JP2002238838A - Duodenum endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a duodenum endoscope that can smoothly and easily make a diagnosis and perform treatment by easily having a front view of a Vater's papilla. SOLUTION: An observation optical axis going outward from an observation aperture 12 viewing from the hand side, inclines clockwise to an upward direction UP in the bent direction of a curved part 3.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a duodenal endoscope which is inserted from the mouth into the duodenum via the stomach.

[0002]

2. Description of the Related Art An important role of a duodenal endoscope is to insert various treatment tools such as a contrast tube into a pancreatic bile duct having an opening in the duodenum to perform various treatments on gallstones and the like without laparotomy.

[0003] The duodenal endoscope used for this purpose is not special as compared with a general endoscope, and a bending portion which is bent by remote control from the hand side is provided at the distal end portion of the insertion portion flexible tube. ing.

[0004] A distal end main body having an observation window and a treatment tool outlet on the side surface is connected to the distal end of the curved portion, and an observation optical axis directed outward from the observation window is directed upward in the bending direction of the curved portion. It is suitable.

[0005]

One of the problems when a duodenal endoscope is used is that, as shown in FIG. 7, a Vater's papilla 101 having an outlet opening of a pancreaticobiliary duct to a duodenum 100 is used. When viewed from the hand side, the light enters only near the right end of the observation field A obtained from the observation window 12 of the endoscope.

[0006] This is a restriction caused by the anatomical shape of the lumen from the mouth into which the endoscope is inserted, passes through the stomach and reaches the duodenum. In many cases, it was difficult to perform diagnosis and treatment smoothly.

Accordingly, an object of the present invention is to provide a duodenal endoscope which allows smooth and easy diagnosis and treatment by easily observing Vater's papilla in frontal view.

[0008]

In order to achieve the above object, a duodenal endoscope according to the present invention is provided with a curved portion which is bent by remote operation from a hand side at a distal end portion of an insertion portion flexible tube, In a duodenal endoscope in which an observation window and a treatment tool outlet are arranged on the side surface and a distal end body is connected to a distal end of a curved portion, an observation optical axis directed outward from the observation window when viewed from the hand side is curved. It is inclined clockwise with respect to the upward direction in the bending direction of the part.

It is preferable that the observation optical axis is inclined by 10 ° to 45 ° with respect to the upward direction in the bending direction of the curved portion.

[0010]

Embodiments of the present invention will be described with reference to the drawings. FIG. 3 shows the entire configuration of the duodenal endoscope, in which a bending section 3 is connected to a distal end of an insertion section flexible tube 2 connected to an operation section 1 and an observation window or the like is disposed.
1 is connected to the tip of the bending portion 3.

A bending operation knob 5 (5UD, 5RL) for bending an operation wire 4 in an arbitrary direction and at an arbitrary angle by remote control is disposed on a side of the upper half of the operation unit 1. An operation button 6 and a suction operation button 7 are arranged on the front. At the lower end of the operation unit 1, an entrance 8 for the treatment instrument insertion channel is provided to project obliquely upward.

The vertical bending operation knob 5UD includes an upper operation wire 4U and a lower operation wire 4D each having a distal end connected to a distal end portion of the bending portion 3 so as to bend the bending portion 3 in each of up and down directions. Each base end is connected, and the bending portion 3 can be bent at an arbitrary angle in each of the vertical direction by rotating the vertical bending operation knob 5UD.

The “upward direction” in the bending direction of the bending portion 3 is the “UP” direction indicated by an arrow in FIG.
The direction coincides with the front side of the operation unit 1 and coincides with the upper direction of the observation screen.

The left and right bending operation knobs 5RL arranged so as to overlap with the vertical bending operation knobs 5UD have left ends connected to the front end portions of the bending portions 3 so as to bend the bending portions 3 in the left and right directions. The base ends of the operating wire 4L for the right direction and the operating wire 4R for the right direction (shown in FIG. 6) are connected, and the bending portion 3 can be freely moved in each of the left and right directions by rotating the right and left bending operation knob 5RL. Angle can be bent.

FIG. 4 is a side sectional view of a portion of the bending portion 3 near the front end and the front end main body 11. However, the cross section of the bending portion 3 in the up-down direction is shown, but the cross section including the observation optical axis X is shown for the distal end main body 11.

The tip end body 11 is formed in a shape in which one side surface of a round bar-shaped material is scraped off in a plane, and an observation window 12 and an illumination window 13 are arranged side by side on the plane portion 11a. Is smoothly rounded.

An emission end face of a light guide fiber bundle 17 for illumination is arranged inside the illumination window 13, and an object is illuminated by illumination light radiated outward from the illumination window 13.

The observation optical axis X extending outward from the observation window 12 is perpendicular to the observation window 12.
The observation light image of the subject incident from the
After being bent at a right angle by 4, an image is formed on the incident end face of the image guide fiber bundle 16 by the objective lens 15.

The bending portion 3 is a publicly-known one formed by rotatably connecting a plurality of node rings 31 with rivets or the like, and the operating portion 1 of the four operating wires 4U, 4D, 4L, and 4R. It bends in the direction where the operation wire pulled from the side is located.

FIG. 5 shows a front view of the flat portion 11a on which the observation window 12 and the illumination window 13 are arranged, and shows a treatment tool outlet 21 which is an outlet opening of the treatment tool insertion channel.
Are formed side by side with the observation window 12 and the illumination window 13, and a treatment tool raising piece 22 for controlling the projection direction of the treatment tool is arranged in the treatment tool outlet 21.

FIG. 6 is a perspective view of the vicinity of the connecting portion between the bending portion 3 and the distal end main body 11 as viewed from the hand side (that is, the operating portion 1 side).
The relationship between the mounting positions of the tips of D, 4L, and 4R and the observation optical axis X is shown.

As shown in FIG. 6, the distal end of the upward operation wire 4U is connected and fixed to the upward UP position of the bending section 3, and the upward operation wire 4U is pulled from the operation section 1 side. This causes the bending portion 3 to bend in the upward direction UP.

On the other hand, the observation optical axis X perpendicular to the observation window 12 is tilted clockwise by an angle θ with respect to the upward direction UP when viewed from the near side. (The flat portion 11a of the distal end portion main body 11 in which the observation window 12 is arranged is formed in such a direction). Θ is 10 ° to 45 °
In the range of degrees.

FIG. 1 shows a state in which the bending portion 3 of the duodenal endoscope constructed as described above is bent in the upward direction UP, and the observation optical axis X is viewed from the near side with respect to the upward direction UP. Tilted clockwise. Note that the alternate long and short dash line indicates an upward direction extending from the insertion portion flexible tube 2 to the bending portion 3.

When the thus constructed duodenal endoscope is inserted from the patient's mouth through the stomach to the duodenum, FIG.
As shown in FIG. 2, the upward direction UP of the curved portion 3 located in the duodenum 100 is shifted to the left from the Vater's nipple 101 from the anatomical shape, but the observation optical axis X is , The Vater's nipple 101 can be observed near the center of the observation range A.

[0026]

According to the present invention, when viewed from the hand side, the observation optical axis directed outward from the observation window is inclined clockwise with respect to the upward direction in the bending direction of the curved portion. When the endoscope is inserted from the mouth into the duodenum via the stomach, the observation optical axis is directed to the Vater's nipple, making it possible to perform a diagnosis and treatment smoothly and easily by viewing the Vater's nipple in front. it can.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a state in which a curved portion of a duodenal endoscope according to an embodiment of the present invention is bent upward.

FIG. 2 is a schematic diagram showing a cross section perpendicular to an axis viewed from the hand side in a state where the duodenal endoscope according to the embodiment of the present invention is inserted into the duodenum.

FIG. 3 is an external view showing the entire configuration of a duodenal endoscope according to an embodiment of the present invention.

FIG. 4 is a side sectional composite view of a distal end portion of the duodenal endoscope according to the embodiment of the present invention.

FIG. 5 is an external view of the duodenal endoscope according to the embodiment of the present invention as viewed from the front, where a flat portion where an observation window and an illumination window are arranged at the distal end portion is arranged.

FIG. 6 is a perspective view of the vicinity of a connection portion between the curved portion and the distal end body of the duodenal endoscope according to the embodiment of the present invention, as viewed from the hand side.

FIG. 7 is a schematic view of a state in which a conventional duodenal endoscope is inserted into the duodenum, and a cross section perpendicular to the axis is viewed from the hand side.

[Explanation of symbols]

 3 Bending part 4U Upward operation wire 5UD Up / down bending operation knob 11 Tip body 12 Observation window A Observation range X Observation optical axis UP Upward

Claims (2)

[Claims] A bending portion which is bent by remote operation from a hand side is provided at a distal end portion of an insertion portion flexible tube, and a distal end portion main body having an observation window and a treatment instrument protruding port arranged on a side surface is provided at the bending portion. In the duodenal endoscope connected to the distal end, when viewed from the hand side, the observation optical axis directed outward from the observation window is inclined clockwise with respect to the upward direction in the bending direction of the bending portion. A duodenal endoscope characterized by the following. 2. The duodenal endoscope according to claim 1, wherein the observation optical axis is inclined by 10 ° to 45 ° with respect to an upward direction in the bending direction of the bending portion.