JP2006192089A - Distal end part of endoscope to be inserted into large intestine - Google Patents

Distal end part of endoscope to be inserted into large intestine Download PDF

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JP2006192089A
JP2006192089A JP2005006978A JP2005006978A JP2006192089A JP 2006192089 A JP2006192089 A JP 2006192089A JP 2005006978 A JP2005006978 A JP 2005006978A JP 2005006978 A JP2005006978 A JP 2005006978A JP 2006192089 A JP2006192089 A JP 2006192089A
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distal end
endoscope
large intestine
outer diameter
end portion
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JP4648712B2 (en
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Teruo Ouchi
輝雄 大内
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Pentax Corp
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Abstract

<P>PROBLEM TO BE SOLVED: To provide a distal end part of an endoscope to be inserted into the large intestine to be hardly disengaged from a fold of the intestinal tract when the intestinal tract is straightened by hooking the distal end of an insertion part on the fold of the intestinal tract and pulling the distal end up to the hand side, permitting the insertion part to be easily and smoothly inserted into the large intestine. <P>SOLUTION: The distal end part of the endoscope to be inserted into the large intestine comprises an observation window 7 for taking in an optical image of a subject disposed on a distal end surface 5a of a distal end body 5 connected to the distal end of a bending part 2 which can be bent by the remote controlling. In the distal end of the endoscope, a guard part 6 is formed to project on the outer periphery of the distal end body 5. The guard part 6 has a larger outer diameter D6 than the outer diameter D2 of the bending part 2. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

この発明は大腸挿入用内視鏡の先端部に関する。   The present invention relates to a distal end portion of an endoscope for large intestine insertion.

大腸挿入用内視鏡は被検者の肛門から大腸内に挿入されるが、大腸を肛門側から辿ると、短い直腸を通過してＳ字結腸において小さな曲率半径で文字通りＳ字状にカーブして下向結腸に至り、さらに下向結腸から横行結腸に移行する部分でも９０°以上に屈曲している場合がほとんどである。   An endoscope for inserting a large intestine is inserted into the large intestine from the subject's anus. When the large intestine is traced from the anus side, it passes through a short rectum and literally curves in an S shape with a small radius of curvature in the sigmoid colon. In most cases, the portion that reaches the descending colon, and further transitions from the descending colon to the transverse colon is bent at 90 ° or more.

しかも、直腸以外の部分は体壁に固定されておらず、Ｓ字結腸等は外力で自由に伸縮したり形状が変わったりする場合が多いので、大腸内に無闇に内視鏡を押し込んでも腸管が奥へ伸ばされてしまうだけで内視鏡を大腸の深部へ挿入するのは困難である。   In addition, parts other than the rectum are not fixed to the body wall, and the sigmoid colon and the like often expand and contract freely or change shape due to external force. It is difficult to insert the endoscope into the deep part of the large intestine simply by extending the back.

そこで、内視鏡の挿入部をある程度まで腸管内に挿入したら、挿入部先端に形成されている湾曲部を遠隔操作により小さな曲率半径で屈曲させ、挿入部先端を腸管のヒダに引っ掛けて手元側に引き寄せることにより腸管をアコーディオンのように縮ませて直線状態にし、それを適宜繰り返すことで深部へ挿入するのが有力な挿入テクニックの一つである。   Therefore, after inserting the insertion portion of the endoscope into the intestinal tract to some extent, the bending portion formed at the distal end of the insertion portion is bent with a small radius of curvature by remote control, and the distal end of the insertion portion is hooked on the fold of the intestinal tract. One of the powerful insertion techniques is to make the intestinal tract shrink like an accordion by pulling it into a straight line, and then insert it deeply by repeating it appropriately.

そのようにして大腸内に挿入される大腸挿入用内視鏡の先端部は一般に、挿入部の前方の被写体の光像を取り込むための観察窓が挿入部の先端面に配置されている。そして、その挿入部の先端面の外縁から前方に突出する先端フードが設けられたものが多かったが（例えば、特許文献１）、近年は先端フードを設けないものが多くなっている（例えば、特許文献２）。
特開平１０−２４８７９２ 特開２００２−１２５９１５ In general, the distal end portion of the endoscope for inserting a large intestine inserted into the large intestine is generally provided with an observation window on the distal end surface of the insertion portion for capturing a light image of a subject in front of the insertion portion. And although there were many things which were provided with the tip hood which protrudes ahead from the outer edge of the tip face of the insertion part (for example, patent documents 1), in recent years many things which do not provide a tip hood are increasing (for example, Patent Document 2).
JP 10-248792 A JP2002-125915

従来の大腸挿入用内視鏡で上述のような挿入手技を行う際には、挿入部先端を腸管のヒダに引っ掛けて手元側に引き寄せると挿入部先端とヒダとの係合が滑って外れ、挿入操作を最初からやり直さなければならなくなって挿入に非常に時間がかかる場合が少なくない。   When performing the above insertion procedure with a conventional colonoscopy endoscope, when the distal end of the insertion portion is hooked on the fold of the intestinal tract and pulled toward the proximal side, the engagement between the distal end of the insertion portion and the fold slips off, In many cases, the insertion operation takes a long time because the insertion operation has to be performed again from the beginning.

そこで本発明は、挿入部の先端を腸管のヒダに引っ掛け手元側に引き寄せて腸管を直線化する際にヒダとの係合が外れ難く、挿入部を大腸内に容易かつ円滑に挿入することができる大腸挿入用内視鏡の先端部を提供することを目的とする。   Therefore, the present invention makes it easy to smoothly and smoothly insert the insertion portion into the large intestine when the distal end of the insertion portion is hooked on the fold of the intestinal tract and pulled toward the proximal side to straighten the intestinal tract. An object of the present invention is to provide a distal end portion of an endoscope for large intestine insertion.

上記の目的を達成するため、本発明の大腸挿入用内視鏡の先端部は、遠隔操作によって屈曲させることができる湾曲部の先端に連結された先端部本体の先端面に、被写体の光像を取り込むための観察窓が配置された大腸挿入用内視鏡の先端部において、湾曲部の外径より大きな外径を有する鍔状部を先端部本体の外周に突出形成したものである。   In order to achieve the above object, the distal end portion of the endoscope for large intestine insertion of the present invention has a light image of the subject on the distal end surface of the distal end portion body connected to the distal end of the bending portion that can be bent by remote operation. In the distal end portion of the endoscope for large intestine insertion in which an observation window for taking in is arranged, a hook-like portion having an outer diameter larger than the outer diameter of the curved portion is formed to protrude from the outer periphery of the distal end portion main body.

なお、鍔状部が先端部本体の軸線方向に間隔をあけて複数形成されていてもよく、その場合に、複数の鍔状部のうち前方に位置する鍔状部の外径が後方に位置する鍔状部の外径より小さく形成されていてもよい。   Note that a plurality of hook-shaped portions may be formed at intervals in the axial direction of the tip body, and in this case, the outer diameter of the hook-shaped portion positioned in the front among the plurality of hook-shaped portions is positioned rearward. You may form smaller than the outer diameter of the bowl-shaped part to do.

また、鍔状部に、周方向に間隔をあけて複数の凹部が形成されていてもよく、鍔状部が先側へ漸次外径が小さくなるテーパ状に形成されていてもよい。   In addition, a plurality of recesses may be formed in the flange-like portion at intervals in the circumferential direction, or the flange-like portion may be formed in a tapered shape in which the outer diameter gradually decreases toward the front side.

本発明の大腸挿入用内視鏡の先端部によれば、湾曲部の外径より大きな外径を有する鍔状部を先端部本体の外周に突出形成したことにより、挿入部の先端を腸管のヒダに引っ掛け手元側に引き寄せて腸管を直線化する際に鍔状部がヒダによく引っ掛かってヒダとの係合が外れ難く、挿入部を大腸内に容易かつ円滑に挿入することができる。   According to the distal end portion of the endoscope for large intestine insertion of the present invention, the hook-shaped portion having an outer diameter larger than the outer diameter of the curved portion is formed to protrude from the outer periphery of the distal end portion main body, so that the distal end of the insertion portion is connected to the intestinal tract. When the intestinal tract is hooked on the fold and drawn into the proximal side to straighten the intestinal tract, the hook-like portion is easily hooked on the fold and is not easily disengaged from the fold, so that the insertion portion can be easily and smoothly inserted into the large intestine.

遠隔操作によって屈曲させることができる湾曲部の先端に連結された先端部本体の先端面に、被写体の光像を取り込むための観察窓が配置された大腸挿入用内視鏡の先端部において、湾曲部の外径より大きな外径を有する鍔状部を先端部本体の外周に突出形成する。   At the distal end of the endoscope for large intestine insertion, where the observation window for capturing the optical image of the subject is arranged on the distal end surface of the distal end main body connected to the distal end of the curved portion that can be bent by remote operation A hook-like part having an outer diameter larger than the outer diameter of the part protrudes from the outer periphery of the tip body.

図面を参照して本発明の実施例を説明する。
図３は大腸挿入用内視鏡の外観図であり、可撓性の挿入部１の先端付近に形成された湾曲部２は、挿入部１の基端に連結された操作部３において操作ノブ４を操作することにより、二点鎖線で示されるように、任意の方向に任意の角度だけ屈曲させることができる。 Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 is an external view of the endoscope for inserting a large intestine. A bending portion 2 formed near the distal end of the flexible insertion portion 1 is operated by an operation knob in the operation portion 3 connected to the proximal end of the insertion portion 1. By operating 4, it can be bent at an arbitrary angle in an arbitrary direction as indicated by a two-dot chain line.

湾曲部２の先端に連結された硬質の短円柱状の先端部本体５には、対物光学系や固体撮像素子等各種の機能要素が内蔵されており、先端部本体５によって挿入部１の最先端部分が構成されている。そして先端部本体５の外周には、鍔状部６が全周にわたって突出形成されている。   The rigid short cylindrical tip body 5 connected to the tip of the bending portion 2 incorporates various functional elements such as an objective optical system and a solid-state imaging device. The tip portion is configured. A flange-like portion 6 is formed on the outer periphery of the tip portion main body 5 so as to protrude over the entire periphery.

図１と図２は、挿入部１の最先端部付近の側面部分断面図と斜視図であり、被写体の光像を取り込むための観察窓７や照明窓８等が先端部本体５の先端面５ａに配置されていて、挿入部１の前方を内視鏡観察することができる。   FIGS. 1 and 2 are a side sectional view and a perspective view of the vicinity of the most distal portion of the insertion portion 1, and an observation window 7 and an illumination window 8 for capturing a light image of a subject are provided on the distal end surface of the distal end body 5. It is arrange | positioned at 5a and can observe the front of the insertion part 1 by endoscope.

鍔状部６は、外径寸法Ｄ６が湾曲部２の外径（厳密には、湾曲部２の先端寄りの部分の最大外径）Ｄ２より大きな円環状に形成されており、略半円形の断面形状で先端部本体５の外周面から滑らかなアール曲線を描いて例えば１〜３ｍｍ程度突出する状態に形成されている。ただし、鍔状部６を半円形以外の断面形状に形成してもよい。   The bowl-shaped portion 6 is formed in an annular shape having an outer diameter dimension D6 larger than the outer diameter of the curved portion 2 (strictly, the maximum outer diameter of the portion near the tip of the curved portion 2) D2, and is substantially semicircular. The cross-sectional shape is formed so as to project a smooth rounded curve from the outer peripheral surface of the tip body 5 and project, for example, about 1 to 3 mm. However, the hook-shaped portion 6 may be formed in a cross-sectional shape other than the semicircular shape.

図４は、上述のように構成された実施例の大腸挿入用内視鏡を大腸内に挿入している状態を示しており、例えば腸管のカーブ部分において、鍔状部６が腸管内壁部のヒダ１００を通過した位置で遠隔操作により湾曲部２を屈曲させ、鍔状部６をヒダ１００の裏面部分に係合させる。   FIG. 4 shows a state where the large intestine insertion endoscope of the embodiment configured as described above is inserted into the large intestine. For example, in the curved portion of the intestinal tract, the bowl-shaped portion 6 is the inner wall of the intestinal tract. The bending portion 2 is bent by remote control at a position passing through the fold 100, and the hook-shaped portion 6 is engaged with the back surface portion of the fold 100.

そして、図５に示されるように挿入部１を手元側に引き寄せる操作を行えば、鍔状部６に係合するヒダ１００が肛門側に引き寄せられることにより腸管が縮んで真っ直ぐな状態になるので、引き続き適宜の回転操作等も行ってから挿入部１を押し込み操作することで、大腸深部への挿入を容易に行うことができる。   If the operation of pulling the insertion portion 1 toward the hand side as shown in FIG. 5 is performed, the intestinal tract 100 is pulled to the anal side and the intestinal tract contracts and becomes straight. Then, the insertion portion 1 can be pushed in and then inserted into the deep part of the large intestine by performing an appropriate rotation operation and the like.

このような動作に際して、本発明においては、湾曲部２の外径Ｄ２より大きな外径Ｄ６で先端部本体５から突設された鍔状部６がヒダ１００によく引っ掛かって、挿入部１を手元側に引き寄せる操作をしたときにヒダ１００との係合が簡単には外れないので、腸管を迅速に真っ直ぐな状態に縮めることができる。   In such an operation, in the present invention, the hook-like portion 6 protruding from the distal end main body 5 with an outer diameter D6 larger than the outer diameter D2 of the bending portion 2 is well caught by the fold 100, and the insertion portion 1 is held at hand. Since the engagement with the fold 100 is not easily disengaged when an operation of pulling it toward the side is performed, the intestinal tract can be quickly shortened to a straight state.

図６は本発明の第２の実施例の大腸挿入用内視鏡の先端部を示しており、先端部本体５の軸線方向に間隔をあけて複数の鍔状部６を形成したものである。このように構成することによりヒダ１００に対する引っ掛かり能がより向上し、先端部本体５の外周面からの鍔状部６の突出高を例えば０．５〜２ｍｍ程度に低くすることができる。   FIG. 6 shows the distal end portion of the endoscope for large intestine insertion according to the second embodiment of the present invention, in which a plurality of bowl-shaped portions 6 are formed at intervals in the axial direction of the distal end portion main body 5. . With this configuration, the catching ability with respect to the fold 100 is further improved, and the protruding height of the hook-like portion 6 from the outer peripheral surface of the tip portion main body 5 can be lowered to, for example, about 0.5 to 2 mm.

図７は本発明の第３の実施例の大腸挿入用内視鏡の先端部を示しており、第２の実施例と同様に先端部本体５の軸線方向に間隔をあけて複数の鍔状部６ａ，６ｂが形成されている。   FIG. 7 shows the distal end portion of the endoscope for large intestine insertion according to the third embodiment of the present invention. Similar to the second embodiment, a plurality of hook-like shapes are spaced apart in the axial direction of the distal end portion main body 5. Portions 6a and 6b are formed.

ただし、この実施例においては二つの鍔状部６ａ，６ｂのうちの前方に位置する鍔状部６ａの外径が後方に位置する鍔状部６ｂの外径より小さく形成されている（即ち、Ｄ６ａ＜Ｄ６ｂ）ことにより、腸管内への挿入時にヒダ１００に対する鍔状部６ａ，６ｂの引っ掛かりが小さくなっている。   However, in this embodiment, the outer diameter of the hook-shaped part 6a located at the front of the two hook-shaped parts 6a, 6b is formed smaller than the outer diameter of the hook-shaped part 6b positioned at the rear (that is, Due to D6a <D6b), the hooks 6a and 6b are less likely to catch on the fold 100 when inserted into the intestinal tract.

図８と図９は、本発明の第４の実施例の大腸挿入用内視鏡の先端部の側面図とそのIX−IX断面図であり、鍔状部６の外周部に周方向に間隔をあけて複数の凹部９が形成されている。   8 and 9 are a side view and a cross-sectional view of the distal end portion of the endoscope for large intestine insertion according to the fourth embodiment of the present invention, and its IX-IX sectional view. A plurality of recesses 9 are formed with a gap.

このように構成することにより、鍔状部６をヒダ１００に引っ掛けて軸線周りに捩じる操作を加えて腸管を回動させ、腸管内への挿入をより容易に行える場合がある。なお、凹部９の数は実用上３〜１２個程度の範囲にあるのが望ましい。   With such a configuration, there is a case where the operation of hooking the hook-like portion 6 on the fold 100 and twisting it around the axis is added to rotate the intestinal tract so that it can be inserted into the intestinal tract more easily. In practice, the number of recesses 9 is preferably in the range of about 3 to 12.

図１０は本発明の第５の実施例の大腸挿入用内視鏡の先端部を示しており、鍔状部６が先側へ漸次外径が小さくなるテーパ状に形成されており、このように構成することによって腸管内への挿入をよりスムーズに行うことができる。また、第４の実施例と同様の凹部９が、鍔状部６の先端部本体５の表面にまたがって形成されている。   FIG. 10 shows the distal end portion of an endoscope for large intestine insertion according to the fifth embodiment of the present invention, and the hook-like portion 6 is formed in a tapered shape whose outer diameter gradually decreases toward the front side. With this configuration, insertion into the intestinal tract can be performed more smoothly. A recess 9 similar to that of the fourth embodiment is formed across the surface of the tip body 5 of the bowl-shaped portion 6.

本発明の第１の実施例の大腸挿入用内視鏡の先端部の側面部分断面図である。It is side surface fragmentary sectional view of the front-end | tip part of the endoscope for large intestine insertion of the 1st Example of this invention. 本発明の第１の実施例の大腸挿入用内視鏡の先端部の斜視図である。It is a perspective view of the front-end | tip part of the endoscope for large intestine insertion of the 1st Example of this invention. 本発明の第１の実施例の大腸挿入用内視鏡の全体構成を示す外観図である。1 is an external view showing an overall configuration of a large intestine insertion endoscope according to a first embodiment of the present invention. 本発明の第１の実施例の大腸挿入用内視鏡の使用状態の略示図である。It is a schematic diagram of the use condition of the endoscope for large intestine insertion of the 1st example of the present invention. 本発明の第１の実施例の大腸挿入用内視鏡の使用状態の略示図である。It is a schematic diagram of the use condition of the endoscope for large intestine insertion of the 1st example of the present invention. 本発明の第２の実施例の大腸挿入用内視鏡の先端部の側面部分断面図である。It is side surface fragmentary sectional view of the front-end | tip part of the endoscope for large intestine insertion of the 2nd Example of this invention. 本発明の第３の実施例の大腸挿入用内視鏡の先端部の側面部分断面図である。It is a side surface fragmentary sectional view of the front-end | tip part of the endoscope for large intestine insertion of the 3rd Example of this invention. 本発明の第４の実施例の大腸挿入用内視鏡の先端部の側面図である。It is a side view of the front-end | tip part of the endoscope for large intestine insertion of the 4th Example of this invention. 本発明の第４の実施例の鍔状部の図８におけるIX−IX断面図である。It is IX-IX sectional drawing in FIG. 8 of the bowl-shaped part of the 4th Example of this invention. 本発明の第５の実施例の大腸挿入用内視鏡の先端部の側面図である。It is a side view of the front-end | tip part of the endoscope for large intestine insertion of the 5th Example of this invention.

符号の説明Explanation of symbols

１ 挿入部
２ 湾曲部
５ 先端部本体
５ａ 先端面
６ 鍔状部
７ 観察窓
９ 凹部
１００ ヒダ
Ｄ２ 湾曲部の外径
Ｄ６ 鍔状部の外径 DESCRIPTION OF SYMBOLS 1 Insertion part 2 Bending part 5 Tip part main body 5a Tip end face 6 Gutter-like part 7 Observation window 9 Recessed part 100 Deflection D2 Outer diameter of curved part D6 Outer diameter of gutter-like part

Claims (5)

遠隔操作によって屈曲させることができる湾曲部の先端に連結された先端部本体の先端面に、被写体の光像を取り込むための観察窓が配置された大腸挿入用内視鏡の先端部において、
上記湾曲部の外径より大きな外径を有する鍔状部を上記先端部本体の外周に突出形成したことを特徴とする大腸挿入用内視鏡の先端部。 In the distal end portion of the endoscope for large intestine in which an observation window for capturing a light image of a subject is arranged on the distal end surface of the distal end main body connected to the distal end of the bending portion that can be bent by remote operation,
A distal end portion of an endoscope for large intestine insertion, characterized in that a bowl-shaped portion having an outer diameter larger than the outer diameter of the curved portion is formed to protrude from the outer periphery of the distal end portion main body. 上記鍔状部が上記先端部本体の軸線方向に間隔をあけて複数形成されている請求項１記載の大腸挿入用内視鏡の先端部。   The distal end portion of the endoscope for large intestine insertion according to claim 1, wherein a plurality of the hook-shaped portions are formed at intervals in the axial direction of the distal end portion main body. 上記複数の鍔状部のうち前方に位置する鍔状部の外径が後方に位置する鍔状部の外径より小さく形成されている請求項２記載の大腸挿入用内視鏡の先端部。   The distal end portion of the endoscope for large intestine insertion according to claim 2, wherein an outer diameter of the hook-shaped portion positioned forward among the plurality of hook-shaped portions is smaller than an outer diameter of the hook-shaped portion positioned rearward. 上記鍔状部に、周方向に間隔をあけて複数の凹部が形成されている請求項１、２又は３記載の大腸挿入用内視鏡の先端部。   The distal end portion of the endoscope for large intestine insertion according to claim 1, 2 or 3, wherein a plurality of concave portions are formed at intervals in the circumferential direction in the bowl-shaped portion. 上記鍔状部が先側へ漸次外径が小さくなるテーパ状に形成されている請求項１、２、３又は４記載の大腸挿入用内視鏡の先端部。   The distal end portion of the endoscope for large intestine insertion according to claim 1, 2, 3, or 4, wherein the flange-like portion is formed in a tapered shape in which the outer diameter gradually decreases toward the front side.
JP2005006978A 2005-01-14 2005-01-14 End of endoscope for large intestine insertion Expired - Fee Related JP4648712B2 (en)

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US11/331,168 US20060173241A1 (en) 2005-01-14 2006-01-13 Front end structure of endoscope
DE102006002052A DE102006002052A1 (en) 2005-01-14 2006-01-16 Front end structure for endoscope insertable into the colon, includes number of protrusions on the bendable tip of the endoscope that enable endoscope to be hooked to crease in colon to enable advancement of endoscope deeply into colon

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