JP2003339632A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope excellent in a high frequency treatment operation by treatment tools. <P>SOLUTION: Two channels 17 and 18 for inserting treatment tools are provided at an endoscope 1. The distal end sides of treatment tools 53 and 54 respectively inserted from treatment tool insertion ports 19 and 20 are made to project from two treatment tool rockable tables 14 and 15 provided at the channel exit part of a distal end part 5. By operating an R button, e.g. of a B switch 83 provided at the rockable table operation part 22 of an operation part 3, when the treatment tool 53 which is inserted is a high frequency treatment tool connected to a cauterization apparatus 86 through an electric cable 88, the rockable table 14 is rocked to the right to rock the distal end side of the treatment tool 53 to the right and a lesioned mucosal tissue, etc., is cut open, etc., with a simple operation by energizing by a cut open mode. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope capable of performing various treatments by swinging (tilting) a treatment instrument that is projected from an opening of a treatment instrument insertion channel.

[0002]

2. Description of the Related Art By inserting an elongated insertion portion into a body cavity, various internal medical treatments can be performed by observing organs in the body cavity or the like, and using a treatment instrument inserted in a treatment instrument insertion channel as necessary. BACKGROUND ART Medical endoscopes have been widely used from the past. For example, a procedure of endoscopically excising a lesion site in a body cavity by inserting an incision treatment tool such as a high-frequency knife is also useful. Is widely recognized.

For example, the endoscope disclosed in Japanese Unexamined Patent Publication No. 2001-212078 is provided with two forceps raising mechanisms, and a method of inserting a treatment tool into each of the two treatment tool insertion channels to perform a treatment is shown. . In addition, JP-A-8-308852
According to the publication, by connecting an electric cord with a switch to the high-frequency treatment instrument, the output of the high-frequency current can be started and stopped by the switch located near the high-frequency treatment instrument.

In the above endoscope, a forceps raising mechanism for raising the two treatment tool insertion channels in different directions is provided at the distal end opening portions of the two treatment tool insertion channels, and the grasping procedure is inserted into one of the treatment tool insertion channels. A treatment (hereinafter referred to as grasping forceps) is combined with an incision treatment instrument such as a high-frequency knife inserted into the other treatment instrument insertion channel to perform treatment. Specifically, it is described that the lesioned mucous membrane portion or its vicinity is grasped by grasping forceps and lifted up, and then cut off with a high-frequency knife.

[0005]

[Patent Document 1] Japanese Unexamined Patent Application Publication No.
In the endoscope of 001-212078, the rocking (tilting) operation of the high-frequency treatment instrument and the high-frequency ON / OFF operation for starting and stopping the output of the high-frequency current are separate.

Further, even if the electric cord disclosed in Japanese Unexamined Patent Publication No. 8-308852 is used, the high frequency ON / OFF operation can be performed near the hand side of the high frequency treatment instrument, but it is also independent from the swing operation of the high frequency treatment instrument. Was.

(Object of the Invention) The present invention has been made in view of the above points, and an object thereof is to provide an endoscope excellent in high-frequency treatment operation by a treatment tool.

[0008]

In order to achieve the above object, at least one or more treatment instrument insertion channels are provided in an insertion portion having an observation optical system, and a treatment instrument led out from the treatment instrument insertion channel. And a treatment instrument swinging table for swinging the instrument in a predetermined direction is formed.
In an endoscope provided with a treatment instrument swinging table swinging means capable of remotely operating the treatment instrument swinging table, the treatment instrument swinging table swinging means is an electric device inserted through the treatment instrument insertion channel. By providing the surgical treatment instrument with a current-carrying means for supplying a high-frequency current at the same time as swinging, the treatment for swinging the treatment instrument drawn out from the treatment instrument insertion channel in a predetermined direction can be easily performed, and The endoscope which allows easy high-frequency current operation is realized by making it possible to easily apply high-frequency current.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 5 relate to a first embodiment of the present invention. FIG. 1 shows the entire configuration of an endoscope of the first embodiment, and FIG. FIG. 3 is a perspective view showing the configuration of the treatment instrument rocking table of FIG. 3, FIG. 3 is a view seen from the upper side of FIG. 2, FIG. 4 is a state in which treatment is performed with an endoscope, and FIG. It is a figure which shows that the treatment tool detection sensor was provided in the insertion opening.

As shown in FIG. 1, an endoscope 1 according to a first embodiment of the present invention has an elongated insertion portion 2 having flexibility.
And the operating portion 3 on the hand side provided at the rear end of the insertion portion 2.
And a universal cord 4 into which a light guide or the like is inserted is extended from a side portion of the operation portion 3, and a connector (not shown) at an end portion of the universal cord 4 is detachably connected to the light source device and the video processor. .

The insertion portion 2 has a hard tip portion 5 provided at its tip, a bendable first bending portion 6 provided at the rear end of the tip portion 5, and a rear end of the first bending portion 6. A bendable second bending portion 7 provided on the upper end and a flexible tube portion 8 which is long and flexible from the rear end of the second bending portion 7 to the front end of the operation portion 3.
It consists of and.

The first bending portion 6 provided at the rear end of the tip portion 5
Can be bent substantially up and down and left and right in the field of view by the near side operation with the first bending operation section 26 provided at the near side operation section 3. Further, the second bending section 7 can be bent substantially up and down in the visual field by an operation on the near side with the second bending operation section 27 provided in the operation section 3. Further, the first bending portion 6 and the second bending portion 7 can be bent independently.

An observation window 9 for observation, an illumination window 10 for illumination, and an air / water supply nozzle 11 for air / water supply, which is opposed to the observation window 9, are provided on the front end surface of the front end portion 5, and a front for water / jet injection. A water injection port 12 is provided.

A treatment instrument rocking base storage portion 13 is formed at the tip portion 5, and inside the treatment instrument rocking base storage portion 13, a first treatment tool rocking base 14 and a second treatment tool rocking base 14 are formed. The treatment instrument swinging base 15 is held swingably. In addition, in the present specification, as will be understood from the following description, “swing” is used to mean a greater tilting action. In other words, the tilting is a tilting movement. For example, when an operation of tilting the treatment tool (or treatment tool rocking table) to the right from the tilted direction to the left is performed, the tilting to the left becomes small once and becomes neutral. After this state, it will tilt to the right this time, and this kind of tilting, that is, the meaning of tilting that can be tilted from the state of swinging to the left to the state of swinging to the right Is used. Further, the movement from the swaying state to the left side (or the right side, the upper side, and the lower side) to the neutral state may be performed, and vice versa.

The first treatment instrument rocking base 14 is capable of rocking (tilting) substantially in the lateral direction of the visual field, while the second treatment tool rocking base 15 is the first treatment tool rocking base. 14 rocking (tilting)
It can swing in a direction orthogonal to the direction, in this case, approximately in the vertical direction of the visual field.

A first treatment tool insertion channel 17 and a second treatment tool insertion channel 18 are inserted inside the insertion portion 2. First treatment instrument insertion channel 17
The front end side thereof communicates with the opening of the first treatment instrument rocking base 14, and the rear end side thereof communicates with the first treatment instrument insertion port 19 of the operation section 3.

The second treatment tool insertion channel 18 is also provided.
Communicates with the opening of the second treatment instrument rocking base 15,
The rear end side communicates with the second treatment tool insertion port 20 of the operation unit 3.

The operating section 3 includes a (first treatment instrument swing base 14
And rocking operation of the second treatment tool rocking base 15), a rocking base operating unit 22, a gripping unit 25 held by an operator, a first bending operating unit 26, and a second bending operation. And a section 27 are provided. An air / water supply control button 28, a suction control button 29, and an image control button 30 are provided near the first bending operation section 26.

By operating the air / water control button 28 and the suction control button 29, it is possible to control air / water supply and suction. In addition, by operating the image control button 30, the image captured by the image pickup device built in the observation window 9 of the endoscope 1 is displayed as a still image, and the like. No video processor can control the image processing operation.

Inside the swing base operating section 22, a first treatment tool swing base operating mechanism 31 (not shown but attached for the sake of clarity) is provided with a second treatment tool swing mechanism. Drive base operating mechanism 32 (coded for the same reason as code 31)
Is built in, and each electric switch is provided outside the rocking table operating unit 22. Each electric switch will be described separately. Further, on the outer surface of the rocking table operating section 22, a front water supply inlet 23 and a rocking table operating wire cleaning port 24 are provided.
Is provided. The front water supply injection port 23 communicates with the front water supply injection port 12.

The swing base operating wire cleaning port 24 is opened in the treatment tool swing mount housing portion 13 of the distal end portion 5. Further, a syringe (not shown) can be connected to the swing base operating wire cleaning port 24, and a cleaning liquid or the like can be sent into the operating wire insertion channel 60 (see FIG. 3).

Outside the first bending operation portion 26, there are provided a first bending portion operation knob 35, a first bending portion operation knob 36, and a first bending portion operation knob 36.
A rotary / fixing lever 38 and a first rotary / fixing knob 39. A second bending portion operation knob 37 and a second rotation / fixing knob 40 are provided outside the second bending operation portion 27.

The first bending portion operating knob 35 is provided on the first bending portion 6
The bending operation knob in the up-and-down direction of the first bending operation portion 26
Alternatively, an up / down operation wire (not shown) extending from the first bending portion 6 is connected inside the grip portion 25. The first bending portion operation knob 36 is an operation knob for bending the first bending portion 6 in the left-right direction, and is the first bending operation portion 26 or the grip portion 2.
Left and right operation wires (not shown) extending from the first bending portion 6 are connected inside the portion 5.

The rotation and fixing of the first bending portion operating knob 35 is switched by the first rotating / fixing lever 38, while
The rotation and fixing of the first bending portion operating knob 36 can be switched by the first rotating / fixing knob 39.

The second bending portion operating knob 37 is an operating knob for bending the second bending portion 7 in the vertical direction, and extends from the second bending portion 7 inside the second bending operating portion 27 or the grip portion 25. A vertical operation wire (not shown) is connected. The rotation and fixing of the second bending portion operation knob 37 is performed by the second rotation /
It is switched by the fixed knob 40.

Further, the insertion portion breakage prevention member 41 and the universal cord breakage prevention member 42 provided at the base ends of the universal cords 4 have the insertion portion 2 and the universal cord 4 respectively.
This is a member for preventing breakage at the root of the.

Hereinafter, the treatment instrument inserted through the first treatment instrument insertion channel 17 is referred to as a first treatment instrument 53, while the treatment instrument inserted through the second treatment instrument insertion channel 18 is referred to as a second treatment instrument. Will be referred to as a treatment tool 54.

By the way, in the case of FIG. 1, the first treatment tool 5 is used.
3 is a high frequency knife, and the second treatment tool 54 is a grasping forceps. Next, each electric switch provided outside the rocking table operating portion 22 will be described.

The rocking table operating section 22 includes four rocking table operating switches, specifically, A switch 82 and B switch 8.
3, a C switch 84 and a D switch 85 are provided. First, the A switch 82 will be described.

While the R button portion of the A switch 82 is continuously pressed, the first treatment instrument rocking base 14 moves the first treatment instrument rocking base operating mechanism 31 in the rocking base operating portion 22. It tilts (moves so as to tilt) to the right by (not shown).
When the pushing is stopped, the swing (tilt) of the first treatment tool swing base 14 stops.

When the L button portion is pushed, the first treatment instrument rocking base 14 tilts to the left, and when pushing is stopped, the tilting stops in that state. Similarly, for the U button and the D button, the second treatment instrument rocking base 15 is moved by the second treatment instrument rocking base operating mechanism 32 (not shown) in the rocking base operating section 22.
Can tilt down. Detailed structures of the first treatment instrument swinging base 14 and the second treatment instrument swinging base 15 will be described later with reference to FIG.

As shown in FIG. 1, the rocking table operating unit 22 can be connected to an ablation device 86 as a high frequency cautery power supply device for supplying a high frequency power through an electric cable 88, and the rocking table operating unit 22. By operating the B switch 83 and the C switch 84 provided on the
4 and the first treatment tool rocking base 15 can be rocked, and the inserted treatment tool is energized by a high-frequency current connected to the cauterization device 86 by the electric cable 88 to perform treatment. In this case, it is possible to control the operation of energizing the high frequency current by the cautery device 86 in conjunction with each other.

The B switch 83 will be described below.
The switch for controlling the start and stop of the output of the high frequency current from the cauterization device 86 is the B switch 8 of the rocking table operating unit 22.
3, the C switch 84, and the B switch 83 and the C switch 84 are connected to the cauterization device 86 via a detachable electric cable 88.

A patient electrode 87 formed in a sheet shape so as to be in close contact with the skin of a human body for passing a high frequency current into the body cavity is also connected to the ablation device 86 by an electric cable 88.

First inserted in the first treatment instrument insertion port 19
The treatment tool 53 is a high-frequency knife (for conducting a treatment by passing a high-frequency current) as described above, and the electric cable 8
At 8 it is connected to a cauterization device 86. Inside the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20, treatment instrument detection sensors 89 are respectively arranged as shown in FIG. When the L button and the R button of the B switch 83 are operated in this state, the first treatment instrument rocking base 14 can be tilted to the left and the right (and can be rocked by tilting in the left-right direction). Further, during tilting (swinging), a high frequency current in the incision mode (CUT) can be supplied from the first treatment tool 53 into the body cavity. In other words, in this case, the first
The treatment tool 53 can be moved to the left and right.

Incidentally, the first treatment tool insertion channel 1
It is detected by the treatment instrument detection sensor 89 that a high frequency knife which is a high frequency treatment instrument is inserted in 7. U
When the button or the D button is operated, the second treatment instrument rocking base 1
5 can be swung up and down, respectively. Since the treatment tool detection sensor 89 detects that the second treatment tool 54 is not a high-frequency treatment tool, the cauterization device 86 does not operate even if the U button or the D button is operated.

The second treatment instrument 5 is inserted into the first treatment instrument insertion port 19.
4. If the first treatment tool 53 is inserted through the second treatment tool insertion port 20, the opposite is true. That is, when the L button and the R button of the B switch 83 are operated, only the first treatment tool swing base 14 moves to the left and right. The ablation device 86 does not operate. When the U button and D button of the B switch 83 are operated, the cautery device 86 is activated and the second treatment instrument rocking base 1 is operated.
5 tilts up and down.

Next, the C switch 84 will be described. This is the same as the B switch 83, except that when the first treatment tool swing base 14 is tilted, a high-frequency current in the coagulation mode (COAG) is supplied from the first treatment tool 53 into the body cavity. Next, the D switch 85 will be described.

When the D switch 85 is pressed, no matter which tilted state (swing state) the first treatment instrument swing base 14 and the second treatment instrument swing base 15 are in, the swing neutral state (each treatment). The tool returns to a state in which it can be taken out straight from the first treatment tool insertion channel 17 and the second treatment tool insertion channel 18.

As described above, the A switch 82 is related to the rocking table operation and is not energized, and the B switch 83 and the C switch 84 perform rocking table operation and energization control in the incision and coagulation modes.

The structure of the first treatment instrument rocking base 14 will be described with reference to FIG. On the upper surface and the lower surface of the first treatment tool insertion opening 45 of the first treatment tool swing base 14, the end portion 5 of the first rotation shaft is provided.
5, 56 project, and these end portions 55, 56 are rotatably held by support holes (not shown) provided on the inner wall surface of the treatment instrument rocking base storage portion 13.

Two mounting holes 59 are provided at positions on both sides of the first rotary shaft so as to sandwich the end portions 55 and 56.
A wire end member 58 fixed to the end of the operation wire 57 is rotatably held in each attachment hole 59.

As described above, the end portions 55, 5 of the first rotating shaft are
6 is rotatably held in the treatment instrument rocking base storage unit 13, and the first treatment instrument rocking base 14 is configured to rotate within the treatment tool rocking base storage unit 13 about the first rotation axis. One of the operation wires 57 of the book can be remotely tilted to the pulled side.

FIG. 2 shows the swing neutral state.
The first treatment instrument 53 inserted into the treatment instrument insertion channel 17 of the above protrudes from the first treatment instrument insertion hole 45 in a straight state as shown in FIG. Since the second treatment tool swing base 15 is also the same as the first treatment tool swing base 14, only different member numbers are shown in parentheses.

FIG. 3 is a view showing how the first treatment instrument 53 projected from the first treatment instrument swinging table 14 swings within the observation visual field range θ of the observation window 9. . As shown in FIG. 1, the observation window 9 is arranged above the first treatment instrument swinging table 14. In FIG. 3, the observation window 9 is shown by a chain double-dashed line. The reference numeral 5a indicates the tip end surface.

The two operation wires 57 pass through the operation wire insertion channel 60 and are connected to the first treatment tool rocking table operating mechanism 31 (not shown) in the rocking table operating section 22.
Switch 82 or B switch 83 or C switch 8
You can pull it with 4.

The first treatment tool 53 swings substantially horizontally on the screen with the first rotation shaft 55 as the center of rotation. The swing locus of the tip of the first treatment tool 53 draws an arc shape.

When the swinging neutral state (position) A is set when the first treatment instrument 53 is in the straight state, the first treatment instrument 53 drawn out from the first treatment instrument swing base 14 is swing neutral. The position A can be oscillated substantially right and left about the center.

Second treatment tool rocking base 1 which rocks in the vertical direction
Also in the case of No. 5, since the structure is the same as that of the first treatment instrument rocking base 14, description thereof will be omitted. Only the numbers of different members are shown in parentheses. First treatment tool swing base 14 and second treatment tool swing base 15
The four operation wire insertion channels 60 including the above are merged into one in the oscillating table operating portion 22, and then opened to the oscillating table operating wire cleaning port 24.

Next, the operation of this embodiment will be described. Figure 4
[Fig. 2] is a diagram showing a state of actually performing treatment with the endoscope 1 shown in Fig. 1. The diseased mucous membrane portion M is grasped and lifted by the second treatment instrument 54 (in this case, grasping forceps) derived from the second treatment instrument swinging table 15, and the foot thereof is derived from the first treatment instrument swinging table 14. The figure shows a state in which the first treatment tool 53 (in this case, a high-frequency knife) that has been cut is opened in the left-right direction.

The swing of the first treatment instrument swing base 14 and the second treatment instrument swing base 15 can be electrically controlled by an electric switch of the A switch 82, the B switch 83 or the C switch 84. it can. By the B switch 83 or the C switch 84, the first treatment instrument swinging table 14 and the second treatment instrument swinging table 15 can be swung, and the cauterization device 86 can also be driven in conjunction.

When the D switch 85 is pressed, the rocking neutral state (each treatment tool is moved to the first First treatment tool insertion channel 17 and second treatment tool insertion channel 1
It is possible to return from 8 to a state where it can be taken out straight).

As shown in FIG. 4, the second treatment instrument rocking base 15
The lesioned mucosal part M by the second treatment tool 54 derived from
Gripping and operating the U button of the A switch 82, for example, to bring it into a suspended state, and then the first treatment tool 53 (which has been tilted leftward by pressing the L button of the A switch 82) is switched to the B switch. By pressing the R button 83 and tilting (swinging) a large amount to the right, the energization is performed in the cutting mode, and the cutting procedure can be performed by a simple operation.

The present embodiment has the following effects. Since the rocking operation of the high-frequency treatment instrument and the high-frequency treatment (energization) can be operated with one switch, treatment work such as incision can be performed efficiently. Since the rocking table can be easily returned to the rocking neutral state, it is effective when inserting or removing the treatment tool. The treatment tool can be inserted and removed with a light force. Also, the treatment tool is less damaged.

The number of rocking bases may be one instead of two. For example, in the case of only the first treatment instrument rocking base 14, each switch of the A switch 82 to the C switch 84 displays only R and L, and the displays of U and D disappear. The bending operation of the first bending portion 6 and the second bending portion 7 may be electrically operated by an electric switch.

(Second Embodiment) Next, a second embodiment of the present invention will be described with reference to FIG. The endoscope according to the present embodiment is similar to the endoscope according to the first embodiment, except that the swing base operating unit 22 is used.
The upper switches are different, and the swing base operating unit 22 shown in FIG.
B is adopted.

In this swing base operating section 22B, the B switch 83 and the C switch 84 are provided with energization changeover switches 90 instead of the A switch 82 in the swing base operating section 22 shown in FIG. There is.

When the energization changeover switch 90 is turned on, FIG.
Is the B switch 83 of the first embodiment.
It can be used in the same way as the
Then, the B switch 83 shown in FIG.
The same function as the switch 82 is obtained (the high-frequency treatment tool is not energized).

The C switch 84 is also the same as above, and its explanation is omitted. Other configurations are similar to those of the first embodiment. The operation and effect of this embodiment are almost the same as those of the first embodiment.

(Third Embodiment) Next, a third embodiment of the present invention will be described with reference to FIG. In the endoscope of the present embodiment, the switches on the rocking base operating unit 22 in the first embodiment are changed to foot switches 91.

That is, the foot switch 91 is provided with the A switch 82 to the D switch 85, and the electric cable 8
The device 8 can be connected to the cauterization device 86. The other configuration is the same as that of the first embodiment. The operation and effect of this embodiment are almost the same as those of the first embodiment.

By the way, conventionally, Japanese Patent Laid-Open No. 2001-1700
The 06 endoscope had two rocking bases, and the operating sections for operating the respective rocking bases could be operated independently. However, it is difficult to operate because there is no indication as to which one of the operating parts of each rocking table should be rocked. Therefore, the above-mentioned problems can be solved by adopting the configuration shown in FIGS. 8 and 9.

First, the configuration of FIG. 8 will be described. Note that FIG.
FIG. 8A is a side view of the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20 viewed from the side of the grip portion 25 (of the operation unit 3), and FIG. The top view which looked at the 1st treatment tool insertion port 19 and the 2nd treatment tool insertion port 20 from the upper surface direction of the treatment tool insertion port 19 and the 2nd treatment tool insertion port 20 is shown.

In the vicinity of the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20, swing table swing switches 92a and 92b indicating the swing direction are provided. In the vicinity of the first treatment tool insertion port 19, a rocking base swing switch 92a of a rocking table related to the first treatment tool insertion port 19 is provided, while the second treatment tool insertion port 20 is provided. In the vicinity, a rocking table rocking switch 92 of a rocking table related to the second treatment instrument insertion port 20 is provided.
b is provided.

When each of the rocking base rocking switches 92a and 92b is pushed, the rocking base (treatment tool) on the pushed side moves substantially in the display direction indicated by the rocking base rocking switches 92a and 92b. Therefore, the above problems can be solved.

Next, the configuration of FIG. 9 will be described. 9A shows a perspective view of the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20 seen obliquely from the side of the grip portion 25, and FIG. 9B shows the first treatment instrument insertion port 19. The sectional view which shows the inside of the treatment tool insertion port 19 or the 2nd treatment tool insertion port 20 is shown.

As shown in FIG. 9A, the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20 are respectively a first treatment instrument insertion port body 93 and a second treatment instrument insertion port body 94. The first treatment instrument insertion port body 93 and the second treatment instrument insertion port body 94 are housed in the body housing parts 95 and 96 so as to be swingable vertically and horizontally.

As shown in FIG. 9B, the treatment tool insertion port main body 93 or 9 is provided on the inner wall of the main body accommodating portions 95 and 96.
4 is moved up and down and left and right, the rocking base rocking switch 92a
Alternatively, a switch contact 96a or 96b capable of turning ON / OFF the switch 92b is provided. Further, as shown in FIG. 9 (A), the swinging direction of the rocking table associated with the first treatment instrument insertion port 19 and the rocking direction of the rocking platform associated with the second treatment instrument insertion port 20 are respectively. It is displayed in the vicinity of the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20.

For example, when the treatment instrument insertion port main body 93 is tilted in the direction in which it is desired to swing, the swing base swing switch 97a on the tilted side is turned on, and the swing base can be moved in the display direction. Figure 8
Alternatively, the effect of the configuration shown in FIG. 9 is that the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20 are provided near the first treatment instrument insertion port 19 and the second treatment instrument insertion port 20. Since the rocking switch of the rocking table respectively related to and is provided and the rocking direction is displayed, the operation is easy.

As a conventional example, Japanese Patent Laid-Open No. 11-1922.
An external channel tube was attached to the tip of the endoscope disclosed in No. 03. However, since the externally attached channel tube does not have the treatment tool swinging table, the tip of the treatment tool cannot be moved up and down or left and right, for example, and the procedural property is poor.

FIG. 10 and FIG. 11 show an endoscope 71 in which the above problems are eliminated. First, the configuration shown in FIG. 10 will be described.

The endoscope 71 is composed of an endoscope main body 72 and a single or a plurality of external channel members 73 which can be attached to and detached from the insertion section 2 of the endoscope main body 72 (in FIG. 10, one external channel). Although it is shown in the case of the member 73, 2
It is also possible to attach one or more, and in FIG. 11, the case where two channel members 73 are attached is shown.

At least one flat surface portion 74a is provided on the outer periphery of the distal end portion 5 of the endoscope main body 72. A holding portion 75 having a C-ring shape is provided on the distal end side of the external channel member 73 so that the external channel member 73 can be detachably fixed to the insertion portion 2 of the endoscope main body 72 externally. The flat surface portion 74b provided at the tip of the external channel member 73 contacts the flat surface portion 74a on the endoscope side.

A flat channel is provided in the external channel member 73, the first treatment instrument rocking base 14 is arranged in the tip end opening, and further communicates with the opening 45 of the treatment instrument rocking base 14. A treatment instrument insertion channel 76 is provided so that the treatment instrument can be inserted through the opening on the proximal side.

On the near side of the external channel member 73, an external channel gripping portion 77 having an opening (insertion port) communicating with the treatment instrument insertion channel 76 and an operating knob 78 are provided. By rotating 78, the first treatment tool rocking base 14, which is rockably held in the distal end opening of the external channel member 73, can be rocked horizontally or vertically, for example.

Next, a further explanation will be given with reference to FIG. FIG. 11 is a view seen from the distal end side when two external channel members 73 of FIG. 10 are attached to the distal end portion 5 of the endoscope main body 72.

The two first and second treatment instrument oscillating bases 14 and 15 oscillate along the plane of the plane portion 74a. Tip portions 5 of the two external channel members 73
The attachment position to the can be changed arbitrarily.

That is, it is possible to freely change the position where the treatment tool is inserted into the endoscopic image observed through the observation window 9. The external channel member 73 is disposable.

The endoscope 71 shown in FIGS. 10 and 11 has the following effects. Since the external channel member 73 is a disposable device, there is no need to wash and disinfect the swing part of the first treatment tool swing base 14. Moreover, since the external channel member 73 may be attached when treatment is required, the endoscope main body 7
The diameter of the insertion portion 2 of 2 can be reduced.

Further, since it is the externally attached channel member 73 with the first treatment instrument swinging base 14, the operability is good. Further, since the tip portion 5 is provided with the flat surface portion 74a,
It is easy to fix the external channel member 73. Furthermore, since at least one flat surface portion 74a is provided on the distal end portion 5, procedurality can be further improved by attaching a plurality of external channel members 73.

[Additional Notes] 0. At least one or more treatment instrument insertion channels in the insertion section having the observation optical system,
A treatment tool tilting base for tilting the treatment tool drawn out from the treatment tool insertion channel in a predetermined direction is formed, and a treatment tool tilting base capable of remotely operating the treatment tool tilting table on the hand side from the insertion portion. In the endoscope provided with tilting means, the treatment tool tilting table tilting means is a current-carrying means for energizing a high-frequency current at the same time as tilting with respect to the electrosurgical treatment tool inserted in the treatment tool insertion channel. An endoscope characterized by adding functions. 1. At least one or more treatment instrument insertion channels and a treatment instrument tilting base for tilting the treatment instrument drawn out from the treatment instrument insertion channel in a predetermined direction are formed in the insertion section having the observation optical system, and From the insertion part to the hand side,
In an endoscope provided with a treatment tool tilting table tilting means capable of remotely controlling the treatment tool tilting table, the treatment tool tilting table tilting means is configured such that the treatment tool inserted into the treatment tool inserting channel is for electrosurgery. An endoscope having a detection means for detecting whether or not it is a treatment tool, and a control function for energizing a high-frequency current at the same time as tilting by the detection output of the detection means.

2. At least one flat surface portion is formed on the outer circumference of the distal end portion of the endoscope, and the external channel with the treatment implement swing base is provided so that the treatment implement swing base swings along the plane direction of the flat face portion. An endoscope which is detachably fixed to the flat surface portion.

As described above, according to the present invention,
It is possible to oscillate while applying an electric current to at least one high-frequency treatment instrument. That is, it is possible to provide an endoscope in which high-frequency treatment is easy.

[Brief description of drawings]

FIG. 1 is a perspective view showing an overall configuration of an endoscope according to a first embodiment of the present invention.

FIG. 2 is a perspective view of a configuration of a first treatment tool swing table.

FIG. 3 is a view seen from the upper surface side of FIG.

FIG. 4 is a diagram showing a state in which treatment is performed with an endoscope.

FIG. 5 is a view showing that a treatment tool detection sensor is provided at an insertion opening of the treatment tool.

FIG. 6 is a plan view showing the configuration of a rocking table operating section according to the second embodiment of the present invention.

FIG. 7 is a diagram showing a foot switch provided with a rocking base operating portion according to a third embodiment of the present invention.

FIG. 8 is a diagram showing a configuration in the vicinity of a treatment instrument insertion opening provided with a swing base swing switch.

FIG. 9 is a diagram showing a configuration in the vicinity of a treatment tool insertion port, which has a different configuration from that in FIG. 8;

FIG. 10 is a view showing an endoscope in which an external channel in which a treatment tool swinging base is provided on the endoscope body is detachably attached.

FIG. 11 is a view showing a front end surface in a state where two external channels are attached.

[Explanation of symbols]

1 ... Endoscope 2 ... insertion part 3 ... Operation part 4 ... Universal code 5 ... Tip 6, 7 ... Curved part 9 ... Observation window 10 ... Lighting window 11 ... Air / water nozzle 13 ... Treatment tool rocking table storage section 14 ... First treatment tool rocking table 15 ... Second treatment instrument rocking platform 17 ... Channel for inserting first treatment instrument 18 ... Channel for inserting second treatment instrument 19 ... First treatment instrument insertion port 20 ... Second treatment instrument insertion port 22 ... Rocking table operation unit 26 ... 1st bending operation part 27 ... Second bending operation section 53 ... First treatment tool 54 ... Second treatment tool 55, 56 ... Edge 57 ... Operation wire 58 ... Wire end member 59 ... Mounting hole 60 ... Operation wire insertion channel 82 ... A switch 83 ... B switch 84 ... C switch 85 ... D switch 86 ... Cauterization device 88 ... Electric cable 89 ... Treatment tool detection sensor

   ─────────────────────────────────────────────────── ─── Continued front page    (72) Inventor Hisao Yabe             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. F-term (reference) 4C060 KK03 KK04 KK05 KK06 KK07                       KK47                 4C061 AA00 BB02 CC06 DD03 FF43                       HH24 HH25 HH57

Claims (3)

[Claims] 1. A treatment instrument swinging device configured to swing at least one or more treatment instrument insertion channels and a treatment instrument led out from the treatment instrument insertion channel in a predetermined direction in an insertion section having an observation optical system. An endoscope including a table and a treatment tool rocking table rocking means capable of remotely operating the treatment tool rocking table on the hand side of the insertion section, wherein the treatment tool rocking table rocks. The means is also provided with an energizing means for energizing the electrosurgical treatment instrument inserted through the treatment instrument insertion channel with a high-frequency current simultaneously with rocking. 2. The endoscope according to claim 1, wherein the treatment instrument swinging table swinging means is disposed in the vicinity of the proximal side opening of the treatment instrument insertion channel. 3. The endoscope according to claim 1, wherein the switch portion of the treatment instrument swinging table swinging means is a foot switch.