JP2003079565A - Treatment tool insertion aid for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment tool insertion aid for an endoscope capable of enhancing the insertability of a treatment tool into a treatment-tool passing channel by achieving prevention of buckling of the treatment tool for the endoscope, a reduction in the time to insert or withdraw the treatment tool into the channel, and a reduction in an assistant's man hours. SOLUTION: The operation of inserting or withdrawing a catheter 1 into or out of the treatment-tool insertion part 7 of the endoscope 2 is intermittently carried out by repeating the operation of moving, together with an inner cylinder member 16, the catheter 1 locked to the locking part 18a of the inner cylinder member 16, as the operation of moving the inner cylinder member 16 into and out of an outer cylinder member 15 is carried out. Also, a guide wire fixing part 33 is provided for inserting a guide wire 8 into an insertion aid body 17 and fixing it there.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention assists the insertion operation of an endoscopic treatment instrument such as an elongated catheter that is inserted into a channel of an endoscope and inserted into the body in, for example, endoscopic surgery. The present invention relates to a treatment instrument insertion aid for an endoscope.

[0002]

2. Description of the Related Art Generally, after an endoscope is inserted into a patient's body, an endoscope treatment tool such as an elongated catheter is inserted into a channel of the endoscope to treat a disease in the patient's body. Procedures such as endoscopic surgery are widely performed.

When performing an endoscopic treatment for treating a disease in the body of a patient using the endoscope, the distal end of the insertion portion of the endoscope is usually placed in the body of the patient to be treated. It is generally practiced to insert a treatment tool such as a catheter to a living tissue of a treatment target after inserting the treatment tool such as a guide wire under X-ray fluoroscopy after inserting the treatment tool up to the vicinity.

Specifically, for example, when endoscopic treatment is performed on a pancreatic duct, a bile duct, a hepatic duct or the like using an endoscope, the following work is performed. First, in FIG.
After inserting the tip portion c of the insertion portion b of the endoscope a shown in (A) and (B) to, for example, the vicinity of the duodenal papilla, a catheter d is inserted into the treatment instrument insertion channel of the endoscope a,
The distal end portion d1 of the catheter d is endoscopically inserted into the pancreatic duct or the bile duct. Next, the guide wire e is inserted from the mouthpiece d2 on the proximal end side of the inserted catheter d.

After that, it was confirmed under X-ray that the guide wire e was correctly inserted into the pancreatic duct or the bile duct, and the proximal end side of the guide wire e was grasped by hand as shown in FIG. 22 (A). At the same time, the catheter d is pulled out from the treatment instrument insertion channel of the endoscope a. During this operation, as shown in FIG. 22 (B), if the distal end portion d1 of the catheter d comes out from the forceps port g on the operation part f side of the endoscope a, a guide near the forceps port g of the endoscope a is guided. The wire e is grasped and the catheter d is completely withdrawn from the endoscope a.

Next, the proximal end side of the guide wire e is inserted into the insertion hole of another treatment tool, and in the state of being guided by this guide wire e, another treatment tool is inserted into the endoscope a of the endoscope a. Insert into channel. After that, the above-described work is repeated for the number of times of changing the treatment tool.

A treatment tool such as a catheter d used for these treatments is 190c in consideration of the length of the insertion portion b of the endoscope a.
Generally, it has a length of m or more. Furthermore, in order to perform the replacement work of the treatment tool in the above procedure, FIG.
As shown in, in a state in which the distal end portion of the guide wire e is projected a predetermined length from the treatment instrument insertion channel of the endoscope a (for example, the distal end of the guide wire e is inserted into the pancreatic duct or the bile duct), The length L1 of the guide wire e at the extending portion extending from the forceps port g on the operation portion f side of the endoscope a to the outside needs to be equal to or longer than the length of the catheter d.
Therefore, the total length of the guide wire e needs to be equal to or longer than the total length of the insertion portion b of the endoscope a and the treatment instrument such as the catheter d, and thus at least 400 c.
About m was necessary.

[0008]

In the conventional structure, the catheter d is inserted into the channel for inserting the treatment tool of the endoscope a.
When inserting or removing the catheter, an operator such as an operator grasps the catheter d with fingers and pushes the catheter d into the treatment instrument insertion channel of the endoscope a little by little, or the treatment instrument of the endoscope a. It is done manually by pulling out the catheter d from the insertion channel. Therefore, since the magnitude of the operation force for pushing the catheter d during the work of pushing the catheter d into the treatment instrument insertion channel of the endoscope a varies widely, the operation force for pushing the catheter d is smaller than an appropriate magnitude. If it becomes large, there is a problem that the catheter d buckles.

Further, when a treatment instrument having a large outer diameter is inserted into the treatment instrument insertion channel of the endoscope a, the work of inserting and removing the catheter d into the treatment instrument insertion channel of the endoscope a becomes heavy. There is. Further, when the treatment instrument such as the catheter d is inserted into and removed from the treatment instrument insertion channel of the endoscope a using the guide wire e as a guide, the frictional resistance at the time of inserting and removing the catheter d is further increased. d
There is a problem in that the insertion / removal work of (1) becomes heavier and the insertion / removal work of the catheter d takes time.

Further, since the length of the catheter d and the guide wire e is long, an assistant or the like may be used when exchanging a treatment instrument such as the catheter d inserted in the treatment instrument insertion channel of the endoscope a. You need a helper. for that reason,
It takes time and effort to replace the treatment tool such as the catheter d,
There is a problem that treatment time such as endoscopic surgery becomes long.

The present invention has been made in view of the above circumstances, and an object thereof is to buckle a catheter during an operation of inserting and removing an endoscopic treatment tool such as a catheter from a treatment tool insertion channel of an endoscope. A treatment instrument for an endoscope capable of achieving prevention, shortening of insertion / removal work time, reduction of man-hours for caregivers, etc., and improvement of insertability of the treatment instrument into the treatment instrument insertion channel of the endoscope. To provide an insertion aid.

[0012]

According to a first aspect of the present invention, an outer cylinder member and an inner cylinder having one end portion inserted into the outer cylinder member and the other end portion extending outside the outer cylinder member. An endoscope connecting portion that is connected to a treatment tool insertion portion of an endoscope in one of the outer cylinder member and the inner cylinder member, and a guide wire insertion portion and the guide. When an endoscope treatment tool having a side hole communicating with the wire insertion portion is inserted into the inner tubular member, a treatment tool locking portion that hooks a finger to lock the endoscope treatment tool. Are provided respectively, and the tubular member on the side of the treatment instrument locking portion is slidably supported along the axial direction with respect to the tubular member on the side of the endoscope connecting portion, and the outer tubular member and the inner tubular member are The endoscopic treatment tool locked to the treatment tool locking portion with the relative sliding movement between the treatment tools. Endoscope treatment tool insertion assist for intermittently performing an operation of inserting and removing the endoscopic treatment tool into and from the treatment tool insertion portion of the endoscope by repeating an operation of moving together with the tubular member on the locking portion side In addition to providing a tool body, a guide wire fixing portion for fixing the guide wire pulled out to the outside from the side hole of the endoscope treatment tool is provided in the endoscope treatment tool insertion assisting tool body. Is a treatment instrument insertion aid for an endoscope. In the invention of claim 1, when the endoscope treatment tool insertion assisting tool main body is used, the endoscope treatment tool is inserted into the inner tubular member, and the tubular member on the side of the endoscope connecting portion is used. On the other hand, the tubular member on the side of the treatment instrument locking portion is slid along the axial direction. At this time, with the sliding motion of the tubular member on the treatment instrument engaging portion side, the endoscope instrument along with the tubular member on the treatment instrument engaging portion side is viewed with the endoscopic treatment instrument engaged with the treatment instrument engaging portion. An operation of inserting and removing the treatment tool for the endoscope from the treatment tool insertion portion of the endoscope, and an operation of returning only the tubular member on the side of the treatment tool locking portion in a state where the treatment tool for the endoscope is unlocked. By repeating the operation alternately, the operation of inserting and removing the endoscopic treatment tool into and from the treatment tool insertion portion of the endoscope is performed intermittently. further,
By fixing the guide wire pulled out from the side hole of the treatment instrument for endoscope to the guide wire fixing part of the main body of the treatment instrument insertion aid for endoscope, no assistant is required, and the treatment of the endoscope is completed. The insertability of the treatment instrument into the instrument insertion channel is improved.

According to a second aspect of the invention, there is provided the endoscopic treatment tool insertion assisting tool according to the first aspect, wherein the endoscopic treatment tool is a catheter. Further, in the invention of claim 2, when the endoscope treatment tool insertion assisting tool main body is used, the treatment tool is applied to the tubular member on the side of the endoscope connecting portion while the catheter is inserted into the inner tubular member. The tubular member on the locking portion side is slid along the axial direction. At this time, in accordance with the sliding motion of the tubular member on the treatment instrument engaging portion side, the catheter is attached to the treatment instrument engaging portion side while the catheter is retained on the treatment instrument engaging portion. The catheter is inserted into and removed from the instrument insertion portion, and the operation of returning only the tubular member on the treatment instrument engagement portion side with the catheter unlocked is alternately repeated to insert the catheter into the treatment instrument insertion portion of the endoscope. Intermittently inserting and removing. Furthermore, by fixing the guide wire pulled out from the side hole of the catheter to the guide wire fixing portion of the main body of the treatment instrument insertion aid for endoscopes, no helper is required and the treatment instrument can be inserted through the endoscope. This is to improve the insertability of the treatment tool into the channel.

According to a third aspect of the present invention, there is provided the endoscopic treatment tool insertion assisting tool according to the first aspect, wherein the outer tubular member is formed by a part of the endoscope channel. . In the invention according to claim 3, the outer tube member of the treatment instrument insertion aid body for endoscope is formed by a part of the endoscope channel, so that the treatment instrument insertion aid body for endoscope can be installed inside. It is designed to be built in integrally with the endoscope.

According to a fourth aspect of the present invention, in the main body of the treatment instrument insertion aid for an endoscope, a slit for inserting the guide wire is formed in the inner tubular member, and the guide wire fixing portion is formed in the outer tubular member. Claim 1 characterized by the above.
Is a treatment instrument insertion aid for an endoscope. In the invention of claim 4, the guide wire extended from the insertion portion of the guide wire of the endoscopic treatment tool to the outside of the endoscopic treatment tool through the side hole is used as an endoscopic treatment tool insertion aid. The guide wire is guided to the guide wire fixing part of the outer cylinder member through the slit of the inner cylinder member in the main body of the tool, and the guide wire is fixed to this guide wire fixing part, which eliminates the need for a helper and allows the treatment tool insertion channel of the endoscope to be inserted. The catheter insertability is improved.

[0016]

BEST MODE FOR CARRYING OUT THE INVENTION A first embodiment of the present invention will be described below with reference to FIGS. 1 (A) and (B) to FIGS. 11 (A) to (E). 1 (A) and 1 (B) are external-type catheter insertion aids that assist the operation of inserting the catheter 1 which is the endoscopic treatment tool of the present embodiment into the treatment tool insertion channel of the endoscope 2. Tool (endoscopic treatment tool insertion aid)
3 shows a state in which 3 is assembled to the endoscope 2. Here, in the endoscope 2, an elongated insertion portion 4 to be inserted into a patient's body, a proximal operation portion 5 connected to a proximal end portion of the insertion portion 4, and a proximal end portion to the operation portion 5. And a universal cord (not shown) connected to each other. The endoscope 2 of the present embodiment is a side-view endoscope 2 for observing a direction substantially orthogonal to the axial direction of the insertion section 4.

The side-view type endoscope 2 is provided with a side-view reference surface of a substantially flat shape in which the outer peripheral surface of the distal end portion of the insertion portion 4 is cut out. An illumination window of an illumination optical system and an observation window of the observation optical system, which are not shown, are juxtaposed in the front-rear direction on this side-view reference surface. Further, a forceps port 6a is provided beside the side-by-side portion where the illumination window and the observation window are provided on the side-view reference plane. The forceps opening 6 a is a treatment instrument insertion channel 6 as a treatment instrument insertion guide path provided inside the insertion portion 4 of the endoscope 2.
And constitutes the opening at the tip.

Further, the operation portion 5 on the hand side is provided with a treatment instrument insertion portion 7 which communicates with the proximal end portion of the treatment instrument insertion channel 6. Then, the catheter 1 of the present embodiment, other endoscopic treatment tools, the medical guide wire 8 or the like is appropriately and selectively inserted into the treatment tool insertion channel 6 from the treatment tool insertion portion 7. After being guided to the distal end portion side of the insertion portion 4 through the treatment instrument insertion channel 6, it is projected to the outside from the forceps port 6a at the distal end portion.

Further, FIG. 2A shows the catheter 1 of this embodiment. Catheter 1 of the present embodiment
As shown in FIG. 2B, is formed by a two-lumen tube in which two lumens 9a and 9b are formed in a shaft-shaped catheter body 1a of the catheter 1. Further, an inflatable balloon 10 is arranged on the outer peripheral surface of the distal end portion of the catheter 1. The distal end of one lumen 9a is connected to the internal space of the balloon 10.

The base portion of the catheter 1 has a base portion 1
1 is provided. An external device connecting portion 12 that communicates with the base end portion of the lumen 9a is disposed on the outer peripheral surface of the mouthpiece portion 11. An external device such as a syringe 13 (see FIG. 1 (B)) is detachably connected to the external device connecting portion 12 as needed.

A guide wire lumen (guide wire insertion portion) through which the guide wire 8 can be inserted is formed in the other lumen 9b of the catheter 1. Further, a side hole 14 communicating with the guide wire lumen 9b is formed at an appropriate position in the axial direction on the outer peripheral surface of the catheter 1 of the present embodiment. The guide wire 8 inserted from the distal end of the guide wire lumen 9b of the catheter 1 can be pulled out to the outside through the side hole 14.

Further, in the catheter insertion aid 3 of the present embodiment, as shown in FIG. 3, an outer cylinder member 15 detachably connected to the treatment tool insertion portion 7 of the endoscope 2 and the outer cylinder member. 1
5 is provided with an insertion assisting tool main body 17 having an inner cylinder member 16 inserted into the inside of the insertion assisting tool 5. Here, the outer cylinder member 15 and the inner cylinder member 16 are made of a material harder than that of the catheter 1, for example, a fluorine resin, a polystyrene resin, a polyolefin resin, or a polyamide resin. The hard material of the outer cylinder member 15 and the inner cylinder member 16 may be, for example, polytetrafluoroethylene, polyamide, polyethylene, polysulfone, polyphenylsulfone, acrylonitrile butadiene, or the like.
It may be either styrene (ABS) or any metal material such as stainless steel, aluminum or nickel titanium.

Further, the base end portion of the inner tubular member 16 is extended to the outside of the outer tubular member 15, and a gripping portion 18 having a diameter larger than that of the outer tubular member 15 is formed at this extended portion. Then, the inner tubular member 16 is slid while holding the grip portion 18. A locking portion 18a is formed at an end edge of the grip portion 18 to lock the catheter 1 with a finger when the catheter 1 is inserted into the inner tubular member 16.

Then, by pushing and pulling the inner tubular member 16 along the axial direction while holding the holding portion 18, the inner tubular member 16 is moved to the outer tubular member 15 as shown in FIGS. It is possible to project and retract into the storage position where the inner cylinder member 16 is housed inside and the projecting position where the inner cylinder member 16 is moved to the outside of the outer cylinder member 15 as shown in FIGS.

Further, as shown in FIG. 4, an engaging convex portion 19 is formed on the outer peripheral surface of the distal end portion of the inner cylindrical member 16 so as to project outward. The outer diameter of the engaging protrusion 19 is the outer cylinder member 1.
The diameter is set to be substantially the same as the inner diameter dimension of No. 5.

Further, a slit 20 for inserting the guide wire 8 is formed in the cylindrical wall portion of the inner cylindrical member 16 along the axial direction of the inner cylindrical member 16 over the entire length of the inner cylindrical member 16. Of course, the slit 20 may be formed in a part of the inner cylinder member 16 instead of the entire length of the inner cylinder member 16.
The slit width of the slit 20 is set so that the guide wire 8 can be inserted therein and the catheter 1 cannot be inserted therethrough. It should be noted that, on the outer peripheral surface of the inner tubular member 16, an index 21 indicating the insertion length of the inner tubular member 16 inserted into the outer tubular member 15 around the slit 20 as shown in FIG.
Is provided.

An outer cylinder large-diameter portion 22 having a larger diameter than the other portions is formed at the tip of the outer cylinder member 15. As shown in FIG. 4, the inner cylinder member 1 is provided at the axial center of the outer cylinder large diameter portion 22.
A small-diameter connecting cylindrical body 23 having a diameter substantially the same as the inner diameter dimension of 6 is arranged. The connecting tubular body 23 is a treatment instrument insertion portion 7 of the endoscope 2.
It is designed to be detachably connected to.

A liquid delivery port 24 is provided on the outer peripheral surface of the large diameter portion 22 of the outer cylinder. The inner end of the liquid feed port 24 is communicated with the inside of the connecting cylinder body 23. Further, a syringe (not shown) can be attached to the outer end portion of the liquid feeding port 24, and liquid can be fed from the liquid feeding port 24 into the treatment instrument insertion portion 7 of the endoscope 2 through the inside of the connecting tubular body 23. It is like this.

A valve cartridge mounting hole 25 is formed on the outer peripheral surface of the outer cylinder large diameter portion 22 in a direction substantially orthogonal to the axial direction of the outer cylinder member 15. As shown in FIG. 5A, the valve cartridge mounting hole 25 has a substantially rectangular entrance side opening 25a having a large opening area on one end side and a smaller opening area on the other end side than the entrance side opening 25a. Each locking opening 25b is formed. Further, between the inlet side opening 25a of the valve cartridge mounting hole 25 and the locking opening 25b, there is a tapered inclined surface 25c whose opening area gradually decreases toward the locking opening 25b side. Has been formed. In the valve cartridge mounting hole 25, step portions 25d for preventing erroneous insertion are formed at both end edges on the front end side of the substantially rectangular inlet side opening 25a. A valve cartridge 26, which will be described later, is removably inserted into the valve cartridge mounting hole 25 through the inlet opening 25a.

Further, the valve cartridge 26 is shown in FIG.
As shown in FIG.
A cartridge body 27 having a shape corresponding to is provided. The central portion of the cartridge body 27 is shown in FIG.
As shown in (C), a through hole 28 that penetrates vertically is formed. An elastic valve 29, which is a forceps plug, is provided in the through hole 28.
Mounting hole 30 and a small diameter hole 3 having a smaller diameter than the mounting hole 30
1 and 1 are formed. An elastic valve 29 is provided in the mounting hole 30.
Is detachably attached.

As shown in FIG. 7A, the elastic valve 29 has a cylindrical body 29a having a diameter substantially equal to the inner diameter of the mounting hole 30, and a film-shaped valve body 29b which closes an opening at one end of the cylindrical body 29a. And are provided. A small hole 29c for inserting a treatment tool is formed in the center of the valve body 29b. This small hole 29
The diameter c is set to be smaller than the diameter of the guide wire 8 inserted through the catheter 1.

Further, as shown in FIG. 6 (D), the cartridge body 27 has a step portion 25d on both sides of the end face on the side of the small diameter hole 31 for preventing erroneous insertion in the valve cartridge mounting hole 25 of the outer cylinder member 15. Notched grooves 27a each having a different shape are formed. As shown in FIG. 4, the valve cartridge 26 is inserted into the valve cartridge mounting hole 25 of the outer cylinder member 15 with the elastic valve 29 mounted in the mounting hole 30. At this time, the cutout groove 27a of the cartridge body 27 and the step portion 25d of the valve cartridge mounting hole 25 of the outer cylinder member 15 are aligned with each other, so that the elastic valve 29 of the cartridge body 27 is properly oriented (valve). The valve cartridge 26 is detachably attached to the outer cylinder member 15 with the mounting hole 30 of the elastic valve 29 of the cartridge 26 facing rearward.

Further, when the valve cartridge 26 is mounted in the valve cartridge mounting hole 25 of the outer cylinder member 15, as shown in FIG. 5A, the end portion 27b of the cartridge body 27 on the side of the narrow portion is mounted on the valve cartridge. With the valve cartridge 26 protruding outward from the locking opening 25 b of the hole 25, the valve cartridge 26 is attached to the valve cartridge mounting hole 2 of the outer cylinder member 15.
It is locked to 5. Therefore, when removing the valve cartridge 26 from the valve cartridge mounting hole 25, the end portion 27b of the cartridge main body 27 on the side of the narrower portion is pushed, so that the valve cartridge 26 can be easily moved from the valve cartridge mounting hole 25 to the outside. It can be pushed out.

Further, on the inner peripheral surface of the base end portion of the outer tubular member 15, there is provided an inward protruding projection 32 for preventing the inner tubular member 16 from coming off from the outer tubular member 15. The inside diameter of the retaining projection 32 is set to be substantially the same as the outside diameter of the inner tubular member 16. Then, as shown in FIG. 9, the outer cylinder member 15 is moved from the outer cylinder member 15 to the outermost protruding position where the inner cylinder member 16 is pulled out to the outermost side.
The engagement convex portion 19 of the inner tubular member 16 is brought into contact with the retaining projection 32 to prevent the inner tubular member 16 from falling off the outer tubular member 15. In addition, the insertion length of the inner tubular member 16 into the outer tubular member 15 is set to about 5 cm to 80 cm.

Further, the protrusion 32 for preventing the outer cylinder member 15 from coming off
And the outer peripheral surface of the inner tubular member 16, a first contact portion between the outer peripheral surface of the inner tubular member 16 and the outer peripheral member 15
The second contact portion between the inner cylindrical surface and the inner peripheral surface of the outer cylindrical member 15 and the inner cylindrical member 16 except when the catheter insertion aid 3 is used.
Means are provided to lock the space between and.

Further, a guide wire fixing portion 33 is arranged on the outer peripheral surface of the base end portion of the outer tubular member 15. A wire locking groove 34 having a groove width smaller than the wire diameter of the guide wire 8 is formed in the guide wire fixing portion 33. Further, as shown in FIG. 12 (B), a guide wire insertion groove 42 is provided in the end edge portion of the outer tubular member 15 along the radial direction. The outer end portion of the guide wire insertion groove 42 communicates with the wire locking groove 34 of the guide wire fixing portion 33. Further, the inner end portion of the guide wire insertion groove 42 is communicated with the slit 20 of the inner tubular member 16.

Then, the guide wire 8 extending from the guide wire lumen 9b of the guide wire 8 of the catheter 1 through the side hole 14 to the outside of the catheter 1 is inserted into the slit 2 of the inner tubular member 16 of the main body 17 of the catheter insertion aid.
The guide wire 8 can be guided to the guide wire fixing portion 33 of the outer tubular member 15 through 0, and the guide wire 8 can be hooked and fixed in the wire locking groove 34 of the guide wire fixing portion 33.

Next, the operation of the above configuration will be described.
The catheter insertion assisting tool 3 of the present embodiment is used when the catheter 1 is inserted into and removed from the treatment tool insertion portion 7 of the endoscope 2. Here, the operation of the catheter insertion assisting tool 3 during the operation of inserting the catheter 1 into the treatment tool inserting portion 7 of the endoscope 2 will be described.

When the catheter insertion aid 3 is used, the catheter insertion aid 3 is connected to the treatment instrument insertion portion 7 of the endoscope 2 as shown in FIG. 1 (A). At this time, the connecting tube body 23 at the tip of the outer tube member 15 is detachably connected to the treatment instrument insertion section 7 of the endoscope 2. A guide wire 8 is previously inserted in the treatment instrument insertion channel 6 of the endoscope 2.

Subsequently, after inserting the rear end portion of the guide wire 8 into the guide wire lumen 9b of the catheter 1, the operation of inserting the catheter 1 along the guide wire 8 is performed. At this time, the caregiver holds the rear end of the guide wire 8.

During the insertion operation of the catheter 1, the distal end of the catheter 1 is inserted into the inner tubular member 16 of the main body 17 of the insertion aid.
After being inserted therein, the inner tubular member 16 is projected and retracted inside and outside the outer tubular member 15 in a state where the catheter 1 and the grasping portion 18 of the inner tubular member 16 are grasped together. At this time, the operation of inserting the catheter 1 into the treatment instrument insertion portion 7 of the endoscope 2, that is, the operation of inserting the catheter 1 to the left in FIG. It is performed as follows.

At the time of inserting the catheter 1, the inner cylinder member 16 is moved to a protruding position outside the outer cylinder member 15, and the finger is hung on the catheter 1 to lock the catheter 1 to the grip portion 18 of the inner cylinder member 16. After being locked to 18a, the inner cylinder member 16 is inserted into the outer cylinder member 15 as shown in FIG. At this time, the rear end of the guide wire 8 is held by the caregiver. By this operation, the catheter 1 is inserted by one stroke of the inner tubular member 16.

After that, the locking of the catheter 1 is released at the moving position of the inner tubular member 16 inside the outer tubular member 15. In this state, the catheter 1 is not held and only the inner tubular member 16 is moved to the right in FIG. 10 (B). At this time, the rear end of the guide wire 8 is held by the caregiver. During this operation, the catheter 1 is locked by the elastic valve 29 and does not move.

Further, the following FIG. 10 (C) to FIG. 11 (A)
Then, the catheter insertion operation shown in FIG.
That is, the inner tubular member 16 is moved to the inside of the outer tubular member 15 in a state where the inner tubular member 16 projects outside the outer tubular member 15 and holds the catheter 1 and the holding portion 18 of the inner tubular member 16 together. Thus, the operation of inserting the catheter 1 for one stroke of the inner tubular member 16 and the operation of returning the inner tubular member shown in FIG.
In the state where the catheter 1 is unlocked at the movement position inside 5, the operation of moving only the inner tubular member 16 to the projecting position outside the outer tubular member 15 without holding the catheter 1 is alternately repeated. . As a result, the catheter 1 is inserted into the endoscope 2
The operation of inserting the treatment instrument into the treatment instrument insertion section 7 is intermittently performed,
Elongated catheter 1 without the catheter 1 buckling
Can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2.

When the above-mentioned intermittent insertion operation of the catheter 1 progresses and the side hole 14 of the catheter 1 moves to the position of the catheter insertion aid 3, the guide pulled out from the side hole 14 of the catheter 1 to the outside. The wire 8 is guided to the guide wire fixing portion 33 of the outer cylindrical member 15 through the slit 20 of the inner cylindrical member 16, and the guide wire 8 is guided to the guide wire fixing portion 33 of the catheter insertion aid main body 17 as shown in FIG. 11B. The operation of inserting and fixing is performed. This eliminates the need for an assistant who holds the rear end of the guide wire 8 in the subsequent operations.

Thereafter, as shown in FIG. 11C, a catheter insertion operation similar to the catheter insertion operation shown in FIG. 10A described above, and FIG. 10B described above shown in FIG. 11D. The catheter 1 can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2 without buckling by alternately repeating the inner cylinder member returning operation shown in FIG.

Further, as shown in FIG. 11D, with the distal end of the catheter 1 projected outward from the forceps port 6a at the distal end of the insertion portion 4 and the balloon 10 extended outward, As shown in FIG. 11 (E), the base part 1 of the catheter 1
The syringe 13 is connected to the external device connecting portion 12 of No. 1.
The working fluid pumped from the syringe 13 is supplied into the balloon 10 through the lumen 9a of the catheter 1 and the balloon 10 is inflated. In this state, treatment using the catheter 1 is performed. At this time, the inner tube member 16 of the catheter insertion aid 3 is projected to the outer tube member 15 in a state in which the finger is hooked and the catheter 1 is locked to the locking portion 18a of the grip portion 18 of the inner tube member 16. By immersing the catheter 1, the catheter 1 can be moved back and forth between the position shown in FIG. 11 (E) and the position shown in FIG. 1 (B). For example, a procedure such as quarrying using a balloon catheter can be performed by one person. It can be easily performed by the surgeon without the assistance of a caregiver.

When the catheter 1 is pulled out from the treatment instrument insertion portion 7 of the endoscope 2, the catheter insertion assisting instrument 3 is used.
Is operated as follows. First, the inner tube member 16 is inserted into the outer tube member 15, and a finger is hung at the moving position to insert the catheter 1
After being locked to the locking portion 18a of the inner tubular member 16, an operation of moving the inner tubular member 16 together with the catheter 1 to a protruding position outside the outer tubular member 15 is performed. Thereby, the work of pulling out the catheter 1 by one stroke of the inner cylinder member 16 is performed.

Subsequently, the engagement of the catheter 1 with the inner tubular member 16 is released at the protruding position outside the outer tubular member 15. In this state, an operation of returning only the inner tubular member 16 to the moving position where it is inserted into the outer tubular member 15 is performed. During this operation, the catheter 1 is locked by the elastic valve 29 and does not move.

After that, the inner cylinder member 16 is inserted into the outer cylinder member 15, and a finger is hung at the moving position to lock the catheter 1 to the locking portion 18a of the inner cylinder member 16, and then the inner cylinder member 16 is inserted.
By moving the catheter 1 together with the catheter 1 to a projecting position outside the outer tubular member 15, the catheter 1 is pulled out by one stroke of the inner tubular member 16, and the inner tubular member is projected at the projecting position outside the outer tubular member 15. 16 in a state where the catheter 1 is unlocked, only the inner tubular member 16 is moved to the outer tubular member 15.
By repeatedly performing the operation of returning the catheter 1 to the moving position inserted therein, the operation of withdrawing the catheter 1 from the treatment instrument insertion portion of the endoscope 2 can be performed intermittently.

Therefore, the following effects can be obtained with the above-mentioned structure. That is, in the catheter insertion assisting tool 3 of the present embodiment, the catheter insertion operation shown in FIG. 10A described above and the inner tube member returning operation shown in FIG. Can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2 without buckling. Thereby, particularly when the catheter 1 is soft, or when the insertion resistance when inserting the catheter 1 into the treatment instrument insertion portion 7 of the endoscope 2 is large and the insertion operation is heavy, it is possible to easily insert the catheter 1. There is. for that reason,
When the catheter 1 is inserted into or removed from the treatment instrument insertion channel 6 of the endoscope 2, buckling of the catheter 1 can be prevented, the insertion / extraction work time can be shortened, and the man-hours of caregivers can be reduced. The insertability of the catheter 1 into the second treatment tool insertion channel 6 can be improved.

In the present embodiment, the side hole 14 communicating with the guide wire lumen 9b is formed at an appropriate axial position on the outer peripheral surface of the catheter 1, and the side hole 14 is inserted from the distal end of the guide wire lumen 9b of the catheter 1. The guide wire 8 is pulled out from the side hole 14 to the outside. Therefore, for example, as shown in FIG. 2 (C), a guide wire to be used as compared with the case where the guide wire 8 inserted from the distal end portion of the guide wire lumen 9b of the catheter 1 is pulled out from the rear end position of the catheter 1 to the outside. Since the length of 8 can be shortened, the guide wire 8
Can be made easier to handle.

Further, in the catheter insertion assisting tool 3 of the present embodiment, a slit 20 for inserting the guide wire 8 is provided in the tubular wall portion of the inner tubular member 16, and a guide wire is provided on the outer peripheral surface of the proximal end portion of the outer tubular member 15. The fixing portion 33 is provided, and the guide wire 8 extended from the guide wire lumen 9b of the guide wire 8 of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 20 of the inner tubular member 16 of the catheter insertion aid main body 17. The guide wire 8 is guided to the guide wire fixing portion 33 of the outer tubular member 15 so that the guide wire 8 can be hooked and fixed in the wire locking groove 34 of the guide wire fixing portion 33. In this state, the operator can easily perform the work of inserting the catheter 1 into the treatment instrument insertion portion 7 of the endoscope 2 along the guide wire 8 without the assistance of a caregiver.

Further, the inner tube member 16 of the catheter insertion aid 3 is inserted into the outer tube member 15 in a state in which the finger is hooked to lock the catheter 1 to the locking portion 18a of the grip portion 18 of the inner tube member 16. By pushing and retracting the catheter, the catheter 1 can be moved back and forth to the position shown in FIG. 11 (E) and the position shown in FIG. 1 (B). Therefore, there is an effect that one operator can easily perform a procedure such as gallstone quarrying using a balloon catheter without the assistance of a caregiver.

Further, in the catheter insertion aid 3 of this embodiment, the valve cartridge mounting hole 25 is provided at the tip of the outer tubular member 15, and the valve cartridge 26 is removably mounted in this valve cartridge mounting hole 25. It is possible to easily replace only the elastic valve 29, which is the forceps plug of the valve cartridge 26 having poor durability and cleanability. Therefore, there is no need to replace other usable parts other than the elastic valve 29 which is the forceps plug of the valve cartridge 26, which is economical, and the function is deteriorated only by replacing the elastic valve 29 of the valve cartridge 26. It is possible to repeatedly use the catheter insertion assisting tool 3 without using it.

Further, FIGS. 12A and 12B show a first modification of the guide wire fixing portion 33 in the catheter insertion aid 3 of the first embodiment. In this modification, an outward convex portion 41 is integrally formed on the outer peripheral surface of the end edge portion of the outer tubular member 15, and a slit-shaped wire locking groove 42 is provided in the convex portion 41. This wire locking groove 42
The groove width is set to be smaller than the wire diameter of the guide wire 8.

In this modification, the guide wire 8 extended from the guide wire lumen 9b of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 20 of the inner tubular member 16 in the main body 17 of the catheter insertion aid to the outside. Guide to the guide wire fixing portion 33 of the tubular member 15,
The guide wire fixing portion 33 can be inserted and fixed in the wire locking groove 42.

13A and 13B show a second modification of the guide wire fixing portion 33 in the catheter insertion aid 3 of the first embodiment. In this modified example, a substantially V-shaped engagement groove 5 is formed on the outer peripheral surface of the end portion of the outer tubular member 15.
1 is formed, and the elastic body 52 is attached to the inner surface portion of the engagement groove 51.

In this modification, the guide wire 8 extended from the guide wire lumen 9b of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 20 of the inner tubular member 16 in the main body 17 of the catheter insertion aid to the outside. Guide to the guide wire fixing portion 33 of the tubular member 15,
The guide wire fixing portion 33 can be fixed by inserting it into the elastic body 52 of the V-shaped engaging groove 51.

Further, FIGS. 14A and 14B show a third modification of the guide wire fixing portion 33 in the catheter insertion aid 3 of the first embodiment. In this modification, a wire locking groove 61 having a groove width smaller than the wire diameter of the guide wire 8 is formed at the edge portion of the cylinder wall of the outer cylinder member 15.

In this modification, the guide wire 8 extending from the guide wire lumen 9b of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 20 of the inner tubular member 16 of the main body 17 of the catheter insertion aid to the outside. Guide to the guide wire fixing portion 33 of the tubular member 15,
The guide wire fixing portion 33 can be inserted and fixed in the wire locking groove 61.

FIGS. 15A and 15B show a fourth modification of the guide wire fixing portion 33 in the catheter insertion aid 3 of the first embodiment. In this modification, a mounting groove 71 is formed in an end edge portion of the cylindrical wall of the outer cylindrical member 15, and a guide wire fixing tool 72 is mounted in the mounting groove 71.

In this modification, the guide wire 8 extended from the guide wire lumen 9b of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 20 of the inner tubular member 16 in the main body 17 of the catheter insertion aid to the outside. Guide to the guide wire fixing portion 33 of the tubular member 15,
The guide wire fixing member 72 of the guide wire fixing portion 33
It can be fixed by hooking on.

Further, FIGS. 16 (A), (B) and FIG.
Shows a second embodiment of the present invention. In this embodiment, the configuration of the catheter insertion aid 3 of the first embodiment (see FIGS. 1A and 1B to 11A to 11E) is modified as follows. .

That is, in the present embodiment, the outer cylinder member 81 of the catheter insertion aid 3 is formed with the outer cylinder slit 81 at a position corresponding to the slit 20 of the inner cylinder member 16 to extend the slit 20. A guide wire fixing portion 3 having a configuration similar to that of the catheter insertion assisting tool 3 of the first embodiment is provided at a position near the outer cylinder large diameter portion 22 at the distal end portion of 15.
3 is provided.

In this embodiment, the catheter 1 is inserted into the treatment instrument insertion portion 7 of the endoscope 2 along the guide wire 8 by using the catheter insertion aid 3 as in the first embodiment. When performing the operation, the side hole 14 of the catheter 1
The guide wire 8 pulled out from the inside to the inner cylinder member 16
Slit 20 and outer cylinder slit 81 of outer cylinder member 15
The guide wire 8 is guided to the guide wire fixing portion 33 of the outer tube member 15 through the guide wire 8, and the guide wire 8 is inserted into the guide wire fixing portion 33 of the catheter insertion aid main body 17 and fixed. In this state, the rear end of the guide wire 8 does not need to be held by the caregiver, and therefore the first embodiment is also used in this embodiment.
The same effect as that of the embodiment can be obtained.

18 to 20 show a third embodiment of the present invention. This embodiment is the first embodiment (FIGS. 1A and 1B to FIG. 11A).
The configuration of the catheter insertion aid 3 (see (E)) is changed as follows.

That is, in the present embodiment, a built-in type catheter insertion assisting tool 9 in which the catheter insertion assisting tool 3 of the first embodiment is incorporated in the operating portion 5 of the endoscope 2.
1 is provided. This catheter insertion aid 91
Then, the outer tubular member 92 is formed by a part of the treatment instrument insertion channel 6 of the endoscope 2.

Further, the inner cylinder member 93 is inserted into the outer cylinder member 92 to form an insertion assisting tool main body 94. A base end portion of the inner tubular member 93 extends from the end edge position of the operating portion 5 to the outside of the outer tubular member 92, and a grip portion 95 having a diameter larger than that of the outer tubular member 92 is formed in the extended portion. There is. Then, the inner cylinder member 93 is slid while the grip portion 95 is gripped. An engaging portion 95 for engaging the catheter 1 with a finger when the catheter 1 is inserted into the inner tubular member 93 at the end edge portion of the grip portion 95.
a is formed.

Then, with the grip portion 95 being gripped, the inner cylinder member 93 is pushed and pulled in the axial direction to set the inner cylinder member 93 inside the outer cylinder member 92 at the stored position. The inner cylinder member 93 can be projected and retracted at a protruding position where the inner cylinder member 93 has been moved to the outside of the outer cylinder member 92.

Further, on the outer peripheral surface of the distal end portion of the inner cylinder member 93, an engaging convex portion 96 which is provided so as to project outward is formed. The outer diameter of the engaging projection 96 is set to be substantially the same as the inner diameter of the outer tubular member 92.

Further, a slit 97 for inserting the guide wire 8 is formed in the cylindrical wall portion of the inner cylindrical member 93 along the axial direction of the inner cylindrical member 93 over substantially the entire length of the inner cylindrical member 93. The slit width of the slit 97 is set so that the guide wire 8 can be inserted therethrough and the catheter 1 cannot be inserted therethrough. In addition, on the outer peripheral surface of the inner tubular member 93, an index 98 is provided around the slit 97 for displaying the insertion length of the inner tubular member 93 inserted into the outer tubular member 92.

Further, as shown in FIG. 19, a valve cartridge mounting hole 99 is formed in the operation portion 5 of the endoscope 2 at a position corresponding to the distal end portion of the outer tubular member 92. A valve cartridge 100 having the same structure as the valve cartridge 26 of the first embodiment is detachably inserted into the valve cartridge mounting hole 99.

Further, on the inner peripheral surface of the base end portion of the outer cylinder member 92, a retaining projection 101 for preventing the inner cylinder member 93 from falling out of the outer cylinder member 92 is provided so as to protrude inward. The inner diameter of the retaining projection 101 is set to be substantially the same as the outer diameter of the inner tubular member 93. And the outer cylinder member 9
In a state in which the inner tubular member 93 is moved to the outermost protruding position where the inner tubular member 93 is pulled out to the outermost side from 2, the engaging convex portion 96 of the inner tubular member 93 contacts the retaining projection 101 of the outer tubular member 92. The inner cylinder member 93 is prevented from falling off from the outer cylinder member 92.

Further, the protrusion 10 for preventing the outer cylinder member 92 from coming off
1 and the outer peripheral surface of the inner tubular member 93, the engaging projection 96 on the outer peripheral surface of the tip end portion of the inner tubular member 93, and the outer tubular member 9.
A second contact portion between the inner peripheral surface of the outer peripheral member 2 and the inner peripheral surface of the inner peripheral member 2 forms a means for locking the outer cylindrical member 92 and the inner cylindrical member 93 so that they do not move except when the catheter insertion aid 91 is used. Has been done.

Further, in the operation portion 5 of the endoscope 2, the guide wire fixing portion 1 having the same structure as the guide wire fixing portion 33 of the first embodiment is provided at a position corresponding to the base end portion of the outer tubular member 92.
02 is provided. Then, the guide wire 8 extended from the guide wire lumen 9b of the guide wire 8 of the catheter 1 through the side hole 14 to the outside of the catheter 1 is passed through the slit 97 of the inner tubular member 93 of the main body 94 of the catheter insertion aid to allow the operation portion 5 to move. Guide wire fixing part 1
The guide wire 8 can be hooked and fixed on the guide wire fixing portion 102.

The length of the guide wire 8 used in this embodiment is the length Y of the treatment instrument insertion channel 6 of the endoscope 2 and the treatment instrument insertion channel 6 as shown in FIG. Is set to an appropriate length that is greater than the total length of the projection length X of the distal end portion of the catheter 1 projected from the distal end portion.

Next, the operation of the above configuration will be described.
The built-in type catheter insertion aid 91 of the present embodiment is used when the catheter 1 is inserted into and removed from the treatment instrument insertion portion 7 of the endoscope 2. Here, for example, at the time of inserting the catheter 1, a finger is put on the catheter 1 to insert the catheter 1 into the inner tubular member 9 as in the catheter insertion assisting tool 3 of the first embodiment.
The catheter for one stroke of the inner tubular member 93 by pushing the inner tubular member 93 into the outer tubular member 92 from the outside of the outer tubular member 92 in a state of being locked to the locking portion 95a of the grasping portion 95 of No. 3. 1 and the inner cylinder member returning operation of returning only the inner cylinder member 93 without holding the catheter 1 in a state where the locking of the catheter 1 is released at the moving position of the inner cylinder member 93. Thus, the catheter 1 can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2 without buckling.

When the insertion operation of the catheter 1 progresses intermittently and the side hole 14 of the catheter 1 moves to the position of the catheter insertion aid 3, the guide pulled out from the side hole 14 of the catheter 1 to the outside. The operation of guiding the wire 8 to the guide wire fixing portion 102 of the outer cylinder member 92 through the slit 97 of the inner cylinder member 93 and inserting and fixing the guide wire 8 into the guide wire fixing portion 102 of the catheter insertion aid main body 94 is performed. . This eliminates the need for an assistant who holds the rear end of the guide wire 8 in the subsequent operations.

Thereafter, a similar catheter insertion operation and an inner cylinder member returning operation are alternately repeated to cause the catheter 1
Can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2 without buckling.

Further, also when the catheter 1 is pulled out from the treatment instrument insertion portion 7 of the endoscope 2, the catheter 1 can be pulled out by the same operation as the catheter insertion aid 3 of the first embodiment. .

Therefore, also in the catheter insertion assisting tool 91 of the present embodiment, as in the first embodiment, when the catheter 1 is particularly soft, or when the catheter 1 is inserted into the treatment tool insertion portion 7 of the endoscope 2. Since the insertion resistance at this time is large and the catheter 1 can be easily inserted when the insertion operation is heavy, when the catheter 1 is inserted into or removed from the treatment instrument insertion channel 6 of the endoscope 2, It is possible to achieve bending prevention, shortening of insertion / removal work time, reduction of man-hours for caregivers, etc., and it is possible to improve the insertability of the catheter 1 into the treatment instrument insertion channel 6 of the endoscope 2.

Further, in this embodiment, a built-in type catheter insertion assisting tool 91 in which the catheter insertion assisting tool 3 of the first embodiment is incorporated in the operating portion 5 of the endoscope 2 is used.
Since this is provided, in addition to the same effects as the first embodiment, there is an effect that the work of attaching and detaching the catheter insertion aid 3 to and from the endoscope 2 can be omitted.

FIG. 21 shows a fourth embodiment of the present invention. This embodiment mode is the first embodiment mode (see FIGS. 1A and 1B to FIGS. 11A to 11E).
The configuration of the catheter insertion aid 3 is changed as follows.

That is, the catheter insertion assisting tool 101 of this embodiment has an inner tubular member 102 detachably connected to the treatment instrument insertion portion 7 of the endoscope 2, and is slidable with respect to the inner tubular member 102. And an outer cylinder member 103 supported by.

Further, a large diameter cylindrical portion 104 having a large diameter is formed at one end of the inner cylindrical member 102. This large-diameter cylindrical portion 10
At the axial center of 4, there is provided a connecting cylinder 105 that is detachably connected to the treatment instrument insertion portion 7 of the endoscope 2.

A liquid delivery port 106 is provided on the outer peripheral surface of the large-diameter cylindrical portion 104. This liquid delivery port 10
The inner end of 6 is communicated with the inside of the connecting cylinder 105.
Further, a syringe (not shown) can be attached to the outer end of the liquid feeding port 106, and liquid can be fed from the liquid feeding port 106 into the treatment instrument insertion portion 7 of the endoscope 2 through the inside of the connecting cylinder 105. It is like this.

A valve cartridge mounting hole 106 is formed on the outer peripheral surface of the large-diameter cylindrical portion 104 in a direction substantially orthogonal to the axial direction. A valve cartridge 107 having the same structure as the valve cartridge 26 of the first embodiment is detachably inserted into the valve cartridge mounting hole 106.

A large-diameter grip portion 108 is formed at the base end of the outer cylinder member 103. Then, this grip 1
The outer cylinder member 103 is slid in the axial direction while holding 08. A treatment tool locking portion 108a is formed at an end edge portion of the grip portion 108 to lock the catheter 1 with a finger when the catheter 1 is inserted into the inner tubular member 102.

Further, a slit 109 for inserting the guide wire 8 is formed on the cylindrical wall portion of the outer cylindrical member 103. Further, the outer tubular member 103 is provided on the tubular wall portion of the inner tubular member 102.
A slit 110 connected to the slit 109 is formed. A guide wire fixing portion 111 is arranged at the end of this slit 110. The guide wire fixing portion 111 is formed with a wire locking groove 112 having a groove width smaller than the wire diameter of the guide wire 8.

Then, the guide wire 8 extended from the guide wire lumen 9b of the guide wire 8 of the catheter 1 through the side hole 14 to the outside of the catheter 1 is inserted into the slit 109 and the inner cylinder of the outer tube member 103 of the catheter insertion aid 101. The guide wire 8 is guided to the guide wire fixing portion 111 of the inner tubular member 102 through the slit 110 of the member 102, and the guide wire 8 can be hooked and fixed in the wire locking groove 112 of the guide wire fixing portion 111.

When the catheter insertion aid 101 of this embodiment is used, the catheter 1 is inserted into the inner tubular member 102.
The outer cylinder member 1 on the side of the treatment instrument locking portion 108a is inserted into the inner cylinder member 102 on the side of the endoscope connecting portion 105 while being inserted therein.
03 is slid along the axial direction. At this time, with the sliding movement of the outer tubular member 103 on the treatment instrument engaging portion 108a side, with the catheter 1 retained on the treatment instrument engaging portion 108a, the outer tubular member 10 on the treatment instrument engaging portion 108a side.
3, an operation of inserting / removing the catheter 1 from the treatment instrument insertion portion 7 of the endoscope 2, and an operation of returning only the outer tubular member 103 on the treatment instrument engagement portion 108a side in a state where the engagement of the catheter 1 is released. The operation of inserting / removing the catheter 1 into / from the treatment instrument insertion portion 7 of the endoscope 2 is intermittently performed by repeating the above. Further, the guide wire 8 pulled out from the side hole 14 of the catheter 1 to the outside is used as a catheter insertion aid 101.
By fixing the guide wire to the guide wire fixing portion 111, an assistant is not required, and the insertability of the catheter 1 into the treatment instrument insertion channel 6 of the endoscope 2 can be improved.

Therefore, the following effects are obtained with the above-mentioned structure. That is, in the catheter insertion aid 101 of the present embodiment, as described above, the insertion operation of inserting the catheter 1 together with the outer tubular member 103 and the outer tubular member 103.
Catheter 1 by repeating the operation of returning only
The catheter 1 can be easily inserted into the treatment instrument insertion portion 7 of the endoscope 2 without buckling. This allows
In particular, when the catheter 1 is soft, or when the insertion resistance when inserting the catheter 1 into the treatment instrument insertion portion 7 of the endoscope 2 is large and the insertion operation is heavy, the catheter 1 can be easily inserted. Therefore, the catheter 1 is replaced with the endoscope 2
It is possible to prevent buckling of the catheter 1 during the work of inserting / removing the treatment instrument insertion channel 6, shortening of the insertion / removal work time, reduction of man-hours of caregivers, etc., and the treatment instrument insertion channel of the endoscope 2 can be achieved. The insertability of the catheter 1 into the catheter 6 can be improved.

Further, in the catheter insertion assisting tool 101 of the present embodiment, the outer tubular member 103 is provided with the slit 109 for inserting the guide wire 8, and the inner tubular member 102 is provided with the outer tubular member 103. The slit 110 connected to the slit 109 of the catheter 1 is provided, and the guide wire fixing portion 111 is provided on the inner tubular member 102, and the guide wire lumen 9b of the guide wire 8 of the catheter 1 is extended to the outside of the catheter 1 through the side hole 14. The guide wire 8 is attached to the slit 109 of the outer tubular member 103 and the slit 110 of the inner tubular member 102 in the catheter insertion aid 101.
Through the inner tubular member 102 to the guide wire fixing portion 111, and the wire locking groove 1 of the guide wire fixing portion 111
The guide wire 8 can be hooked and fixed to the guide wire 12. In this state, the operator can easily perform the work of inserting the catheter 1 into the treatment instrument insertion portion 7 of the endoscope 2 along the guide wire 8 without the assistance of a caregiver.

Furthermore, the present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. Note (Additional Item 1) An inner cylinder having a proximal end and a distal end having an inner diameter that allows a treatment instrument for an endoscope to be inserted, and a portion except a part of a proximal portion of the inner cylinder can be inserted. An outer cylinder having a proximal end and a distal end having different inner diameters, and one end of the outer cylinder forms a detachable attachment / detachment portion at the channel opening portion of the endoscope, so that the inner cylinder and the outer cylinder can be inserted. A catheter insertion aid for an endoscope, characterized in that a slit connecting the inside and outside of the inner cylinder is provided from the proximal end to the distal end of the inner cylinder.

(Supplementary Note 2) A locking means for preventing the treatment tool for endoscope from moving outward together with the inner cylinder when the inner cylinder moves in a direction in which the inner cylinder protrudes outward. The catheter insertion aid for endoscopes according to item 1 above.

(Additional Item 3) The endoscopic catheter according to Additional Item 1 having an elastic valve through which an endoscope treatment tool can be inserted and which shuts off a passage leading to the endoscope channel side. Insertion aid.

(Additional Item 4) The endoscopic catheter insertion aid according to Additional Item 2, wherein the locking means is an elastic valve.

(Additional Item 5) The catheter insertion aid for an endoscope according to Additional Items 3 and 4, wherein the elastic valve is detachable.

(Additional Item 6) The endoscopic catheter insertion aid according to Additional Item 1, wherein the slit has a size capable of inserting the guide wire.

(Additional Item 7) The endoscopic catheter insertion aid according to Additional Item 6, wherein the slit has a size that does not allow the endoscopic treatment tool to pass therethrough.

(Additional Item 8) The catheter insertion aid for an endoscope according to Additional Item 1 having a locking means for locking the guide wire to the outer cylinder.

(Additional Item 8-2) The endoscopic catheter insertion aid according to Additional Item 8, wherein the locking means is disposed in the vicinity of the outer cylinder.

(Additional Item 9) The catheter insertion aid for an endoscope according to Additional Item 1 having means for locking the outer cylinder and the inner cylinder so that the outer cylinder and the inner cylinder do not move except when in use.

(Additional Item 10) The endoscopic catheter insertion aid according to Additional Item 1, wherein the inner cylinder is made of a member harder than the insertion portion of the endoscopic treatment tool.

(Additional Item 11) The endoscopic catheter insertion aid according to Additional Item 1, wherein the outer cylinder is made of a member that is harder than the insertion portion of the endoscopic treatment instrument.

(Additional Item 12) The additional item 1 wherein the inner cylinder and the outer cylinder are made of a member that is harder than the insertion portion of the endoscopic treatment tool.
A catheter insertion aid for endoscopes according to item 1.

(Additional Item 13) The additional member 10, 11, wherein the member harder than the insertion portion of the endoscope treatment tool is one of a fluorine resin, a polystyrene resin, a polyolefin resin, and a polyamide resin. Item 12. The catheter insertion aid for endoscope according to Item 12.

(Additional Item 14) The member harder than the insertion portion of the endoscope treatment tool is polytetrafluoroethylene, polyamide, polyethylene, polysulfone, polyphenylsulfone, acrylonitrile-butadiene-
Additional notes 10, 1 which is either styrene (ABS)
The catheter insertion aid for endoscopes according to any one of 1 and 12.

(Additional Item 15) The additional item 10, wherein the member that is harder than the insertion portion of the endoscope treatment tool is one of metallic materials such as stainless steel, aluminum, and nickel titanium.
11. The catheter insertion aid for endoscopes according to 11, 12.

(Additional Item 16) The endoscopic catheter insertion aid according to Additional Item 1, wherein the inner cylinder is provided with an index in the longitudinal direction.

(Additional Item 17) The endoscopic catheter insertion aid according to Additional Item 1, wherein the outer tube or the inner tube is provided with a passage capable of sending a fluid to the endoscope channel in a part thereof.

(Additional Item 18) The endoscopic catheter insertion aid according to Additional Item 1, wherein the insertion length of the inner cylinder into the outer cylinder is between 5 cm and 80 cm.

(Additional Item 19) The catheter insertion aid for an endoscope according to Additional Item 1, wherein a part of the endoscope channel is an outer cylinder.

(Additional Item 20) An inner cylinder having a proximal end and a distal end having an inner diameter that allows insertion of a treatment instrument for an endoscope, and most of the inner cylinder except the proximal portion can be inserted. An outer cylinder having a proximal end and a distal end having different inner diameters, and one end of the outer cylinder forms a detachable attachment / detachment portion at the channel opening portion of the endoscope, so that the inner cylinder and the outer cylinder can be inserted. In the insertion aid for an endoscope, the locking means for locking the guide wire is located in the proximal end direction of the inner cylinder and has a connecting portion for connecting the guide wire locking means and the outer cylinder. A characteristic endoscopic catheter insertion aid.

[0116]

According to the first aspect of the present invention, when the endoscope treatment tool is inserted into the inner tubular member, a locking portion for hooking a finger to lock the endoscope treatment tool is provided. Provided at the outer end of the inner tubular member,
With the operation of projecting and retracting the inner cylinder member into and out of the outer cylinder member, the endoscope is repeated by repeating the operation of moving the treatment instrument for an endoscope locked in the locking portion of the inner cylinder member together with the inner cylinder member. A main body of the endoscopic treatment tool insertion assisting tool that intermittently inserts and removes the endoscopic treatment tool into and from the endoscopic treatment tool insertion portion is provided. Since the guide wire fixing portion for inserting and fixing the guide wire pulled out to the outside from the side hole of the treatment instrument for a mirror is provided, the treatment instrument for an endoscope such as a catheter is used as a channel for inserting the treatment instrument of the endoscope. Prevents the catheter from buckling during insertion and removal
It is possible to shorten the insertion / removal work time, reduce the man-hours of the caregiver, and improve the insertability of the treatment instrument into the treatment instrument insertion channel of the endoscope.

According to the second aspect of the present invention, when the main body of the treatment instrument insertion aid for an endoscope is used, the inner tubular member is projected and retracted into and out of the outer tubular member while the catheter is inserted into the inner tubular member. Then, with the operation of projecting and retracting the inner tubular member, the operation of locking the catheter with the outer end portion of the outer tubular member by hooking the finger with the inner tubular member being moved to the projecting position outside the outer tubular member, The operation of inserting and removing the catheter into and from the treatment instrument insertion portion of the endoscope is repeated by repeating the operation of inserting the outer cylinder member into the inner cylinder member and releasing the locking of the catheter at the moving position within the inner cylinder member. Performed intermittently, and furthermore, by inserting and fixing the guide wire pulled out to the outside from the side hole of the catheter into the guide wire fixing portion of the main body of the treatment instrument insertion aid for an endoscope, a helper becomes unnecessary, A catheter to the channel for inserting the treatment tool of the endoscope It is possible to improve the insertability.

According to the third aspect of the present invention, by forming the outer cylinder member of the main body of the endoscopic treatment tool insertion assisting tool by a part of the endoscope channel, the main body of the endoscopic treatment tool insertion assisting tool. Can be built in integrally with the endoscope.

According to the invention of claim 4, the guide wire extended from the insertion portion of the guide wire of the endoscopic treatment tool to the outside of the endoscopic treatment tool through the side hole is used as the endoscopic treatment tool. By guiding the guide wire to the guide wire fixing part of the outer tube member through the slit of the inner tube member in the main body of the insertion assisting tool and fixing the guide wire to this guide wire fixing part, no helper is required, and a treatment tool can be inserted through the endoscope. The insertability of the catheter into the channel can be improved.

[Brief description of drawings]

FIG. 1 shows a use state of a catheter insertion aid according to a first embodiment of the present invention, (A) is a side view showing a set state of the catheter insertion aid, and (B) is a catheter insertion aid. The side view which shows the state which the catheter was inserted in the channel of the endoscope by.

FIG. 2A is a side view showing a cross section of a part of a catheter used in the catheter insertion aid of the first embodiment, and FIG. 2B is a sectional view taken along line 2B-2B of FIG. (C)
FIG. 3 is a side view showing a general catheter.

FIG. 3 is a side view of the catheter insertion aid according to the first embodiment.

FIG. 4 is a side view showing a cross section of the upper half of the catheter insertion aid of the first embodiment.

5A is a sectional view taken along line 5A-5A in FIG. 4, and FIG.
[Fig. 4] is a side view showing an end face of a grip portion of an inner cylinder member.

FIG. 6 shows a valve cartridge of the catheter insertion aid of the first embodiment, (A) is a top view of the valve cartridge, (B) is a side view of the valve cartridge, and (C) is (A). 6C-6C line sectional view, (D) is a bottom view of the valve cartridge.

7A and 7B show a valve body of the valve cartridge according to the first embodiment, FIG. 7A is a plan view of the valve body, and FIG. 7B is a longitudinal sectional view of the valve body.

FIG. 8 is a side view showing a state in which the inner tubular member of the catheter insertion aid of the first embodiment is moved to a protruding position outside the outer tubular member.

FIG. 9 is a side view showing a cross section of the upper half of the catheter insertion aid in a state where the inner tubular member of the catheter insertion aid of the first embodiment is moved to a protruding position outside the outer tubular member.

FIG. 10 is an explanatory diagram for explaining a catheter insertion operation performed by the catheter insertion aid of the first embodiment.

FIG. 11 is an explanatory view for explaining the latter half operation when inserting the catheter by the catheter insertion aid of the first embodiment.

12A and 12B show a first modification of the guide wire fixing portion in the catheter insertion aid of the first embodiment, where FIG. 12A is a side view of the outer cylinder member, and FIG. Plan view.

13A and 13B show a second modification of the guide wire fixing portion in the catheter insertion aid of the first embodiment, where FIG. 13A is a side view of the outer tubular member, and FIG. Plan view.

14A and 14B show a third modification of the guide wire fixing portion in the catheter insertion aid of the first embodiment, where FIG. 14A is a side view of the outer tubular member, and FIG. Plan view.

15A and 15B show a fourth modified example of the guide wire fixing portion in the catheter insertion aid of the first embodiment, where FIG. 15A is a side view of the outer tubular member, and FIG. Plan view.

16A and 16B show a catheter insertion aid according to a second embodiment of the present invention, wherein FIG. 16A is a plan view of the catheter insertion aid, and FIG. 16B is a side view showing an end face of a grip portion of an inner tubular member. Fig.

FIG. 17 is a side view showing a state in which the inner cylinder member of the catheter insertion aid of the second embodiment is moved to a protruding position outside the outer cylinder member.

FIG. 18 is a side view showing a length relationship between an endoscope and a catheter into which the catheter insertion assisting tool according to the third embodiment of the present invention is incorporated.

FIG. 19 is a side view showing the valve cartridge attachment portion of the operation portion of the endoscope in the catheter insertion aid of the third embodiment.

FIG. 20 is a longitudinal cross-sectional view of a main part showing an assembled state of the catheter insertion aid in the operation part of the endoscope according to the third embodiment.

FIG. 21 is a side view showing the catheter insertion assisting tool according to the fourth embodiment of the present invention.

FIG. 22 shows a use state of a guide wire when performing an endoscopic treatment using an endoscope by a conventional method,
(A) is explanatory drawing for demonstrating the operation which pulls out a catheter from the treatment tool insertion channel of an endoscope, (B) is explanatory drawing for demonstrating the operation which pulls out a catheter completely from an endoscope.

[Explanation of symbols]

1 catheter (treatment tool for endoscope) 2 endoscope 3 Catheter insertion aids 7 Treatment tool insertion part 8 guide wire 9b Guide wire lumen (guide wire insertion part) 14 side hole 15 Outer cylinder member 16 Inner cylinder member 17 Treatment tool insertion aid body for endoscope 18a locking part 33 Guide wire fixing part

Claims (4)

[Claims] 1. An outer cylinder member, and an inner cylinder member having one end side inserted into the outer cylinder member and the other end side extending to the outside of the outer cylinder member. One of the inner tubular members is provided with an endoscope connecting portion that is connected to the treatment instrument insertion portion of the endoscope, and the other is provided with a guide wire insertion portion and a side hole that communicates with the guide wire insertion portion. When the endoscopic treatment tool is inserted into the inner tubular member, a treatment tool locking portion is provided to lock the endoscopic treatment tool by hooking a finger on the endoscope coupling portion side. The tubular member on the side of the treatment instrument engaging portion is slidably supported in the axial direction with respect to the tubular member, and with the relative sliding operation between the outer tubular member and the inner tubular member, The endoscope treatment tool locked in the treatment tool locking section is moved together with the tubular member on the treatment tool locking section side. By providing the endoscope treatment tool insertion assisting tool main body that intermittently inserts and removes the endoscope treatment tool into and from the treatment tool insertion portion of the endoscope by repeating the operation of An endoscope treatment instrument insertion characterized in that a guide wire fixing portion for fixing the guide wire pulled out to the outside from the side hole of the endoscope treatment instrument is provided in the main body of the treatment instrument insertion aid for endoscope. Auxiliary equipment. 2. The endoscopic treatment tool insertion assisting tool according to claim 1, wherein the endoscopic treatment tool is a catheter. 3. The outer cylinder member is formed by a part of the endoscope channel.
A treatment instrument insertion aid for an endoscope according to. 4. The endoscope treatment tool insertion assisting tool main body has a slit formed in the inner tubular member for inserting the guide wire and a guide wire fixing portion formed in the outer tubular member. The endoscopic treatment tool insertion aid according to claim 1.