JP2002306398A - 内視鏡装置及び留置チューブの留置方法 - Google Patents

内視鏡装置及び留置チューブの留置方法

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Publication number
JP2002306398A
JP2002306398A JP2002023347A JP2002023347A JP2002306398A JP 2002306398 A JP2002306398 A JP 2002306398A JP 2002023347 A JP2002023347 A JP 2002023347A JP 2002023347 A JP2002023347 A JP 2002023347A JP 2002306398 A JP2002306398 A JP 2002306398A
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Japan
Prior art keywords
distal end
endoscope
guide catheter
guide
endoscope insertion
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JP3939158B2 (ja
Inventor
Nobuyuki Matsuura
伸之 松浦
Masaaki Nakazawa
雅明 中沢
Toshio Nakamura
俊夫 中村
Hisao Yabe
久雄 矢部
Yorio Matsui
頼夫 松井
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Olympus Corp
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Olympus Optical Co Ltd
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Priority to JP2002023347A priority Critical patent/JP3939158B2/ja
Priority to US10/067,585 priority patent/US6786864B2/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131—Accessories for endoscopes
    • A61B1/0014—Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
    • A61B1/05—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)

Abstract

(57)【要約】 【課題】 体腔内に留置チューブ又はこの留置チューブ
をガイドするためのガイド部材を留置する際、操作性良
く、簡便に留置操作を行なうことが可能な内視鏡装置及
び留置チューブの留置方法を実現する。 【解決手段】 内視鏡装置１は、内視鏡挿入部１１の外
周軸方向に沿わせて配設する留置チューブ又はガイド部
材（ガイドカテーテル３０）の先端部を前記内視鏡挿入
部１１の先端部２１側に着脱自在に固定保持するため
に、前記内視鏡挿入部１１の先端部２１に対して着脱自
在に設ける固定具（ガイドカテーテル固定具３１ａ）を
有して構成される。

Description

【発明の詳細な説明】
【０００１】
【発明の属する技術分野】本発明は、内視鏡装置及び留
置チューブの留置方法に関する。
【０００２】
【従来の技術】一般に、医療用等に用いられる内視鏡
は、生体体腔内の小手術や生体組織の検査等を行なうこ
とができる。
【０００３】従来、内視鏡は、挿入部の内部に設けられ
た処置具挿通用チャンネルを介して留置チューブやガイ
ドワイヤ等のガイド部材を体腔内へ導き、体腔内へ留置
したりしている。また、特開平１１−１９２２０３号公
報に記載されている内視鏡では、挿入部先端部側に内視
鏡とは別体のものとして、必要により外付けチャンネル
を装着固定して設け、この外付けチャンネルを介して処
置具等を体腔内に挿入可能にしている。
【０００４】
【発明が解決しようとする課題】しかしながら、従来の
内視鏡では、体腔内に留置チューブを留置する際、体腔
内に挿入した内視鏡挿入部の処置具挿通用チャンネルを
介してガイドワイヤを挿通し、このガイドワイヤを介し
て体腔内の目的部位まで留置チューブを導き、留置チュ
ーブを目的部位に留置している。そして、留置チューブ
を留置した後、内視鏡を抜去する場合、ガイドワイヤや
留置チューブの長さが内視鏡挿入部の長さの２倍以上必
要になり、留置操作する上で繁雑であった。この煩雑さ
は、特開平１１−１９２２０３号公報に記載されている
内視鏡でも同様であった。
【０００５】また、従来の内視鏡や特開平１１−１９２
２０３号公報に記載されている内視鏡では、上記処置具
挿通用チャンネルの内径と同等かあるいはこれより径の
大きい留置チューブを上記処置具挿通用チャンネルに挿
通させることができない。このため、上記内視鏡は、上
記処置具挿通用チャンネルの内径より太い径を有する留
置チューブを留置する場合、ガイドワイヤを留置したま
ま内視鏡挿入部を体外に抜去し、留置したガイドワイヤ
に沿って留置チューブを体腔内の目的部位まで導いてい
た。しかしながらこのような操作では、留置チューブの
留置が完了するまで繁雑な作業が必要であった。また、
この場合、内視鏡挿入部を抜去したままの状態で留置チ
ューブを体腔内の目的部位まで導くことになり、内視鏡
観察下で上記留置操作を行なうことができず、留置操作
する上で繁雑であった。
【０００６】本発明は、これらの事情に鑑みてなされた
ものであり、体腔内に留置チューブ又はこの留置チュー
ブをガイドするためのガイド部材を留置する際に、操作
性良く、簡便に留置操作を行なうことが可能な内視鏡装
置及び留置チューブの留置方法を提供することを目的と
する。
【０００７】
【課題を解決するための手段】本発明の請求項１の内視
鏡は、内視鏡挿入部の外周軸方向に沿わせて配設する留
置チューブ又はこの留置チューブをガイドするためのガ
イド部材の先端部を前記内視鏡挿入部の先端部側に着脱
自在に固定保持するために、前記内視鏡挿入部の先端部
に対して着脱自在に設ける固定具を有することを特徴と
している。本発明の請求項２の内視鏡装置は、体腔内に
挿入される細長な挿入部を有する内視鏡と、この内視鏡
挿入部の外周軸方向に沿わせて配設する留置チューブ又
はこの留置チューブをガイドするためのガイド部材の先
端部を前記内視鏡挿入部の先端部側に着脱自在に固定保
持するために前記内視鏡挿入部の先端部に設けた固定具
と、を具備したことを特徴としている。本発明の請求項
３の留置チューブの留置方法は、体腔内に挿入される細
長な内視鏡挿入部の先端部に、ガイドカテーテルの先端
部を着脱自在に固定保持するガイドカテーテル固定具を
装着し、前記内視鏡挿入部の外周軸方向に沿わせて前記
ガイドカテーテルの先端部を前記ガイドカテーテル固定
具に固定保持し、前記ガイドカテーテルの先端部を固定
保持した状態で前記内視鏡挿入部を体腔内に挿入して目
的部位まで到達させ、前記ガイドカテーテルの先端部を
前記ガイドカテーテル固定具から外し、前記ガイドカテ
ーテル内にガイドワイヤを挿入し、このガイドワイヤ先
端を前記ガイドカテーテル先端から突出させ、前記ガイ
ドカテーテルを体腔内から抜去する一方、前記ガイドワ
イヤ先端を目的部位に到達させ、留置チューブを前記ガ
イドワイヤに沿わせて体腔外から目的部位まで挿入し、
この留置チューブを体腔内の目的部位に留置し、その
後、前記内視鏡挿入部を体腔内から抜去することを特徴
としている。この構成により、体腔内に留置チューブ又
はこの留置チューブをガイドするためのガイド部材を留
置する際、操作性良く、簡便に留置操作を行なうことが
可能な内視鏡装置及び留置チューブの留置方法を実現す
る。
【０００８】
【発明の実施の形態】以下、図面を参照して本発明の実
施の形態を説明する。 （第１の実施の形態）図１ないし図８は本発明の第１の
実施の形態に係る図である。図１は本発明の第１の実施
の形態の内視鏡装置の全体構成を示す全体構成図であ
る。図２は図１の内視鏡挿入部の先端部側を示す斜視図
である。図３は図２の内視鏡挿入部の先端部に装着する
ガイドカテーテル固定具を示す説明図であり、図３
（ａ）はガイドカテーテル固定具の斜視図、図３（ｂ）
は図３（ａ）の断面図である。図４は図３（ｂ）のガイ
ドカテーテル固定保持部の先端側に形成した縮径部が貫
通するように構成したガイドカテーテル固定具の断面図
である。図５は本発明の第１の実施の形態の留置チュー
ブの留置方法を説明する説明図であり、図５（ａ）は内
視鏡挿入部の先端部に装着したガイドカテーテル固定具
にガイドカテーテルの先端部を固定保持している際の説
明図、図５（ｂ）は図５（ａ）の状態からガイドカテー
テルの先端部をガイドカテーテル固定具のガイドカテー
テル固定保持部から外した際の説明図、図５（ｃ）は図
５（ｂ）の状態からガイドカテーテル内にガイドワイヤ
を挿入しガイドカテーテルの先端からガイドワイヤを突
出させた際の説明図、図５（ｄ）は図５（ｃ）の状態か
らガイドカテーテルのみを体腔内から抜去した際の説明
図、図５（ｅ）は図５（ｄ）の状態からガイドワイヤの
先端を目的部位に到達させた後、このガイドワイヤに沿
わせて留置チューブを目的部位まで挿入している際の説
明図である。図６は図３の他の変形例を示すガイドカテ
ーテル固定具の説明図であり、図６（ａ）は図３（ａ）
のガイドカテーテル固定具に縮径形状部を形成した達磨
形状のガイドカテーテル固定具の斜視図、図６（ｂ）は
図６（ａ）の断面図である。図７は図６の変形例を示す
ガイドカテーテル固定具の説明図であり、図７（ａ）は
図６（ａ）のガイドカテーテル固定具にテーパ部を形成
して、先端方向に向かってテーパ状に縮径したガイドカ
テーテル固定具の斜視図、図７（ｂ）は図７（ａ）の断
面図である。図８は図７の変形例を示すガイドカテーテ
ル固定具の説明図であり、図８（ａ）は図７（ａ）のガ
イドカテーテル固定具の後端部に延出する舌状部を設け
たガイドカテーテル固定具の斜視図、図８（ｂ）は図８
（ａ）の断面図である。
【０００９】図１に示すように本発明の第１の実施の形
態を備えた内視鏡装置１は、撮像装置として図示しない
撮像手段を有する電子内視鏡（単に内視鏡）２と、この
内視鏡２に照明光を供給する光源装置３と、前記内視鏡
２で得た画像信号に対して信号処理を行なうビデオプロ
セッサ４と、このビデオプロセッサ４から出力される映
像信号を受けて内視鏡画像を表示するモニタ５とで主に
構成されている。尚、前記ビデオプロセッサ４は、映像
信号を記録再生するＶＴＲ６と、映像信号により被写体
像を印字するビデオプリンタ７と、映像信号を記録する
大容量の記憶装置であるビデオディスク８等が接続され
るようになっている。
【００１０】前記内視鏡２は、先端部に図示しない撮像
手段を内臓し、観察対象の管腔内に挿入可能な細長で可
撓性を有する挿入部１１と、この挿入部１１の基端側に
折れ止め部１２を介して連結した保持部を兼ねる操作部
１３と、この操作部１３の側部から延出し、端部にコネ
クタ部１４を有する可撓性のユニバーサルコード１５と
から構成される。前記挿入部１１は、先端から硬質の先
端部２１と、この先端部２１の基端側に連設され湾曲自
在に形成された湾曲部２２と、この湾曲部２２の基端側
に連設された可撓性を有する可撓管部２３とで構成され
る。
【００１１】前記操作部１３には、前記挿入部１１の湾
曲部２２を遠隔操作で上下方向に湾曲させる上下湾曲操
作ノブ２４ａと、同じく前記湾曲部２２を左右方向に湾
曲させる左右湾曲操作ノブ２４ｂとが設けられている。
これら上下操作ノブ２４ａと左右操作ノブ２４ｂとを同
時に操作することで、前記湾曲部２２を上下左右の中間
方向（ツイスト方向）へ湾曲させることも可能である。
また、前記操作部１３は、この前端付近に処置具挿入口
２５が設けられている。この処置具挿入口２５は、操作
部１３と挿入部１１、そして湾曲部２２内部に挿通配設
された図示しない処置具挿通用チャンネルに連結してい
る。この処置具挿入口２５から処置具挿通用チャンネル
を経て処置具の先端側を前記挿入部１１の先端部２１の
開口２６から突出可能となっている。また、前記操作部
１３は、送気・送水操作を遠隔操作する送気送水ボタン
２７ａ、吸引操作を遠隔操作する吸引ボタン２７ｂ及び
画像静止ボタン、レリーズボタン、調光方法切り換えボ
タン等のビデオプロセッサ４の機能を遠隔操作する操作
スイッチ２７ｃを設けている。
【００１２】前記内視鏡２は、前記光源装置３から照明
光が供給されるようになっている。前記光源装置３から
供給された照明光は、内視鏡２内の図示しないライトガ
イドを経由して照明光学系２８から被写体を照明するよ
うになっている。照明された被写体像は、前記内視鏡挿
入部１１の先端部２１に内蔵された対物光学系２９から
取り込まれ、前記撮像手段で撮像されるようになってい
る。ビデオプロセッサ４は、前記内視鏡２の撮像手段か
らの撮像信号を図示しない信号処理回路で信号処理し、
モニタ５に伝送して内視鏡画像を表示させるようになっ
ている。
【００１３】図２に示すように前記内視鏡２は、この内
視鏡挿入部１１の外周軸方向に留置チューブやガイドワ
イヤ等のガイド部材を沿わせるようになっている。尚、
図中では、ガイド部材としてガイドカテーテル３０を沿
わせている。
【００１４】本実施の形態では、前記内視鏡挿入部１１
の外周軸方向に沿わせて配設する前記ガイド部材として
前記ガイドカテーテル３０の先端部を前記内視鏡挿入部
１１の先端部２１側に着脱自在に固定保持するために、
前記内視鏡挿入部１１の先端部２１に対して着脱自在に
設ける固定具を有するように構成する。
【００１５】前記ガイドカテーテル３０の先端部を前記
内視鏡挿入部１１の先端部２１側に対して着脱自在に固
定保持するためのガイドカテーテル固定具３１ａは、略
円筒状の弾性材料で形成されている。このガイドカテー
テル固定具３１ａは、貫通孔である内視鏡先端取付孔３
２に前記内視鏡挿入部１１の先端部２１を着脱自在に嵌
着することで、この内視鏡挿入部１１の先端部２１に固
定装着されるようになっている。
【００１６】図３（ａ），（ｂ）に示すように前記内視
鏡先端取付孔３２の内径は、前記内視鏡挿入部１１の先
端部２１の外径より若干小さく形成されており、前記弾
性材料の弾性変形により前記内視鏡挿入部１１の先端部
２１に締め付け固定するようになっている。
【００１７】前記ガイドカテーテル固定具３１ａは、固
定保持手段としてガイドカテーテル固定保持部３３ａを
設けている。このガイドカテーテル固定保持部３３ａ
は、前記ガイドカテーテル３０の先端部の外径より若干
小さく形成されている穴部であり、前記内視鏡先端取付
孔３２と同様に前記弾性材料の弾性変形により前記ガイ
ドカテーテル３０の先端部を固定保持するようになって
いる。
【００１８】また、ガイドカテーテル固定具は、図４に
示すようなガイドカテーテル固定保持部３３ｂを形成し
て構成しても良い。図４に示すようにガイドカテーテル
固定具３１ｂは、ガイドカテーテル固定保持部３３ｂの
先端側に縮径部３４を形成し、この縮径部３４が貫通す
るように構成している。この場合、このガイドカテーテ
ル固定具３１ｂは、前記ガイドカテーテル固定保持部３
３ｂから前記ガイドカテーテル３０を外す前に、後述す
るガイドワイヤを前記縮径部３４に挿入固定することが
できるようになっている。
【００１９】また、ガイドカテーテル固定具は、図６に
示すような構成のものでも良い。図６（ａ），（ｂ）に
示すように、ガイドカテーテル固定具３１ｃはガイドカ
テーテル固定保持部３３ｃ部分に向かって縮径形状部３
５を形成している。これにより、ガイドカテーテル固定
具３１ｃは、前記内視鏡挿入部１１の先端部２１に着脱
自在に装着したとき、挿入部先端の外径を小さく抑える
ことができ、体腔内への挿入もより容易になる。
【００２０】また、ガイドカテーテル固定具は、図７に
示すような構成のものでも良い。図７（ａ），（ｂ）に
示すように、ガイドカテーテル固定具３１ｄは前記ガイ
ドカテーテル固定具３１ｃと同様に縮径形状部３５を形
成している。更にガイドカテーテル固定具３１ｄはガイ
ドカテーテル固定保持部３３ｄ部分にテーパ部３６を形
成して、先端方向に向かってテーパ状に縮径して構成さ
れている。これにより、ガイドカテーテル固定具３１ｄ
は、前記内視鏡挿入部１１の先端部２１に着脱自在に装
着したとき、前記ガイドカテーテル固定具３１ｃよりも
挿入性が容易となる。
【００２１】更に、ガイドカテーテル固定具は、図８に
示すような構成のものでも良い。図８（ａ），（ｂ）に
示すようにガイドカテーテル固定具３１ｅは、前記ガイ
ドカテーテル固定具３１ｄと同様な形状で、更に、後端
部に延出する舌状部３７を設けて構成されている。これ
により、ガイドカテーテル固定具３１ｅは、前記内視鏡
挿入部１１の先端部２１に着脱自在に装着し、更に前記
舌状部３７を図示しない医療用テープ等で固定すること
で前記内視鏡挿入部１１の先端部２１に対してより強固
に固定することができる。
【００２２】尚、上述したガイドカテーテル固定具３１
ａ〜３１ｅは、これらガイドカテーテル固定保持部３３
ａ〜３３ｅ部分の弾性変形による締め付け固定に限られ
るものではなく、固定保持手段として粘着性を有する粘
着部材で形成し、この粘着部材の粘着力により前記ガイ
ドカテーテル３０を固定保持するように構成しても良
い。
【００２３】また、後述するようにガイドカテーテル固
定具３１ａ〜３１ｅは、前記ガイドカテーテル３０を固
定保持した状態で内視鏡挿入部１１と共に体腔内に挿入
された後、前記ガイドカテーテル３０の手元側を引っ張
ることにより、このガイドカテーテル３０の先端部の固
定保持が容易に解除されて、脱着できるものであれば良
い。
【００２４】このように構成されたガイドカテーテル固
定具３１ａ〜３１ｅを前記内視鏡挿入部１１の先端部２
１に着脱自在に装着して構成した内視鏡装置１を用い
て、留置チューブを留置する留置チューブの留置方法に
ついて図５を用いて説明する。尚、ここでは、図２，図
３を用いて説明したガイドカテーテル固定具３１ａを用
いて説明する。先ず、ガイドカテーテル固定具３１ａ
は、内視鏡先端取付孔３２に前記内視鏡挿入部１１の先
端部２１を着脱自在に嵌着することで、この内視鏡挿入
部１１の先端部２１に固定装着される。
【００２５】そして、ガイドカテーテル３０を内視鏡挿
入部１１の外周軸方向に沿わせて、図５（ａ）に示すよ
うに、ガイドカテーテル固定具３１ａのガイドカテーテ
ル固定保持部３３ａにガイドカテーテル３０の先端部を
挿入して固定保持する。そして、ガイドカテーテル３０
の先端部を固定保持した状態で内視鏡挿入部１１を体腔
内に挿入する。内視鏡挿入部１１が体腔内の目的部位ま
で到達したら、ガイドカテーテル３０を手元側に引っ張
り、図５（ｂ）に示すようにガイドカテーテル３０の先
端部をガイドカテーテル固定具３１ａのガイドカテーテ
ル固定保持部３３ａから外す。
【００２６】ガイドカテーテル固定具３１ａのガイドカ
テーテル固定保持部３３ａからガイドカテーテル３０の
先端部を外した状態で、図５（ｃ）に示すようにガイド
カテーテル３０内にガイドワイヤ４１を挿入しガイドカ
テーテル３０の先端からガイドワイヤ４１を突出させ
る。そして、図５（ｄ）に示すようにガイドカテーテル
３０を体腔内から抜去する一方、ガイドワイヤ４１の先
端を目的部位に到達させる。
【００２７】次に、図５（ｅ）に示すようにこのガイド
ワイヤ４１に沿わせて留置チューブ４２を体腔外から目
的部位まで挿入して目的部位に到達させる。この留置チ
ューブ４２を体腔内の目的部位に留置し、その後、内視
鏡挿入部１１を体腔内から抜去することで、留置チュー
ブ４２の留置が完了する。尚、留置チューブ４２の挿入
位置は、内視鏡２の図示しない撮像手段で撮像されて得
た内視鏡画像によって確認することができる。
【００２８】この結果、本実施の形態は、留置チューブ
４２の留置を行なう過程で、内視鏡を抜去しなくても、
内視鏡２の処置具挿通用チャンネル内径より太い留置チ
ューブ４２を留置できるので操作性が良い。また、本実
施の形態は、留置チューブ４２の留置を行なう途中で、
内視鏡２を抜去していないので、留置チューブの位置を
内視鏡画像により確認することができ、正確な位置に留
置チューブ４２を留置することができる。
【００２９】尚、上述した留置チューブ４２の留置方法
は、ガイドワイヤ４１、ガイドカテーテル３０等を使用
せず、直接留置チューブ４２先端を固定保持する固定具
を用いて構成するようにしても良い。
【００３０】また、本実施の形態では、図示しない撮像
手段を内視鏡挿入部１１の先端部２１に内蔵した電子内
視鏡に本発明を適用しているが、本発明はこれに限定さ
れず、照明された被写体像を先端部に内蔵した対物光学
系で取り込み、この取り込んだ被写体像をイメージガイ
ドバンドル等の伝達手段により接眼部に伝達する光学式
内視鏡に本発明を適用しても当然良いし、内視鏡先端部
に絶縁カバーを装着したものでも良い。
【００３１】（第２の実施の形態）図９ないし図１１は
本発明の第２の実施の形態に係り、図９は本発明の第２
の実施の形態を備えた内視鏡挿入部の先端部側を示す斜
視図、図１０は図９の内視鏡挿入部の先端部に装着する
カテーテル固定具を示す説明図であり、図１０（ａ）は
カテーテル固定具の斜視図、図１０（ｂ）は図１０
（ａ）の断面図、図１１は留置チューブの留置方法を説
明する内視鏡挿入部の先端部側を示す説明図である。
【００３２】上記第１の実施の形態は、前記内視鏡挿入
部１１の外周軸方向に沿わせて配設するガイドカテーテ
ル３０の先端部を前記内視鏡挿入部１１の先端部２１側
に着脱自在に固定保持するために、前記内視鏡挿入部１
１の先端部２１に対して着脱自在に設けるガイドカテー
テル固定具３１ａを有するように構成しているが、本第
２の実施の形態では前記内視鏡挿入部１１の外周軸方向
に沿わせて配設するカテーテルの先端部を前記内視鏡挿
入部１１の先端部２１側に着脱自在に固定保持するため
に、前記内視鏡挿入部１１の先端部２１に対して着脱自
在に設ける固定具を有するように構成する。それ以外の
構成は上記第１の実施の形態と同様なので説明を省略
し、同じ構成には同じ符号を付して説明する。
【００３３】即ち、図９に示すように前記内視鏡２は、
この内視鏡挿入部１１の外周軸方向にカテーテル５０を
沿わせるようになっている。 前記カテーテル５０の先
端部を固定保持するためのカテーテル固定具５１は、前
記ガイドカテーテル固定具３１ａとほぼ同様な略円筒状
の弾性材料で形成されている。このカテーテル固定具５
１は、貫通孔である内視鏡先端取付孔５２に前記内視鏡
挿入部１１の先端部２１を着脱自在に嵌着することで、
この内視鏡挿入部１１の先端部２１に固定装着されるよ
うになっている。
【００３４】図１０（ａ），（ｂ）に示すように前記内
視鏡先端取付孔５２の内径は、前記内視鏡挿入部１１の
先端部２１の外径より若干小さく形成されており、前記
弾性材料の弾性変形により前記内視鏡挿入部１１の先端
部２１に締め付け固定するようになっている。
【００３５】前記カテーテル固定具５１は、固定保持手
段としてカテーテル固定保持部５３を設けている。この
カテーテル固定保持部５３は、前記カテーテル５０の外
径より細径に形成され、更にくびれ部５４を有している
穴部である。前記カテーテル固定保持部５３は、前記弾
性材料の弾性変形により前記カテーテル５０の先端部を
弾性的に潰して挿入可能であり、前記くびれ部５４部分
で更に前記カテーテル５０の先端部を弾性的に変形さ
せ、前記カテーテル５０の先端部を固定保持するように
なっている。尚、前記カテーテル固定具５１は、図６〜
図８で説明した前記ガイドカテーテル固定具３１ｂ〜３
１ｅと同様な構成であっても良い。
【００３６】このように構成されたカテーテル固定具５
１を前記内視鏡挿入部１１の先端部２１に着脱自在に装
着して構成した内視鏡装置を用いて、カテーテル５０を
留置するカテーテル５０の留置方法について説明する。
先ず、カテーテル固定具５１は、内視鏡先端取付孔５２
に前記内視鏡挿入部１１の先端部２１を着脱自在に嵌着
することで、この内視鏡挿入部１１の先端部２１に固定
装着される。
【００３７】そして、カテーテル５０を内視鏡挿入部１
１の外周軸方向に沿わせて、カテーテル固定具５１のカ
テーテル固定保持部５３にカテーテル５０の先端部を挿
入して固定保持する。そして、カテーテル５０の先端部
を固定保持した状態で内視鏡挿入部１１を体腔内に挿入
する。内視鏡挿入部１１が体腔内の目的部位まで到達し
たら、カテーテル５０を手元側に引っ張り、このカテー
テル５０の先端部をカテーテル固定具５１のカテーテル
固定保持部５３から外し、目的部位に到達させる。
【００３８】このカテーテル５０を体腔内の目的部位に
留置し、その後、内視鏡挿入部１１を体腔内から抜去す
ることで、カテーテル５０の留置が完了する。尚、カテ
ーテル５０の挿入位置は、内視鏡２の図示しない撮像手
段で撮像されて得た内視鏡画像によって確認することが
できる。
【００３９】この結果、本第２の実施の形態は、上記第
１の実施の形態と比べてガイドワイヤ４１を使用するこ
となく直接カテーテル５０を留置できるので操作性が良
い。
【００４０】（第３の実施の形態）図１２は本発明の第
３の実施の形態に係るガイドワイヤの留置方法を説明す
る内視鏡の挿入部先端側を示す説明図であり、図１２
（ａ）は内視鏡挿入部の先端部に粘着テープを巻き、こ
の端部を一部出している際の説明図、図１２（ｂ）は図
１２（ａ）の状態から一部出した粘着テープの粘着部に
ガイドワイヤの先端部を粘着させた際の説明図、図１２
（ｃ）は図１２（ｂ）の状態から粘着テープの粘着部端
部を折り返してガイドワイヤの先端部を固定保持してい
る際の説明図、図１２（ｄ）は図１２（ｃ）の状態から
ガイドワイヤの先端部を粘着テープの粘着部から引き抜
いて外した際の説明図である。
【００４１】本第３の実施の形態では、固定具として粘
着テープを用い、ガイド部材としての前記ガイドワイヤ
４１の先端部を前記内視鏡挿入部１１の先端部２１側に
着脱自在に固定保持するように構成する。それ以外の構
成は上記第１の実施の形態と同様なので説明を省略し、
同じ構成には同じ符号を付して説明する。
【００４２】即ち、図１２に示すように前記内視鏡２
は、この内視鏡挿入部１１の外周軸方向にガイドワイヤ
４１を沿わせ、このガイドワイヤ４１の先端部を固定保
持するための固定具として医療用テープ等の粘着テープ
５５を用いる。
【００４３】次に、この粘着テープ５５を用いて、ガイ
ドワイヤ４１を留置するガイドワイヤ４１の留置方法に
ついて説明する。図１２（ａ）に示すように内視鏡挿入
部１１の先端部２１に、先端側から見て反時計方向に粘
着テープ５５を巻き、末端部を先端部２１に対して浮い
た状態にしておく。この粘着テープ５５の末端部におけ
る粘着部５５ａに図１２（ｂ）に示すようにガイドワイ
ヤ４１の先端部を粘着させる。そして、図１２（ｃ）に
示すように粘着テープ５５の粘着部５５ａ端部を折り返
してガイドワイヤ４１の先端部を固定する。このことに
より、ガイドワイヤ４１の先端部は、内視鏡挿入部１１
の先端部２１側に固定保持される。
【００４４】そして、ガイドワイヤ４１の先端部を固定
保持した状態で内視鏡挿入部１１を体腔内に挿入する。
内視鏡挿入部１１が体腔内の目的部位まで到達したら、
ガイドワイヤ４１を手元側に引っ張り、図１２（ｄ）に
示すようにガイドワイヤ４１の先端部を粘着テープ５５
の粘着部５５ａから引き抜いて外し、目的部位に到達さ
せる。このガイドワイヤ４１を体腔内の目的部位に留置
し、その後、内視鏡挿入部１１を体腔内から抜去するこ
とで、ガイドワイヤ４１の留置が完了する。
【００４５】この結果、本第３の実施の形態は、上記第
１の実施の形態と比べて長いガイドワイヤ４１を使用す
る必要がないので操作性が良い。すなわち、あらかじめ
ガイドカテーテルを体腔内に挿入しておき、その後にガ
イドワイヤを挿入する場合は、ガイドカテーテルを抜き
去る際に、手元側（体腔外）でガイドワイヤも一緒に抜
けないように押さえておく必要がある。手元側でガイド
ワイヤを押さえるためには、処置具挿入口２５より手元
側に露出するガイドワイヤの寸法を、ガイドカテーテル
の全長よりも長くすることが必要である。ガイドワイヤ
にそれだけの長さを付与すると、ガイドワイヤの取り回
しが煩雑になってしまう。また、上記第１、第２の実施
の形態と比べて内視鏡挿入部１１の先端部２１に特別な
固定具を準備する必要が無い。また、体腔内への挿入性
が良く、更に、内視鏡挿入部１１の先端部２１の外径が
異なるものにも対応可能である。
【００４６】尚、本発明は、以上述べた実施形態のみに
限定されるものではなく、発明の要旨を逸脱しない範囲
で種々変形実施可能である。
【００４７】［付記］ （付記項１） 内視鏡挿入部の外周軸方向に沿わせて配
設する留置チューブ又はこの留置チューブをガイドする
ためのガイド部材の先端部を前記内視鏡挿入部の先端部
側に着脱自在に固定保持するために、前記内視鏡挿入部
の先端部に対して着脱自在に設ける固定具を有すること
を特徴とする内視鏡装置。
【００４８】（付記項２） 体腔内に挿入される細長な
挿入部を有する内視鏡と、この内視鏡挿入部の外周軸方
向に沿わせて配設する留置チューブ又はこの留置チュー
ブをガイドするためのガイド部材の先端部を前記内視鏡
挿入部の先端部側に着脱自在に固定保持するために前記
内視鏡挿入部の先端部に設けた固定具と、を具備したこ
とを特徴とする内視鏡装置。
【００４９】（付記項３） 体腔内に挿入される細長な
内視鏡挿入部の先端部に、ガイドカテーテルの先端部を
着脱自在に固定保持するガイドカテーテル固定具を装着
し、前記内視鏡挿入部の外周軸方向に沿わせて前記ガイ
ドカテーテルの先端部を前記ガイドカテーテル固定具に
固定保持し、前記ガイドカテーテルの先端部を固定保持
した状態で前記内視鏡挿入部を体腔内に挿入して目的部
位まで到達させ、前記ガイドカテーテルの先端部を前記
ガイドカテーテル固定具から外し、前記ガイドカテーテ
ル内にガイドワイヤを挿入し、このガイドワイヤ先端を
前記ガイドカテーテル先端から突出させ、前記ガイドカ
テーテルを体腔内から抜去する一方、前記ガイドワイヤ
先端を目的部位に到達させ、留置チューブを前記ガイド
ワイヤに沿わせて体腔外から目的部位まで挿入し、この
留置チューブを体腔内の目的部位に留置し、その後、前
記内視鏡挿入部を体腔内から抜去することを特徴とする
留置チューブの留置方法。
【００５０】（付記項４） 前記固定具は、弾性材料に
より形成していることを特徴とする付記項１に記載の内
視鏡。
【００５１】（付記項５） 前記固定具は、粘着性を有
する粘着性部材で形成していることを特徴とする付記項
１に記載の内視鏡。
【００５２】（付記項６） 前記弾性材料は、シリコ
ン、弾性エラストマ等であることを特徴とする付記項４
に記載の内視鏡。
【００５３】（付記項７） 前記固定具は、弾性材料に
より形成していることを特徴とする付記項２に記載の内
視鏡装置。
【００５４】（付記項８） 前記固定具は、粘着性を有
する粘着性部材で形成していることを特徴とする付記項
２に記載の内視鏡装置。
【００５５】（付記項９） 前記弾性材料は、シリコ
ン、弾性エラストマ等であることを特徴とする付記項７
に記載の内視鏡装置。
【００５６】
【発明の効果】以上説明したように本発明によれば、体
腔内に留置チューブ又はこの留置チューブをガイドする
ためのガイド部材を留置する際、操作性良く、簡便に留
置操作を行なうことが可能である。
【図面の簡単な説明】
【図１】 本発明の第１の実施の形態の内視鏡装置の全
体構成を示す全体構成図である。
【図２】 図１の内視鏡挿入部の先端部側を示す斜視図
である。
【図３】 図２の内視鏡挿入部の先端部に装着するガイ
ドカテーテル固定具を示す説明図である。
【図４】 図３（ｂ）のガイドカテーテル固定保持部の
先端側に形成した縮径部が貫通するように構成したガイ
ドカテーテル固定具の断面図である。
【図５】 本発明の第１の実施の形態の留置チューブの
留置方法を説明する説明図である。
【図６】 図３の他の変形例を示すガイドカテーテル固
定具の説明図である。
【図７】 図６の他の変形例を示すガイドカテーテル固
定具の説明図である。
【図８】 図７の他の変形例を示すガイドカテーテル固
定具の説明図である。
【図９】 本発明の第２の実施の形態を備えた内視鏡挿
入部の先端部側を示す斜視図である。
【図１０】 図９の内視鏡挿入部の先端部に装着するカ
テーテル固定具を示す説明図である。
【図１１】 留置チューブの留置方法を説明する内視鏡
挿入部の先端部側を示す説明図である。
【図１２】 本発明の第３の実施の形態に係るガイドワ
イヤの留置方法を説明する内視鏡の挿入部先端側を示す
説明図である。
【符号の説明】
１ …内視鏡装置 ２ …内視鏡 １１ …挿入部 １３ …操作部 ２１ …先端部 ３０ …ガイドカテーテル（ガイド部材） ３１ａ〜３１ｅ…ガイドカテーテル固定具 ３２ …内視鏡先端取付孔 ３３ａ〜３３ｅ…ガイドカテーテル固定保持部 ４１ …ガイドワイヤ ４２ …留置チューブ
───────────────────────────────────────────────────── フロントページの続き (72)発明者 矢部 久雄 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 (72)発明者 松井 頼夫 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 Ｆターム(参考） 4C061 CC06 DD03 GG13 GG15 GG24 HH56

Claims (3)

    【特許請求の範囲】
  1. 【請求項１】 内視鏡挿入部の外周軸方向に沿わせて配
    設する留置チューブまたはこの留置チューブをガイドす
    るためのガイド部材の先端部を前記内視鏡挿入部の先端
    部側に着脱自在に固定保持するために、前記内視鏡挿入
    部の先端部に対して着脱自在に設ける固定具を有するこ
    とを特徴とする内視鏡装置。
  2. 【請求項２】 体腔内に挿入される細長な挿入部を有す
    る内視鏡と、 この内視鏡挿入部の外周軸方向に沿わせて配設する留置
    チューブ又はこの留置チューブをガイドするためのガイ
    ド部材の先端部を前記内視鏡挿入部の先端部側に着脱自
    在に固定保持するために前記内視鏡挿入部の先端部に設
    けた固定具と、 を具備したことを特徴とする内視鏡装置。
  3. 【請求項３】 体腔内に挿入される細長な内視鏡挿入部
    の先端部に、ガイドカテーテルの先端部を着脱自在に固
    定保持するガイドカテーテル固定具を装着し、 前記内視鏡挿入部の外周軸方向に沿わせて前記ガイドカ
    テーテルの先端部を前記ガイドカテーテル固定具に固定
    保持し、 前記ガイドカテーテルの先端部を固定保持した状態で前
    記内視鏡挿入部を体腔内に挿入して目的部位まで到達さ
    せ、 前記ガイドカテーテルの先端部を前記ガイドカテーテル
    固定具から外し、 前記ガイドカテーテル内にガイドワイヤを挿入し、この
    ガイドワイヤ先端を前記ガイドカテーテル先端から突出
    させ、 前記ガイドカテーテルを体腔内から抜去する一方、前記
    ガイドワイヤ先端を目的部位に到達させ、 留置チューブを前記ガイドワイヤに沿わせて体腔外から
    目的部位まで挿入し、この留置チューブを体腔内の目的
    部位に留置し、その後、前記内視鏡挿入部を体腔内から
    抜去することを特徴とする留置チューブの留置方法。
JP2002023347A 2001-02-06 2002-01-31 内視鏡装置 Expired - Fee Related JP3939158B2 (ja)

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US10/067,585 US6786864B2 (en) 2001-02-06 2002-02-05 Endoscopic system and method for positioning an indwelling tube

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JPH11299725A (ja) * 1998-04-21 1999-11-02 Olympus Optical Co Ltd 内視鏡用フード

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007268270A (ja) * 2006-03-30 2007-10-18 Ethicon Endo Surgery Inc 内視鏡用付属装置取付器具
JP2020010744A (ja) * 2018-07-13 2020-01-23 パナソニック株式会社 内視鏡
JP7099894B2 (ja) 2018-07-13 2022-07-12 ｉ－ＰＲＯ株式会社 内視鏡
US11659981B2 (en) 2018-07-13 2023-05-30 i-PRO Co., Ltd. Endoscope with a holder including a lens and an image sensor

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