JP2005230085A - Over-tube with balloon - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an over-tube with a balloon capable of reducing the frictional resistance between an inner layer of an over-tube body and an insertion part of an endoscope, and increasing the operability. <P>SOLUTION: The over-tube with the balloon is for inserting/guiding the insertion part of the endoscope or a treatment instrument, or the like. At least the inner layer 12a as the inner surface of the over-tube body 12 is made of a fluororesin over the whole length. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an overtube with a balloon that is externally or transanally inserted into a body cavity and externally fitted to an endoscope or the like that observes the inside of the body cavity.

  As a procedure for inserting a medical endoscope into a deep digestive tract cavity in a body cavity, for example, the small intestine, there are a case where it is inserted orally and a case where it is inserted transanally. In any case, since the intestinal tract is bent flexibly, even if the insertion part of the endoscope is pushed out of the body cavity, the force is not easily transmitted to the distal end part of the insertion part, and it is difficult to insert it deeply. is there.

  Therefore, an endoscope tube is provided at the distal end portion of the endoscope so that the insertion portion of the endoscope can be smoothly inserted into a complicatedly bent intestine, and an overtube (externally inserted into the endoscope insertion portion) A double-balloon endoscope system in which an overtube balloon is provided at the tip of a sliding tube is known (for example, see Patent Document 1).

  This is because after inserting the overtube that serves as a guide when inserting the endoscope insertion portion into the deep part to the deep part of the intestine, the overtube balloon is inflated to fix the overtube balloon to the intestinal tract. In this state, by retracting the overtube, the intestinal tract is bent to insert the endoscope insertion portion deeper.

Also, when the overtube balloon is inflated and the overtube is fixed to the intestinal tract, the balloon is made of a soft material such as latex so as not to place a burden on the intestinal tract and the internal pressure of the balloon is measured. Thus, there is also known one that can control the pressure (see, for example, Patent Documents 2 and 3).
JP 11-290263 A JP 2001-340462 A JP 2002-301019 A

  However, the overtube for guiding the endoscope to the intestinal tract is formed of a flexible synthetic resin material, but the friction resistance at the sliding portion between the insertion portion of the endoscope and the overtube is large. There's a problem.

  In particular, the overtube inserted into a bent intestine such as the small intestine or the large intestine is bent in a complicated manner, so that friction when pushing the insertion part of the endoscope inserted through the inside or advancing and retracting the overtube There is a problem that it cannot be smoothly operated due to resistance, and in particular, an endoscope for small intestine has a long insertion portion, and the frictional resistance further increases. In order to solve these problems, it is conceivable to supply a lubricant between the overtube and the insertion portion. However, it is necessary to supply the lubricant frequently, and the operation becomes complicated.

  The present invention has been made paying attention to the above circumstances, and its object is to provide a balloon with which the friction resistance between the inner layer of the overtube main body and the insertion portion of the endoscope can be reduced and the operability can be improved. To provide an overtube.

  In order to achieve the above object, according to a first aspect of the present invention, in the overtube with a balloon for inserting and guiding the insertion portion of the endoscope, the treatment tool and the like into the body cavity, at least the inner surface of the overtube main body is made of fluorine-based. It is made of resin.

  A second aspect of the present invention is that the overtube main body of the first aspect has a two-layer structure in which an inner layer is made of a fluorine-based resin and an outer layer is made of a thermoplastic resin.

  According to a third aspect of the present invention, when the outer diameter of the inner layer of the second aspect is A and the inner diameter of the outer layer is B, the inner layer and the outer layer are in close contact as A> B.

  According to a fourth aspect of the present invention, an air supply conduit for supplying air to the balloon is disposed between the inner layer and the outer layer of the second aspect.

  According to a fifth aspect of the present invention, the thermoplastic resin forming the outer layer of the second aspect is a multi-lumen tube, and a pipe line of the multi-lumen tube is used as an air supply line for supplying air to the balloon.

  According to this invention, at least the inner surface of the overtube body is made of a fluorine-based resin having self-lubricating properties, so that the frictional resistance with the insertion portion of the endoscope can be reduced and the operability can be improved. is there.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 to 4 show a first embodiment, FIG. 1 is a side view of the entire double balloon endoscope, FIG. 2 is a longitudinal side view of a distal end portion of an insertion portion, and FIG. 3 shows an overtube main body. , (A) is a longitudinal side view, (B) is a cross-sectional view taken along the line AA, and FIG.

  As shown in FIGS. 1 and 2, for example, an endoscope 1 for a small intestine has an elongated flexible insertion portion 2, and a bending portion 3 is interposed at a distal end (tip side) of the insertion portion 2. The tip structure portion 4 is provided. An operation unit 5 is provided at the proximal end (base end side) of the insertion unit 2, and an angle operation knob 6 is provided in the operation unit 5. Furthermore, the operation part 5 is connected to a universal cord 8 having a connector 7 at the distal end.

  The distal end configuration portion 4 of the insertion portion 2 is provided with an observation optical system (not shown) such as an illumination optical system and a solid-state imaging device, and the insertion portion 2 is provided with a forceps channel (not shown). Is in communication with the treatment instrument insertion port 10 of the operation unit 5.

  An endoscope overtube 11 can be extrapolated to the insertion portion 2, an overtube balloon 13 is provided at the distal end of the overtube body 12, and a gripping portion 14 is provided at the proximal end. ing. As shown in FIGS. 3A and 3B, the overtube main body 12 is formed in a two-layer structure from the inner layer 12a and the outer layer 12b over the entire length. The inner layer 12a is a fluorine-based resin having self-lubricating properties, and the outer layer 12b is formed of a thermoplastic resin such as urethane having excellent adhesiveness. Note that the inner side surface may be simply fluorine-coded.

  Further, one end of a first air supply tube 15 as an air supply line is connected to the overtube balloon 13 provided at the distal end of the overtube main body 12, and the other end is connected to an air such as an air pump. A connection port 16 connected to a supply source (not shown) is provided. The first air supply tube 15 is interposed between the inner layer 12a and the outer layer 12b.

  Further, to explain further, when the outer diameter of the inner layer 12a is A and the inner diameter of the outer layer 12b is B, A> B. In other words, the inner layer 12a and the outer layer 12b are brought into close contact with each other by an interference fit, thereby being integrated and fixing the first air supply tube 15 at the same time.

  Further, as shown in FIG. 2, a pair of annular grooves 18a for attaching an endoscope balloon 19 described later in the circumferential direction to the outer peripheral portion of the distal end constituting portion 4 and the bending portion 3 of the endoscope 1 as shown in FIG. 18b is provided. An endoscopic balloon 19 is fitted and fixed in the annular grooves 18a and 18b using its elasticity.

  The endoscope balloon 19 is an elastic body made of rubber or a synthetic resin material, is formed in a cylindrical shape, and is provided with openings 19a and 19b at both ends thereof. The opening portions 19a and 19b are integrally provided with annular convex portions 20a and 20b that are elastically engaged and fixed to the annular grooves 18a and 18b. That is, the endoscope balloon 19 is attached by fitting from the front end portion of the distal end constituting portion 4 of the endoscope 1 in a state where the balloon 19 is expanded in the diameter increasing direction.

  Further, an insertion hole 21 that opens inside the endoscope balloon 19 is provided in the distal end configuration portion 4 of the endoscope 1, and a connection tube 22 that extends inside the insertion portion 2 is provided in the insertion hole 21. ing. The connecting tube 22 is connected to the distal end of the air supply conduit 9 inserted in the insertion portion 2. At this time, the air supply line 9 is inserted into the universal cord 8 from the insertion part 2 through the operation part 5 and is connected to an air supply connection port 23 provided in the connector 7. Since it is not exposed, it has the effect of not interfering with the procedure. Further, the air supply line 23 provided in the connector 7 of the endoscope 1 is connected to an air supply source (not shown) via an air supply tube (not shown).

  Next, the operation of the double balloon endoscope will be described.

  FIG. 4 shows a procedure for observing the inner wall of the intestinal tract by orally inserting a double balloon endoscope into the small intestine, where a is the esophagus, b is the stomach, and c is the small intestine. First, the overtube main body 12 is inserted into the insertion portion 2 of the endoscope 1 and the endoscope balloon 19 and the overtube balloon 13 are deflated by releasing air.

  Next, as shown in FIG. 4A, the insertion portion 2 of the endoscope 1 is inserted into the body cavity through the patient's mouth, and the bending portion 3 is operated by operating the angle operation knob 6 of the operation portion 5. The insertion part 2 is inserted into the small intestine c through the esophagus a and the stomach b. And when the front-end | tip structure part 4 of the insertion part 2 of the endoscope 1 passes the duodenum, for example, a remote controller etc. are operated and an air supply source is driven.

  As shown in FIG. 4B, when the endoscope balloon 19 is inflated by supplying air to the endoscope balloon 19 via the air supply connection port 23, the endoscope balloon 19 is The distal end component 4 of the endoscope 1 is fixed to the small intestine c while being pressed against the inner wall of the small intestine c. In this state, when the gripping portion 14 of the overtube main body 12 is gripped and the overtube main body 12 is advanced along the insertion portion 2, the distal end of the overtube main body 12 becomes the rear end portion of the endoscope balloon 19. Led up to.

  Next, as shown in FIG. 4C, the remote controller or the like is operated again to supply air from the air supply source to the overtube balloon 13 via the first air supply tube 15. Accordingly, the overtube balloon 13 is inflated and pressed against the inner wall of the small intestine c, and the distal end of the overtube body 12 is fixed. In this state, when the gripping portion 14 of the overtube main body 12 is gripped and the overtube main body 12 is retracted integrally with the insertion portion 2 of the endoscope 1, it is inserted together with the overtube main body 12 by the tensile force. Since the radius of curvature of the portion 2 is large and is in a substantially straight state, it is possible to shorten the small intestine c by removing excessive bending of the small intestine c.

  Next, as shown in FIG. 4D, when the endoscope balloon 19 is deflated by extracting air, the insertion portion 2 of the endoscope 1 is pushed toward the deep portion of the small intestine c. 2 is inserted toward the deep part of the small intestine c while being guided by the overtube body 12.

  When the distal end constituting portion 4 of the insertion portion 2 of the endoscope 1 has advanced to a desired position of the small intestine c, as shown in FIG. 4 (E), the endoscope balloon is again passed through the air supply conduit 23. Air is supplied to 19 to inflate the endoscope balloon 19, and the endoscope balloon 19 is pressed against the inner wall of the small intestine c to fix the tip constituting portion 4.

  In this state, the overtube balloon 13 is deflated by removing the air, and the overtube body 12 is advanced along the insertion portion 2 by grasping the grasping portion 14 of the overtube body 12. When the distal end of the overtube main body 12 reaches the rear end of the endoscope balloon 19, the overtube balloon 13 is expanded again as shown in FIG.

  By repeating this operation, the distal end constituting portion 4 of the endoscope 1 can be inserted to the deep portion of the small intestine c. Further, during the procedure, the overtube body 12 is frequently advanced and retracted along the insertion portion 2 of the endoscope 1, but the inner layer 12a of the overtube body 12 is formed of a fluorine-based resin having excellent self-lubricity. Therefore, the frictional resistance is small, and the overtube main body 12 and the insertion portion 2 can be relatively moved with a light force. Therefore, the operability can be improved. Further, since the air supply conduit 9 is inserted into the insertion portion 2, the overtube body 12 can be smoothly advanced and retracted.

  Furthermore, since a fluororesin excellent in self-lubricating property is used, it is not necessary to supply a lubricant between the insertion portion 2 and the overtube main body 12, so that a simple inspection can be provided. .

  Further, the outer layer 12b of the overtube body 12 is formed of a thermoplastic resin such as urethane having excellent adhesiveness. Therefore, the overtube balloon 13 attached to the overtube body 12 can be firmly bonded.

  FIG. 4 shows a procedure for orally inserting a double balloon endoscope into the small intestine, but basically the same applies when the double balloon endoscope is inserted into the small intestine via the large intestine transanally. It is.

  FIG. 5 shows a second embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. 5A and 5B show the overtube main body, in which FIG. 5A is a longitudinal side view, and FIG. 5B is a cross-sectional view taken along line BB.

  In the present embodiment, the inner layer 12a of the overtube body 12 is made of a fluororesin, and the thermoplastic resin forming the outer layer 12b is made of a multi-lumen tube 25, and the conduit of the multi-lumen tube 25 is supplied to the overtube balloon 13 Therefore, the air supply pipe 26 is used. In addition, a thick portion 25a is formed in a part of the multi-lumen tube 25 so as to be eccentric, and an air supply conduit 26 is provided in the thick portion 25a. Accordingly, the air supply pipe 26 is not crushed and blocked, and a constant pipe line can always be maintained. An air supply tube 28 is connected to the air supply line 26 via a base 27.

  In addition, in the said embodiment, although the overtube externally fitted by the insertion part of an endoscope was demonstrated, it can apply also to the overtube which inserts and guides a treatment tool. Further, only a part of the inner surface of the overtube may be formed of a fluororesin.

  According to each of the embodiments, the following configuration is obtained.

  (Appendix 1) An overtube with a balloon for inserting and guiding an insertion portion of an endoscope, a treatment instrument, etc. into a body cavity, wherein at least the inner surface of the overtube main body is formed of a fluorine-based resin. .

  (Appendix 2) The overtube main body has a balloon at the distal end and a two-layer structure of an inner layer and an outer layer, and an air supply tube for supplying air to the balloon is interposed between the inner layer and the outer layer. The overtube with balloon as set forth in appendix 1, wherein

  (Supplementary note 3) The balloon according to supplementary note 2, wherein the outer layer is a multi-lumen tube having a thick portion, and an air supply conduit for supplying air to the balloon is provided in the thick portion of the multi-lumen tube. With over tube.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Moreover, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, you may combine suitably the component covering different embodiment.

1 is an overall side view of a double balloon endoscope showing a first embodiment of the present invention. The vertical side view of the front-end | tip part of the insertion part of the embodiment. The overtube main body of the embodiment is shown, (A) is a longitudinal side view, (B) is a cross-sectional view along the AA line. The same embodiment is shown, (A)-(F) is an operation explanatory view of a double balloon type endoscope. The overtube main body of 2nd Embodiment of this invention is shown, (A) is a vertical side view, (B) is sectional drawing which follows a BB line.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Insertion part, 3 ... Bending part, 4 ... Tip structure part, 6 ... Operation part, 12 ... Overtube main body, 12a ... Inner layer, 12b ... Outer layer, 13 ... Overtube balloon, 15 ... Air supply tube, 19 ... Endoscope balloon

Claims (5)

In an overtube with a balloon that guides the insertion part and treatment tool of an endoscope into a body cavity,
An overtube with a balloon, wherein at least the inner surface of the overtube main body is formed of a fluorine-based resin.   The overtube with a balloon according to claim 1, wherein the overtube main body has a two-layer structure in which an inner layer is made of a fluororesin and an outer layer is made of a thermoplastic resin.   3. The overtube with a balloon according to claim 2, wherein when the outer diameter of the inner layer is A and the inner diameter of the outer layer is B, the inner layer and the outer layer are in close contact as A> B.   The overtube with a balloon according to claim 2, wherein an air supply conduit for supplying air to the balloon is disposed between the inner layer and the outer layer.   The overtube with a balloon according to claim 2, wherein the thermoplastic resin forming the outer layer is a multi-lumen tube, and a pipe line of the multi-lumen tube is used as an air supply line for supplying air to the balloon.

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