JP2006025823A - Endoscopic treatment system and treatment instrument for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To allow an operator of an endoscope to operate a treatment instrument in an endoscopic treatment system. <P>SOLUTION: The treatment instrument 2 is inserted into a treatment instrument channel 5 of the endoscope 1 to be used in the endoscopic treatment system. A first driving means 35 is disposed inside the endoscope 1. A reel 30 for taking up a treatment instrument insertion part 21 of the treatment instrument 2 is rotatably mounted at the proximal end of the endoscope 1, and a roller 45 for clasping the treatment instrument insertion part 21 together with the reel 30 is also disposed at the proximal end. The reel 30 and the roller 45 constitute a second drive means 36 for driving the treatment instrument 2. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an endoscope treatment system used by being inserted into a body, and an endoscope treatment tool used therefor.

Some endoscopes used when performing examinations in the digestive tract and the like can insert a treatment tool for an endoscope and perform treatment on a living body. In this type of endoscope treatment system, there is known a system that includes an electric roller and is capable of electrically inserting a treatment tool and removing the treatment tool from the endoscope (for example, see Patent Document 1). ). Specifically, a pair of rollers is disposed so as to sandwich a long treatment instrument insertion portion in the treatment instrument, and the rollers are driven by rotation of a motor.
Here, the treatment instrument is provided with a distal treatment section for treating the living body at the distal end of the treatment instrument insertion section. As the distal treatment section, for example, there is one provided with a pair of gripping pieces that can be freely opened and closed. In this case, when the operation transmission means connected to the pair of grip pieces is advanced and retracted, the grip pieces open and close. The operation transmitting means is inserted into the sheath of the treatment instrument insertion portion so as to be able to advance and retreat. The sheath and the operation transmission means are pulled out from the endoscope to the outside of the body, and their end portions are connected to the operation portion.
JP-A-57-117823

However, since the insertion portion of the endoscope treatment tool is long, it is difficult to handle. In addition, since the operation portion is provided at the end of the long insertion portion as described above, an assistant other than the endoscope operator is required for the operation portion of the treatment instrument. For this reason, it has been desired that the endoscope operator can perform not only the insertion / extraction of the insertion portion but also the operation of the distal treatment portion.
The present invention has been made in view of such circumstances, and an object thereof is to facilitate the operation of the treatment instrument with a simple configuration. Also, it is to enable an endoscope operator to operate the treatment tool.

An invention according to claim 1 of the present invention that solves the above-described problems is a treatment having a flexible sheath inserted through an endoscope inserted into a body and a treatment instrument channel provided in the endoscope. An endoscopic treatment instrument in which a treatment section for performing treatment on a living body is provided at the distal end of the instrument insertion section, and an operation transmitting means connected to the drive section of the treatment section is inserted into the sheath so as to be movable forward and backward; First driving means for driving the sheath along the treatment instrument channel; and second driving means capable of driving the sheath and the operation transmission means along the treatment instrument channel, the second driving means comprising: The endoscope treatment system includes a reel that winds up the treatment instrument for an endoscope, and a roller that presses against the treatment instrument for the endoscope together with the reel.
In this endoscope treatment system, the insertion portion of the endoscope treatment tool is stored in a state of being wound around a reel, and when used, the insertion portion is extended by a reel and a roller, and further, the first drive means is used for internal insertion. Send it to the tip of the endoscope. Further, when the endoscope treatment tool is removed, the insertion portion is pulled back by each driving means and wound around the reel.

According to a second aspect of the present invention, in the endoscopic treatment system according to the first aspect, the path length of the endoscopic treatment tool is set between the first driving means and the second driving means. It is provided with the detour route which increases.
In this endoscope treatment system, since the insertion portion drawn out from the second drive means is guided to the first drive means through the detour path, the length of the insertion portion that is actually inserted is larger than the distance between the drive means. Lengthens.

According to a third aspect of the present invention, in the endoscope treatment system according to the second aspect, the detour path has a curved tubular member that can be inserted through the sheath and the operation transmitting means.
In this endoscope treatment system, the bypass path is made of a curved tubular member, so that the path length of the insertion portion can be increased.

According to a fourth aspect of the present invention, in the endoscope treatment system according to any one of the first to third aspects, the feeding speed of the second driving means is matched with the feeding speed of the first driving means. A drive means interlocking mechanism is provided.
In this endoscope treatment system, when the insertion portion is drawn out by the first driving means, the driving means interlocking mechanism operates, and the feeding speed of the second driving means is matched with that of the first driving means. Thereby, the insertion part is driven at a constant speed.

According to a fifth aspect of the present invention, in the endoscope treatment system according to the fourth aspect of the present invention, a differential mechanism is provided that makes the second driving means differential with respect to the first driving means.
In this endoscope treatment system, when the differential mechanism is driven, the second drive means can be made to differential with respect to the first drive means. For example, the second drive means can be driven with the first drive means stopped, or the first drive means can be driven with the second drive means stopped.

The invention according to claim 6 is the endoscope treatment system according to any one of claims 1 to 5, wherein the operation transmitting means protrudes from a proximal end portion of the sheath, and the protruding portion includes the An operation tube that is pressed against the second driving means is attached.
In this endoscope treatment system, when only the second drive means is driven, the drive part of the treatment part can be driven.

The invention according to claim 7 is the endoscope treatment system according to any one of claims 1 to 7, wherein the first drive means is oriented in a direction along the treatment instrument channel. It has a turning means for turning to a first direction for driving and a second direction for rotating the sheath around an axis.
In this endoscope treatment system, when the first drive means is in the first direction, the insertion portion of the treatment instrument for endoscope can be inserted and removed. When the first drive means is in the second direction, the insertion portion can be rotated about the axis.

According to an eighth aspect of the present invention, in the endoscope treatment system according to the seventh aspect, the second driving means is provided so as to be rotatable around an axis of the treatment instrument channel.
In this endoscope treatment system, when the second driving means is rotated, the insertion portion is rotated together with the reel, and the treatment portion provided at the distal end of the insertion portion is rotated. As a result, the direction of the drive unit is adjusted to a position suitable for treatment.

The invention according to claim 9 is provided with a treatment section for performing treatment on a living body at a distal end of a treatment instrument insertion section that is inserted into a treatment instrument channel provided in the endoscope and has a flexible sheath, In an endoscope treatment instrument in which an operation transmitting means connected to a drive unit of a treatment unit is inserted into the sheath so as to be able to advance and retreat, a cassette detachably attachable to the endoscope, and provided in the cassette, First driving means for driving a sheath along the treatment instrument channel; and second driving means provided in the cassette and capable of driving the sheath and the operation transmitting means along the treatment instrument channel; The second driving means includes a reel that winds up the endoscope treatment tool, and a roller that presses against the endoscope treatment tool together with the reel. .
With this endoscope treatment tool, the insertion portion can be wound around a reel when not in use. In use, the second drive means is operated to feed out the insertion portion from the reel. The insertion portion fed out from the reel is further driven by the first driving means and guided to the distal end of the endoscope.

According to a tenth aspect of the present invention, in the endoscope treatment tool according to the ninth aspect, the path length of the endoscope treatment tool is between the first drive means and the second drive means. It is characterized by having a detour route that increases
In this endoscope treatment tool, since the detour path is formed of a curved tubular member, the path length of the insertion portion can be increased, and the distance between the driving means can be shortened accordingly.

According to an eleventh aspect of the present invention, in the endoscope treatment instrument according to the ninth or tenth aspect, a driving means interlocking mechanism that matches the feeding speed of the second driving means with the feeding speed of the first driving means. Is provided.
In this endoscopic treatment tool, when the insertion portion is extended by the first drive means, the drive means interlocking mechanism is activated to make the extension speed of the second drive means coincide with the first drive means. Thereby, the insertion part is driven at a constant speed.

According to a twelfth aspect of the present invention, in the endoscope treatment instrument according to the eleventh aspect, a differential mechanism is provided for making the second driving means differential with respect to the first driving means. .
In this endoscopic treatment instrument, when the differential mechanism is driven, the second drive means can be made to differential with respect to the first drive means. For example, when the treatment section of the endoscope treatment tool is driven by the second drive means, only the drive section of the treatment section can be driven by the differential mechanism.

  According to the present invention, the first driving means and the second driving means are provided, and when the endoscope treatment tool is automatically inserted and removed or the driving portion is driven automatically, the second driving means is provided. In addition, since the reel including the roller for winding the insertion portion and the roller is configured, the insertion portion can be easily handled with a simple configuration. Further, by controlling the drive of the first drive means and the second drive means, it becomes possible to automatically and electrically operate the endoscope treatment tool including the drive of the treatment section drive section. Therefore, the operation by the endoscope operator becomes possible, and the procedure can be performed accurately and quickly.

The best mode for carrying out the invention will be described in detail with reference to the drawings.
FIG. 1 shows a schematic configuration of an endoscope treatment system according to the first embodiment.
As shown in FIG. 1, the endoscope treatment system is configured by inserting an endoscope treatment tool (treatment tool) 2 through an endoscope 1.
The endoscope 1 has an operation unit 3 that is operated by an endoscope operator such as a practitioner, and a flexible insertion unit 4 that is inserted into the body is provided at the distal end of the operation unit 3. At the distal end of the insertion portion 4, an imaging device (not shown), an illumination optical system, and the like are provided, and a distal end opening 6 of a treatment instrument channel 5 through which the treatment instrument 2 is inserted is formed. The treatment instrument channel 5 penetrates the endoscope 1 from the distal end of the insertion section 4 to the proximal end of the operation section 3, and the insertion port 8 for inserting the treatment instrument 2 on the proximal end side of the operation section 3. Is formed. A storage device 10 is attached to the proximal end of the operation unit 3.
On the outer peripheral surface of the operation unit 3, a switch 11 that performs suction, air supply, illumination switching, and the like, and a knob (not shown) that changes the tip of the insertion unit 4 are provided. A universal cord 13 connected to the control device is connected to the side of the operation unit 3.

The treatment instrument 2 is a grasping forceps in which a distal treatment section 22 is provided at the distal end of a flexible treatment instrument insertion section 21.
The distal treatment section 22 has a support member 23, and a pair of grip pieces 24 are rotatably supported by the support member 23 by a shaft 25. The gripping pieces 24 are arranged to face each other so that the teeth are engaged with each other, and each of them is connected to a link mechanism (not shown).
The treatment instrument insertion portion 21 is inserted into the treatment instrument channel 5 and has a sheath 26 connected to the distal treatment section 22. The sheath 26 is formed of a tightly wound coil, and a long and flexible operation wire 27 serving as an operation transmission means is inserted therein so as to be able to advance and retract.
The distal end of the operation wire 27 is connected to the pair of gripping pieces 24 via a link mechanism. Further, the operation wire 27 protrudes from the proximal end portion of the long sheath 26, and an operation tube 28 is attached to the protruding portion of the operation wire 27. The operation tube 28 constituting the operation transmission means together with the operation wire 27 has substantially the same outer diameter as the sheath 26. The distal end of the operation tube 28 is connected to the proximal end portion of the sheath 26 via an elastic member 29.

The proximal end portion of the operation tube 28 is wound around the reel 30 of the storage device 10. Further, a fixing member 31 is attached to the proximal end of the operation tube 28. The fixing member 31 is attached to the outer peripheral surface of the reel 30 in the storage device 10, and the base end of the operation tube 28 is fixed to a predetermined position of the reel 30 by the fixing member 31.
The reel 30 has a substantially cylindrical shape, and the treatment instrument insertion portion 21 is wound around the outer peripheral surface thereof. The rotation shaft 32 of the reel 30 is rotatably supported by the cassette 33 of the storage device 10.

Such a treatment instrument 2 is automatically and electrically driven by a first drive unit 35 provided in the operation unit 3 of the endoscope 1 and a second drive unit 36 provided in the storage device 10. It has become so.
The first drive means 35 is disposed in the widened portion 5 a on the proximal end side of the treatment instrument channel 5. The first driving means 35 has a pair of rollers 37 and 38 arranged so as to sandwich the treatment instrument insertion portion 21. The outer peripheral surfaces of the rollers 37 and 38 are in pressure contact with the treatment instrument insertion portion 21. The rotation shafts 39 and 40 of the rollers 37 and 38 are arranged so as to be substantially orthogonal to the length direction of the treatment instrument channel 5 and in parallel. Each rotary shaft 39, 40 is rotatably supported by the endoscope 1 by a bearing (not shown) or the like. A first motor 42 is connected to the rotation shaft 39 via a transmission mechanism 41. The transmission mechanism 41 includes a gear that reduces the rotation of the first motor 42 to a rotation speed suitable for driving the treatment instrument 2. The first motor 42 is a motor with a brake, and is electrically connected to the control unit 43. Note that the roller 38 rotates in accordance with the rotation of the roller 37.

  The second drive means 36 includes the reel 30 and a roller 45 arranged so as to sandwich the treatment instrument insertion portion 21 together with the reel 30. The roller 45 is smaller than the diameter of the reel 30 and is in pressure contact with the treatment instrument insertion portion 21 at the outer peripheral surface thereof. The width of the outer peripheral surface of the roller 45 is substantially equal to the width of the outer peripheral surface of the reel 30. The rotation shaft 46 of the roller 45 is rotatably supported by the storage device 10 so as to be parallel to the rotation shaft 32 of the reel 30. The rotation shaft 46 of the roller 45 is connected to the second motor 48 via the transmission mechanism 47. The transmission mechanism 47 is composed of a gear that decelerates the rotation of the second motor 48 to a rotation speed suitable for driving the treatment instrument insertion portion 21. And the treatment tool insertion part 21 is driven by rotating the reel 30. The second motor 48 is electrically connected to the control unit 43.

  The control unit 43 is provided in the operation unit 3 of the endoscope 1 and is a device that controls the driving amount and driving direction of the motors 42 and 48. In this embodiment, the control unit 43 selects the switch 11 of the operation unit 3 of the endoscope 1 to energize the motors 42 and 48 with current from the power source. Specifically, in the first mode in which the treatment instrument insertion portion 21 is inserted into and removed from the treatment instrument channel 5, the first drive means 35 is stopped while the treatment instrument insertion section 21 is inserted, and only the second drive means 36 is used. The second mode for driving the can be selected.

Next, the operation of this endoscope treatment system will be described.
When the treatment instrument 2 is inserted into the endoscope 1 and the distal treatment section 22 is projected from the distal end of the endoscope 1, the switch 11 is operated to drive the first drive means 35 and the second drive means 36 in synchronization. Let The second drive unit 36 rotates the roller 45 in a direction in which the treatment instrument insertion portion 21 is sent to the distal end side of the endoscope 1. The reel 30 rotates in accordance with the rotation of the roller 45, and the treatment instrument insertion portion 21 wound around the reel 30 is drawn out from the reel 30. The treatment instrument insertion portion 21 fed out from the reel 30 moves forward along the treatment instrument channel 5 and is guided to the first drive means 35 disposed in the widened portion 5a. The first driving means 35 rotates the pair of rollers 37 and 38 at the same speed as the roller 45 of the second driving means 36 and sends the treatment instrument insertion portion 21 to the distal end side. The unit 21 is driven to the distal end side of the endoscope 1. When the endoscope operator confirms that the distal treatment section 22 of the treatment instrument 2 protrudes from the distal end of the endoscope 1 by a predetermined length, the endoscope operator operates the switch 11 to stop the driving means 35 and 36. At this time, the pair of rollers 37, 38 of the first driving means 35 is in pressure contact with the sheath 26, and the roller 45 of the second driving means 36 and the reel 30 are in pressure contact with the operation tube 28.

When opening the pair of grasping pieces 24 of the distal treatment section 22, the endoscope operator operates the switch 11 to select the second mode. The controller 43 brakes the first motor 42 of the first drive means 35 and operates the second drive means 36 with the sheath 26 fixed. The transmission mechanism 47 and the second motor 48 drive the roller 45 at a smaller rotational speed than in the first mode. When the roller 45 and the reel 30 driven thereby advance the operation tube 28, the operation wire 27 attached to the operation tube 28 moves forward, and a pair of grips connected to the operation wire 27 via a link mechanism. The piece 24 opens. When the roller 45 is rotated in the reverse direction, the operation tube 28 is retracted so as to be wound around the reel 30, and the pair of gripping pieces 24 are closed.
When the treatment instrument 2 is removed, in the first mode, the first drive means 35 and the second drive means 36 are driven in the opposite direction to that during insertion while being synchronized. The operation tube 28 and the sheath 26 are sequentially wound around the reel 30.

In this embodiment, since the treatment instrument insertion portion 21 is wound around the reel 30, the treatment instrument 2 can be compactly assembled and the operability is improved. At this time, since the driving means for inserting and removing the treatment instrument 2 includes the reel 30, the mechanism can be simplified. Furthermore, the treatment instrument insertion portion 21 can be reliably wound and fed out.
Further, the first drive means 35 and the second drive means 36 are provided so that the treatment instrument 2 can be inserted and removed when both the drive means 35 and 36 are driven in synchronism with each other. When the driving means 36 is differentiated, the distal treatment section 22 can be operated, so that the endoscope operator can operate the treatment instrument 2.
Further, since the base end portion of the operation tube 28 is fixed to the reel 30, the operation tube 28 is prevented from slipping and the treatment instrument insertion portion 21 can be smoothly wound and fed out.

In addition, it is good also as an endoscope treatment system as shown in FIG. In this endoscope treatment system, the treatment instrument 50 includes the storage device 10, and the storage device 10 is detachably attached to the endoscope 1. In this case, a mounting portion 51 that is engaged with the endoscope 1 is provided at the distal end of the storage device 10. A concave portion 52 for engaging the attachment portion 51 is provided at the proximal end portion of the operation portion 3 of the endoscope 1.
A first drive unit 35, a second drive unit 36, and a control unit 43 are disposed in the storage device 10. The housing device 10 is provided with an electric terminal (not shown) so that electric power is supplied to the control unit 43 from the endoscope 1 side.
In such an endoscope treatment system, the same operations and effects as described above can be obtained. Furthermore, the treatment tool 50 can be easily replaced.

  In FIG. 2, the recess 52 may be formed in an annular shape, and the treatment instrument insertion portion 21 may pass through the respective axes of the endoscope 1 and the storage device 10. In this case, the storage device 10 can be rotated around the axis of the treatment instrument channel 5. When the storage device 10 is rotated, the treatment instrument insertion portion 21 fixed to the reel 30 rotates around the axis, and the distal treatment portion 22 protruding from the distal end of the endoscope 1 also rotates. If comprised in this way, it will become possible for the endoscope operator to adjust the direction of the front-end | tip treatment part 22 by rotating the accommodating apparatus 10 manually, and a procedure will become easy.

Next, a second embodiment of the present invention will be described with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as 1st Embodiment. In addition, overlapping description is omitted.
As shown in FIG. 3, the endoscope treatment system has first drive means 55 in the widened portion 5 a of the treatment instrument channel 5.
The first driving means 55 has a roller support portion 56, and two rollers 37 and 38 are rotatably supported on the roller support portion 56. The rotation shafts 39 and 40 of the rollers 37 and 38 are arranged in parallel, and the treatment instrument insertion portion 21 (sheath 26) is sandwiched between the outer peripheral portions of the rollers 37 and 38 while being pressed. The rotation shaft 40 of the roller 38 is connected to the first motor 57 via the transmission mechanism 41.
The roller support portion 56 is formed with a slit 58 through which the treatment instrument insertion portion 21 is inserted substantially in the center. The slit 58 extends from the front end surface of the roller support portion 56 to the base end surface, and opens on one side surface (front side in FIG. 3) of the roller support portion 56. Further, the other side surface (the back side in FIG. 3) corresponding to the bottom of the slit 58 is formed with a notch 59 by a predetermined length from the front end surface side. The predetermined length is a length exceeding the rollers 38 from the front end surface of the roller support portion 56.

Such first driving means 55 is rotatably supported by the deflecting means 60 in the widened portion 5a of the endoscope.
The turning means 60 has two rotating shafts 61 and 62 attached so as to sandwich the roller support portion 56 therebetween. The rotary shafts 61 and 62 are arranged coaxially, and the axis passes through the centers of the two rollers 37 and 38. A turning motor 64 is connected to the rotating shaft 62 via a transmission mechanism 63. The turning motor 64 is connected to the control unit 43.
The control unit 43 drives the first mode, the second mode, and the turning unit 60 so that the first driving unit 55 drives the treatment instrument insertion unit 21 along the treatment instrument channel 5. The first mode, or the third mode in which the direction of the first driving means 55 is changed to the second direction changed by approximately 90 degrees from the first direction, can be executed.

  The treatment instrument insertion portion 21 of the treatment instrument 2 has a sheath 26, and an operation wire 27 is inserted into the sheath 26 so as to freely advance and retract. As shown in FIG. 4, the operation wire 27 has a first wire 65 passed through the sheath 26. The distal end portion of the first wire 65 is connected to the link mechanism of the distal treatment section 22 (see FIG. 1). A rotation connecting portion 66 is provided at the proximal end portion of the first wire 65. The rotation connecting portion 66 includes an engagement protrusion 67 attached to the first wire 65 and a housing portion 68 that covers the engagement protrusion 67 rotatably. A distal end portion of the second wire 69 is connected to the accommodating portion 68. The proximal end portion of the second wire 69 protrudes from the proximal end portion of the sheath 26 to which an operation tube 28 is attached.

This endoscope treatment system can automatically and electrically rotate the distal treatment section 22 around its axis.
That is, the endoscope operator operates the switch 11 to select the third mode. The control unit 43 operates the diverting means 60 and rotates the first driving means 55 by 90 degrees from the first direction to change the direction in the second direction. As a result, as shown in FIG. 5, the treatment instrument insertion portion 21 is disposed so as to pass through the notch 59 of the roller support portion 56 while the pair of rollers 37 and 38 are in pressure contact with the treatment instrument insertion portion 21. Thereafter, the controller 43 drives the motors 42 and 57 of the first drive means 55 to rotate the pair of rollers 37 and 38 in the same direction. As a result, the sheath 26 sandwiched between the pair of rollers 37 and 38 rotates around the axis. When the sheath 26 rotates, the distal treatment section 22 attached to the distal end of the sheath 26 rotates. The first wire 65 connected to the distal treatment section 22 also rotates. However, since the rotation connection portion 66 is provided at the proximal end portion of the first wire 65 and the rotation connection portion 66 rotates idly, the second wire 69 and the operation tube 28 do not rotate. Therefore, the treatment instrument insertion portion 21 is not twisted.
When the distal treatment section 22 is positioned in the rotational direction, the second mode is selected. After the first drive means 35 is turned in the first direction, the motors 42 and 57 are braked. Further, the second driving means 36 is driven, the operation tube 28 is moved forward and backward, and the pair of gripping pieces 24 are opened and closed.

  In this embodiment, since the treatment instrument insertion portion 21 is wound around the reel 30, the treatment instrument 2 can be compactly assembled and the operability is improved. Furthermore, since the first drive means 35 is configured to be rotatable by the turning means 60 and the sheath 26 is rotated so that the distal treatment section 22 is electrically rotated about the axis, the procedure is facilitated. At this time, since a part of the operation wire 27 is configured to be idled around the axis, it is possible to prevent the operation tube 28 from rotating when the distal treatment section 22 is rotated.

Next, a third embodiment of the present invention will be described with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as each said embodiment. In addition, overlapping description is omitted.
As shown in FIGS. 6 and 7, the endoscope treatment system includes an endoscope 1 and a treatment tool 2 configured to be detachable from the endoscope 1. In the storage device 10, the first drive means 71 and the second drive means 72 are arranged substantially in parallel, and both the drive means 71 and 72 are connected by a drive means interlocking mechanism 73. Furthermore, a detour path 74 that extends the path length of the treatment instrument insertion portion 21 between the first drive means 71 and the second drive means 72 is provided.

  The first drive means 71 has a first motor 75 having a transmission mechanism and a brake, and a gear 76 is attached to the output shaft of the first motor 75. A gear 77 and a gear 78 are meshed with the gear 76. Among these, the gear 77 is attached to one end of the rotating shaft 79. The rotating shaft 79 is rotatably supported by the storage device 10, and a roller 38 is attached to the rotating shaft 79, and an interlocking gear 80 is attached to the other end. The interlocking gear 80 is meshed with the interlocking gear 81, and a roller 37 is attached to a rotation shaft 82 (see FIG. 6) of the interlocking gear 81.

A gear 78 meshed with the gear 76 on the first motor 75 side constitutes a drive means interlocking mechanism 73. This drive means interlocking mechanism 73 includes a differential gear (differential mechanism) 83. As the differential gear 83, for example, the one described in JP-A-7-267094 can be used.
Specifically, the gear 78 is attached to one end of the rotating shaft 84. The rotating shaft 84 is rotatably supported by the storage device 10, and a bevel gear 85 constituting a differential gear 83 is attached to the other end. A bevel gear 86 is disposed opposite to the bevel gear 85, and two bevel gears 87 and 88 are meshed with each of the bevel gears 85 and 86. The bevel gears 87 and 88 are rotatably supported by an external gear 96, and the external gear 96 is connected to a second motor 98 that constitutes the second drive means 72. Further, one end portion of the rotating shaft 89 of the second driving means 72 is attached to the bevel gear 86 of the differential gear 83. The rotating shaft 89 is rotatably supported by the storage device 10, and a roller 45 and an interlocking gear 90 are attached to the other end portion of the rotating shaft 89. The interlocking gear 90 is meshed with the interlocking gear 91. The interlocking gear 91 is attached to the rotating shaft 32 of the reel 30.

  The detour path 74 guides the treatment instrument insertion portion 21 fed from the roller 45 and the reel 30 of the second drive means 72 to the first drive means 71, and is a tube through which the treatment instrument insertion section 21 is inserted so as to freely advance and retract. Consists of. As shown in FIG. 6, the opening 74a on the proximal end side of the detour path 74 is disposed at a position facing the treatment instrument insertion section 21 pressed against the roller 45 and the reel 30, from which the detour path 74 is spirally wound. The opening 74 b at the other end is arranged at a position facing the pair of rollers 37 and 38 of the first driving means 71.

The operation of this endoscope treatment system will be described.
When the treatment instrument 2 is inserted, the first mode 75 is selected and the first motor 75 is driven to rotate. The first motor 75 rotates the bevel gear 85 of the differential gear 83, and the bevel gear 89 is reversely rotated via two bevel gears 87 and 88 meshing with the first gear 75. Along with this, the roller 45 connected to the bevel gear 89 rotates, and the reel 30 connected via the interlocking gears 90 and 91 is driven. As a result, the treatment instrument insertion portion 21 wound around the reel 30 is fed out. The treatment instrument insertion portion 21 drawn out from the reel 30 is guided to the opening 74a of the detour path 74, passes through the detour path 74 while being curved according to its shape, exits from the opening 74b, and is driven by the first drive means. 71 is introduced between a pair of rollers 37 and 38, where a driving force is applied again.
When opening and closing the pair of gripping pieces 24, the second mode is selected, the first motor 75 is braked, and the sheath 26 is fixed by the pair of rollers 37 and 38. At this time, the bevel gear 85 of the differential gear 83 connected to the first motor 75 is fixed. Thereafter, when the second motor 98 is rotated, the external gear 96 is rotated and the two bevel gears 87 and 88 are rotated. As described above, since the bevel gear 85 is fixed, only the bevel gear 86 is rotated, and the roller 45 and the reel 30 are rotated. The operation tube 28 advances and retreats according to the rotation direction of the roller 45, and the pair of grip pieces 24 connected to the operation tube 28 opens and closes.

According to this embodiment, since the treatment instrument insertion portion 21 is wound around the reel 30, the treatment instrument 2 can be compactly assembled, and the operability is improved.
Further, since the differential gear 83 is provided to control the insertion / extraction of the treatment instrument 2 and the driving of the distal treatment section 22, the driving mechanism can be made compact. In particular, when the treatment tool 2 is inserted / removed, it is driven by one motor, so that it is not necessary to perform control to rotate each motor synchronously as in the case of using a plurality of motors.
Further, since the detour path 74 is provided, the distance between the driving means 71 and 72 can be shortened, and the treatment instrument 2 can be downsized. If the detour path 74 is not provided, it is necessary to increase the distance between the first drive means 71 and the second drive means 72. This is because even when the treatment instrument 2 is slightly protruded from the distal end of the endoscope 1 or is largely protruded, the first driving means 71 is pressed against the sheath 26 and the second driving means 72 is operated. This is for making pressure contact with the tube 28. In the present embodiment, the path length of the treatment instrument insertion portion 21 is secured by inserting the detour path 74, and the linear distance between the driving means 71 and 72 can be shortened. Therefore, in the endoscope 1 in which the treatment instrument 2 can be automatically and electrically operated, the endoscope 1 can be reduced in size and the operability can be improved.

Next, a fourth embodiment of the present invention will be described with reference to the drawings. In addition, the same code | symbol is attached | subjected to the same component as each said embodiment. In addition, overlapping explanation is omitted.
As shown in FIGS. 8 to 10, the present embodiment relates to the form of a reel.
The reel 100 shown in FIG. 8 has a thin cylindrical shape, and a collar 101 for preventing the treatment instrument insertion portion 21 from falling off is formed outward in the radial direction. On the outer peripheral surface of the reel 100, a spiral groove 102 is carved. The depth of the groove 102 is equal to or less than the radius of the treatment instrument insertion portion 21, and the sheath 26 or the operation tube 28 is fitted into the groove 102.
In such a reel 100, since the treatment instrument insertion portion 21 is wound up spirally following the groove 102, the treatment instrument insertion portion 21 can be easily wound.

Moreover, the reel 105 shown in FIG. 9 is covered with a highly viscous member 106 on the outer peripheral surface in contact with the treatment instrument insertion portion 21. Such a member 106 is manufactured from, for example, a silicone resin.
In the reel 105, when the treatment instrument insertion portion 21 is wound, the friction generated between the treatment instrument insertion portion 21 and the member 106 can be increased, so that the treatment instrument insertion portion 21 is prevented from slipping. .

  Furthermore, the reel 107 shown in FIG. 10 has an outer peripheral surface covered with a highly viscous member 106, and a protrusion 108 is provided in a spiral shape. The height of the protruding portion 108 is equal to or less than the radius of the treatment instrument insertion portion 21, and the sheath 26 or the operation tube 28 is fitted in a groove defined by the protruding portion 108 and the member 106. The protrusion 108 may not be manufactured from a highly viscous material. Such a reel 107 combines the effects of both the reel 100 shown in FIG. 8 and the reel 105 shown in FIG.

The present invention is not limited to the above embodiments and can be widely applied.
For example, in the endoscope treatment system as shown in FIG. 2, the motors 42 and 48 and the control unit 43 of the driving means 35 and 36 may be provided on the endoscope 1 side. In this case, the output shafts of the motors 42 and 48 disposed on the endoscope 1 side are projected from the endoscope 1 and the output shafts are engaged with and disengaged from the rotation shafts 39 and 46 on the rollers 37 and 45 side. Configure freely. In such an endoscope treatment system, since the relatively inexpensive rollers 42 and 48 and the like are provided on the treatment tool 50 side, the cost of the treatment tool 50 can be reduced.

  Further, in the endoscope treatment system as shown in FIG. 7, the storage device 10 is configured to be detachable from the endoscope 1, and each drive means 71 and 72, the drive means interlocking mechanism 73 and the detour path 74 are stored. You may arrange | position in the apparatus 10. FIG. Further, the rotary shaft 79 and the rotary shaft 89 may be divided, and the motors 75 and 88 and the differential gear 83 may be arranged on the endoscope 1 side.

It is sectional drawing which shows the structure of the endoscope treatment system in embodiment of this invention. It is sectional drawing which shows the structure of the endoscope treatment system at the time of comprising an accommodation apparatus so that attachment or detachment is possible. It is sectional drawing which shows the case where the 1st drive means is comprised rotatably. It is a partially expanded sectional view which shows the structure of a treatment tool insertion part. It is sectional drawing explaining the state which changed the 1st drive means. It is a figure explaining arrangement | positioning of each drive means. It is a figure which shows the structure of each drive means, Comprising: It is an arrow line view of the axial direction of a treatment tool channel. It is sectional drawing which shows a reel. It is sectional drawing which shows a reel. It is sectional drawing which shows a reel.

Explanation of symbols

1 Endoscope 2,50 Treatment Tool (Endoscope Treatment Tool)
5 treatment instrument channel 21 treatment instrument insertion section 22 distal treatment section 24 grasping piece (drive section)
26 Sheath 27 Operation wire 28 Operation tube 30 Reel 33 Cassette 35, 71 First drive means 36, 72 Second drive means 45 Roller 60 Turning means 73 Drive means interlocking mechanism 74 Detour path 83 Differential gear (differential mechanism)

Claims (12)

An endoscope inserted into the body,
A treatment section for performing treatment on a living body is provided at the distal end of a treatment instrument insertion section that is inserted into a treatment instrument channel provided in the endoscope and has a flexible sheath, and is connected to a drive section of the treatment section. A treatment instrument for an endoscope in which an operation transmission means is inserted into the sheath so as to freely advance and retract;
First driving means for driving the sheath along the treatment instrument channel;
Second driving means capable of driving the sheath and the operation transmitting means along the treatment instrument channel;
An endoscope treatment system comprising: a reel that winds up the endoscope treatment tool; and a roller that presses the endoscope treatment tool together with the reel. .   The endoscopic treatment according to claim 1, further comprising a detour path that increases a path length of the endoscopic treatment tool between the first driving unit and the second driving unit. system.   The endoscope treatment system according to claim 2, wherein the bypass path includes a curved tubular member that can be inserted through the sheath and the operation transmission unit.   The endoscope according to any one of claims 1 to 3, further comprising a driving unit interlocking mechanism that matches a feeding speed of the first driving unit with a feeding speed of the second driving unit. Treatment system.   The endoscope treatment system according to claim 4, further comprising a differential mechanism that makes the second drive unit differential with respect to the first drive unit.   6. The operation tube according to claim 1, wherein the operation transmission means protrudes from a proximal end portion of the sheath, and an operation tube that is pressed against the second drive means is attached to the protruding portion. The endoscope treatment system according to one item.   The first drive means has direction changing means for changing the direction into a first direction for driving the sheath in a direction along the treatment instrument channel and a second direction for rotating the sheath around an axis. The endoscope treatment system according to any one of claims 1 to 7, wherein the endoscope treatment system is characterized in that   The endoscope treatment system according to claim 7, wherein the second drive means is provided so as to be rotatable around an axis of the treatment instrument channel. A treatment section for performing treatment on a living body is provided at the distal end of a treatment instrument insertion section that is inserted into a treatment instrument channel provided in the endoscope and has a flexible sheath, and is connected to a drive section of the treatment section. In the endoscopic treatment instrument in which the operation transmitting means is inserted into the sheath so as to be able to advance and retreat,
A cassette detachably attached to the endoscope;
First driving means provided in the cassette and driving the sheath along the treatment instrument channel;
Second driving means provided in the cassette and capable of driving the sheath and the operation transmitting means along the treatment instrument channel;
The second driving means includes a reel for winding the endoscope treatment instrument, and a roller that presses the endoscope treatment tool together with the reel. Ingredients.   The endoscope for an endoscope according to claim 9, further comprising a detour path for increasing a path length of the endoscope treatment tool between the first drive unit and the second drive unit. Treatment tool.   The endoscopic treatment instrument according to claim 9 or 10, further comprising a drive means interlocking mechanism that matches a feed speed of the second drive means with a feed speed of the first drive means. The endoscopic treatment instrument according to claim 11, further comprising a differential mechanism that makes the second driving unit differential with respect to the first driving unit.

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