JP2000262465A - Endoscopic guide tube for upper alimentary canal - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent a guide tube from being buckled about in the pharynx or duodenum by constituting a tube body by successively arranging a flexible part, a hard part and a flexible part in order from a grip side. SOLUTION: The tube body 5 of this endoscopic guide tube 1 is constituted by successively arranging a flexible part 7, a hard part and a flexible part in order from a grip part 6 side. Since the flexible part 7 is arranged at the tip of the endoscopic guide tube 1, the buckling is hardly caused about at the tip of the endoscopic guide tube 1. Therefore, since the endoscopic guide tube 1 can be inserted according to the traveling of the duodenum and the jejunum and ileum of the small intestine, the insertability is improved. Further, since the base end-side flexible part 7 of the tube body 5 of the endoscopic guide tube 1 is arranged in the throat root of a patient, the flexible part 7 can be curved along the curve of the pharynx. Since the buckling in the base end-side flexible part 7 of the tube body 5 of the endoscopic guide tube 1 can be hardly caused, the insertability of an endoscope 2 can be improved.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope guide tube for an upper gastrointestinal tract, and more particularly, to an endoscope guide for an upper gastrointestinal tract which assists insertion of an endoscope in a small intestine when observing the endoscope. About pipes.

[0002]

2. Description of the Related Art As shown in FIG. 4, when an endoscope is inserted into a small intestine H4 via an esophagus H1, a stomach H2, and a duodenum H3, which are upper digestive tracts, a guide tube is generally used. Instead of the endoscope alone. When the endoscope alone is inserted into the patient as described above, the following operation is performed. First, the endoscope inserted into the stomach H2 from the esophagus H1 is guided further downstream along the great bay H2a of the stomach H2. Here, when the endoscope located in the great bay H2a of the stomach H2 is further pushed forward, the tip of the endoscope extends along the great bay H2a of the stomach H2 to the pylorus H5, the duodenal bulb H3a, and the entrance of the duodenal descending leg H3b. Can be reached. In FIG. 4, H2c is a stomach angle, H3c is a duodenal flat leg, H3d is a duodenal papilla, H6 is an ileum, and H7 is a Treitz tough body.

Further, since the upper digestive tract of the human body is bent in a substantially S-shape from the stomach H2 to the duodenal flat leg H3c,
If the endoscope is to be pushed further beyond the entrance of the descending duodenal limb H3b, even if the endoscope is pushed in from the hand side, the endoscope insertion portion is pushed so as to push down the large bay H2a of the stomach H2 downward. Therefore, the pushing force of the endoscope is not transmitted to the distal end side of the endoscope. At this time, in some cases, the insertion portion of the endoscope may be deformed into a loop inside the stomach H2 due to the pushing force of the endoscope.

[0004] Therefore, the surgeon bends the curved portion of the endoscope at the entrance of the duodenal bulb H3a and the duodenal descending leg H3b, and places the distal end of the endoscope on the duodenal bulb H3a or the duodenal descending leg H3b. Hook. In this state, the endoscope insertion portion is twisted and rotated while the endoscope insertion portion is slightly pulled back. Then, the insertion part located in the great bay H2a moves toward the small bay H2b, the insertion part of the endoscope is located along the small bay H2b, and the insertion part of the endoscope is moved from the esophagus H1 to the duodenal descending leg H3b. It is arranged in a shape (see FIG. 2 (B)) stretched linearly up to that point.

[0005] Thereafter, in this state, the operator pushes the insertion portion of the endoscope from the near side, whereby the force is transmitted to the distal end of the endoscope, and the insertion portion of the endoscope is inserted toward the small intestine H4. can do. However, such a procedure imposes a burden on the surgeon, and is not always easy to insert.

Japanese Unexamined Patent Publication No. 10-262918 discloses a guide tube which is an endoscope insertion aid for guiding an endoscope for small intestine. In order to solve the above-mentioned problem when the endoscope alone is inserted, the guide tube disclosed in the above publication is used.

The operation of inserting an endoscope when using such a guide tube is as follows. First, the guide tube is attached to the insertion portion of the endoscope in advance, and the endoscope alone is used to attach the distal end of the endoscope to the duodenal bulb portion H3a or below the duodenum in a state where the guide tube is positioned near the insertion portion. Insert up to leg H3b.
Then, the guide tube is inserted using the insertion portion of the endoscope as a guide. At this time, by inserting the guide tube, the insertion portion of the endoscope, which is loosened in the large bay H2a of the stomach H2, was deformed to a state of being straightened, whereby the stomach H2 was straightened from the esophagus H1 to the duodenal descending leg H3b. Shape (Fig. 2
(See (B)).

Further, the part beyond the duodenum H3 is a soft organ as compared with the stomach H2, and since the small intestine H4 is bent in an S-shape, a rigid guide tube is inserted into the small intestine H4. When the mirror is inserted, the living tissue may be damaged, or the guide tube itself may buckle. Therefore, Japanese Patent Application Laid-Open
In Japanese Patent Application Laid-Open No. 0-262918, these problems are solved by forming the distal end side of the guide tube flexibly.

[0009]

However, since the pharynx is bent toward the esophagus, the subject is left for a long time with the chin raised so as to be as straight as possible from the pharynx to the esophagus. Will be retained. Therefore, there is a problem that a large burden is imposed on the subject. further,
A stiff guide tube can cause buckling.

In Japanese Patent Application Laid-Open No. 10-262918, the boundary between the flexible portion formed on the distal end side of the guide tube and other hard portions is not particularly specified. Here, it is sufficient that the length is such that the flexible portion is arranged on the duodenal descending leg H3.

However, when the endoscope is inserted into the small intestine H4, for example, with the distal end of the endoscope inserted into a predetermined position in the small intestine H4, the rear end of the flexible portion of the guide tube is inserted into the stomach. When a guide tube having a length of the flexible portion long enough to reach the large bay H2a of H2 is used, the following problem occurs. That is, during the operation of inserting the guide tube along the insertion section of the endoscope, the pressing force for pushing the guide tube is transmitted to the distal end side of the guide tube. At this time, the pressing force for pushing the guide tube is transmitted to the tip of the hard portion, but when the flexible portion is deformed along the shape of the large bay H2a, the pressing force of the guide tube is reduced to the large bay H2.
a is pushed downward, and the pressing force of the guide tube is not sufficiently transmitted to the tip of the guide tube.

In the above publication, the relationship between the insertion portion of the endoscope and the length of the guide tube is not particularly specified, and attention has been paid to reducing the burden on the operator and the patient. There is no actual situation.

The present invention has been made in view of the above circumstances, and an object thereof is to provide an endoscope guide tube for an upper gastrointestinal tract capable of preventing the guide tube from buckling around the pharynx or duodenum. It is in.

Another object of the present invention is to provide an endoscope guide tube for an upper gastrointestinal tract which can be easily inserted into the duodenum.

Another object of the present invention is to provide an endoscope for the upper gastrointestinal tract, which enables insertion into the vicinity of the duodenum by an endoscope alone, thereby reducing the burden on the patient and improving the operability of the operator. A mirror guide tube is provided.

[0016]

According to a first aspect of the present invention, there is provided a tube having flexibility, through which an insertion portion of an endoscope is inserted, and a tube provided at a base end of the tube, In the upper gastrointestinal tract endoscope guide tube having a grasping portion connected to the proximal end side of the insertion portion of the endoscope, the tube body is sequentially softened from the grasping portion side, a hard portion, and a soft portion in order. An endoscope guide tube for an upper digestive tract, which is arranged and configured. According to the first aspect of the present invention, when the endoscope is inserted into the small intestine via the esophagus, stomach, and duodenum, which are upper digestive tracts, the soft portion of the proximal end portion of the tube body on the grasping portion side becomes the patient. Being placed at the throat of the patient, it bends the soft part along the bend of the large larynx, making it difficult for buckling to occur, and the soft part at the tip of the tube body is placed around the duodenum of the patient Accordingly, the soft portion is curved in accordance with the shape around the duodenum, so that buckling hardly occurs.

According to a second aspect of the present invention, the length from the base end of the endoscope guide tube to the hard portion of the tube is set to about 60 to 90% of the entire length of the endoscope guide tube. The endoscope guide tube for an upper gastrointestinal tract according to claim 1, characterized in that: According to the second aspect of the present invention, the rigid portion of the tube body can be disposed from the patient's esophagus to the duodenum, whereby the tube is straightened from the esophagus to the duodenum via the stomach (from the bay to the antrum and pylorus). Thus, the insertability of the endoscope to the deep part is improved, and the endoscope can be easily inserted into the duodenum.

According to a third aspect of the present invention, the effective length of the insertion portion of the endoscope is set to 1.9 times or more of the entire length of the tube body. It is an endoscope guide tube. According to the third aspect of the present invention, the endoscope alone can be inserted into the vicinity of the duodenum in advance, thereby reducing the burden on the patient and improving the operability of the operator.

[0019]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. 1 (A) to 1 (E) and FIGS. 2 (A) and 2 (B). FIG. 1B shows the entire endoscope guide tube (endoscope overtube) 1 for the upper digestive tract according to the present embodiment.

FIG. 1A shows an applied endoscope 2 to which an endoscope guide tube 1 for an upper digestive tract according to the present embodiment is attached. The endoscope 2 is provided with an elongated insertion section 3 and an operation section 4 on a hand side connected to a base end of the insertion section 3. Note that the effective length of the insertion portion 3 of the endoscope 2 of the present embodiment is L1, and the outer diameter is D1 (see FIG. 1C).
And

Further, the endoscope guide tube 1 of the present embodiment has an elongated tube body 5 which is flexible and through which the insertion portion 3 of the endoscope 2 is inserted, and a base of the tube body 5. A grip portion 6 is provided at an end portion and is connected to a proximal end side of the insertion portion 3 of the endoscope 2. Further, the tube body 5 is configured by sequentially arranging a soft part (soft part) 7, a hard part (hard part) 8, and a soft part 7 from the grip part 6 side.
Here, the soft portion 7 of the tube body 5 is formed by a soft flexible tube, and the hard portion 8 is formed by a hard flexible tube. In addition, the tube body 5
A rubber hood 9 made of an elastic rubber member is provided at the leading end of the hood.

Also, between the rubber hood 9 and the front end of the soft portion 7 on the front end, between the rear end of the soft portion 7 on the front end and the front end of the hard portion 8, and between the rear end of the hard portion 8 and The flexible portion 7 on the rear end side is connected to the distal end portion by a cylindrical ring member 10. Here, each ring member 10
Has an X-ray opacity in which shadows can be confirmed even under X-ray fluoroscopy.

The rubber hood 9 and the flexible portion 7 on the tip side
1C, the rear end of the rubber hood 9 is externally fitted to the outer peripheral surface of the distal end portion of the ring member 10 and the outer peripheral portion of the rear end portion of the ring member 10 as shown in FIG. In the state where the distal end portion of the flexible portion 7 on the distal end side is externally fitted to the surface, a yarn winding portion 11 is formed by winding a yarn around the outer peripheral surface of the external fitting portion.
The adhesive 12 is applied and fixed to the outer peripheral surface of. In addition, a connecting portion (see FIG. 1D) between the rear end of the soft portion 7 on the front end side and the front end of the hard portion 8, and the rear end and the soft portion 7 on the rear end side of the hard portion 8. A fixing portion having the same configuration is formed in a connecting portion between the fixing portion and the front end portion.

The outer peripheral surface and the inner peripheral surface of the rubber hood 9 are each formed with a tapered tapered surface whose diameter decreases toward the distal end. Further, although the inner diameter D2 of the rubber hood 9 is smaller than the inner diameter D3 of the tube body 5, the outer diameter D1 of the insertion portion 3 of the applicable endoscope 2 is different.
It is set to a larger state.

Also, the gripper 6 of the endoscope guide tube 1 is
As shown in (E), a gripper body 13 and a tightening ring 14 screwed to the distal end of the gripper body 13 are provided. Here, a male screw portion 13a and a tapered tapered tube receiving portion 13b protruding from a distal end side of the male screw portion 13a are provided at a distal end portion of the grip portion main body 13. Further, the fastening ring 14 is provided with a screw hole 14a screwed with the male screw portion 13a of the grip portion main body 13, and a tube fixing portion 14b having a shape corresponding to the tube receiving portion 13b of the grip portion main body 13. Then, with the rear end portion of the flexible portion 7 on the rear end side of the tube body 5 fitted in the tube receiving portion 13b of the grip portion main body 13, the screw hole 14a of the tightening ring 14 and the male screw of the grip portion main body 13 are formed. The portion 13a is screwed. At this time, the rear end of the flexible portion 7 of the tube body 5 is sandwiched and fixed between the tube fixing portion 14b of the tightening ring 14 and the tube receiving portion 13b of the grip portion main body 13 with the screwing of the tightening ring 14. Has become.

A luer base 15 is provided on the outer peripheral surface of the grip body 13. Further, a rubber packing 16 of an elastic rubber member is provided at a base end of the gripper body 13. The rubber packing 16 is provided with an endoscope insertion hole 16a having substantially the same diameter as the outer diameter D1 of the insertion portion 3 of the applicable endoscope 2.

The length of the endoscope guide tube 1 of the present embodiment is set as follows. That is, the entire length L2 of the endoscope guide tube 1 is, for example, 100 cm. Further, the distal end of the rigid portion 8 of the tube body 5 is disposed at a position 75 cm from the proximal end of the endoscope guide tube 1. The length of the grip 6 is 4 cm.

Here, the desirable position of the tip of the rigid portion 8 is desirably located near the duodenal papilla H3d when the guide tube 1 in FIG. It is generally said that the position of the duodenal papilla H3d in an adult is about 60 cm to 65 cm from the incisor. In the endoscope guide tube 1 of the present embodiment, the length is set such that the distal end of the rigid portion 8 can be disposed near the duodenal descending leg H3b where the duodenal bulb H3a to the duodenal papilla H3d are located.

Note that the tip of the rigid portion 8 of the tube body 5 needs to be set within a range of 60 cm to 90 cm due to variations due to the human body. Therefore, the total length of the endoscope guide tube 1 is L
2, and when the length from the base end of the endoscope guide tube 1 to the distal end of the rigid portion 8 is L3, 60 ≦ L3 / L2 × 100 ≦
The range was set to 90.

Further, in this embodiment, a general adult is considered, and the total length L2 of the endoscope guide tube 1 is set to 100 cm.
Is set as a standard, but when considering a target having a body shape that is out of the standard, for example, a child or a person with a good physique, the total length L2 of the endoscope guide tube 1 is 100.
cm to 110c
The length may be in the range of m. Therefore, the total length L2 of the endoscope guide tube 1 is set to 80 cm ≦ L2 ≦ 110 cm.

In the present embodiment, the position of the boundary on the proximal end side of the rigid portion 8 of the endoscope guide tube 1 is set to 30 cm from the proximal end of the endoscope guide tube 1. The width of the setting range of the position of the boundary portion on the base end side of the rigid portion 8 is about 25 to 35 cm.

Further, the effective length L1 of the insertion portion 3 of the endoscope 2 applied to the endoscope guide tube 1 of 100 cm according to the present embodiment.
Is set to 190 cm. Here, the effective length L1 of the insertion section 3 of the endoscope 2 is a length on the distal end side with respect to the buckling member interposed between the insertion section 3 and the operation section 4. The ratio of the effective length L1 of the insertion portion 3 of the endoscope 2 to the total length L2 of the guide tube 1 is such that the insertion portion 3 of the endoscope 2 is inserted alone to the vicinity of the duodenum H3 without inserting the guide tube 1. It is set to a length as long as possible. In the present embodiment, 1.9 is used.
≤ L1 / L2.

The length L3 from the base end of the guide tube 1 to the boundary between the distal end of the hard portion 8 and the soft portion 7 is about 60 to 90% of the total length L2 of the guide tube 1. Is set to As described in the present embodiment, the ratio between the total length L2 of the endoscope guide tube 1 and the length L3 from the base end of the endoscope guide tube 1 to the distal end of the rigid portion 8 is about 75%
Is particularly preferred. That is, it is a numerical value suitable for an ordinary person.

Next, the operation of the above configuration will be described.
Here, referring to FIGS. 2 (A) and 2 (B), the pharynx H0, the esophagus H1, the stomach H2, and the stomach H2 of the patient, which is the upper digestive tract, using the upper digestive tract endoscope guide tube 1 of the present embodiment. Duodenal H3
The procedure for inserting the insertion section 3 of the endoscope 2 into the small intestine H4 via the above will be described. First, the endoscope guide tube 1 for the upper gastrointestinal tract according to the present embodiment is in a state where the endoscope guide tube 1 is shifted to the proximal end side of the insertion portion 3 of the endoscope 2 as shown in FIG. Then, the endoscope guide tube 1 is set in the insertion section 3 of the endoscope 2.

In this state, the endoscope insertion portion 3 protruding from the distal end of the endoscope guide tube 1 is inserted into the body cavity. At this time, the endoscope insertion part 3 is inserted into the pharynx H0, esophagus H1, and stomach H of the patient.
2. It is sequentially led in the order of duodenum H3. And FIG.
As shown in (A), the distal end of the insertion section 3 of the endoscope 1 is set so as to be hooked from the duodenal bulb H3a to the duodenal descending leg H3b.

Thereafter, the endoscope guide tube 1 is inserted into the endoscope insertion section 3.
Along the body cavity. At this time, the endoscope guide tube 1 is inserted into the body such that the rigid portion 8 of the endoscope guide tube 1 is disposed from the esophagus H1 to the duodenum H3 as shown in FIG.

FIG. 2B shows a state in which the endoscope guide tube 1 is disposed at a predetermined position on the human body, and the endoscope insertion section 3 is inserted to the deep part of the ileum H6. Here, since the endoscope insertion portion 3 is inserted along the great bay H2a of the stomach H2, the distal end portion of the endoscope insertion portion 3 projects at least 90 cm or more from the distal end of the endoscope guide tube 1. Need to be.

Therefore, when the effective length of the insertion portion 3 of the endoscope 2 is L1, the relationship with the total length L2 of the endoscope guide tube 1 is 1.9 ≦ L1 / L2, so 8 in application
When the endoscope guide tube 1 of 0 cm is used, the effective length L1 of the insertion portion 3 of the endoscope 2 is 152 cm or more.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the tube body 5 of the endoscope guide tube 1 is configured by sequentially arranging the soft portion 7, the hard portion 8, and the soft portion 7 from the grip portion 6 side. And since the flexible part 7 is arrange | positioned at the front-end | tip of the endoscope guide tube 1 of this Embodiment, buckling near the front-end | tip of the endoscope guide tube 1 does not occur easily. Here, the jejunum and ileum H6 of the small intestine H4 including the duodenum H3 including the duodenum H3 are relatively soft and have a large bend, but the duodenum H3 and the small intestine H
Since the endoscope guide tube 1 can be inserted in accordance with the travel of the jejunum 4 and the ileum H6, the insertability is improved.

Furthermore, since the flexible portion 7 on the proximal end side of the tube body 5 of the endoscope guide tube 1 is arranged at the base of the patient's throat, the larynx H0 has a large bend, but is flexible along the bent shape of the larynx H0. The part 7 can be curved. For this reason, buckling can be prevented from easily occurring in the flexible portion 7 on the proximal end side of the tube body 5 of the endoscope guide tube 1, so that the endoscope 2 can be easily inserted and the endoscope guide tube 1 can be improved. Since the tube body 5 is not straightened, there is little invasion to the patient.

Further, since the rubber hood 9 is provided at the forefront of the endoscope guide tube 1, the mucous membrane does not easily get caught between the insertion portion 3 of the endoscope 2 and the endoscope guide tube 1. Patient safety is improved. Furthermore, this rubber hood 9
Is formed in a tapered shape toward the distal end, so that the endoscope guide tube 1 can easily pass through the pylorus H5 having a small inner diameter.
Can be improved.

Further, in the present embodiment, the endoscope guide tube 1
From the base end of the endoscope guide tube 1 to the rigid portion 8.
80cm ≦ L2 ≦ 1 when L3 is the length to the tip of
Since 10 cm and 60% ≦ L3 / L2 × 100 ≦ 90% were set, the rigid portion 8 of the endoscope guide tube 1 was connected to the esophagus H1 of the patient.
To the duodenum H3. Therefore, stomach H2 from esophagus H1 (stomach angle H2 from small bay H2b)
c, from the pylorus H5) to the duodenum H3, so that the endoscope 2 can be more easily inserted deep into the upper digestive tract.

When the effective length of the endoscope 2 applied to the endoscope guide tube 1 of the present embodiment is L1, 1.9 ≦ L
Since it is set to 1 / L2, the length of the insertion portion 3 of the endoscope 2 protruding from the distal end of the endoscope guide tube 1 can be sufficiently ensured. Therefore, as shown in FIG.
Can easily be hooked on the duodenum H3, so that the operation of arranging the endoscope guide tube 1 at a desired position with the insertion portion 3 of the endoscope 2 as a guide is facilitated. Workability can be improved.

The rubber packing 1 is attached to the base end of the grip 6.
Since the attachment 6 is provided, it is possible to prevent the filth coming out of the tube body 5 of the endoscope guide tube 1 from flowing out to the operator side, which is sanitary.

Further, a luer cap 1 is provided on the outer peripheral surface of the gripper 6.
5 is provided, and the rubber packing 16 is provided at the base end of the gripping portion 6, so that the lure base 15 is provided between the tube body 5 of the endoscope guide tube 1 and the outer peripheral surface of the insertion portion 3 of the endoscope 2. Lubricant can be injected. Therefore, the frictional resistance between the tube body 5 of the endoscope guide tube 1 and the outer peripheral surface of the insertion section 3 of the endoscope 2 can be reduced, so that the insertability of the endoscope 2 can be further improved. There is also.

FIG. 3 shows a second embodiment of the present invention. In this embodiment, the most distal end of the tube body 5 in the upper digestive tract endoscope guide tube 1 of the first embodiment (see FIGS. 1A to 1E and FIGS. 2A and 2B). The configuration of the unit is changed as follows.

That is, in this embodiment, the member 2 corresponding to the rubber hood 9 and the ring member 10 of the first embodiment is used.
1 is provided with a tip rubber hood unit 22 integrally formed by insert molding. In this embodiment, the same effects as in the first embodiment can be obtained.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) In an endoscope overtube having flexibility, a tube body composed of a hard portion and a soft portion and a gripping portion, the effective length of the endoscope to be applied is C, Assuming that the overall length of the overtube is B and the length from the hand side of the overtube to the tip of the hard portion of the tube is A, 60 ≦ A / B × 100 ≦ 90,1.
An endoscope overtube having a relationship of 9 ≦ C / B.

(Additional Item 2) The endoscope overtube according to additional item 1, wherein when the overall length of the overtube is B, 80 cm ≦ B ≦ 110 cm.

(Additional Item 3) The endoscope overtube according to additional item 1, wherein the tube body of the endoscope overtube is connected in the order of a soft part, a hard part, and a soft part.

(Conventional Techniques of Supplementary Items 1 and 2) Conventionally, an endoscope overtube has a flexible and hard portion and a soft portion as described in Japanese Patent Application Laid-Open No. 10-262918. There is known an endoscope overtube having a tube body and a gripping portion. However, there is no conventional endoscope overtube that shows a relationship between the effective length of the endoscope applied to the endoscope overtube and the total length of the endoscope overtube. As a result, the overtube could not be arranged at a desired position, and the insertability was sometimes impaired.

In the conventional endoscope overtube, the distal end of the hard portion of the tube body is not clear. Therefore, even if the endoscope overtube is inserted along the endoscope insertion part, the hard part of the tube of the endoscope overtube does not catch on the duodenal bulb or the descending leg of the duodenum, and the endoscope overtube is not inserted. The tip of the tube fell into the stomach and could not be linearized from the esophagus to the duodenum, resulting in impaired insertability.

(Problems to be Solved by Additional Items 1 and 2)
As shown in FIG. 2 (A), the endoscope overtube is passed through the endoscope insertion tube to the endoscope insertion portion to which the endoscope is inserted. Move and hold the overtube. Then, the insertion portion of the endoscope protruding from the end of the endoscope overtube is inserted into the body cavity, and the end of the endoscope insertion portion is inserted from the duodenal bulb to the duodenal descending leg. then,
Slide the overtube for the endoscope along the endoscope insertion section with the overtube for the endoscope, and when the tip of the harder part of the tube body of the overtube for the endoscope is sufficiently inserted into the duodenum, Advance the insertion of the endoscope after the duodenum.

Conventionally, the length of the insertion portion of the endoscope to be applied to the endoscope overtube and the total length of the endoscope overtube have not been clearly defined. was there.

When the effective length of the insertion section of the endoscope to be applied is too short with respect to the entire length of the endoscope overtube, and the endoscope overtube is held at the base end of the endoscope insertion section. The insertion portion of the endoscope cannot be hooked on the duodenal bulb or the duodenum, and thus the overtube cannot be arranged at a desired position, and the insertability may be impaired.

Further, in the related art, the tip of the harder portion of the tube body is not clear with respect to the endoscope overtube. Therefore, even if the endoscope overtube is inserted along the endoscope insertion part, the hard part of the tube of the endoscope overtube does not catch on the duodenal bulb or the descending leg of the duodenum, and the endoscope overtube is not inserted. The tube tip could fall into the stomach. As a result, the esophagus to the duodenum cannot be linearized, and the insertability may be impaired.

(Purposes of Additional Items 1 and 2) The present application has been devised in view of the above problems, and has as its object to improve the insertability of an endoscope.

(Means for Solving the Problem in Additional Item 1)
In an endoscope overtube having flexibility, a tube body composed of a hard part and a soft part and a gripping part, the effective length of the applicable endoscope is C, and the total length of this overtube is B When the length from the hand side of the overtube to the tip of the hard portion of the tube is A, the overscope for an endoscope has a relationship of 60 ≦ A / B × 100 ≦ 90, 1.9 ≦ C / B. tube.

(Means for Solving the Problem in Additional Item 2)
In an endoscope overtube having flexibility, a tube body composed of a hard part and a soft part and a gripping part, the effective length of the applicable endoscope is C, and the total length of this overtube is B When the length from the hand side of the overtube to the tip of the hard portion of the tube is A, 80 cm ≦ B ≦ 110 cm, 60 ≦ A / B × 10
An endoscope overtube having a relationship of 0 ≦ 90, 1.9 ≦ C / B.

(Conventional technique of Appendix 3) Conventionally, an overtube for an endoscope is composed of a flexible, hard part and a soft part, as described in JP-A-10-262918. 2. Description of the Related Art An endoscope overtube having a tube body and a grip portion is known. However, in the conventional endoscope overtube, the distal end side of the tube body is configured to be soft, and the proximal side remains a hard tube. Therefore, the tube was easily straightened at the throat of the patient, and the invasion of the patient was large. Conversely, when the tube is forcibly bent, the tube body is easily buckled, and the insertability may be impaired.

(Problem to be Solved by Additional Item 3) Conventionally, an endoscope overtube is disclosed in Japanese Patent Application Laid-Open No. 10-2629.
As described in Japanese Patent Publication No. 18, an overtube for an endoscope having a flexible, hard tube and a soft tube, and a grip portion is known. However, in the conventional endoscope overtube, the distal end side of the tube body is configured to be soft and the proximal side remains a hard tube. Therefore, when the distal end of the tube is inserted into the duodenum and the ileum therebefore, it can be inserted along the running of the intestine due to its softness,
The tube was easily straightened near the patient's throat, and the patient was invasive. Conversely, when the tube is forcibly bent, the tube body is easily buckled, and the insertability may be impaired.

(Purpose of Supplementary Item 3) The present application has been devised in view of the above problems, and reduces invasion to a patient.
An object of the present invention is to improve the insertability of an endoscope.

(Means for Solving the Problem in Additional Item 3)
2. The endoscope overtube according to claim 1, wherein the tube body of the endoscope overtube is connected in the order of a soft part, a hard part, and a soft part.

(Effects of Additional Items 1 to 3) When the total length B of the overtube for an endoscope and the length from the base end of the overtube for an endoscope to the distal end of the rigid portion are A, 80 cm
By setting ≦ B ≦ 110 cm and 60% ≦ A / B × 100 ≦ 90%, the rigid portion of the endoscopic overtube can be placed from the patient's esophagus to the duodenum, thereby allowing the esophagus to stomach (small). From the bay to the antrum and pylorus) to the duodenum,
The insertability of the endoscope up to a deep portion can be improved.

When the effective length of the endoscope applied to this overtube is C, by setting 1.9 ≦ C / B, the endoscope insertion portion protruding from the end of the endoscope overtube Since the length of the endoscope can be sufficiently secured, the distal end of the endoscope insertion portion can be easily hooked on the duodenum. Therefore, it becomes easy to arrange the endoscope overtube at a desired position using the insertion portion of the endoscope as a guide, and it is possible to improve the workability at the time of insertion.

The jejunum and ileum beyond the duodenum, including the duodenum, are relatively soft and have large bends. The distal end of the endoscope overtube has a flexible part, so that the endoscope overtube can be inserted as the duodenum, jejunum, and ileum travel, preventing buckling near the endoscope overtube end. It hardly occurs, and the insertability is improved.

A flexible portion is provided on the proximal end side of the tube body of the overtube for an endoscope, and the flexible portion is disposed at the throat of a patient. The larynx has a large bend, but buckling is unlikely to occur because the flexible portion curves along the bend. Accordingly, the insertability of the endoscope is improved, and the invasion to the patient is reduced because the tube is not straightened.

A rubber hood is provided at the forefront of the endoscope overtube, which makes it difficult for the mucous membrane to be caught between the endoscope insertion portion and the endoscope overtube, thereby improving patient safety. I do. Further, since the rubber hood is formed in a tapered shape toward the distal end, the rubber hood can easily pass through the pylorus having a small inner diameter, and the insertability of the endoscope overtube can be improved.

Since the rubber packing is attached to the base end of the gripping portion, it is possible to prevent the waste coming out of the tube from flowing out to the operator side, which is sanitary.

Since the luer base is provided on the outer periphery of the gripper and the packing is provided at the base end of the gripper, a lubricant is applied between the overtube for endoscope and the outer periphery of the endoscope insertion part from the luer base. Since the injection can be performed and the frictional resistance can be reduced, the insertability of the endoscope can be improved.

[0071]

According to the first aspect of the present invention, the tube body is constituted by sequentially arranging the soft part, the hard part, and the soft part from the gripping part side, so that the guide tube buckles around the pharynx and the duodenum. Can be prevented.

According to the second aspect of the present invention, the length from the base end of the endoscope guide tube to the hard portion of the tube is set to be about 60 to 90% of the entire length of the endoscope guide tube. Can be easily inserted into the duodenum.

According to the third aspect of the present invention, since the effective length of the insertion portion of the endoscope is set to 1.9 times or more of the entire length of the tube body, it is possible to insert the endoscope alone to the vicinity of the duodenum in advance. Thus, the burden on the patient can be reduced and the operability of the operator can be improved.

[Brief description of the drawings]

FIG. 1 shows a first embodiment of the present invention;
(A) is a side view of the entire endoscope, (B) is a side view of the entire endoscope guide tube for the upper gastrointestinal tract, (C) is a longitudinal sectional view showing a distal end portion of the tube body of the endoscope guide tube, (D) is a longitudinal sectional view showing an intermediate portion of the tube body of the endoscope guide tube, and (E) is a longitudinal sectional view showing a grip portion of the endoscope guide tube.

FIG. 2 shows a state of use of the endoscope guide tube for the upper gastrointestinal tract according to the first embodiment, where (A) is a view for explaining a state before the endoscope guide tube is inserted into a body. Figure, (B)
FIG. 4 is an explanatory diagram for explaining a state in which the endoscope guide tube is inserted into a body.

FIG. 3 is a longitudinal sectional view showing a distal end rubber hood unit in an endoscope guide tube for an upper digestive tract according to a second embodiment of the present invention.

FIG. 4 is an explanatory diagram for explaining a procedure for inserting an endoscope into an upper digestive tract of a human body.

[Explanation of symbols]

 2 Endoscope 3 Insertion part 5 Tube body 6 Grip part 7 Soft part (soft part) 8 Hard part (hard part)

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[Procedure amendment]

[Submission date] May 25, 1999 (1999.5.2
5)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] Claim 1

[Correction method] Change

[Correction contents]

[Procedure amendment 2]

[Document name to be amended] Statement

[Correction target item name] Claim 2

[Correction method] Change

[Correction contents]

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Kansai Naito, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Haruhiko Kaiya 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Takahiro Kishi 2-43-2 Hatagaya, Shibuya-ku, Tokyo F-term (reference) 4C061 AA03 BB00 CC00 DD03 FF24 GG24

Claims (3)

[Claims] 1. A tube having flexibility and through which an insertion portion of an endoscope is inserted, and a tube disposed at a base end of the tube, and a base end side of the insertion portion of the endoscope. An endoscope guide tube for an upper gastrointestinal tract having a grip portion connected to a tube, wherein the tube body is sequentially softened from the grip portion side,
An endoscope guide tube for an upper gastrointestinal tract, wherein a hard portion and a soft portion are sequentially arranged. 2. A length from a base end of the endoscope guide tube to a hard portion of the tube body is set to about 60 to 90% with respect to the entire length of the endoscope guide tube. An endoscope guide tube for an upper gastrointestinal tract according to claim 1. 3. The endoscope guide tube for an upper gastrointestinal tract according to claim 1, wherein the effective length of the insertion portion of the endoscope is set to 1.9 times or more of the entire length of the tube body. .