JP4348713B2 - Double balloon endoscope device - Google Patents

Description

  The present invention provides a first balloon that is attached to the outer periphery of the distal end of an insertion portion of an endoscope, and a second balloon that is attached to the outside of the distal end of an overtube through which the insertion portion of the endoscope is inserted to guide the insertion of the insertion portion. It is related with the double balloon type endoscope apparatus which expands and contracts and inserts the said insertion part in a body cavity.

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

  On the other hand, the double-balloon type endoscope apparatus disclosed in Patent Document 2 includes an endoscope in which a first balloon that can be expanded and contracted is attached to the outer periphery of the distal end of the endoscope insertion portion, and an expansion and contraction of the distal end of the endoscope. A free second balloon is attached, and an endoscope insertion portion is inserted, and an overtube serving as a guide when inserting the insertion portion is provided. This double balloon type endoscope apparatus performs the insertion and removal operations of the overtube and the endoscope insertion portion and the expansion and contraction operations of the first and second balloons according to a predetermined procedure, thereby It is inserted deep in the digestive tract.

In addition, the double balloon endoscope apparatus of Patent Document 2 uses an endoscope dedicated to a double balloon in which an air supply / suction port for expanding and contracting the first balloon is formed at the distal end of the insertion portion. In this dedicated endoscope, an air supply port connected to an air pump is provided in the hand operation unit, and this air supply port is communicated with the air supply / suction port via an air tube inserted through the insertion unit. Yes.
JP-A-10-248794 JP 2002-301019 A

  However, the double-balloon endoscope device of Patent Document 2 can be used only with a double-balloon endoscope in which an air supply port is formed at the distal end of the insertion portion, and the air supply is delivered to the distal end of the insertion portion. There was a problem that a normal endoscope without a mouth could not be used.

  The present invention has been made in view of such circumstances, and as a double-balloon endoscope, a double-balloon endoscope apparatus that can be used for a normal endoscope that does not have a balloon inflation / deflation function. The purpose is to provide.

  In order to achieve the above object, the first aspect of the present invention is the insertion of the first balloon that is attached to the outer periphery of the distal end of the insertion portion of the endoscope and the insertion portion of the endoscope. In a double-balloon endoscope apparatus in which a second balloon attached to the outer peripheral portion of the overtube to be guided is expanded and contracted and the insertion portion is inserted into a body cavity, the first balloon is attached to the overtube. A first flow path for supplying and sucking air to be expanded and contracted and a second flow path for supplying and sucking air for expanding and contracting the second balloon are provided, and the first flow path on the overtube side is provided. The distal end portion and the first balloon are connected to each other by an air supply tube that enables a relative insertion / extraction operation of the overtube and the insertion portion.

  According to a second aspect of the present invention, in the first aspect, the air supply tube is detachably connected to an air supply port formed at a distal end portion of the first flow path of the overtube. The balloon is configured to be detachable from the overtube.

  According to a third aspect of the present invention, in the first aspect, the distal end portion of the first flow path on the overtube side and the first balloon are separated by removing the air supply tube. It is said.

  According to a fourth aspect of the present invention, in the first or second aspect, the air supply tube is formed in a spiral shape.

  According to a fifth aspect of the present invention, in the first aspect, the first balloon is attached to an outer periphery of a tube, and an insertion portion of the endoscope is inserted into the tube so that the first balloon is an endoscope. It is attached to the outer periphery of the distal end of the insertion portion.

  According to the double balloon type endoscope apparatus according to the present invention, the first flow path for supplying and sucking air for inflating and contracting the first balloon is provided in the overtube, and the front end portion of the first flow path and the first flow path are provided. Since one balloon is connected by an air supply tube that allows relative insertion and removal of the overtube and the insertion portion, a normal endoscope can be used as a double balloon type endoscope. The relative insertion / extraction operation between the overtube and the insertion portion can be performed smoothly.

  A preferred embodiment of a double balloon endoscope apparatus according to the present invention will be described below with reference to the accompanying drawings.

  FIG. 1 shows a system configuration diagram of an endoscope apparatus to which a double balloon endoscope apparatus according to the present invention is applied. The endoscope apparatus shown in FIG. 1 includes an endoscope 10, an overtube 50, and a balloon control device 100.

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

  The hand operation unit 14 is provided with an air / water supply button 16, a suction button 18, and a shutter button 20 that are operated by an operator, and a pair of angle knobs 22, 22 and a forceps insertion unit 24 are respectively provided. It is provided in the position.

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

  As shown in FIG. 2, the distal end surface 37 of the distal end portion 36 is provided with an objective optical system 38, an illumination lens 40, an air / water feeding nozzle 42, a forceps port 44, and the like at predetermined positions. The endoscope 10 shown in FIG. 1 is a normal endoscope in which no air supply / suction port is formed at the distal end portion 36 as shown in FIG. 2, but if it is an endoscope dedicated to a double balloon, An air supply / suction port is formed on the outer periphery of the distal end portion 36. The air supply / suction port communicates with a balloon air supply port formed in the hand operation unit 14 of FIG. 1 via an air tube inserted through the insertion unit 12. In FIG. 1, the code | symbol 30 has shown the balloon with which the insertion part front-end | tip outer periphery part of the endoscope only for a double balloon is mounted | worn. The balloon 30 is inflated by air supplied from the air supply / suction port, and is deflated by sucking air from the air supply / suction port.

  On the other hand, the overtube 50 shown in FIG. 1 includes a tube main body 51 having a second balloon and a first balloon 80. The first balloon 80 is a spirally formed air supply tube (air supply tube). ) 82 is connected to the tip of the tube body 51 via 82. The tube main body 51 is formed in a cylindrical shape as shown in FIGS. 3 and 4 and has an inner diameter slightly larger than the outer diameter of the insertion portion 12. The tube body 51 is configured by covering the outside of a flexible resin tube made of urethane or the like with a lubrication coat and covering the inside with a lubrication coat. Further, a tubular gripping portion 52 is connected to the proximal end portion of the tube main body 51, and the insertion portion 12 of the endoscope 10 is inserted from the gripping portion 52 toward the tube main body 51.

  As shown in FIG. 3, balloon air supply ports 54 and 90 are provided on the proximal end side of the tube main body 51. An air tube (second flow path) 56 having an inner diameter of about 1 mm is connected to the balloon air supply port 54, and an air tube (first flow path) having an inner diameter of about 1 mm is similarly connected to the balloon air supply port 90. 92 is connected, and these air tubes 56 and 92 are bonded to the outer peripheral surface of the tube main body 51 and extend to the tip of the tube main body 51 as shown in FIGS. Note that the air tubes 56 and 92 and the tube body 51 may be integrally formed as shown in FIG.

  As shown in FIG. 4, the tip 58 of the tube body 51 is formed in a tapered shape. A second balloon 60 made of an elastic material such as rubber is attached to the proximal end side of the distal end 58 of the tube main body 51. The second balloon 60 is mounted in a state where the tube main body 51 penetrates, and includes a central bulging portion 60c and attachment portions 60a and 60b at both ends thereof. The distal end side attachment portion 60a is folded inside the bulging portion 60c, and the folded attachment portion 60a is fixed to the tube main body 51 by winding the X-ray contrast yarn 62. The proximal end mounting portion 60 b is disposed outside the second balloon 60, and the thread 64 is wound around and fixed to the tube main body 51.

  The air tube 56 described above is opened inside the bulging portion 60c, and an air supply / suction port 57 is formed. Therefore, when air is supplied from the balloon air supply port 54 in FIG. 3, the air is blown out from the air supply / suction port 57 in FIG. 4 and the second balloon 60 is inflated. When air is sucked from the balloon air supply port 54, air is sucked from the air supply suction port 57, and the second balloon 60 is deflated.

The first balloon 80 is made of an elastic body such as rubber, and is attached to a short tube 84 so as to be freely expandable and contractible. The first balloon 80 is formed of a central bulging portion 80c and attachment portions 80a and 80b at both ends thereof. The first balloon 80 is formed in the tube 84 so that the air supply / suction port 86 is positioned inside the bulging portion 80c. It is attached. The attachment portions 80a and 80b are formed to have a diameter smaller than the diameter of the tube 84, and after being brought into close contact with the outer peripheral surface of the tube 84 with its elastic force, the threads 88 and 90 are wound and fixed. Note that the inner diameter of the tube 84 is slightly smaller than the outer diameter of the flexible portion 32 of the insertion portion 12, and the tube 84 and the flexible portion 32 are firmly fitted by the interference of the difference, so that the treatment in the body cavity is performed. Sometimes, the first balloon 80 is prevented from coming out of the flexible portion 32.

  4 shows the first balloon 80 provided with the tube 84, but FIG. 3 shows the first balloon 80 formed without the tube 84 and formed in a floating ring or donut shape. According to the first balloon 80 of FIG. 3, the first balloon 80 is mounted on the insertion portion 12 side by the air pressure of the first balloon 80 itself.

  The air supply / suction port 86 is formed at one end of an air tube 94 bonded to the outer peripheral surface of the tube 84. The other end of the air tube 94 is opened outside the first balloon 80, and one end 82A of the air supply tube 82 is connected to the opening 94A. The other end 82 </ b> B of the air supply tube 82 is detachably fitted and connected to a distal end opening (air supply port) 92 </ b> A of the air tube 92 extending to the distal end portion of the tube main body 51. Therefore, when air is supplied from the balloon air supply port 90 in FIG. 3, the air is blown out from the air supply / suction port 86 in FIG. 4 through the air tube 92, the air supply tube 82, and the air tube 94, and the first balloon is supplied. 80 is inflated. Further, when air is sucked from the balloon air supply port 90, air is sucked from the air supply suction port 86, and the first balloon 80 is deflated. In the embodiment, the first balloon 80 is attached to the tube 84. However, the present invention is not limited to this, and the first balloon 80 is directly attached to the flexible portion 32 of the insertion portion 12 protruding from the tube body 51. May be. In this case, the air tube 94 may be bonded or formed on the first balloon 80.

  Reference numeral 66 in FIG. 3 is an inlet for injecting a lubricating liquid such as water into the tube main body 51, and this inlet 66 is connected to the proximal end portion side of the tube main body 51 through a thin tube 68. It is communicated to.

  The balloon control device 100 in FIG. 1 is a device that supplies and sucks fluid such as air to the first balloon 80 and supplies and sucks fluid such as air to the second balloon 60. The balloon control device 100 includes a device main body 102 having a pump, a sequencer, and the like (not shown) and a hand switch 104 for remote control.

  On the front panel of the apparatus main body 102, a power switch SW1, a stop switch SW2, a pressure gauge 106 for the first balloon 80, and a pressure gauge 108 for the second balloon 60 are provided. Further, a tube 110 for supplying and sucking air to the first balloon 80 and a tube 120 for supplying and sucking air to the second balloon 60 are attached to the front panel of the apparatus main body 102. In the middle of each of the tubes 110 and 120, there are reservoir tanks 130 and 140 for storing body fluids flowing back from the first balloon 80 and the second balloon 60 when the first balloon 80 and the second balloon 60 are damaged. Provided.

  On the other hand, the hand switch 104 holds the same stop switch SW3 as the stop switch SW2 on the apparatus main body 102 side, the ON / OFF switch SW4 that supports pressurization / decompression of the first balloon 80, and the pressure of the first balloon 80. There is provided a pause switch SW5 for holding, an ON / OFF switch SW6 for supporting pressurization / depressurization of the second balloon 60, and a pause switch SW7 for holding the pressure of the second balloon 60. The hand switch 104 is electrically connected to the apparatus main body 102 via a cable 150.

  The balloon control device 100 configured as described above supplies air to the first balloon 80 and the second balloon 60 to inflate them, and controls the air pressure to a constant value to control the first balloon 80 and the second balloon 60. Is held in an expanded state. In addition, air is sucked and deflated from the first balloon 80 and the second balloon 60, and the air pressure is controlled to a constant value to hold the first balloon 80 and the second balloon 60 in a deflated state.

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

  First, the insertion portion 12 of the endoscope 10 is inserted through the tube main body 51 of the overtube 60, and the flexible portion 32 of the insertion portion 12 protruding from the distal end of the tube main body 51 is inserted into the tube 84 on the first balloon 80 side. Insert and fix. In this state, as shown in FIG. 6A, the insertion portion 12 is inserted into the intestinal tract (for example, the descending leg of the duodenum) 70 with the tube body 51 of the overtube 50 placed on the insertion portion 12. At this time, the first balloon 80 and the second balloon 60 are deflated.

  Next, as shown in FIG. 6B, the second balloon 60 is inflated by supplying air to the second balloon 60 in a state where the distal end 58 of the tube body 51 is inserted to the bent portion of the intestinal tract 70. As a result, the second balloon 60 is locked to the intestinal tract 70, and the distal end 58 of the tube body 51 is fixed to the intestinal tract 70.

  Next, as shown in FIG. 6C, only the insertion part 12 of the endoscope 10 is inserted into the deep part of the intestinal tract 70. At this time, the air supply tube 82 (not shown) extends, so that the insertion operation of the insertion portion 12 is not hindered. Then, as shown in FIG. 6 (d), air is supplied to the first balloon 80 and inflated. Thereby, the first balloon 80 is fixed to the intestinal tract 70.

  Next, after sucking air from the second balloon 60 to contract the second balloon 60, the tube body 51 is pushed in and inserted along the insertion portion 12 as shown in FIG. And after pushing the front-end | tip 58 of the tube main body 51 to the vicinity of the 1st balloon 80, as shown in FIG.6 (f), air is supplied to the 2nd balloon 60 and it is made to expand. Thereby, the second balloon 60 is fixed to the intestinal tract 70. That is, the intestinal tract 70 is grasped by the second balloon 60.

  Next, as shown in FIG. 6 (g), the tube main body 51 is pulled together. As a result, the intestinal tract 70 contracts substantially straight, and the tube body 51 is not bent or bent excessively.

  Next, as shown in FIG. 6 (h), air is sucked from the first balloon 80 to contract the first tube 80. And the front-end | tip part 36 of the insertion part 12 is inserted in the deep part of the intestinal tract 70 as much as possible. That is, the insertion operation shown in FIG. Thereby, the front-end | tip part 36 of the insertion part 12 can be inserted in the deep part of the intestinal tract 70. FIG. When inserting the insertion portion 12 into a deeper portion, after performing a fixing operation as shown in FIG. 6D, a pushing operation as shown in FIG. ), A hand dragging operation as shown in FIG. 6G, and an insertion operation as shown in FIG. Thereby, the insertion part 12 can be further inserted into the deep part of the intestinal tract 70.

  As described above, in the overtube 50 according to the embodiment, the first balloon 80 is attached to the tip of the tube main body 51 having the second balloon 60 via the air supply tube 82. As a double balloon type endoscope, a normal endoscope in which no air supply / suction port is formed at the tip can be used. Further, since the first balloon 80 is attached to the distal end of the tube main body 51 via the extendable air supply tube 82, the tube body 51 and the insertion portion 12 are relatively moved by the expansion / contraction action of the air supply tube 82. The insertion / extraction operation can be performed smoothly.

  Further, since the air supply tube 82 is formed in a spiral shape, the air supply tube 82 can be disposed without being bulky by inserting the insertion portion 12 into the internal space of the spiral air supply tube. The shape of the air supply tube 82 is not limited to a spiral, and for example, as shown by a two-dot chain line in FIG.

  Further, the air supply tube 82 is detached from the air tube 92 of the tube main body 51, and the first balloon 80 is removed from the tube main body 51, whereby the balloon 30 (see FIG. 1) is attached to the distal end outer peripheral portion in advance. This tube main body 51 can be used for the endoscope.

  Furthermore, the first balloon 80 is attached to the outer periphery of the tube 84, the insertion portion 12 is inserted into the tube 84, and the first balloon 80 is attached to the outer periphery of the distal end of the insertion portion of the endoscope 10. Attachment of the balloon 80 to the outer periphery of the distal end of the insertion portion is facilitated.

System configuration diagram of an endoscope apparatus to which a double balloon type endoscope apparatus according to the present invention is applied The perspective view which shows the front-end | tip part of the insertion part of an endoscope Side view of overtube Side sectional view showing the tip of the overtube through which the insertion section is inserted Cross section of tube body of overtube Explanatory drawing which shows the operation method of the endoscope apparatus shown in FIG.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 50 ... Overtube, 51 ... Tube main body, 52 ... Gripping part, 54, 90 ... Balloon air inlet, 56, 92, 94 ... Air tube, 60 ... second balloon, 62 ... X-ray contrast thread, 64 ... thread, 66 ... injection port, 80 ... first balloon, 82 ... air supply tube, 100 ... balloon control device, 102 ... device main body, 104 ... hand switch

Claims (5)

A first balloon that is attached to the outer periphery of the distal end of the insertion portion of the endoscope and a second balloon that is attached to the outer peripheral portion of the distal end of the overtube through which the insertion portion of the endoscope is inserted to guide insertion of the insertion portion are expanded. In a double-balloon endoscope device that is compressed and inserted into the body cavity,
The overtube is provided with a first flow path for supplying and sucking air for expanding and contracting the first balloon, and a second flow path for supplying and sucking air for expanding and contracting the second balloon. The tip of the first flow path on the overtube side and the first balloon are connected by an air supply tube that enables a relative insertion / extraction operation of the overtube and the insertion portion. A double-balloon endoscope device characterized by the above.   The air supply tube is detachably connected to an air supply port formed at a distal end portion of the first flow path of the overtube, and the first balloon is configured to be detachable from the overtube. The double-balloon endoscope apparatus according to claim 1, wherein   2. The double balloon endoscope according to claim 1, wherein the distal end portion of the first flow path on the overtube side and the first balloon are separated by removing the air supply tube. apparatus.   The double-balloon endoscope apparatus according to claim 1 or 2, wherein the air supply tube is formed in a spiral shape.   The first balloon is attached to an outer periphery of a tube, the insertion portion of the endoscope is inserted into the tube, and the first balloon is attached to an outer periphery of a distal end of the insertion portion of the endoscope. 2. The double balloon endoscope apparatus according to 1.

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