JP2005046275A - Endoscope insertion aid - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope insertion aid securing a high insertion property even if an insertion rout is long or complicatedly curved. <P>SOLUTION: This endoscope insertion aid is provided with an inside overtube 1B for inserting the endoscope in the inside and capable of assuming a flexible and passively shape-variable first state and a second state of being fixed its shape by a frictional force; and an outside over tube 1A for inserting the inside overtube 1B in the inside and capable of assuming the first state and the second state. This aid is inserted in the body cavity by repeating the following actions that the outside over tube 1A is fixed, the inside over tube 1B is advanced in the body cavity with the help of the curved part of the endoscope, then the over tube 1B is fixed, and the over tube 1 is followedly advanced therein. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope insertion aid, and more particularly to an endoscope insertion aid used when inserting an endoscope or the like.
[0002]
[Prior art]
When an endoscope is inserted into a body cavity, a force acting on the body cavity due to the pressure of an organ or the like acts, and it may be difficult to insert the endoscope alone. A so-called endoscope overtube (hereinafter referred to as an overtube as appropriate) is widely used in such a case. By inserting the overtube into the body cavity together with the endoscope, for example, there is an advantage that the insertion path of the endoscope into the body cavity is secured, and the subsequent insertion / extraction of the endoscope becomes easy.
[0003]
In an endoscope system using such an overtube, a flexible adjustment mechanism for adjusting the hardness of the overtube is provided in the overtube, and depending on the hardness of the organ into which the overtube is inserted, For example, Japanese Patent Application Laid-Open No. 2002-369971 discloses a technique for reducing the pain of a patient during insertion by changing the hardness of an overtube.
[0004]
In addition, endoscope insertion aids such as an endoscope guide wire or an intestinal cord are used as guides when the endoscope is inserted into the body and inserted into the body. Are known.
[0005]
[Patent Document 1]
JP 2002-369971 A
[0006]
[Problems to be solved by the invention]
When an overtube as described above is inserted into a luminal organ such as the large intestine or the small intestine, it is inserted together with the endoscope with the help of bending by the bending portion provided at the distal end portion of the endoscope. Will do. Therefore, when the insertion path is long, etc., even if the endoscope and the endoscope insertion aid are pushed into the body cavity with a pressing force, the force is not sufficiently transmitted to the distal end due to the softness and the insertion is performed. Operation may be difficult.
[0007]
In addition, after inserting an endoscope guide wire or intestinal cord into a body cavity, the endoscope is inserted when the endoscope is inserted into the endoscope channel using the endoscope guide wire or intestinal cord as a guide. If the path has parts that bend or bend with a small radius, it may be difficult to insert a flexible endoscope without pulling them to straighten the luminal organ . In such a case, forcible deformation is forced on the luminal organ, which may cause pain to the patient or damage to the luminal organ.
[0008]
The present invention has been made in view of the above circumstances, and provides an endoscope insertion aid that can ensure high insertability even when the insertion path is long or complicatedly bent. It is an object.
[0009]
[Means for Solving the Problems]
In order to achieve the above object, the endoscope insertion aid according to the first invention is capable of inserting the endoscope into the inside, and maintains the first state and the shape which are flexible and variable in shape. A first tubular member that can be fixed in the second state, and for inserting the first tubular member into the interior, and when the first tubular member is most inserted, the first tubular member A second tubular member configured so that a distal end portion of one tubular member protrudes from the distal end portion by a predetermined length and can take the first state and the second state; and One of the first tubular member and the second tubular member has the first state and the other has the second state. It was made to be inserted into the body cavity by relatively proceeding with what is in the state of Than it is.
[0010]
An endoscope insertion aid according to the second invention is the endoscope insertion aid according to the first invention, wherein the tubular member has a variable diameter in a direction perpendicular to the longitudinal direction. And a second friction member configured to abut against the first friction member to generate a frictional force when the diameter of the first friction member changes. The second state is taken when a friction force is generated between the first friction member and the second friction member, and the first state is taken when the friction force is not generated. It is composed of.
[0011]
Further, the endoscope insertion aid according to the third invention can be inserted into the channel of the endoscope, and is fixed in a state that maintains the first state and the shape that are flexible and variable in shape. A string-like member capable of taking two states, and the string-like member is inserted into the body cavity in the first state, and then takes the second state, and in the second state It is designed to guide the insertion of the endoscope.
[0012]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
1 to 5 show a first embodiment of the present invention. FIG. 1 is a cross-sectional view and a perspective view showing a configuration of an overtube, and FIG. 2 shows a plurality of overtubes having different lengths and diameters. FIG. 3 is a side view showing a combined configuration, FIG. 3 is a diagram showing an operation procedure when inserting using a plurality of overtubes having different lengths and diameters, and FIG. 4 is a diagram showing a plurality of overtubes having different lengths and diameters in a large intestine. FIG. 5 is a view showing a state when inserted into the inside, and FIG. 5 is a view showing a stopper mechanism in a plurality of overtubes having different lengths and diameters.
[0013]
As shown in FIGS. 1 (A) and 1 (B), an overtube 1 that is a tubular member includes a flexible tube portion 3 whose main portion is an insertion portion, and the flexible tube portion 3. It is roughly divided into an operation unit 2 provided on the hand side.
[0014]
The flexible tube portion 3 includes a friction member 8 sandwiched between a cylindrical inner sheath 6 and a cylindrical outer sheath 7 having an inner peripheral surface larger in diameter than the outer peripheral surface of the inner sheath 6. It consists of
[0015]
The inner sheath 6 is formed of, for example, a soft resin, and an inner side thereof is an endoscope insertion hole 13 for inserting an insertion portion of the endoscope.
[0016]
Similarly, the outer sheath 7 is formed of a soft resin, for example, and has a friction surface that generates a frictional force when its inner peripheral surface comes into contact with the outer peripheral side of the friction member 8. In addition, a marker 14 that can be confirmed by X-rays is provided on the outer peripheral surface on the distal end side of the outer sheath 7 so that the distal end position at the time of insertion can be confirmed.
[0017]
The friction member 8 is formed in a substantially tubular shape by winding an elongated plate-like member in a spiral shape, and its outer peripheral side comes into contact with the inner peripheral surface of the outer sheath 7 to cause friction. It is a friction surface for generating force. The friction member 8 is fixed to the inner peripheral side of the inner sheath 6 by a fixing portion 11 at the distal end in the insertion direction.
[0018]
Next, the operation unit 2 includes an inner sheath fixing member 12 that fixes the proximal end portion of the inner sheath 6 and an outer sheath fixing member 10 that fixes the proximal end portion of the outer sheath 7. In the moving groove 5 between, the transmission member 9 for fixing the proximal side of the friction member 8 and the operation lever 4 fixed to the transmission member 9 are arranged in the circumferential direction (or in the circumferential direction and axial direction as necessary). It is supported and configured to be rotatable.
[0019]
The overtube 1 is configured such that its entire length is shorter than the length of an insertion portion of an endoscope 20 described later.
[0020]
The action of curving the shape of the overtube 1 having such a configuration and then fixing it is as follows.
[0021]
First, the insertion portion of the endoscope is inserted into the endoscope insertion hole 13 of the overtube 1, and the insertion portion of the endoscope is changed to a desired shape. Then, the flexible tube portion 3 is passively bent in accordance with the shape change of the insertion portion of the endoscope.
[0022]
In this state, when the operation lever 4 is rotated in a direction to unwind the friction member 8, the friction member 8 which is wound to form a substantially tubular shape expands in the radial direction. When the outer peripheral side of the friction member 8 and the inner peripheral surface of the outer sheath 7 are in surface contact, the frictional force as described above can be applied between them. Even if the shape of the overtube 1 is changed in this state, the curved shape of the flexible tube portion 3 is fixed because the frictional force acts against the force.
[0023]
On the other hand, in order to return the fixed flexible tube portion 3 to a state in which the shape can be changed again, the operation lever 4 may be rotated in a direction in which the winding of the friction member 8 is tightened. Thereby, when the friction member 8 is contracted in the radial direction and the surface contact between the friction member 8 and the outer sheath 7 is released, the shape change of the flexible tube portion 3 is allowed.
[0024]
In this first embodiment, a plurality of such overtubes are used to constitute an endoscope insertion aid that secures a body cavity space when an endoscope or the like is inserted.
[0025]
That is, the two types of overtubes shown in FIG. 2 are basically configured as described with reference to FIG. However, the inner overtube 1B has a smaller outer diameter of the flexible tube portion 3 than the outer overtube 1A, and has a diameter that can be inserted into the endoscope insertion hole 13 of the overtube 1A. Yes. Furthermore, the length of the overtube 1B in the insertion direction of the flexible tube portion 3 is longer than the length of the entire overtube 1A in the insertion direction. The difference in length between the flexible tube portion 3 of the overtube 1B and the entire overtube 1A at this time is the same as the stroke during insertion (for example, the length of the curved portion of the endoscope 20) as described later. It is desirable to be able to secure a degree above.
[0026]
Accordingly, when the flexible tube portion 3 of the overtube 1B is inserted into the endoscope insertion hole 13 of the overtube 1A, as shown in FIG. 3, the distal end portion of the flexible tube portion 3 of the overtube 1B However, it extends from the front-end | tip part of the flexible tube part 3 of 1 A of overtubes. The endoscope 20 is inserted into the endoscope insertion hole 13 of the overtube 1B in the double overtubes 1A and 1B.
[0027]
With reference to FIG. 3, the operation procedure when performing insertion using two types of overtubes will be described.
[0028]
The overtube 1B is inserted into the overtube 1A, and the tip position of the overtube 1A and the tip position of the overtube 1B are substantially matched. Furthermore, in a state where the endoscope is inserted to the distal end portion in the overtube 1B, the overtube 1A and the overtube 1B are softened to be variable in shape.
[0029]
In this state, the overtube 1A, the overtube 1B, and the endoscope are integrally inserted into the body cavity while observing with the endoscope.
[0030]
When the insertion is performed to a certain extent, the outer overtube 1A is fixed and, as shown in FIG. 3 (A), using the aid of the conduit by the endoscope insertion hole 13 secured in the overtube 1A. The overtube 1B and the endoscope are integrally inserted further into the interior.
[0031]
After the overtube 1B and the endoscope are inserted to some extent, the overtube 1B is then fixed and the overtube 1A is softened to be variable in shape, and the overtube 1A is made as shown in FIG. 3 (B). Then, it is inserted along the fixed overtube 1B.
[0032]
Thus, when the tip of the overtube 1A catches up with the tip of the overtube 1B, this time, as shown in FIG. 3C, the overtube 1A is fixed and the overtube 1B is softened to change its shape. Then, the overtube 1B and the endoscope are integrally inserted further into the inside while using the aid of the duct by the endoscope insertion hole 13 secured in the overtube 1A.
[0033]
When the overtube 1B and the endoscope are inserted to some extent, as shown in FIG. 3D, the overtube 1B is fixed and the overtube 1A is softened to be variable in shape, and the overtube 1A is fixed. Insert along the overtube 1B.
[0034]
By repeating such a procedure, the endoscope and the overtube are inserted.
[0035]
At the time of insertion, as described above, since the fixing and softening of the overtube 1A and the overtube 1B are alternately switched, when an interlocking mechanism is provided and one of them is fixed, the other is automatically softened. It is good to do so. For example, if the friction member 8 of one overtube is configured to be right-handed and the friction member 8 of the other overtube is configured to be left-handed, when the operation lever 4 is rotated in the same direction, one is fixed, The other will be softened. Therefore, it is conceivable to attach an attachment member that can move the operation levers 4 of both overtubes in cooperation. In addition, it is preferable to configure so that the interlocking can be selected as desired. In the above example, the attachment member may be removable.
[0036]
Next, with reference to FIG. 4, how the endoscope is inserted into the large intestine using a plurality of overtubes will be described.
[0037]
First, as shown in FIG. 4A, the endoscope 20 is inserted into the lumen organ 19 such as the rectum or the large intestine with the endoscope 20 inserted through the double overtubes 1A and 1B. At this time, for example, the shape holding function of the overtube 1A is turned on (that is, fixed). Then, when inserted to a certain extent, the shape of the luminal organ 19 ahead is curved.
[0038]
Next, as shown in FIG. 4B, with the shape retaining function of the overtube 1A turned on, the shape retaining function of the overtube 1B is turned off (that is, softened), and the endoscope is used. The overtube 1B is bent together with the endoscope by bending with the bending portion of the endoscope while observing, and the overtube 1B and the endoscope are inserted into the lumen organ 19 integrally. To go. This insertion is performed up to, for example, the portion where the luminal organ 19 is curved in different directions.
[0039]
In this state, while turning on the shape holding function of the overtube 1B and turning off the shape holding function of the overtube 1A, the overtube 1A is shown in FIG. 4C along the fixed overtube 1B. Insert like so.
[0040]
Thus, when the tip of the overtube 1A catches up with the tip of the overtube 1B, the shape holding function of the overtube 1A is turned on, and the shape holding function of the overtube 1B is turned off. As shown in FIG. 2, the overtube 1B and the endoscope are further inserted into the luminal organ 19. The insertion length at this time is also performed up to, for example, the portion where the bending direction of the luminal organ 19 changes.
[0041]
By repeatedly performing such an operation, the plurality of overtubes 1A and 1B and the endoscope can be inserted into the luminal organ 19 such as the large intestine.
[0042]
Subsequently, a configuration for defining an upper limit of the amount by which the tip of the overtube 1B protrudes from the tip of the overtube 1A will be described with reference to FIG.
[0043]
First, FIG. 5 (A) shows that a tapered surface 16 is provided in the middle of the outer peripheral surface of the overtube 1B from the distal end side to the proximal side by a projecting length, and inside the distal end portion of the overtube 1A. A tapered surface 15 for receiving the tapered surface 16 is provided.
[0044]
As a result, when the overtube 1B protrudes from the tip of the overtube 1A by a predetermined length, the taper surface 15 and the taper surface 16 come into contact with each other to prevent the overtube 1B from protruding further. Yes.
[0045]
Next, FIG. 5 (B) shows that an outer flange 18 is provided in the middle of the outer peripheral surface of the overtube 1B from the front end side to the proximal side by the protruding length, and the end portion of the overtube 1A is provided. An inner flange 17 for receiving the outer flange 18 is provided inside.
[0046]
Also with such a configuration, the upper limit of the protruding amount of the overtube 1B can be similarly defined.
[0047]
In addition, although the example using two overtubes 1A and 1B was demonstrated above, it is not limited to this, You may make it use the number of three or more overtubes.
[0048]
In this case, the plurality of overtubes are configured so that the overall length becomes longer as the outer diameter is smaller, and the insertion portion of the endoscope is configured to be longer than the innermost overtube. good.
[0049]
Further, by using an endoscope having a shape maintaining function instead of the above-described overtube 1B, the same operational effects as the above-described operational effects of the two overtubes 1A and 1B can be obtained. Is possible.
[0050]
According to the first embodiment, instead of using the overtube alone as an auxiliary tool for inserting an endoscope, a plurality of overtubes having different lengths and diameters are combined to be softened and fixed. By inserting while alternately performing the conversion, a high insertion property can be obtained even when the insertion path is long or the insertion path is bent in a complicated manner.
[0051]
Further, since the marker 14 that can be confirmed by X-rays is provided at the tip of the overtube, the insertion position can also be confirmed by using X-ray contrast.
[0052]
Further, since the stopper mechanism is provided so that the inner overtube does not protrude too much from the tip of the outer overtube, it is possible to perform an operation of alternately inserting the appropriate protruding amount as a stroke.
[0053]
6 to 12 show a second embodiment of the present invention. FIG. 6 is a perspective view showing a configuration of an endoscope guide wire, and FIG. 7 is a cross-sectional view showing a configuration of the endoscope guide wire. 8 is a cross-sectional view showing another configuration example of the endoscope guide wire, FIG. 9 is a cross-sectional view showing the configuration of the distal end soft portion of the endoscope guide wire, and FIG. 10 is an internal view using the endoscope guide wire. FIG. 11 is a view showing a state when an endoscope is inserted into the large intestine, FIG. 11 is a view showing a state when the endoscope is orally inserted into the stomach and small intestine using an endoscope guide wire, and FIG. It is a figure which shows a mode when inserting an endoscope using a mirror guide wire.
[0054]
In the second embodiment, the same parts as those in the first embodiment described above are denoted by the same reference numerals, description thereof is omitted, and only different points will be mainly described.
[0055]
In the second embodiment, an endoscope guide wire 21 is used as an auxiliary tool for inserting an endoscope.
[0056]
The endoscope guide wire 21 is configured to have a function capable of taking a softened and variable shape state and a fixed and held shape shape, that is, a shape holding function. FIG. As shown in FIG. 4, the main part is a flexible part 23 serving as an insertion part, a tip soft part 24 provided on the tip side of the flexible part 23, and a proximal side of the flexible part 23 The operation unit 22 is roughly divided into two.
[0057]
As shown in FIG. 7, the configuration of the flexible portion 23 and the operation portion 22 among these is except that the diameter is smaller than that of the overtube 1 in the first embodiment described above. Although it is substantially the same as the flexible tube portion 3 and the operation portion 2 of the overtube 1, the end portion on the hand side of the operation portion 22 is closed by the member 25 because there is no need to insert the endoscope inside. Is different. Further, the endoscope guide wire 21 is configured to be longer than the entire length of the endoscope channel.
[0058]
In the example shown in FIG. 7, the flexible portion 23 is configured to have a tubular shape like the flexible tube portion 3 of the overtube 1. However, as described above, the endoscope is inserted into the tube. Therefore, it is not necessarily limited to the tubular shape.
[0059]
FIG. 8 is a diagram illustrating another configuration example of the flexible portion 23.
[0060]
The flexible portion 23 is configured by sandwiching the friction member 8 between a columnar shaft member 26 and a cylindrical outer sheath 27 having an inner peripheral surface having a larger diameter than the shaft member 26. ing.
[0061]
The shaft member 26 has a distal end portion 26 a rotatably engaged with a bearing 27 a provided at a distal end side lid portion of the outer sheath 27.
[0062]
Further, the front end portion of the friction member 8 is fixed to the shaft member 26 by the fixing portion 11.
[0063]
On the other hand, it is the same as the overtube 1 that the inner peripheral surface of the outer sheath 27 is a friction surface that generates a frictional force when it comes into contact with the outer peripheral side of the friction member 8.
[0064]
In such a configuration, the friction member 8 expands in the radial direction by rotating in the direction in which the friction member 8 is unwound, and the curved shape is fixed by the frictional force with the inner peripheral surface of the outer sheath 27. In the same manner as described above, the friction member 8 is reduced in the radial direction by turning in the direction in which the winding of the friction member 8 is tightened, and the shape change is allowed.
[0065]
When the configuration as shown in FIG. 8 is used, there is an advantage that a useless pipe line is not generated in the inside, so that the diameter is more suitable.
[0066]
In the configuration shown in FIG. 8, the inner peripheral surface of the outer sheath 27 is a normal surface, the outer peripheral surface of the shaft member 26 is a friction surface, and the inner surface of the friction member 8 is a friction surface. Similarly, the function of fixing the shape or softening can be achieved.
[0067]
Next, with reference to FIG. 9, an example of the configuration of the tip soft portion 24 will be described.
[0068]
The tip soft portion 24 is configured by arranging spheres 29 made of a solid such as resin in a line with almost no gap, and covering these spheres 29 with a soft resin material 28.
[0069]
The configuration of the tip soft portion 24 is not limited to that shown in FIG. 9, and may be formed of a highly soft resinous material, or may be formed using a coil or the like. good. In short, the endoscope guide wire 21 may be configured so that the distal end thereof does not damage the intestinal wall or the like when the endoscope guide wire 21 is pushed into a luminal organ such as the intestinal tract.
[0070]
With reference to FIG. 10, a state when the endoscope guide wire 21 as described above is inserted into the large intestine will be described.
[0071]
First, the endoscope 31 is inserted through the anus and inserted up to the rectum or the portion of the luminal organ 19 that is at the first corner.
[0072]
Thereafter, as shown in FIG. 10A, a flexible endoscope guide wire 21 is passed through a lumen of a large intestine or the like through a channel 32 (for example, a forceps channel or a suction channel) 32 of the endoscope 31. Insert deep into organ 19. At this time, since the distal end soft portion 24 is provided as described above, the intestinal wall is not damaged.
[0073]
Then, the shape holding function of the endoscope guide wire 21 is turned on, and as shown in FIG. 10B, the endoscope is inserted along the endoscope guide wire 21 whose shape is fixed. go. At this time, the endoscope 31 is sufficiently flexible so that the endoscope 31 can be inserted without being deformed even if it is pushed along the fixed endoscope guide wire 21. Are assumed to be of a different type.
[0074]
Next, with reference to FIG. 11, a state when the endoscope is orally inserted into the stomach or small intestine will be described.
[0075]
First, the endoscope 31 is inserted orally from the esophagus to the stomach or the duodenum. Thereafter, the flexible endoscope guide wire 21 is inserted through the channel 32 of the endoscope 31 to a deep portion in the luminal organ 19 such as the small intestine.
[0076]
Then, the shape holding function of the endoscope guide wire 21 is turned on, and the endoscope is inserted along the endoscope guide wire 21 whose shape is fixed as in the example shown in FIG. It is the same.
[0077]
In the case shown in FIGS. 10 and 11, when the endoscope is inserted using the endoscope guide wire, more specifically, as shown in FIG.
[0078]
First, as shown in FIG. 12, the endoscope 31 is inserted to the front of the curved portion of the luminal organ 19. Then, as shown in FIG. 12A, the endoscope guide wire 21 is inserted through the channel 32 of the endoscope 31.
[0079]
When the endoscope guide wire 21 is inserted, the endoscope guide wire 21 abuts against a curved portion of the luminal organ 19 but can be flexibly bent. Therefore, as shown in FIG. The endoscope guide wire 21 is bent along 19 paths and inserted further to the end.
[0080]
In the state as shown in FIG. 12B, by turning on the shape holding function of the endoscope guide wire 21, the endoscope 31 has, for example, the endoscope guide wire 21 as a rail. Like a monorail, it can proceed smoothly along the endoscope guide wire 21 (see FIG. 12C).
[0081]
According to the second embodiment as described above, an endoscope guide wire having an effect similar to that of the first embodiment described above and having a shape maintaining function is used as an auxiliary tool for inserting an endoscope. Thus, even when the insertion path is long or the insertion path is bent in a complicated manner, it is possible to obtain a high insertion property of the endoscope.
[0082]
Furthermore, by providing the tip soft part, it is possible to prevent the organ wall and the like from being damaged.
[0083]
FIGS. 13 to 17 show a third embodiment of the present invention. FIG. 13 is a perspective view showing the configuration of the intestinal cord, and FIG. 14 is a sectional view including a partial side view showing the configuration of the intestinal cord. 15 is a perspective view and a partial cross-sectional view showing another example of the structure of the distal end portion of the bowel cord, FIG. 16 is a diagram showing a state when the bowel cord is orally inserted into the stomach and small intestine, and FIG. It is a figure for demonstrating the effect | action of the intestinal cord of a form in contrast with the effect | action of the conventional enteric cord.
[0084]
In the third embodiment, portions that are the same as those in the first and second embodiments described above are denoted by the same reference numerals, description thereof is omitted, and only differences are mainly described.
[0085]
The bowel cord 21A is configured to have a function that can take a softened and variable shape state and a fixed and held shape, that is, a shape holding function, as shown in FIG. In addition, as shown in the second embodiment described above, the flexible portion 23 serving as an insertion portion and the operation portion 22 provided on the proximal side of the flexible portion 23 are further included. A balloon 45 is attached to the distal end side of the flexible portion 23 via a flexible tube 44, and a balloon valve 41 having a tube 42 is attached to the proximal side of the operation portion 22. When the balloon 45 is inflated, for example, the balloon 45 is configured to have an outer diameter substantially equal to or slightly larger than the inner diameter of the human large intestine.
[0086]
Thus, since the bowel cord 21A is configured to send air to the balloon 45 on the distal end side, it is necessary to secure an internal conduit, and the conduit as shown in FIG. The member 25 that closes on the hand side is not provided.
[0087]
More specifically, as shown in FIG. 14, the enteric cord 21 </ b> A presses the flexible tube 44 into a base 46 provided on the distal end side of the flexible portion 23 from the outside, and the distal end of the flexible tube 44. For example, the balloon 45 is airtightly attached to the side through an O-ring 47.
[0088]
Further, the intestinal cord 21A is provided with a base 43 on the hand side of the operation portion 22, and the tube 42 of the balloon valve 41 is press-fitted into the base 43 airtightly from the outside.
[0089]
Further, in the configuration as shown in FIG. 13 or FIG. 14, a tip soft portion 24 may be further provided on the tip side as shown in FIG.
[0090]
That is, as shown in FIG. 15A, a balloon 45 is provided on the distal end side of the flexible portion 23, and a distal end soft portion 24 is further provided on the distal end side thereof.
[0091]
More specifically, as shown in FIG. 15B, the flexible tube 44 is attached to the distal end side of the flexible portion 23, and the flexible tube 44 has a plurality of vent holes 44a. Yes.
[0092]
A balloon 45 is attached from the outside so as to include the ventilation hole 44a inside, and the distal end side and the proximal side thereof are hermetically sealed by an O-ring 47, for example.
[0093]
Then, on the distal end side of the flexible tube 44, the distal flexible portion 24 having the structure as shown in FIG. 9 of the second embodiment described above closes the conduit on the distal end side of the flexible tube 44. Attached.
[0094]
As shown in FIG. 16, such an enteric cord 21 </ b> A starts to be inserted into the body by orally swallowing the balloon 45 at the tip. The balloon 45 is discharged from the anus to the outside of the body through a luminal organ 19 such as the stomach, duodenum, small intestine, large intestine, and the like, with a peristaltic motion or the like as a driving force.
[0095]
Since the flexible portion 23 is attached to the balloon 45 as described above, the flexible portion 23 is also sequentially fed into the body as the balloon 45 moves, and from the oral to the anus. The route will be inserted.
[0096]
Next, a state when the endoscope 31 is inserted into the body using such an enteric cord 21A will be described with reference to FIG.
[0097]
When the endoscope 31 is inserted using the conventional bowel cord 91, first, the bowel cord 91 is inserted from the oral cavity to the anus using a balloon. Next, when the bowel cord 91 is inserted through the channel of the endoscope 31 and the endoscope 31 is to be inserted into the body, the bowel cord 91 is pulled as shown in FIG. Therefore, it is necessary to straighten the bent portion of the luminal organ 19 in the body. This is because if the luminal organ 19 is bent or bent with a small radius of curvature, it becomes difficult to insert the flexible endoscope 31 into the body. Therefore, when the conventional intestinal cord 91 is used, the organ is forced to be deformed abnormally, so that not only is the patient suffering, but the organ may be damaged.
[0098]
On the other hand, when inserting the endoscope 31 using the intestinal cord 21A of the present embodiment, first, the shape maintaining function of the intestinal cord 21A is turned on by operating the operating portion 22 of the intestinal cord 21A. To.
[0099]
The intestinal cord 21A in this state is inserted into a channel provided in the endoscope 31, and the endoscope 31 is inserted into the body as shown in FIG. 17A while using the intestinal cord 21A as a guide. Insert it. At this time, in the same manner as described above, the endoscope 31 advances along the intestinal cord 21A like a monorail while the intestinal cord 21A having a fixed shape plays a role like a rail. Even if the path in the body cavity is long and complicated, the endoscope 31 can move smoothly along the path.
[0100]
According to such 3rd Embodiment, while having the effect substantially the same as 1st, 2nd embodiment mentioned above, using an enteric string which has a shape maintenance function as an auxiliary tool for endoscope insertion This makes it possible to reduce patient pain and damage to organs.
[0101]
Further, by providing the balloon, it is possible to efficiently insert the bowel cord into the body cavity using the peristaltic motion. Furthermore, by providing the tip soft part, it is possible to prevent the organ wall and the like from being damaged.
[0102]
It should be noted that the present invention is not limited to the above-described embodiments, and various modifications and applications can be made without departing from the spirit of the invention.
[0103]
[Appendix]
According to the above-described embodiment of the present invention described in detail above, the following configuration can be obtained.
[0104]
(1) A flexible tube portion configured to have a friction member that generates a frictional force by contacting each other and configured to be able to bend freely by receiving an external force; and in the flexible tube portion A friction force adjusting mechanism for adjusting the frictional force generated by the friction member, and adjusting the frictional force by the frictional force adjusting mechanism, so that the flexible tube portion remains in an arbitrary shape. An overtube for an endoscope, which is a tubular member through which an endoscope can be inserted, having a shape holding function capable of being fixed;
An endoscope that is inserted into and used in the endoscope overtube;
An endoscope system comprising:
[0105]
(2) The endoscope overtube is configured such that the entire length thereof is shorter than the length of the portion of the endoscope that can be inserted into the endoscope overtube. The endoscope system according to appendix (1).
[0106]
(3) The endoscope overtube includes a plurality of endoscopes, and an inner diameter of one endoscope overtube is larger than an outer diameter of another endoscope overtube, and the other endoscopes The endoscope system according to appendix (1), wherein the mirror overtube can be inserted into the one endoscope overtube.
[0107]
(4) The endoscope system according to (3), wherein the plurality of endoscope overtubes are configured such that the overall length becomes longer as the outer diameter is smaller.
[0108]
(5) The remarks (3), wherein the plurality of endoscope overtubes are configured to have operation means for controlling each frictional force adjusting mechanism independently. The endoscope system described in 1.
[0109]
(6) The plurality of endoscope overtubes are configured to have two independent endoscope overtubes, and the shape maintaining function of one endoscope overtube is turned on. The endoscope system according to appendix (3), further comprising an interlocking mechanism that turns off the shape maintaining function of the other endoscope overtube in conjunction with each other.
[0110]
(7) The plurality of endoscope overtubes are positioned outside the self and a mechanism for restricting the amount of protrusion from the tip of the other endoscope overtube inserted through the endoscope. The endoscope according to appendix (3), characterized in that the endoscope has at least one of a mechanism for restricting the amount of protrusion from the distal end of the endoscope overtube. Mirror system.
[0111]
(8) The endoscope system according to appendix (1), wherein the endoscope overtube includes a marker that can be confirmed by X-rays at a distal end portion.
[0112]
(9) an endoscope with a channel;
A flexible portion configured to have a friction member that generates a frictional force by contacting each other and configured to be able to bend freely by receiving an external force, and the frictional member in the flexible portion is generated. A friction force adjusting mechanism for adjusting the friction force, and by adjusting the friction force by the friction force adjusting mechanism, the flexible portion can be fixed in an arbitrary shape. An endoscope insertion assisting string-like member having a shape maintaining function, the outer diameter of which is smaller than the inner diameter of the channel of the endoscope, and which can be inserted into the channel;
An endoscope system comprising:
[0113]
(10) The endoscope insertion assisting string-like member is configured to have a soft part on the distal end side that is softer than the flexible part when the shape maintaining function is turned off. The endoscope system according to appendix (9).
[0114]
(11) The endoscope system according to appendix (9), wherein the endoscope insertion assisting string member is longer than a total length of the channel.
[0115]
(12) The endoscope includes the endoscope insertion assisting string member inserted through the channel in a state where the shape holding function of the endoscope insertion assisting string member is turned on. Additional note (9) characterized in that it has a sufficiently flexible endoscope insertion portion that does not deform the shape of the endoscope insertion assisting string-like member even when the endoscope is pushed in. The endoscope system described.
[0116]
(13) The endoscope insertion assisting string member is provided with a balloon having an outer diameter substantially equal to or slightly larger than an inner diameter of a human large intestine at a distal end thereof (9) ) Endoscope system.
[0117]
(14) A first tubular tube that can be inserted through the endoscope and can have a first state that is flexible and variable in shape and a second state that is fixed while maintaining the shape. Members,
The first tubular member is inserted through the first tubular member. When the first tubular member is inserted most, the distal end portion of the first tubular member protrudes from the distal end portion by a predetermined length. A second tubular member configured to take the first state and the second state;
Comprising
One of the first tubular member and the second tubular member takes the first state and the other takes the second state, so that the second state is taken. An endoscope insertion aid characterized by being inserted into a body cavity by relatively advancing what is in the state of 1.
[0118]
(15) The tubular member is in contact with the first friction member whose diameter in the direction perpendicular to the longitudinal direction is variable, and when the diameter of the first friction member changes. A second friction member configured to generate a friction force, and the second friction member is configured to generate a friction force when the friction force is generated between the first friction member and the second friction member. The endoscope insertion aid according to appendix (14), which is configured to take a state and take the first state when the frictional force is not generated.
[0119]
(16) It has an interlocking mechanism that allows one of the first tubular member and the second tubular member to take the first state automatically when the other takes the first state. Endoscope insertion aid according to Supplementary Note (14) or Supplementary Note (15), characterized in that.
[0120]
(17) Additional notes (14) and additional notes (14), characterized by having a mechanism for restricting the maximum length of the protruding amount of the distal end portion of the first tubular member from the distal end side of the second tubular member. (15) or the endoscope insertion aid according to appendix (16).
[0121]
(18) A marker that can be confirmed by X-rays is provided at the distal end portion of the first tubular member, or the distal end portion of the first tubular member and the distal end portion of the second tubular member. The auxiliary tool for inserting an endoscope according to appendix (14).
[0122]
(19) A string-like member that can be inserted into a channel of an endoscope and can take a first state that is flexible and variable in shape and a second state that is fixed while maintaining the shape. Comprising
The string-like member is inserted into the body cavity in the first state, and then takes the second state to guide insertion of the endoscope in the second state. An auxiliary tool for inserting an endoscope.
[0123]
(20) The string-like member is in contact with the first friction member whose diameter in the direction perpendicular to the longitudinal direction is variable, and when the diameter of the first friction member changes. A second friction member configured to generate a frictional force, and when the frictional force is generated between the first frictional member and the second frictional member, the second frictional member is formed. The auxiliary instrument for inserting an endoscope according to appendix (19), wherein the first state is taken when the frictional force is not generated.
[0124]
(21) The string-like member has an outer diameter that is substantially equal to or slightly larger than the inner diameter of the human large intestine at the distal end side of the flexible portion that can take the first state and the second state. Endoscope insertion aid according to appendix (19) or appendix (20), characterized by comprising a balloon having
[0125]
(22) The string-like member has a tip softness that is softer than the flexible portion taking the first state on the tip side of the flexible portion capable of taking the first state and the second state. Endoscope insertion aid according to Supplementary Note (19), Supplementary Note (20), or Supplementary Note (21), characterized in that the endoscope insertion part is configured.
[0126]
【The invention's effect】
As described above, according to the endoscope insertion aid of the present invention, it is possible to ensure high insertability even when the insertion path is long or when it is bent in a complicated manner.
[Brief description of the drawings]
FIG. 1 is a cross-sectional view and a perspective view showing a configuration of an overtube in a first embodiment of the present invention.
FIG. 2 is a side view showing a configuration in which a plurality of overtubes having different lengths and diameters are combined in the first embodiment.
FIG. 3 is a diagram showing an operation procedure when insertion is performed using a plurality of overtubes having different lengths and diameters in the first embodiment.
FIG. 4 is a diagram showing a state when a plurality of overtubes having different lengths and diameters are inserted into the large intestine in the first embodiment.
FIG. 5 is a view showing a stopper mechanism in a plurality of overtubes having different lengths and diameters in the first embodiment.
FIG. 6 is a perspective view showing a configuration of an endoscope guide wire according to a second embodiment of the present invention.
FIG. 7 is a cross-sectional view showing a configuration of an endoscope guide wire in the second embodiment.
FIG. 8 is a cross-sectional view showing another configuration example of the endoscope guide wire in the second embodiment.
FIG. 9 is a cross-sectional view showing a configuration of a distal end soft portion of an endoscope guide wire in the second embodiment.
FIG. 10 is a diagram showing a state when an endoscope is inserted into the large intestine using an endoscope guide wire in the second embodiment.
FIG. 11 is a diagram showing a state when the endoscope is orally inserted into the stomach or small intestine using the endoscope guide wire in the second embodiment.
FIG. 12 is a diagram showing a state when an endoscope is inserted using an endoscope guide wire in the second embodiment.
FIG. 13 is a perspective view showing a configuration of an intestinal cord according to a third embodiment of the present invention.
FIG. 14 is a cross-sectional view including a partial side view showing the configuration of the bowel cord in the third embodiment.
FIG. 15 is a perspective view and a partial cross-sectional view showing another example of the configuration of the distal end portion of the bowel cord in the third embodiment.
FIG. 16 is a diagram showing a state when the intestinal cord is orally inserted into the stomach or small intestine in the third embodiment.
FIG. 17 is a view for explaining the action of the bowel cord of the present embodiment in comparison with the action of the conventional bowel cord in the third embodiment.
[Explanation of symbols]
1, 1A, 1B ... Overtube (overtube for endoscope) (tubular member)
2 ... Operation part
3 ... Flexible tube
4. Operation lever (operation means)
5 ... Moving groove
6 ... Inner sheath
7 ... Outer sheath (second friction member, friction force adjusting mechanism)
8. Friction member (first friction member, friction force adjusting mechanism)
9 ... Transmission member
10: Outer sheath fixing member
11 ... fixed part
12 ... Inner sheath fixing member
13 ... Endoscope insertion hole (insertion hole)
14 ... Marker
15, 16 ... Tapered surface (mechanism for regulating the maximum length of protrusion)
17 ... Inner flange (mechanism for regulating the maximum length of protrusion)
18 ... Outer flange (mechanism for regulating the maximum length of protrusion)
20, 31 ... Endoscope
21 ... Endoscope guide wire (string member, endoscope insertion assisting string member)
21A ... bowel cord (string member, endoscope insertion assisting string member)
22 ... operation unit
23. Flexible part
24 ... tip soft part
26 ... Shaft member
27 ... Outer sheath (second friction member, friction force adjusting mechanism)
28 ... Resin material
29 ... sphere
41. Balloon valve
44 ... Soft tube
45 ... Balloon

Claims (3)

A first tubular member that can be inserted through the endoscope and that can take a first state that is flexible and shape-variable, and a second state that is fixed while maintaining the shape;
The first tubular member is inserted through the first tubular member. When the first tubular member is inserted most, the distal end portion of the first tubular member protrudes from the distal end portion by a predetermined length. A second tubular member configured to take the first state and the second state;
Comprising
One of the first tubular member and the second tubular member takes the first state and the other takes the second state, so that the second state is taken. An endoscope insertion aid characterized by being inserted into a body cavity by relatively advancing what is in the state of 1. The tubular member has a first friction member whose diameter in a direction perpendicular to the longitudinal direction is variable, and when the diameter of the first friction member changes, the tubular member abuts on the first friction member to generate a friction force. A second friction member configured to generate the second friction member, and when the frictional force is generated between the first friction member and the second friction member, the second state is taken. 2. The endoscope insertion assisting device according to claim 1, wherein the endoscope insertion auxiliary device is configured to take the first state when the frictional force is not generated. A string-like member that can be inserted into a channel of an endoscope and can take a first state that is flexible and variable in shape and a second state that is fixed while maintaining the shape. ,
The string-like member is inserted into the body cavity in the first state, and then takes the second state to guide insertion of the endoscope in the second state. An auxiliary tool for inserting an endoscope.

Images