JP2003305002A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To enable a guide wire to be fixed at the end of the endoscope insertion tube with simple operation, and to fully ensure the fixing strength. <P>SOLUTION: An operating tool raising base 27 is provided with a guide wire fixing groove 72 that fixes only the guide wire 20 on a side 71 of an operating tool guiding surface 29. Further, the operating tool raising base 27 is provided with a wire fixing hole 73 to fix a means of pulling the operating tool raising base 27, and with a rotating shaft hole 74 at a position where it serves as the axis for the rotation. The height and the position of the guide wire fixing groove 72 are determined so that the thin guide wire may be pinched and fixed between the guide wire fixing groove 72 and the storage chamber side wall at the distal end of the endoscope when the operating tool raising base 27 is raised. <P>COPYRIGHT: (C)2004,JPO

Description

Description: BACKGROUND OF THE INVENTION [0001] 1. Field of the Invention
Guide wire from the treatment instrument insertion channel
The guide wire is used to guide the treatment tool to the affected area
For endoscopy and endoscopic surgery of the pancreaticobiliary system
It relates to a suitable endoscope. [0002] Conventionally, an endoscope having a bending function has been used.
Techniques for performing diagnosis and treatment in a body cavity have been put to practical use. [0003] As an example of a technique using an endoscope, in recent years,
Endoscopy to locate disease in the gastrointestinal and pancreaticobiliary systems
The use of objective measures is increasing. Using an endoscope
Endoscopic imaging of the bile duct and pancreatic duct is necessary for the treatment of the pancreaticobiliary system
Gallstones in the common bile duct, etc.
There is also a therapeutic treatment or the like that is collected by a needle or a grasping treatment tool. In addition, endoscopic treatment of the pancreatic duct, bile duct, hepatic duct, etc.
When doing this, usually insert the distal end of the endoscope into the duodenum
Insert up to the vicinity of the nipple, and from there under X-ray fluoroscopy
Guide the treatment device such as a catheter into the pancreatic duct, bile duct,
Selective insertion into the hepatic duct has been performed. More specifically, the following operation is performed.
FIGS. 56 and 57 show a process using such a conventional endoscope.
It is explanatory drawing explaining the replacement | exchange operation of a fixture. [0006] The surgeon has previously determined the contents shown in Figs. 56 and 57.
Insert the distal end 903 of the insertion section 902 of the endoscope 901 into duodenal milk.
After inserting near the head, the treatment instrument
Catheter 904 into the channel for
Endoscope 904 of the pancreatic duct or bile duct
Insert inside. Next, the base of the inserted catheter 904 is
The guide wire 905 is inserted from the base 912 on the end side. Then, under X-ray, the guide wire 905 is
Make sure that the pancreatic duct or bile duct is inserted correctly.
As shown in FIG. 56, the proximal side of the guide wire 905
The catheter 904 with the endoscope 901 while holding the
Perform the operation of pulling out from the fixture insertion channel. this
During operation, the distal end of the catheter 904 as shown in FIG.
911 is a channel opening on the operation unit 906 side of the endoscope 901.
When it comes out of the mouth 907, the channel of the endoscope 901
By grasping the guide wire 905 near the opening 907,
The catheter 904 is completely pulled out of the endoscope 901. Next, the proximal end of the guide wire 905 is
The guide wire 905 is inserted into the insertion hole of the treatment instrument.
In the state of being guided, another treatment tool is
Through the channel opening 907 to the treatment instrument insertion channel.
You. After that, repeat the above operations for the number of replacements of the treatment tool.
Return. The treatment tools used for these treatments are generally
Considering the length of the endoscope 901
Is set. The guide wire 905 is connected to the endoscope 90.
More than the sum of the length of 1 and the length of the treatment tool is required
Need to be at least about 400 cm.
Was. [0011] Such a conventional guide
Endoscope to guide the treatment instrument to the pancreatic duct, bile duct, and hepatic duct using dwire
In a mirror, the guide wire is long, about 400 cm,
Do not allow the guide wire to touch dirty areas such as the floor
It is a cumbersome task to manage the
The treatment tool must be moved the entire length of the long guidewire.
If the treatment tool cannot be replaced,
It took longer for me to take time. Therefore, the treatment tool
It takes a lot of time to guide and replace
There was a disadvantage. Further, when performing the work of replacing the treatment tool,
Is difficult to replace by the surgeon and caregiver alone,
To route the guidewire and the appropriate treatment tool,
At least two caregivers are needed in the operating room. That
High human costs and high financial burden on hospitals and patients
There is also a problem that it becomes difficult. In response to this, US Pat.
No. 971 includes a guide wire on a catheter shaft.
A longitudinal opening between the distal and proximal ends of the yalum
To shorten the guide wire by extending
First, pull out the catheter shaft from the guide wire
Disclosed bile duct catheter that is easy to replace
Have been. This biliary catheter is a guidewire
A first opening on the proximal side of the body, and a first opening on the proximal end side.
It has a communicating second opening and extends from the slit.
By holding the guide wire out,
Enables insertion / removal of a treatment tool running on it while fixed
It was done. However, in the above configuration, the guide wire
When the treatment tool passes through the fixed position, the surgeon and
Collaboration was required. In other words, the hand from the guide wire
When the treatment tool is moved away from the endoscope
The wire also moves at the same time.
Replace the treatment tool with the tip inserted in the duodenal papilla
The endoscope for the treatment instrument insertion channel
The guide wire by the same amount while pulling out the treatment tool.
Insert Or, similarly, a channel for inserting a treatment tool
While inserting the treatment tool into the
You have to do two actions at the same time
The operation was very complicated and troublesome. [0015] Also, it is not possible for the surgeon and the caregiver to approach each other.
Work is very poor for both parties.
Was. [0016] The present applicant has shown that the same effect is obtained.
Japanese Patent Application No. 2001-104390 discloses a treatment instrument
A slit is provided at the top of the guide surface of the platform, and the slit
By locking the guide wire, the guide wire can be
Fix the ear and remove the hand from the guide wire
Although an endoscope that makes it possible to exchange tools is described,
This shears the guidewire at two different points.
The guide wire to the slit depending on the usage environment.
Entry may be insufficient and guidewires and processing
Depending on the usage environment of the fixture, the required fixing strength cannot be maintained.
There was something. Also, as an endoscope having a treatment instrument raising table
Prevents damage when the treatment tool is raised on the treatment tool elevator.
Various prior arts exist for this purpose. Among them, a movable member such as a treatment instrument raising table is newly added.
In addition, changing the raising angle of the treatment tool
By having, there is something which holds down the damage of the treatment tool,
These are movable parts newly provided at the tip,
Traction means for operating the material are provided at the insertion section and at the tip
Therefore, the diameter of the insertion portion was increased.
In addition, since the structure of the tip becomes complicated, cleaning and disinfection
The business was bad. [0019] Further, Japanese Patent Application No. 2001-1 filed by the present applicant.
Like No. 04390, by raising the elevation angle more than before
When the guide wire is lifted, the guideway for the distal end of the endoscope
Guide wire with shear force between the upper surface of
With an endoscope that is pinched and fixed, the
Raise the treatment tool elevator to the guide wire fixing angle.
Doing so may damage the treatment tool,
The surgeon needs careful lifting to avoid this.
Was. As a result, the working time is extended and the surgeon and patient are tired.
Was. On the other hand, in particular, cases using an endoscope such as pancreatic bile
Multiple guidewires, especially during stent placement
Into the body and insert the stent through each guidewire
Such a procedure is actually performed. Multiple moths in the body
When inserting a stent into one of the
Make sure that the tip of the id wire does not go
The wire must be fixed. Also, at the same time
Multiple guidewires running in parallel with the wire
It is necessary to fix the guide wire so as not to go. When
Rollers, like Japanese Patent Application No. 2001-104390,
If there is only one slit to fix the wire,
Where only one guidewire can be fixed
There was a problem. In response to this, a guide wire is fixed.
It is conceivable to provide multiple slits.
Just increasing the number of slits for fixing
After the guide wire enters the slit, the second guide
Guide wire where the wire is already guided to the first slit
I got caught in the ear and guided it to the second slit well
Sometimes it was not possible to fix it properly. In the case of pancreatobiliary disease, the patient is raised on the treatment tool raising table.
There is a scene in which the treatment tool is moved forward and backward in a state where the treatment tool is applied. Treatment tool
A treatment tool such as a coil sheath moves back and forth along the guide surface of the elevator.
In this case, the burden on the top of the treatment tool guiding surface was heavy.
Also, a procedure to fix the guide wire with the endoscope tip
There are slits on the erecting platform, but this is a treatment
The burden on the slit due to the reciprocation of the tool was even greater. [0023] For these reasons, long-term use of the
In some cases, it was necessary to change the fixture raising stand. Here, Japanese Utility Model Publication No. 58-50884 discloses
Supports the forceps shaft with the treatment instrument raising stand main body and the auxiliary member,
Remove the instrument raising stand alone without removing the forceps shaft
There is something to make it, but this is the wall of the rotating part
Backlash when rotating the treatment tool
There was a problem because of the occurrence of. Further, the forceps shaft portion is considerably
Because a force is applied, in a two-body structure
There is a possibility that play may occur when the treatment instrument raising platform is rotated. In order to rotate the treatment instrument raising table,
Although there are traction means such as ears, the prior art
Is connected to the main body of the treatment instrument
At the time of replacement, it is necessary to replace not only the treatment instrument
The operation provided on the operation unit to replace the traction means
It is also necessary to disassemble the operation method, which is very troublesome.
Was. The present invention has been made in view of the above circumstances.
Guides the distal end of the endoscope insertion section with simple operation
In addition to being able to fix the wire, in this case
The first is to provide an endoscope that can secure sufficient fixing strength.
The purpose of. Further, according to the present invention, the tip of the endoscope is made thicker,
Two steps of raising angle of treatment instrument raising table without complicating
A second object is to provide an endoscope that can be operated.
You. The present invention also includes a plurality of guide wires.
A third object is to provide an endoscope that can be fixed with an endoscope.
Target. In addition, the present invention raises a troublesome treatment instrument.
Without replacing the entire table, damage to the treatment tool
To provide an endoscope in which only the easy parts can be easily replaced.
As a fourth object. [0031] To achieve the above object,
The endoscope according to claim 1 has a distal end hard portion on the distal end side.
Insertion section with built-in treatment instrument insertion channel inside
Operating part connected to the proximal end side of the insertion part;
Near the opening of the treatment instrument insertion channel on the distal end side of the entrance
A treatment tool guide surface is provided beside and guides the treatment tool.
And a process that can be started up by an operation from the operation unit.
The instrument raising table and the side of the treatment tool guiding surface of the treatment tool raising table
Provided from the opening of the treatment instrument insertion channel
And a groove for guiding only the derived guide wire.
And guides to the groove when the treatment instrument raising table is raised.
Guide wire, the groove and the distal end hard portion of the
It is characterized by being sandwiched and fixed between. Embodiments of the present invention will be described below with reference to the drawings.
This will be described with reference to FIG. (First Embodiment) FIGS. 1 to 12 show a first embodiment of the present invention.
FIG. 1 shows an endoscope and various external devices.
Shows the schematic configuration of the entire endoscope system incorporating
FIG. 2 is a schematic view showing an endoscope with a guide wire extended.
FIG. 3 is a perspective view showing a distal end portion of the insertion portion of FIG.
FIG. 4 is a cross-sectional view showing a distal end portion of the endoscope.
FIG. 5 is a sectional view of the endoscope viewed from the direction A1 in FIG.
FIG. 6 is a perspective view of a treatment instrument raising stand, and FIG.
The treatment tool elevator guides the guide wire into the guide wire locking groove.
FIG. 8 is an explanatory view showing a state where the treatment instrument is guided and raised, and FIG.
The table guides the treatment tool into the guide wire locking groove and
FIG. 9 is an explanatory diagram showing a state in which the guide wire is raised.
First, a description will be given of an operation for fixing the wire to the dwire locking groove.
Explanatory drawing, FIG. 10 shows guide wire in guide wire locking groove.
FIG. 11 is a second explanatory view for explaining the operation in the case of fixing.
When fixing the guidewire in the guidewire locking groove
FIG. 12 is a third explanatory view illustrating the
4th work for explaining the operation in the case of fixing to the guide wire locking groove
FIG. (Configuration) First, an endoscope apparatus 1 will be described with reference to FIG.
1 shows a schematic configuration of the entire system. As shown in FIG.
As described above, the endoscope device 1 includes an endoscope 2 and various external devices.
And is incorporated. As the external device, the light source device 3 and the image processing
Device 4, monitor 5, input keyboard 6, suction pump
There are devices such as a device 7 and a water bottle 8. These devices carry
It is installed on a shelf 10 with a 9. The endoscope 2 has an insertion portion 12 and an operation
The unit 13 and the universal cord 14 are provided.
You. The insertion portion 12 is formed to be elongated, and is inserted into a body cavity.
It is to be inserted. The operation unit 13 includes the endoscope 2
And is connected to the proximal end of the insertion portion 12
I have. The operating unit 13 has a universal cord 14
The ends are connected. Further, the insertion portion 12 is flexible from the proximal end side.
A tube portion 15, a bending portion 16, and a tip portion 17 are provided.
I have. The flexible tube portion 15 is formed to be elongated and has flexibility.
ing. A bending portion 16 is connected to a distal end of the flexible tube portion 15.
ing. The distal end portion 17 is located at the foremost position of the insertion portion 12.
Have been. Also, a universal unit connected to the operation unit 13
A connector 18 is provided at the tip of the cord 14.
You. The connector 18 includes a light guide tube and an electric contact portion.
Is provided. The connector 18 is connected to an external device.
Connected to the light source device 3 and the image processing device 4
Have been. Further, on the outer peripheral surface of the distal end portion 17 of the endoscope 2,
Is a concave shape with one side cut out as shown in FIG.
A notch 21 is formed. And this notch 21
A channel opening 22 is disposed on one side of the channel.
Further, an observation optical system is provided beside the channel opening 22.
Of the objective lens 23 and the illumination lens 24 of the illumination optical system
They are arranged side by side. The rear wall surface of the notch 21 of the tip 17
25 is provided with a nozzle (not shown) for air supply and water supply.
You. Then, water or water is applied from this nozzle to the outer surface of the objective lens.
Spray a fluid such as air to clean the lens surface.
It is configured as follows. Also, as shown in FIG.
The section 13 includes a bending operation section 61 and an air / water button 62.
And a suction operation button 63 are provided. Bending operation
The portion 61 is formed in a dial shape, and has a curved portion of the insertion portion 12.
Perform the operation to bend the up / down / left / right direction.
Swelling. In addition, the operation unit 13 of the endoscope 2
Forceps opening to the treatment instrument insertion channel 26 shown in FIG.
64 are provided. The endoscope 2 has an air / water button 62.
Gas and liquid selectively to the nozzle at the tip 17
It is configured to squirt with the body. Further, by operating the suction operation button 63,
Of the distal end portion 17 through the treatment instrument insertion channel 26.
The suction force is selectively applied to the channel opening portion 22 so that the body cavity
It is configured to collect mucus and the like in the inside. As shown in FIG. 4 and FIG.
Inside 13, a raising wire 30 shown in FIG. 3 is operated.
Instrument operating mechanism 41 for the operation is built in. Ki
The base end of the upper wire 30 is made of a hard rod material such as metal.
Wire fixing member 42 is integrally fixed with solder or the like.
ing. The base end of the wire fixing member 42 is shown in FIG.
As shown, a locking groove 43 formed of a concave portion is formed. Further, at the base end of the wire fixing member 42,
Is a link member 44 made of a hard block body such as a metal.
Fixed. The link member 44 has a wire fixing portion
An insertion hole 45 for the material 42 is formed. And this re
The base of the wire fixing member 42 is inserted into the insertion hole 45 of the link member 44.
The end part is inserted. Base end of wire fixing member 42
The entire area where the locking groove 43 is formed is the link member 44.
Is inserted into the insertion hole 45. The link member 44 includes a wire fixing member.
A female screw portion 46 into which the fixing screw 47 of 42 is inserted is provided.
Have been. Then, the female screw portion 46 of the link member 44 is screwed.
The tip of the fixed fixing screw 47 is
The locking groove 43 is locked while being inserted into the locking groove 43.
You. As a result, the wire fixing member 42 becomes the link member 44
It is connected in the state fixed to. Further, the operation section 13 includes
A base 48 serving as a base of the unit 13 is provided. Soshi
As a result, the link member 44 advances and retreats in the longitudinal direction of the base 48.
Arranged freely. The link member 44 has an arm 49
One end is rotated by a link shaft 50 which is a rod-shaped shaft member.
It is linked to Base 48 on link shaft 50
At the end opposite to the side end, a C-type or E-type retaining ring
A locking member 51 made of the same is engaged. The other end of the arm 49 is shown in FIG.
Raising operation knob 65 provided adjacent to bending operation section 61
Is linked to As a result, the endoscope 2 is
The arm 49 and the link portion are operated by operating the raising operation knob 65.
3 through a material 44 and a wire fixing member 42 in order.
The upper wire 30 is pulled, and the treatment tool raising table 27 is treated.
It is configured so that it can be raised and lowered about the erecting table rotation fulcrum
Has been established. The endoscope 2 includes a treatment instrument insertion channel 2.
6 and out of the channel opening 22 shown in FIG.
Guide catheter and guide wire 2 led out to the side
0 is raised by raising the treatment instrument raising table 27
It is configured as follows. Next, the configuration of the distal end portion 17 of the insertion portion 12 will be described.
Then, it will be described in detail with reference to FIG. As shown in FIG.
In addition, the distal end portion 17 has a distal end hard portion 31 as a distal end portion main body.
And a non-conductive material such as resin to cover the
A formed tip cover 32 is provided. Tip power
The bar 32 is fixed to the distal end hard portion 31 by bonding or the like.
You. Further, the distal end hard portion 31 has a guide for a treatment tool or the like.
An introductory guide path 33 for guiding the entrance to the distal end side is formed.
You. The introduction guide path 33 is provided in the insertion section 12 of the endoscope 2.
A treatment instrument insertion guide as a disposed treatment instrument insertion guideway
It is formed continuously with the channel (insertion hole) 26. The distal end of the introduction guide path 33 has a hard tip.
Is a space formed by the material portion 31 and the tip cover 32.
An accommodation room 34 is provided. And this accommodation room 3
4, the distal end of the treatment instrument insertion channel 26
A channel opening 22 forming an opening is formed.
You. The accommodation room 34 has a channel 23 inside.
Treatment tools and guide catheters introduced through
The treatment tool raising table 27 for raising the tool to a desired position
It is arranged. One end of the treatment instrument raising table 27 is
The treatment tool raising table rotation fulcrum 28 provided on the end rigid portion 31
More pivotal. The treatment instrument raising table rotation fulcrum 28 is an introduction guideway.
33 are disposed in the lower part of the tip opening part. Soshi
The treatment tool raising table 27 is connected to the treatment tool raising table rotation fulcrum 28.
Standing indicated by a solid line in FIG.
From the position to the treatment instrument raising position indicated by the two-dot chain line in the figure.
It is mounted so as to move up and down freely. The treatment tool raising table 27 has a treatment tool and a guide.
Guide surface 29 for guiding a treatment tool such as a catheter
Is formed. Further, a raising wire is provided on the treatment tool raising table 27.
The tip of 30 is fixed. This raising wire 30
A guide pipe 35 inserted into the insertion portion 12,
Guided to the operation unit 13 side through the tube 36 to raise the treatment instrument.
It is connected to the table operation mechanism 41. And this raising
With the towing operation of the ear 30, the treatment tool raising table 27 is raised.
It is configured to be raised and lowered about the upper table rotation fulcrum 28.
Have been. Next, the treatment instrument raising table 2 which is a main part of the present invention will be described.
7 is shown. As shown in FIG. 6, the treatment instrument raising table 27
Only the guide wire 20 is engaged with the side 71 of the fixture guiding surface 29.
A guide wire locking groove 72 for stopping is provided. In addition,
Means for pulling the treatment tool raising table 27 is provided on the placement tool raising table 27.
Wire fixing hole 73 for fixing the
A rotation shaft hole 74 is provided at a position where. Pivot axis
The center of the hole 74 is positioned at the fulcrum 28 of the treatment instrument raising table shown in FIG.
Coincide with the center. For setting the size of the guide wire locking groove 72
This will be described with reference to FIGS. As shown in FIG. 7 and FIG.
20 has a thin outer diameter. The guide catheter 70 is a guide wire.
The outer diameter is larger than that of the sleeve 20. In the first embodiment, the treatment instrument raising table 27
, The thin guide wire 20 is moved to the position shown in FIG.
As shown, the guide wire locking groove 72 and the distal end hard portion 31
Between the storage chamber side walls 75 of the storage chamber 34 formed
So that the side wall 75 of the storage chamber or the tip cover 32
Height of the guide wire locking groove 72 with respect to the side wall 76 of
The position has been set. In the first embodiment, FIG.
As shown in FIG.
Of the guide wire locking groove 72,
The guide instrument is raised by raising the treatment instrument
The catheter 70 falls on the treatment instrument guide surface 29 as indicated by the wavy line.
As shown in FIG.
Height, position of guide wire locking groove 72 with respect to side wall 76
Is set. Each ridge line portion of the guide wire locking groove 72
To reduce damage to the outer skin of the guidewire 20
R chamfering may be performed as long as the fixing strength is not reduced
No. With such a structure, the insertion portion of the endoscope 2
12 has a distal end hard portion 31 on the distal side, and has a treatment tool inside.
The insertion channel 26 is built-in. The operation section 13 is provided at the base end side of the insertion section 12.
Connected. The treatment instrument raising table 27 is located at the tip of the insertion section 12.
In the vicinity of the opening of the treatment instrument insertion channel 26 on the end side
Provided, having a treatment tool guiding surface 29 for guiding the treatment tool
Can be started up by operation from the operation unit 13
It has become. The guide wire locking groove 72 is formed by
It is provided on the side part 71 of the treatment tool guiding surface 29 of the upper base 27,
Gas drawn out from the opening of the treatment instrument insertion channel 26
The groove guides only the guide wire. When the treatment instrument raising table 27 is raised,
Is a guide wire guided by the guide wire locking groove 72.
An ear is pinched between the groove and the distal end hard portion 31.
Is fixed. (Operation) The operation of the main part of the first embodiment will be described.
explain about. First, the surgeon operates the endoscope 2 shown in FIG.
For inserting the treatment tool shown in FIG. 3 from the forceps opening 64 of the operation unit 13
A guide catheter 70 shown in FIG.
Enter. At this time, the treatment instrument raising stand 27 is in an inverted state.
Remove the guide catheter 70 from the channel opening 22
Project into the pancreas / bile duct (not shown)
insert. Thereafter, the guide catheter 7 currently in use is
0 is the treatment tool to be used next.
Do). The guide catheter 70 in this case is used next.
The operation of replacing the treatment tool to be used with reference to FIGS.
explain. In FIGS. 9 to 12, the solid line in FIG.
The arrow indicates the movement of the operation unit 13 of the endoscope 2,
Represents the viewing direction. In this case, the nipple is displayed on the screen of the monitor 5 in FIG.
80 (see FIG. 9), the guide category
Insert the guide wire 20 from the back end of the catheter 70
You. The distal end of the guide wire 20 is
Insertion to target site in pancreas / bile duct through wire lumen
The observation image (endoscope image) of the endoscope 2 and the X-ray
Check under fluoroscopy. Thereafter, the operator removes the guide catheter 70.
At the same time, the guide wire 20 is also removed.
Make sure that the caregiver follows the surgeon's
While maintaining the zero position, the distal end of the guide catheter 70 is processed.
Work collaboratively until it comes to the operation unit side from the fixture raising stand 27.
Do. As shown in FIG. 9, the guide wire 20 is
/ With the operation unit 13 in the bile duct,
By twisting the rotating torsion tip 17 clockwise, as shown in FIG.
As shown, the guide wire 20 is moved from the treatment instrument guiding surface 29.
It is guided to the guide wire locking groove 72. In other words, intentionally
When the nipple 80 is viewed from the front, the nipple 80 moves to the left edge of the screen
Will be in a state where In that state, instantly raise as shown in FIG.
The treatment tool raising table 27 is raised up to the maximum by the operation knob 65.
You. Then, as shown in FIG. 11, the guide wire 20
While being fixed in the guide wire locking groove 72, the treatment instrument
It is raised without being guided by the conductive surface 29, and the distal end hard portion 3 is raised.
The first housing chamber side wall 75 is locked by the wire locking groove 72. In this state, the guide wire 20 is securely fixed.
Have been. Then, operate the watch while turning it clockwise earlier.
The working portion 13 (tip portion 17) is fixed to the guide wire 20.
As shown in FIG. 12, the nipple is again
80 is viewed from the front. In that state,
While confirming that the hook 20 does not move,
Pull out 70 at a stretch. Thereafter, while the guide wire is fixed,
Next, insert the treatment tool to be used from the proximal end side of the guide wire 20.
The treatment instrument while the guide wire 20 is used as a guide.
It is inserted into the treatment instrument insertion channel 26. The distal end of the treatment instrument fixes the guide wire.
When the treatment instrument raising table 27 is hit, the raising operation knob 6
By the operation of 5, the treatment instrument raising table 27 is inverted. This
Thus, the fixation of the guide wire 20 is released. Thereafter, it is the same as when the operator inserts the treatment tool.
Occasionally a caregiver may push the guidewire 20
Thus, the treatment tool is guided to a target site. The above method is repeated as necessary. (Effective
Result) According to the first embodiment, the operation unit 13 of the endoscope 2
The normal operation of operating the start-up operation knob 65
Only by operating the fixture raising stand 27, the accommodation chamber side wall 75 and the wire
With the guide wire 20 interposed between the locking grooves 72,
It is possible to fix the guide wire 20. In addition, guide Y
The provision of the hook locking groove 72 allows the guide wire locking groove 72
Guide wire 20 guided to
Fixed securely. In this case, the treatment instrument is fixed on the treatment instrument raising base.
In the same position than fixing by the slit provided on the guide surface
Because it is sandwiched and fixed, the fixing strength is strong,
It is possible to fix the guide wire under the working environment. Thus, the endoscope insertion section can be operated with a simple operation.
To fix the guidewire to the tip of the
In addition, the fixing strength in this case can be sufficiently ensured. The wire locking groove 72 has a guide wire.
The treatment tools other than the hook 20 are not locked,
Since only the hook 20 is fixed, there is no damage to the conventional treatment tool. As described above, in the first embodiment, the tip
Since the guide wire 20 can be fixed at the portion 17,
The length of the wire 20 can be reduced. Therefore, guide Y
And the work space of the head 20 is easy,
There is an important effect. In addition, replacement of the treatment tool becomes easy.
Also help reduce the number of caregivers and reduce work time
It goes. In addition, since conventional treatment tools can be used,
Treatment operability is improved by using a treatment tool that is familiar to the patient.
It can maintain the same state. Therefore, the conventional operation of the treatment tool
Quicker and easier without compromising the method and operational feeling
The treatment tool can be replaced. FIG. 13 shows the first embodiment shown in FIGS.
It is a perspective view of the treatment tool raising stand which shows the modification of embodiment. As shown in FIG. 13, the first embodiment
The treatment tool raising table 27 of the modified example includes a guide wire locking groove 72.
To the sides 71, 71 on both sides of the treatment instrument guiding surface 29, respectively.
Provided. According to such a modification, FIGS.
When the same effects as in the first embodiment shown in FIG.
In both cases, the tip 17 is rotated in the direction opposite to that of FIG.
The guide wire 27 can be locked. (Second Embodiment) FIGS. 14 to 20
FIG. 14 relates to a second embodiment of the present invention, and FIG.
FIG. 1 is a cross-sectional view showing an operation mechanism of a treatment instrument raising table of an operation unit, and FIG.
5 is a perspective view of a link member, and FIG. 16 is a perspective view of a second traction member.
FIG. 17 and FIG. 17 are perspective views of the guide member, and FIG.
FIG. 19 is a first explanatory view showing the operation, and FIG.
FIG. 20 is a third explanatory view showing the operation of the operation unit.
It is. In the description of the second embodiment, FIG.
Components other than FIG. 20 will be described with reference to FIGS. 1 to 12.
I will tell. (Structure) In the second embodiment, the structure shown in FIG.
The raising wire 30 connected to the treated instrument raising table 27,
Wire fixing member of operation unit 93 of endoscope 92 shown in FIG.
And is fixed by solder or the like. With the aforementioned arm 49
The link member 94 fixed by the link shaft 50 includes:
As shown in FIG. 15, an opening 95 is provided at a part on the tip side.
And a hole 96 communicating with the opening 95 is provided.
I have. In the hole 96, the wire fixing member 42 is inserted into the opening 95.
It is provided to let it pass. The width of the opening 95 is shown in FIG.
Larger than the width of the engagement protrusion 102 of the second traction member 101.
The treatment instrument raising table 27 is further raised from the first maximum raising position.
Have a stroke width that is equal to The wire fixing member 42 has a hole 96 and a second traction
In a guide hole 103 provided in an engagement protrusion 102 of a member 101
Then, through an engagement hole 104 provided above the guide hole 103,
The second traction member 101 and the fixing screw 47 shown in FIG.
Is defined. The engagement protrusion 102 guides the link member 94.
Opening 11 provided in guide member 111 shown in FIG.
2 and the second traction member 101 is
Exist in parallel. Further, the engagement protrusion of the second traction member 101
Rack gear 105 is provided on the surface opposite to 102
You. The rack gear 105 is provided as shown in FIG.
Of the second lever arm 107 of the second raising lever 106
Engage with pinion gear 109 located on rotating shaft 108
You. That is, in accordance with the rotation operation of the second raising lever 106,
As a result, the pinion gear 109 rotates, and accordingly, the second traction portion
The engagement protrusion 102 can move in the axial direction in conjunction with the material 101.
It has become. In the second embodiment, the operation unit 9
3, an opening 11 for projecting the second raising lever 106
3 is formed. The opening 113 is provided with watertightness inside the operation unit.
To maintain it, a waterproof cover 100 is provided. waterproof
For the material of the cover, elastic members such as rubber and plastic are good.
No. [0093] It should be noted that one of the operations for maintaining watertightness in the operation section is performed.
Although the waterproof cover 100 is described as an example, the watertight function is maintained.
The waterproof cover 100 is not limited to this. (Operation) The second operation will be described with reference to FIGS.
The operation of the embodiment will be described. Fig. 18
19 is the first maximum raised state, FIG. 20 is the second maximum
This shows a rising state. First, as shown in FIG.
The treatment instrument raising table 27 is tilted by rotating 65 toward the hand.
To the installation state. In this case, the link member 94 is directed toward the distal end.
Move to the maximum movement position of. At that time, the operation unit side wall surface 9
7 pushes the engagement protrusion 102, so that the second traction member 101
The second raising lever moves with the movement of the second traction member 101.
-106 moves to the maximum inverted position. When raising the treatment tool to the first maximum raising position
Is operated to rotate the raising operation knob 65 toward the endoscope distal end.
As a result, the link member 94 is pulled toward the operation section,
The wire fixing members 42 and 30 connected to the member 94 are pulled.
Then, the treatment instrument raising table 27 is rotated and raised. The first maximum operable by the raising operation knob 65
FIG. 19 shows a state where the operation has been performed to the raising position. In the state shown in FIG. 19, the opening of the link member 94 is
When the tip side wall surface 98 of the portion 95 pushes the engagement protrusion 102,
The second traction member 101 moves to a certain position. This
The second raising lever 106 rotates to a certain position. The second raising lever 1 is further moved from the state shown in FIG.
20 is rotated to the endoscope distal end side, as shown in FIG.
So that the rack gear 105 and the pinion gear 109
The second traction member 101 further moves to the operation unit 93 side
Then, the engagement protrusion 102 is pulled to move up the treatment instrument.
The rising angle of the table 27 further increases. When the treatment instrument raising table 27 is to be inverted,
By operating the operation knob 65 and the second raising lever 106,
Return the link member 94 and the second traction member 101 to the inverted position.
You. The above method is repeated as necessary. With such a configuration and operation, the rising wire
The torsion 30 performs towing operation of the treatment instrument raising table 27.
It is a means. The raising operation knob 65 operates this traction means.
This is the first operation means that enables the operation. The second raising lever 106 performs the first operation.
The treatment instrument raising table 27 is provided near the
In the state that the maximum possible rise by the operation of the first operation means,
Second operating means for further enabling the towing means;
Has become. (Effect) According to such a second embodiment,
If you start up treatment tools with different damage levels when starting up
And selectively operating the raising angle of the treatment instrument raising table 27.
Can be performed, and damage to the treatment tool can be prevented. Further, according to the second embodiment, the treatment tool
The pulling means of the elevator 27 has a structure in the tip portion and the insertion portion.
The outer diameter of the tip and the insertion
The diameter can be suppressed. With this, the endoscope tip
Raise the treatment instrument raising platform without making the part thick and complicated.
A two-stage operation of the upper corner can be made possible. In addition,
The operation lever is provided with a raising operation knob 65 for the first raising and a second raising.
Is noticed because it is separated by the second raising lever 106 for
Erroneous operation such as maximizing the angle without using
Decrease. Further, the endoscope of the second embodiment is
Cleaning and disinfection can be performed in the same manner as before. (Third Embodiment) FIGS. 21 and 22 show a third embodiment of the present invention.
FIG. 21 is a treatment tool of an operation unit of an endoscope.
FIG. 2 is a sectional view showing a first maximum raising state of the raising table operating mechanism, FIG.
Reference numeral 2 denotes a second-most operation mechanism of the treatment tool raising stand of the operation unit of the endoscope.
It is sectional drawing which shows a large rising state. (Configuration) As shown in FIG.
In the operation unit 123 of the endoscope 122 in the form of FIG.
The rack gear 105 and the pinion gear 10 shown in FIG.
In place of the actuation mechanism of FIG.
Arm connecting the first member 124 and the second arm
The arm 125 has a two-body configuration. The first arm 124
The raising operation knob 65 is connected to the first connection shaft 126.
You. The first arm 124 and the second arm 125 are a second connecting shaft
127. The second raising lever 136 has a rotation shaft 138
Shape that can press the second connecting shaft 127 when it turns
In the shape. The pressing position of the second raising lever 136 is
The second connecting shaft 127 smoothly.
Thus, it has a spherical pressing portion 139. Omitted in the figure
However, the second raising lever 136 is attached to the waterproof cover 100.
Covered. (Operation) As shown in FIG.
The operation of the valve 65 raises the treatment instrument to the maximum position of the first raising range.
The upper base 27 is turned up. At this time, the first arm 124
And the second arm 125 are kept on a straight line. afterwards,
If you want to raise it further, operate the raising operation knob 65.
Operate the second raising lever 136 while fixing it with the finger of the person
As a result, the pressing portion 139 is rotated around the rotation shaft 138 as a second link.
The connecting shaft 127 is pressed. Then, as shown in FIG.
The first arm 124 and the second arm 125 are pushed out.
In this state, since the raising operation knob 65 is fixed,
The first arm starting from the first connection shaft 126 of the one arm 124
124 is rotated, so that it is connected to the second arm 125
The link member 44 is pulled to the operation unit side. This
Thus, the treatment instrument raising table 27 is further raised. (Effect) According to the third embodiment, the second
Achieve the same effect as in the above embodiment by reducing the number of parts
The manufacturing cost can be reduced. (Fourth Embodiment) FIG. 23 and FIG.
FIG. 23 is a perspective view of an endoscope according to a fourth embodiment of the present invention.
FIG. 24 is a plan view showing the treatment instrument raising table at the end, and FIG.
It is an enlarged view of the top part of a fixture guidance surface. FIG. 23 and FIG.
The parts not shown in FIG.
This is the same as the first embodiment. (Structure) Referring to FIGS. 23 and 24, the fourth
An embodiment will be described. As shown in FIG.
The upper table 141 is provided at the distal end of the endoscope, and
Can be guided to a desired position. Of the treatment instrument raising table 141
At the top of the treatment instrument guiding surface 142 that is substantially V-shaped,
First, which locks only the wires 151 and 152 in a detachable manner.
It has a slit 143 and a second slit 144 substantially in parallel.
ing. Each slit 143, 144 is a guide wire.
Can be fixed stably even if the outer diameter of the jaws 151 and 152 is different
A desirable V-groove shape is desirable. The depth of each of the slits 143 and 144 is shown in FIG.
As shown in FIG. 4, guide wires 151 and 152 are engaged.
When the height of the top of the guide wires 151, 152
The height is set to be almost the same as the extension of the treatment instrument guiding surface 142.
I have decided. The first slit 143 and the second slit 143
Between 144, a guide that is a part of the treatment tool guide surface 142 is provided.
The top 145 is left. With such a structure, the treatment instrument insertion
Only the guide wire led out from the channel opening is engaged.
The slit for removably locking the treatment tool erecting table 141
A plurality of treatment instrument guide surfaces 142 are provided. (Operation) In the fourth embodiment, the guide wire
With only the ears 151 and 152 protruding, the treatment tool
By raising the elevator 141, two guide wires
The jaws 151 and 152 have a substantially V-shaped inclination of the treatment tool guiding surface 142.
The first slit 143 or the second slit 1
It is guided to 44. The movement of the guide wires 151 and 152 at this time
FIG. First, as shown in FIG.
In the lit (tentatively, here, the first slit 143),
One guide wire (here, temporarily, the first guide wire 1
51). Then the other guidewa
The ear (here, the second guide wire 152) is the first
Since the slit 143 is already closed,
145 through the other slit (here the second slot
(Referred to as a unit 144). At this time, the first slot
Height of the top of the guide wire 151 engaged with the socket 143
The second guide is
The wire 152 is hooked on the first slit 143.
Instead, it is smoothly guided to the second slit 144. (Effect) According to such a fourth embodiment,
If multiple guide wires are lifted, the treatment instrument at the end of the endoscope can be raised.
Can be fixed to multiple slits on the table. Also, in this case,
Guide the guide wire to the slit smoothly and cheaply
It is performed regularly. FIG. 25 shows the fourth embodiment shown in FIGS.
Enlargement of the top of a treatment tool guide surface showing a modification of the embodiment
FIG. Is as follows. As shown in FIG. 25, the treatment instrument raising table 141
The width of the opening of each slit 143, 144 is the guide width
The width A2 of the jaws 151 and 152 and the treatment tool guiding surface 142 is the smallest.
I am trying to be. According to such a modification, the slit 14
By narrowing the openings of 3,144, the first guide wire
The second guide wire is hooked on the slit where the hook is inserted
It is possible to further prevent fogging. (Fifth Embodiment) FIG. 26 to FIG.
FIG. 26 is a perspective view of an endoscope according to a fifth embodiment of the present invention.
FIG. 27 is a perspective view showing a treatment instrument raising table at an end, and FIG.
FIG. 29 is an exploded perspective view of a table and a plan view of a first raising member of FIG. 28.
You. (Structure) As shown in FIG. 26, the fifth embodiment
The treatment instrument raising table 161 at the distal end of the endoscope in the form of
The treatment instrument can be guided to a desired position by operation from the
Things. As shown in FIG. 26 and FIG.
The upper base 161 includes a first raising member 162 and a second raising member 163.
And both are a first raising member 162 and a second raising member
Rail 164 and rail engaging projection 16 provided in
8 engages and is fixed. Further, as shown in FIG. 27 and FIG.
A plurality of engagement holes 165, 166, 16
7 and the rail engaging projection 168 has an engaging hole 1
65, 166, 167 at positions corresponding to the engagement protrusions 169.
Are provided in the same number. The plurality of engaging holes 165, 166, 16
7 and the size of the engagement protrusion 169 are determined by the second raising member 163.
If you increase the outer diameter in order from the insertion direction,
good. The engaging holes 165, 166, 167 and the engaging projection
The raising 169 is performed from the first raising member 162 to the second raising.
A mechanism for preventing the member 163 from falling off easily
Has become. [0130] The first raising member 162 has a treatment tool
A rotating shaft hole 74 serving as a central axis when rotating the table 161;
It has a wire fixing hole 73 for connecting the traction means.
You. The second raising member 163 is a treatment tool of the treatment tool raising table 161.
It is the top of the guiding surface 170. (Operation) Second raising of the treatment instrument raising table 161
The replacement operation when the member 163 is damaged is described below. The worker first puts the second raising member 163 on the pen
And apply force so that the engagement projection 169 comes off.
Pull out along the groove 164. At that time,
May break the engagement protrusion 169. When the old second raising member 163 is removed.
Then, the mounting operation of the new second raising member 163 is started.
In this case, the worker sets the rail engagement projection 168 in the rail groove.
164, the second raising member 1 is attached to the first raising member 162.
63 is engaged. At this time, the engaging projection 169 is elastically deformed.
And when it reaches a predetermined position,
65, 166, 167 and the engaging projection 169 are engaged and fixed.
Is done. The worker repeats this as necessary.
You. (Effect) According to the fifth embodiment, the treatment instrument raising table 16
1. Only the top of the treatment tool guide surface 170, which is most susceptible to damage
Without removing the treatment instrument raising table 161 from the endoscope.
Be exchangeable. This breaks the endoscope tip cover.
To raise the pulling means such as the raising wire and the fulcrum
Extremely work because there is no need to remove it
And work time is greatly reduced. Also, the rotating part
The rotation shaft hole 74 is integral with the first raising member 162.
Because there is no risk of backlash during rotation, it is repeated
Resistance has also improved. (Sixth Embodiment) FIGS. 29 to 31 show
FIG. 29 is a perspective view of an endoscope according to a sixth embodiment of the present invention.
FIG. 30 is a perspective view showing a treatment instrument raising table at an end, and FIG.
FIG. 31 is an exploded perspective view of the base, and FIG. 31 is a perspective view of a second raising member.
You. (Structure) As shown in FIGS. 29 and 30,
Treatment instrument raising table 18 at the distal end of the endoscope according to the sixth embodiment
1 is that the treatment tool raising base 181 is connected to the first raising member 182 and the second raising member 182.
It consists of a raising member 183. The second raising member 183 is connected to the treatment instrument guiding surface 19.
Only the position where the treatment tool at the top of 0 frequently contacts
You. As shown in FIG. 30 and FIG.
A notch 184 is provided at the top of the treatment tool guiding surface of the member 182.
Have been killed. The second raising member 183 has a notch 184
It is formed to engage. The first raising member 182 and the first
2 The raising member 183 is provided on the first raising member 182.
Engagement projection 188 provided on hole 185 and second raising member 183
It is fixed by engaging with. Also, a first raising member
A notch bottom surface 191 at a notch 184 at 182;
When the bottom surface 192 of the second raising member 114 is fitted, the
(2) The movement of the raising member 183 in the rotation direction is restricted. (Operation) In the sixth embodiment, the second
The operation of replacing the raising member 183 will be described below. The operator first puts the second raising member 183 on the pen
And the engaging projection 188 is disengaged from the engaging hole 185.
And pull it out. At that time, if necessary
The projection 188 may be destroyed. When the old second raising member 183 is removed.
Then, the mounting operation of the new second raising member 183 is started.
The operator aligns the notch 184 with the second raising member 18.
3 is engaged. At this time, the engaging projection 188 deforms elastically.
While reaching the predetermined position, the engagement hole 185
And the engaging projection 188 is engaged with the second raising member 183 in FIG.
It is fixed as shown in FIG. This is repeated as necessary. (Effect) According to the sixth embodiment, the fifth embodiment
In addition to the effect of the above, the shape of the second raising member can be simplified.
This facilitates processing and leads to cost reduction. (Seventh Embodiment) FIG. 32 shows a seventh embodiment of the present invention.
Of the treatment instrument raising table at the distal end of the endoscope according to the seventh embodiment.
It is a perspective view which shows a 2nd raising member. (Structure) As shown in FIG.
The material 203 is attached to the second raising member 183 of the sixth embodiment.
On the other hand, a slit 204 for fixing a V-shaped guide wire
Is provided. Slit 2 for fixing guide wire
04 may be provided on the second raising member 163 of the fifth embodiment.
Good. (Operation) According to the seventh embodiment, the sixth embodiment
The second raising member 203 can be replaced similarly to the embodiment.
In addition, the endoscope described in Japanese Patent Application No. 2001-104390.
Guide wire is inserted into the fixed slit 204 by the same operation as a mirror.
Can be fixed. (Effect) According to the seventh embodiment, the fifth embodiment
In addition to the effects of the sixth embodiment, insertion / removal of a treatment tool, etc.
Guide wire fixing slits
Can be easily changed. Also, fixed guide wire type scope
And conventional scope can be selected only by changing the second raising member
Therefore, the desired specifications can be matched with one scope as needed.
I can respond. In addition, the guidewire fixed scope
In particular, it is suitable for the outer diameter of the guide wire that the surgeon prefers to use.
It has a slit that has been adjusted and a fixed strength that suits the surgeon's preference.
The slit to be used can be selected by the second raising member. (Eighth Embodiment) FIG. 33 shows the eighth embodiment of the present invention.
Of the treatment instrument raising table at the distal end of the endoscope according to the eighth embodiment.
It is a perspective view which shows a 2nd raising member. (Structure) As shown in FIG.
The member 213 is formed of an elastic member such as rubber. Second
The raising member 213 is provided on the first raising member 182 in FIG.
The engaging projection 218 which engages with the engaging hole 185 is provided.
You. At the top of the treatment tool guiding surface of the second raising member 213, a seventh
A slit 214 is provided as in the embodiment.
You. (Operation) According to the eighth embodiment, the seventh embodiment
The second raising member 213 can be replaced similarly to the embodiment.
At the same time, the guide wire can be fixed to the fixed slit 214
Wear. (Effect) According to the eighth embodiment, the seventh embodiment
In addition to the effects of the embodiment, the slit 214
Material, frictional resistance increases compared to conventional metal materials,
When the wire is clamped and fixed in the slit 214
Increases fixing strength. In this case, the second raising member 213 is used.
The elastic member deteriorates quickly, but is easy to replace.
The member 213 can maintain the required fixing strength. 2nd rise
The material 213 should be provided not on the entire guiding surface but on a part.
Therefore, the feeling of insertion of the treatment tool is not greatly affected. (Ninth Embodiment) FIG. 34 and FIG.
According to a ninth embodiment of the present invention, FIG.
FIG. 35 is an exploded perspective view of the raising table, and FIG.
It is sectional drawing which shows a part. In FIGS. 34 and 35, FIGS.
The same components as those in the first embodiment shown in FIG.
The same reference numerals are given and the description is omitted. (Structure) As shown in FIG.
The table 327 includes a first raising member 342 and a second raising member 343.
And both are a first raising member 342 and a second raising member
Rail 344 and rail engaging projection 34 provided in
The engagement is fixed at 8. Here, the first raising member 342 is provided.
Provided on the rail structure 344 and the second raising member 343.
The rail engaging projection 348 is a distal end portion of the endoscope shown in FIG.
When the treatment instrument raising table 327 is attached to the
For the optical system, illumination system, etc.
The rail ends before the inner part of the rail. to this
Thus, the second raising member 343 is opposed to the first raising member 342.
Therefore, it can be engaged only from one direction. Further, a plurality of engaging holes 3 are provided on the rail groove 344.
45, 346, 347, and the second raising member 34
Corresponds to the engagement holes 345, 346, 347 when 3 is installed
And the same number of engagement projections 349 are provided at the positions where the engagement projections 349 are provided. The first raising member 342 and the second raising member
The connection position of 343 is as shown in FIG.
When the 327 rises up to the maximum, the
The connection surface between the lug engagement protrusion 348 and the rail groove 344 is
It is provided at a position lower than the bar 32. The end portion 317 of the endoscope has a distal end.
The bar 32 has a detachable structure. With such a structure, the ninth embodiment
Then, the first raising member 342 and the second raising member 343 are engaged.
Rail engaging protrusion 348 and rail groove 344
It is provided perpendicularly to the insertion part axial direction from the one surface.
In this case, the rail engagement protrusion 348 and the rail groove 34 in this case are used.
4 to a surface opposite to the one surface of the treatment instrument raising table 327.
In a range that does not penetrate through. (Operation) In the ninth embodiment, the second
The work of replacing the raising member 343 will be described below. The worker
Instead, remove the tip cover 32. Next, the second raising member 3
43 is gripped with pliers or the like, and is a side corresponding to the outer periphery of the tip 317.
Pull out with force. At that time, if necessary
The projection 349 may be destroyed. When the old second raising member 343 is removed.
Then, the operation of attaching a new second raising member 343 is started.
The operator fits the rail groove 344 and moves the outside of the tip 317.
The second raising member 343 is engaged from the side corresponding to the circumference. (Effect) According to the ninth embodiment, the fifth embodiment
In addition to the effects of the embodiment, the contact of the second
Continuing, unless the tip cover 32 is removed, the first raising member 3
Because it cannot be removed from the body,
The fixing of the upper member 343 becomes more reliable. (Tenth Embodiment) FIGS. 36 and 37
36 relates to a tenth embodiment of the present invention, and FIG.
FIG. 37 is an exploded perspective view of the treatment instrument raising stand, and FIG.
It is sectional drawing which shows a front-end | tip part. In FIGS. 36 and 37, FIGS.
The same components as those in the first embodiment shown in FIG.
The same reference numerals are given and the description is omitted. (Structure) As shown in FIGS. 36 and 37,
Treatment instrument raising table 367 provided at distal end portion 357 of the endoscope
Is composed of the first raising member 372 and the second raising member 373.
Both are a first raising member 372 and a second raising member 373.
The rail groove 374 and the rail engagement protrusion 375 provided on the
It is fixed. A first raising member 372 and a second raising member 373
Is fixed with screws. In this case, the first rising
The material 372 and the second raising member 373 are connected to the rail groove 374 and the rail.
In the state where the first raised portion is engaged with the
From the side wall of the tip of the material 372 toward the second raising member 373
Female screws 376 and 377 are provided diagonally,
It is fixed at 8. That is, in the tenth embodiment, the first
The contact surface of the raising member 372 with the second raising member 373
A female screw 376 of a first screw hole is provided, and the first raising member is provided.
The contact of the second raising member 373 corresponding to the contact surface of the second
A female screw 377 of a second screw hole is provided on the contact surface,
By screwing into the hole, the first raising member 372 and the second
It has a fixing screw 378 for connecting and fixing the raising member 373.
ing. (Function) Second raising of the treatment instrument raising table 367
The replacement operation when the member 373 is damaged is described below. First, the operator raises the treatment instrument raising table 367.
Then, the fixing screw 378 is removed, and the second raising member 373 is
Pull out along the groove 374. When the old second raising member 373 is removed.
Then, the operation of attaching a new second raising member 373 is started.
Align the rail engagement protrusion 375 with the rail groove 374, and
The raising member 373 is engaged with the first raising member 372. No.
Female screw 37 of first raising member 372 and second raising member 373
6,377, the female screws 376,377
The first raising member 372 is integrated with the fixing screw 378.
Then, the second raising member 373 is fixed. (Effect) According to the tenth embodiment, the tenth embodiment
In addition to the effects of the fifth embodiment, the first raising member 372 and
The second raising member 373 can be fixed more firmly. Ma
In addition, the second raising member 373 is fixed only by screw fixing.
Therefore, it is easy to remove the second raising member 373 at the time of replacement.
You. (Eleventh Embodiment) (Configuration) In the eleventh embodiment, FIGS.
The first raising member 162 and the second raising member of the fifth embodiment shown in FIG.
The upper member 163 is fixed by an adhesive. (Operation) In the eleventh embodiment, the
The surface where the first raising member 162 and the second raising member 163 are in contact with
Then, an adhesive is applied thinly or in the form of a spot. At the time of replacement, the first raising member 162 is pressed down,
By pulling the second raising member 163, the second raising member 16
3 becomes possible. (Effects) According to the eleventh embodiment, the
In addition to the effects of the fifth embodiment, the first raising member 162
The configuration of the second raising member 163 is simplified, and the design is easy.
In addition, the cost is reduced. Also, replacement of the first raising member 162
The work at the time becomes easy. (Twelfth Embodiment) (Structure) In the twelfth embodiment, FIGS.
The second raising member 163 of the fifth embodiment shown in FIG.
A material different from that of the raising member 162 is used. In this case, the second
The material of the raising member 163 is difficult to process, but has low frictional resistance.
Not with ceramic. (Operation) In the twelfth embodiment, the
Replacement of the second raising member 163 by the same operation as the fifth embodiment.
Can be performed. (Effect) According to the twelfth embodiment, the
In addition to the effects of the fifth embodiment, the entire treatment instrument raising stand
The second raised part using a material (material) that is difficult to process with the shape
Material that is difficult to process is used by processing material 163
Will be possible. In this case, the second raising member 163 is
This improves the insertion / removal of the treatment tool and
The durability is also improved. (Thirteenth Embodiment) FIGS. 38 to 41
FIG. 38 relates to a thirteenth embodiment of the present invention, and FIG.
FIG. 39 is a plan view showing a treatment instrument raising table at the distal end of the treatment instrument.
Plan view showing the relationship between the elevator and the guide wire and the treatment tool,
40 is an enlarged view of the slit of FIG. 38, and FIG.
It is sectional drawing which shows the front-end | tip part of an insertion part. (Structure) Referring to FIGS. 38 and 41, the thirteenth
An embodiment will be described. As shown in FIG.
The raising table 411 is attached to the distal end portion 407 of the endoscope shown in FIG.
Provided to guide the treatment instrument 70 shown in FIG. 39 to a desired position.
enable. The treatment tool guiding surface 412 of the treatment tool raising table 411
A substantially L-shaped slit 413 is provided at the top of the. As shown in FIG. 40, the slit 413
Vertical slit 414, horizontal slit 415,
The guide wire 20 that has entered the straight slit portion 414 is
It has a guiding surface 416 for guiding to the lit part 415. The width t of the slit 413 is
When the outer diameter of 0 is D1 and the outer diameter of the other treatment tools is D2,
The dimensional relationship is Dl <t <D2. In addition, L
The horizontal slit portion 415 of the slit 413 is shown in FIG.
Treatment tool for the distal end cover 32 provided at the distal end portion 407 of the endoscope
It is set to be lower than the insertion surface 420. (Operation) Only the guide wire 20 is connected to the endoscope.
With the protruding end, the treatment instrument raising table 411 is raised.
As a result, the guide wire 2 is moved along the treatment instrument guiding surface 412.
0 is directed to the vertical slit portion 414 of the L-shaped slit 413.
Be guided. The guide wire 20 is exposed to water through the guiding surface 416.
When guided to the flat slit portion 415, as shown in FIG.
By operating the raised operation knob 65, the treatment instrument raising table 411 is operated.
To the inverted state. As described above, the guide wire 20 is connected to the horizontal slot.
The horizontal position can be achieved by inverting it while it is
The treatment tool insertion surface 42 at a position higher than the lit portion 415
0 pushes up the guidewire 20. This allows for
41 through the tool insertion surface 420 and the substantially L-shaped slit 413.
As shown by the arrow, a shearing force is generated at a short distance.
Thereby, the guide wire 20 is fixed. To release the fixation of the guide wire 20,
Loosen the inverted state of the treatment instrument raising table 411 and use the guide wire.
By passing the treatment tool through 20, the L-shaped slit 413
When the tip of the treatment tool abuts, there is no guide
The ear 20 is pushed by the treatment tool and is guided through the horizontal slit portion 415.
Guided to the vertical slit portion 414 through the conductive surface 416,
It comes off the slit 413. (Effect) According to the thirteenth embodiment, the thirteenth embodiment
The same effect as in the first embodiment can be obtained. (Fourteenth Embodiment) FIGS. 42 to 44 show a fourteenth embodiment of the present invention.
FIG. 42 is a perspective view of an insertion portion of an endoscope according to the fourteenth embodiment.
FIG. 43 is a plan view of the end portion when the guide wire is fixed.
FIG. 44 is a first explanatory view for explaining the operation, and FIG.
It is a 2nd explanatory view explaining an operation at the time of fixing. Note that in FIGS. 42 to 44, FIGS.
The same components as those in the first embodiment shown in FIG.
The same reference numerals are given and the description is omitted. (Structure) As shown in FIGS. 42 to 44,
A treatment instrument raising base 431 is provided at the distal end 427 of the endoscope.
Can be The side wall of the accommodation room 432 of the treatment instrument raising table 431
At 433 and 434, treatment instrument guide members 435 and 436 are provided.
I am. The shape of the treatment instrument guiding members 435 and 436 is
It is easy to guide instruments and the like to the central part of the treatment instrument raising table 431.
And have a semicircular shape. In addition, this treatment instrument guiding member 43
5,436 are formed of an elastic member such as rubber. (Operation) In the fourteenth embodiment, the treatment tool
Guide wire 20 is used to guide the treatment instrument raising table 431
When the treatment tool elevating base 431 is out of the surface 440,
The treatment instrument as shown by the arrow in FIG.
And the guide wire 20 and the like are the treatment tool guiding members 435 and 436.
Treatment tool raising table 431 having a treatment tool guiding surface 440 along
Guided to the center. When further raising, take measures
The raising table 431 is made of a metal material such as SUS.
To get over the treatment instrument guide members 435 and 436
You can do it. (Effect) According to the fourteenth embodiment, the processing
Without restricting the raising range of the fixture raising table 431,
A treatment tool or guide wire that has deviated from the guide surface of the
Assuredly guided to the center of the treatment instrument raising table 431.
And the treatment is improved. (Fifteenth Embodiment) FIGS. 45 and 46
FIG. 45 relates to a fifteenth embodiment of the present invention, and FIG.
The treatment tool guide member protrudes from the side wall of the storage room of the elevator
FIG. 46 is a side view of the accommodation room of the treatment instrument raising stand.
FIG. 9 is a cross-sectional view showing a state where the treatment tool guiding member is retracted from
You. (Structure) As shown in FIGS. 45 and 46,
The fifteenth embodiment is directed to a treatment instrument guide of the fourteenth embodiment.
The treatment instrument guiding members 455 and 455 are located at the same positions as the members 435 and 436.
455 are arranged. The treatment instrument guiding member 455 is pulled
It is connected to the pull wire 461. [0194] A towing wire extending from the treatment instrument guiding member 455.
The ear 461 is curved by a roller 462 and is shown in FIG.
To the operating unit 13 which has been operated. The operation means is shown in FIG.
Uses the same link mechanism as the operating means of the treatment tool elevator described above
are doing. (Effect) In the normal case, as shown in FIG.
To the treatment tool guiding member 455
It is stored in the wall 433. [0196] The treatment tool or guide wire is positioned at the desired position on the screen.
If it is lifted out of position, pull
By operating 461, the treatment instrument guiding member 4 as shown in FIG.
55 is projected from the side wall 433. The desired position of the treatment tool
After confirming that the treatment device has been guided, raise the treatment tool
When applying, pull the pulling wire 461 again.
By storing the treatment instrument guiding member 455 in the side wall 433,
The fixture raising platform can be raised smoothly to the maximum position. (Effect) According to the fifteenth embodiment, the fifth embodiment
In addition to the effects of the fourteenth embodiment, the treatment tool guiding member
The resistance of the treatment tool guiding member is reduced because the table riser does not come into contact with it.
improves. FIGS. 47 and 48 show a fifteenth embodiment of the present invention.
FIG. 47 relates to a modification of the embodiment, and FIG.
Section showing the treatment instrument guide member protruding from the side wall of the patient
FIG. 48 and FIG. 48 show that the treatment tool is guided from the side wall of the accommodation room of the treatment tool raising stand.
It is sectional drawing which shows the state which the guide member retracted. In the modification shown in FIGS.
Guidance for guiding the treatment instrument by the gear 671 and the pinion gear 672
The member 473 and the pull wire 461 are linked. In such a modification, FIG. 45 and FIG.
An effect similar to that of the fifteenth embodiment shown in FIG. 46 is obtained.
It is. (Sixteenth Embodiment) FIGS. 49 and 50
FIG. 49 relates to a sixteenth embodiment of the present invention, and FIG.
Shows how to insert the treatment tool through the guide wire
FIG. 50 shows a guide wire for an endoscope.
FIG. 4 is a second explanatory view showing a state in which the treatment tool is inserted through
You. (Structure) As shown in FIGS. 49 and 50,
The treatment tool 570 according to the sixteenth embodiment has a distal end portion 571.
Is the range that passes through the curved portion 16 of the insertion section 12 of the endoscope 2.
At the position corresponding to the forceps opening 64, the tip 571
572 that indicates that the light passes through the inside of the curved portion 16
Or markings. (Operation) The operator inserts the treatment tool of the endoscope 2
Channel 26 to treatment tool 570
With the guide wire 20 for guiding already inserted,
The distal end portion 5 of the treatment tool 570 from the rear end side of the guide wire 20
Insert 71. At that time, as shown in FIGS.
Then, by raising the treatment instrument raising table 27, the endoscope end
Increase the frictional resistance between the part 17 and the treatment instrument raising table 27, and
The wire 20 is fixed. The distal end 571 of the treatment tool 570
When the surgeon inserts the part where the
At the position of the forceps opening 64 for holding the fixture, the index 57
2 comes out. In the part where the index 572 exists, the operator pays attention
Then, the treatment tool 570 is inserted. After the tip 571 has passed through the curved portion 16
Is the indicator 572 is the treatment instrument insertion channel 2 of the endoscope 2
6 and disappears when the operator enters the curved portion 16.
It can be seen that the treatment tool has passed
Perform insertion. The same operation is performed when removing the treatment tool.
U. (Effect) According to the treatment tool 570 of the sixteenth embodiment,
When inserting / removing the treatment tool 570 through the guide wire 20,
Resistance occurs between the id wire 20 and the treatment tool 570.
Therefore, the guide wire 20 is moved by the treatment tool 570 and
It is easy, but with the index 572, the operator is treated carefully
Can be warned to insert or remove the tool, resulting in a guide
The wire 20 is hung and does not move. Thereby, the treatment tool 5
It is not necessary to carefully insert the 70 over the entire length.
By paying attention only to places where the wire 20 moves easily
It will save you time. (Seventeenth Embodiment) FIGS. 51 to 53
FIG. 51 relates to a seventeenth embodiment of the present invention, and FIG.
FIG. 52 is a sectional view of the distal end portion of the insertion portion of FIG.
FIG. 53 is a first explanatory view for explaining the effect of the state in comparison with the conventional method.
Describes the effect of the seventeenth embodiment by comparing it with the related art.
FIG. (Structure) As shown in FIG.
In the distal end portion 617 of the endoscope according to the embodiment,
Link member 622 rotated about rotation shaft 621
Is held between the upper surface of the introduction guide path 633 and the guide wire 20.
Hold down the guidewire 20 with the surface when fixing
The contact surface 623 is provided on the link member 622. (Operation) In the seventeenth embodiment, the guide
With the wire 20 protruding, the link member 622 is raised.
The guide is nipped with the upper surface of the introduction guide path 633 by being raised.
It is fixed to the wire 20. The tip of the conventional endoscope shown in FIGS.
At the end 657, a guide capable of locking the guide wire 20
A wire fixing treatment tool raising table 662 is provided. guide
As shown in FIG. 53, the wire fixing treatment tool raising base 662 is
In addition, the guide wire 20 is held
When fixing the wire, the guide wire 20 is pressed with a corner. (Effect) According to the seventeenth embodiment, the
Press the guide wire from point contact to surface contact
Therefore, the load on the outer skin of the guide wire is small. (Eighteenth Embodiment) FIGS. 54 and 55
FIG. 54 relates to an eighteenth embodiment of the present invention, and FIG.
55 is a sectional view showing a storage tube, and FIG. 55 is a drainage tube.
FIG. 4 is an explanatory diagram showing a use state of the hub. (Structure) As shown in FIG.
The tube 701 is a pancreatic / bile duct in which bile, pancreatic juice, etc. are narrowed.
Are discharged. [0213] Drain line of drainage tube 701
A check valve 703 is provided in a part of 702. The drainage tube 701 moves in the direction of arrow A.
Check valve 5 in pancreas / bile duct and arrow B in duodenum
19 is set so that the liquid flows only in the B direction.
You. (Operation) As shown in FIG.
The tube 701 is inserted into the stenosis 710. Not a flow
Bile and other fluids flow as if they were normal, and
Can the food and gastric juice on the duodenal side enter the pancreas / bile duct?
No. (Effects) According to the seventeenth embodiment, the
Prevents backflow of food, gastric juice, etc. in the drainage tube
Wear. [Supplementary Notes] The above-described aspects of the present invention described in detail above
According to the embodiment, the following configuration can be obtained.
You. (Additional Item 1) A hard tip portion is provided on the tip side.
Insertion section with built-in treatment instrument insertion channel inside
Operating part connected to the proximal end side of the insertion part;
Near the opening of the treatment instrument insertion channel on the distal end side of the entrance
A treatment tool guide surface is provided beside and guides the treatment tool.
And a process that can be started up by an operation from the operation unit.
The instrument raising table and the side of the treatment tool guiding surface of the treatment tool raising table
Provided from the opening of the treatment instrument insertion channel
And a groove for guiding only the derived guide wire.
And guides to the groove when the treatment instrument raising table is raised.
Guide wire, the groove and the distal end hard portion of the
An endoscope characterized by being sandwiched and fixed therebetween. (Appendix 2) Guide the treatment tool to a desired position
A possible treatment instrument raising table and a towing operation of the treatment instrument raising table
Traction means to perform and a first to make the traction means operable
Operating means, provided near the first operating means;
The treatment instrument raising table can be operated by operating the first operation means.
The towing means can be further towed with the maximum upright position
And a second operating means.
Endoscope. (Supplementary Item 3) The treatment instrument raising stand is
Raise the maximum raising range that does not damage the treatment tool.
Highest height to allow the guide wire to be fixed
The endoscope according to claim 2, comprising: (Appendix 4) A treatment tool insertion channel is provided inside
And a connector connected to the proximal end of the insertion section.
Operating part and the treatment tool insertion at the distal end side of the insertion part
Provided near the channel opening to guide the treatment tool
Having a treatment tool guiding surface and operating from the operation unit
A treatment instrument raising table that can be raised by the
Guide wire derived from the opening of the fixture insertion channel
Raise the slit to lock only the hook
Endoscope characterized by providing a plurality of treatment tool guide surfaces
mirror. (Appendix 5) Guide slits are provided in the slits.
The top of the guide wire when the hook is engaged
It will be approximately the same height as the line connecting the treatment tool guide surfaces on both sides of
The slit is formed as described above.
The endoscope according to claim 1. (Appendix 6) The treatment instrument insertion channel
Insertion section with built-in channel, and provided at the tip of this insertion section
The treatment tool can be guided around the rotation axis so that it can be guided to a desired position.
Moving the treatment instrument raising table and the treatment instrument raising table
The treatment instrument raising table is provided with
A first raising member engageable with the pivot and the traction means;
Attached to the first raising member in a detachable state,
And a second raising member forming a part of the treatment instrument guiding surface.
An endoscope characterized in that: (Additional Item 7) The first raising member and the second raising member
The raising member includes the first tool during use of the treatment tool raising table.
So that the second raising member does not easily come off from the raising member
7. A drop-off prevention mechanism is provided.
The endoscope as described. (Additional Item 8) As the falling-off prevention mechanism,
A rail engaging protrusion and a plurality of protrusions are provided at a lower end of the second raising member.
An upright is provided, and the first upright member is engaged with the rail engagement protrusion.
Rail groove and an engagement hole to engage with the projection are provided.
The endoscope according to claim 7, wherein: (Additional Item 9) Attachment / detachment to the tip of the insertion portion
Having a possible tip cover, the treatment tool of the tip cover
The height of the first raising member and the height of the first raising member are larger than the height of one surface in contact with the raising table.
(2) The connecting portion of the raising member is provided low, and the first raising member is provided.
Engaging projection and rail groove for engaging the second raising member with the rail
Is provided perpendicularly to the axial direction of the insertion portion from the one surface.
And the rail engaging projection and the rail groove in this case.
Through to the opposite side of the one side of the treatment tool elevator
8. The apparatus according to claim 7, wherein the area is provided within a range that does not exist.
Endoscope. (Additional Item 10) The first raising member
A first screw hole is provided on a contact surface with the second raising member, and the first screw hole is provided.
Contact of the second raising member corresponding to the contact surface of the first raising member
Providing second screw holes in the surface and screwing into these screw holes
To connect and fix the first raising member and the second raising member.
The fixing screw according to claim 7, further comprising a fixing screw.
Endoscope. (Additional Item 11) The second raising member may be
Guide wire fixed to lock only the guide wire
The slit according to claim 6, further comprising:
Endoscope. (Additional Item 12) The second raising member is a bullet
12. The method according to claim 11, wherein the member is made of a conductive member.
Endoscope. (Additional Item 13) The second raising member may be a second raising member.
(1) It is made of a hard member different from the raising member.
The endoscope according to claim 6. (Supplementary Item 14) From Bile Duct with Stenosis of Bile
In the drainage tube to be drained,
A drainage switch that is partially provided with a check valve
Tube. (Appendix 15) Pancreatic juice from pancreatic duct with stenosis
In the drainage tube to be drained,
A drainage switch that is partially provided with a check valve
Tube. As described above, according to the present invention, a simple
Fix the guide wire to the distal end of the endoscope insertion section
As well as sufficient fixing strength in this case.
The treatment tool can be secured without damage to the guidewire
Length can be shortened. For this reason, guide wire routing
And a large work space is not required.
You. In addition, replacement of the treatment tool becomes easier, and the number of caregivers is reduced.
It also leads to shortening of work time. In addition,
Can be used, so that the surgeon
The use can maintain a state in which the treatment operability is good.
Therefore, the conventional operation method of the treatment tool and the operation feeling are impaired.
The treatment tool can be easily replaced in a shorter time without any trouble.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a schematic diagram showing a schematic configuration of an entire system of an endoscope device incorporating an endoscope according to a first embodiment of the present invention and various external devices. FIG. 2 is a perspective view showing a distal end portion of an insertion portion of the endoscope in a state where a guide wire according to the first embodiment of the present invention is led out. FIG. 3 is a sectional view showing a distal end portion of the insertion section of the endoscope according to the first embodiment of the present invention. FIG. 4 is a sectional view showing the inside of the operation unit of the endoscope according to the first embodiment of the present invention. FIG. 5 is a sectional view showing the inside of the endoscope as viewed from the direction A1 in FIG. 4; FIG. 6 is a perspective view of a treatment instrument raising stand according to the first embodiment of the present invention. FIG. 7 is an explanatory view showing a state in which the treatment tool raising table according to the first embodiment of the present invention guides the guide wire to the guide wire locking groove and raises the guide wire. FIG. 8 is an explanatory view showing a state in which the treatment tool raising table according to the first embodiment of the present invention guides the treatment tool to the guide wire locking groove and raises the treatment tool halfway. FIG. 9 is a first explanatory view illustrating an operation when the guide wire according to the first embodiment of the present invention is fixed to the guide wire locking groove. FIG. 10 is a second explanatory diagram illustrating an operation when the guide wire according to the first embodiment of the present invention is fixed to the guide wire locking groove. FIG. 11 is a third explanatory diagram illustrating an operation when the guide wire according to the first embodiment of the present invention is fixed to the guide wire locking groove. FIG. 12 is a fourth explanatory diagram illustrating an operation when the guide wire according to the first embodiment of the present invention is fixed to the guide wire locking groove. FIG. 13 is a perspective view of a treatment instrument raising base showing a modification of the first embodiment shown in FIGS. 1 to 12. FIG. 14 is a cross-sectional view showing an operation mechanism of a treatment tool raising base of an operation unit of the endoscope according to the second embodiment of the present invention. FIG. 15 is a perspective view of a link member of an endoscope according to a second embodiment of the present invention. FIG. 16 is a perspective view of a second traction member of the endoscope according to the second embodiment of the present invention. FIG. 17 is a perspective view of a guide member according to a second embodiment of the present invention. FIG. 18 is a first explanatory diagram illustrating an operation of an operation unit according to the second embodiment of the present invention. FIG. 19 is a second explanatory view showing the operation of the operation unit according to the second embodiment of the present invention. FIG. 20 is a third explanatory view showing the operation of the operation unit according to the second embodiment of the present invention. FIG. 21 is a cross-sectional view illustrating a first maximum raising state of a treatment tool raising table operating mechanism of an operation unit of an endoscope according to a third embodiment of the present invention. FIG. 22 is a cross-sectional view showing a second maximum raised state of the operation mechanism of the treatment instrument raising base of the operation unit of the endoscope according to the third embodiment of the present invention. FIG. 23 is a plan view showing a treatment instrument raising table at a distal end portion of an endoscope according to a fourth embodiment of the present invention. FIG. 24 is an enlarged view of the top of the treatment tool guiding surface of FIG. 23; FIG. 25 is an enlarged view of the top of a treatment tool guiding surface showing a modification of the fourth embodiment. FIG. 26 is a perspective view showing a treatment instrument raising table at a distal end portion of an endoscope according to a fifth embodiment of the present invention. FIG. 27 is an exploded perspective view of a treatment instrument raising stand according to a fifth embodiment of the present invention. FIG. 28 is a plan view of a first raising member according to a fifth embodiment of the present invention. FIG. 29 is a perspective view showing a treatment instrument raising stand at a distal end portion of an endoscope according to a sixth embodiment of the present invention. FIG. 30 is an exploded perspective view of a treatment instrument raising stand according to a sixth embodiment of the present invention. FIG. 31 is a perspective view of a second raising member according to a sixth embodiment of the present invention. FIG. 32 is a perspective view showing a second raising member of a treatment instrument raising table at a distal end portion of an endoscope according to a seventh embodiment of the present invention. FIG. 33 is a perspective view showing a second raising member of a treatment instrument raising table at a distal end portion of an endoscope according to an eighth embodiment of the present invention. FIG. 34 is an exploded perspective view of a treatment instrument raising stand according to a ninth embodiment of the present invention. FIG. 35 is a sectional view showing a distal end portion of an insertion section of an endoscope according to a ninth embodiment of the present invention. FIG. 36 is an exploded perspective view of a treatment instrument raising stand of an endoscope according to a tenth embodiment of the present invention. FIG. 37 is a sectional view showing a distal end portion of an insertion section of an endoscope according to a tenth embodiment of the present invention. FIG. 38 is a plan view showing a treatment instrument raising table at a distal end portion of an endoscope according to a thirteenth embodiment of the present invention. FIG. 39 is a plan view showing the relationship between a treatment tool elevator, a guidewire, and a treatment tool according to a thirteenth embodiment of the present invention. FIG. 40 is an enlarged view of a slit according to a thirteenth embodiment of the present invention. FIG. 41 is a sectional view showing a distal end portion of an insertion section of an endoscope according to a thirteenth embodiment of the present invention. FIG. 42 is a plan view of a distal end portion of an insertion section of an endoscope according to a fourteenth embodiment of the present invention. FIG. 43 is a first explanatory view illustrating an operation when fixing a guide wire of an endoscope according to a fourteenth embodiment of the present invention; FIG. 44 is a second explanatory diagram illustrating an operation when fixing a guide wire of an endoscope according to a fourteenth embodiment of the present invention. FIG. 45 is a cross-sectional view showing a state in which a treatment tool guiding member protrudes from a side wall of a storage chamber of a treatment tool raising stand according to a fifteenth embodiment of the present invention. FIG. 46 is a sectional view showing a state in which the treatment tool guiding member is retracted from the side wall of the accommodation room of the treatment tool raising stand according to the fifteenth embodiment of the present invention. FIG. 47 is a cross-sectional view showing a state in which a treatment instrument guiding member protrudes from a side wall of a storage chamber of a treatment instrument elevator according to a modification of the fifteenth embodiment of the present invention. FIG. 48 is a cross-sectional view showing a state in which the treatment instrument guiding member is retracted from the side wall of the accommodation room of the treatment instrument elevator according to the modification of the fifteenth embodiment of the present invention. FIG. 49 is a first explanatory view showing a state where a treatment tool is inserted through a guide wire into an endoscope according to a sixteenth embodiment of the present invention. FIG. 50 is a second explanatory view showing a state where a treatment tool is inserted through a guide wire into the endoscope according to the sixteenth embodiment of the present invention. FIG. 51 is a sectional view of a distal end portion of an insertion section of an endoscope according to a seventeenth embodiment of the present invention. FIG. 52 is a first explanatory view for explaining the effects of the seventeenth embodiment of the present invention in comparison with the conventional example. FIG. 53 is a second explanatory view for explaining effects of the seventeenth embodiment of the present invention by comparison with the related art. FIG. 54 is a sectional view showing a drainage tube according to an eighteenth embodiment of the present invention. FIG. 55 is an explanatory view showing a use state of the drainage tube according to the eighteenth embodiment of the present invention. FIG. 56 is a first explanatory view illustrating a procedure for replacing a treatment tool using a conventional endoscope. FIG. 57 is a second explanatory view for explaining a procedure for replacing a treatment tool using a conventional endoscope. [Description of Signs] 1 endoscope device 2 endoscope 12 insertion section 17 distal end section 22 channel opening section 26 treatment instrument insertion channel 27 treatment instrument raising table 71 side section 72 guide wire Lock groove

Claims (1)

Claims: 1. An insertion portion having a distal end hard portion on a distal end side and having a treatment instrument insertion channel built therein, an operation portion connected to a proximal end side of the insertion portion, A treatment tool raising table that is provided near the opening of the treatment tool insertion channel on the distal end side of the insertion portion, has a treatment tool guiding surface for guiding a treatment tool, and can be raised by an operation from the operation unit. A groove provided on a side of the treatment tool guide surface of the treatment tool raising table, for guiding only a guide wire derived from an opening of the treatment tool insertion channel, and raising the treatment tool raising table. An endoscope, wherein a guide wire guided to the groove when raised is sandwiched and fixed between the groove and the hard distal end portion.