JP2000152985A - Manipulator for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make a drainage tube easily usable without forming the tube into a special shape and the position where the tube is retained easily changeable. SOLUTION: This manipulator for endoscope for retaining an endoscope at a narrow segment in the bile duct has a guide tube 5 to guide a drainage tube 1 and a pusher tube 7 to push forward the drainage tube 1 mounted on the guide tube 5. The drainage tube 1 is retained on an engaging part 6 formed on the tip end part of the guide tube 5 and the position of the drainage tube 1 is changed to retain the drainage tube 1 at a suitable position by the engaging part 6.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment tool for an endoscope which is inserted into a body cavity through a treatment tool insertion channel of an endoscope and in which a drainage tube is placed at a stenosis in a biliary tract.

[0002]

2. Description of the Related Art In particular, when a patient, such as an elderly person, who does not have enough physical strength to withstand surgery, suffers from jaundice because bile cannot be discharged into the duodenum due to stenosis in the biliary tract, transendoscopic examination is required. There is known a treatment in which a drainage tube is inserted into a bile duct from a duodenal papilla and the drainage tube is placed in a stenosis of the bile duct to secure a bile drainage passage.

[0003]

[Problems to be Solved by the Invention]
As a procedure for endoscopically placing a drainage tube in a stenosis in the biliary tract, first, a guide wire is inserted endoscopically into the biliary tract, and the guide tube is inserted into the biliary tract using the guide wire as a guide. Insert up to. Thereafter, the drainage tube is fitted on the guide tube, the guide tube is used as a guide, and the drainage tube is pushed in by the pusher tube, and the drainage tube is inserted into the stenosis in the biliary tract and is left.

[0004] In this procedure, if the drainage tube is pushed too much when pushing the drainage tube with the pusher tube, the drainage tube goes beyond the position of the stenosis portion to be placed. In this case, the drainage tube cannot be pulled back, and the guide wire, guide tube, and pusher tube that have already been inserted must be once removed from the endoscope and replaced with the endoscope in order to place the drainage tube in place. It is necessary to insert a grasping forceps through a mirror, grasp the rear end of the drainage tube that has been pushed too far, and pull it back.

[0005] As a method for reliably pulling back the drainage tube that has been pushed too far, Japanese Patent Laid-Open No. 5-22 is disclosed.
Japanese Patent Application Laid-Open No. 0227 or JP-A-57-99940 proposes a structure in which a grip portion having a shape easily gripped by grip forceps is provided at a rear end portion of the drainage tube. In such a drainage tube, a rigid grip portion is formed at the rear end, and the rigid portion at the rear end lowers the ease of insertion of the drainage tube into the biliary tract. In addition, the rear end of the drainage tube has a shape in which a hard portion protrudes, but there is a problem that this protruding portion becomes a new cause of preventing bile discharge. Furthermore, since the operation of introducing the grasping forceps into the biliary tract is also performed with the guide wire removed, the operation is difficult and troublesome.

On the other hand, Japanese Utility Model Laid-Open Publication No. Hei 7-303 proposes a drainage tube collecting tool which can be used with a guide wire inserted. This is provided with a tip at the distal end of the collecting tool, which is fitted to the rear end of the drainage tube. However, when collecting the drainage tube outside the body, the guide tube and pusher tube used for inserting the drainage tube into the biliary tract must be removed from the body, and then the collection tool must be inserted again. This requires the operation of inserting the, which is a troublesome and troublesome operation. Further, it is necessary to form a special shape at the rear end portion of the drainage tube so as to be fitted to the tip of the collecting tool, and the drainage tube cannot be used unless the drainage tube has the special shape.

Further, Japanese Patent Publication No. Hei 7-14405 discloses that
A proposal has been made in which a rear end portion of a drainage tube is tapered, and a distal end of a guide tube is fitted to and engaged with the tapered end portion. Even in the case of this system, it is necessary to give a special shape to the rear end portion of the drainage tube, and a general drainage tube having a straight rear end cannot be used. Furthermore, since the distal end of the guide tube only reaches the rear end of the drainage tube, the drainage tube is inserted using only the guide wire as a guide. Is significantly reduced.

(Objects of the Invention) The present invention has been made in view of the above-mentioned problems, and the objects thereof are as follows.
For endoscopes that can be used easily without giving a special shape to the drainage tube, it is easy to change the placement position of the drainage tube, and the drainage tube can be placed in the appropriate place in the biliary tract It is to provide a treatment tool.

[0009]

SUMMARY OF THE INVENTION In order to solve the above-mentioned problems, the present invention provides an inner tube for inserting a drainage tube into a stenosis in a biliary tract by being inserted into a body cavity through a treatment tool insertion channel of an endoscope. In the treatment instrument for an endoscope, a guide tube that is inserted into an inner hole of the drainage tube and guides the drainage tube into a body cavity, a pusher unit that pushes the drainage tube attached to the guide tube forward, and A locking means for holding the drainage tube at the position of the distal end of the guide tube or the pusher means, and a release means for releasing the drainage tube held by the locking means.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] An endoscope treatment tool according to a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a longitudinal sectional view of a treatment tool for an endoscope to which a drainage tube is attached, and FIGS. 2 to 4 are explanatory views of a use state of the treatment tool for an endoscope.

(Structure) In FIG. 1, reference numeral 1 denotes a drainage tube. The drainage tube 1 is attached to a treatment tool 2 for an endoscope as a drainage tube insertion tool described later to constitute a drainage tube insertion assembly. ing.

The drainage tube 1 is made of, for example, an elongate flexible tubular member made of polyethylene, and the flap-shaped locking portions 1a and 1b are respectively provided on the outer peripheral surfaces of the distal end portion and the proximal end portion of the drainage tube 1. It is provided to project obliquely toward the center. The drainage tube 1 is also called a prosthesis, and is a so-called indwelling tube (stent) in the sense that it is indwelled in a lumen. In addition, the drainage tube 1 used in this embodiment may have another generally known configuration.

The endoscope treatment instrument 2 includes an elongated tubular guide tube (guide catheter) 5 which is introduced into a body cavity through a channel of the endoscope. The drainage tube 1 is fitted on the outer periphery of the guide tube 5 and is slidably mounted on the guide tube 5. Then, the guide tube 5 serves as a guide when the drainage tube 1 is introduced endoscopically to the biliary tract.

The guide tube 5 is made of, for example, a tube made of polytetrafluoroethylene having the same diameter over its entire length, and its substantially entire length is straight. A meandering or helically twisted bent portion 6 is formed. The locking portion 6 constitutes locking means for holding the drainage tube 1 at the position of the distal end of the guide tube 5.

The locking portion 6 of the guide tube 5 has a diameter of an envelope circle connecting the tops of the meandering or spiral torsion, that is,
The locking portion 6 is manufactured such that the maximum outer diameter is the same as the inner diameter of the drainage tube 1. In addition, the maximum outer diameter of the locking portion 6 is such that after the drainage tube 1 is fitted in this portion, the holding performance of appropriately locking the drainage tube 1 and the positioning after the positioning of the biliary tract in a proper position are performed. It is set in consideration of the release performance of detaching the guide tube 5, but usually the outer diameter is the same as the inner diameter of the drainage tube 1, or is larger than the inner diameter of the drainage tube 1 by 1/10 or less, that is, the drainage tube 1 If the inner diameter is 2 mm, the maximum outer diameter of the locking portion 6 is 2 m
It is preferable to set the distance between m and 2.2 mm.

The guide wire 4 is inserted through the inner hole of the guide tube 5. The guide tube 5 is slidable along the guide wire 4, and the guide tube 5 is guided endoscopically to the biliary tract along the guide wire 4.

A pusher tube 7 is slidably fitted on the outer periphery of the guide tube 5 at a position closer to the hand than the drainage tube 1. That is, the drainage tube 1 is fitted on the outer periphery of the guide tube 5, and the pusher tube 7 is fitted on the rear end side of the drainage tube 1. The pusher tube 7 constitutes a pusher means for pushing the drainage tube 1 mounted on the guide tube 5 forward.

At the proximal end of the pusher tube 7, a thick operation knob 8 is provided. The operation knob 8 is gripped to operate the pusher tube 7.

(Operation) First, the guide wire 4 is inserted into the biliary tract through a channel of an endoscope (not shown), and the guide wire 4 is inserted to a position beyond the stenosis 10. Next, the guide tube 5 is put on the guide wire 4 from its proximal side, the guide tube 5 is pushed forward using the guide wire 4 as a guide, and the locking portion 6 is inserted to a position beyond the stenosis portion 10 in the biliary tract. Subsequently, the drainage tube 1 is fitted to the guide tube 5 from the hand side, and then the pusher tube 7 is fitted. Then, with the pusher tube 7, the drainage tube 1 is pushed in, and the guide tube 5 is used as a guide.
The drainage tube 1 is introduced into the biliary tract, and the drainage tube 1 is positioned at the stenosis 10.

Here, if the drainage tube 1 is excessively pushed into the locking portion 6 of the guide tube 5 and pushed over the stenosis portion 10 as shown in FIG. 2, the drainage tube 1 is left as it is. When the tube 1 is placed, poor drainage of bile caused by the stenosis 10 cannot be improved, and the drainage tube 1 cannot function as a medical device.

Therefore, the drainage tube 1 is connected to the stenosis 1
You have to pull it back to the right place at zero. In the present embodiment, a locking portion 6 is formed near the distal end portion of the guide tube 5, and the drainage tube 1 is fitted and locked to and held by the locking portion 6. That is, the drainage tube 1 is locked on the outer periphery of the locking portion 6 by the frictional engagement between the inner surface of the drainage tube 1 and the outer peripheral surface of the locking portion 6.

In this state, if the guide tube 5 is pulled back toward the user, the drainage tube 1 can be pulled back to the position of the stenosis portion 10 while being held on the outer periphery of the locking portion 6 as shown in FIG. In addition, when the distal end of the pusher tube 7 is in contact with the rear end of the drainage tube 1, the drainage tube 1 can be advanced by moving both the drainage tube 1 and the pusher tube 7 together, so that the delicate position is improved. Can be corrected, and accurate positioning can be easily performed.

After the drainage tube 1 is positioned at an appropriate position in the stenosis part 10 in this manner, the distal end of the pusher tube 7 is applied to the rear end of the drainage tube 1 to support the drainage tube 1, and the drainage tube 1 and the pusher tube 7 are supported. In a state where is fixed so as not to move, only the guide tube 5 is strongly pulled back to the hand side. Then, as shown in FIG. 4, since the drainage tube 1 is in a state where it does not move by abutting against the tip of the pusher tube 7, the drainage tube 1 is positioned and fixed in place in the stenosis portion 10 without being followed by being pulled by the guide tube 5. It remains as it is and is detained. That is, the release means operates, and only the guide tube 5 is pulled out from the inner hole of the drainage tube 1 and detaches. The drainage tube 1 held by the locking portion 6 of the guide tube 5 is detached from the guide tube 5 by the operation of the release means, and the stenosis portion 10 is released.
Only the drainage tube 1 remains at the appropriate position.

After the above operation is completed, the guide tube 5, pusher tube 7, and guide wire 4 are removed from the body cavity together with the endoscope, and a series of medical operations is completed. (Effect) By using the present embodiment, even if the drainage tube 1 is pushed in to a position excessively beyond the position of the stenosis portion 10, the guide tube which is an insertion guide tool of the drainage tube 1 is bothersome. 5 and the pusher tube 7 are removed, and instead, a troublesome work of re-inserting the grasping forceps and the like is performed without performing
Immediately pulling the drainage tube 1 back toward the user, positioning the stenosis portion 10 at a proper position and placing the tube in the stenosis portion 10 can be easily performed. Therefore, excessively over the stenosis 10,
Correction work when the drainage tube 1 is pushed in is simple and can be performed quickly,
The treatment time can be greatly reduced, and the burden on the patient can be significantly reduced.

[Second Embodiment] An endoscopic treatment tool according to a second embodiment of the present invention will be described with reference to FIGS. FIG. 5 is a longitudinal sectional view of a distal end portion of the endoscope treatment tool to which the drainage tube is attached, and FIG. 6 is an explanatory diagram of a use state of the endoscope treatment tool.

(Construction) This embodiment is similar to the drainage tube 1 and the guide tube 5 in the first embodiment described above.
This is a modification in which the locking means for increasing the frictional force between the drainage tube 1 and the pusher tube 7 is the same as that of the first embodiment described above. .

The guide tube 5 in this embodiment has a plurality of openings 12a, 1
2b is formed as a side hole penetrating from the inner hole of the guide tube 5 toward the outer periphery. In addition, each opening 12a,
Reference numeral 12b is disposed to be separated from the front and back of the guide tube 5 in the axial direction. The distal end of the yarn 11 is attached to a wall portion adjacent to the opening 12a located on the distal end side of the inner hole of the guide tube 5, and the rear end portion of the yarn 11 is connected to the guide tube from the opening 12a located on the distal end side. 5 and is led to the opening 12b located on the rear end side,
b again enters the inner hole of the guide tube 5, is stored in the inner hole of the guide tube 5, and is guided to the near side through the inner hole of the guide tube 5.

The loaded yarn 11 is exposed on the outer periphery of the distal end portion of the guide tube 5 in this manner, and the exposed yarn 11 secures a frictional force with the drainage tube 1 fitted on the guide tube 5. Make up the means of combination. In order to secure friction with the drainage tube 1, when the yarn 11 has a clearance between the inner periphery of the drainage tube 1 and the outer periphery of the guide tube 5, the yarn 11 has the same diameter as the clearance or the clearance. It is preferable to have a diameter within twice as large as The thread 11 is formed of a material having sufficient flexibility and moderate frictional resistance, for example, silk. In addition to silk, materials such as cotton, polyamide, and polyethylene may be used.

(Operation) First, the yarn 11 protrudes from the opening 12a located on the front end side to the outer periphery of the guide tube 5 and is exposed, and again enters the inner hole of the guide tube 5 from the opening 12b located on the rear end side. The guide tube 5 is guided to the near side through the inner hole. In this state,
The guide tube 5 is inserted into the biliary tract through a channel of an endoscope (not shown) until the distal end of the guide tube 5 passes over the stenosis.

Subsequently, the drainage tube 1 is fitted to the guide tube 5 from the hand side, and the pusher tube 7 is fitted to a position behind the drainage tube 1. Then, using the guide tube 5 as a guide, the drainage tube 1 is pushed toward the distal end by the pusher tube 7, and the drainage tube 1 is positioned at an appropriate position in the stenosis portion 10.

However, if the drainage tube 1 reaches a position beyond the stenosis 10 due to being excessively pushed by the pusher tube 7, the following treatment is performed. That is, the guide tube 5 and the pusher tube 7 are pulled back toward the user. Then, as shown in FIG. 5, the exposed portion of the yarn 11 is pressed into the inner hole of the drainage tube 1, and the drainage tube 1 is locked to the guide tube 5.

By pulling back the guide tube 5 and the pusher tube 7 in the state where the drainage tube 1 is locked to the guide tube 5 as described above,
The drainage tube 1 is retracted and pulled back to a proper position in the stenosis 10. In addition, when the distal end of the pusher tube 7 is in contact with the rear end of the drainage tube 1, the drainage tube 1 can be advanced by moving both the drainage tube 1 and the pusher tube 7 together, so that the delicate position is improved. Can be corrected, and accurate positioning can be easily performed.

After the drainage tube 1 is positioned at a proper position in the stenosis 10, the portion of the thread 11 protruding out of the guide tube 5 is strongly pulled while holding the guide tube 5 so as not to move. Then, the tip of the thread 11 exposed on the outer periphery at the tip of the guide tube 5 is separated from the portion of the guide tube 5, and the opening 12a and the opening 12b
And is drawn into the inner hole of the guide tube 5.
The thread 11 press-fitted into the gap between the drainage tube 1 and the guide tube 5 is removed, and the holding state of the drainage tube 1 is released, so that the drainage tube 1 returns to a state where it can freely move on the outer periphery of the guide tube 5. I do.

Subsequently, as shown in FIG. 6, the distal end of the pusher tube 7 is held against the rear end of the drainage tube 1 so as not to move, and only the guide tube 5 is pulled back to the hand side. Thereafter, the pusher tube 7 is also pulled back to the hand side. As a result, the drainage tube 1 is accurately positioned and left in place at the stenosis 10.

After the above operation is completed, both the guide tube 5 and the pusher tube 7 are removed from the body cavity together with the endoscope, and the medical operation is completed. (Effects) According to the present embodiment, the drainage tube 1 can be quickly and easily positioned and indwelled in a proper position of the stenosis 10 in the biliary tract as compared with the first embodiment, and the guide tube 5 Since the vicinity of the distal end does not meander, it can be easily inserted into a body cavity where it is originally difficult to insert tubes, such as the stenotic part 10.

[Third Embodiment] An endoscope treatment tool according to a third embodiment of the present invention will be described with reference to FIG. FIG. 7 is an explanatory diagram of a use state of the endoscope treatment tool equipped with a drainage tube.

(Construction) This embodiment is similar to the drainage tube 1 and the guide tube 5 in the first embodiment described above.
As a locking means for increasing the frictional force with the guide tube 5, a coating 15 of isoprene rubber is formed on the outer circumference of the guide tube 5 from the distal end of the guide tube 5 to a position immediately before the position of 50 mm. Here, as the material used for the coating 15, any other material having an appropriate friction resistance can be used. For example, butadiene rubber, ethylene-propylene rubber, acrylic rubber, butyl rubber, nitrile rubber, Chloroprene rubber, fluorine rubber, silicone rubber or the like may be used.

(Operation) The operation of the present embodiment is almost the same as that of the first embodiment, except that the drainage tube 1 is locked by the frictional force depending on the coating 15.

(Effect) According to the present embodiment, as compared with the second embodiment described above, the drainage tube 1 can be easily and quickly positioned and placed in a proper position of the stenosis 10 in the biliary tract. Since the thread 11 is not used, the operation of detaching the drainage tube 1 locked on the guide tube 5 can be achieved by simply pulling out the guide tube 5 strongly toward the hand, and the drainage tube 1 can be easily detached. it can. In addition, since the outer periphery of the guide tube 5 near the distal end is covered with the soft rubber coating 15, there is an advantage that insertion into the body cavity can be performed softly and damage to the mucous membrane is reduced.

[Fourth Embodiment] An endoscopic treatment tool according to a fourth embodiment of the present invention will be described with reference to FIG. FIG.
FIG. 3 is a vertical cross-sectional view near the distal end portion of the endoscope treatment tool equipped with a drainage tube.

(Construction) This embodiment is similar to the drainage tube 1 and the guide tube 5 in the first embodiment described above.
As a locking means for increasing the frictional force with the guide tube 5, the guide tube 5 is provided with
Five platinum pipes 21 having radiopaque properties are attached to the position of 0 mm by caulking or the like. Here, the outer diameter of the platinum pipe 21 protrudes as much as the outer diameter of the guide tube 5 or within one-tenth of the inner diameter of the drainage tube 1.
It is configured such that a step 22 occurs between the two. The outer surface of the platinum pipe 21 is coated with a different color, and red, white, blue, green, and yellow paints are sequentially applied from the tip.

Here, the material of the platinum pipe 21 is X
Any material having line opacity can be applied. For example, tungsten, tantalum, gold, silver, stainless steel, and a composite material thereof may be used.

(Operation) First, the guide tube 5 is inserted through the endoscope to a position beyond the stenosis in the biliary tract.
Here, the patient's biliary tract is imaged by the X-ray apparatus. In this X-ray image, five platinum pipes 21
Each of the platinum pipes 2
The position of 1 is confirmed. From the positional relationship of these platinum pipes 21, the length from the duodenal papilla to the stenosis 10 or the length of the stenosis 10 is measured. Based on the length measured here, the surgeon determines the optimal length of the drainage tube 1 and moves the drainage tube 1 from the proximal side to the distal side using the guide tube 5 as a guide as in the first embodiment. And insert it.

When the drainage tube 1 is inserted beyond the stenosis 10, the guide tube 5 and the pusher tube 7 are pulled back to the proximal side. At this time, in the drainage tube 1, a platinum pipe 21 provided near the distal end of the guide tube 5 is pressed into the drainage tube 1, and the drainage tube 1 is locked on the guide tube 5.

By pulling the guide tube 5 back toward the user while the drainage tube 1 is locked, the drainage tube 1 returns to a proper position of the stenosis 10 and is positioned.

Next, by removing the guide tube 5 and the pusher tube 7, after the drainage tube 1 is placed in the stenosis 10, the endoscope is removed from the body cavity, and the medical operation is completed. In addition, the same operation and effect as those of the third embodiment can be obtained. According to the fourth embodiment, as compared with the third embodiment described above, the five platinum pipes 21 are checked under X-ray fluoroscopy before the drainage tube 1 is inserted, so that the duodenal papilla is confirmed. There is also an advantage that it has a function of measuring the length between the stenosis part 10 and the required length of the drainage tube 1.

[Fifth Embodiment] An endoscope treatment tool according to a fifth embodiment of the present invention will be described with reference to FIGS. 9 is a perspective view of the vicinity of the distal end of the treatment tool for an endoscope to which a drainage tube is attached, and FIG.
It is a longitudinal cross-sectional view in a -gamma plane.

(Construction) The drainage tube 1 here is also made of an elongated flexible tubular member, and the flap-shaped engaging portions 1a, 1 are provided on the outer peripheral surfaces of the distal end portion and the proximal end portion, respectively.
Each of b has a general shape provided obliquely projecting toward the center of the drainage tube 1 and is made of a fluororesin.

The drainage tube 1 is slidably fitted on the outer periphery of the guide tube 5. The guide tube 5 is formed of a tube made of perfluoroalkoxy. Guide tube 5 is pusher tube 7
Is slidably and removably inserted into one inner hole 7a formed in the above.

The pusher tube 7 has two inner holes 25a and 25b penetrating the entire length of the pusher tube 7, in addition to the inner hole 7a through which the guide tube 5 is inserted. Then, a string 26 is inserted into one inner hole 25a so as to penetrate the distal end from the proximal end of the pusher tube 7, and the string 2
Numeral 6 is inserted into and removed from the inner holes 25a and 25b so as to pass through the other inner hole 25b and return to the hand side again after being hooked on the locking portion 1b of the drainage tube 1.

Here, the string 26 constitutes a locking means for holding the drainage tube 1, and the material is not limited as long as it is a flexible and elongated member. In this embodiment, polytetrafluoroethylene is used. Other materials that can be applied to the string 26 include:
Fibers such as silk and cotton, resins such as polyethylene, and stainless steel wires can be applied.

An elastic cap 27 is attached to the proximal end of the pusher tube 7, and the inner holes 7a, 25a, 25
The opening b is covered. The above elastic cap 2
7, a plurality of slits 28 are formed to penetrate the guide tube 5 and the cord 26 in a liquid-tight manner. The elastic cap 27 also has a function of temporarily holding the guide tube 5 and the string 26 passing therethrough by friction.

(Operation) First, the guide tube 5 is inserted through an endoscope (not shown) until the distal end of the guide tube 5 exceeds the stenosis 10 in the biliary tract. Next, the middle portion of the string 26 passed through the inner holes 25a and 25b of the pusher tube 7 is hooked on the locking portion 1b of the drainage tube 1, and the drain tube 1 and the pusher tube 7 are sequentially placed on the guide tube 5 in this order. Put on from the side. Then, with the guide tube 5 stopped so as not to move in the body cavity,
When the drainage tube 1 is pushed from the near side by the pusher tube 7, the drainage tube 1 is pushed by the tip of the pusher tube 7 and the guide tube 5 is pushed.
The guide is guided into the biliary tract, and the drainage tube 1 can be positioned at the stenosis 10.

Here, when the drainage tube 1 is excessively pushed in and the drainage tube 1 is pushed into a position beyond the stenosis portion 10, it is necessary to pull the drainage tube 1 back to the position of the stenosis portion 10.
Then, both the guide tube 5 and the pusher tube 7 or only the pusher tube 7 is pulled back to the hand side. At this time, the string 26 is pulled together with the pusher tube 7, and the drainage tube 1 holding the string 26
To the position of the stenosis 10. Also, if both the drainage tube 1 and the pusher tube 7 are moved together with the front end of the pusher tube 7 abutting against the rear end of the drainage tube 1, the drainage tube 1 can be advanced, so that a delicate position correction can be made. It is possible and accurate positioning can be easily performed.

After the drainage tube 1 is positioned at a proper position in the stenosis portion 10, one end of the cord 26 is released, and the other end is pulled toward the hand, so that the string 26 hooked on the locking portion 1b is pulled.
Comes off. Thereafter, with the pusher tube 7 fixed, the guide tube 5 is strongly pulled back toward the user. At this time, the drainage tube 1 is
The guide tube 5
Is pulled out from the inner hole of the drainage tube 1 and detached, the drainage tube 1 is released from the guide tube 5, and the drainage tube 1 is accurately placed at the stenosis position of the stenosis portion 10. After the above operation is completed, the guide tube 5 and the pusher tube 7 are removed from the body cavity together with the endoscope, and the medical operation is completed.

(Effect) By using this embodiment, the drainage tube 1 that has excessively passed over the stenosis portion 10
The guide tube 5 and the pusher tube 7, which are insertion tools for the drainage tube 1, are pulled back to the proximal side without removing the grasping forceps and the like again.
Because it can be positioned and detained in the right place,
The operation is not troublesome, and the treatment time can be reduced, so that the burden on the patient can be reduced. In addition, since the pull-back is performed by using the flap-shaped locking portion of the drainage tube 1, there is no fear of damaging the inner surface of the body of the drainage tube 1, and there is an advantage that the bile discharge property after indwelling is high.

<Supplementary Notes> An endoscope treatment tool which is inserted into a body cavity through a treatment tool insertion channel of an endoscope and allows a drainage tube to be placed in a stenosis in a biliary tract, wherein the drainage tube is inserted through an inner hole of the drainage tube. And a pusher for pushing the drainage tube attached to the guide tube forward, and a lock for holding the drainage tube at the position of the distal end of the guide tube or the pusher. And a releasing means for releasing the drainage tube held by the locking means.

2. The endoscope treatment tool, wherein the pusher means is slidably mounted on the guide tube from behind the drainage tube, and has a pusher tube for pushing the drainage tube using the guide tube as a guide. .

3. The locking means for holding the drainage tube has an elongated thread-like member including a string, and the thread-like member is engaged with a part of the drainage tube (for example, a flap-like locking portion) fitted on the guide tube. 2. The endoscope treatment tool according to claim 1, wherein the endoscope can be stopped and the drainage tube can be pulled, and the releasing means pulls out the thread-like member.

4. An inner hole through which the elongated thread-like member passes;
4. The endoscopic treatment according to claim 3, further comprising a multi-lumen tube having an inner hole through which the guide tube passes, and the multi-lumen tube constituting the pusher means for pushing the drainage tube. Utensils.

5. The locking means is constituted by a frictional engagement means in which a frictional resistance with the drainage tube is increased at a distal end portion of the guide tube inserted into an inner hole of the drainage tube as compared with a hand side. 2. The treatment tool for an endoscope according to claim 1.

6. 6. The endoscope according to claim 5, wherein the release means is a pusher tube for pushing the drainage tube, which is slidably fitted on the guide tube at a position close to the drainage tube. Mirror treatment tool.

7. The friction engagement means for increasing the frictional resistance with the drainage tube is characterized in that an elongated thread-like member is located between the drainage tube and the guide tube to increase the frictional resistance.
The treatment tool for an endoscope according to the above item.

8. The means for increasing the frictional resistance of the guide tube with the drainage tube may be such that the distal end of the guide tube is formed in an inflected (for example, meandering or spiral) shape to increase the outer diameter, thereby increasing the frictional resistance. Clause 5, 6, or 7 characterized in that:
The treatment tool for an endoscope according to the above item.

9. 8. The treatment tool for an endoscope according to claim 7, wherein the means for detaching the drainage tube is released by pulling out the elongated thread-like member.

10. The means for increasing the frictional resistance between the guide tube and the drainage tube is constituted by coating an elastomer formed on an outer peripheral portion of a distal end portion of the guide tube. The treatment tool for an endoscope according to the above.

11. The means for detaching the drainage tube is a pusher tube slidably fitted to the guide tube and pushed into the drainage tube, the pusher tube being located at the proximal side of the drainage tube. Endoscope treatment tool.

[0068]

As described above, according to the present invention, it is easy to change the position where the drainage tube is placed,
The drainage tube can be accurately placed in a proper place in the stenosis of the biliary tract. Further, it is simple because it can be used without a drainage tube having a special shape.

[Brief description of the drawings]

FIG. 1 is a vertical cross-sectional view of a treatment tool for an endoscope according to a first embodiment.

FIG. 2 is an explanatory view of a state of use of the endoscope treatment tool.

FIG. 3 is an explanatory diagram of a use state of the endoscope treatment tool.

FIG. 4 is an explanatory view of a state of use of the endoscope treatment tool.

FIG. 5 is a longitudinal sectional view of a distal end portion of an endoscope treatment tool according to a second embodiment.

FIG. 6 is an explanatory diagram of a use state of the endoscope treatment tool.

FIG. 7 is an explanatory diagram of a use state of the endoscope treatment tool according to the third embodiment.

FIG. 8 is an explanatory diagram of a use state of the endoscope treatment tool according to the fourth embodiment.

FIG. 9 is an explanatory diagram of a use state of the endoscope treatment tool according to the fifth embodiment.

FIG. 10 is a longitudinal sectional view of the use state of the endoscope treatment tool.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Drainage tube, 2 ... Endoscope treatment tool, 4 ... Guide wire, 5 ... Guide tube, 6 ... Locking part, 7 ... Pusher tube, 10 ... Stenosis part.

Claims (1)

[Claims] 1. A treatment tool for an endoscope which is inserted into a body cavity through a treatment tool insertion channel of an endoscope and in which a drainage tube is placed in a stenosis in a biliary tract, wherein the treatment tool is inserted through an inner hole of the drainage tube. A guide tube for guiding the drainage tube into the body cavity; a pusher means for pushing the drainage tube attached to the guide tube forward; and the drainage tube at a position of the distal end of the guide tube or the pusher means. And a releasing means for releasing the drainage tube held by the locking means.