CN1933764B - Insertion device - Google Patents

Abstract

An insertion device has an insertion section to be inserted into a subject, an observing section provided on the distal side of the insertion section, and a rotation section for rotating that portion of the insertion section which is more on the proximal end side than the observing section to produce a propulsion force when the insertion section is inserted into the subject, the center of the rotation being the insertion axis of the insertion section.

Description

Insert device

Technical field

The present invention relates to a kind of insertion device that improves medical treatment device to endoceliac insertion.

Background technology

In the past, such endoscope is used widely, promptly, by the elongated insertion section insertion tube intracavity that endoscope had is observed intraluminal internal organs, and as required treatment apparatus is run through and be inserted into the treatment apparatus that is located on the insertion section and insert in the general channels, thereby can carry out various treatments and disposal.

Usually, in the endoscope with elongated insertion section, the front in the insertion section is provided with bending section.Be connected with operating line on the bool that constitutes this bending section, bending section moves at for example above-below direction and the enterprising line bend of left and right directions by the advance and retreat of this operating line.The advance and retreat of operating line can be carried out for example crooked knob enforcement rotating operation that is located on the operating portion by the operator.

Complicated tube chamber is being inserted in the insertion section, when for example as large intestine etc., forming in 360 ° of annular tube chambers, the operator twists operation to the insertion section when the operation crooked knob makes bending section carry out flexure operation, so that the leading section of insertion section is inserted to observing the purpose position.

Yet, need skillfully to can under the situation that not bring misery, successfully the insertion section being run through being inserted in the complicated large intestine at short notice to the patient.The operator of lack of experience requires great effort in running through insertion process thereby might lose direction of insertion when the insertion section is inserted into the depths, perhaps in that the insertion section is run through when inserting to the depths, makes the walking state distortion of intestinal.Therefore, the various schemes that are used to improve the insertion of insertion section have been proposed.

For example, drive the propulsion plant that a kind of like this medical apparatus and instruments has been shown in the flat 10-113396 communique the Japanese documentation spy, that is, this propulsion plant can easily and hang down the depths that infringement ground guides to medical apparatus and instruments biological tube chamber.In this propulsion plant, on rotary part, be provided with flank with respect to the axioversion of this rotary part.Therefore, be rotated action by making rotary part, the revolving force of rotary part is converted to propulsive force by flank, thereby the medical apparatus and instruments that is connected with propulsion plant moves to the depths direction under the effect of above-mentioned propulsive force.

Yet, open in the propulsion plant of medical apparatus and instruments of flat 10-113396 communique the Japanese documentation spy, can rotate with respect to this medical apparatus and instruments in the front of medical apparatus and instruments as the rotary part that inserts accessory, but rotary part roughly is arranged on this medical apparatus and instruments integratedly.Therefore, have when being used for observing treatment apparatus that the treatment apparatus of disposing in being examined intravital observation unit or being used to make to tested having a medical check-up runs through insertion and inserting at least one of opening of general channels at the front end of for example medical apparatus and instruments, if above-mentioned technology is applied to these medical apparatus and instruments, following problems then appears.That is, when observing tested having a medical check-up, rotary part might hinder the field of view of observation unit.When tested disposal object position of having a medical check-up was disposed, rotary part might hinder disposal.

Summary of the invention

The present invention finishes in view of above-mentioned condition, and its purpose is to provide a kind of such insertion device, and this insertion device can improve medical treatment device to endoceliac insertion, and the function that does not reduce medical apparatus and instruments and had.

Insertion device of the present invention has: the insertion section, tested having a medical check-up inserted in this insertion section, assisting the medical apparatus and instruments that in tested having a medical check-up, carries out medical act to being examined intravital insertion, and can on the direction of going into, relatively advance and retreat with respect to above-mentioned medical apparatus and instruments to the tested interpolation of having a medical check-up; And rotating part, it is the center rotation to insert direction of principal axis that this rotating part makes above-mentioned insertion section, with above-mentioned insertion section to the above-mentioned fashionable generation propulsive force of body interpolation that is examined.

Description of drawings

Fig. 1 is the figure that the structure of device is inserted in explanation.

Fig. 2 is the figure of the structure of explanation insertion section guide member.

Fig. 3 is the figure of explanation insertion section guide member to the insertion state of big enteral.

Fig. 4 illustrates the figure that is inserted near the insertion section guide member of caecum portion.

Fig. 5 is the figure that explanation runs through the insertion section guide member step in the slotting general channels of the treatment apparatus that inserts on the insertion section that is located at endoscope.

Fig. 6 is that explanation serves as the figure that the state of big enteral is inserted the insertion section of endoscope in guiding with the insertion section guide member.

Fig. 7 is the figure of other structures of explanation insertion section guide member.

Fig. 8 is the figure of other structures of explanation insertion section guide member.

Fig. 9 is the figure that the structure example of the insertion section guide member with first guide tube part and second guide tube part is described.

Figure 10 is the figure that the metal wire rod that constitutes first guide tube part and second guide tube part is shown.

Figure 11 is the profile along the XI-XI line of Figure 10.

Figure 12 is the profile along the XII-XII line of Figure 10.

Figure 13 is the figure that other structures of the insertion section guide member with first guide tube part and second guide tube part are described.

Figure 14 is the figure that another structure of the insertion section guide member with first guide tube part and second guide tube part is described.

Figure 15 is the figure of another structure of explanation insertion section guide member.

Figure 16 is the figure of the another structure of explanation insertion section guide member.

Figure 17 is the figure of the structure of explanation insertion section guiding tube.

Figure 18 is the figure that first guiding element that the insertion section guiding tube is shown arrives the state of S font colon portion.

Figure 19 is the figure of state of the gauffer of first guiding element that the insertion section guiding tube the is shown intestinal wall of crossing S font colon portion.

Figure 20 illustrates the figure of the first guiding element of insertion section guiding tube by the state of S font colon portion.

Figure 21 shows the sketch map of whole large intestine of the deflection state of the first guiding element of insertion section guiding tube, big enteral and line parts.

Figure 22 illustrates the figure that first guiding element arrives the deflection state of the insertion section guiding tube under near the state of caecum portion.

Figure 23 is the figure of the structure of the first guiding element of explanation with through hole that bobbin connects.

Figure 24 is the figure that the structure of the bobbin with different eccentric shafts is described.

Figure 25 is the drawing in side sectional elevation of insertion section guiding tube.

Figure 26 is the front view from the middle observed insertion section of bobbin guiding tube.

Figure 27 is the figure of the state of first guiding element that the insertion section guiding tube the is shown bending section that arrives large intestine.

Figure 28 is the figure of insertion section guiding tube rotation.

Figure 29 is the figure of the structure of explanation insertion section guiding tube.

Figure 30 is the figure of the state of first guiding element that the insertion section guiding tube the is shown bending section that arrives large intestine.

Figure 31 is the figure of the state of the first guiding element of the explanation insertion section guiding tube gauffer of crossing the large intestine intestinal wall.

Figure 32 is the figure of the structure of explanation insertion section guiding tube.

Figure 33 is the figure of the structure of explanation insertion section guiding tube.

Figure 34 is the figure that the structure of the insertion section guiding tube that is provided with spheroid and holding member is described.

Figure 35 is the drawing in side sectional elevation of fore-end that is provided with the insertion section guiding tube of spheroid and holding member.

Figure 36 is the figure that the structure of the insertion section guiding tube that is provided with a plurality of revolving parts is described.

Figure 37 is the major part enlarged drawing that amplifies the major part of expression insertion section guiding tube.

Figure 38 is the figure of wall state of contact that the crooked position of the front end guide parts of insertion section guiding tube and S font colon portion is shown.

Thereby Figure 39 illustrates further the advance figure of the crooked state of the part of front end guide parts of insertion section guiding tube.

Thereby Figure 40 illustrates further the advance further figure of crooked state of a part of front end guide parts of insertion section guiding tube.

Figure 41 illustrates the figure that the insertion section guiding tube is inserted near the state of caecum portion.

Figure 42 is the major part enlarged drawing that amplifies the part of the structure of representing the insertion section guiding tube.

Figure 43 is the effect that illustrates when the insertion section guiding tube inserted large intestine, and the figure of wall state of contact of the crooked position of the front end guide parts of insertion section guiding tube and S font colon portion is shown.

Figure 44 is the effect that illustrates when the insertion section guiding tube inserted large intestine, thereby and the figure that further the insertion section guiding tube is pushed the crooked state of the part that makes front end guide parts is shown.

Figure 45 is the effect that illustrates when the insertion section guiding tube inserted large intestine, thereby and illustrates and further the insertion section guiding tube is pushed the further figure of crooked state of a part that makes front end guide parts.

Figure 46 is the major part enlarged drawing that amplifies a part that is illustrated in the structure of inserting the endoscope-use insertion aid that uses in the device.

Figure 47 is the major part enlarged drawing that amplifies a part that is illustrated in the structure of inserting the endoscope-use insertion aid that uses in the device.

Figure 48 is the effect that illustrates when the insertion section guiding tube inserted large intestine, and the figure of wall state of contact of the crooked position of the front end guide parts of insertion section guiding tube and S font colon portion is shown.

Figure 49 is the effect that illustrates when the insertion section guiding tube inserted large intestine, thereby and the figure that further the insertion section guiding tube is pushed the crooked state of the part that makes front end guide parts is shown.

Figure 50 is the effect that illustrates when the insertion section guiding tube inserted large intestine, thereby and illustrates the insertion section guiding tube is pushed the further figure of crooked state of a part that makes front end guide parts.

Figure 51 is the figure that the structure of the insertion section guiding tube that is provided with capsule endoscope is described.

Figure 52 is the figure of the state of capsule endoscopic that the insertion section guiding tube the is shown bending section that arrives large intestine.

Figure 53 is the figure of the state of the capsule endoscopic of the explanation insertion section guiding tube gauffer of crossing the large intestine intestinal wall.

Figure 54 is the figure that the structure of the insertion section guiding tube that is provided with capsule endoscope is described.

Figure 55 is the profile of fore-end of insertion section guiding tube that is provided with the capsule endoscope of Figure 54.

Figure 56 is the figure that the structure of the insertion section guiding tube that is provided with capsule endoscope is described.

Figure 57 is the figure that the structure of the insertion section guiding tube that is provided with capsule endoscope is described.

Figure 58 is the drawing in side sectional elevation of fore-end of insertion section guiding tube that is provided with the capsule endoscope of Figure 57.

Figure 59 is the drawing in side sectional elevation that is provided with the insertion section guiding tube of air bag.

Figure 60 is the figure that the insertion section guiding tube that is provided with air bag arrives the bending section of large intestine.

Figure 61 is the figure that the airbag inflation of the insertion section guiding tube that inserts big enteral is described.

Figure 62 is the longitudinally profile of the structure of explanation guide member rotary apparatus.

Figure 63 is the front view of the structure of explanation guide member rotary apparatus.

Figure 64 is the longitudinally profile that explanation makes the guiding tube rotation and the mobile guiding tube rotary apparatus of keeping straight on.

Figure 65 is the front view of explanation guiding tube rotary apparatus.

Figure 66 is that explanation is installed in the endoscope of insertion section and the figure of insertion section guide member with the slotting logical aid of guiding tube.

Figure 67 is that explanation is installed in the endoscope of insertion section and the figure of insertion section guide member with the front end lid.

Figure 68 is that explanation is provided with the endoscope of the slotting logical protuberance of guiding tube that forms the guiding tube inserting hole and the figure of insertion section guide member on the insertion section.

Figure 69 is the figure of explanation while the insertion section of following the endoscope that the insertion section guide member is inserted into.

Figure 70 is the figure that other structure example of device are inserted in explanation.

Figure 71 is the figure that the structure of device is inserted in explanation.

Figure 72 is the figure of the position relation of the insertion section of the structure of explanation insertion section guide member and endoscope and insertion section guide member.

Figure 73 is the figure that explanation is configured in the insertion section guide member of outer circumferential side big enteral, that be configured in the insertion section.

Figure 74 is the figure that near the insertion section guide member of the caecum portion outer circumferential side, that be configured in the insertion section that arrives large intestine is described.

Figure 75 is the figure that explanation is provided with the structure of location insertion section guide member of rotating unit and insertion section.

Figure 76 is the figure of other allocation positions relations of explanation insertion section of endoscope and insertion section guide member.

Figure 77 is the state of big enteral is inserted the insertion section in explanation under the state that the bending section that makes the insertion section is given prominence to from the insertion section guide member figure.

Figure 78 is the figure that the state of the depths that the insertion section further is inserted into big enteral under the state that the bending section that makes the insertion section is given prominence to from the insertion section guide member is described.

Figure 79 is the figure of the structure of explanation insertion section guide member.

Figure 80 is that explanation makes the insertion section guide member run through the figure of the state that inserts big enteral by the guide member rotary apparatus.

Figure 81 is that explanation is with the figure of insertion section guide member from the state of anus insertion.

Figure 82 is that explanation makes the insertion section guide member be inserted into the figure of the state of large intestine depths.

To be explanation be inserted near the figure of the state the caecum portion with the endoporus of the insertion section of the endoscope insertion section guide member by being inserted into the large intestine depths to Figure 83.

The specific embodiment

Following with reference to the description of drawings embodiments of the present invention.

First embodiment that inserts device is described referring to figs. 1 through Fig. 6.

As shown in Figure 1, the insertion device 1 of present embodiment mainly is made of endoscope 2 and endoscope-use insertion aid 3 as medical treatment device.

Endoscope 2 is finders, constitutes to comprise: insertion section 11, operating portion 12 and general cable 13.Insertion section 11 is strips, has for example above length of 500mm.Operating portion 12 is arranged on the base end side of insertion section 11.General cable 13 extends out from the sidepiece of operating portion 12.

Insertion section 11 is provided with rigid 14 of front end, bending section 15 and flexible pipe portion 16 and constitutes by connecting successively from front.Bending section 15 for example constitutes in direction bending up and down freely.Flexible pipe portion 16 has flexibility.On operating portion 12, be provided with treatment apparatus inlet 17.Treatment apparatus inlet 17 is inserted general channels (with reference to the label 11a of Fig. 5) with treatment apparatus and is communicated with, and it is to be used to make the treatment apparatus that is located in the insertion section 11 to run through the slotting of insertion thread a pipe that this treatment apparatus is inserted general channels.

In endoscope 2, have light supply apparatus 4, video processor 5 and monitor 6 as external device (ED).Light supply apparatus 4 is supplied with endoscope 2 with illumination light.Video processor 5 has signal processing circuit, its supply is used for driving signal that the not shown imaging apparatus that is located in the endoscope 2 is driven, and will generate picture signal by the signal of telecommunication that imaging apparatus carries out sending after the opto-electronic conversion, to monitor 6 outputs.On the picture of monitor 6, show endoscopic images by receiving from the picture signal of video processor 5 outputs.

It is to insert accessory that endoscope-use inserts aid 3, mainly is made of for example guiding tube 21 and guiding tube rotary apparatus 22 as the insertion section guide member.Guiding tube rotary apparatus 22 has guiding tube fixed part 24 and as the motor 23 of rotating part.Motor 23 makes guiding tube 21 rotate to predetermined direction around guiding tube fore and aft axis (hereinafter referred to as around axle).Motor 23 is arranged near the platform 25a of for example rotary apparatus with car (being designated hereinafter simply as car) 25 that is disposed at patient's 7 horizontal beds 8.Specifically, motor 23 is fixed on the platform 25a in the mode that the motor reel 23a of motor 23 is parallel to the upper plane of platform 25a by not shown fixed part.

One is fixed with guiding tube fixed part 24 on the motor reel 23a of motor 23.Be fixed on the guiding tube fixed part 24 of motor reel 23a the end that loading and unloading are equipped with guiding tube 21 freely, i.e. base end side end.

Therefore, if thereby make motor 23 be driving condition motor reel 23a rotation, then one is fixed in the guiding tube 21 that the guiding tube fixed part 24 on this motor reel 23a installed and pivots.

In addition, label 26 is the protecting tubes that prevent the bed in the guiding tube 21 contact operating rooms.In the endoporus of protecting tube 26, run through and be inserted with guiding tube 21 with the loose fit state.Thus, can prevent guiding tube 21 direct contact beds etc.End 26a, the 26b of protecting tube 26 loads and unloads respectively and is mounted and fixed on freely on the protecting tube holding member 27,28.A protecting tube holding member 27 for example is configured on the bed 8 by the support 29 of adjustable-height position.Another protecting tube holding member 28 is configured in that the set desk 25b of car 25 go up and is relative with motor 23.Also can use drip molding shape etc., among the figure longitudinally the upper surface side opening and have flexible female member and replace above-mentioned protecting tube 26.

Guiding tube 21 shown in Fig. 2 is the so-called insertion sections of inserting in body cavity, considers to the endoceliac slotting general character, and for example be serpentine pipe.Guiding tube 21 for example is that rustless steel is made, and forms helically and be wound with the metal wire rod 31 of two-layer predetermined diameter size and have predetermined flexible.Therefore, be provided with surperficial formed spiral-shaped 21a at the outer surface of guiding tube 21 by metal wire rod 31.

In addition, many (for example four) metal wire rods 31 of also can reeling constitute guiding tube 21.In addition, during around metal wire rod 31,, perhaps change the angle of spiral, can carry out various settings the characteristic of guiding tube 21 by improving the adaptation between the metal wire rod in helical coil.In addition, the outside dimension of guiding tube 21 is set to this guiding tube 21 and can runs through the treatment apparatus that inserts endoscope 2 and insert in the general channels 11a.

The effect of the insertion device 1 of structure as mentioned above is described.

The preparation process that is used for guiding tube 21 is inserted big enteral is described.

When for example caecum portion that is inserted into large intestine was run through in the insertion section 11 of endoscope 2, at first medical personnel's (abbreviating the staff as) prepared protecting tube 26 and the guiding tube 21 with desirable insertion.Then, the staff is fixed on each end of protecting tube 26 on the protecting tube holding member 27,28.Next, the staff is run through guiding tube 21 in the endoporus that inserts protecting tube 26.Then, will be installed on the guiding tube fixed part 24 that is fixed in motor reel 23a, the other end for example is configured on the support 29 from an end of the outstanding guiding tube 21 of protecting tube 26.Thus, the preparation that is used to that guiding tube 21 is run through and inserts big enteral finishes.In addition, when preparing endoscope-use insertion aid 3, also carry out the preparation of endoscope 2, light supply apparatus 4, video processor 5 and monitor 6.

The step of large intestine is inserted guiding tube 21 in explanation.

At first, as shown in Figure 1, operator (not shown) controls the front part of guiding tube 21, and the leading section of guiding tube 21 is inserted big enteral from the patient 7 of accumbency on bed 8 anus 71.So spiral-shaped the 21a that is formed on the outer surface of guiding tube 21 contacts with intestinal wall.At this moment, being formed on spiral-shaped the 21a on the guiding tube 21 and the state of contact of intestinal wall gauffer is the relation of external screw thread and female thread.

Under this contact condition, make the motor 23 of guiding tube rotary apparatus 22 be the rotation driving condition.So, 24 rotations of guiding tube fixed part, thus the rotation that the guiding tube 21 on this guiding tube fixed part 24 is scheduled to be installed in.Like this, shown in the arrow of Fig. 3, spiral-shaped 21a of guiding tube 21 becomes the state that is rotating around direction of principal axis with from the mode of base end side forward end side shifting.

Thus, the contact portion generation of spiral-shaped 21a of the guiding tube 21 of rotation and intestinal wall gauffer make external screw thread with respect to female thread move such, make guiding tube 21 progressive propulsive forces.That is, spiral-shaped 21a is the insertion section, also is the propulsive force generating unit.Then, guiding tube 21 is advanced to the depths in large intestine under the effect of propulsive force.At this moment, the operator can operate the guiding tube 21 of being controlled to advance on hand.In addition, propulsive force also can be operation on hand auxiliary that advances guiding tube 21.

The guiding tube 21 that inserts from anus 71 advances towards S font colon portion 73 from rectum 72 under the effect of above-mentioned propulsive force and operator's operation on hand.Then, as shown in Figure 3, guiding tube 21 arrives S font colon portion 73.At this moment, the contact length of spiral-shaped 21a of guiding tube 21 and intestinal wall is long.Therefore, under the gauffer state of contact or the state of guiding tube 21 complicated bends of the part of spiral-shaped 21a and S font colon portion 73, can obtain stable propulsive force.And, because that guiding tube 21 has is enough flexible, thus advance smoothly and by S font colon portion 73 along intestinal wall, and do not change the walking state of the S font colon portion 73 that the position changes easily.

Then, the guiding tube 21 of rotation status is by the bending section of S font colon portion 73 with descending colon portion 74 intersections that lack mobility, again by descending colon portion 74 and the spleen bending 76 that is imbued with transverse colon portion 75 intersections of mobility, the wall along the liver bending 77 of transverse colon portion 75 and ascending colon portion 78 intersections advances smoothly then.Then, as shown in Figure 4, arrive near the caecum portion 79 at purpose position for example, and do not change the walking state of large intestine.

If the operator judges guiding tube 21 and arrived near the caecum portion 79, then the staff will take off from guiding tube fixed part 24 from the base end part of the outstanding guiding tube 21 of protecting tube 26 according to operator's indication.Then, from protecting tube 26, take out guiding tube 21.

In addition, in the present embodiment, the direction of rotation of the guiding tube 21 that rotates by the guiding tube rotary apparatus can be set at a just direction (direction of advance), also can set for according to some cycles or switch arbitrarily and carry out left rotation and right rotation.By the left rotation and right rotation of combination guiding tube rotary apparatus, guiding tube moves forward and backward in body cavity repeatedly.Thus, even the front end of guiding tube is just in case tangled by the gauffer of intestinal or little recess when advancing, this tangles also and can be disengaged when retreating.Then, when advancing next time, stagger a little in the position by making intestinal and the position of guiding tube, can before so that can not tangle once more.

The step of big enteral is inserted the insertion section 11 of endoscope 2 in explanation.

Shown in the arrow of Fig. 5; the base end part of the guiding tube 21 that the operator will take out from protecting tube 26 inserts to operating portion 12 sides from front opening 14b, and the front end face 14a that this front opening 14b is located at rigid 14 of front end goes up and inserts general channels 11a with treatment apparatus and is communicated with.Then, shown in the line of the single-point among the figure, make the base end part of guiding tube 21 outstanding from the treatment apparatus inlet 17 that is located on the operating portion 12.

If the operator confirms that guiding tube 21 from treatment apparatus inlet 17 outstanding scheduled volumes, then for big enteral is inserted in insertion section 11, makes endoscope 2 become observable state.Then, the operator is run through the treatment apparatus that inserts insertion section 11 at guiding tube 21 and is inserted under the state in the general channels 11a, and rigid 14 of the front end that constitutes insertion section 11 inserted big enteral from anus 71.Like this, the illumination light irradiation of penetrating by the illuminating window 14c from the front end face that is located at rigid 14 of front end forms the observation image of big enteral, the imaging on the shooting face of imaging apparatus by the observation window 14d that constitutes observation portion of the observation image of this big enteral shows the endoscopic images of the image that comprises guiding tube 21 then on the picture of monitor 6.

Here, the operator confirms on one side to run through the bearing of trend of the guiding tube 21 that inserts big enteral on the picture of monitor 6, Yi Bian make the operation of bending section 15 bendings and twist the operation etc. of insertion section 11, simultaneously, as shown in Figure 6 with insertion section 11 insertions.At this moment, owing to run through the labelling of direction of insertion that the guiding tube 21 that inserts big enteral becomes expression insertion section 11 in advance, so the operator can successfully carry out operating and can not losing direction of insertion to the insertion of big enteral depths.Then, rigid 14 of the front end of insertion section 11 is inserted near the caecum portion 79.

If shown endoscopic images confirms that it is near the caecum portion 79 that insertion section 11 has arrived the purpose position on the picture of operator by monitor 6, then for the splanchnoscopy that carries out big enteral then carry out the operation that retracts of insertion section 11.At this moment, keep guiding tube 21 to run through being inserted in treatment apparatus to insert state in the general channels 11a, perhaps check inserting under the state that takes out guiding tube 21 the general channels 11a from treatment apparatus.

In addition, illustrate and the insertion section 11 of endoscope 2 is being inserted under the state of large intestines the situation that guiding tube 21 returns to the anus side from the depths of large intestine.Under these circumstances, the operator is keeping that guiding tube 21 is run through and is being inserted in treatment apparatus to insert under the state in the general channels 11a, the base end part of guiding tube 21 is installed on the motor reel of motor 23 on the fixed guiding tube fixed part 24 of institute.Then, the operator carries out the action with above-mentioned guiding tube 21 insertion large intestines once more, and it is arrived near caecum portion 79, and then carries out the action with the insertion section 11 insertion large intestines of endoscope 2.

Like this, the purpose position that guiding tube is run through be inserted into big enteral, the base end part side that will be configured in external guiding tube then runs through to be inserted the treatment apparatus that is located in the endoscope and inserts in the general channels, will be in guiding tube again and run through and be inserted in the insertion section that this treatment apparatus inserts under the state in the general channels and insert in large intestine.Thus, can observe by the observation window of endoscope on one side and run through the guiding tube that is configured in big enteral with inserting, on one side the insertion section is inserted to the depths.Therefore, the operator can not lose the direction that the insertion section is inserted into the insertion section insertion.And, by observing the insertion state of guiding tube, while can carry out suitable bending operation, twist operation the insertion section is inserted.Therefore, can successfully the insertion section be inserted into the depths of tube chamber at short notice.

In addition, insert in the aid at the endoscope-use that constitutes by guiding tube and guiding tube rotary apparatus, by outer surface spiral-shaped portion is set at guiding tube, guiding tube is being inserted under the state of big enteral for example, spiral-shaped the contact condition with the gauffer of intestinal wall of guiding tube becomes the relation of so-called external screw thread and female thread.In addition, under this contact condition, the motor rotation of guiding tube rotary apparatus is driven so that guiding tube is rotating around direction of principal axis, thereby the revolving force of guiding tube can be converted to propulsive force, the guiding tube of rotation status is advanced to the depths of large intestine with respect to the mode that female thread moves with external screw thread.

In the present embodiment, be that large intestine describes with the tube chamber of the insertion section that is inserted with endoscope, but the tube chamber that insert the insertion section is not limited to large intestine, also can be from the oral cavity to the esophagus, the tube chamber of stomach and small intestinal etc.

In addition, in the present embodiment, guiding tube 21 is the serpentine pipes that constitute around the metal wire rod 31 of two-layer predetermined diameter size by helical coil, but the structure of guiding tube 21 is not limited thereto, and also can be the structure shown in following Fig. 7 to Figure 16.

Other structure example of guiding tube are described with reference to Fig. 7 to Figure 16.

Guiding tube 21A shown in Figure 7 constitutes spiral-shaped 21a by the different two kinds of metal wire rods 32,33 in the assemble line footpath spiral of for example reeling then.In this structure, suitably select to set the line footpath of metal wire rod 32,33.

Like this, in guiding tube 21A, spiral-shaped 21a is made of the different two kinds of metal wire rods 32,33 in line footpath.Thus, form the concavo-convex size of spiral-shaped 21a, can suitably be adjusted in the propulsive force that is produced when spiral-shaped 21a contacts with the gauffer of intestinal wall by appropriate change.

Guiding tube 21B shown in Figure 8 constitutes by setting in advance soft resin duct member 34 that spiral-shaped 21a constitute by shaping or the outer peripheral face of the duct member that formed by the soft resin parts being carried out the soft resin duct member 34 that machining forms spiral-shaped 21a, and is aforesaid with the helically wound structure of metallic wire coil to replace.

Like this, guiding tube 21B is made of the soft resin duct member 34 with spiral-shaped 21a.Thus, can obtain cheap guiding tube by being shaped, so can realize the disposable use of guiding tube.In addition, wait by shaping, cutting to form spiral-shaped 21a, can easily change shape, pitch of spiral-shaped 21a etc.Therefore, can provide the guiding tube of spiral-shaped 21a with suitable tube chamber, the guiding tube of spiral-shaped 21a with the desirable shape of operator perhaps is provided.

In guiding tube 21C shown in Figure 9, make formation from insert endoceliac front end to the first guide tube part 20A flexible of part midway and constitute from being configured in body cavity outside midway partly to the change in flexibility of the second guide tube part 20B of cardinal extremity.Specifically, with the flexible flexible softness that constitutes than the second guide tube part 20B of the first guide tube part 20A.Therefore, constitute the metal wire rod 35 that shown in Figure 10 being used to constitutes guiding tube 21C by front part 35a and base end side part 35b, the cross sectional shape of wherein said front part 35a is formed by the circle of easy bending as shown in figure 11, and the cross sectional shape of base end side part 35b is as shown in figure 12 by being difficult to crooked square formation.

Like this, in guiding tube 21C, make to be positioned at the flexible of the outer second guide tube part 20B that constitutes of body cavity than inserting the flexible hard of the endoceliac first guide tube part 20A.Thus, compare, can significantly improve performance from revolving force to the leading section side of guiding tube 21C that transmit with flexible identical above-mentioned guiding tube 21,21A, 21B.In addition, in guiding tube 21C, the first guide tube part 20A successfully can be run through being inserted into complicated intraluminal depths, on the other hand, the second guide tube part 20B successfully can be run through the treatment apparatus that inserts endoscope 2 and insert among the general channels 11a.

In addition, make to insert to be configured in the body cavity and to constitute the flexible of the first guide tube part 20A from front end to part midway and be configured in body cavity outside and constitute from part midway, be not limited to the cross sectional shape of the extremely above-mentioned metal wire rod 35 shown in Figure 12 of above-mentioned Fig. 9 to the structure of the change in flexibility of the second guide tube part 20B of cardinal extremity.

For example, in guiding tube 21D shown in Figure 13, change the flexible of the flexible of the first guide tube part 20A and the second guide tube part 20B by using two kinds of different metal wire rods 36,37.Specifically, at the metal wire rod 36 that constitutes the first guide tube part 20A with constitute in the metal wire rod 37 of the second guide tube part 20B, for example can change flexible by the difference of line footpath, material characteristic or heat treatment etc.Label 38 be used for different metal wire rod 36,37 be connected to each other be integral be connected and fixed parts 38.

In addition, in guiding tube 21E shown in Figure 14, use identical metal wire rod 39, on the other hand, change the flexible of the flexible of the first guide tube part 20A and the second guide tube part 20B by the number of plies that changes the spiral part that the coiling metal wire rod constitutes.In this case, the outside dimension with the first guide tube part 20A forms thinner than the outside dimension of the second guide tube part 20B.

And then, in above-mentioned resin making conduit 21B shown in Figure 8, also can change the flexible of the flexible of the first guide tube part 20A and the second guide tube part 20B by the wall thickness that illustrated pipe has been omitted in change.In this case also can with the above-mentioned outside dimension that similarly changes.

Above-mentioned guiding tube 21,21A, 21B, 21C, 21D, 21E represents wound skein product or the structure of spiral is set on resin component.Yet, also can be as shown in figure 15, be configured like that and constitute guiding tube 21F by on body 41, covering the damping coil 42 that constitutes spiral-shaped 21a.Label 43 is that the end one with damping coil 42 is fixed on the fixed part on the body 41.The end of damping coil 42 is fixed on the body 41 by fixing band 44a and binding agent 44b one.

In above-mentioned guiding tube 21,21A, 21B, 21C, 21D, 21E, 21F, spiral-shaped 21a is set continuously on whole length.Yet, as shown in figure 16, in the first guide tube part 20A, be on the basis of the propulsive force of considering spiral-shaped 21a, with uniformly-spaced or arbitrary interval the part a plurality of structures with spiral body 21b of spiral-shaped 21a are set.Thus, in guiding tube 21G, reduce the contact portion of spiral-shaped 21a and body wall, thereby can alleviate the burden that the donor cornice comes.

As mentioned above, be provided with a plurality of or spiral-shaped portion is set continuously, can guarantee the contact area of lumen wall and spiral-shaped portion by the part.Thus, can realize the raising of the propulsive force of guiding tube.

Second embodiment that inserts device is described with reference to Figure 17 to Figure 28.

The structure of the insertion device of present embodiment and the structure of above-mentioned first embodiment are roughly the same, but it is different with first embodiment to be provided with the structure of front end guide parts in the front of insertion section guide member.Therefore, about with the identical structure of above-mentioned first embodiment, omit its diagram and detailed explanation, different parts only are described below.

Explanation has the structure of the guiding tube 21 of front end guide parts with reference to Figure 17.

As shown in the figure, guiding tube 21 is to consider flexible serpentine pipe, and it forms around double layer of metal wire rod 31 by helical coil.Therefore, be provided with surperficial formed spiral-shaped 21a at the outer surface of guiding tube 21 by metal wire rod 31.

Leading section at the guiding tube 21 of present embodiment is provided with first guiding element 50 and bobbin (wire shaft) parts (being designated hereinafter simply as the line parts) 51 that constitute front end guide parts.Line parts 51 are set to extend out from the front end of guiding tube 21.Specifically, line parts 51 are fixed on the leading section of guiding tube 21 by fixed part 52 one by for example soldering etc.Elder generation's guiding element 50 is provided in a side of the roughly spheroid of line parts 51 front ends.

Line parts 51 are fixed on the front end of guiding tube 21 by fixed part 52, and have the lengthwise central shaft on the axle identical with the lengthwise central shaft of guiding tube 21.Therefore, line parts 51 are located on the concentric shafts with guiding tube 21.Line parts 51 have the length of 10mm to 100mm, are for example formed by metal single lines such as rustless steel or piano wires.In addition, line parts 51 have flexible high flexible than guiding tube 21.In other words, line parts 51 constitute than guiding tube 21 and are easier to bending.

In addition, line parts 51 are not limited to above-mentioned metal single line, also can be the metal multi cords.In addition, the material of line parts 51 can be the elastomer with petroleum compounds such as being scheduled to flexible plastics or rubber etc.And then line parts 51 also can be the superelastic alloy lines.By the superelastic alloy line is used for line parts 51, even extremely crooked, the restoring force of replying former state is also very strong.Therefore, u turn does not take place to the insertion of intraluminal depths direction in guiding tube 21 easily.

Describe the first guiding element 50 of fixing online parts 51 front ends below in detail.

Elder generation's guiding element 50 for example forms roughly spheroid by metal parts, and its surface is slick guide surface.This is the front end of the online parts 51 of first guiding element 50 installations of spheroid roughly, and makes the central point of this elder generation's guiding element 50 be positioned on the fore and aft axis of line parts 51.The diameter of elder generation's guiding element 50 is set to predetermined diameter, i.e. the scope of 2mm-30mm.In addition, the diameter dimension of first guiding element 50 some selection of inserting according to the treatment apparatus of patient 7 lumen diameter or endoscope 2 in the internal diameter of general channels 11a set.

In addition, also being not limited to metal parts about the material of first guiding element 50, also can be to have the elastomer that biocompatible and its surface have the petroleum compound such as plastics of guide surface of slick roughly sphere or rubber etc.That is, the sliding of gauffer that is preferred for crossing lumen walls such as large intestine is good, i.e. the little material of coefficient of friction.In addition, first guiding element 50 preferred light-duty materials, the inside that can make guide's part 50 in lightness for example is hollow.And then, preferably constitute by transparent resin etc.

The effect of the guiding tube 21 with the first guiding element 50 that constitutes as mentioned above is described.

Here, owing to the preparation process that is used for guiding tube 21 insertion large intestines is identical with above-mentioned first embodiment, so omit its explanation.

Next the action that guiding tube 21 is inserted large intestine is described.

At first as above-mentioned shown in Figure 1, operator (not shown) controls the front part of guiding tube 21, and the leading section of guiding tube 21 is inserted big enteral from the patient 7 of accumbency on bed 8 anus 71.Like this, spiral-shaped the 21a that is formed on guiding tube 21 outer surfaces contacts with intestinal wall.At this moment, being formed on spiral-shaped the 21a on the guiding tube 21 and the contact condition of intestinal wall gauffer is the relation of external screw thread and female thread.

Under this contact condition, the operator drives motor 23 rotations of guiding tube rotary apparatus 22.Like this, guiding tube 21 is rotating on direction of principal axis.At this moment, be delivered to the first guiding element 50 of guiding tube 21, first guiding element 50 is being rotated on direction of principal axis from the rotation of guiding tube 21 and line parts 51.In the contact portion of spiral-shaped 21a with the gauffer of intestinal wall of the guiding tube 21 of rotation, generation make external screw thread with respect to female thread move such, make guiding tube 21 progressive propulsive forces.Then, guiding tube 21 is being advanced to S font colon portion 73 in rectum 72 under the effect of propulsive force.

As shown in figure 18, the first guiding element 50 of guiding tube 21 arrives S font colon portion 73.At this moment, the guide surface of the first guiding element 50 of guiding tube 21 becomes the gauffer state of contact with S font colon portion 73.The first guiding element that contacts with the intestinal wall of the S font colon portion 73 with gauffer 50 cooperates the rotation of guiding tube 21 on one side and rotates, Yi Bian successfully cross with its roughly spherical surface, be the gauffer that the part of guide surface contacts.And then if guiding tube 21 advances in large intestine inside, then first guiding element 50 is promoted by the sweep of line parts 51 along S font colon portion, thereby guiding tube 21 is guided to direct of travel.

As shown in figure 19, cooperate therewith, line parts 51 are along the sweep bending of S font colon portion, and then, as Figure 20, shown in Figure 21, the fore-end of the guiding tube 21 that is connected with line parts 51 is crooked equally, and is directed along the sidewall of S font colon portion 73.In addition, formerly under the intestinal wall state of contact of guiding element 50 and S font colon portion 73, spiral-shaped the 21a of guiding tube 21 and the gauffer of intestinal wall also are the relations of external screw thread and female thread.Therefore, the guiding tube of rotation status 21 advances smoothly along intestinal wall, is not imbued with position change flexible and the S font colon portion that the position changes easily and can not make.

Then, while crossing the gauffer of intestinal wall with first guiding element 50, the guiding tube 21 of rotation status passed through S font colon portion 73 by the mode that the bending direction of thread toward member spare 51 pulls.Like this, as shown in figure 22, guiding tube 21 is spleen bending 76, transverse colon portion 75 and the bending section of ascending colon portion 78 intersections is the intestinal wall of liver bending 77 and advancing smoothly along the bending section of S font colon portion 73 and descending colon portion 74 intersections that lack mobility, descending colon portion 74 and the bending section that is imbued with transverse colon portion 75 intersections of mobility, arrives then near the caecum portion 79 for example and does not change the walking state of large intestine.

In this traveling process, because spiral-shaped 21a of guiding tube 21 is long with the contact length of intestinal wall, so formerly under the state of guiding element 50 and intestinal wall state of contact and guiding tube 21 complicated bends, can obtain stable propulsive force.And, because that guiding tube 21 has is enough flexible, thus in the process of advancing in large intestine inside, for example can advance smoothly along intestinal wall, and can not make the position change of the S font colon portion 73 that the position changes easily.

After the first guiding element 50 of guiding tube 21 front ends arrives near the caecum portions 79, take off the base end part of the guiding tube of giving prominence to from protecting tube 26 21 from guiding tube fixed part 24.Then, from the base end part side guiding tube 21 is taken out from protecting tube 26.

About the step of next carrying out, that is, the step of big enteral and the endoscopic procedures of big enteral are inserted in the insertion section 11 of endoscope 2, since identical with above-mentioned first embodiment, so omit its explanation.

Like this, insertion device according to present embodiment, with guiding tube insertion tube intracavity, for example during large intestine etc., the roughly sphere of the first guiding element by being located at the guiding tube front, be that the part of guide surface contacts with the gauffer of intestinal wall and can easily cross the gauffer of intestinal wall.

In addition, the line parts by guiding tube can make guiding tube easily insert to the depths direction along the bending of each bending section of large intestine etc. to the direct of travel bending of first guiding element.

Therefore, by inserting the insertion section that intraluminal guiding tube advances endoscope, can easily carry out insertion until the depths along running through in advance.Thus, can be more successfully at short notice the insertion section of endoscope be inserted into the purpose position, and bring misery to the patient.

In addition, the structure of first guiding element is not limited to above-mentioned embodiment, also can be structure for example shown in Figure 23.As shown in figure 23, the first guiding element 50A of present embodiment formerly has the through hole that line parts 51 slotting wildcards are put in the guiding element center.The front end of online parts 51 and midway the part precalculated position be provided with a pair of retainer 51a, clamping is provided with rotation first guiding element 50A freely between this a pair of retainer 51a.The profile of these retainers 51a is set to the opening of going up set through hole greater than first guiding element 50A.Therefore, first guiding element 50A is configured to rotate freely around the fore and aft axis of line parts 51.

In the first guiding element 50A of this structure, if contact with intestinal wall as the guide surface on surface, then line parts 51 idle running.In addition, if the bending section of arrival large intestine etc., then first guiding element 50A carries out suitable rotation.Its result is that first guiding element 50A can easily cross the gauffer of intestinal wall, and its guide surface does not bring unnecessary rotary load to intestinal wall.Therefore, can make guiding tube 21 more successfully arrive the depths of large intestine etc.

In addition, the structure of line parts 51 and guiding tube 21 being set on concentric shafts the position of line parts 51 and guiding tube relation is not limited in shown in above-mentioned embodiment, also can be that Figure 24 is to structure shown in Figure 26.

In the present embodiment, as shown in figure 24, be located at the fore and aft axis of line parts 51 of guiding tube 21 front ends and the fore and aft axis of guiding tube 21 and have different axles.That is, line parts 51 are with respect to the eccentricity of central axis setting of guiding tube 21.In other words, the fore and aft axis of line parts 51 is the eccentric shafts from the rotating shaft staggered positions of guiding tube 21.

As Figure 25 and shown in Figure 26, the cardinal extremity of line parts 51 part the fore-end that inserts guiding tube 21 by the inner surface of pipeline of guiding tube 21 and the surperficial clamping of eccentric part 53, and fixes by fixed part 52 one.The front end of online parts 51 is fixed with first guiding element 50A.In addition, the fore and aft axis of line parts 51 is configured to the center by first guiding element 50.That is, be provided with the line parts 51 with eccentric shaft at the front end of guiding tube 21, the front end of online parts 51 is provided with first guiding element 50.

Explanation has the effect with respect to the guiding tube 21 of the line parts 51 of the eccentricity of central axis of guiding tube 21 with reference to Figure 27 and Figure 28.

Guiding tube 21 is rotating on direction of principal axis, and guiding tube 21 is advanced in large intestine with respect to the mode that female thread moves with external screw thread.Then, as shown in figure 27, when guiding tube 21 arrived the bending section of large intestine, the part of the guide surface of first guiding element 50 contacted with intestinal wall.Under this state, because guiding tube 21 is rotating, so as shown in figure 28, first guiding element 50 departs from around axial position with the eccentric shaft of line parts 51.Thus, while first guiding element 50 moves in intestinal wall along with the rotation of guiding tube 21 changes around axial position, successfully cross the gauffer of intestinal wall easily so become.Therefore, guiding tube 21 can easily arrive the depths of large intestine etc.

The 3rd embodiment that inserts device is described with reference to Figure 29 to Figure 35.

The structure of the insertion device of present embodiment and the structure of above-mentioned second embodiment are roughly the same, but it is different to be located at the structure and second embodiment of front end guide parts of front of insertion section guide member.Therefore, about with the identical structure of above-mentioned second embodiment, omit its diagram and detailed explanation, different parts only are described below.

As shown in figure 29, at the front end of the guiding tube 21 of present embodiment wired parts 51 are installed.In addition, being provided with a plurality of on these line parts 51 is five first guiding element 50A here.On five first guiding element 50A, be provided with through hole by its center.In through hole, run through and insert wired parts 51.The diameter dimension of through hole is set at the diameter greater than line parts 51.In addition, the front end of online parts 51 is provided with the profile retainer 51a bigger than the opening of the through hole of first guiding element 50A.Five first guiding element 50A are set to not come off from line parts 51 by retainer 51a.

Thus, online parts 51 run through among five first guiding element 50A of insertion the surface of the front end opening side of first guiding element 50A foremost and retainer 51a butt, the surface of the cardinal extremity peristome side of the first guiding element 50A of rearmost end and the front end face side butt of guiding tube 21.Therefore, can prevent that five first guiding element 50A from coming off from line parts 51, and five first guiding element 50A can rotate freely or stop with respect to line parts 51.

Explanation is provided with the effect of the guiding tube 21 of a plurality of first guiding element 50A with reference to Figure 30 and Figure 31.

Guiding tube 21 is rotating on direction of principal axis, and guiding tube 21 is advanced in large intestine with respect to the mode that female thread moves with external screw thread.Then, as shown in figure 30, be positioned at guiding tube 21 front first guiding element 50A guide surface a part and large intestine etc. intestinal wall, particularly S font colon portion 73 (with reference to Figure 21) etc. bending section the intestinal wall butt and contact.At this moment, the first guiding element 50A of front end is owing to respect to 51 rotations of line parts freely, so even guiding tube 21 rotates, the first guiding element 50A of front end does not rotate yet.Therefore, the first guiding element 50A of front end brings meaningless load can for the intestinal wall of large intestine of being contacted etc.

In addition, as shown in figure 31, because five first guiding element 50A of the intestinal wall of the bending section by large intestine etc. rotate freely, so little with the influence of the line parts 51 of guiding tube 21 rotations.Therefore, five first guiding element 50A cooperate the state of the gauffer of the intestinal wall that is passed through, can be as shown by arrows to around direction of principal axis or best direction rotation in axial opposite direction.That is, the guide surface of each first guiding element 50A is on one side to rotating around direction of principal axis or the some directions in axial opposite direction, Yi Bian successfully cross the gauffer of intestinal wall.

In addition, if guiding tube 21 further advances in large intestine inside, then first guiding element 50A is successfully guided by the sweep along S font colon portion 73.Cooperate therewith, line parts 51 are directed into along the sweep bending of S font colon portion 73, and the fore-end of the guiding tube 21 that is connected is pulled crookedly equally.That is, while be in mode that gauffer that the guiding tube 21 of rotation status can cross intestinal wall with the first guiding element 50A of front end pulled by the bending direction of thread toward member spare 51 each bending section by large intestine, thus the depths of large intestine etc. easily arrived.

Above result is, on the basis of the effect of second embodiment, because five first guiding element 50A of guiding tube 21 do not rotate when contacting with intestinal wall, perhaps particularly in each bending section of tube chamber, be not subjected to line parts 51 rotation influence and rotate freely, so can easily cross the gauffer of intestinal wall, and not bring the load that can not bear to intestinal wall.

Therefore, the operator can make the insertion section 11 of guiding tube and endoscope 2 successfully arrive the depths of large intestine etc.Thus, can be successfully at short notice the insertion section of endoscope be inserted into the purpose position, and bring misery to the patient.

In addition, shown in figure 32, also can be, be provided with a plurality of when being five first guiding elements on the online parts 51 here, to be positioned on the first guiding element 50 fixing online parts 51 foremost, the through hole of insertion that line parts 51 are run through is set in the mode by its center in four first guiding element 50A, and the first guiding element 50A beyond the first guiding element 50 foremost can freely rotate around the fore and aft axis of line parts 51.

In addition, as shown in figure 33, also can be, eight first guiding elements are set on for example online parts 51, fixedly front end and intermediary two first guiding elements 50 on the online parts 51, the through hole of insertion that line parts 51 are run through is set in the mode by its center in remaining six first guiding elements 50, and the fore and aft axis that six first guiding element 50A can winding part 51 freely rotates.

Configuration example as first guiding element, as shown in figure 33, among rotation six first guiding element 50A freely three for example are set between front end and intermediary first guiding element 50, its excess-three first guiding element 50A is located at base end side on the line parts 51, promptly is arranged on from intermediary first guiding element 50 to the line parts 51 of guiding tube 21.Its result is that the rotatory force of line parts 51 is passed to the first guiding element 50 that is positioned on front end and intermediary, the fixing online parts 51, thereby further increases the propulsive force of guiding piece 21.

In addition, in second embodiment and the 3rd embodiment, show the front end guide parts of such formation: the front end at guiding tube 21 is provided with line parts 51, and a first guiding element is set at least with respect to these line parts 51, but the structure of front end guide parts is not limited thereto, and also can be Figure 34 and structure shown in Figure 35.

As Figure 34 and shown in Figure 35, in the present embodiment, be such structure: have the holding member 55 of guide surface in the front setting of guiding tube 21, this guide surface is made of for example slick outer surface of three spheroids of clamping.This holding member 55 is made of two parts cutting apart, and uniformly-spaced has three hole portions 56 in the inside of each component parts.In these three hole portions 56, dispose the spheroid 57 that the surface has guide surface respectively.Front end at two component parts cutting apart is provided with lid 50a.Thereby by this lid 50a two component parts cutting apart are become one and constitute holding member 55.

Holding member 55 is substantial cylindrical, has chamfering 55a on the relative both direction of its outer peripheral face.Therefore, the part of the guide surface of spheroid 57 is exposed from the chamfering 55a that holding member 55 is had.In addition, the aperture of three hole portions 56 is set to less times greater than the diameter of spheroid 57.Its result is that the spheroid 57 that is configured in the holding member 55 can freedom diversely rotate.Therefore, as mentioned above, thereby spheroid 57 freely rotates and guiding tube 21 easily can be inserted.

In addition, also can be as shown in figure 36, be provided with at the front end of guiding tube 21 and a plurality ofly be four paired rotors 58 here and make their longitudinally axle approximate vertical with respect to line parts 51.These paired rotors 58 for example are roughly circular, have the slick guide surface of the gauffer of the intestinal wall that is used to cross large intestine etc. on its surface.Be through with bolster 59 in the through hole separately that on rotor 58, is provided with.Be provided with the removal stop section 59a bigger than the through hole of rotor 58 at the two ends of these bolsters 59.Therefore, these rotors 58 are configured to respect to bolster 59 rotations freely.In addition, these rotors 58 are configured to have orthogonal axle from the front of line parts 51.That is, the turning cylinder of adjacent rotors 58 is on the roughly orthogonal direction.

Thus, make guiding tube 21 when the depths of large intestine direction is advanced, rotor 58 rotates, thereby can easily cross the gauffer of the intestinal wall that contacts with the guide surface of rotor 58,

With reference to Figure 37 to Figure 41 the 4th embodiment of the present invention is described.

The structure of the insertion device of present embodiment and the structure of above-mentioned second embodiment are roughly the same, but it is different to be located at the structure and second embodiment of front end guide parts of front of insertion section guide member.Therefore, about with the identical structure of above-mentioned second embodiment, omit its diagram and detailed explanation, different parts only are described below.

Guiding tube 21 shown in Figure 37 is serpentine pipes of considering to the endoceliac slotting general character.Guiding tube 21 for example is that rustless steel is made, and it is to form by the metal wire rod 31 of helical coil around two-layer predetermined diameter size, and has predetermined flexible.

Leading section at guiding tube 21 is provided with the front end guide parts that are made of first guiding element 50 and bobbin parts (being designated hereinafter simply as the line parts) 60.Line parts 60 are made of first bending section 61 and second bending section 62.Elder generation's guiding element 50 is roughly spheroids that smooth outer surface forms, and it constitutes guide's parts foremost.First bending section 61 is to have flexible thread-like member, and it is located near the guiding tube 21 position, is the base end part side.Second bending section 62 is to have flexible thread-like member, and it is connected setting with first guiding element 50 with first bending section 61.

In the present embodiment, guiding tube 21, first bending section 61 and second bending section 62 all have flexible, and first bending section 61 is set to more soft than second bending section 62.

In addition, second bending section 62 is set to more soft than guiding tube 21, and perhaps both have about equally flexible.

In addition, the length relation of first bending section 61 and second bending section 62 is set at:

The length of the length of second bending section 62 〉=first bending section 61.

In addition, the diameter of first guiding element 50 is set to the diameter greater than guiding tube 21.

The effect of the guiding tube that is provided with the flexible front end guide parts of having set bending section 61,62 as mentioned above is described.

Here, the preparation process that is used for guiding tube 21 is inserted large intestines is identical with above-mentioned first embodiment, so omit its explanation.

Next the action that guiding tube 21 is inserted large intestine is described.

At first as above-mentioned shown in Figure 1, operator (not shown) controls the front part of guiding tube 21, the first guiding element 50, the line parts 60 that constitute the front end guide parts of guiding tube 21 leading sections are inserted big enteral from the patient 7 of accumbency on bed 8 anus, then insert guiding tube 21.Like this, spiral-shaped the 21a that is formed on guiding tube 21 outer surfaces contacts with intestinal wall.At this moment, the contact condition that is formed on the gauffer of spiral-shaped 21a on the guiding tube 21 and intestinal wall is the relation of external screw thread and female thread.

Under this contact condition, make the motor 23 of guiding tube rotary apparatus 22 be the rotation driving condition.So guiding tube fixed part 24 rotation, thereby be installed in the rotation that the base end part of the guiding tube 21 on this guiding tube fixed part 24 is scheduled to.This rotation is passed to front from base end part, thereby shown in the arrow of Figure 38, spiral-shaped 21a of guiding tube 21 becomes the state that is rotating around direction of principal axis with from the mode of base end side forward end side shifting.

Thus, the contact portion generation of spiral-shaped 21a of the guiding tube 21 of rotation and the gauffer of intestinal wall make external screw thread with respect to female thread move such, make guiding tube 21 progressive propulsive forces.So guiding tube 21 advances to the depths in large intestine under the effect of propulsive force.At this moment, the operator can operate the guiding tube 21 of being controlled to advance on hand.

The guiding tube 21 that inserts from anus 71 advances to S font colon portion 73 from rectum 72 by above-mentioned propulsive force and operator's operation on hand.Then, as shown in figure 38, guiding tube 21 arrives S font colon portion 73.At this moment, because the 21a of spiralization portion that is formed on the outer surface of guiding tube 21 is long with the contact length of intestinal wall, so rotating guiding tube 21 is in bending and be imbued with in the S font colon portion 73 of mobility and advance smoothly.So the first guiding element 50 of guiding tube 21 becomes the state with the wall butt of S font colon portion 73.

Under this state,, then become state shown in Figure 39 if guiding tube 21 is further acted on predetermined propulsive force.At this moment under the state, the wall state of contact (with reference to above-mentioned Figure 38) of guiding tube 21 before guiding elements 50 with the crooked position of S font colon portion 73 further pushed, thereby in 61 bendings of first bending section, first guiding element 50 is advanced to direction of insertion along wall.At this moment and since second bending section 62 be formed harder than first bending section 61, so play the effect that first guiding element 50 is advanced along wall.Further, if guiding tube 21 is pushed under the effect of propulsive force, then as shown in figure 40, first guiding element 50 smoothly advances along wall.

Then, first guiding element 50 is by S font colon portion 73, and guiding tube 21 is also advanced to same directional smoothing thereupon.In this travel condition, also can be crooked even too push guiding tube 21, the first bending sections 61 along with wall to wall.Therefore, first guiding element 50 is smoothly advanced, and can not make to advance and is hindered because of entering the concavo-convex grade that is formed on the intestinal tube wall.

Then, the guiding tube 21 that is in rotation status is by S font colon portion 73, advance smoothly with the wall of the liver bending 77 of ascending colon portion 78 intersections with the spleen bending 76 that is imbued with transverse colon portion 75 intersections of mobility, transverse colon portion 75 along S font colon portion 73 and bending section, the descending colon portion 74 of descending colon portion 74 intersections that lack mobility then, thereby arrive as shown in figure 41 near the caecum portion 79 at purpose position for example, and do not change the walking state of large intestine.

If the operator judges the front end guide parts of guiding tube 21 and has arrived near the caecum portion 79 that then the staff accepts the indication from the operator, takes out guiding tube 21 from protecting tube 26.Then then carry out the insertion section 11 of endoscope 2 is inserted the operation of big enteral.

About the step of next being carried out, that is, the step of big enteral and the endoscopic procedures of big enteral are inserted in the insertion section 11 of endoscope 2, since identical with above-mentioned first embodiment, so omit its explanation.

Like this, when the front end position at guiding tube is provided with front end guide parts,, will constitute the line component settings of front end guide parts for having different flexibilities according to the position difference as present embodiment.Thus, for example guiding tube is being inserted under the state of big enteral, formerly guiding element is with after the wall of intestinal tube contacts, and when guiding tube further advanced under the effect of propulsive force, the first bending section bending was followed in this, and first guiding element is smoothly advanced along wall.

In addition, also can be as shown in figure 42, soft body 63 by elongated shape constitutes guiding tube 21H, this soft body 63 does not constitute spiral-shaped 21a on the outer surface, promptly, only consider to the endoceliac slotting general character, can with the outer surface of at least a portion at the tested position that contacts of having a medical check-up on applied the hydrophilic polymer coating that for example is used to improve lubricity.

Explanation is provided with the effect of the guiding tube of having set flexible front end guide parts as mentioned above on body 63.

Here, owing to the preparation process that is used for guiding tube 21H insertion large intestine is identical with above-mentioned the 4th embodiment, so omit its explanation.

Next the action of guiding tube 21H being inserted large intestine is described.

At first as above-mentioned shown in Figure 1, operator (not shown) controls the front part of guiding tube 21H, the first guiding element 50, the line parts 60 that constitute the front end guide parts of guiding tube 21H leading section are inserted big enteral from the patient 7 of accumbency on bed 8 anus, then insert guiding tube 21H.So the part of the outer surface of the body 63 of formation guiding tube 21H contacts with intestinal wall.At this moment, the moisture of human body and hydrophilic polymer combination, thus form moisture film on the surface of body 63, with the lubricity between raising and the large intestine.

Under this contact condition, make the motor 23 of guiding tube rotary apparatus 22 be the rotation driving condition.So, guiding tube fixed part 24 rotation, thus the rotation that the base end part of the guiding tube 21H on this guiding tube fixed part 24 is scheduled to be installed in.This rotation is passed to front from base end part, shown in the arrow of Figure 43, makes the body 63 of guiding tube 21H become the state that is rotating around direction of principal axis.At this moment, the operator operates the guiding tube 21H that is controlled to advance on hand.

Thus, the outer surface of the body 63 of rotation contacts with the gauffer of intestinal wall on complete cycle.So the lubricity of body 63 improves, thereby can guiding tube 21H be advanced smoothly in large intestine to the depths by operation on hand.

Then as shown in figure 43, guiding tube 21H arrives S font colon portion 73.At this moment, the first guiding element 50 of guiding tube 21 is the wall state of contact with the crooked position of S font colon portion 73.Under this state,, then become state shown in Figure 44 if further push guiding tube 21H.At this moment, under the wall state of contact of first guiding element shown in Figure 43 50 and the crooked position of S font colon portion 73, push guiding tube 21H, thereby in 61 bendings of first bending section, first guiding element 50 is advanced to direction of insertion along wall.At this moment, because that second bending section 62 is formed is harder than first bending section 61, so first guiding element 50 is advanced along wall.

Further push the operation on hand of guiding tube 21H from this state.So as shown in figure 45, first guiding element 50 smoothly advances along wall, and first guiding element 50 is by S font colon portion 73.So guiding tube 21H follows moving of first guiding element 50 and also smoothly advances on equidirectional.Under this state, even too push guiding tube 21H, first bending section 61 also can the flexural deformation along with wall.Therefore, first guiding element 50 can be advanced smoothly, can be because of not entering the recess of the gauffer that on the wall of intestinal tube, forms, or tangled etc. and make to advance by protuberance and hindered.

Like this, by constituting guiding tube by the body of considering the tube chamber interpolation general character, and by under this contact condition, the motor rotation of guiding tube rotary apparatus is driven so that guiding tube is rotating around direction of principal axis, the revolving force of guiding tube can be converted to propulsive force, thereby the guiding tube that is in rotation status is advanced to the large intestine depths with respect to the mode that female thread moves with external screw thread.

In addition, the structure of having set the flexible front end guide parts of insertion section guiding tube is not limited to above-mentioned the 4th embodiment, also can be following Figure 46 or structure shown in Figure 47.In addition, about with the identical structure of above-mentioned the 4th embodiment, omit its diagram and detailed explanation, below different parts only are described.

As shown in figure 46, in the present embodiment, the front end guide parts that are fixedly installed on guiding tube 21 front ends constitute as follows, that is: first bending section 64 that will constitute with the same first guiding element 50 that forms of the 4th embodiment, by thread-like member with is connected second bending section, 65 connections that a plurality of roughly spheroids are set and form and is arranged to one.

In the present embodiment, first guiding element 50 is connected setting with first bending section 64 by the same thread-like member 64a that extends out from above-mentioned first bending section 64.A plurality of (being four in the present embodiment) that the state that thread-like member 64a wears string with perforation keeps constituting second bending section 65 are spheroid 65a roughly.Position, boundary at first bending section 64 and second bending section 65 is provided with retainer 64b.

The flexible relation flexible and second bending section 65 flexible, first bending section 64 of the guiding tube 21 in the present embodiment be set to above-mentioned the 4th embodiment in the relation of each parts just the same.

In addition, the length of the length of first bending section 64 and second bending section 65 is set to following relation:

The length of the length of second bending section 65 〉=first bending section 64.

And then the diameter of first guiding element 50 is set at the diameter greater than guiding tube 21.

The effect and above-mentioned the 4th embodiment of guiding tube 21 of bending section 65,64 that possesses such formation is identical.In addition, thus obtained effect is also identical.In addition, the thread-like member 64a and first bending section 64 are formed by same material, only dispose roughly spheroid 65a on this thread-like member 64a, can constitute flexible second bending section 65 different with first bending section 64.Therefore, can help the raising of productivity ratio and the reduction of manufacturing cost.

On the other hand, as shown in figure 47, in the present embodiment, the front end guide parts that are fixedly installed on guiding tube 21 front ends are arranged on whose forwardmost end portions, and constitute as follows, that is: the first bending section 64A, the 64B that constitutes with above-mentioned first guiding element 50, joint portion 66, by thread-like member be connected one group of second bending section 65 that a plurality of roughly spheroids is set and forms and connect and be arranged to one.Joint portion 66 is the same with first guiding element 50, is the movable connecting portion that is made of spheroid roughly.

In the present embodiment, first guiding element 50 is connected setting with first bending section 64 by the same thread-like member 64a that extends out from above-mentioned first bending section 64.It (is 4 * 2=8) spheroid 65a roughly in the present embodiment that the state that this thread-like member 64a wears string with perforation keeps constituting a plurality of of one group of second bending section 65.

Position, boundary at first bending section 64 and second bending section 65 of base end side is provided with retainer 64b.Also be provided with retainer 64b at second bending section 65 of base end side and the position, boundary of joint portion 66.Position, boundary at joint portion 66 and second bending section 65 of front also is provided with retainer 64b.In addition, be aligned in sequence with first guiding element 50, second bending section 65, the first bending section 64B, joint portion 66, the first bending section 64B, second bending section 65 and the first bending section 64A from front.That is, constitute in the front end guide parts in the present embodiment, dispose one group of second bending section 65, thereby flexible position, two places is set by mode with clamping joint portion 66.

Here, the flexible relation flexible and second bending section 65 flexible, the first bending section 64A, 64B of the guiding tube in the present embodiment 21 be set to above-mentioned first embodiment in the relation of each parts just the same.

In addition, the length relation of the length of the first bending section 64A, 64B and second bending section 65 is set to:

The length of the length of the length of second bending section 65 〉=first bending section 64A＞first bending section 64B.

And then the diameter of first guiding element 50 is set at the diameter greater than guiding tube 21.

The effect of guiding tube 21 of bending section 65,64B, 64B, 65,64A that possesses such formation is as described below.

Owing to the preparation process that is used for guiding tube 21 insertion large intestines is identical with above-mentioned embodiment, so omit its explanation.

Next the step of guiding tube 21 being inserted large intestine is described.

At first, operator (not shown) controls the front part of guiding tube 21, and the guiding tube 21 that will possess first guiding element 50, bending section 65,64B, 64B, 65,64A inserts big enteral from the patient 7 of accumbency on bed 8 anus.So the first guiding element 50 of guiding tube 21 contacts with intestinal wall.

Under this contact condition, the operator drives the motor rotation of guiding tube rotary apparatus, and controls guiding tube 21 it is advanced in body cavity.Thus, guiding tube 21 advances to the depths in large intestine.Then, the guiding tube 21 that inserts from anus advance to S font colon portion 73 from rectum, thereby as shown in figure 48, guiding tube 21 arrives S font colon portions 73 by propulsive force and operator's operation on hand.Under this state shown in Figure 48, the first guiding element 50 outstanding at the front end of guiding tube 21 contacts with the wall of the crooked position of S font colon portion 73.If further push guiding tube 21, then become state shown in Figure 49 from this state.

At this moment, the wall state of contact by before guiding element 50 and the crooked position of S font colon portion 73 pushes guiding tube 21, and making the first bending section 64B is center curvature with joint portion 66.In addition, meanwhile, first guiding element 50 is advanced to direction of insertion along wall, thereby becomes joint portion 66 and wall state of contact.Here, because that one group of second bending section 65 is formed is harder than the first bending section 64A, 64B, so play the effect that first guiding element 50 is advanced along wall.

Further, if push guiding tube 21, then as shown in figure 50, first guiding element 50 smoothly advances along wall.Then, first guiding element 50 is by S font colon portion 73, and guiding tube 21 is also smoothly advanced equidirectional thereupon.In this state, even too push guiding tube 21 to wall, the first bending section 64A, 64B are also crooked along with wall, therefore first guiding element 50 is smoothly advanced, and can be because of not entering the recess that is formed on the intestinal tube wall, or tangled etc. and make to advance by protuberance and hindered, thereby arrive near the caecum portion at purpose position for example.

If the operator judges the front end guide parts of guiding tube 21 and arrived near the caecum portion, then the staff accepts to take out guiding tube 21 from operator's indication from protecting tube 26.Then then carry out the insertion section 11 of endoscope 2 is inserted the operation of big enteral.

About the step of next being carried out, that is, the step of big enteral is inserted in the insertion section 11 of endoscope 2, since identical with above-mentioned embodiment, so omit its explanation.

As discussed above, in the present embodiment, one group of second bending section 65 is set by the mode that constitutes with clamping joint portion 66, also can effectively use more complicated crooked position.

Thus, when use so-called sleeve pipe described later (being also referred to as slip pipe) such, when the insertion section of endoscope is run through the insertion accessory that inserts inner form and is used as inserting accessory, inserting the external diameter that is examined intravital position is telescopic external diameter.Relative therewith, insert under the situation in the circulation passage constituting the treatment apparatus that above-mentioned insertion accessory (guiding tube 21) is run through insert endoscope, inserting the external diameter that is examined intravital position is the external diameter of the insertion section of endoscope.Therefore, can prevent to the position that the tested interpolation of having a medical check-up is gone into bigger than casing diameter, thereby can be under patient's the situation tested having a medical check-up, prevent to impose on the patient and more bear.

In addition, constitute free to advance or retreat with respect to the field of view zone of observation portion by the leading section that will insert accessory, testedly have a medical check-up or when tested object position of having a medical check-up behavior such as disposed, can be configured in outside the field of view zone of observation portion for example observing inserting accessory.Therefore, can prevent to insert accessory as far as possible hinder behaviors such as observation or disposal.

With reference to Figure 51 to Figure 61 the 5th embodiment of the present invention is described.

In the present embodiment, make first guiding element 50 be the capsule endoscopic 80 of capsule shape, this structure is different from the embodiment described above.Therefore,, omit its diagram and detailed explanation, below different parts only are described about the structure identical with above-mentioned embodiment.

Capsule endoscopic 80 shown in Figure 51 constitutes for slick guide surface with its surface.Front at capsule endoscopic 80 has: be configured for photographic images observation portion observation window 81 and be used for the illuminating window 82 of irradiating illumination light.

The base end side that is fixed with the line parts 51 of capsule endoscopic 80 is fixed on the guiding tube 21.Therefore, capsule endoscopic 80 rotates along with the rotation of guiding tube 21.Therefore, in the rotary course of guiding tube 21, image shown on the picture of not shown monitor might be with this rotation rotation.In order to prevent the generation of this problem, in the present embodiment, by not shown video processor, according to the swing circle of guiding tube rotary apparatus 22, the image shown to monitor is rotated correcting process, thereby shows common endoscopic images on the picture of monitor.

In addition, this capsule endoscopic 80 can be disposable also can be reusable.In addition, also can be to the outer surface of capsule endoscopic 80, promptly guide surface is implemented the processing that improves lubricity.

The effect of guiding tube 21 of the insertion device 1 of present embodiment is described.

In addition, because the preparations before guiding tube 21 being run through the insertion large intestine etc. are identical with above-mentioned embodiment, so omit its explanation.

At first, the operator lies under the state of bed on 8 patient 7, and capsule endoscopic 80 sides of guiding tube 21 are inserted big enteral from anus 71.So the outer peripheral face of guiding tube 21 becomes and the intestinal wall state of contact.Here, the operator drives motor 23 rotations of guiding tube rotary apparatus 22.So guiding tube 21 is rotating around direction of principal axis, thereby this guiding tube 21 is advanced in large intestine with respect to the mode that female thread moves with external screw thread.

So, shown in Figure 52, be positioned at the intestinal wall of the part of guide surface of capsule endoscopic 80 of front of guiding tube 21 and large intestine etc., for example the intestinal wall butt and the contact of the bending section of S font colon portion etc.At this moment, because the rotation of guiding tube 21 is delivered to line parts 51, so capsule endoscopic 80 is in rotation status along with the rotation of guiding tube 21.At this moment, the captured image of observation window by capsule endoscopic 80 81 is rotated correcting process by video processor according to the swing circle of guiding tube rotary apparatus 22, shows common endoscopic images thus on the picture of monitor.Thus, the operator can judge the state of capsule endoscopic 80 with respect to intestinal wall exactly from picture, thus can also carry out best operation on hand except propulsive force, thus guiding tube 21 is advanced smoothly to the depths of large intestine.

In addition, shown in Figure 53, the capsule endoscopic 80 of the intestinal wall of the bending section by large intestine etc. cooperates the state of the gauffer of the intestinal wall that it passed through, and owing to the rotation of the line parts 51 that rotate with guiding tube 21 is delivered to this capsule endoscopic 80, so this capsule endoscopic 80 is rotating around direction of principal axis.Therefore, Yi Bian the guide surface of capsule endoscopic 80 is rotating the gauffer of successfully crossing intestinal wall on one side around direction of principal axis.

And then if guiding tube 21 advances in large intestine inside, then capsule endoscopic 80 is successfully guided along the sweep of S font colon portion, cooperates therewith, and line parts 51 are along the sweep bending of S font colon portion.So the crooked on one side similarly quilt on one side of fore-end that connects the guiding tube 21 of wired parts 51 pulls the ground guiding.

Then, cross the gauffer of intestinal wall with capsule endoscopic 80 by the mode of the bending direction of thread toward member spare 51 pulling each bending section while be in the guiding tube 21 of rotation status by large intestine.Then, after the capsule endoscopic 80 of confirming to be positioned at guiding tube 21 front ends on picture had arrived near the caecum portion, the operator was in order to carry out the splanchnoscopy of big enteral, and carried out for example retracting of guiding tube 21.Then, while retract the endoscopic observation that carries out large intestine.

Thus, according to present embodiment, as above-mentioned embodiment, guiding tube 21 run through be inserted into predetermined position after, need not once more the insertion section 11 of endoscope 2 to be inserted in patients 7 the tube chamber and just can carry out endoscopic observation.

Therefore, the operator can make the guiding tube 21 that possesses capsule endoscopic 80 easily arrive the depths of large intestine etc., and can successfully carry out endoscopic observation at short notice, and brings misery for patient 7.In addition, by capsule endoscopic 80 being configured in the front side of the front end face of guiding tube 21, can prevent reliably that guiding tube 21 from hindering the visual field.

In addition.In the present embodiment, in Figure 51, be that they are become from the outstanding state of the front guide surface of capsule endoscopic 80, but observation window 81, illuminating window 82 are the states that are positioned at a face with the front guide surface.

In addition, also can be shown in Figure 54, at the leading section of guiding tube 21 support unit 83 and anti-avulsion parts 84 are set.Anti-avulsion parts 84 supporting front ends are fixed with the line parts 51 of capsule endoscopic 80 and make these line parts 51 rotations freely, also have the effect that comes off of preventing simultaneously concurrently.

Specifically, shown in Figure 55, anti-avulsion parts 84 are tubulars, and are formed with the through hole that is used for inserting logical layout line parts 51 in the bottom surface of inner space central authorities.The base end part of online parts 51 is provided with removal stop section 85.The profile of removal stop section 85 is set at the diameter dimension greater than through hole.Therefore, have under the state of removal stop section 85, can prevent that principal vertical line parts 51 come off from guiding tube 21 in the internal configurations of anti-avulsion parts 84.

In addition, anti-avulsion parts 84 are after slotting wildcard has been put line parts 51, and are fixing with respect to the support unit 83 of guiding tube 21.According to this structure, the capsule endoscopic 80 of the front end of fixing online parts 51 with respect to guiding tube 21 rotations freely.

Its result is, even the external diameter of capsule endoscopic 80 is big, also can prevent from reliably to bring unnecessary rotary load to intestinal wall,, can prevent that the unnecessary friction that the guide surface by capsule endoscopic 80 causes is attached on the intestinal wall that is.In addition, because the observation window 81 captured images by capsule endoscopic 80 do not rotate with the rotation of guiding tube 21, so with compare according to the situation that the swing circle of guiding tube rotary apparatus 22 carries out Flame Image Process by not shown video processor, can easily on monitor, carry out Flame Image Process to show common image.

In addition, the structure that possesses the guiding tube 21 of capsule endoscopic 80 is not limited to above-mentioned embodiment, also for example shown in Figure 56, on capsule endoscopic 80, be provided with and run through the longitudinally through hole 80a at its center, and in this longitudinally through hole 80a, run through and be configured to from the outstanding fixed bending section 86 of mode of the front end of guiding tube 21.Bending section 86 is flexible high bar-like members.Be used for preventing to be configured in the retainer 86a that the capsule endoscopic 80 on this bending section 86 comes off being provided with on the bending section 86.In this figure, constitute front end guide parts by capsule endoscopic 80 and bending section 86.

According to this structure, even the shape of capsule endoscopic 80 is big, bending section 86 also can follow the into intestinal wall channeling conduct of direction.Therefore, can reduce the resistance that between the front guide surface of capsule endoscopic 80 and intestinal wall, produced.In addition, can observe the leading section of the bending section 86 more side-prominent, on the picture of monitor, show the image of bending section 86 thus than capsule endoscopic 80 forward end by the observation window 81 of capsule endoscopic 80.Therefore, the bending section 86 of operator by confirming to give prominence to from capsule endoscopic 80 can be discerned the direct of travel of guiding tube 21, thereby can realize inserting the further raising of the general character.

In addition, also can constitute like that shown in Figure 57, that is: the leading section at guiding tube 21 is provided with circular fixed part 87, and on this fixed part 87 capsule endoscopic 80 is installed.In this structure,, hinder the visuals field so can prevent guiding tube 21 reliably because capsule endoscopic 80 is configured in than the close front side of the front end face of guiding tube 21.

The surface of capsule endoscopic 80 has slick guide surface, has observation window 81 that is used for photographic images and the illuminating window 82 that is used for irradiating illumination light in the front of capsule endoscopic 80.Base end side at capsule endoscopic 80 is provided with fixed protrusion 88, and this fixed protrusion 88 inserts in the endoporus of fixed part 87 set on the guiding tube 21.The fixed protrusion 88 of capsule endoscopic 80 is substantial cylindrical shapes, and is configured in the endoporus on the fixed part 87 that is formed at guiding tube 21 in predetermined chimeric mode.

In addition, under the state of the fixed protrusion 88 of capsule endoscopic 80 in shown in Figure 58, inserting the fixed part 87 that is configured in guiding tube 21 like that, fix and be integral by being located at hold-down screw 89 on the fixed part 87.

In addition, also can front end guide parts be installed, but the air bag 90 of expansion, contraction is set in the front of guiding tube 21 shown in Figure 59 like that in the front of guiding tube 21.

Leading section at guiding tube 21 is fixed with the roughly hollow joint 91 of tubular.In hollow joint 91, be communicated with pipe 92, be used for delivered inside gas to air bag 90, or the inner air of suction.On the front outer peripheral face of hollow joint 91, hermetic be connected with the base end part of air bag 90.

The other end of pipe 92 is connected with joint 93 air-tightness that have sealing ring 95 in inside.The cardinal extremity peristome of this joint 93 is connected with the pump-line 94 of supplying gas that is connected in the not shown air pump of supplying gas.The pump-line 94 of supplying gas is guaranteed air-tightness with the connecting portion of joint 93 by the sealing ring 95 that is located at joint 93 inside.Therefore, the inside of air bag 90 is communicated with the air pump air-tightness of supplying gas.

The gas of sending from the air pump of supplying gas for example air etc. and is admitted to the inside of air bag 90 by the pump-line 94 of supplying gas, joint 93, pipe 92 and hollow joint 91.Thus, be full of air, thereby air bag 90 is roughly spherical owing to its air pressure is expanded in air bag 90 inside.Form roughly spheric guide surface on the air bag 90 when expanding.Guide surface is soft and smooth.In addition, the air pump suction if the air of air bag 90 inside is supplied gas, then air bag 90 shrinks.

Shown in Figure 60, if guiding tube 21 arrives in the tube chambers for example bending section of large intestine, the then gauffer of intestinal wall and the front end face butt that is located at the air bag 90 of guiding tube 21 front ends.At this moment, air is delivered to the inside of air bag 90 from the air pump of supplying gas.So air bag 90 expands shown in Figure 61.Be expanded to roughly spherically by air bag 90, contact with the gauffer of intestinal wall, and the fore-end of guiding tube 21 is along the bending of intestinal wall and bending as the part of its surperficial guide surface.Further, under the effect of propulsive force, the guide surface of air bag 90 is successfully crossed the gauffer of intestinal wall, thereby guiding tube 21 is advanced to the depths of large intestine.

Like this, expansible air bag is imbued with flexibility, and crosses the gauffer of intestinal wall smoothly, thereby makes guiding tube insert the depths of large intestine, can prevent more reliably that thus air bag is to the unnecessary load of lumen wall effect.

In addition, in the above-described embodiment, show such structure: fixed guide pipe fixed part 24 on the motor reel 23a of motor 23, with an end of guiding tube 21 is that the base end side end is installed on this guiding tube fixed part 24, and guiding tube 21 is rotated, but the structure of guiding tube rotary apparatus 22 is not limited to above-mentioned embodiment, also can be for example the guiding tube rotary apparatus 22A shown in Figure 62 and Figure 63 or the guiding tube rotary apparatus 22B shown in Figure 64 and Figure 65 etc.

Guiding tube rotary apparatus 22A shown in Figure 62 and Figure 63 is made of with motor (being designated hereinafter simply as the rotation motor) 153 apparatus main body portion 151, device cover body portion 152 and guiding tube rotation.In this guiding tube rotary apparatus 22A, be formed with guide member configured slot (the being designated hereinafter simply as groove) 151b that is used to dispose guiding tube 21 in the precalculated position of the upper plane 151a of apparatus main body portion 151.

Rotation is motor that the guiding tube 21 that is configured in groove 151b is pivoted with motor 153.On the motor reel 153a of rotation, be set with as rotary body and rotation roller 153b with predetermined elastic force with motor 153.Rotation is configured to the predetermined pressing force and the state of guiding tube 21 butts with roller 153b.Thus, rotation is passed to guiding tube 21 with the rotary driving force of motor 153, thereby makes this guiding tube 21 rotations.

Rotation is installed on the precalculated position of device cover body portion 152 with the erecting tools 154 of motor 153 by for example L font.The rotation that is installed in the device cover body portion 152 by erecting tools 154 is set to the position of the motor reel 153a of motor 153 relation: be parallel to the upper plane 151a of apparatus main body portion 151, and also be parallel to groove 151b.Therefore, rotation is driven so that rotation is rotated to predetermined direction with roller 153b with motor 153, thereby guiding tube 21 is pivoted.

On the other hand, the guiding tube rotary apparatus 22B shown in Figure 64 and Figure 65 is made of with motor (being designated hereinafter simply as first motor) 153 and guiding tube feed motor (being designated hereinafter simply as second motor) 157 apparatus main body portion 155, device cover body portion 156, rotation.Precalculated position at the upper plane 155a of apparatus main body portion 155 is formed with guiding tube configured slot (the being designated hereinafter simply as groove) 155b that is used to dispose guiding tube 21.

First motor 153 is to make to be configured in the motor that the guiding tube 21 in the groove 155b pivots.On the motor reel 153a of first motor 153, be set with rotation roller 153b.Rotation has predetermined elastic force with roller 153b, and with predetermined pressing force and guiding tube 21 butts.Thus, the rotary driving force of first motor 153 is passed to guiding tube 21 by rotation with roller 153b, thereby makes this guiding tube 21 rotations.

On the other hand, second motor 157 is the motor that the guiding tube 21 that is configured in groove 155b upwards kept straight on move (following also be designated as craspedodrome) at the guiding tube fore and aft axis with predetermined speed.Being set with on the motor reel 157a of second motor 157 keeps straight on uses roller 157b.Keeping straight on has predetermined elastic force with roller 157b, and with predetermined pressing force and guiding tube 21 butts.Thus, the rotary driving force of second motor 157 is passed to guiding tube 21 by keeping straight on roller 157b, thereby this guiding tube 21 is kept straight on.

First motor 153 is installed on the precalculated position of device cover body portion 156 by the first motor mounting instrument 154.Second motor 157 is installed on the precalculated position of device cover body portion 156 by the second motor mounting instrument 158.

The position relation that is installed in the motor reel 153a of first motor 153 in the device cover body portion 156 by the first motor mounting instrument 154 is configured to: be parallel to the upper plane 155a of apparatus main body portion 155, and also be parallel to groove 155b.On the other hand, the position relation that is installed in the motor reel 157a of second motor 157 in the device cover body portion 156 by the second motor mounting instrument 158 is set to: be parallel to the upper plane 155a of apparatus main body portion 155, and perpendicular to groove 155b.

Therefore, first motor 153 is driven so that rotation is rotated to predetermined direction with roller 153b, thereby guiding tube 21 pivot.In addition, second motor 157 is driven so that craspedodrome is rotated to predetermined direction with roller 157b, thereby guiding tube 21 is kept straight on the fore and aft axis direction.

In addition, in the above-described embodiment, guiding tube 21 is inserted logical be configured in the tube chamber after, from the middle part of this guiding tube 21 base end side is run through in the slotting general channels 11a of the treatment apparatus that inserts on the insertion section 11 that is located at endoscope 2, and on picture, confirm on one side the observation image of guiding tube 21, on one side insertion section 11 is inserted into the depths of big enteral.Yet, the insertion section 11 of endoscope 2 is inserted into endoceliac depths while also can shown in Figure 66 to Figure 69, observe guiding tube 21 like that.

Illustrate while observing the method that endoceliac guiding tube is inserted into the insertion section of endoscope endoceliac depths that is configured in reference to Figure 66 to Figure 69.

In Figure 66, be such structure: guiding tube is inserted on rigid 14 of the front end that logical aid 145 is installed in insertion section 11.On the slotting logical aid 145 of guiding tube, the guiding tube with guiding tube inserting hole 145a is set and inserts general protuberance 145b.In guiding tube inserting hole 145a, run through and be inserted with guiding tube 21.

Promptly, in the structure of this figure, after in guiding tube 21 being run through the insertion body cavity, not from the middle part of this guiding tube 21 base end side to be run through the treatment apparatus that inserts on the insertion section 11 that is located at endoscope 2 to insert in the general channels 11a, be located at guiding tube and insert among the guiding tube inserting hole 145a on the logical aid 145 but it is run through to be inserted into, described guiding tube is inserted logical aid 145 and is installed on rigid 14 of the front end.

Then, identical with above-mentioned embodiment, the operator is in order to insert insertion section 11 big enteral and to make endoscope 2 be observable state, and guiding tube will be installed insert rigid 14 of the front end of the insertion section 11 of logical aid 145 and insert big enteral from anus 71.So demonstration comprises the endoscopic images of the image of guiding tube 21 on the picture of monitor 6.Here, the operator confirms on one side the bearing of trend of guiding tube 21 on the picture of monitor 6, make the operation of bending section 15 bendings on one side and twist the operation etc. of insertion section 11, thereby with rigid 14 of the front end of insertion section 11 to the insertion of the depths of big enteral.Thus, except the effect and effect identical, can also eliminate guiding tube 21 is run through the trouble of inserting in the slotting general channels 11a of treatment apparatus with above-mentioned embodiment.

In addition, shown in Figure 67, the front end lid 146 that is provided with guiding tube inserting hole 146a is installed on rigid 14 of the front end of insertion section 11, is replaced guiding tube to insert logical aid 145, also can obtain identical effect and effect with this.In addition, shown in Figure 68, the guiding tube that is formed with guiding tube inserting hole 14e is set on rigid 14 of the front end of insertion section 11 inserts general protuberance 14f, replace on insertion section 11, installing guiding tube with this and insert logical aid 145 and front end lid 146, also can obtain identical effect and effect.

In addition, in Figure 69, not to run through in the slotting general channels 11a of the treatment apparatus that inserts on the insertion section 11 that is located at endoscope 2 with running through the endoceliac guiding tube 21 of insertion, perhaps run through and insert among guiding tube inserting hole 145a, 146a, the 14e, and guiding tube 21 is being configured under the endoceliac state, insertion section 11 is inserted to intraluminal depths.

That is, run through under the state that inserts big enteral, big enteral is inserted from anus 71 in the insertion section 11 of endoscope 2, and on the picture of monitor 6, show the image of guiding tube 21 at guiding tube 21.Then, on one side on picture, confirm to run through the bearing of trend that inserts endoceliac guiding tube 21, make the operation of bending section 15 bendings on one side and twist the operation etc. of insertion section 11, simultaneously, with rigid 14 of the front end of insertion section 11 to the insertion of the depths of big enteral.Thus, eliminated the operator with guiding tube 21 run through insert treatment apparatus insert in the general channels 11a or guiding tube inserting hole 145a, 146a, 14e in trouble.

In addition, also can be shown in Figure 70, base end part with guiding tube 21 is installed on the guiding tube fixed part 24 in advance, and the front of this guiding tube 21 is run through in the slotting general channels 11a of insertion treatment apparatus from treatment apparatus inlet 17, and outstanding from front opening 14b.In addition, label 49 is protecting tubes, is configured between protecting tube holding member 28 and the treatment apparatus inlet 17.Other structures are identical with above-mentioned insertion device 1 shown in Figure 1, to same parts mark same numeral and omission explanation.

The effect of the insertion device 1 in the present embodiment is described.

The step that to insert to large intestine from the guiding tube 21 that front opening 14b gives prominence to as mentioned above is described.

At first, control the front part that treatment apparatus from be located at insertion section 11 is inserted the outstanding guiding tube 21 of the front opening of general channels 11a.Then, the leading section of guiding tube 21 is inserted big enteral from the patient 7 of accumbency on bed 8 anus.Then, make motor 23 be the rotation driving condition as mentioned above.Thus, the guiding tube 21 of rotation status advances smoothly along each wall of rectum 72, S font colon portion 73, descending colon portion 74, transverse colon portion 75, ascending colon portion 78.Its result is, the leading section of guiding tube 21 arrives near the caecum portion 79 at purpose position for example, and do not change the walking state of large intestine.

If the operator judges the leading section of guiding tube 21 and arrived near the caecum portion 79, then next rigid 14 of the front end of the insertion section 11 of endoscope 2 inserted big enteral from anus 71.That is, after guiding tube 21 is inserted big enteral, then big enteral is inserted in the insertion section 11 of endoscope 2.Then, same as described above, the operator confirms the bearing of trend of guiding tube shown on the picture of monitor 6 21 on one side, Yi Bian make the operation of bending section 15 bendings and twist the operation etc. of insertion section 11, thus rigid 14 depths to big enteral of the front end of insertion section 11 inserted.At this moment, the operator can not lose direction of insertion, and rigid 14 of the front end of insertion section 11 successfully can be inserted near caecum portion 79.

Like this, guiding tube is become run through and insert the treatment apparatus that is located in the insertion section and insert state in the general channels, and the purpose position that guiding tube is run through be inserted into big enteral.Thus, can be after guiding tube be inserted into the purpose position, save the step that this guiding tube is run through insert treatment apparatus to be inserted in the general channels and carry out the insertion section of endoscope to endoceliac insertion.Therefore, shortened from beginning to insert the time of guiding tube to the insertion section that begins to insert endoscope.In addition, other effects are identical with above-mentioned embodiment with effect.

With reference to Figure 71 to Figure 78 the 6th embodiment of the present invention is described.

Shown in Figure 71, the insertion device 100 of present embodiment mainly inserts aid 103 by endoscope 102 and endoscope-use and constitutes.

Endoscope 102 constitute have insertion section 111, operating portion 112 and general cable 113.Operating portion 112 is located at the base end side of insertion section 111.General cable 113 extends out from the sidepiece of operating portion 112.

Insertion section 111 constitutes from front and is connected with rigid of front end (with reference to the label 114 of Figure 72), bending section (with reference to the label 115 of Figure 72) and flexible pipe portion 116 successively.Bending section 115 for example constitutes on direction up and down bending freely.Flexible pipe portion 116 has flexibility.Be provided with treatment apparatus inlet 117 at operating portion.Treatment apparatus inlet 117 be located at insertion section 111 in and be used to run through the slotting general channels (not shown) of the treatment apparatus that inserts treatment apparatus and be communicated with.

In endoscope 102, have light supply apparatus 4, video processor 5 and monitor 6 as external device (ED).Light supply apparatus 4 is supplied with endoscope 102 with illumination light.Video processor 5 has signal processing circuit, its supply is used to make the driving signal that is located at the not shown imaging apparatus driving in the endoscope 102, and will generate picture signal by the signal of telecommunication that imaging apparatus carries out sending after the opto-electronic conversion, to monitor 6 outputs.Thereby on the picture of monitor 6, receive from the picture signal of video processor 5 outputs and show endoscopic images.

Endoscope-use inserts aid 103 and mainly is made of for example guiding tube 121 and above-mentioned guiding tube rotary apparatus 22A as the insertion section guide member.Guiding tube rotary apparatus 22A for example is arranged on patient's 7 horizontal beds 8.

Shown in Figure 72, be the insertion section 111 that disposes endoscope 1 02 in the endoporus in the inner space of guiding tube 121.Specifically, guiding tube 121 is made of rotatable parts 131, aid main part 132 and serpentine pipe portion 133.

Rotatable parts 131 are made of piped rotating main body 131a of portion and a plurality of bearing 131b that are configured in the inner peripheral surface side of the 131a of this rotating main body portion.Rotatable parts 131 are installation portions, for example dispose rigid 114 of the front end of the insertion section 111 that constitutes endoscope 102 in the inner peripheral surface side of these rotatable parts 131.Under this configuration status, rotatable parts 131 rotate freely with respect to rigid 114 of front end.

On the other hand, serpentine pipe portion 133 for example is that rustless steel is made, and is formed helically and is wound with the metal wire rod 133a of predetermined diameter size and has predetermined flexible.The outer surface of serpentine pipe portion 133 is provided with surperficial formed spiral-shaped the 133b by metal wire rod 133a.In addition, many (for example four) metal wire rods of also can reeling form spiral-shaped 133b.In this case, helical coil around the time, by improving the adaptation between the metal wire rod, perhaps change the angle of spiral, can carry out various settings to the characteristic of guiding tube 121.

On the precalculated position of the front inner peripheral surface of aid main part 132, for example be fixed with rotatable parts 131 by hold-down screw 134 one.In addition, on the base end side outer peripheral face of aid main part 132, for example be fixed with an end of serpentine pipe portion 133 by coiling bonding one such as (not shown).That is, the insertion section 111 of endoscope 102 is with respect to aid main part 132 and the 133 loose fits configuration of serpentine pipe portion.Under this configuration status, guiding tube 121 is the so-called sleeve pipes that coat the insertion section 111 of endoscope 102, and this sleeve pipe becomes the insertion section of endoscope 102.

Therefore, rotatable parts 131, aid main part 132 and serpentine pipe portion 133 are rotated freely with respect to insertion section 111 for the guiding tube 121 that one constitutes, and free to advance or retreat as shown by arrows.

In addition, implement chamfer machining, damage with the body wall that is used to prevent the donor intracavity or mucosa etc. in the front of aid main part 132.

The effect of the insertion device 100 that constitutes as mentioned above is described.

The preparation process of explanation before large intestine is inserted in the insertion section 111 of endoscope 102.

When for example caecum portion that is inserted into large intestine was run through in the insertion section 111 of endoscope 102, at first, the staff prepared to comprise the guiding tube 121 of rotatable parts 131, and these rotatable parts 131 have predetermined internal diameter size.Next, the insertion section 111 of endoscope 102 is run through in the endoporus that inserts guiding tube 121.Then, for example shown in the figure of the centrage upside of Figure 72, rigid 114 of the front end of insertion section 111 is configured to perhaps roughly be in the state with one side with respect to rotatable parts 131 outstanding scheduled volumes.Under this endoscope's configuration status, can prevent that guiding tube 121A from hindering the field of view of endoscope 102.

Next, will be in the insertion sections 111 that are directed the 121 covering states of managing is configured on the guiding tube rotary apparatus 22A.At this moment, with the front end face of guiding tube 121 with for example from the state configuration of the outstanding scheduled volume of front end face of apparatus main body portion 151 in groove 151b.In addition, make light supply apparatus 4, video processor 5 and monitor 6 be open mode.Thus, under the state that guiding tube 121 is installed in the insertion section 111, the preparation that insertion section 111 is inserted to the depths of large intestine finishes.

An example of the step of large intestines is inserted in the insertion section 111 that explanation will be equipped with the endoscope 102 of guiding tube 121.

Shown in above-mentioned Figure 71, operator (not shown) controls the side on hand of insertion section 111, and the front that will be in the insertion section 111 that is directed 121 states that cover of managing is partly inserted big enteral from the patient 7 of accumbency on bed 8 anus.So, the observation image of the big enteral that the illumination light that the illuminating window (not shown) from the front end face that is arranged on rigid 114 of front end penetrates is shone is by constituting the observation window 114b of the observation 114a of portion, imaging on the shooting face of imaging apparatus, and on the picture of monitor 6, show endoscopic images.At this moment, formed spiral-shaped 133b contacts with intestinal wall on the outer surface of the serpentine pipe portion 133 that constitutes guiding tube 121.

Under this contact condition, being formed on spiral-shaped the 133b in the serpentine pipe portion 133 and the state of contact of intestinal wall is the relation of external screw thread and female thread.The rotation of guiding tube rotary apparatus 22A is driven here, with motor 153 rotations.Rotate with roller 153b by rotation, guiding tube 121 pivots shown in the arrow of Figure 73.That is, the rotary driving force that will rotate with motor 153 with roller 153b by rotation passes to serpentine pipe portion 133, makes guiding tube 121 become the state that pivots with respect to insertion section 111 thus.

By guiding tube 121 rotation, the contact portion generation of spiral-shaped 133b and intestinal wall make external screw thread with respect to female thread move such, make guiding tube 121 progressive propulsive forces.So guiding tube 121 advances at the wall of the effect lower edge of propulsive force rectum 72, thereby shown in the dotted line for example among Figure 73, advance to the depths of big enteral.At this moment, shown in the figure of the centrage downside of above-mentioned Figure 72, the front of guiding tube 121 partly becomes the outstanding state of front end face than rigid 114 of front end.Thus, the part of range of observation of viewing optical system that is located at the front end face of rigid 114 of front end is directed managing 121 rotatable parts 131 and covers.

At this moment, on the picture of the monitor 6 that the operator observes, show that the part of the image of large intestine is directed managing 121 endoscopic images that cover.That is, the operator judges guiding tube 121 and has advanced when confirming the image of guiding tube 121 in the part of endoscopic images shown on picture.Then, carry out insertion section 111 is pushed the operation of scheduled volume by operation on hand.So, forwards move in the endoporus of guiding tube 121 by insertion section 111, make rigid 114 of front end once more shown in the figure of the centrage upside of above-mentioned Figure 72 like that, become with respect to rotatable parts 131 outstanding scheduled volumes, perhaps roughly be in state with one side.At this moment, on picture, only show the endoscopic images of large intestine, and do not comprise the image of guiding tube 121.

Promptly, confirm to have or not the image of guiding tube 121 in the part of operator's shown endoscopic images on the picture of monitor 6, when showing the image of guiding tube 121, position judgment overhang from its image, thereby make the operation of bending section 115 bendings and twist operation of inserting moving portion 111 or the operation on hand that pushes insertion section 111, insertion section 111 is inserted to the depths of big enteral.

Then, shown in the dotted line of Figure 73, near guiding tube 121 arrives S font colon portions 73 when grade, bending section, because spiral-shaped the 133b that is formed on guiding tube 121 outer surfaces is long with the contact length of intestinal wall, thus rotating guiding tube 121 under the effect of propulsive force in bending and be imbued with in the S font colon portion 73 of mobility and advance smoothly.At this moment, the operator observes endoscopic images shown on the picture of monitor 6.Then, if affirmation covers the image of the guiding tube 121 of endoscopic images, then carry out suitable operation on hand, making rigid 114 of the front end of insertion section 111 is not with respect to intestinal wall, but with respect to moving in the endoporus of guiding tube 121.

That is, thus repeatedly channeling conduct pipe 121 under the effect of propulsive force big enteral move and the endoporus of operator with respect to guiding tube 121 in push insertion section 111 and make its progressive moving.Thus, guiding tube 121 and insertion section 111 are by S font colon portion 73, then along the bending section of S font colon portion 73 with descending colon portion 74 intersections that lack mobility, descending colon portion 74 and the spleen bending 76 that is imbued with transverse colon portion 75 intersections of mobility, transverse colon portion 75 advances smoothly with the wall of the liver bending 77 of ascending colon portion 78 intersections, near thereby shown in Figure 74, arrive the caecum portion 79 at purpose position for example, and walking state that can bigger change large intestine.

If operator's shown endoscopic images from the picture is judged insertion section 111 and arrived near the caecum portion 79, the rotation of guiding tube rotary apparatus 22A is stopped the rotation with motor 153.Thus, guiding tube 121 halts.In order to carry out the splanchnoscopy of big enteral, then carry out retracting of insertion section 111 here.At this moment, under the state that guiding tube 121 is installed in the insertion section 111, and, perhaps roughly be under the state with one side, check at rigid 114 outstanding scheduled volume of the front end that makes the insertion section.

In addition, also can insert the not shown foot switch that is provided on the aid 103 being rotated with the driving control of motor 153 at the endoscope-use of present embodiment.

Like this, serpentine pipe portion is provided with spiral-shaped portion, the insertion section of configuration endoscope in the endoporus of guide member with this serpentine pipe portion, and big enteral is inserted in the insertion section that will be in the state that guide member is installed, and to make guide member be rotation status, thereby guide member rotates with respect to the insertion section, and its revolving force is converted to propulsive force thus, thereby the guide member that covers the insertion section moves with respect to large intestine and this insertion section.Then, when the operator confirms guide member mobile by observed endoscopic images, the insertion section is moved with respect to guide member.Then, by channeling conduct parts repeatedly under the effect of propulsive force with respect to the insertion section of moving and being undertaken by operator's operation on hand of large intestine with respect to the moving of the endoporus of guide member, can the insertion section be inserted to the depths of large intestine by guide member.

Thus, during the image of operator's shown guide member on the picture of having confirmed monitor, can carry out suitable bending operation and twist operation, and can alleviate the strength of push operation, thereby successfully the insertion section is inserted into the depths of tube chamber at short notice.

In addition, insert in the aid, be provided with spiral-shaped portion at the outer surface of the serpentine pipe portion that constitutes guide member at the endoscope-use that constitutes by guide member and guide member rotary apparatus.Therefore, insert in the insertion section that guided member is covered state under the state of big enteral for example, be formed on the relation that spiral-shaped the contact condition with intestinal wall on the guide member becomes so-called external screw thread and female thread.Therefore, under this contact condition, by the motor rotation that constitutes the guide member rotary apparatus is driven, can make guide member be converted to external screw thread and move such propulsive force, thereby guide member is moved smoothly with respect to large intestine with respect to female thread at the revolving force on direction of principal axis.

In addition, in the above-described embodiment, the propulsive force by guide member only makes guide member move, and the insertion section is moved with respect to the endoporus of guide member, and moving of channeling conduct parts and moving of insertion section repeatedly, thereby the insertion section is inserted to the depths of large intestine.Yet, also can be as follows, by constituting the insertion section 111 and the guiding tube 121A of endoscope 102, come under the effect of the propulsive force of guiding tube 121A, to make insertion section 111 move to endoceliac depths.

The insertion section 111 of endoscope 102 is inserted into other structures of endoceliac depths with reference to Figure 75 explanation.

As shown in the figure, the guiding tube 121A of present embodiment rotates freely structure with respect to the insertion section 111 of endoscope 102 at same position.That is, rigid 114 of the front end that constitutes aid main part 132A and insertion section 111 is provided with the location rotating unit, is used to make guiding tube 121A not move with respect to insertion section 111 advance and retreat.

The location rotating unit is by all groove 132a on the inner peripheral surface precalculated position that is arranged on aid main part 132A and be configured on the outer peripheral face of rigid 114 of front end and snap in the latch for printed circuit 135 that is configured among all groove 132a and constitute.Latch for printed circuit 135 for example has predetermined elastic force.

When the insertion section 111 of endoscope 102 being run through the endoporus that inserts guiding tube 121A, overcome latch for printed circuit 135 elastic force and with on the chimeric from the outside precalculated position that is configured in rigid 114 of front end of the aid main part 132A of guiding tube 121A.Thus, latch for printed circuit 135 cards that are located on rigid 114 of the front end only are configured in all groove 132a of aid main part 132A.So guiding tube 121A rotates freely, and do not move with respect to insertion section 111 advance and retreat.Under this endoscope's configuration status, the front end face of endoscope 102 is to be configured to be positioned at front side than aid main part 132A from the outstanding mode of the front end face of aid main part 132A.Therefore, can prevent reliably that guiding tube 121A from hindering the field of view of endoscope 102.

In addition, shown in for example above-mentioned Figure 73, under spiral-shaped the 133b and intestinal wall state of contact on the outer surface that is formed at serpentine pipe portion 133, rotation is driven with motor 153 rotations, and when on guiding tube 121A, producing propulsive force, make guiding tube 121A begin to advance along the wall of rectum 72 by propulsive force.At this moment, because card only disposes the latch for printed circuit 135 that is located on rigid 114 of the front end in all groove 132a of the aid main part 132A that constitutes guiding tube 121A, so insertion section 111 is also along with the mobile one of above-mentioned guiding tube 121A is advanced.That is, move to the depths of big enteral by guiding tube 121A, card only is configured in the interior insertion section 111 of endoporus of this guiding tube 121A and moves to the depths of big enteral too.

Like this, form all grooves on the aid main part of guiding tube constituting, on the other hand, on rigid of the front end of the insertion section that constitutes endoscope, latch for printed circuit is set, thereby it is mobile that guiding tube can not advanced and retreat with respect to the insertion section, but rotate structure freely.Thus, under the state of guiding tube rotation and generation propulsive force, the insertion section of endoscope can be followed the advance and retreat of guiding tube and move with respect to the large intestine advance and retreat.

In addition, in the present embodiment, by all groove 132a on the inner peripheral surface precalculated position that is arranged on aid main part 132A be configured on the outer peripheral face of rigid 114 of front end and snap in the latch for printed circuit 135 that is configured among all groove 132a and constitute the location rotating unit.But the location rotating unit is not limited thereto, and also can be in rigid side of front end all grooves to be set, and the structure of latch for printed circuit etc. is set in the inner peripheral surface side of aid main part 132A.

In addition, in the present embodiment, the direction of rotation of motor is rotated to a direction around the guide member fore and aft axis for making guide member, but motor also can be to make the guide member left type of rotation arbitrarily.

In addition, in the present embodiment, by while utilize endoscopic images on the picture confirm repeatedly channeling conduct pipe 121 with respect to the insertion section 111 of moving and being undertaken by operation on hand of large intestine with respect to the moving of the endoporus of guiding tube 121, realize insertion section 111 is inserted into the depths.But, also can be as shown below, by guiding tube 121 insertion section 111 of endoscope 102 is inserted into endoceliac depths.

The insertion section 111 of endoscope 102 is inserted into other structures of endoceliac depths with reference to Figure 76 to Figure 78 explanation.

Shown in Figure 76, in the present embodiment, the front end face of guiding tube 121 is configured on the flexible pipe 116 that constitutes insertion section 111.That is, curvature section of endoscope 115 is configured to be positioned at front than the front end face of guiding tube 121.

When the operator inserts big enteral in the insertion section 111 that will dispose guiding tube 121, make endoscope 102 be observable state.Then, will insert big enteral from anus 71 from the outstanding insertion section 111 of the front end face of guiding tube 121.So, on the picture of monitor 6, show the endoscopic images that endoscope 102 is obtained.Herein, while the operator observes endoscopic images that insertion section 111 is inserted to the depths of big enteral.So guiding tube 121 also inserts big enteral from anus 71.Herein, the operator utilizes the propulsive force of guiding tube 121, Yi Bian observe endoscopic images, Yi Bian insertion section 111 is moved to the depths of big enteral.

That is, operator's shown endoscopic images from the picture of monitor 6 is judged direction of insertion, and is absorbed in the operation on hand that makes bending section 115 suitably carry out flexure operation and twist the operation etc. of insertion section 111.In addition, about the operation on hand that insertion section 111 is moved to the depths, depend on the propulsive force of guiding tube 121.Can successfully the insertion section be inserted into the tube chamber depths thus.

With reference to Figure 79 to Figure 83 the 7th embodiment of the present invention is described.

Shown in Figure 79, the insertion section guide member of present embodiment is that guiding tube 140 is serpentine pipes of having considered to the endoceliac slotting general character, for example be that rustless steel is made, and form helically and be wound with the metal wire rod 141 of predetermined diameter size and have predetermined flexible.Therefore, the outer surface of guiding tube 140 is provided with surperficial formed spiral-shaped the 141a by metal wire rod 141.In addition, the internal diameter size of guiding tube 140 is configured to make the insertion section 111 of above-mentioned endoscope 102 to run through insertion.

Shown in Figure 80, the endoscope-use of present embodiment insertion aid 103A constitutes has guiding tube 140 and guiding tube rotary apparatus 22A.In the present embodiment, the rotatable and loose fit sliding freely of guiding tube 140 is configured in the protecting tube 143 that is wound in cylinder 142.Cylinder 142 for example is located at cylinder with on the platform 144a of car 144.Other structures are identical with the 6th embodiment, and same parts are marked same label, omit explanation.

The step of large intestine is inserted guiding tube 140 in explanation.

At first, shown in Figure 80, operator (not shown) controls the front part of guiding tube 140, and the leading section of guiding tube 140 is inserted big enteral from the patient 7 of accumbency on bed 8 anus.So spiral-shaped the 141a that is formed on the outer surface of guiding tube 140 contacts with intestinal wall.At this moment, the contact condition that is formed on spiral-shaped 141a on the guiding tube 140 and intestinal wall becomes the relation of external screw thread and female thread.

Under this contact condition, make the rotation of guiding tube rotary apparatus 22 be the rotation driving condition with motor 153.So shown in the arrow of Figure 81, spiral-shaped 141a of guiding tube 140 becomes the state that is rotating around direction of principal axis with from the mode of base end side forward end side shifting.

Thus, in the contact portion of spiral-shaped 141a with the intestinal wall of the guiding tube 140 of rotation, generation make external screw thread with respect to female thread move such, make guiding tube 140 progressive propulsive forces.So guiding tube 140 advances to the depths in large intestine under the effect of propulsive force.At this moment, the operator can operate the guiding tube 140 of being controlled to advance on hand.

Like this, the guiding tube 140 that inserts from anus 71 advances to S font colon portion 73 from rectum 72 by propulsive force and operator's operation on hand.Then, shown in Figure 81, guiding tube 140 arrives near the S font colon portion 73.At this moment, because spiral-shaped the 141a that is formed on guiding tube 140 outer surfaces is long with the contact length of intestinal wall, so the guiding tube 140 that rotates is in bending and be imbued with in the S font colon portion 73 of mobility and advance smoothly.

Then, the guiding tube 140 that is in rotation status advances with the wall of the liver bending 77 of ascending colon portion 78 intersections with the spleen bending 76 that is imbued with transverse colon portion 75 intersections of mobility, transverse colon portion 75 along S font colon portion 73 and bending section, the descending colon portion 74 of descending colon portion 74 intersections that lack mobility smoothly by S font colon portion 73.Then, shown in Figure 82, arrive near the liver bending 77 of the ascending colon portion 78 at purpose position for example, and do not change the walking state of large intestine.

Judge guiding tube 140 by the operator and arrived after the purpose position, then, from the insertion section 111 of endoscope 102 being inserted in the endoporus of guiding tubes 140 from the base end side opening of anus 71 to the outstanding guiding tube 140 in outside.Then, the operator confirms on one side the bearing of trend of guiding tube 140 on the picture of monitor 6, make the operation of bending section 115 bendings on one side and twist the operation etc. of insertion section 111, simultaneously, with insertion section 111 insertions.So shown in Figure 83, insertion section 111 is outstanding from the front opening of the guiding tube 140 that is positioned at big enteral, and rigid 114 of front end be configured near the caecum portion 79.

In the present embodiment, advance in the endoporus that runs through the guiding tube 140 that inserts big enteral in insertion section 111, and be directed to the large intestine depths.Therefore, the operator can not lose direction of insertion, and insertion section 111 is successfully inserted near the caecum portion 79 with can significantly alleviating insertion strength.In addition, after the operator confirms that on the picture of monitor 6 insertion section 111 has arrived near the caecum portion 79 at purpose position, next carry out the splanchnoscopy of big enteral.

Like this, the insertion section of guide member and endoscope is not made up, but after guide member being run through the purpose position that is inserted into big enteral in advance, the insertion section of endoscope is run through in the endoporus that inserts guide member from the base end side opening that is configured in external guide member.Thus, the operator can not lose the direction of insertion that the insertion section is inserted, and can carry out suitable bending operation and twist operation, thereby with small insertion strength the purpose position is inserted in the insertion section of endoscope.

According to these, run through to be inserted into the inside of inserting accessory by medical apparatus and instruments with endoscope etc., can improve extensive use at the various medical devices of insertion section with various outer diameter.In addition, owing to insert the outer circumferential side that accessory is positioned at the insertion section, in medical apparatus and instruments, do not use this treatment apparatus to insert circulation passage by inserting accessory with the slotting circulation passage of treatment apparatus.

Therefore, insert in the medical apparatus and instruments of endoscope etc. of circulation passage only having a treatment apparatus, when using treatment apparatus that object positions such as lesion portion are disposed, need not to carry out to insert and take out the operation of inserting accessory etc. the circulation passage from treatment apparatus, and can instantaneously dispose, therefore realized the raising of the property disposed.

In addition, as mentioned above, by constituting medical apparatus and instruments run through to insert inner and make auxiliary insertion accessory rotation is carried out in the insertion of medical apparatus and instruments, and make medical apparatus and instruments outstanding from the front of inserting accessory in advance, thus when carrying out tested observation of having a medical check-up or disposal etc., can prevent to hinder tested observation of having a medical check-up or disposal etc., observe or the property disposed so can further improve because of inserting accessory.

In addition, the present invention is not limited only to above-mentioned embodiment, but can implement various distortion in the scope that does not break away from inventive concept.

Claims (8)

1. one kind is inserted device, it is characterized in that this insertion device has:

This inserts the insertion section of device, tested having a medical check-up inserted in the insertion section of this insertion device, to being examined intravital insertion, the insertion section of described endoscope is provided with the rigid portion of front end, bending section and flexible pipe portion and constitutes by connecting successively from front with the insertion section of assisting the endoscope that carries out medical act in tested having a medical check-up;

The insertion section of this insertion device has runs through inner space of inserting inside and the insertion section that can make above-mentioned endoscope from the outstanding opening of the front end of the insertion section of this insertion device with the insertion section of this endoscope, and can relatively advance and retreat with respect to above-mentioned endoscope on the direction of going into to the tested interpolation of having a medical check-up in the insertion section of this insertion device; With

The insertion section that rotating part, this rotating part make above-mentioned insertion device is the center rotation to insert direction of principal axis, with the insertion section of above-mentioned insertion device to the above-mentioned fashionable generation propulsive force of body interpolation that is examined,

Wherein, in that the insertion section of above-mentioned insertion device is fashionable to the tested interpolation of having a medical check-up, the position that can contact with tested inwall of having a medical check-up of the insertion section of this insertion device is provided with the propulsive force generating unit of following above-mentioned rotation and producing propulsive force, and,

Above-mentioned curvature section of endoscope is configured in than the more forward distolateral position of the front end face of the insertion section of above-mentioned insertion device.

2. insertion device according to claim 1 is characterized in that,

The front end that above-mentioned endoscope is examined intravital insertion section in insertion has to be used to observe and is examined intravital observation portion and/or is used for to being examined the slotting opening of threading a pipe that the treatment apparatus of disposing at intravital object position runs through insertion,

The insertion section of above-mentioned insertion device can be with respect to the field of view zone of observation portion and/or the slotting opening of threading a pipe of treatment apparatus, is being examined on the intravital direction of insertion advance and retreat relatively.

3. insertion device according to claim 1 is characterized in that, the position that can contact with above-mentioned tested inwall of having a medical check-up in the insertion section of above-mentioned insertion device is provided with a plurality of above-mentioned propulsive force generating units with arbitrary interval.

4. insertion device according to claim 3 is characterized in that, the position that can contact with above-mentioned tested inwall of having a medical check-up in the insertion section of above-mentioned insertion device is uniformly-spaced to be provided with a plurality of above-mentioned propulsive force generating units.

5. insertion device according to claim 1 is characterized in that, above-mentioned propulsive force generating unit above-mentioned insertion device insertion section can with whole position that above-mentioned tested inwall of having a medical check-up contacts on be provided with continuously.

6. according to claim 3 or 4 described insertion devices, it is characterized in that above-mentioned propulsive force generating unit is spiral-shaped portion.

7. insertion device according to claim 5 is characterized in that, above-mentioned propulsive force generating unit is spiral-shaped portion.

8. insertion device according to claim 1 is characterized in that, the front of the insertion section of above-mentioned insertion device and base end side flexible different.

Images