JP2004194740A - Endoscope apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope apparatus wherein a diameter of an insertion member having two or more treatment instrument guiding tables is made thin so that a lifting up guiding range of the treatment instrument projected from a pointed head of the insertion member can be widely secured. <P>SOLUTION: The endoscope apparatus comprises an optical system 3 for observation, the first treatment instrument guiding table 14 which guides the first treatment instrument 26 in the approximately vertical direction in a screen of an endoscopic image for observation and the second treatment instrument guiding table 15 which guides the second treatment instrument 27 in the approximately horizontal direction in the screen of the endoscopic image, at the pointed head 1 of the endoscope insertion member. Also, in this endoscope apparatus, a position of a rotation shaft of the second treatment instrument guiding table 15 is disposed at the pointed head side of the endoscope insertion member in the longitudinal direction against the position of the rotation shaft of the first treatment instrument guiding table 14. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an endoscope apparatus including a plurality of treatment instrument insertion channels, and a treatment instrument guide table for guiding a treatment instrument protruding from an opening of each treatment instrument insertion channel.
[0002]
[Prior art]
An illumination optical system for projecting illumination light, an observation optical system for observing an observation site, an elongated and flexible insertion section having a treatment instrument insertion channel into which various treatment instruments are inserted, and a proximal end side of the insertion section The medical device is provided with an operation unit for operating the insertion unit, and inserts the insertion unit into a body cavity to observe an organ in the body cavity and perform various treatments with a treatment tool inserted through a treatment tool channel. Endoscope devices are widely used.
[0003]
In order to efficiently process this endoscopic treatment, a plurality of treatment tool insertion channels are provided, and various treatment tools are inserted through the respective treatment tool insertion channels to perform treatment for a lesion site in a body cavity. The mirror device includes, for example, two forceps elevating mechanisms that elevate in different directions at the distal end openings of two treatment instrument insertion channels provided in the insertion portion, and are respectively inserted into the two treatment instrument insertion channels. There has been proposed an endoscope apparatus in which each of the treatment tools can be individually raised by a forceps raising mechanism (for example, see Patent Document 1).
[0004]
Specifically, forceps raising mechanisms that rise in different directions are provided at the distal end openings of two treatment instrument insertion channels provided in the endoscope insertion section, respectively. A treatment instrument for grasping (hereinafter, referred to as grasping forceps) is inserted, and a treatment instrument for incision (hereinafter, referred to as dissecting forceps) such as a needle-shaped electric scalpel is inserted into the other treatment instrument insertion channel, thereby obtaining a lesion mucosa. Alternatively, the vicinity thereof is gripped and lifted by gripping forceps, and a foot portion of the lifted lesion mucosa is cut off by incision forceps.
[0005]
[Patent Document 1]
JP-A-2001-212078 (pages 3 and 4, FIGS. 1 to 6).
[0006]
[Problems to be solved by the invention]
The endoscope device proposed in Patent Document 1 described above has a rotation axis position of a first forceps raising mechanism for grasping forceps for guiding a treatment tool in the vertical direction, and an incision for guiding the treatment tool in the left and right direction. The rotation axis position of the second forceps raising mechanism for the forceps is provided at substantially the same position in the longitudinal direction of the insertion portion.
[0007]
Generally, it is desirable that the insertion portion of the endoscope device be reduced in diameter in order to be inserted into a body cavity.
[0008]
However, at the distal end of the endoscope insertion portion, not only the first and second treatment tool insertion channels and the first and second forceps raising mechanisms provided in the openings of the insertion channels, but also the observation optical system and the illumination. Since the optical system, the air supply / water supply channel, and the like are also disposed, the rotation axis position of the first forceps raising mechanism and the rotation axis position of the second forceps raising mechanism are substantially the same with respect to the longitudinal direction of the insertion portion. If it is provided at the position, it becomes a factor that hinders reduction in the diameter of the distal end of the insertion portion.
[0009]
Further, when the rotation axis positions of the first forceps raising mechanism and the second forceps raising mechanism are at the same position, the treatment tools that have been raised by the first and second forceps raising mechanisms are respectively operated by the respective forceps raising mechanisms. In order to avoid collision with the upper mechanism, the raising operation range is narrowed, the lifting range and lifting force of the mucous membrane during the incision treatment of the lesion mucosa described above are insufficient, and the range that can be incised is narrowed, and the resection work is inefficient. There was an issue.
[0010]
The present invention has been made in view of the above circumstances, and can reduce the diameter of an endoscope insertion section having a plurality of treatment instrument insertion channels, and raise a treatment instrument protruding from the distal end of the insertion section. An object of the present invention is to provide an endoscope apparatus which can secure a wide guiding range and has excellent endoscope treatment efficiency.
[0011]
[Means for Solving the Problems]
The endoscope apparatus of the present invention observes the distal end of the first treatment instrument that is led out through the observation optical system including the observation window and the first treatment instrument insertion channel at the distal end of the endoscope insertion section. A first treatment tool guide table for guiding the image of the endoscope image observed by the optical system in a substantially vertical direction, and a tip of a second treatment tool led out through a second treatment tool insertion channel; In an endoscope provided with a second treatment tool guide table for guiding the image substantially in the horizontal direction, the rotation axis position of the first treatment tool guide table and the rotation of the second treatment tool guide table An axial position is displaced with respect to a longitudinal direction of the endoscope insertion portion, and the endoscope insertion portion is disposed.
[0012]
The rotation axis position of the second treatment instrument guide table of the endoscope apparatus according to the present invention is disposed closer to the distal end of the endoscope insertion section than the rotation axis position of the first treatment instrument guide table. And
[0013]
The endoscope apparatus according to the present invention also includes an observation optical system including an observation window, a first channel opening of a first treatment instrument insertion channel, and a first channel opening at the distal end of the endoscope insertion section. A first treatment tool guide table for guiding a first treatment tool derived from the portion about the first rotation axis, a second channel opening of the second treatment tool insertion channel, and the second channel opening An endoscope provided with a second treatment tool guide table that guides a second treatment tool derived from the section around a second rotation axis in a direction different from the first treatment tool. The treatment tool guidance of the first treatment tool guide table is a pulsating guidance that does not exceed an imaginary plane including a center point of the first channel opening and a center line of the first rotation axis, and the second treatment is performed. The treatment tool guiding of the tool guiding table includes a center point of the second channel opening and a second rotation axis. A swing guide that extends over an imaginary plane including a center line, and wherein the second rotation axis is disposed closer to the longitudinal end of the endoscope insertion section than the first rotation axis. And
[0014]
ADVANTAGE OF THE INVENTION The endoscope apparatus of this invention can reduce the diameter of the front-end | tip of an insertion part, and can secure the raising guide range of a 1st treatment tool guidance table and a 2nd treatment tool guidance table widely, and an endoscope. Treatment efficiency is improved.
[0015]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. First, an embodiment of an endoscope apparatus according to the present invention will be described with reference to FIGS.
[0016]
FIG. 1 is a front view showing a configuration of a distal end portion of an insertion section of an embodiment of the endoscope apparatus according to the present invention. FIG. 2 is an internal configuration of a distal end section of the insertion section of an embodiment of the endoscope apparatus according to the present invention. FIG. 3 is a perspective view showing first and second treatment instrument guide tables of an embodiment of the endoscope apparatus according to the present invention, and FIG. 4 is an embodiment of the endoscope apparatus according to the present invention. FIG. 5 is a cross-sectional view showing a configuration of a second treatment tool guide table at the distal end portion of the insertion section of the embodiment, and FIG. 5 is a treatment tool using the first and second treatment tool guide tables of one embodiment of the endoscope apparatus according to the present invention. FIG. 6 is an explanatory diagram for explaining the operation of the endoscope device, FIG. 6 is an explanatory diagram for explaining the reason for setting the arrangement position of the first treatment instrument guide table at the distal end portion of the insertion section in one embodiment of the endoscope apparatus according to the present invention, and FIG. FIG. 8 is an explanatory diagram for explaining the reason for setting the arrangement position of the first treatment instrument guide table at the distal end portion of the insertion section in one embodiment of the endoscope apparatus according to the present invention. FIG. 9 is an explanatory view for explaining the operation of the treatment tool by the first and second treatment tool guide tables shown in FIG. 7, and FIG. 9 is a front end of the second treatment tool guide table in one embodiment of the endoscope apparatus according to the present invention. FIG. 10 is an explanatory view for explaining the reason for setting the side opening shape, FIG. 10 is an explanatory view for explaining the operation of the treatment tool by the first and second treatment tool guide tables shown in FIG. 9, and FIG. 11 is an endoscope according to the present invention. FIG. 12 is a cross-sectional view showing the internal configuration of the distal end portion of the insertion section when the rotational axis positional relationship between the first and second treatment tool guide tables in one embodiment of the mirror device is exchanged. FIG. 12 is an endoscope apparatus according to the present invention. FIG. 13 is a perspective view showing the first and second treatment instrument guide tables in a case where the rotational axis positional relationship between the first and second treatment instrument guide tables in one embodiment is changed, and FIG. 13 is an endoscope according to the present invention. Second embodiment in the case where the positional relationship between the rotation axes of the first and second treatment tool guide tables in one embodiment of the device is exchanged. Cross-sectional view showing the swing range of the treatment instrument by the treatment instrument induction stage, FIG. 14 is an explanatory diagram for explaining an endoscopic treatment operation by the endoscope apparatus according to the present invention.
[0017]
Although not shown, the endoscope device of the present invention includes an elongated flexible insertion portion to be inserted into a body cavity, and an operation portion provided at a base end of the insertion portion, and the insertion portion has a distal end. The distal end portion, the bending portion, and the flexible tube portion are sequentially arranged from the side, and an operation portion is provided at a base end of the flexible tube portion. The operation portion includes a bending operation mechanism for operating the bending portion, a treatment instrument insertion hole, It is composed of a treatment instrument raising operation mechanism, a universal code incorporating a light guide and a signal cable, and the like.
[0018]
As shown in FIG. 1, the distal end portion 1 of the insertion section of the endoscope apparatus has an observation window 3 at a substantially central portion of the front surface of the distal end portion 1 of the insertion section. In the observation window 3, an observation optical system 11 including an objective lens and a solid-state imaging device for converting an observation site image from the objective lens into an imaging signal is arranged.
[0019]
Two illumination windows 4 are provided diagonally in the drawing with respect to the observation window 3. An illumination optical system 13 including an illumination lens and a light guide fiber for guiding illumination light is arranged in the illumination window 4.
[0020]
The distal end portion 1 is provided with an air supply / water supply nozzle 5 for spraying cleaning water onto the observation window 3 to wash the objective lens, or for supplying air to the objective lens and the body cavity, and is capable of supplying water in the observation direction. The front water supply port 6, a first treatment tool guide table 14, and a second treatment tool guide table 15 are provided.
[0021]
The first treatment tool guide table 14 is provided on the left side of the observation window 3 in the drawing, and is remotely operated by a first operation wire 18 from an operation unit (not shown) to observe the endoscope. A swing operation is performed substantially in the vertical direction of the image. The second treatment tool rocking table 15 is provided below the observation window 3 in the drawing, and is remotely operated from an operation unit by two operation wires, a second operation wire 24 and a third operation wire 25. The swing operation is performed substantially in the left-right direction of the endoscope image.
[0022]
The direction indicated by the arrow P in FIG. 1 indicates a substantially upward direction of the endoscope image. That is, the upper direction of the screen of the endoscopic image displayed on the reproduction display monitor is in the direction of the arrow P based on the imaging signal of the observation site generated and imaged by the solid-state imaging device constituting the observation optical system 11 of the observation window 3. is there.
[0023]
The first treatment tool guide table 14 has an opening that opens from the front to the side of the distal end portion 1, and the second treatment tool guide table 15 has an opening that opens only in the front surface of the distal end portion 1. Part.
[0024]
In the case where the first treatment instrument guide table 14 is in the maximum raised state, the outer edge viewed from the distal end side of the distal end portion 1 is indicated by a two-dot chain line 14 'in the figure. When the table 14 is swung to the maximum raised state, it does not jump from the outer diameter of the distal end portion 1 of the insertion portion.
[0025]
As shown in FIG. 1, one of the illumination windows 4 is disposed at a substantially middle right position where the observation window 3 and the air / water supply nozzle 5 are disposed, and the other of the illumination windows 4 is the first The treatment tool guide table 14 and the second treatment tool guide table 15 are disposed obliquely downward in the drawing. Further, the front water supply port 6 is disposed substantially on the right side between the observation window 3 and the second treatment instrument guide table 15.
[0026]
The distal end portion 1 of the endoscope insertion portion is covered with an electrically insulating cover 12, and the observation window 3, the illumination window 4, the air / water nozzle 5, the front water inlet 6, and the first treatment instrument guide table are provided. The portion where the second treatment tool guide table 14 and the second treatment tool guide table 15 are provided is opened to the minimum necessary.
[0027]
The internal configuration of the first treatment tool guide table 14 and the second treatment tool guide table 15 at the distal end portion 1 will be described with reference to FIG. FIG. 2 is a cross-sectional view of the distal end portion 1 of the endoscope insertion section taken along the line AA ′ shown in FIG.
[0028]
A first channel opening 8 of a first treatment instrument insertion channel 7 and a second channel opening 10 of a second treatment instrument insertion channel 9 built in the insertion portion are provided at the distal end portion 1. The first treatment tool guide table 14 is provided in the first channel opening 8, and the second treatment tool guide table 15 is provided in the second channel opening 10.
[0029]
The proximal sides of the first treatment instrument insertion channel 7 and the second treatment instrument insertion channel 9 have a first treatment instrument insertion hole provided on an outer surface of an operation unit (not shown) and a second treatment. It communicates with the tool insertion hole. That is, the treatment tool inserted through the first and second treatment tool insertion holes of the operation unit passes through the first and second treatment tool insertion channels 7 and 9 to open the first and second channel openings. The first and second treatment tool guide tables 14 and 15 are led out of the first and second treatment tools 8 and 10.
[0030]
The first treatment tool guide table 14 and the second treatment tool guide table 15 are rotatably attached to the distal end component 2 by a first rotation shaft 16 and a second rotation shaft 22, respectively. The first treatment tool guide 14 shown by a solid line in the figure indicates a completely inverted state, and the first treatment tool guide 14 'shown by a two-dot chain line indicates a maximum raised state.
[0031]
The first treatment tool 26 protruding from the first treatment tool guide table 14 is moved from the inside of the field of view of the endoscope observation range to the outside of the field of view and from the outside of the field of view to the field of view as shown by a two-dot chain line in the figure. The swing is guided in a substantially vertical direction.
[0032]
Further, the guide range of the first treatment instrument 26 does not exceed the virtual plane K including the center point M of the first channel opening 8 and the first rotation axis center 40 of the first rotation axis 16. Swing is induced.
[0033]
The protruding distance L from the distal end surface of the distal end portion 1 to the distal end of the first treatment instrument 26 when the distal end of the first treatment instrument 26 is guided to swing out of the field of view is, for example, the length of observation and treatment. About 10 mm or more.
[0034]
On the other hand, the second treatment tool guide table 15 swings the second treatment tool 27 shown by a two-dot chain line in the left-right direction (the direction of the front and back of the paper surface of FIG. 2) in the field of view of the endoscope observation range. Induce.
[0035]
The first treatment tool guide table 14 has a distal end of a first operation wire 18, and the second treatment tool guide table 15 has a second operation wire 24 and a third operation wire 25 (not shown). The distal end is connected and fixed, and the base end of each of the first operation wire 18, the second operation wire 24, and the third operation wire 25 is inserted into the insertion portion, and the treatment tool guide table provided in the operation portion. It is connected to an operation mechanism and is remotely operated by the treatment tool guiding table operation mechanism.
[0036]
The second rotating shaft 22 is inserted from the outer peripheral direction of the distal end component 2, and is prevented from coming off by the electrically insulating cover 12.
[0037]
Next, the appearance and the positional relationship of the first treatment tool guide table 14 and the second treatment tool guide table 15 will be described with reference to FIG.
[0038]
The first treatment tool guide table 14 has a cubic shape in its entirety, and a distal end of the first operation wire 18 is rotatably attached to a distal end side via a first wire terminal member 17. The first operation wire 18 is inserted between the first treatment tool guide table 14 and the observation window 3 (see FIG. 1), and the first operation wire 18 is inserted from the side surface on the second treatment tool guide table 15 side. It is attached to one wire end member 17. A first rotating shaft hole 37 to which the first rotating shaft 16 is attached is provided on the hand side of the first treatment instrument guide table 14. That is, when the first operation wire 18 is pulled, the first treatment instrument guide table 14 rotates upward in the drawing about the first rotation shaft hole 37.
[0039]
A recess 38 is formed at a part of the bottom of the first treatment tool guide table 14 to avoid collision interference with the second treatment tool guide table 15, and the first treatment is performed in the longitudinal direction of the upper surface. The tool 26 is inserted and placed, and has a concave surface for facilitating swing guidance.
[0040]
The second treatment tool guide table 15 has a cylindrical shape in which a part of a circular arc portion on the hand side is cut off, and the second treatment tool 27 is inserted and penetrated in a diametrical direction from a side surface from which the arc is cut off. A treatment tool insertion portion 28 is formed. A second rotation shaft hole 21 into which the second rotation shaft 22 is inserted is formed in the center of the lower surface 31 of the second treatment instrument guide table 15.
[0041]
The upper surface 30 and the lower surface 31 of the second treatment instrument guide table 15 have cutout surfaces provided in different directions, and the cutout surfaces have the second operation wire 24 and the third operation wire. The respective ends of the wires 25 are rotatably attached via second wire end members 29a and 29b.
[0042]
That is, when the first operation wire 24 and the second operation wire 25 are operated, the first operation wire 24 and the second operation wire 25 are rotated left and right around the first rotation shaft hole 21 in the drawing. The second treatment tool guide table 15 is rotated by one operation wire in addition to using two operation wires (the second and third operation wires 24 and 25) as described above. Is also good.
[0043]
The two surfaces of the upper surface 30 and the lower surface 31 of the second treatment tool swing table 15 are slid with the distal end component 2 as sliding surfaces. Although the material is not particularly limited, it is desirable to use a member having excellent corrosion resistance and moisture resistance.
[0044]
The opening shape of the distal end side of the treatment tool insertion portion 28 is formed in a rectangular shape having a ridge 39 substantially parallel to an upper surface 30 and a lower surface 31 which are sliding surfaces, as shown in the figure. Note that a surface instead of the ridge may be provided in the vicinity of the opening on the distal end side.
[0045]
Note that the center 40 of the first rotation shaft of the first treatment tool guide table 14 is the center of the first rotation shaft 16 attached to the first rotation shaft hole 37, and the second treatment tool guide table 15 The second rotation axis center 41 is the center of the second rotation axis 22 attached to the second rotation axis hole 21, and the center of the first rotation axis center 40 and the second rotation axis center 41. As for the positional relationship, as shown in the figure, the second rotation axis center 41 is disposed at the distal end side in the longitudinal direction by a distance X from the first rotation axis center 40.
[0046]
Next, the relationship between the second treatment tool guide table 15 and the second treatment tool 27 will be described with reference to FIG. FIG. 4 is a sectional view taken along the line BB shown in FIG. 1 and viewed from the direction of the arrow.
[0047]
When the second operation wire 24 and the third operation wire 25 are pulled, respectively, the second treatment tool guide table 15 is swung right and left about the second rotation axis center 41. The center 41 of the second rotation axis substantially coincides with the center of the visual field.
[0048]
The left and right rotation of the second treatment tool guide table 15 is restricted by the A surface of the distal end component 2 in the figure and the rear end side B surface of the second treatment tool guide table 15 from which the arc is cut off. Thus, rotation in both the left and right directions can be restricted.
[0049]
The second operation wire 24 and the third operation wire 25 are remotely operated by a guide table operation mechanism of an operation unit (not shown) in a state where tension is applied to each of the second operation wire 24 and the third operation wire 25.
[0050]
In the treatment tool insertion portion 28 of the second treatment tool guide table 15, the front end side opening 32 is narrower than the rear end side opening 33. That is, the treatment instrument insertion portion 28 has a substantially funnel shape as a whole.
[0051]
Further, the front end side opening 32 is narrower than the second channel opening 10 and the rear end side opening 33 is wider than the second channel opening 10 (the front side opening 32 <the second channel opening). Part 10 <rear end side opening 33).
[0052]
The second treatment tool 27 inserted from the second treatment tool insertion hole of the operation unit passes through the second treatment tool insertion channel 9, and the second channel opening 10, the second treatment From the second treatment tool guide table 15 to the front outside of the distal end surface of the distal end portion 1 through the rear end opening 33 of the treatment tool insertion portion 28 of the treatment tool insertion table 15 and the distal end opening 32 of the treatment tool insertion portion 28. And projected.
[0053]
As shown in the drawing, the second treatment tool 27 is guided by the second treatment tool guide table 15 to swing substantially horizontally in a range not exceeding the visual field of the observation range.
[0054]
In this second treatment tool 27, both swinging swing guidances are performed over a virtual plane R including the center point N of the second channel opening 10 and the second rotation axis center 41.
[0055]
The distal end of the second treatment tool 27 described here moves in an arc shape, but may have a mechanism that moves in a straight line.
[0056]
In the first treatment tool 26 shown in FIG. 4, the state shown by P in the figure shows the state where the first treatment tool 26 is within the observation range, and the state shown by Q in the figure is , The first treatment tool 26 is out of the observation range.
[0057]
In the endoscope apparatus having such a configuration, the image is reproduced and displayed on a monitor screen based on an image signal generated and generated by a solid-state image sensor constituting the observation optical system 11 provided in the observation window 3 of the distal end portion 1. A first treatment tool 26 oscillated and guided by the first treatment tool guide table 14 displayed on the endoscope image, and a second treatment tool 27 swayed and guided by the second treatment tool guide table 15 Will be described with reference to FIG.
[0058]
The octagonal frame in the figure is the range of the imaging screen and the observation visual field range. The inside of the frame is within the observation visual field, and the outside of the frame is outside the visual field.
[0059]
The distal end of the first treatment tool 26 is moved in a substantially vertical direction of the visual field by the first treatment tool guide table 14, and is guided to swing from inside the visual field to outside the visual field and from outside the visual field to the visual field. That is, the first treatment tool 26 in the completely inverted state within the visual field indicated by the solid line in the figure and the first treatment tool 26 ′ in the maximum raised state outside the visual field indicated by the two-dot chain line in the figure are swung. Be guided.
[0060]
The distal end of the second treatment tool 27 is moved by the second treatment tool guide table 15 substantially in the left and right direction of the field of view, and is guided to swing without exceeding the inside of the field of view. In other words, the second treatment tool 27 shown by a solid line in the drawing is the second treatment tool guide table 15 in the neutral state, and the second treatment tool 27 'shown by the two-dot chain line is the second treatment tool guide table 15 Is in the state of being swung to the left or right to the maximum.
[0061]
The shape of the visual field, which is the range of the imaging screen, is not limited to the octagon, but may be a quadrangle or a circle.
[0062]
The arrow F in the figure of FIG. 5 showing this imaging screen indicates how the water supplied from the front water supply port 6 enters and looks within the field of view, and is supplied toward substantially the center of the field of view.
[0063]
Further, as shown by an arrow H in the drawing, the tip trajectory of the second treatment instrument 27 has a curve not only on a substantially straight line but also upward or downward from a central portion that divides the left and right equally toward both sides. It may be a curve you draw.
[0064]
The distal end portion 1 of the endoscope insertion section having such a configuration is arranged such that the second rotation axis of the second treatment instrument guide table 15 is positioned with respect to the first rotation axis center 37 of the first treatment instrument guide table 14. The center 41 is provided on the distal end surface side in the longitudinal direction of the distal end portion 1, and the first operation wire 18 for operating the first treatment instrument guide table 14 is inserted through the observation window 3 side. The diameter of the portion 1 can be reduced.
[0065]
Next, the arrangement of the first operation wire 18 of the first treatment instrument guide table 14 will be described with reference to FIGS.
[0066]
A first operation wire 18 for swinging and guiding the first treatment instrument guide table 14 of the distal end portion 1 shown in FIG. 1 is attached to the first treatment instrument guide table 14 through the observation window 3 side. ing.
[0067]
The first operation wire 18 of the first treatment instrument guide table 14 is arranged not on the observation window 3 side but on the outside of the first treatment instrument guide table 14 opposite to the observation window 3 as shown in FIG. Suppose it was done. Note that the distance between the observation window 3 and the first treatment tool guide table 14 is set to the same size as the distal end portion 1 of the present invention shown in FIG.
[0068]
That is, in the arrangement position and dimensional state of the first treatment instrument guide table 14 and the like including the observation window 3 provided on the distal end surface of the distal end portion 1 of the endoscope insertion portion of the present invention shown in FIG. The arrangement position of only the first operation wire 18 was set outside the first treatment instrument guide table 14. The outer diameter of the distal end portion 1 when the installation position of the first operation wire 18 is in the state shown in FIG. 1 is indicated by a two-dot chain line in FIG. If it is located outside, the outer diameter of the distal end portion 1 becomes large as shown by the solid line in FIG.
[0069]
When the position of the first treatment tool guide table 14 is brought closer to the observation window 3 as shown in FIG. 7 from the arrangement state of the first operation wire 18 shown in FIG. 6, the outer diameter of the distal end portion 1 is increased. Can be made equivalent to the case of FIG.
[0070]
However, as shown in FIG. 7, when the first treatment tool guide table 14 is shifted toward the observation window 3 and the first operation wire 18 is arranged outside the first treatment tool guide table 14, As shown in FIG. 8, in the screen of the endoscope image captured by the observation optical system 11 of the observation window 3 of the distal end portion 1, the first treatment tool 26 becomes thicker as it approaches the observation window 3. The operability of the treatment tool deteriorates very sharply, and the operability of the treatment tool deteriorates when the swing is induced in a direction in which the distance between the second treatment tool 27 and the first treatment tool 26 approaches.
[0071]
From this point, in the endoscope apparatus of the present invention, as shown in FIG. 1, the first operation wire 18 of the first treatment tool guide table 14 is disposed on the observation window 3 side to perform treatment. The operability is good, and the outer diameter of the distal end portion 1 can be reduced.
[0072]
Next, the shape of the distal end side opening 32 of the treatment tool insertion portion 28 of the second treatment tool guide table 15 will be described with reference to FIGS. 9 and 10.
[0073]
As shown in FIG. 3, the distal end opening 32 of the treatment tool insertion portion 28 of the second treatment tool guide table 15 provided at the distal end portion 1 of the endoscope device of the present invention is connected to the second treatment tool. It is a substantially rectangular shape having a ridge 39 parallel to the upper surface 30 and the lower surface 31 of the guide table 15.
[0074]
On the other hand, as shown in FIG. 9, the distal end side opening 32 has a circular shape. A circle shown by a two-dot chain line in the circular distal opening 32 in the figure indicates the second treatment tool 27.
[0075]
When the distal end opening 32 of the treatment instrument insertion portion 28 guides the circular second treatment instrument guide table 15 to swing left and right, the second treatment instrument 27 becomes the inner surface of the circular distal end opening 32. Along the left and right directions as indicated by arrows in the figure, and within the screen of the endoscope image at that time, the second treatment tool 27 moves as shown in FIG. That is, when the tip of the second treatment tool 27 is moved to the left and right as shown by the two-dot chain line toward the periphery of the screen, the tip of the second treatment tool 27 moves toward the periphery of the screen. For example, when the second treatment tool 27 is an incision tool, it becomes difficult to incise the root of the lesion from the center of the screen.
[0076]
That is, as shown in FIG. 3, the distal end side opening 32 of the treatment tool insertion portion 28 of the second treatment tool guide table 15 provided at the distal end portion 1 of the insertion portion of the endoscope device of the present invention is The treatment instrument guide table 15 has a substantially rectangular shape having a ridge line 39 parallel to the upper surface 30 and the lower surface 31 of the treatment instrument guide table 15. The treatment operability of the treatment instrument 27 and the swing locus of the distal end of the second treatment instrument 27 can be easily predicted.
[0077]
Next, a positional relationship between the first rotation shaft 16 of the first treatment tool guide table 14 and the second rotation shaft 22 of the second treatment tool guide table 15 will be described with reference to FIGS. 11 to 13. I do.
[0078]
The positional relationship between the first rotation shaft 16 of the first treatment tool guide table 14 provided on the distal end portion 1 of the endoscope device of the present invention and the second rotation shaft 22 of the second treatment tool guide table 15 is as follows. As shown in FIGS. 2 and 3, the second rotating shaft 22 is provided at a position of a distance X on the distal end side of the distal end portion 1 in the longitudinal direction with respect to the first rotating shaft 16.
[0079]
On the other hand, as shown in FIGS. 11 to 13, the positional relationship between the first rotation shaft 16 and the second rotation shaft 22 is reversed so that the second rotation shaft 16 Is disposed at a position of a distance X on the proximal side in the longitudinal direction of the distal end portion 1. The other configuration and the positional relationship are the same as those in FIGS.
[0080]
As described above, when the second rotating shaft is disposed at the position of the distance X on the hand side in the longitudinal direction of the distal end portion 1 with respect to the first rotating shaft 16, the first rotating shaft 16 becomes the second rotating shaft. As shown in FIG. 12, the overlapping height H ′ of the first treatment tool guide table 14 and the second treatment tool guide table 15 is greater than that of FIG. 3 is higher than the overlapping height H of the first treatment tool guide table 14 and the second treatment tool guide table 15 (H ′> H). In other words, it becomes a position outside the outer diameter position of the distal end portion 1 of the present invention shown in FIG. 2 and the diameter cannot be reduced (the two-dot chain line on the electrically insulating cover 12 shown in FIG. The outer diameter of the distal end portion 1 in the case of the positional relationship between the first rotating shaft 16 and the second rotating shaft 22 is shown).
[0081]
Further, the fact that the second rotating shaft 22 is provided at a position closer to the distal end portion 1 by the distance X than the first rotating shaft 16 means that, as shown in FIG. , From the distal end surface of the distal end portion 1 to the second rotational axis center 41 'on the hand side. That is, as shown in FIG. 13, the swing guidance range of the second treatment tool 27 'of the present invention shown by the two-dot chain line is narrower than the swing guidance range of the second treatment tool 27' shown by the solid line.
[0082]
In other words, the solid line second treatment instrument 27 'is in a swinging state at the position of the second rotation axis center 41' in the case shown in FIGS. 11 and 12, and the two-dot chain line second treatment instrument 27 ' In the swing state of the position of the second rotation shaft center 41, when the position of the second rotation shaft 22 moves toward the distal end portion 1, the swing guiding range of the second treatment tool 27 becomes narrow.
[0083]
Therefore, as shown in FIGS. 2 to 4, the endoscope apparatus according to the present invention includes the first rotation axis center 40 of the first rotation axis 16 of the first treatment instrument guide table 14 provided at the distal end portion 1. In contrast, by positioning the second rotation axis center 41 of the second rotation shaft 22 of the second treatment instrument guide table 15 on the distal end side of the distal end portion 1 in the longitudinal direction, the distal end portion 1 can be reduced in diameter. Thus, the swing guidance range of the second treatment tool 27 can be widened.
[0084]
The treatment of a lesion mucosa in a body cavity using the endoscope apparatus of the present invention described above will be described with reference to FIG.
[0085]
The above-described insertion section 34 of the endoscope apparatus of the present invention is inserted into a body cavity while viewing an endoscope image captured and generated by a solid-state imaging device provided at the distal end of the insertion section 34. When the insertion section 34 reaches the vicinity of the affected mucosa, a treatment tool provided with an injection needle is inserted into the second treatment tool insertion channel 9 of the insertion section 34 of the endoscope, and the lower layer of the diseased mucous membrane, such as saline, is inserted. The drug solution is injected to raise the mucosal layer including the affected mucosa.
[0086]
Next, as shown by a dotted line in FIG. 14, the lesion mucous membrane or its periphery is gripped by using the gripping forceps 35 as the first treatment tool 26 protruding from the first treatment tool insertion channel 7. When the grasping forceps 35 grasps the diseased mucous membrane, as shown by the solid line in the figure, the grasping forceps 35 is lifted and guided by the first treatment tool guide table 14 to lift the mucous membrane including the diseased mucous membrane. The tip of the grasping forceps 35 when the diseased mucous membrane is lifted by the grasping forceps 35 can be guided to swing out of the visual field of the endoscope image. In addition, since the length of the arm of the first treatment tool guide table 14 (the distance from the center of the first rotation axis 40 to the tip of the first treatment tool guide table 14) can be increased, the grasping forceps 35 at the time of raising can be obtained. The contact length can be made long, and as a result, it can be stably raised with a large force.
[0087]
In this way, when the diseased mucous membrane grasped by the grasping forceps 35 is lifted by the upward swing guide of the first treatment tool swing table 14, the injection needle is inserted into the second treatment tool insertion channel 9. Instead of the provided forceps, the incision forceps 36 as the second treatment tool 27 is inserted, and the second treatment tool guide table 15 is swung to swing the foot or submucosa layer of the lifted mucous membrane left and right. And make an incision. The incision forceps 36 is swung completely left and right by the second treatment tool guide table 22 and is always displayed in the field of view of the endoscope image, so that the incision treatment by the incision forceps 36 can be constantly monitored.
[0088]
Next, another embodiment of the present invention will be described with reference to FIG.
[0089]
In the embodiment of the present invention described above, the second treatment tool guide table 15 is remotely operated in the left and right direction by the two operation wires 24 and 25. However, as shown in FIG. The second treatment tool guide table 15 may be remotely operated in the left-right direction by the operation wire 44. In this case, as the hard operation wire 44, a wire made of a material that does not loosen or deform when pushed or pulled is used. Thus, the number of operation wires can be reduced and the diameter of one operation wire can be reduced.
[0090]
Except for the hard operation wire 44 of the second treatment instrument guide table 15, the configuration is the same as that described above.
[0091]
As described above, the endoscope apparatus of the present invention includes the first treatment tool guide table 14 that moves substantially vertically on the screen of the endoscope imaging screen, and the second treatment tool guide table 14 that moves substantially horizontally on the screen. The treatment tool guide table 15 is not arranged on substantially the same plane in the horizontal direction of the screen, and their rotation axes are such that the second rotation axis center 41 is the first rotation axis center with respect to the longitudinal direction of the insertion section. The length from the tip of the second treatment tool guide table 15 to the second rotation axis center 41 is located on the tip side of the rotation axis center 40, and the length of the guide table of the first treatment tool guide table 14 is It is shorter than the length from the tip to the center 40 of the first rotation shaft. For this reason, the diameter of the distal end portion 1 can be reduced.
[0092]
In addition, the second treatment tool 27 can swing in the left-right direction over a wide range, and the first treatment tool 26 can move from the leading end of the first treatment tool guide table 14 to the first rotation axis center 40. Since the length is long, the first treatment instrument 26 can be guided up and down reliably and with a larger force.
[0093]
In other words, when the grasping forceps 35 are used for the first treatment tool 26 and the incision forceps 36 are used for the second treatment tool 27, the grasping forceps 35 can be used to securely raise the lesion mucous membrane with a larger force, and furthermore, The root can be resected over a wide area with the incision forceps 36, so that a wide range of incision treatments can be reliably performed at once, and the treatment operation efficiency is greatly improved.
[0094]
In addition, since the concave portion 38 is formed in the first treatment tool guide table 14, the first treatment tool guide table 14 and the second treatment tool guide table 15 partially interfere with each other in projection toward the distal end side. And the overlapping height H between the first treatment instrument guide table 14 and the second treatment instrument guide table 15 can be reduced, and the distal end portion 1 can be further reduced in diameter. Since the tool guide table 15 fits within the entire length of the first treatment tool guide table 14, the longitudinal direction of the distal end portion 1 does not become long.
[0095]
Further, the distal end side opening 32 of the second treatment instrument guide table 15 is formed with a ridge 39 that is substantially parallel to the upper surface and the lower surface that are sliding surfaces. Even if the treatment tool guide table 15 swings right and left, the second treatment tool guide table 15 swings within the endoscope imaging screen, and there is no upward or downward displacement of the distal end of the treatment tool 27 around the screen. The trajectory of the tip of the tool 27 is easy to predict and the incision operation is easy.
[0096]
Alternatively, since the front water supply port 6 is arranged between the observation window 3 and the second treatment tool guide table 15 in the vertical direction of the endoscope imaging screen, the forward water supply direction and the projecting direction of the second treatment tool 27 are provided. Can be close and substantially parallel. As a result, if a hemostatic device is used as the second treatment tool 27, it is easy to find a hemostatic point, and it is easy to perform hemostatic treatment.
[0097]
Further, by arranging the first operation wire 18 of the first treatment instrument guide table 14 on the observation window 3 side, as described above, the outer diameter of the distal end portion 1 is reduced, and the treatment operability is improved. Can be realized.
[0098]
In the endoscope apparatus according to the present invention in which the opening of the guide table is formed on the side surface of the distal end portion 1, the distal end of the first treatment tool guide table 14 has the outer diameter of the distal end portion even at the maximum rising as described above. Therefore, the safety is enhanced as in the conventional endoscope apparatus with a forceps raising base.
[0099]
[Appendix]
According to the embodiment of the present invention described in detail above, the following configuration can be obtained.
[0100]
(Appendix 1)
An observation optical system composed of an observation window and an endoscope image for observing the distal end of the first treatment tool led out through the first treatment instrument insertion channel at the distal end of the endoscope insertion section using the observation optical system. A first treatment tool guide table for guiding the screen substantially in the vertical direction, and a distal end of the second treatment tool derived through the second treatment tool insertion channel are guided substantially in the horizontal direction of the screen of the endoscope image. And a second treatment tool guide table,
The rotation axis position of the first treatment instrument guide table and the rotation axis position of the second treatment instrument guide table are displaced with respect to the longitudinal direction of the endoscope insertion section. Endoscope device.
[0101]
(Appendix 2)
2. The endoscope according to claim 1, wherein the rotation axis position of the second treatment tool guide table is located closer to the distal end of the endoscope insertion section than the rotation axis position of the first treatment tool guide table. Mirror device.
[0102]
(Appendix 3)
An observation optical system including an observation window, a first channel opening of a first treatment instrument insertion channel, and a first treatment instrument led out from the first channel opening are provided at the distal end of the endoscope insertion section. A first treatment tool guide table for guiding around the first rotation axis, a second channel opening of the second treatment tool insertion channel, and a second treatment tool led out from the second channel opening. An endoscope provided with a second treatment tool guide table for guiding around the second rotation axis in a direction different from the first treatment tool,
The treatment instrument guidance of the first treatment instrument guidance table is a pulsating guidance that does not exceed an imaginary plane including a center point of the first channel opening and a center line of the first rotation axis, and The treatment tool guide of the treatment tool guide table is a swing guide that crosses a virtual plane including the center point of the second channel opening and the center line of the second rotation axis, and the second rotation axis is An endoscope apparatus, wherein the endoscope apparatus is disposed on the distal end side in the longitudinal direction of the endoscope insertion portion with respect to the first rotation axis.
[0103]
(Appendix 4)
An observation optical system consisting of an observation window and an endoscope image for observing the distal end of the first treatment instrument led out through the first treatment instrument insertion channel at the distal end of the endoscope insertion section with the observation optical system. The first treatment tool guiding table for guiding the screen substantially in the vertical direction and the tip of the second treatment tool derived through the second treatment tool insertion channel are guided substantially in the horizontal direction of the screen of the endoscope image. And a second treatment tool guide table,
An endoscope apparatus wherein the length from the fulcrum to the tip of the second treatment tool guide table is shorter than the length from the fulcrum to the tip of the first treatment tool guide table.
[0104]
(Appendix 5)
The first treatment tool guide table is for avoiding collision interference with the second treatment tool guide table and for reducing the overlapping height of the first treatment tool guide table and the second treatment tool guide table. The endoscope apparatus according to any one of supplementary notes 1, 3, and 4, wherein the endoscope apparatus has a concave portion.
[0105]
(Appendix 6)
The supplementary note 1, wherein the second treatment tool guide table has upper and lower surfaces which are sliding plane surfaces, and a rectangular treatment tool insertion portion having a ridge line portion parallel to the upper and lower surfaces. The endoscope apparatus according to any one of supplementary note 3 and supplementary note 4.
[0106]
(Appendix 7)
The first operation wire for remotely operating the first treatment instrument guide table, wherein the first operation wire is inserted through an observation window side provided at a distal end portion of the endoscope insertion portion. An endoscope apparatus according to any one of supplementary notes 4.
[0107]
(Appendix 8)
The endoscope according to any one of appendix 1, appendix 3, and appendix 4, wherein the first treatment instrument guide table does not exceed the outer diameter of the distal end portion between the endoscope insertion portions when the first treatment instrument guide table is maximally raised. apparatus.
[0108]
(Appendix 9)
A front water supply port provided at a distal end portion of the endoscope insertion section is disposed between an observation window and a second treatment tool guide table in a vertical direction of the endoscope imaging screen; The endoscope according to any one of appendix 1, appendix 3, and appendix 4, wherein the guide table is disposed so as to be close to the projecting direction of the second treatment tool from which the projecting table is projected and to supply water substantially in parallel. apparatus.
[0109]
【The invention's effect】
In the endoscope apparatus of the present invention, a plurality of treatment instrument guide tables are provided at the distal end portion of the endoscope insertion section, and a wide range for guiding the treatment instrument to swing by the treatment instrument guide table can be secured. The diameter can be easily reduced, the operation of inserting the endoscope and the operation of the treatment tool can be reliably performed, and the effect of improving the efficiency of treatment of the endoscope is obtained.
[Brief description of the drawings]
FIG. 1 is a front view showing a configuration of a distal end portion of an insertion section of an embodiment of an endoscope apparatus according to the present invention.
FIG. 2 is a cross-sectional view showing an internal configuration of a distal end portion of an insertion section of the endoscope apparatus according to one embodiment of the present invention.
FIG. 3 is a perspective view showing first and second treatment instrument guide tables of the embodiment of the endoscope apparatus according to the present invention.
FIG. 4 is a cross-sectional view showing a configuration of a second treatment tool guide table at the distal end of the insertion section of the endoscope apparatus according to one embodiment of the present invention.
FIG. 5 is an explanatory diagram illustrating the operation of the treatment tool by the first and second treatment tool guide tables of the embodiment of the endoscope apparatus according to the present invention.
FIG. 6 is an explanatory diagram for explaining the reason for setting the arrangement position of the first treatment instrument guide table at the distal end portion of the insertion section in the embodiment of the endoscope apparatus according to the present invention.
FIG. 7 is an explanatory view illustrating the reason for setting the arrangement position of the first treatment tool guide table at the distal end portion of the insertion section in one embodiment of the endoscope apparatus according to the present invention.
FIG. 8 is an explanatory view for explaining the operation of the treatment tool by the first and second treatment tool guide tables shown in FIG. 7;
FIG. 9 is an explanatory diagram for explaining the reason for setting the distal end side opening shape of the second treatment instrument guide table in one embodiment of the endoscope apparatus according to the present invention.
FIG. 10 is an explanatory view for explaining the operation of the treatment tool by the first and second treatment tool guide tables shown in FIG. 9;
FIG. 11 is a cross-sectional view showing the internal configuration of the distal end portion of the insertion section when the rotational axis positional relationship between the first and second treatment instrument guide tables is reversed in the embodiment of the endoscope apparatus according to the present invention.
FIG. 12 shows the first and second treatment tool guide tables in the embodiment of the endoscope apparatus according to the present invention when the rotational axis positional relationship between the first and second treatment tool guide tables is reversed. Perspective view.
FIG. 13 is a perspective view of an endoscope apparatus according to an embodiment of the present invention. Sectional drawing which shows a movement range.
FIG. 14 is an explanatory diagram illustrating an endoscope treatment operation by the endoscope apparatus according to the present invention.
FIG. 15 is a front view showing a distal end portion of an insertion section of another embodiment of the endoscope apparatus according to the present invention.
[Explanation of symbols]
1 ... tip
2 ... Tip component
3. Observation window
4: Lighting window
5. Air / water nozzle
6: Front water outlet
7. First treatment instrument insertion channel
8 1st channel opening
9: second treatment instrument insertion channel
10: second channel opening
12 ... Electrical insulating cover
13. Illumination optical system
14: First treatment tool guide table
15: Second treatment tool guide table
16 First rotation axis
17 first wire end member
18 First operation wire
22: second rotation axis
24 ... second operation wire
25: Third operation wire
26 first treatment tool
27: Second treatment tool
28… Treatment instrument insertion part
29: second wire end member
32 ... tip side opening
33 ... rear end side opening

Claims (3)

An observation optical system composed of an observation window and an endoscope image for observing the distal end of the first treatment tool led out through the first treatment instrument insertion channel at the distal end of the endoscope insertion section using the observation optical system. A first treatment tool guide table for guiding the screen substantially in the vertical direction, and a distal end of the second treatment tool derived through the second treatment tool insertion channel are guided substantially in the horizontal direction of the screen of the endoscope image. And a second treatment tool guide table,
The rotation axis position of the first treatment instrument guide table and the rotation axis position of the second treatment instrument guide table are displaced with respect to the longitudinal direction of the endoscope insertion section. Endoscope device. The rotation axis position of the second treatment instrument guide table is located closer to the distal end of the endoscope insertion section than the rotation axis position of the first treatment instrument guide table. Endoscope device. An observation optical system including an observation window, a first channel opening of a first treatment instrument insertion channel, and a first treatment instrument led out from the first channel opening are provided at the distal end of the endoscope insertion section. A first treatment tool guide table for guiding around the first rotation axis, a second channel opening of the second treatment tool insertion channel, and a second treatment tool led out from the second channel opening. An endoscope provided with a second treatment tool guide table for guiding around the second rotation axis in a direction different from the first treatment tool,
The treatment instrument guidance of the first treatment instrument guidance table is a pulsating guidance that does not exceed an imaginary plane including a center point of the first channel opening and a center line of the first rotation axis, and The treatment tool guide of the treatment tool guide table is a swing guide that crosses a virtual plane including the center point of the second channel opening and the center line of the second rotation axis, and the second rotation axis is An endoscope apparatus, wherein the endoscope apparatus is disposed on the distal end side in the longitudinal direction of the endoscope insertion portion with respect to the first rotation axis.

Images