジュールを取り付けた状態を示す説明図
【図８】把持用モジュールを取り付けた内視鏡の作用を示す説明図
【図９】図９ないし図１１は本発明の第２実施形態に係り、図９は
内視鏡用モジュールの別の構成である生検用モジュールと内視鏡の先端の構成を示す説明図
【図１０】内視鏡の先端部に生検用モジュールを取り付けた状態を示す説明図
【図１１】生検用ジュールを取り付けた内視鏡の作用を示す説明図
【図１２】図１２ないし図１４は本発明の第３実施形態に係り、図１２は
内視鏡用モジュールのまた他の構成である拡張用モジュールと内視鏡の先端の構成を示す説明図
【図１３】内視鏡の先端部に拡張用モジュールを取り付けた状態を示す説明図
【図１４】拡張用ジュールを取り付けた内視鏡の作用を示す説明図
【図１５】図１５ないし図１９は本発明の第４実施形態に係り、図１５は
内視鏡用モジュールのまた別の構成である切開用モジュールと内視鏡の先端の構成を示す説明図
【図１６】内視鏡の操作部を示す説明図
【図１７】内視鏡の先端部に切開用モジュールを取り付けた状態を示す説明図
【図１８】体腔内の患部に切開部を配置している状態を示す説明図
【図１９】切開部で患部を切開する様子を示す説明図
【符号の説明】
１…内視鏡システム
２…内視鏡
３…結紮用モジュール
２２…先端突出部
２３ａ…係止用孔部
３１ａ…突出部配置用孔
３５…リング操作用ワイヤ
３６ａ…係止爪部
３７…第２連結部材
４１…第１連結部材[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope system including an endoscope used in endoscopy and endoscopic surgery, and treatment equipment.
[0002]
[Prior art]
Conventionally, by inserting an elongated insertion portion into a body cavity, the internal organs of the body cavity are observed, and a treatment device (also referred to as a treatment tool) inserted into a treatment channel as necessary is used. Medical endoscopes capable of various therapeutic treatments are widely used.
[0003]
The treatment instrument has an elongated structure so that the treatment instrument channel of the endoscope has a small diameter (about 3 mm) and can be inserted into a long (about 2 m) lumen. For this reason, since there is a possibility that the elongated treatment device may be broken or broken when inserted into the treatment channel of the endoscope, the medical practitioner inserts the treatment device into the treatment channel. I had to pay close attention to.
[0004]
For example, in Japanese Patent Application Laid-Open No. 64-80335, in order to prevent breakage when the treatment instrument is inserted, a member having an appropriate elasticity is used for the treatment equipment, or the tip shape is made smooth. An endoscope that improves the performance is shown.
[0005]
In addition, when performing a treatment endoscopically, since the endoscope and the treatment tool are independent, the medical staff uses both hands to perform complicated endoscope operations and treatment tool operations. In addition, since several people including a caregiver have to operate the endoscope and the treatment tool, a skilled operation technique is required. For this reason, in order to facilitate the operation of the endoscope and the treatment instrument, there is one in which the operation part of the treatment instrument is connected and fixed to the endoscope operation part.
[0006]
[Problems to be solved by the invention]
However, as shown in the above-mentioned Japanese Patent Application Laid-Open No. 64-80335, the improvement of the material and the curved shape of the shape do not fundamentally solve the problem. In particular, when a special material is used, the material There are problems that it is difficult to obtain, is unsuitable for mass production due to complicated manufacturing methods, and treatment tools are expensive.
[0007]
In addition, in order to facilitate the operation of the endoscope and the treatment tool, in the case where the endoscope and the treatment tool are connected and fixed, the operation part of the endoscope and the operation part of the treatment tool interfere with each other. There was a problem of getting worse.
[0008]
In addition, after the treatment, when performing post-treatment such as washing and disinfection of slender treatment equipment, there is a problem that it is difficult to wash and it takes time for the post-treatment, and the treatment tool is stored and managed after the post-treatment. However, since the treatment tool is elongated, there is a problem that the storage space is increased.
[0009]
The present invention has been made in view of the above circumstances, Occurs when inserting into a channel Prevents damage to the treatment tool, easy operation under the endoscope, Than An object of the present invention is to provide an endoscope system that can be stored in a small space.
[0010]
[Means for Solving the Problems]
The endoscope system according to the present invention includes a plurality of types of endoscope modules each having different treatment means for performing a treatment on a living tissue, and the plurality of types of endoscope modules. Endoscope systems each comprising an endoscope attached to an endoscope insertion part,
The endoscope is provided at a distal end portion of the endoscope insertion portion, and a distal end projecting portion serving as a detachable attaching / detaching unit for the endoscope module, and an operation portion connected to the endoscope insertion portion. An operation handle for remotely operating the treatment means of the endoscope module attached to the endoscope insertion portion, one end portion being fixed to the operation handle, an attaching / detaching means and an operation at the other end portion Also serves as a force transmission means Have a threaded part A transmission wire provided with one connecting member, and a wire channel that is provided in the endoscope insertion portion and also serves as an air / liquid supply channel through which the transmission wire is inserted;
The endoscope module communicates with the main body portion so as to face an arrangement hole serving as an attaching / detaching means for fitting and arranging the distal end protruding portion of the endoscope insertion portion and an opening on the distal end side of the wire channel. A hole having an opening to be disposed; and an attachment / detachment means and an operation extending to the endoscope side through the hole and detachably attached to the first connecting member provided in the transmission wire at an end Also serves as a force transmission means A first threaded portion having a threaded portion with which the threaded portion of the first connecting member is screwed. And an operation wire for operating the treatment means having two connecting members.
[0011]
According to this configuration, an endoscopic treatment can be performed by attaching an endoscope module having treatment means to the distal end portion of the endoscope insertion portion, and the endoscope module is removed from the endoscope insertion portion. It can be stored in a state.
[0012]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
1 to 8 relate to a first embodiment of the present invention, and FIG. 1 is an example of a distal end portion of an endoscope constituting an endoscope system and an endoscope module attached to the endoscope. 2 is a cross-sectional view illustrating the configuration of the ligation module, FIG. 2 is an explanatory diagram illustrating the configuration of the operation unit of the endoscope, and FIG. 3 is a grasping module as an example of another endoscope module and the distal end of the endoscope FIG. 4 is an explanatory view showing a state in which a ligation module is attached to the distal end portion of the endoscope, and FIG. 5 is a view for explaining the operation of the endoscope to which the ligation module is attached. 6 is a diagram for explaining the state of use when the elastic ring is continuously attached to the affected part, FIG. 7 is a diagram for explaining a state in which the grasping module is attached to the distal end portion of the endoscope, and FIG. It is explanatory drawing which shows the effect | action of an endoscope.
[0013]
As shown in FIG. 1, an endoscope system 1 according to this embodiment includes an endoscope 2 and a ligation module 3 that is one of endoscope modules that can be attached to and detached from a distal end portion 21 of the endoscope 2. It consists of and.
[0014]
The distal end portion 21 of the endoscope 1 transmits an operating force to a fixed attachment / detachment hole 23 having a distal end protruding portion 22 that also serves as an attachment / detachment means for making the ligation module 3 attachable / detachable and a locking hole portion 23a. The transmission wire 4 is configured to have a wire channel 24 through which the transmission wire 4 can be inserted and retracted. The front end portion of the transmission wire 4 has a cylindrical shape, and a first connection member 41 serving as an attaching / detaching means and an operating force transmission means is fixedly provided on the inner peripheral surface of the first connection member 41. A female screw 42 is formed.
[0015]
The ligation module 3 is made of a hard and transparent resin member and is formed in a substantially convex shape. The ligation module 3 has a small diameter and faces the distal end portion 21 of the endoscope 2 as a detachable portion. A main body portion 30 having a cap portion 32 having a slightly larger diameter than the portion 31, and a ligation tool 33 serving as a treatment means including a ligation elastic ring 34 and a ring operation wire 35 disposed on the outer peripheral surface of the cap portion 32. It is configured. A second connecting member 37 that is substantially cylindrical and serves as an attaching / detaching means and an operating force transmitting means is fixed to the proximal end portion of the ring operating wire 35, and is attached to the distal end portion of the second connecting member 37. Is formed with a male screw 38 that meshes with the female screw 42 of the first connecting member 41.
[0016]
The cap portion 32 of the main body portion 30 of the ligation module 3 is formed with a treatment cavity portion 32b having an opening 32a on the distal end side where an affected part can be disposed. Further, the connecting portion 31 has a protruding portion arrangement hole 31a into which the distal end protruding portion 22 of the distal end portion 21 is fitted and arranged, and a locking claw portion 36a serving as an attaching / detaching means inserted into the fixed attaching / detaching hole 23. An attaching / detaching protrusion 36 provided at the distal end and a wire insertion hole 31b through which the ring operation wire 35 is inserted so as to freely advance and retract are formed. The wire insertion hole 31b communicates with the treatment cavity 32b, and the protrusion placement hole 31a communicates with the treatment cavity 32b through a communication hole 32c.
[0017]
The ring operation wire 35 is formed by twisting a plurality of wire wires 35a and 35b, and the ring operation wire 35 that has passed through the wire insertion hole 31b is disposed in the treatment cavity 32b. It is divided into. The distal ends of the wire wires 35a and 35b separated in the treatment cavity portion 32b extend so as to be disposed on the outer peripheral surface of the cap portion 32.
[0018]
A plurality of guide portions 35c are provided at equal intervals on the tip portions of the wire wires 35a and 35b, respectively, and the tip portions including these guide portions 35c are arranged on the outer peripheral surface of the cap portion 32, and The elastic ring 34 is disposed at a predetermined position with respect to the guide portion 35c.
[0019]
As shown in FIG. 2, the wire channel 24 formed in the distal end portion 21 is formed up to the operation portion 5 of the endoscope 1, and the proximal end portion of the transmission wire 4 inserted through the wire channel 24. Is fixed to a rotatable shaft 51a of a rotary operation handle 51 for generating an operating force for operating the treatment means of the endoscope module provided in the operation unit 5. As a result, the transmission wire 4 moves forward and backward by rotating the rotational operation handle 51.
[0020]
The wire channel 24 communicates with an air / liquid feeding channel 53 having an opening at the side of the operation unit 5 in the middle of the channel 24. The opening end 52 is provided with a base 55 having a packing 54 provided therein. The base 55, the air / liquid supply channel 53, and the wire channel 24 guide the liquid or gas. A channel for liquid feeding is formed.
[0021]
The endoscope 1 includes an optical lens (not shown), a light transmission means that allows an optical image input through the optical lens to be observed on the endoscope hand side, and a distal end portion is curved in a desired direction. The operation portion 5 is provided with an operation knob (not shown) for bending the bending portion in the vicinity of the rotation operation handle 51.
[0022]
Further, the other form of the endoscope module is not limited to the ligation module 3, and there is a grasping module 6 as shown in FIG. 3, for example. The holding module 6 is made of a hard resin member and is formed in a substantially pipe shape. The module body 61 has substantially the same shape as the connecting portion 31 of the main body 30 of the ligation module 3 and three holding portions 63a, 63b, It is comprised with the holding | gripping tool 62 which is a treatment means provided with 63c.
[0023]
The module main body 61 is provided with a projecting portion arrangement hole 31a into which the distal end projecting portion 22 of the distal end portion 21 serving as an attaching / detaching portion facing the distal end portion 21 of the endoscope is fitted and disposed, and the fixed attaching / detaching hole 23. A wire insertion hole 31b through which an attaching / detaching projection 36 provided at the tip of the engaging claw 36a to be engaged and a gripper operating wire 63 for projecting and retracting the grippers 63a, 63b, 63c is inserted. Is formed. The wire insertion hole 31 b is a through hole, and the protruding portion arrangement hole 31 a communicates with the outside through a communication hole 64. A substantially cylindrical second connecting member 37, which is an attaching / detaching means similar to that provided at the base end portion of the ring operation wire 35, is fixed to the base end portion of the gripping portion operation wire 63. The configuration of the endoscope and other configurations are the same as those of the endoscope system shown in FIG. 1, and the same members are denoted by the same reference numerals and description thereof is omitted.
[0024]
The operation of the endoscope system 1 configured as described above will be described.
First, before inserting the endoscope 1 into the body cavity, the ligation module 3 to be mounted on the distal end portion 21 of the endoscope 1 is taken out from the endoscope modules stored in the storage box. Then, the second connection fixed to the female screw 42 of the first connection member 41 fixed to the distal end portion of the transmission wire 4 of the endoscope 1 and the proximal end portion of the operation wire 35 of the ligation module 3. The male screw 38 of the member 37 is screwed and fixed. Subsequently, the attaching / detaching protrusion 36 of the main body 30 is arranged in the fixing attaching / detaching hole 23, and the positions of the tip protruding portion 22 and the protruding portion arranging hole 31a are arranged. After matching, the ligation module 3 and the endoscope 2 move in the approaching direction. Then, the tip protruding portion 22 is fitted into the protruding portion arranging hole 31a and arranged at a predetermined position, and the engaging claw portion 36a is engaged with the engaging hole portion 23a, as shown in FIG. The ligation module 3 is integrally fixed to the distal end portion 22 of the endoscope 2.
[0025]
Next, the endoscope 1 in which the ligation module 3 is integrally fixed to the distal end portion 21 is inserted to the vicinity of the examination site in the body cavity, and an opening provided on the distal end side of the cap portion 32 of the ligation module 3. The part 32a is moved until it faces the affected part 10 in the body cavity.
[0026]
Next, suction is applied by a suction device (not shown) through a base 55 provided at the opening end 52 of the operation unit 5 of the endoscope 1. Then, the air in the body cavity is sucked through the air supply / liquid supply channel formed by the base 55, the air supply / liquid supply channel 53 and the wire channel 24. The affected part 10 is sucked into the treatment cavity 32b.
[0027]
Here, the rotation operation handle 51 provided in the operation unit 5 of the endoscope 1 is operated to wind up the transmission wire 4. As a result, the transmission wire 4 advances and retreats, and the ring operation wire 35 connected to the transmission wire 4 moves toward the hand side, so that the guide portion 35c provided at the distal end moves, The elastic ring 34 disposed on the outer peripheral surface of the cap portion 32 is pushed by the guide portion 35c and gradually moves. Then, as shown in FIG. 5, the elastic ring 34 drops from the front of the main body 30 and contracts, thereby ligating the root of the affected area 10 sucked into the treatment cavity 32b by its own elastic force. To do.
[0028]
Subsequently, as shown in FIG. 6, the elastic ring 34 can be ligated to a plurality of locations by moving the endoscope 1 as indicated by the arrow without removing it from the body and repeating the above operation. is there.
[0029]
Further, when a treatment other than ligation is subsequently performed, the endoscope 2 is removed from the body cavity. The ligation module 3 and the distal end portion 21 of the endoscope 1 are moved away from each other while pushing the locking claw portion 36a engaged with the locking hole portion 23a of the fixing attachment / detachment hole 23. As a result, the ligation module 3 is separated from the distal end portion 21 of the endoscope 1.
[0030]
Next, the other endless module such as the gripping module 6 shown in FIG. 3 is connected to the distal end of the transmission wire 4 in the same manner as when the ligating module 3 is attached to the distal end portion 21 of the endoscope 2. The female screw 42 and the male screw 38 of the second connecting member 37 fixed to the proximal end portion of the gripping portion operation wire 63 of the gripping module 6 are screwed and fixed, and then the module main body 61 is attached and detached. The protrusion 36 is disposed in the fixing attachment / detachment hole 23 and the tip protrusion 22 and the protrusion disposition hole 31a are aligned so that the grasping module 6 and the endoscope 2 are moved closer to each other. Go. Then, the tip protruding portion 22 is fitted into the protruding portion arranging hole 31a and arranged at a predetermined position, and the engaging claw portion 36a is engaged with the engaging hole portion 23a, as shown in FIG. The grasping module 6 is integrally fixed to the distal end portion 21 of the endoscope 2.
[0031]
Subsequently, the rotary operation handle 51 of the operation unit 5 of the endoscope 1 is operated so that the gripping parts 63a, 63b, 63c of the gripping module 6 are housed in the wire insertion hole 31b and the wire channel. And move to the target site.
[0032]
Then, by operating the rotary operation handle 51 to move the transmission wire 4 forward and backward, the gripping part operation wire 63 connected to the transmission wire 4 is advanced and retracted, so that the gripping parts 63 a, 63 b, and 63 c are projected and retracted. Then, as shown in FIG. 8, the affected part 10a can be grasped by the grasping parts 63a, 63b, 63c. Then, after grasping the affected area 10a, the endoscope 2 is removed from the body cavity and the treatment is terminated.
[0033]
In this way, instead of inserting an elongated treatment instrument into the endoscope treatment channel, a small endoscope module having treatment means is configured to be detachable from the distal end portion of the endoscope. Treatment that occurred when the treatment instrument was inserted into the channel by providing a connection means for connecting and fixing the transmission wire inserted through the endoscope and the operation means for operating the treatment means provided in each module The breakage of the tool can be eliminated, and the storage space for the endoscope module can be reduced. This greatly improves the management of the treatment tool.
[0034]
In addition, since an operation handle for operating the treatment means of the endoscope module is provided in the vicinity of an operation knob or the like provided in the operation section of the endoscope, the operation of the endoscope and the module for the endoscope are provided. The treatment means provided in the can be easily operated.
[0035]
FIGS. 9 to 11 relate to a second embodiment of the present invention, FIG. 9 is an explanatory view showing the configuration of the biopsy module and the distal end of the endoscope, which are another configuration of the endoscope module, and FIG. FIG. 11 is an explanatory view showing a state in which the biopsy module is attached to the distal end portion of the endoscope, and FIG. 11 is an explanatory view showing the operation of the endoscope attached with the biopsy module.
[0036]
As shown in FIG. 9, the biopsy module 7, which is another configuration of the endoscope module, includes a module main body 71 formed in a substantially pipe shape with a hard resin member, and a pair of biopsy forceps 72, 72, for example. It is comprised with the biopsy forceps tool 73 which is a treatment means provided.
[0037]
The module main body 71 is operated to open and close the distal end portion arrangement hole 74 into which the distal end portion 21 including the distal end protruding portion 22 serving as the attachment / detachment portion of the endoscope 2 is fitted and disposed, and the biopsy forceps 72 and 72. A wire insertion hole 76 is formed through which the forceps operation wire 75 to be inserted is removably inserted. A screw hole 71a communicating with the tip portion arrangement hole 74 is provided on the outer peripheral surface of the module main body 71, and a fixing screw 77 serving as an attaching / detaching means is arranged in the screw hole 71a. Yes.
[0038]
The wire insertion hole 76 communicates with the tip portion arrangement hole 74, and the tip portion arrangement hole 74 communicates with the outside through a communication hole 78. Further, a second connecting member 37 having a substantially cylindrical shape, which is a detachable means similar to those provided at the proximal end portions of the ring operating wire 35 and the gripper operating wire 63, is provided at the proximal end portion of the forceps operating wire 75. It is fixed. In addition, it is the same as that of the said 1st Embodiment except not having formed the hole for fixing | fixed attachment / detachment in the other structure and endoscope, The same sign is attached | subjected to the same member and description is abbreviate | omitted.
[0039]
As shown in FIG. 10, the internal thread 42 of the first connecting member 41 fixed to the distal end portion of the transmission wire 4 of the endoscope 1 and the proximal end portion of the forceps operation wire 75 of the biopsy module 7 are fixed. The male screw 38 of the second connecting member 37 provided is screwed and fixed. Subsequently, the distal end portion 21 of the endoscope 2 is inserted into the distal end portion arranging hole 74 of the module main body 71, and then the fixing screw 77. The biopsy module 7 is fixed integrally to the distal end portion 21 of the endoscope 2. As in the first embodiment, the endoscope 2 is introduced into the body cavity with the biopsy forceps 72 of the biopsy module 7 closed.
[0040]
As shown in FIG. 11, the forceps operation wire 75 connected to the transmission wire 4 is operated by operating the rotary operation handle 51 provided in the operation unit 5 of the endoscope 1 to advance and retract the transmission wire 4. The biopsy forceps 72 opens and closes and the biopsy of the affected area 10b is performed.
[0041]
Thus, in this embodiment, since the endoscope module and the endoscope are fixed with screws, the attachment and detachment is easy and the endoscope is more powerful than the case of the first embodiment. The mirror and the endoscope module can be connected and fixed. Other operations and effects are the same as those in the first embodiment.
[0042]
FIGS. 12 to 14 relate to a third embodiment of the present invention. FIG. 12 is an explanatory view showing the configuration of the expansion module and the distal end of the endoscope, which are other configurations of the endoscope module, and FIG. FIG. 14 is an explanatory view showing a state in which the expansion module is attached to the distal end portion of the endoscope, and FIG. 14 is an explanatory view showing the operation of the endoscope attached with the expansion module.
[0043]
As shown in FIG. 12, the expansion module 8, which is another configuration of the endoscope module, includes a module main body 81 formed in a substantially pipe shape with a hard resin member, and the outer peripheral surface of the module main body 81 is covered. It is comprised with the balloon 82 formed with the member which has the elasticity arranged. The module main body 81 is provided with a convex portion 81a formed with a male screw at the base end portion thereof, so that the female screw formed at the distal end portion of the substantially pipe-shaped joining member 83 is engaged with the male screw. It has become. The module main body 81 is configured so that the inner diameter dimension of the convex portion 81a gradually becomes smaller by screwing the joint member 83 into the convex portion 81a and rotating the joint member 83 in the tightening direction. ing. The balloon 82 is fixed to the module main body 81 by a bobbin adhering portion 82a.
[0044]
Further, the module main body 81 is provided with a distal end portion arrangement hole 84 into which the distal end portion 21 including the distal end protruding portion 22 serving as an attachment / detachment portion of the endoscope 2 is fitted and disposed, and for expanding the balloon 82. An air / liquid feeding passage 85 through which gas or liquid is sent, and a tip side cavity 86 having an opening at the tip are formed.
[0045]
One end of the air / liquid supply passage 85 has an opening on the outer peripheral surface where the balloon 82 of the module main body 81 is arranged, and the other end communicates with the tip portion arrangement hole 84. Further, the distal end portion arranging hole 84 communicates with the distal end side cavity portion 86 through a communication hole 84a. Further, a connection member 87 having a substantially nipple shape formed of a hollow and elastic member that serves both as an attaching / detaching means and an air / liquid supply passage forming means is provided at the other end of the air / liquid supply passage 85. It is arranged. The connecting member 87 can be inserted into and removed from the wire channel 24 provided in the endoscope 2.
[0046]
The connecting member 87 is formed of a member that has good adhesion such as silicone, natural rubber, isoprene rubber, or neoprene rubber, and does not cause liquid leakage or air leakage. Other configurations and the endoscope are the same as those in the above-described embodiment except that the fixing attachment / detachment hole is not formed, and the same members are denoted by the same reference numerals and the description thereof is omitted.
[0047]
A rotation operation handle 51 provided in the operation section 5 of the endoscope 1 is rotated to place the first connecting member 41 fixed to the distal end portion of the transmission wire 4 in the wire channel 24. In this state, the distal end portion 21 of the endoscope 2 is inserted into the distal end portion disposing hole 84 of the module main body 81 through the through hole of the joining member 83, and the connecting member 87 is pushed into the wire channel 24. Go. As a result, the expansion module 8 and the endoscope 2 are temporarily fixed.
[0048]
Next, the joint member 83 is rotated in the closing direction so that the inner diameter of the convex portion 81a is gradually reduced to tighten the inner peripheral surface of the convex portion 81a to the outer peripheral surface of the distal end portion 21 of the endoscope 2. As a result, the expansion module 8 and the endoscope 2 are integrally fixed as shown in FIG.
[0049]
The endoscope 2 having the expansion module 8 attached to the distal end portion 21 is inserted into the body cavity, and a syringe (not shown) is connected to the mouthpiece 55 of the proximal side operation unit, for example, and the liquid in the syringe is supplied to the air / liquid supply channel Inject into 53. Then, the liquid injected from the syringe is injected into the balloon 82 through the wire channel 24 of the endoscope 1, the connection member 87, and the air / liquid supply passage 85, and the balloon 82 is expanded as shown in FIG. To do. With this expanded balloon 82, the affected area 10c is expanded and compressed to release the constricted affected area in the body cavity and to stop and compress the affected area.
[0050]
In this way, by closing the connecting member and the joining member that push the expansion module and the endoscope into the wire channel, the inner diameter of the convex portion is reduced to make the inner peripheral surface of the convex portion the outer peripheral surface of the endoscope distal end portion. The module body and the endoscope are integrally fixed by tightening to the end, so that the endoscope module can be attached and fixed to the endoscope more easily and firmly than in the first embodiment.
[0051]
15 to 19 relate to a fourth embodiment of the present invention. FIG. 15 is an explanatory view showing the configuration of an incision module and the distal end of the endoscope, which are other configurations of the endoscope module, and FIG. FIG. 17 is an explanatory view showing a state in which an incision module is attached to the distal end portion of the endoscope, and FIG. 18 is a state in which the incision portion is arranged in the affected part in the body cavity. FIG. 19 is an explanatory diagram showing a state in which the affected part is incised by the incision part.
[0052]
As shown in FIG. 15, an incision module 9, which is another configuration of the endoscope module, is fixed to a module main body 91 formed in a substantially pipe shape with a hard resin member, and a base end portion of the module main body 91. Thus, the first magnet 92 having a substantially pipe shape serving as an attaching / detaching means and an incision tool 93 which is a treatment means having an incision portion 93a, for example, are configured.
[0053]
The module main body 91 is formed with a treatment cavity 91b having an opening 91a on the distal end side where an affected part can be arranged. The incision tool 93 includes a snare 94 that forms a substantially ring-shaped incision portion 93a, and an incision through which the snare 94 is inserted and moved forward and backward with respect to the module body 91, and the forward and backward movement of the transmission wire 4 is transmitted. The instrument operating tube 95 and a press-fitting member 96 provided on the proximal side of the incising instrument operating tube 95 are configured. Further, a second magnet 97 serving as an attaching / detaching means is provided at the distal end portion 21 of the endoscope 2 so as to be rotatable on the outer periphery of the distal end portion 21. An operation tube 98 is inserted into the wire channel 24 so as to be able to advance and retreat, and the transmission wire 4 is inserted through the operation tube 98.
[0054]
As shown in FIG. 16, the operation portion 5 of the endoscope 1 has a first operation handle 99 a for the first operation force to which an end portion of the transmission wire 4 is connected and a proximal end portion of the operation tube 98. Is connected to the second operating handle 99b for the second operating force, and the first handle 99a and the second handle 99b are moved forward and backward to move the transmission wire 4 and the operating tube 98, respectively. Each can be advanced and retracted. In addition, except that the fixing hole is not formed in the endoscope, it is the same as the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.
[0055]
The operation of the endoscope system 1 including the incision module 9 and the endoscope 2 configured as described above will be described.
First, before inserting the endoscope 1 into a body cavity, the incision module 9 is attached to the distal end of the endoscope 1. At this time, the female screw 42 of the first connecting member 41 of the endoscope 1 and the male screw 38 of the second connecting member 37 of the cutting tool 93 are screwed and fixed to connect the transmission wire 4 and the snare 94.
[0056]
Subsequently, the distal end portion of the operation tube 98 inserted through the wire channel 24 of the endoscope 1 is press-fitted from the proximal side of the press-fitting member 96 of the incision tool 93 so that the operation tube 98 and the incision instrument operation tube are pressed. 95, the second magnet 97 arranged at the distal end portion 21 of the endoscope 1 is inserted into the through hole of the first magnet 92 of the incision module 9, and the respective magnets 92, 97 are inserted. As shown in FIG. 17, the endoscope 1 and the incision module 9 are integrally fixed by the magnetic force.
[0057]
Subsequently, after the endoscope 1 is disposed in the body cavity as in the first embodiment described above, the affected part 10d is drawn into the treatment cavity part 91b by suction force as shown in FIG. At this time, a ring-shaped incision 93a is formed along the snare 94 along the opening 91a of the module main body 91, whereby the sucked affected part 10d is wound around the incision 93a.
[0058]
Next, the second handle 99b of the operation unit 5 is advanced. Then, when the incision tool operation tube 95 is pushed forward, the snare 94 is relatively drawn into the incision tool operation tube 95, and the snare 94 is primarily bound to the root of the affected part 10d.
[0059]
Next, the first handle 99a is retracted toward the hand side. As a result, the snare 94 is largely drawn into the incision instrument operating tube 95 and is secondarily bound, and in this state, the excision of the affected part 10d is completed by applying a high frequency to the snare 94.
[0060]
When the incision module 9 is removed after the treatment is completed and the endoscope is removed from the body cavity, the second magnet 97 provided at the distal end portion 21 of the endoscope 1 is rotated. Thus, the first magnet 92 on the endoscope module side and the second magnet 97 on the endoscope 1 side are repelled by the respective magnets, and the incision module 9 and the endoscope 1 are separated. .
[0061]
Thus, the snare constituting the incision module and the incision tool operation tube can be independently operated. This makes it possible to perform complicated operations such as incision.
[0062]
Further, since the incision module and the endoscope are attached and detached by magnetic force, it is possible to prevent the endoscope and the module from being damaged due to a load even if the attachment and removal are repeated.
[0063]
It should be noted that the present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.
[0064]
[Appendix]
According to the embodiment of the present invention as described above in detail, the following configuration can be obtained.
[0065]
(1) An endoscope system in which an endoscope module having at least one treatment means can be attached to a distal end portion of an endoscope insertion portion via an attaching / detaching means.
[0066]
(2) The endoscope system according to appendix 1, wherein the endoscope includes an operation unit that remotely operates a treatment unit of the endoscope module.
[0067]
(3) The endoscope system according to appendix 2, further comprising an operation force transmission unit that transmits an operation force from the operation unit to the treatment unit. Connecting member
(4) The endoscope module includes a first operation force transmission unit that transmits a first operation force from the operation unit, and a second operation force transmission that transmits a second operation force from the operation unit. The endoscope system according to claim 2, further comprising: means.
[0068]
【The invention's effect】
As described above, according to the present invention, it is possible to provide an endoscope system that can prevent a treatment tool from being damaged, can be easily operated under an endoscope, and can be stored in a small space.
[Brief description of the drawings]
1 to 8 relate to a first embodiment of the present invention, and FIG.
Sectional drawing explaining the structure of the ligation module which is an example of the front-end | tip part of the endoscope which comprises an endoscope system, and the module for endoscopes attached to this endoscope
FIG. 2 is an explanatory diagram showing a configuration of an operation unit of an endoscope
FIG. 3 is an explanatory diagram showing a configuration of a grasping module as an example of another endoscope module and a distal end portion of the endoscope.
FIG. 4 is an explanatory view showing a state in which a ligation module is attached to the distal end portion of the endoscope.
FIG. 5 is a diagram for explaining the operation of an endoscope to which a ligation module is attached.
FIG. 6 is a diagram for explaining a use state when an elastic ring is continuously attached to an affected part.
FIG. 7 is an explanatory view showing a state in which a grasping module is attached to the distal end portion of the endoscope.
FIG. 8 is an explanatory diagram showing the operation of an endoscope with a gripping module attached.
9 to 11 relate to a second embodiment of the present invention, and FIG.
Explanatory drawing which shows the structure of the module for biopsy which is another structure of the module for endoscopes, and the front-end | tip of an endoscope
FIG. 10 is an explanatory view showing a state in which a biopsy module is attached to the distal end portion of the endoscope.
FIG. 11 is an explanatory diagram showing the operation of an endoscope with a biopsy module attached thereto.
12 to 14 relate to a third embodiment of the present invention, and FIG.
Explanatory drawing which shows the structure of the expansion module which is another structure of the module for endoscopes, and the front-end | tip of an endoscope
FIG. 13 is an explanatory view showing a state in which an expansion module is attached to the distal end portion of the endoscope.
FIG. 14 is an explanatory view showing the operation of an endoscope with an expansion module attached thereto.
15 to 19 relate to a fourth embodiment of the present invention, and FIG.
Explanatory drawing which shows the structure of the module for incision which is another structure of the module for endoscopes, and the front-end | tip of an endoscope
FIG. 16 is an explanatory diagram showing an operation unit of an endoscope.
FIG. 17 is an explanatory view showing a state in which an incision module is attached to the distal end portion of the endoscope.
FIG. 18 is an explanatory view showing a state in which an incision is placed in an affected part in a body cavity.
FIG. 19 is an explanatory view showing a state in which the affected part is incised by the incision part.
[Explanation of symbols]
1. Endoscope system
2. Endoscope
3 ... Module for ligation
22 ... tip protrusion
23a ... Hole for locking
31a ... Protrusion placement hole
35 ... Ring operation wire
36a ... Locking claw part
37. Second connecting member
41 ... 1st connection member

Claims

A plurality of types of endoscope modules each having different treatment means for performing a treatment on a living tissue in each main body, and the plurality of types of endoscope modules are attached to the endoscope insertion unit. In an endoscope system comprising an endoscope,
The endoscope is
A tip protrusion provided at a tip of the endoscope insertion portion and serving as a detachable attachment / detachment unit for the endoscope module;
An operation handle that is provided in an operation unit that is connected to the endoscope insertion unit and that remotely operates the treatment means of the endoscope module that is attached to the endoscope insertion unit;
One end is fixed to the operating handle, Ru serves as a detachable unit and the operating force transmitting means at the other end, comprising a first coupling member having a threaded portion, and a transmission wire,
A wire channel that is provided in the endoscope insertion portion and also serves as an air / liquid supply channel through which the transmission wire is inserted;
The endoscope module is in the main body,
An arrangement hole serving as an attaching / detaching means into which the distal end protruding portion of the endoscope insertion portion is inserted and arranged;
A hole provided with an opening arranged to communicate with the opening on the distal end side of the wire channel;
Said through holes extending in the endoscope side, the end portion, Ru serves as a freely detachable means and operating force transmitting means removably attached to said first connection member provided in the transmission wire, the first An operation wire for operating the treatment means having a second connecting member provided with a screw portion into which a screw portion of the connecting member is screwed ,
An endoscope system comprising:

2. The endoscope system according to claim 1, wherein the wire channel communicates with an air / liquid supply channel having an opening in a side portion of the operation unit in a middle portion of the wire channel.

The main body portion is further provided with an attaching / detaching protrusion having a locking claw portion at the distal end as the attaching / detaching means, and the locking claw portion is further disposed as the attaching / detaching means at the distal end portion of the endoscope. the endoscope system according to claim 1, wherein the detachable protrusion is characterized in that a fixed detachable holes to be engaged with a use hole.

In the configuration further comprising a fixing screw as the attaching / detaching means,
The endoscope system according to claim 1, wherein the main body portion is provided with a screw hole that communicates with the placement hole on the outer peripheral surface of the main body portion and into which the fixing screw is screwed.

The endoscope system according to claim 1, wherein a connecting member serving as an attaching / detaching unit for the wire channel and a liquid feeding passage forming unit is provided in the hole.