JP5671360B2 - Endoscope external channel - Google Patents

Description

  The present invention relates to an external channel of an endoscope that is detachably attached to an insertion portion of a flexible endoscope and is used as an auxiliary when performing a treatment using the flexible endoscope.

  When performing various endoscopic procedures such as mucosal dissection (ESD) using a flexible endoscope, the treatment instrument is passed only by the treatment instrument insertion channel built in the endoscope. In many cases, there is not enough channel tube.

  Therefore, the distal end portion of the flexible auxiliary tube can be attached to the distal end hood that is detachably provided at the distal end of the flexible insertion portion of the endoscope, and can be used as the second or third treatment instrument insertion channel. There exists what was made like this (for example, patent document 1).

JP 2008-93247 A

  In the invention described in Patent Document 1, the tip of the auxiliary tube is inserted into the hood from the rear rear side of the tip hood, and the tip position of the auxiliary tube is adjusted by moving it back and forth in the axial direction. Can do.

  However, with such a configuration, the tip of the auxiliary tube can be directed only to a very limited position in the observation field of the endoscope. Therefore, the positional relationship with the treatment tool protruding from the treatment tool insertion channel in the endoscope is arbitrarily set, or so-called counter traction is applied to keep the mucous membrane at a desired position around the affected area from moving. It was difficult to use.

  The present invention freely adjusts the distal end position of the auxiliary tube by an operation from the hand side, and arbitrarily sets the positional relationship with the treatment instrument protruding from the treatment instrument insertion channel provided in the endoscope. Another object of the present invention is to provide an external channel of a highly functional endoscope that can be easily used for counter traction on a mucous membrane at a desired position.

The external channel of the endoscope of the present invention is provided with an annular tip adapter that is detachable so as to surround the outer periphery of the distal end portion of the flexible insertion portion of the endoscope. An auxiliary tube guide hole is formed so as to penetrate in a substantially parallel direction, and a distal end portion of the flexible auxiliary tube arranged outside the flexible insertion portion along with the flexible insertion portion is disposed in the auxiliary tube guide hole. A flexible operation wire that is inserted and arranged so as to be capable of advancing and retreating in the axial direction and that passes through the auxiliary tube guide hole together with the auxiliary tube, with the distal end locked near the distal end of the auxiliary tube. Only one auxiliary tube is disposed along the outer surface of the auxiliary tube so as to be movable back and forth in a direction parallel to the axis of the auxiliary tube, and the auxiliary tube and the distal end portion of the operation wire are connected to the auxiliary tube of the annular tip adapter. The auxiliary tube of the annular distal end adapter of the distal end portion of the auxiliary tube is pulled in the axial direction with respect to the auxiliary tube from the proximal end side in a state of protruding forward from the guide hole. A region that protrudes forward from the guide hole is bent in the direction in which the operation wire is disposed, and a region that can protrude forward from the auxiliary tube guide hole of the annular tip adapter in the tip portion of the auxiliary tube. Is arranged in a state in which the operation wire is exposed along the outer surface of the auxiliary tube, and in the rear region, the wire guide tube into which the operation wire is loosely inserted is heat-shrinkable with the auxiliary tube over the entire length. It is characterized by being tightened and fixed by.

  In the state where the annular tip adapter is attached to the distal end portion of the flexible insertion portion of the endoscope, the region protruding forward from the annular tip adapter of the auxiliary tube is pulled by pulling the operation wire from the rear. The endoscope may be bent in a direction that spreads outward from the front of the distal end portion of the flexible insertion portion of the endoscope.

  In that case, when the operation wire is pulled from behind, the auxiliary tube bends in the area where the operation wire is exposed, and the operation wire moves away from the auxiliary tube in a straight state like a string stretched on the bow in that area. You may make it be in a state.

  In addition, a protrusion stopper may be provided to restrict the protrusion length of the auxiliary tube so that the tip portion of the auxiliary tube does not protrude forward beyond a certain length from the auxiliary tube guide hole. The distal end surface of the tube may constitute a protruding stopper.

  The auxiliary tube may be rotatable in the direction around the axis in the auxiliary tube guide hole together with the operation wire, or the auxiliary tube may be restricted from rotating in the direction around the axis in the auxiliary tube guide hole. Good.

  In that case, in a state where the annular tip adapter is attached to the distal end portion of the flexible insertion portion of the endoscope, the operation wire is pulled from the rear, so that the auxiliary tube protrudes forward from the annular tip adapter. The region may be bent only in the direction extending outward from the front of the distal end portion of the flexible insertion portion of the endoscope.

  The auxiliary tube may be detachable only in a plurality of directions around the axis with respect to the auxiliary tube guide hole, and the auxiliary tube is formed of a double lumen tube, and an operation wire is provided in one of the lumens. It may be inserted loosely.

Further, the annular tip adapter may be formed of a resilient material, and may be attached in a state where the outer periphery of the tip portion of the flexible insertion portion is resiliently tightened.
Alternatively, the annular tip adapter may be attached to the outer periphery of the distal end portion of the flexible insertion portion so as to be rotatable in the direction around the axis line. An attachment ring that is detachably attached in a tightened state may be attached to the annular tip adapter so as to be rotatable in the direction around the axis.

  According to the present invention, the tip position of the auxiliary tube that can be used by being attached to the endoscope only when necessary can be freely adjusted by an operation from the hand side, so that it is provided in the endoscope. When adjusting the positional relationship with the treatment tool protruding from the treatment tool insertion channel or performing high-frequency mucosal dissection, the tip of the auxiliary tube is bent in any direction to any degree. High functionality that can be used to counter traction the mucous membrane at a desired position can be obtained, and since only one operation wire is provided, the diameter of the device does not increase, Does not cause excessive pain to the patient.

1 is a perspective view showing an overall configuration of an external channel of an endoscope according to a first embodiment of the present invention. FIG. FIG. 2 is a cross-sectional view taken along the line II-II in FIG. 1 of the external channel of the endoscope according to the first embodiment of the present invention. It is the elements on larger scale of the front-end | tip part of the external channel of the endoscope which concerns on 1st Example of this invention. 1 is a side cross-sectional view of a state where an external channel of an endoscope according to a first embodiment of the present invention is attached to an endoscope. 1 is a side view showing an overall apparatus configuration in a state where an external channel of an endoscope according to a first embodiment of the present invention is attached to an endoscope. It is a perspective view which shows the whole structure of the external channel of the endoscope which concerns on 2nd Example of this invention. It is side surface sectional drawing of the state in which the external channel of the endoscope which concerns on 2nd Example of this invention was attached to the endoscope. It is side surface sectional drawing of the state in which the external channel of the endoscope which concerns on 2nd Example of this invention was attached to the endoscope. It is a perspective view which shows the whole structure of the external channel of the endoscope which concerns on the 3rd Example of this invention. It is the elements on larger scale of the front-end | tip part of the external channel of the endoscope which concerns on 3rd Example of this invention. It is a perspective view which shows the whole structure of the external channel of the endoscope which concerns on the 3rd Example of this invention. It is a side view which shows the whole structure of the external channel of the endoscope which concerns on the 4th Example of this invention. It is a perspective view which shows the whole structure of the external channel of the endoscope which concerns on the 4th Example of this invention. It is side surface sectional drawing of the state by which the auxiliary tube of the external channel of the endoscope which concerns on 4th Example of this invention was extruded ahead. It is a perspective view which shows the whole structure of the external channel of the endoscope which concerns on the 5th Example of this invention. It is side surface sectional drawing which shows the whole structure of the external channel of the endoscope which concerns on the 5th Example of this invention. It is a perspective view of the attachment ring single-piece | unit of the external channel of the endoscope which concerns on the 5th Example of this invention. It is a perspective view of the annular tip adapter simple substance of the external channel of the endoscope concerning the 5th example of the present invention.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is a perspective view showing the overall configuration of an external channel 1 according to the first embodiment of the present invention.

  The main components of the external channel 1 are an annular tip adapter 2 that is detachable so as to surround the outer periphery of the distal end portion of the flexible insertion portion of the endoscope (not shown), and the flexible insertion of the endoscope. A flexible auxiliary tube 3 arranged outside the flexible insertion portion along with the flexible insertion portion, and a flexible operation wire 4 having a distal end locked in the vicinity of the distal end of the auxiliary tube 3. Various members which will be sequentially described below are provided.

  The annular tip adapter 2 is made of, for example, a resilient rubber material and has a maximum outer diameter of, for example, about 10 to 15 mm. The annular tip adapter 2 is known in the art and constitutes the most advanced portion of the flexible insertion portion of the endoscope. It is attached and fixed to a tip body (not shown) in a state where it is elastically tightened from its outer periphery, and can be removed from the tip body by elastically deforming.

  The auxiliary tube 3 is formed of a single simple fluororesin tube having an inner diameter of about 2 to 3 mm, for example, which functions as a treatment instrument insertion channel. The auxiliary tube 3 is disposed in a direction parallel to the axis of the annular tip adapter 2, and treatment instruments can be inserted into and removed from the inner portion of the auxiliary tube 3.

  Only one operation wire 4 is disposed along the outer surface of the auxiliary tube 3 so that the operation wire 4 can be moved forward and backward in a direction parallel to the axis of the auxiliary tube 3. Therefore, the diameter around the auxiliary tube 3 hardly increases.

  In such an operation wire 4, only a region in the vicinity of the tip (for example, a range of 1 to 5 cm from the tip) is exposed, and in the rear part thereof, the waist is firmly covered with the heat-shrinkable tube 5 together with the auxiliary tube 3. Has been. The rear end portion of the operation wire 4 is exposed so that it can be pushed and pulled.

  FIG. 2 is a cross-sectional view (II-II cross-sectional view in FIG. 1) of a portion where the heat-shrinkable tube 5 is covered with the auxiliary tube 3 and the operation wire 4, and a wire guide tube 9 through which the operation wire 4 passes loosely. Is arranged in parallel with the auxiliary tube 3 along the outer surface of the auxiliary tube 3. The wire guide tube 9 is formed of a fluororesin tube or the like having good slip, and is integrally tightened together with the auxiliary tube 3 by a heat shrink tube 5 over the entire length.

  Returning to FIG. 1, the annular tip adapter 2 is formed with an attachment hole 6 that is elastically closely attached to the outer peripheral portion of the distal end main body of the endoscope so that the auxiliary tube 3 and the operation wire 4 pass through. A tube guide hole 7 is formed in the front-rear direction so as to be parallel to the mounting hole 6 (both parallel to the axis of the annular tip adapter 2). Reference numeral 8 denotes a fixing pin for fixing the most distal portion of the operation wire 4 to the most distal portion of the auxiliary tube 3, and is fixed to the most distal portion of the operation wire 4.

  FIG. 3 is an enlarged view of the distal end opening of the auxiliary tube guide hole 7 that opens to the distal end surface of the annular distal adapter 2, and 3 a is the distal end surface of the auxiliary tube 3. Reference numeral 18 denotes a narrow wire fixing tube made of a heat shrinkable tube that fastens the fixing pin 8 so as to be fixed to the outer peripheral portion of the most distal end portion of the auxiliary tube 3.

  The auxiliary tube guide hole 7 is formed in a circular cross-sectional shape over the entire length, and the auxiliary tube 3, the operation wire 4 attached thereto, the fixing pin 8 at the tip of the auxiliary tube 3, and the like are integrated in the auxiliary tube guide hole 7. It can freely rotate in the direction around the axis, and can advance and retreat in the axial direction.

  FIG. 4 shows a state where the external channel 1 is attached to the endoscope 50. The above-mentioned fixing pin 8 is formed so that only the tip part is thick like a nail head, the tip of the operation wire 4 is fixed to the rear end part thinner than that, and the thin part together with the auxiliary tube 3 is the wire fixing tube 18. It is tightened tightly.

  As a result, even if the operation wire 4 is pulled from behind and a strong tension is applied to the operation wire 4, the fixing pin 8 does not slip out of the wire fixing tube 18 and the traction force of the operation wire 4 is reduced. It acts reliably on the tip of the auxiliary tube 3.

  An observation window 52 for observing the front is disposed on the distal end surface of the flexible insertion portion 51 of the endoscope 50, and a treatment instrument for allowing treatment instruments to pass therethrough is inserted into the flexible insertion portion 51. A channel 53 is inserted and arranged.

  The distal end portion (so-called distal end main body) of the flexible insertion portion 51 of the endoscope 50 is passed through the attachment hole 6 of the annular distal end adapter 2, so that the annular distal end adapter 2 becomes the distal end of the flexible insertion portion 51. The portion is attached in a state where the portion is elastically tightened, and the auxiliary tube 3 is placed in parallel along the outer surface of the flexible insertion portion 51. However, since the flexible insertion portion 51 and the auxiliary tube 3 are both flexible, they are deformed by the force received from the surroundings and are not in parallel during actual use.

  As described above, the auxiliary tube 3 and the operation wire 4 advance and retract in the axial direction in the auxiliary tube guide hole 7 formed in the annular tip adapter 2 by advancing and retreating together in the axial direction as indicated by the arrow A. It is free. However, since the heat-shrinkable tube 5 is formed to have an outer diameter that cannot enter the auxiliary tube guide hole 7, when the auxiliary tube 3 is pushed forward, the distal end surface 5a of the heat-shrinkable tube 5 integrated therewith becomes The auxiliary tube 3 cannot be pushed forward from the annular tip adapter 2 by hitting the rear end opening 7a of the auxiliary tube guide hole 7 located on the rear end surface of the annular tip adapter 2.

  In this way, the protrusion stopper for regulating the protrusion length of the auxiliary tube 3 so that the tip portion of the auxiliary tube 3 does not protrude forward from the auxiliary tube guide hole 7 of the annular tip adapter 2 beyond a certain length, It is formed by the front end surface 5a of the heat-shrinkable tube 5 and the rear end opening 7a of the auxiliary tube guide hole 7 (that is, the rear end surface of the annular front end adapter 2). As described above, the operation wire 4 is exposed along the outer surface of the auxiliary tube 3 in the region on the distal end side of the auxiliary tube 3 that can protrude forward from the auxiliary tube guide hole 7.

  An operation finger hook 10 (not shown in FIG. 1) is attached to the rear end of the operation wire 4. The finger is placed on the operation finger hook 10 to assist the operation wire 4 as indicated by an arrow B. The tube 3 can be moved back and forth in the axial direction.

  FIG. 5 shows the operation wire 4 in a state where the distal end portion of the auxiliary tube 3 is pushed forward from the annular distal end adapter and the distal end surface 5a of the heat shrinkable tube 5 hits the rear end opening 7a of the auxiliary tube guide hole 7. Indicates a state in which a pulling operation is performed from the operation finger hook 10 side.

  Reference numeral 11 denotes a mouthpiece fixedly attached to the rear end of the auxiliary tube 3 so that the operator can hold it with a fingertip. Note that any other mechanism for pushing and pulling the rear end portion of the operation wire 4 may be used.

  An operation portion 55 is provided at the rear end of the flexible insertion portion 51 of the endoscope 50, and the bending operation knob 56 disposed on the operation portion 55 is rotated to operate the flexible insertion portion 51. A known curved portion 57 formed at the distal end portion can be bent at an arbitrary angle in an arbitrary direction. Reference numeral 58 denotes a treatment instrument insertion port provided in the operation section 55 for inserting treatment instruments into the treatment instrument insertion channel 53 described above.

  As shown in FIG. 5, when the operation wire 4 is pulled from the rear end side, the auxiliary tube 3 bends at a portion protruding forward from the annular tip adapter 2. The degree of bending can be arbitrarily adjusted by the pulling amount of the operation finger hook 10.

  The auxiliary tube 3 is bent only in a region where the operation wire 4 is exposed, and the operation wire 4 is separated from the auxiliary tube 3 in a straight state like a string in a range where the auxiliary tube 3 is bent like a bow.

  Further, if the auxiliary tube 3 is rotated in the direction around the axis line from the hand side by grasping the base 11, the operation wire 4 is also rotated together with it, so that the direction of the operation wire 4 with respect to the auxiliary tube 3 is changed at the tip side, The bending direction of the auxiliary tube 3 can be arbitrarily adjusted.

  As described above, in the present invention, only one operation wire 4 is provided, so that the diameter around the auxiliary tube 3 is not increased (thus, no extra pain is given to the patient). Thus, by rotating from the hand side, the tip portion can be bent in an arbitrary direction.

  If a large number (for example, four) of the operation wires 4 are provided, a mechanism that can be easily bent in an arbitrary direction can be obtained. However, by doing so, the diameter of the device becomes large and the pain given to the patient. Will become bigger.

In this way, the position and orientation of the tip of the auxiliary tube 3 can be adjusted arbitrarily, so that the treatment instrument 30 provided in the endoscope 50 can be inserted by inserting the treatment instrument 30 into the auxiliary tube 3. The positional relationship with the treatment tool protruding from the channel 53 can be arbitrarily set, and counter traction can be applied to the mucous membrane at a desired position with the tip of the auxiliary tube 3.

  6 and 7 show an external channel 1 according to the second embodiment of the present invention and a state in which the external channel 1 is attached to the flexible insertion portion 51 of the endoscope 50. FIG. As the auxiliary tube 3, a multi-lumen tube (in this case, a double lumen tube) in which a lumen 3 ′ for inserting a treatment instrument and a lumen through which the operation wire 4 is passed is integrally used, and the operation wire 4 is an auxiliary tube. 3 is not exposed in the tip side region.

  Further, the auxiliary tube 3 is not covered with a heat-shrinkable tube or the like, and the hardness of the auxiliary tube 3 is changed in the middle, and as shown in FIG. A region on the distal end side of the auxiliary tube 3 is a soft portion 3s, and a region behind it is a hard portion 3h having a strong waist. Other configurations are the same as those in the first embodiment.

  As a result, as shown in FIG. 8, when the operation wire 4 is pulled from the rear with the soft portion 3 s of the auxiliary tube 3 protruding forward from the annular tip adapter 2, the operation wire 4 is separated from the auxiliary tube 3. Without doing so, the soft portion 3s of the auxiliary tube 3 bends.

FIG. 9 shows the overall configuration of the external channel 1 according to the third embodiment of the present invention, and only the shape of the auxiliary tube guide hole 7 formed in the annular tip adapter 2 is the same as that of the first embodiment. Is different.

  As shown in an enlarged view in FIG. 10, the auxiliary tube guide hole 7 passes through a wire fixing tube 18 having a dharma shape to fix the distal end portion of the auxiliary tube 3 and the fixing pin 8 together. It is formed in a cross-sectional shape that can be. Other configurations are the same as those of the first embodiment.

  Therefore, as shown in FIG. 11, the auxiliary tube 3 also has a region on the distal end side (that is, a region that bends when the operation wire 4 is pulled) protruding forward from the annular distal adapter 2. When 3 is rotated in the direction around the axis from the hand side, the operation wire 4 is caught in the auxiliary tube guide hole 7 and the rotation of the auxiliary tube 3 in the direction around the axis in the auxiliary tube guide hole 7 is restricted.

  As a result, since the positional relationship of the operation wire 4 with respect to the annular tip adapter 2 and the auxiliary tube 3 is limited to one, the annular tip adapter 2 is attached to the distal end portion of the flexible insertion portion 51 of the endoscope 50. In this state, when the operation wire 4 is pulled from the rear, in this embodiment, the region of the auxiliary tube 3 that protrudes forward from the annular tip adapter 2 is the front of the attachment hole 6 (that is, the endoscope 50 can be moved). It bends only in the direction spreading outward from the front end of the flexible insertion portion 51. This is effective when counter traction is applied.

  12 and 13 show an external channel 1 according to a fourth embodiment of the present invention, in which a rotational direction positioning block 21 having a square cross-sectional shape is fixed in the vicinity of the tip of the heat shrinkable tube 5, A rotation direction positioning hole 22 having a square cross-sectional shape with which the rotation direction positioning block 21 is engaged is formed in the rear end portion of the auxiliary tube guide hole 7. Other configurations are the same as those of the first embodiment.

  As a result, as shown in FIG. 14, in the state where the tip side region of the auxiliary tube 3 protrudes forward from the annular tip adapter 2 and the rotational direction positioning block 21 is engaged with the rotational direction positioning hole 22, In the auxiliary tube guide hole 7, the rotation of the auxiliary tube 3 in the direction around the axis is restricted.

  However, since the engagement direction between the rotation direction positioning block 21 and the rotation direction positioning hole 22 can be rotated and adjusted at 90 ° intervals, the engagement between the rotation direction positioning block 21 and the rotation direction positioning hole 22 is possible. By changing the state, the bending direction of the auxiliary tube 3 can be selected from four directions at intervals of 90 ° according to the use situation.

  In this way, the auxiliary tube 3 can be selectively inserted into and removed from the auxiliary tube guide hole 7 in four directions around the axis. However, the number of selections can be increased by forming the cross-sectional shapes of the rotation direction positioning block 21 and the rotation direction positioning hole 22 into a regular polygon other than a square, such as a regular hexagon or a regular octagon. .

  15 and 16 show the overall configuration of the external channel 1 according to the fifth embodiment of the present invention, in which the outer periphery of the distal end portion of the flexible insertion portion of the endoscope is elastically tightened. An attachment ring 25 made of a resilient material to be attached is disposed on the inner peripheral portion of the attachment hole 6 of the annular tip adapter 2 so as to be rotatable in the direction around the axis (but not to move in the axis direction). . FIG. 17 shows the mounting ring 25, and FIG. 18 shows the auxiliary tube guide hole 7. Other configurations are the same as those in the fourth embodiment.

  As a result, the annular distal end adapter 2 is attached to the outer periphery of the distal end portion of the flexible insertion portion of the endoscope so as to be rotatable in the direction around the axis, and the auxiliary tube 3 is rotated on the hand side, whereby the endoscope The annular tip adapter 2 can be rotated at the tip portion of the flexible insertion portion, whereby the bending direction of the auxiliary tube 3 can be adjusted.

DESCRIPTION OF SYMBOLS 1 External channel 2 Annular tip adapter 3 Auxiliary tube 4 Operation wire 5 Heat shrinkable tube 5a Tip surface (stopper)
6 Mounting hole 7 Auxiliary tube guide hole 7a Rear end opening (stopper)
DESCRIPTION OF SYMBOLS 8 Fixed pin 9 Wire guide tube 21 Rotation direction positioning block 22 Rotation direction positioning hole 25 Mounting ring 30 Treatment tool 50 Endoscope 51 Flexible insertion part

Claims (13)

An detachable annular tip adapter is provided so as to surround the outer periphery of the distal end portion of the flexible insertion portion of the endoscope, and an auxiliary tube guide hole is formed through the annular tip adapter in a direction substantially parallel to the axis. A distal end portion of a flexible auxiliary tube arranged outside the flexible insertion portion along with the flexible insertion portion is inserted and disposed in the auxiliary tube guide hole so as to be movable back and forth in the axial direction. A flexible operation wire that is locked near the distal end of the auxiliary tube and passes through the auxiliary tube guide hole together with the auxiliary tube can be moved forward and backward in a direction parallel to the axis of the auxiliary tube. is arranged only one along the outer surface side of the auxiliary tube, the distal end portion of the auxiliary tube and the operating wire in the state of protruding forward from the auxiliary tube guide hole of the annular tip adapter By pulling operation in the axial direction with respect to said auxiliary tubes the operation wire from the proximal end side, a region which protrudes forwardly from the auxiliary tube guide hole of the annular distal end adapter of the tip portion of the auxiliary tubes the operation The operation wire is bent in the direction in which the wire is arranged and the front end portion of the auxiliary tube can protrude forward from the auxiliary tube guide hole of the annular tip adapter. The wire guide tube into which the operation wire is loosely inserted is tightened and fixed by the heat shrink tube together with the auxiliary tube over the entire length in the rear region. Endoscope external channel.   In a state where the annular tip adapter is attached to the distal end portion of the flexible insertion portion of the endoscope, when the operation wire is pulled from behind, the auxiliary tube protrudes forward from the annular tip adapter. The endoscope external channel according to claim 1, wherein a region of the endoscope is bent in a direction that spreads outward from the front of the distal end portion of the flexible insertion portion of the endoscope. When the operation wire is pulled from behind, the auxiliary tube bends in a region where the operation wire is exposed, and the operation wire is straight from the auxiliary tube in a state like a string stretched on a bow in the region. The external channel of the endoscope according to claim 1 or 2 , wherein the external channel is in a separated state. It claims 1 protruding stopper is provided for the tip portion of the auxiliary tube regulates the projection length of the auxiliary tube so as not to protrude beyond a certain length forward from the auxiliary tube guide hole either 3 An endoscope external channel according to any one of the above items. The endoscope external channel according to claim 4, wherein a distal end surface of the heat-shrinkable tube constitutes the protruding stopper. The endoscope external channel according to any one of claims 1 to 5 , wherein the auxiliary tube is rotatable together with the operation wire in a direction around an axis in the auxiliary tube guide hole. The external channel of the endoscope according to any one of claims 1 to 5 , wherein rotation of the auxiliary tube in the direction around the axis is restricted in the auxiliary tube guide hole. In a state where the annular tip adapter is attached to the distal end portion of the flexible insertion portion of the endoscope, the operation wire is pulled from the rear, so that the auxiliary tube protrudes forward from the annular tip adapter. The endoscope external channel according to claim 7, wherein the region bent is bent only in a direction extending outward from the front of the distal end portion of the flexible insertion portion of the endoscope. The endoscope external channel according to any one of claims 1 to 7 , wherein the auxiliary tube is detachable only in a plurality of directions around an axis with respect to the auxiliary tube guide hole. The external channel for an endoscope according to any one of claims 1 to 9, wherein the auxiliary tube is formed of a double lumen tube, and the operation wire is loosely inserted into one of the lumens. The inner ring tip adapter according to any one of claims 1 to 10, wherein the annular tip adapter is formed of a resilient material, and is attached in a state where the outer periphery of the distal end portion of the flexible insertion portion is resiliently tightened. External channel for endoscope. The endoscope external channel according to any one of claims 1 to 10 , wherein the annular tip adapter is attached to an outer periphery of a tip portion of the flexible insertion portion so as to be rotatable in a direction around an axis. The internal view according to claim 12 , wherein an attachment ring that is detachably attached in a state of being elastically tightened to an outer periphery of a distal end portion of the flexible insertion portion is attached to the annular tip adapter so as to be rotatable in a direction around an axis. Mirror external channel.

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