JP2002330924A - Endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope which is capable of guiding an insertion portion down into the deep part in a celom without carrying out intricate operation. SOLUTION: The insertion portion 4 of the endoscope 1 includes a distal end 11 which is arranged with an observation optical system, active type curving sections 12 which are constituted by successively connecting plural curving barrels 22 and 23 to be curved by operating a curving control knob 5a disposed at a control section 6, passive type curving sections 13 which are constituted by successively connecting the plural curving barrels 23 to be easily curved by receiving external force, a soft flexible tube section 14 which is curved by receiving the external force and a hard variable mechanism 24 which is arranged from the middle portion of the passive type curving sections 13 to the base end of the flexible tube section 14 and changes the hardness on the base end side within a prescribed range from the middle portion of the passive type curving sections 13 by hand operating the hardness change part 6b disposed at the control section 6.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope for inserting an insertion portion into a body cavity deeply.

[0002]

2. Description of the Related Art In recent years, by inserting an elongated insertion portion into a body cavity, a site to be inspected in the body cavity can be observed without the need for an incision, and a therapeutic treatment can be performed using a treatment tool if necessary. Endoscopes that can perform are widely used.

The insertion portion of the endoscope has flexibility so that it can be inserted into a bent insertion path.
However, since the insertion portion has flexibility, it is difficult to smoothly insert the insertion portion into the target portion because the direction of the distal end side is not determined with respect to the operation of the insertion portion near the hand. Insertion into a tight, flexible small intestine was a difficult procedure.

[0004] For this reason, by using an overtube or a stylet, linearization from the esophagus to the duodenum is attempted.
The endoscope was inserted.

[0005]

However, the procedure for straightening from the esophagus to the duodenum is complicated, and it has been difficult to smoothly insert the distal end of the insertion portion deep into the body cavity.

The present invention has been made in view of the above circumstances, and has as its object to provide an endoscope that can guide an insertion portion to a deep part in a body cavity without performing complicated operations.

[0007]

An endoscope according to the present invention is an endoscope having an elongated insertion section and an operation section at a base end of the insertion section, wherein the insertion section has at least an observation section. An active bending section formed by connecting a distal end portion on which an optical system is disposed and a plurality of bending pieces provided on a base end side of the distal end portion and bending by operating a bending operation knob provided on the operation portion. Part, a passive bending part provided on the base end side of the active bending part, and formed by connecting a plurality of bending pieces which are easily bent by receiving an external force; and a base end of the passive bending part. A flexible tube portion that is provided on the side and is bent by receiving an external force, and is disposed between a middle portion of the passive bending portion and a base end of the flexible tube portion, and is provided in the operation portion. By operating the adjusting knob at hand, the hardness at the base end side from the middle of the passive bending portion is set. It has and a hardness variable mechanism for changing a range.

Further, in the endoscope having an elongated insertion portion, a flexible inductor having a plurality of irregularities formed on an outer peripheral surface is protruded forwardly in the insertion portion axial direction at a distal end side portion of the insertion portion. Have been established.

According to this structure, the active bending portion is bent by a manual operation, or the hardness of the variable hardness mechanism is changed by the manual operation, so that the proximal end of the flexible tube portion is moved from the middle of the passive bending portion. By changing the hardness, the distal end portion of the insertion portion can be guided deep into the body cavity.

[0010] Further, an inductor protruding forward in the axial direction of the insertion portion from a tip side portion of the insertion portion serves as an introduction portion for guiding the tip portion of the insertion portion to a deep portion in a body cavity.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 relate to a first embodiment of the present invention, and FIG. 1 is a diagram showing an entire configuration of an endoscope apparatus;
2 is an enlarged view illustrating an active bending portion and a passive bending portion, FIG. 3 is a schematic diagram illustrating an insertion portion, FIG. 4 is a diagram illustrating the operation of the insertion portion, and FIG. It is a figure explaining the effect | action of the insertion part at the time of penetrating to a deep part in a body cavity.

FIG. 5A is a view for explaining a state of the insertion portion when the distal end of the insertion portion reaches the vicinity of the duodenal descending leg of the duodenum, and FIG. 5 (c) is a view for explaining a state in which the distal end of the insertion portion passes through the ligament of Treitz of the duodenum toward the deep part of the small intestine.

As shown in FIG. 1, an endoscope system 10 of the present invention includes, for example, an electronic endoscope (hereinafter, referred to as an endoscope) 1 having a built-in image pickup device (not shown), a light source device 2, and a video device. It mainly comprises a processor 3 and a monitor 4.

The endoscope 1 has an elongated and flexible insertion section 5 and an operation section 6 connected to a base end of the insertion section 5.
And a flexible universal cord 7 extending from the side of the operation unit 6.

At the end of the universal cord 7, there is provided a connector 7a detachably connected to the light source device 2. The connector 7a is provided with, for example, a connection portion 8 which is detachably connected to the video processor 3. The video processor 3 and the monitor 4 are connected by a video cable 9.

Reference numeral 6a denotes an active bending portion 12 described later.
Reference numeral 6b denotes a hardness changing ring for changing the hardness of the hardness variable mechanism 24 described later, and reference numeral 6c denotes a plurality of remote switches for remotely operating the video processor 3, for example. is there.

As shown in FIG. 1 to FIG.
The distal end is fixed to the distal end 11 by operating a rigid distal end 11 at least an observation optical system (not shown) and a bending operation knob 6a provided on the operation unit 6 in order from the distal end side. And a plurality of bending pieces 2 for two and four directions in which four bending wires 21 corresponding to the up, down, left and right directions inserted through the wire guide 20 are pulled and bent.
Active bending portion 12 in which 2,..., 22 are rotatably connected.
A plurality of four-way bending pieces 23,..., 23 which are easily bent by receiving an external force or the like which is exerted by being pressed along a lumen in a body cavity; And a flexible flexible tube portion 14 which is curved by receiving an external force or the like which is exerted by being pressed along a lumen in a body cavity.

In this embodiment, the flexible tube 14 is composed of a first flexible tube 14a and a second flexible tube 14b having different hardness. Then, the flexible tube portion 14
Has a three-layer structure of a metal spiral tube, a metal knitted tube, and a watertight outer tube in order from the inner peripheral side.

The radius of curvature of the passive bending portion 13 is set to be smaller than the radius of curvature of the flexible tube portion 14. Reference numeral 25 denotes a plurality of connected curved pieces 2
The outer tube 25 is made of an elastic rubber and covers the outer tubes 2 and 23. In the present embodiment, the outer tube 25 has a predetermined length.
Are covered with a thread-bonded portion 26 as shown in FIG. That is, in the present embodiment, the plurality of outer tubes 25
Although it is configured to cover with a single outer tube, it may be configured to cover with one outer tube.

As shown in FIGS. 3 and 4, between an intermediate portion of the passive bending portion 13 and a base end of the flexible tube portion 14, a hardness changing function provided as an adjustment knob provided on the operation portion 6 is provided. A hardness variable mechanism 24 that changes the hardness within a predetermined range by operating the ring 6b at hand is arranged.

The variable hardness mechanism 24 adjusts the hardness of the passive bending portion 13 and the flexible tube portion 14.
The hardness change ring having a hardness change coil 24a and a hardness change wire 24b, a traction member (not shown) fixed to the base end of the hardness change wire 24b, and a cam mechanism (not shown) for changing the longitudinal position of the traction member. 6b
It is composed of

The tip of the hardness changing wire 24b is fixed to a substantially central portion of the passive bending portion 13, and the tip of the hardness changing coil 24a is fixed to a predetermined position of the tip of the hardness changing wire 24b.

When the hardness changing wire 24b is not pulled by the pulling member, no external force is applied to the hardness changing coil 24a, so that the hardness changing coil 24a is in a soft state. on the other hand,
When the traction member is moved by rotating the hardness changing ring 6b, a compressive force is gradually applied to the hardness changing coil 24a. This gradually changes the hardness in the bending direction so as to increase.

That is, the surgeon operates the hardness changing ring 6b.
By appropriately changing the hardness of the hardness changing coil 24a, the bending stiffness of the base end side from the approximate center of the passive bending portion 13 and the bending stiffness of the flexible tube portion 14 can be changed within a predetermined range.

The insertion section 5 of the endoscope 1 is set so that the hardness becomes higher in order from the distal end except for the rigid distal end 11. That is, the hardness of the active bending portion 12 and the hardness of the coilless passive bending portion (hereinafter, referred to as a hardness-invariant bending portion) 13a in which the hardness changing coil 24a as the hardness changing mechanism is not provided are substantially the same. The hardness of the passive bending portion with coil (hereinafter, referred to as a variable hardness bending portion) 13b in which the hardness changing coil 24a of the passive bending portion 13 is disposed is higher than the hardness invariable bending portion 13a. I have. Further, the hardness of the first flexible tube portion 14a is higher than that of the variable hardness bending portion 13b. The hardness of the second flexible tube portion 14b is higher than the hardness of the first flexible tube portion 14a.

The distance from the distal end surface of the distal end portion 11 to the proximal end of the active bending portion 12 is, for example, 10 cm, the distance from the distal end surface to the proximal end of the hardness-invariant bending portion 13a is 30 to 50 cm, and the hardness from the distal end surface is 30 to 50 cm. The distance from the proximal end of the variable bending portion 13b is set to 70 to 100 cm, and the distance from the distal end surface to the proximal end of the flexible tube portion 14 is set to 180 to 250 cm. The length of the first flexible tube portion 14a is set to 20.
To 40 cm.

Here, the operation of inserting the distal end portion 11 of the insertion section 5 configured as described above from the nasal cavity to the deep part of the small intestine will be described with reference to FIG. First, the insertion section 5 of the endoscope 1
Is inserted through the nasal cavity, for example, and the bending operation knob 6a of the operation section 6 is operated, while the insertion section 5 is gripped and the tip section 11 is pushed forward. At this time, by operating the hardness changing ring 6b, no external force is applied to the hardness changing coil 24a, that is, the hardness changing coil 24a is kept in a soft state.

The tip 11 inserted from the nasal cavity is shown in FIG.
As shown in (a), it passes through the esophagus and stomach and reaches, for example, the vicinity of the superior duodenal bulb. At this time, the side portion of the hardness-invariant bending portion 13a is pressed against the stomach wall to be bent.
In this state, further pushing operation is performed. Then, the distal end portion 11 further advances toward the duodenal descending leg in a state where the hardness-invariant bending portion 13a is curved.

Then, the distal end 11 reaches the vicinity of the horizontal part of the duodenum. At this time, the hardness-invariant curved portion 13a
Is located near the descending limb of the duodenum, and FIG.
As shown by the two-dot chain line, the variable hardness bending portion 13b is bent in the stomach.

Here, the hardness of the variable hardness mechanism 24 is increased by operating the hardness changing ring 6b. Then, the hardness of the hardness-variable bending portion 13b, the first flexible tube portion 14a, and the second flexible tube portion 14b hardens, and it becomes easy to push. Here, the surgeon performs the pushing operation, operates the bending operation knob 6a to bend the active bending portion 12, and passes the distal end portion 11 through the bending portion between the descending duodenal leg and the horizontal portion of the duodenum,
Thereafter, the bending operation knob 6a is again operated to bring the active bending portion 12 into a substantially linear state, and the distal end portion 11 is pushed to the vicinity of the ascending portion of the duodenum.

When the distal end 11 has reached the vicinity of the duodenal jejunum bend (near the ligament of Treitz), the hardness changing ring 6b is operated to make the hardness of the hardness variable mechanism 24 soft, while the bending operation knob is turned. By operating 6a, the active bending section 12 is bent and pushed forward. As a result, the distal end portion 11 passes through the bent portion in the vicinity of the ligament of Treitz to bend sharply and reaches the flexible small intestine.

Thereafter, the bending operation knob 6a is again operated as appropriate to push the active bending portion 12 while bending the active bending portion 12. Then, the active bending portion 12 passes through the ligament of Treitz and the passive bending portion 13 reaches the ligament of Treitz. At this time, when the passive bending portion 13 is pressed against the ligament of Treitz, the hardness-invariable bending portion 13a and the hardness-variable bending portion 13b are bent as shown in FIG. It goes toward the deep part of.

As described above, the flexible portion after the distal end of the insertion portion of the endoscope is formed by connecting the active bending portion, the passive bending portion, and the flexible tube portion that bend by operating the bending operation knob. In addition, the tip portion of the hardness variable mechanism whose hardness changes by operation of the hardness changing ring is arranged in the middle of the passive bending portion, and the passive bending portion is configured by a hardness invariable bending portion and a variable hardness bending portion, By setting the hardness so that it becomes harder in the order of the active bending section, the hardness invariable bending section, the variable hardness bending section, and the flexible tube section, the propulsive force at the time of the operator's pushing operation is improved to the distal end side of the insertion section. Can be told.

In this embodiment, while the flexible tube portion is composed of the first flexible tube portion and the second flexible tube portion, the hardness of the first flexible tube portion is determined by the second flexible tube portion. By being configured to be softer than the hardness, the rigidity of the flexible tube is harder at the proximal end than at the distal end, so that the thrust at the time of the pushing operation by the operator can be transmitted well to the distal end of the insertion portion.

With these features, the surgeon can push the distal end of the insertion portion relatively deeply into the body cavity by pushing the insertion portion while appropriately operating the bending operation knob and the hardness changing ring. Let me do.

6 to 9 relate to a second embodiment of the present invention. FIG. 6 is a view for explaining the configuration of an insertion portion provided with an inductor at the distal end, and FIG. 7 is a view for explaining the configuration of the inductor. FIG. 8 is a diagram for explaining the operation when the insertion portion is inserted deep into the body cavity, and FIG. 9 is a diagram for explaining the operation of the inductor.

FIG. 7A is a front view of a distal end provided with an inductor, and FIG. 7B is a diagram for explaining the configuration of the inductor and an example of arrangement at the distal end.

As shown in FIG. 6, in the present embodiment, an inductor 40 protrudes from the distal end surface of the distal end portion 11 constituting the distal end of the insertion section 5 of the endoscope 1. The distal end of the inductor 40 projects approximately 6 cm from the distal end surface of the distal end portion 11.
The configuration of the insertion section 5 is the same as that of the first embodiment, and the same members are denoted by the same reference numerals and description thereof will be omitted.

As shown in FIG. 7A, a small-diameter flexible guide 40 is provided near the distal end opening 27a of the treatment instrument insertion channel 27 disposed at the distal end portion 11 of the present embodiment.
Are arranged. As shown in FIG. 7B, the inductor 40 includes a plurality of metal spheres 41 with through holes, and
The wire 4 which is a string-like member inserted through the inside of one through hole 41a
2, a distal end stopper 43a provided at the distal end of the wire 42, and an internal space in which the metal ball 41, the wire 42, and the distal stopper 43 are disposed at the distal end. Silicon rubber, urethane rubber,
It is composed of a waterproof and flexible covering rubber 44 such as a vinyl chloride elastomer or a fluoro rubber, and a base stopper 43b provided at the base of the wire 42. The inductor 40 is connected to the active bending portion 12.
It is more flexible and bends with a smaller radius of curvature. A plurality of steps are formed at the tip of the covering rubber 44 that covers the metal ball 41.

Reference numeral 28a is a lens cover for illumination, and reference numeral 28b is a lens cover for observation. Reference numeral 29 denotes a nozzle whose ejection port faces the observation lens cover 28b. Further, reference numeral 30 denotes an endoscope distal end cap formed of an insulating member, reference numeral 31 denotes a rigid distal end member formed of a hard member such as, for example, stainless steel, and reference numeral 32 denotes a treatment instrument insertion channel constituting the treatment instrument insertion channel 27. Reference numeral 33 denotes a metallic connecting tube for connecting the treatment instrument insertion tube 32 to the distal end component member 31, and reference numeral 45 denotes a fixing portion for integrally fixing the base stopper 43 b to the wire 42. , Composed of an adhesive.

Here, referring to FIGS. 8 and 9, the operation of inserting the insertion section 5 configured as described above to the deep part of the small intestine will be described. In the present embodiment, the tip 11
When guiding to the duodenal bulb, passing through the bent portion between the duodenal descending leg and the horizontal portion of the duodenum, or passing through the bent portion near the ligament of Treitz, and furthermore, the bend is tight as shown in FIG. When pushing through the flexible small intestine, the guide 40 protruding from the distal end portion 11 is first arranged in the target pushing direction, and the pushing operation is performed.
Then, the inductor 40 bends at a small curvature along the bent portion.

At this time, as shown in FIG.
0, the distance between the metal spheres 41 arranged in the wire 42 changes so as to increase, and the tip stopper 4 fixed to the wire 42
3a moves to the distal end side, and the base end stopper 43b
Moves to a range where the rubber comes into contact with the base end face of the connecting portion 44a of the covering rubber 44. That is, the inductor 40 is curved with a small curvature in a range where the base stopper 43b comes into contact with the base surface of the connecting portion 44a of the covering rubber 44.

Thus, the surgeon performs the pushing operation with the inductor 40 disposed at the target site, and the distal end 11 advances through the bent portion of the small intestine with the guide 40 as a guide. Go deeper. Instead of providing the metal spheres 41 with through holes in the covering rubber 44, the inductor 40 may be configured by arranging a spring having a predetermined shape and elasticity.

As described above, the flexible inductor provided at the distal end of the insertion portion and having a small curvature is projected from the distal end surface of the distal end. By arranging in the direction and performing the pushing operation, the distal end portion of the insertion portion can be more easily inserted deep into the body cavity by using the inductor as a guide.

The combination of the inductor and the endoscope is not limited to the combination of the direct-view type endoscope 1 and the inductor 40 as in the present embodiment, but has the following configuration. There may be. The same members as those in the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

FIG. 10 is a view for explaining a configuration example in which an inductor is provided in a perspective endoscope. As shown in FIG. 10, in the present embodiment, the inductor 40 is replaced with a lens cover 50 of an observation optical system. Are combined with a perspective endoscope 52 configured to be disposed on the inclined surface 51a of the distal end portion 51. Reference numeral 53 denotes an inflatable balloon that expands when a liquid or gas is injected. Thus, by combining the inductor with the oblique endoscope, the oblique endoscope can be guided deep into the body cavity by guiding the inductor.

FIG. 11 is a view for explaining a configuration example in which an inductor is provided in a side-view type endoscope. As shown in FIG. 11, in the present embodiment, the inductor 40 is provided with a lens cover of an observation optical system. 50 and the lens cover 54 of the illumination optical system
Is combined with a side-view type endoscope 56 arranged and disposed on the side surface 55a of the camera.

The side view type endoscope 56 has the balloon 5
3, a balloon pipe 57 for injecting or draining liquid, a liquid sending / absorbing pipe 58 for feeding or absorbing liquid at a position distal to the balloon pipe 57, A suction pipe 59 is provided at a position closer to the base end than the balloon pipe 57 for performing suction.

As described above, by combining the inductor with the side-viewing type endoscope, the side-viewing type endoscope can be guided deep into the body cavity. Note that, in FIG. 10, these pipelines are not shown, and each pipeline is provided as needed.

Further, instead of the side-view type endoscope 56,
The diagnostic device shown in FIG. 12 may be used. As shown in the diagram illustrating the configuration of the diagnostic device of FIG. 12, the diagnostic device 65 includes an elongated and flexible lumen 60, and a plurality of metal balls 41 are disposed at the distal end thereof, and can be bent with a small radius of curvature. An inductor portion 61 having flexibility is provided. An intermediate rigid portion 62 is provided in the middle of the lumen 60. The intermediate rigid portion 62 is provided with a lens cover 63a for an observation optical system, a lens cover 63b for an illumination optical system, a balloon 53, and a balloon opening 64. Therefore, it is configured to allow side-viewing.

In the diagnostic device 65, in addition to a monitor 66 and a video processor 67 for displaying an observed image, a diagnostic device transmitting / receiving section 68 for wirelessly transmitting and receiving signals, a signal processing device 69, etc. It is mounted on the cart 70. A signal cable 71, a liquid supply / suction line 72, and a balloon line 73 extend from the proximal end of the lumen 60. At the base ends of the signal cable 71, the liquid supply / suction pipe 72, and the balloon pipe 73, a signal transmission / reception unit 71a, a liquid supply / liquid suction syringe 7 are provided, respectively.
4 is provided with a liquid supply / suction base 72a to which a syringe for liquid supply / absorption in a balloon (not shown) is connected.

Further, as shown in FIG. 13 illustrating a configuration example in which the inductor is provided in the ultrasonic endoscope, the inductor 80 may be provided at the distal end of the ultrasonic endoscope 81. .
The inductor 80 according to the present embodiment includes a spring coil 8 having a predetermined shape and elasticity instead of a metal ball in a covering rubber 82.
3 is a spring inductor.

Reference numeral 84 denotes a lens cover of the observation optical system, reference numeral 85 denotes an ultrasonic probe which rotates when the flexible shaft 86 rotates, and reference numeral 87 denotes an expandable / contractible expandable when injected. It is a balloon. Further, the spring-type inductor 80 may be used instead of the above-described inductor.

As described above, by combining the inductor with the ultrasonic endoscope, the ultrasonic endoscope can be guided deep into the body cavity.

Here, another configuration example of the inductor will be described.
An endoscope having a characteristic feature of the inductor will be described with reference to FIG.

As shown in the figure, in the present embodiment, for example, a through hole 91a through which a guide wire 92 can be inserted is provided in an inductor 91 combined with a direct-view type endoscope 90. This inductor 91 is provided with a connecting portion 90 protruding from the distal end.
The through hole 91a and the guide wire insertion channel 93 provided on the endoscope side are arranged and fixed to each other by thread winding adhesive or the like.

Thus, in the endoscope 90 combined with the inductor 91 provided with the through hole 91a, the endoscope 90 can be smoothly guided to a deep portion in the body cavity by previously guiding the inserted guide wire 92. Can be inserted.

Referring to FIGS. 15 to 17, an endoscope provided with a retractable inductor at its distal end will be described. 15 is a diagram illustrating a configuration example of an endoscope provided with a retractable inductor at a distal end portion, FIG. 16 is a diagram illustrating an operation of the endoscope, and FIG. 17 is an endoscope image displayed on a monitor FIG. In addition,
Reference numeral 15 (a) is a side view of a distal end portion of an endoscope provided with a retractable inductor, and FIG. 15 (b) is provided with a retractable inductor viewed from line AA in FIG. 15 (a). FIG. 2 is a front view of the distal end of the endoscope.

As shown in FIG. 15A, the inductor 100 according to the present embodiment is configured to be able to advance and retreat by a predetermined distance in the direction of the insertion axis from the distal end surface of the distal end portion 102 of the endoscope 101. That is, the inductor 100 includes a plurality of metal spheres 103.
And a wire 104 which is a flexible cord-like member having one end connected to a metal ball 103 e disposed on the base end side, and a base end having a diameter smaller than a channel diameter provided at the base end of the wire 104. It comprises a metal ball 105 and a stopper member 106 which is removably disposed on a wire 104 inside the metal ball 105 by a fixing means such as a clip.

The wire 104 extends outside the endoscope 101 through the forceps stopper 107.
The distance between the stopper 7 and the stopper member 106 is a sliding space for moving forward and backward by a predetermined distance. Then, FIG.
The opening 111a of the wire channel 111 through which the wire 104 is inserted is formed substantially at the center of the distal end face as shown in FIG.

Reference numeral 108 denotes an inflatable balloon, reference numeral 109 denotes an eyepiece, and reference numeral 110 denotes a universal cord having a connector 110a detachably connected to the light source device. Further, an endoscope camera (not shown) is connected to the eyepiece unit 109, and an observation image of an observation part captured by the endoscope is displayed on a monitor screen (not shown).

As described above, the inductor 100 is connected to the endoscope 101.
15A, the distal end portion 102 of the endoscope 101 can be guided deep into the body cavity as a guide when the inductor 100 passes through a bent portion or the like as shown in FIG. it can. Then, when performing endoscopic observation, the stopper member 106 is pushed in and brought into close contact with the forceps plug 107 as shown in FIG. Then, a predetermined gap is formed between the proximal end of the inductor 100 and the distal end surface of the distal end 102.

As a result, the endoscope image of the intestinal wall or the like can be displayed on the monitor screen without being obstructed by the inductor 100 disposed substantially at the center of the endoscope 101 as shown in FIG. Will be displayed.

By arranging the inductor at the center of the distal end of the endoscope, the endoscope provided with the inductor for guiding the body deep into the body cavity can be reduced in diameter. By arranging the endoscope at the center of the intestinal tract, it is possible to improve observation performance by eliminating defects such as red balls caused by illumination light.

In addition, since the inductor can be moved back and forth by hand operation to be changed between the insertion state position and the observation state position, good observation can be performed without obstructing the observation visual field by the inductor.

Referring to FIGS. 18 and 19, an example of an endoscope apparatus in which an ileus tube and an endoscope are combined will be described. FIG. 18 is a diagram illustrating a configuration example of an ileus tube and an endoscope, and FIG. 19 is a diagram illustrating a configuration of a distal end portion of the endoscope.

As shown in FIG. 18, in this embodiment, a ball portion 121 provided at the distal end of an ileus tube 120 has an insertion portion 122 of a small-diameter and elongated endoscope 122.
A hole 121a through which a can be inserted is provided. For this reason,
From the hand side of the ileus tube 120, for example, the gripper 12
An endoscope 122 having an eyepiece 123a can be inserted into the endoscope 122. A light guide 124 for supplying illumination light is detachably attached to the endoscope 122.

The insertability can be improved by applying a hydrophilic lubricating coat to the outer surface of the insertion portion 122a. The ileus tube 120 has a balloon 1
25 and a suction port 126 are provided.

As described above, by providing the hole portion through which the endoscope can be inserted in the ball portion of the ileus tube, the treatment with the ileus tube and the endoscope observation can be performed by a single insertion.

Also, the light guide is detachable from the endoscope, so that the light guide is detached except when the endoscope is being observed, so that good operability can be obtained. Can be.

Further, by providing a grip portion having a diameter larger than that of the insertion portion on the hand side of the insertion portion having a small diameter, the insertion portion of the endoscope can be smoothly inserted into and removed from the ileus tube.

As shown in FIG. 19, the distal end surface of the insertion portion 122a of the endoscope 122 is provided with a chamfer to prevent the intestinal wall and the like from being damaged when the insertion portion 122a protrudes from the ileus tube 120. Good. In addition, this endoscope 1
At 22, a very small diameter portion 122 is provided at the tip of the insertion portion 122a.
b, and a tapered surface is provided between the small-diameter portion 122b and the large-diameter portion 122c. Thus, although not shown, the tapered surface may be brought into contact with the base end of the hole 121a so that the distal end surface of the insertion portion 122a does not protrude from the distal end of the ball portion. This reliably prevents the tip of the endoscope 122 from contacting the intestinal wall or the like.

The structure of the insertion guide tube used in combination with the small intestine endoscope will be described with reference to FIGS. As shown in FIG. 20, the small intestine endoscope 13 of the present embodiment
The insertion guide tube 135 is inserted and disposed in the treatment tool insertion channel 132 provided in the insertion section 131 of the No. 0. This insertion guide tube 135
Is configured to protrude from the distal end surface of the insertion portion 131 by a predetermined amount.

The insertion guide tube 135 is composed of a flexible portion 136 located on the distal end side, and a hard portion 137 located at the base end of the flexible portion 136 and having a hardness set to be higher than that of the flexible portion 136. are doing.

Thus, when the insertion portion 131 is inserted toward the deep part of the small intestine, the flexible portion 136 of the insertion guide tube 135 inserted through the treatment instrument insertion channel 132 of the insertion portion 131 is moved from the distal end surface. By repeatedly performing the guide tube proximal operation for projecting a predetermined amount and the endoscope proximal operation for pushing the insertion portion 131 against the projected insertion guide tube 135, the insertion tube is inserted deep into the small intestine.

In this embodiment, the insertion guide tube 135 has a structure in which the flexible portion 136 and the hard portion 137 having a predetermined length are connected to each other, but this insertion guide tube 135 is connected as shown in FIG. Flexible tube 13
A hard member 139 having a predetermined elastic force such as a guide wire, a stylet, or the like is disposed in the inside of the tube 8 so as to be able to advance and retreat, or as shown in FIG. The configuration may be such that 134 and the like are arranged to be able to advance and retreat so that the positions of the soft part and the hard part can be changed as appropriate.

Thus, during the insertion operation, the guide tube hand operation and the endoscope hand operation for appropriately changing the positions of the soft part and the hard part and appropriately changing the hardness of the insertion guide tube are repeated. Thus, the small intestine endoscope can be inserted more smoothly into the deep part of the small intestine.

As shown in FIG. 23, the endoscope apparatus may be configured by combining the ileus tube 140, the guide wire 141 and the small intestine endoscope 142. That is, as shown in the figure, the guide wire 141 is inserted into the ileus tube 140 inserted to a predetermined position after the treatment, and the ileus tube is removed with the guide wire 141 remaining. The small intestine endoscope 142 is inserted along the wire 141 to the target site.

As a result, the dilatation balloon can be inserted through the treatment instrument insertion channel of the small intestine endoscope to perform dilation treatment of the stenosis. After the treatment, the endoscope can be observed in the small intestine while the endoscope is pulled out.

Further, as shown in FIG. 24 (a), an opening 145 which is a projecting opening of the guide wire 141 or the like of the ileus tube 140 is provided on the side surface, or FIG.
As shown in FIG. 7, an image guide 148 or the like as an observation optical system is integrally fixed to a tube body 147 having a large diameter of the treatment instrument channel 146 via a medical tape 149 to form a small intestine. Good. This makes it possible to increase the diameter of the treatment instrument channel, greatly improve the insertion / extraction of the guide wire, and improve the insertion.

In the present embodiment, the insertion into the deep part of the body cavity has been described using the upper gastrointestinal tract as an example. However, the insertion method is not limited to this. Naturally, it can be used for insertion into a cradle, and a similar effect can be obtained.

The present invention is not limited to the above-described embodiment, but can be variously modified without departing from the gist of the invention.

[Appendix] According to the above-described embodiment of the present invention, the following configuration can be obtained.

(1) In an endoscope having an elongated insertion portion and an operation portion at a base end of the insertion portion, the insertion portion includes at least a distal end portion where an observation optical system is disposed, and an end portion of the distal end portion. An active bending portion provided on the proximal end side and configured by connecting a plurality of bending pieces that bend by operating a bending operation knob provided on the operation portion, and a proximal end side of the active bending portion. A passive bending portion provided by connecting a plurality of bending pieces which are easily bent by receiving an external force; and a soft bending portion provided on a base end side of the passive bending portion and bending by receiving an external force. Flexible tube portion, disposed between the middle portion of the passive bending portion to the proximal end of the flexible tube portion,
An endoscope comprising: a hardness variable mechanism that changes a hardness of a base end side of an intermediate portion of the passive bending portion within a predetermined range by a manual operation of an adjustment knob provided in the operation portion.

(2) The hardness of the active bending portion, the passive bending portion, and the flexible tube portion constituting the insertion portion is determined by changing the hardness of the active bending portion,
2. The endoscope according to claim 1, wherein the endoscope is set so as to become harder in the order of the passive bending portion and the flexible tube portion. (3) The endoscope according to appendix 1, wherein the hardness of the flexible tube portion is changed between the distal end side and the proximal end side, and the proximal end side is set harder than the distal end side. (4) In an endoscope having an elongated insertion portion, a flexible inductor having a plurality of irregularities formed on an outer peripheral surface is provided on an end side of the insertion portion so as to protrude forward in the axial direction of the insertion portion. Endoscope.

(5) The endoscope according to appendix 4, wherein the inductor has an outer diameter smaller than that of the distal end of the endoscope.

(6) The endoscope according to appendix 4, wherein the inductor comprises a plurality of perforated metal balls, a string-like member connecting these metal balls, and fixing means for preventing falling off.

(7) The endoscope according to appendix 4, wherein a channel through which a guide wire can be inserted is provided in the inductor.

(8) The endoscope according to appendix 4, wherein the inductor is movable in the longitudinal direction of the endoscope by operating means provided in the endoscope operating section.

(9) The endoscope according to appendix 4, wherein the stopper member for setting the moving distance of the inductor is detachable from the operating means.

(10) A tip open type ileus tube,
An endoscope apparatus having an endoscope which can be inserted into an inner hole of the ileus tube, wherein the length of the insertion portion of the endoscope is set longer than the length of the insertion portion of the ileus tube. As a result, even when the ileus tube is bent, the distal end of the endoscope protrudes reliably from the distal end surface of the ileus tube.

[0092]

As described above, according to the present invention, it is possible to provide an endoscope that can guide an insertion portion to a deep part in a body cavity without performing complicated operations.

[Brief description of the drawings]

FIG. 1 to FIG. 5 relate to a first embodiment of the present invention, and FIG. 1 is a view showing an entire configuration of an endoscope apparatus.

FIG. 2 is an enlarged view illustrating an active bending portion and a passive bending portion.

FIG. 3 is a schematic diagram illustrating an insertion unit.

FIG. 4 is a view for explaining the operation of an insertion portion.

FIG. 5 is a view for explaining the operation of the insertion portion when the distal end portion of the insertion portion is inserted deep into the body cavity.

FIG. 6 to FIG. 9 relate to a second embodiment of the present invention, and FIG. 6 is a view for explaining a configuration of an insertion portion provided with an inductor at a distal end portion.

FIG. 7 is a diagram illustrating a configuration of an inductor.

FIG. 8 is a diagram illustrating an operation when the insertion portion is inserted deep into the body cavity.

FIG. 9 is a diagram illustrating the operation of an inductor.

FIG. 10 is a diagram illustrating a configuration example in which an inductor is provided in a perspective endoscope.

FIG. 11 is a diagram illustrating a configuration example in which an inductor is provided in a side-viewing type endoscope.

FIG. 12 illustrates a configuration of a diagnostic device.

FIG. 13 is a diagram illustrating a configuration example in which an inductor is provided in an ultrasonic endoscope.

FIG. 14 is a diagram illustrating an endoscope having a characteristic in an inductor.

15 to 17 relate to an endoscope provided with a retractable inductor at a distal end portion, and FIG. 15 illustrates a configuration example of an endoscope provided with a retractable inductor at a distal end portion. Figure

FIG. 16 is a diagram illustrating the operation of the endoscope.

FIG. 17 is a diagram showing an endoscope image displayed on a monitor.

FIG. 18 and FIG. 19 are diagrams illustrating an example of an endoscope apparatus combined with an ileus tube and an endoscope.

FIG. 19 illustrates a configuration of a distal end portion of an endoscope.

20 relates to the configuration of an insertion guide tube used in combination with the small intestine endoscope with reference to FIGS. 20 to 22,
FIG. 20 is a view for explaining the relationship between the small intestine endoscope and the insertion guide tube.

FIG. 21 is a diagram illustrating another configuration example of the insertion guide tube.

FIG. 22 is a view for explaining another configuration example of the insertion guide tube.

FIG. 23 is a diagram illustrating an endoscope apparatus configured by combining an ileus tube, a guide wire, and a small intestine endoscope.

FIG. 24 is a view for explaining another configuration example of the ileus tube.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Endoscope 6 ... Operation part 10 ... Insertion part 12 ... Active bending part 13 ... Passive bending part 13a ... Hardness invariable bending part 13b ... Hardness variable bending part 14 ... Flexible tube part 14a ... First flexible tube part 14b: second flexible tube portion 24: hardness changing mechanism 24a: hardness changing coil 24b: hardness changing wire

Claims (2)

[Claims] 1. An endoscope having an elongated insertion portion and an operation portion at a base end portion of the insertion portion, wherein the insertion portion includes at least a tip end portion where an observation optical system is arranged, and a base portion of the tip end portion. An active bending section provided on an end side and configured by connecting a plurality of bending pieces bent by operating a bending operation knob provided on the operation section; provided on a base end side of the active bending section; A passive bending portion formed by connecting a plurality of bending pieces that are easily bent by receiving an external force; and A flexible tube portion, which is disposed between a middle portion of the passive bending portion and a base end of the flexible tube portion, and is operated in the middle of the passive bending portion by a manual operation of an adjustment knob provided on the operation portion. Hardness variable mechanism that changes the hardness on the base end side of the part within a predetermined range An endoscope comprising: 2. An endoscope having an elongated insertion portion, wherein a flexible inductor having a plurality of irregularities formed on an outer peripheral surface is formed on a distal end side portion of the insertion portion so as to protrude forward in an axial direction of the insertion portion. An endoscope characterized by being provided.