JP4172966B2 - Endoscope hardness variable sheath adapter - Google Patents

Endoscope hardness variable sheath adapter Download PDF

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Publication number
JP4172966B2
JP4172966B2 JP2002231242A JP2002231242A JP4172966B2 JP 4172966 B2 JP4172966 B2 JP 4172966B2 JP 2002231242 A JP2002231242 A JP 2002231242A JP 2002231242 A JP2002231242 A JP 2002231242A JP 4172966 B2 JP4172966 B2 JP 4172966B2
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Japan
Prior art keywords
hardness
annular
endoscope
space
sheath adapter
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JP2004065745A (en
Inventor
秀人 黒澤
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Hoya Corp
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Hoya Corp
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/00078Insertion part of the endoscope body with stiffening means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • A61B1/00135Oversleeves mounted on the endoscope prior to insertion

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)

Description

【0001】
【技術分野】
本発明は、既存の内視鏡に着脱して用いることができる硬度可変シースアダプタに関する。
【0002】
【従来技術およびその問題点】
医療現場では、内視鏡の挿入部の硬度を変化させたいという要求がある。この要求に応えるため、挿入部内に硬度可変機構を内蔵するタイプの内視鏡や、鉗子などの処置具挿通用のチャンネルに硬度可変部材を挿入するタイプの硬度可変装置が提案されている。しかし、前者の内蔵タイプでは、個々の内視鏡に硬度可変機構を設けるためコスト高になってしまい、後者のチャンネル挿通タイプでは、硬度可変部材の挿入時に、チャンネルが本来の目的で使用できなくなる(しにくくなる)という問題があった。
【0003】
【発明の目的】
本発明は、既存の内視鏡にも使用可能であり、内部チャンネルの使い勝手を損なうことのない、内視鏡の硬度可変シースアダプタを得ることを目的とする。
【0004】
【発明の概要】
本発明の硬度可変シースアダプタは、内視鏡の操作部から延びる挿入部の外周面に沿う内管と;この内管との間に環状コイル挿入空間を形成する外管と;この環状コイル挿入空間内に挿入された圧縮コイルばねと;環状コイル挿入空間に連通させて操作部側の端部に形成された、該環状コイル挿入空間よりも外径サイズが大きい環状空間と;この環状空間に直進進退動可能に支持され、環状コイル挿入空間に進入可能な小径先端部を有する移動環と;を有し、移動環の小径先端部により上記圧縮コイルばねを押圧して圧縮度を変化させることを特徴としている。
【0005】
移動環を移動させる操作手段として、移動環に螺合して環状空間から突出し、該環状空間に対する軸方向移動が規制されかつ回動操作可能に支持された硬度調整リングを有し、この硬度調整リングの回転によって移動環が移動されるように構成するとよい。
【0006】
【発明の実施形態】
図1ないし図3は、本発明の一実施形態である硬度可変シースアダプタ10を示している。硬度可変シースアダプタ10は、可撓性を有する硬度可変管部11と、その基部に接続する硬度操作部12とを有している。
【0007】
硬度可変管部11は、外筒11aと内筒11bの間に環状の環状コイル挿入空間11cが形成され、この環状コイル挿入空間11cの前方は先端キャップ11dによって塞がれている。外筒11a及び内筒11bは、ポリウレタンなど可撓性のある材質で形成されている。環状コイル挿入空間11c内には圧縮コイルばね15が挿入されている。圧縮コイルばね15は、自由状態で外筒11a及び内筒11bと略同心の直線筒状をなしている。
【0008】
硬度操作部12は、外筒16aと内筒16bからなるシリンダ部材16を有し、この外筒16aと内筒16bの間の環状空間16cが、環状コイル挿入空間11cに連通している。より具体的には、硬度可変管部11の外筒11aの終端部は、シリンダ部材16の外筒16aの外周面に固定され、内筒11bの終端部は、内筒16bの内周面に固定されている。硬度可変管部11とシリンダ部材16のそれぞれの内筒11b、16bの内径サイズは同じであり、これらの内筒11b、16bの内側に一連の内視鏡挿通空間19が形成されている。一方、シリンダ部材16の外筒16aは硬度可変管部11の外筒11aよりも大径で、環状コイル挿入空間11cよりも環状空間16cの方が、外径サイズが大きくなっている。
【0009】
環状空間16cには、スライダ(移動環)17が軸線方向に直進進退可能に挿入されている。スライダ17は、該直進進退方向への直線溝17aを有し、この直線溝17aに対して、シリンダ部材16の外筒16aの内周面に突設した直進ガイド突起16dが係合しており、この直線溝17aと直進ガイド突起16dの係合によって、スライダ17は直進案内される。スライダ17の外周面にはさらにねじ部17bが形成され、ねじ17bは、硬度調整リング18の内周面に形成したねじ部18aと螺合している。シリンダ部材16の外筒16aには、このねじ部17b、18aの螺合を可能にさせる環状貫通穴16eが形成され、硬度調整リング18は、該環状貫通穴16eに嵌まることで軸方向移動が規制され、シリンダ部材16の軸線を中心として回動可能に支持されている。
【0010】
スライダ17は、ねじ部17bを有する本体部よりも小径な先端押圧部(小径先端部)17cを有し、この先端押圧部17cは、環状コイル挿入空間11c内に挿入されて圧縮コイルばね15の一端部に当接している。圧縮コイルばね15の他端部は、先端キャップ11dに当接して移動規制されている。
【0011】
以上の硬度可変シースアダプタ10では、硬度調整リング18を回動させると、直線溝17aと直進ガイド突起16dによって直進案内されているスライダ17が、ねじ部17b、18aに従って、シリンダ部材16の軸方向に移動する。例えば、図1の状態で硬度調整リング18を所定方向に回動させると、図2のように、環状コイル挿入空間11cへの挿入方向(図の左方)にスライダ17が移動し、硬度調整リング18を逆方向に回動させると、図3のように、環状コイル挿入空間11cから退避する方向(図の右方)にスライダ17が移動する。図2の状態では、環状コイル挿入空間11c内への先端押圧部17cの挿入量が増大するので、圧縮コイルばね15が圧縮され、図3の状態では逆に、先端押圧部17cが退避するため、復元力によって圧縮コイルばね15が伸びる。圧縮コイルばね15は圧縮されると曲がりにくく(硬く)なり、伸びて自由状態に近づくほど曲がりやすく(柔らかく)なる特性を有しているため、硬度調整リング18を適宜操作することにより、硬度可変管部11の曲げ剛性(可撓性)を任意に変化させることができる。
【0012】
図4は、硬度可変シースアダプタ10の使用状態を示している。同図に示す内視鏡20は、体腔内に挿入される挿入部21とその基部側に接続された操作部22を有している。挿入部21は、先端側から順に、湾曲部23と可撓管部24を有しており、さらに可撓管部24が連結部25を介して操作部22に接続している。
【0013】
操作部22からはユニバーサルチューブ26が延設され、ユニバーサルチューブ26の先端には、画像処理装置や光源等を有する外部のビデオプロセッサに対して着脱可能なコネクタ部27が設けられている。挿入部21の先端部には図示しない対物レンズや撮像素子が設けられており、これらによって得られる映像信号は、ビデオプロセッサに送られて電子画像として表示または記録される。また、挿入部21の先端部に設けた配光レンズには、ビデオプロセッサ側の光源からライトガイドファイババンドルを介して照明光が送られる。挿入部21内にはその他にも、流体流通や処置具の挿通に用いられるチャンネル(チューブ)など、様々な内蔵物が設けられている。
【0014】
挿入部21のうち、可撓管部24は可撓性を有している。また、湾曲部23内には、多数の筒状をなす湾曲セグメント(不図示)が長手方向へ向けて整列状態で設けられており、各湾曲セグメントはリベットで順次枢着されている。湾曲セグメントと操作部22に設けた湾曲操作ノブ29とは、図示しない湾曲操作ワイヤを介して接続されており、湾曲操作ノブ29を回動させることにより、各湾曲セグメントがリベットを中心として揺動し、湾曲部23が湾曲される。
【0015】
図1ないし図3に示すように、硬度可変シースアダプタ10の内視鏡挿通空間19は、内視鏡20の挿入部21を挿通可能な内径サイズを有している。硬度可変シースアダプタ10を使用するときには、図4に示すように、湾曲部23が硬度可変管部11の先端から突出するまで、内視鏡20の挿入部21を内視鏡挿通空間19へ挿入していく。すると、硬度可変シースアダプタ10が可撓管部24の略全体を覆う状態となる。この状態で硬度調整リング18を適宜回動させると、前述した硬度可変シースアダプタ10の構造によって圧縮コイルばね15の圧縮度が変化し、その結果、可撓管部24を覆う硬度可変管部11の曲げ剛性が変化して可撓管部24に所望の硬さを付与することができる。
【0016】
以上のように、本実施形態の硬度可変装置では、内視鏡の挿入部の硬度を、その外周面に沿う硬度可変シースアダプタ10によって変化させるものとしたので、硬度可変機構を内蔵しない既存のタイプの内視鏡に使用することができ、コスト的に有利である。また、硬度可変シースアダプタ10は、使用に際して内視鏡20に内蔵された各種チャンネルを使用しないため、各種チャンネルの性能に影響を与えるおそれもない。
【0017】
【発明の効果】
以上のように本発明によれば、既存の内視鏡に着脱して用いることが可能で、内部チャンネルの使い勝手を損なうこともない、内視鏡の硬度可変シースアダプタを得ることができる。
【図面の簡単な説明】
【図1】本発明による硬度可変シースアダプタの一実施形態を示す断面図である。
【図2】図1の硬度可変シースアダプタで、圧縮コイルばねの圧縮度を高めた状態を示す断面図である。
【図3】図1の硬度可変シースアダプタで、圧縮コイルばねの圧縮度を低くした状態を示す断面図である。
【図4】図1ないし図3の硬度可変シースアダプタを内視鏡に装着した使用状態の外観図である。
【符号の説明】
10 硬度可変シースアダプタ
11 硬度可変管部
11a 外筒
11b 内筒
11c 環状コイル挿入空間
11d 先端キャップ
12 硬度操作部
15 圧縮コイルばね
16 シリンダ部材
16a 外筒
16b 内筒
16c 環状空間
16d 直進ガイド突起
16e 環状貫通穴
17 スライダ(移動環)
17a 直線溝
17b ねじ部
17c 先端押圧部
18 硬度調整リング
18a ねじ部
19 内視鏡挿通空間
20 内視鏡
21 挿入部
22 操作部
23 湾曲部
24 可撓管部
[0001]
【Technical field】
The present invention relates to a variable hardness Shisuadapu data that may be used in detaching the existing endoscope.
[0002]
[Prior art and its problems]
In the medical field, there is a demand for changing the hardness of the insertion portion of the endoscope. In order to meet this demand, there have been proposed endoscopes that incorporate a hardness varying mechanism in the insertion portion, and hardness varying devices that insert a hardness varying member into a channel for inserting a treatment instrument such as a forceps. However, with the former built-in type, the cost is increased due to the provision of a hardness varying mechanism for each endoscope, and with the latter channel insertion type, the channel cannot be used for its original purpose when the hardness varying member is inserted. There was a problem (becomes difficult to do).
[0003]
OBJECT OF THE INVENTION
The present invention can be also used to existing endoscopes, an object is to obtain without impairing the usability of the internal channel, the rigidity changing Shisuadapu data of the endoscope.
[0004]
SUMMARY OF THE INVENTION
Hardness variation Shisuadapu motor of the present invention, the inner tube and along the outer peripheral surface of the insertion portion extending from the operation portion of the endoscope; outer tube and forming an annular coil insertion space between the inner tube; the annular coil insertion A compression coil spring inserted into the space ; an annular space formed at the end of the operation portion side in communication with the annular coil insertion space; and an outer diameter size larger than the annular coil insertion space; And a moving ring having a small-diameter tip that is supported so as to be able to move forward and backward and enter the annular coil insertion space, and the compression coil spring is pressed by the small-diameter tip of the moving ring to change the degree of compression. It is characterized by.
[0005]
As the operating means for moving the moving ring, there is a hardness adjusting ring that is screwed into the moving ring and protrudes from the annular space, and is supported so that the axial movement with respect to the annular space is restricted and can be rotated. It is good to comprise so that a moving ring may be moved by rotation of a ring.
[0006]
DETAILED DESCRIPTION OF THE INVENTION
1 to 3 show a hardness variable sheath adapter 10 according to an embodiment of the present invention. The variable hardness sheath adapter 10 includes a flexible hardness variable tube portion 11 and a hardness operation portion 12 connected to the base portion.
[0007]
In the hardness varying tube portion 11, an annular annular coil insertion space 11c is formed between the outer cylinder 11a and the inner cylinder 11b, and the front of the annular coil insertion space 11c is closed by a tip cap 11d. The outer cylinder 11a and the inner cylinder 11b are formed of a flexible material such as polyurethane. A compression coil spring 15 is inserted into the annular coil insertion space 11c. The compression coil spring 15 has a straight cylindrical shape that is substantially concentric with the outer cylinder 11a and the inner cylinder 11b in a free state.
[0008]
The hardness operation unit 12 includes a cylinder member 16 composed of an outer cylinder 16a and an inner cylinder 16b, and an annular space 16c between the outer cylinder 16a and the inner cylinder 16b communicates with the annular coil insertion space 11c. More specifically, the terminal portion of the outer cylinder 11a of the variable hardness tube portion 11 is fixed to the outer peripheral surface of the outer tube 16a of the cylinder member 16, and the terminal portion of the inner tube 11b is fixed to the inner peripheral surface of the inner tube 16b. It is fixed. The inner diameters of the inner cylinders 11b and 16b of the hardness varying tube portion 11 and the cylinder member 16 are the same, and a series of endoscope insertion spaces 19 are formed inside these inner cylinders 11b and 16b. On the other hand, the outer cylinder 16a of the cylinder member 16 has a larger diameter than the outer cylinder 11a of the variable hardness tube portion 11, and the outer space size of the annular space 16c is larger than that of the annular coil insertion space 11c.
[0009]
A slider (moving ring) 17 is inserted into the annular space 16c so as to be able to advance and retreat in the axial direction. The slider 17 has a linear groove 17a in the linear advance / retreat direction, and a linear guide protrusion 16d protruding from the inner peripheral surface of the outer cylinder 16a of the cylinder member 16 is engaged with the linear groove 17a. The slider 17 is linearly guided by the engagement of the linear groove 17a and the linear guide protrusion 16d. A screw portion 17 b is further formed on the outer peripheral surface of the slider 17, and the screw 17 b is screwed with a screw portion 18 a formed on the inner peripheral surface of the hardness adjusting ring 18. An annular through hole 16e that allows the threaded portions 17b and 18a to be screwed is formed in the outer cylinder 16a of the cylinder member 16, and the hardness adjusting ring 18 is moved in the axial direction by fitting into the annular through hole 16e. Is supported, and is supported so as to be rotatable about the axis of the cylinder member 16.
[0010]
The slider 17 has a tip pressing portion (small diameter tip portion) 17c having a diameter smaller than that of the main body portion having the threaded portion 17b. The tip pressing portion 17c is inserted into the annular coil insertion space 11c and the compression coil spring 15 is inserted. It is in contact with one end. The other end of the compression coil spring 15 is in contact with the tip cap 11d and restricted in movement.
[0011]
In the above-described hardness variable sheath adapter 10, when the hardness adjusting ring 18 is rotated, the slider 17 guided linearly by the linear groove 17a and the linear guide protrusion 16d is moved in the axial direction of the cylinder member 16 in accordance with the screw portions 17b and 18a. Move to. For example, when the hardness adjustment ring 18 is rotated in a predetermined direction in the state of FIG. 1, the slider 17 moves in the insertion direction (left side of the drawing) into the annular coil insertion space 11c as shown in FIG. When the ring 18 is rotated in the reverse direction, as shown in FIG. 3, the slider 17 moves in the direction of retreating from the annular coil insertion space 11c (to the right in the figure). In the state of FIG. 2, the amount of insertion of the tip pressing portion 17c into the annular coil insertion space 11c increases, so the compression coil spring 15 is compressed, and conversely in the state of FIG. 3, the tip pressing portion 17c retracts. The compression coil spring 15 is extended by the restoring force. The compression coil spring 15 has a characteristic that it is difficult to bend (hard) when compressed, and is easy to bend (soften) as it expands and approaches a free state. Therefore, the hardness can be varied by appropriately operating the hardness adjusting ring 18. The bending rigidity (flexibility) of the tube part 11 can be arbitrarily changed.
[0012]
FIG. 4 shows the usage state of the hardness variable sheath adapter 10. The endoscope 20 shown in the figure has an insertion portion 21 to be inserted into a body cavity and an operation portion 22 connected to the base side thereof. The insertion portion 21 has a bending portion 23 and a flexible tube portion 24 in order from the distal end side, and the flexible tube portion 24 is connected to the operation portion 22 via a connecting portion 25.
[0013]
A universal tube 26 extends from the operation unit 22, and a connector portion 27 detachably attached to an external video processor having an image processing device, a light source, and the like is provided at the distal end of the universal tube 26. An objective lens and an image sensor (not shown) are provided at the distal end portion of the insertion portion 21, and a video signal obtained by these is sent to a video processor to be displayed or recorded as an electronic image. Illumination light is sent from the light source on the video processor side through the light guide fiber bundle to the light distribution lens provided at the distal end of the insertion portion 21. In addition, various internal components such as a channel (tube) used for fluid circulation and treatment instrument insertion are provided in the insertion portion 21.
[0014]
Of the insertion portion 21, the flexible tube portion 24 has flexibility. In addition, a large number of cylindrical curved segments (not shown) are provided in the curved portion 23 so as to be aligned in the longitudinal direction, and the curved segments are sequentially pivoted by rivets. The bending segment and the bending operation knob 29 provided on the operation unit 22 are connected via a bending operation wire (not shown), and by rotating the bending operation knob 29, each bending segment swings around the rivet. Then, the bending portion 23 is bent.
[0015]
As shown in FIGS. 1 to 3, the endoscope insertion space 19 of the variable hardness sheath adapter 10 has an inner diameter size through which the insertion portion 21 of the endoscope 20 can be inserted. When the variable hardness sheath adapter 10 is used, the insertion portion 21 of the endoscope 20 is inserted into the endoscope insertion space 19 until the bending portion 23 protrudes from the distal end of the variable hardness tube portion 11 as shown in FIG. I will do it. Then, the variable hardness sheath adapter 10 is in a state of covering substantially the entire flexible tube portion 24. When the hardness adjusting ring 18 is appropriately rotated in this state, the degree of compression of the compression coil spring 15 changes depending on the structure of the above-described hardness variable sheath adapter 10, and as a result, the hardness variable tube portion 11 covering the flexible tube portion 24. Thus, the desired rigidity can be imparted to the flexible tube portion 24.
[0016]
As described above, in the hardness variable device according to the present embodiment, the hardness of the insertion portion of the endoscope is changed by the hardness variable sheath adapter 10 along the outer peripheral surface thereof. It can be used for a type of endoscope and is advantageous in terms of cost. In addition, since the variable hardness sheath adapter 10 does not use various channels built in the endoscope 20 when used, there is no possibility of affecting the performance of the various channels.
[0017]
【The invention's effect】
According to the present invention as described above, can be used to removably attached to an existing endoscope, nor impair the usability of the internal channel, it is possible to obtain a hardness variable Shisuadapu data of the endoscope.
[Brief description of the drawings]
FIG. 1 is a cross-sectional view showing an embodiment of a hardness variable sheath adapter according to the present invention.
2 is a cross-sectional view showing a state where the degree of compression of a compression coil spring is increased in the hardness variable sheath adapter of FIG. 1. FIG.
3 is a cross-sectional view showing a state in which the compression degree of the compression coil spring is lowered in the hardness variable sheath adapter of FIG. 1. FIG.
4 is an external view of a usage state in which the hardness variable sheath adapter of FIGS. 1 to 3 is mounted on an endoscope. FIG.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 Hardness variable sheath adapter 11 Hardness variable pipe | tube part 11a Outer cylinder 11b Inner cylinder 11c Annular coil insertion space 11d End cap 12 Hardness operation part 15 Compression coil spring 16 Cylinder member 16a Outer cylinder 16b Inner cylinder 16c Through hole 17 Slider (moving ring)
17a Linear groove 17b Screw portion 17c Tip pressing portion 18 Hardness adjustment ring 18a Screw portion 19 Endoscope insertion space 20 Endoscope 21 Insertion portion 22 Operation portion 23 Bending portion 24 Flexible tube portion

Claims (2)

内視鏡の操作部から延びる挿入部の外周面に挿脱可能な硬度可変シースアダプタであって、
上記挿入部外周面に沿う内管と;
この内管との間に環状コイル挿入空間を形成する外管と;
この環状コイル挿入空間内に挿入された圧縮コイルばねと;
上記環状コイル挿入空間に連通させて操作部側の端部に形成された、該環状コイル挿入空間よりも外径サイズが大きい環状空間と;
この環状空間に直進進退動可能に支持され、上記環状コイル挿入空間に進入可能な小径先端部を有する移動環と;
を有し、上記移動環の小径先端部により上記圧縮コイルばねを押圧して圧縮度を変化させることを特徴とする内視鏡の硬度可変シースアダプタ。
A hardness variable sheath adapter that can be inserted into and removed from the outer peripheral surface of the insertion portion extending from the operation portion of the endoscope ,
An inner pipe along the outer peripheral surface of the insertion part;
An outer tube forming an annular coil insertion space with the inner tube;
A compression coil spring inserted into the annular coil insertion space;
An annular space having an outer diameter size larger than that of the annular coil insertion space, which is formed at the end portion on the operation unit side in communication with the annular coil insertion space;
A movable ring that is supported in this annular space so as to be able to move forward and backward, and has a small-diameter tip that can enter the annular coil insertion space;
An endoscope having a variable hardness , wherein the compression coil spring is pressed by a small-diameter tip portion of the moving ring to change the degree of compression .
請求項1記載の硬度可変シースアダプタにおいて、上記移動環に螺合して上記環状空間から突出し、該環状空間に対する軸方向移動規制されかつ回動操作可能に支持された硬度調整リングを有し、該硬度調整リングの回転により上記移動環が移動される内視鏡の硬度可変シースアダプタ。 Yes In hardness variation sheath adapter of claim 1, wherein said screwed to the moving ring projecting from the annular space, the axial movement is restricted for the annular space and turning operably supported hardness adjusting ring An endoscope hardness variable sheath adapter in which the moving ring is moved by rotation of the hardness adjusting ring .
JP2002231242A 2002-08-08 2002-08-08 Endoscope hardness variable sheath adapter Expired - Fee Related JP4172966B2 (en)

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