JP2006246984A - Distal end part of endoscope - Google Patents

Distal end part of endoscope Download PDF

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JP2006246984A
JP2006246984A JP2005064713A JP2005064713A JP2006246984A JP 2006246984 A JP2006246984 A JP 2006246984A JP 2005064713 A JP2005064713 A JP 2005064713A JP 2005064713 A JP2005064713 A JP 2005064713A JP 2006246984 A JP2006246984 A JP 2006246984A
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distal end
treatment instrument
endoscope
fixing member
pressing
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Japanese (ja)
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Motoko Kawamura
素子 川村
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Pentax Corp
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Pentax Corp
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Abstract

<P>PROBLEM TO BE SOLVED: To provide a safe distal end part of an endoscope in which only a catheter can be removed from a treating instrument insertion channel of the endoscope so that the distal end part of a guide wire does not come out from pancreaticobiliary ducts or the like using the catheter in a general shape without the risk of damaging or closing the pancreaticobiliary ducts or being incapable of removal from the pancreaticobiliary ducts or the like. <P>SOLUTION: A pressurizing and fixing member 6 for pressurizing and fixing a passing object (30) passing through the exit opening 3b of the treating instrument insertion channel 3 is arranged near the exit opening 3b of the treating instrument insertion channel 3 arranged at the distal end 2 of the insertion part 1 of the endoscope so as to be driven forward and backward by a remote operation from the proximal end side of the insertion part 1. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

この発明は内視鏡の先端部に関する。   The present invention relates to a distal end portion of an endoscope.

膵胆管等のような細い管腔内にカテーテルを挿入して、そのカテーテルをさらに別のカテーテルに交換するカテーテル交換術等を行う際には、先ずガイドワイヤが挿通配置されたカテーテルの先端を内視鏡の処置具挿通チャンネルを経由して膵胆管等に挿入し、次いでガイドワイヤの先端部分だけを膵胆管内に残してカテーテルを抜去し、そのガイドワイヤをガイドにして別のカテーテルを挿入する手技がとられる。   When a catheter is inserted into a thin lumen such as the pancreaticobiliary duct and the catheter is replaced with another catheter, the tip of the catheter through which the guide wire is inserted is first inserted. Insert into the pancreaticobiliary duct etc. via the treatment instrument insertion channel of the endoscope, then remove the catheter leaving only the distal end portion of the guidewire in the pancreaticobiliary duct, and insert another catheter using the guidewire as a guide The procedure is taken.

しかし、単純にガイドワイヤの先端を膵胆管内に残してカテーテルだけを抜去しようとすると、内視鏡に設けられている長い処置具挿通チャンネルからカテーテルを引き出す操作をしている際にガイドワイヤの先端部分が膵胆管から抜け出てしまい、全てを始めからやり直さなければならない場合が多々発生する。   However, if the tip of the guide wire is simply left in the pancreaticobiliary duct and only the catheter is to be removed, the guide wire will be removed when the catheter is pulled out from the long treatment instrument insertion channel provided in the endoscope. There are many cases in which the tip part falls out of the pancreaticobiliary duct and everything has to be redone from the beginning.

それを防止するために、ガイドワイヤの先端を膵胆管内で膨らませて抜け止め機能を得られるようにすることも考えられるが、膵胆管の損傷や閉塞をまねいたり、膨らんだまま元へ戻らなくなってガイドワイヤが抜去できなくなるリスクがある等の難点がある。   To prevent this, the tip of the guide wire may be inflated in the pancreaticobiliary duct to obtain a retaining function. As a result, there is a risk that the guide wire cannot be removed.

そこで従来は、ガイドワイヤの手元側を内視鏡の処置具挿通チャンネルの入口部分に選択的に固定することができるようにしていた(例えば、特許文献1)。
特表2002−515305
Therefore, conventionally, the proximal side of the guide wire can be selectively fixed to the entrance portion of the treatment instrument insertion channel of the endoscope (for example, Patent Document 1).
Special table 2002-515305

しかし、特許文献1に記載されているようにガイドワイヤの手元側を内視鏡の処置具挿通チャンネルの入口部分に固定した状態でカテーテルだけを抜去できるようにするには、ガイドワイヤをカテーテルの外面に沿わせる必要があるので、U字溝が外面に全長にわたって形成されたカテーテル等のように特殊な断面形状のカテーテルを使用しなければならず一般的でない。   However, as described in Patent Document 1, in order to be able to remove only the catheter while the proximal side of the guide wire is fixed to the entrance portion of the treatment instrument insertion channel of the endoscope, the guide wire is attached to the catheter. Since it is necessary to extend along the outer surface, a catheter having a special cross-sectional shape such as a catheter in which a U-shaped groove is formed on the outer surface over the entire length must be used.

そこで本発明は、一般的な断面形状のカテーテルを用いて、ガイドワイヤの先端部分が膵胆管内等から抜け出さないようにカテーテルだけを内視鏡の処置具挿通チャンネルから抜去することができ、しかも膵胆管の損傷、閉塞或いは膵胆管からの抜去不能のリスク等のない安全な内視鏡の先端部を提供することを目的とする。   Therefore, the present invention can remove only the catheter from the treatment instrument insertion channel of the endoscope using a catheter having a general cross-sectional shape so that the distal end portion of the guide wire does not come out of the pancreaticobiliary duct or the like. An object of the present invention is to provide a safe distal end portion of an endoscope without risk of damage or obstruction of the pancreaticobiliary duct or inability to remove the pancreaticobiliary duct.

上記の目的を達成するため、本発明の内視鏡の先端部は、内視鏡の挿入部の先端に配置された処置具挿通チャンネルの出口開口付近に、処置具挿通チャンネルの出口開口を通過している通過物を押圧固定するための押圧固定部材を、挿入部の基端側からの遠隔操作で進退駆動することができるように配置したものである。   To achieve the above object, the distal end portion of the endoscope of the present invention passes through the outlet opening of the treatment instrument insertion channel in the vicinity of the outlet opening of the treatment instrument insertion channel disposed at the distal end of the insertion section of the endoscope. A pressing and fixing member for pressing and fixing the passing article is arranged so that it can be driven back and forth by remote operation from the base end side of the insertion portion.

なお、処置具挿通チャンネルの出口開口が挿入部の先端の側面に配置されていて、押圧固定部材が処置具挿通チャンネルの出口開口の後端側から前端側に向かって進退自在であってもよい。   The outlet opening of the treatment instrument insertion channel may be disposed on the side surface at the distal end of the insertion portion, and the pressing and fixing member may be movable forward and backward from the rear end side to the front end side of the outlet opening of the treatment instrument insertion channel. .

また、押圧固定部材の後端に連結された操作ワイヤが挿入部の基端側から押し込み操作されることにより押圧固定部材が前方に移動して通過物を押圧固定し、操作ワイヤが挿入部の基端側から牽引操作されると押圧固定部材が後方に移動して通過物を押圧しない位置に退避するように構成してもよい。   In addition, when the operation wire connected to the rear end of the pressing and fixing member is pressed from the proximal end side of the insertion portion, the pressing and fixing member moves forward to press and fix the passing object, and the operation wire is connected to the insertion portion. When the traction operation is performed from the base end side, the pressing fixing member may move backward to be retracted to a position where the passing object is not pressed.

そして、押圧固定部材の少なくとも通過物に当接する部分が弾力性のある部材で形成されていてもよく、処置具挿通チャンネルの出口開口の内側に通過物の突出方向を制御するための処置具起上片が配置されていて、押圧固定部材が通過物を処置具起上片に押し付けて固定するようにしてもよい。   In addition, at least a portion of the pressing and fixing member that abuts the passing object may be formed of a resilient member, and a treatment instrument for controlling the protruding direction of the passing object inside the outlet opening of the treatment instrument insertion channel. An upper piece may be disposed, and the pressing and fixing member may press and fix the passing material against the treatment instrument raising piece.

本発明によれば、内視鏡の挿入部の先端に配置された処置具挿通チャンネルの出口開口付近にガイドワイヤ(通過物)を押し付けてそこに押圧固定することができるので、一般的な断面形状のカテーテルを用いて、ガイドワイヤの先端部分が膵胆管内等から抜け出さないようにカテーテルだけを内視鏡の処置具挿通チャンネルから抜去することができ、ガイドワイヤの先端部分を膵胆管内に保持するための阻止力が膵胆管には加わらないので、膵胆管の損傷、閉塞或いは膵胆管からガイドワイヤが抜去不能になる等のリスクがない。   According to the present invention, a guide wire (passage) can be pressed near the exit opening of the treatment instrument insertion channel disposed at the distal end of the insertion portion of the endoscope and can be pressed and fixed there. Using a shaped catheter, it is possible to remove only the catheter from the treatment instrument insertion channel of the endoscope so that the distal end portion of the guide wire does not come out of the pancreaticobiliary duct, etc. Since the blocking force for holding is not applied to the pancreaticobiliary duct, there is no risk that the pancreaticobiliary duct is damaged, obstructed, or the guide wire cannot be removed from the pancreaticobiliary duct.

内視鏡の挿入部の先端に配置された処置具挿通チャンネルの出口開口付近に、処置具挿通チャンネルの出口開口を通過している通過物を押圧固定するための押圧固定部材を、挿入部の基端側からの遠隔操作で進退駆動することができるように配置する。   In the vicinity of the outlet opening of the treatment instrument insertion channel disposed at the distal end of the insertion section of the endoscope, a pressing fixing member for pressing and fixing a passing object passing through the outlet opening of the treatment instrument insertion channel is provided on the insertion section. It is arranged so that it can be moved forward and backward by remote control from the base end side.

図面を参照して本発明の実施例を説明する。
図3は内視鏡の全体構成を示しており、この内視鏡は可撓性の挿入部1の先端に連結された先端部本体2の側方を観察領域とするいわゆる側方視型内視鏡であって、観察窓や照明窓等が先端部本体2の側面に配置され、挿入部1の基端に操作部10が連結されている。
Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 shows the overall configuration of the endoscope. This endoscope is a so-called side-viewing type endoscope in which the side of the distal end portion body 2 connected to the distal end of the flexible insertion portion 1 is an observation region. In this endoscope, an observation window, an illumination window, and the like are arranged on the side surface of the distal end main body 2, and an operation unit 10 is connected to the proximal end of the insertion unit 1.

挿入部1内には全長にわたって処置具挿通チャンネル3が挿通配置されていて、その入口開口3aは挿入部1と操作部10との連結部付近に斜め上方に向けて配置され、出口開口3bは観察方向と向きを合わせて先端部本体2の側面に配置されている。   The treatment instrument insertion channel 3 is inserted and disposed in the insertion portion 1 over its entire length, its inlet opening 3a is disposed obliquely upward near the connection portion between the insertion portion 1 and the operation portion 10, and the outlet opening 3b is It is arranged on the side surface of the tip portion main body 2 so as to match the viewing direction.

処置具挿通チャンネル3の出口開口3bの内側には、出口開口3bを通過してそこから外方に突出する処置具等の突出方向を制御するための処置具起上片4が配置されていて、処置具起上片4を回動駆動するための操作ワイヤ5は操作部10に配置された起上片操作レバー11により進退操作される。   Inside the outlet opening 3b of the treatment instrument insertion channel 3, a treatment instrument raising piece 4 for controlling the protruding direction of the treatment instrument or the like that passes through the outlet opening 3b and protrudes outward therefrom is disposed. The operation wire 5 for rotationally driving the treatment instrument raising piece 4 is advanced and retracted by the raising piece operation lever 11 disposed in the operation unit 10.

また、処置具挿通チャンネル3の出口開口3bの内側位置には、処置具挿通チャンネル3の出口開口3bを通っている処置具その他の通過物を押圧固定するための押圧固定部材6が配置されていて、押圧固定部材6を進退駆動するための操作ワイヤ7は操作部10に配置された固定部材操作レバー12により進退操作される。   In addition, a press fixing member 6 for pressing and fixing the treatment instrument and other passing objects passing through the outlet opening 3b of the treatment instrument insertion channel 3 is disposed at an inner position of the outlet opening 3b of the treatment instrument insertion channel 3. Thus, the operation wire 7 for driving the pressing and fixing member 6 forward and backward is advanced and retracted by the fixing member operating lever 12 disposed in the operation unit 10.

図2は先端部本体2付近を拡大して示す斜視図、図1はその側面断面図であり、図2に示される8は観察窓、9は照明窓である。
処置具起上片4は、図1に示されるように支軸4xを中心に回動自在に先端部本体2に取り付けられて処置具挿通チャンネル3の出口開口3bの内部空間の前端側のガイド壁になるように配置され、矢印Aで示されるように操作ワイヤ5が進退操作されると、処置具起上片4が支軸4xを中心に回動して、処置具挿通チャンネル3の出口開口3bから外方に突出する処置具等の突出方向が変化する。
FIG. 2 is an enlarged perspective view showing the vicinity of the tip body 2, FIG. 1 is a side sectional view thereof, 8 shown in FIG. 2 is an observation window, and 9 is an illumination window.
As shown in FIG. 1, the treatment instrument raising piece 4 is attached to the distal end body 2 so as to be rotatable around a support shaft 4 x and is a guide on the front end side of the inner space of the outlet opening 3 b of the treatment instrument insertion channel 3. When the operation wire 5 is moved forward and backward as indicated by an arrow A, the treatment instrument raising piece 4 rotates about the support shaft 4x, and the outlet of the treatment instrument insertion channel 3 is arranged. The protruding direction of the treatment instrument or the like protruding outward from the opening 3b changes.

押圧固定部材6は、例えばフッ素ゴム材等のような弾力性のある材料で棒状に形成されていて、退避時には先端部本体2の後半部分に軸線と平行の向きに形成された収納孔2a内に緩く嵌挿配置され、その先端面が処置具挿通チャンネル3の出口開口3bの内部空間の後端壁付近に位置している。   The pressing and fixing member 6 is formed in a rod shape with an elastic material such as, for example, a fluororubber material. The distal end surface of the treatment instrument insertion channel 3 is positioned in the vicinity of the rear end wall of the outlet opening 3b.

押圧固定部材6の後端部分には操作ワイヤ7の先端が連結されており、矢印Bで示されるように操作ワイヤ7が進退操作されると、押圧固定部材6が二点鎖線で示されるように収納孔2aから前方に突没し、処置具起上片4に押し付けられる位置まで押し出すことができる。なお、押圧固定部材6の後端寄りの部分を金属製にしておけば操作ワイヤ7との連結強度が向上する。   The tip end of the operation wire 7 is connected to the rear end portion of the pressing and fixing member 6. When the operating wire 7 is advanced and retracted as indicated by an arrow B, the pressing and fixing member 6 is indicated by a two-dot chain line. Can be pushed forward from the storage hole 2a to the position where it can be pressed against the treatment instrument raising piece 4. If the portion near the rear end of the pressing and fixing member 6 is made of metal, the connection strength with the operation wire 7 is improved.

図4〜図8は上述のように構成された内視鏡の使用状態を順に示しており、先ず図4及び図5に示されるように、ガイドワイヤ30(通過物)を内挿した状態のカテーテル20を内視鏡の処置具挿通チャンネル3に通して、その処置具挿通チャンネル3の出口開口3bから膵胆管100に向かって突出させたカテーテル20の先端部分を膵胆管100内に差し込む。カテーテル20は一般的な円形断面形状のものである。   FIGS. 4 to 8 sequentially show the usage states of the endoscope configured as described above. First, as shown in FIGS. 4 and 5, the guide wire 30 (passing object) is inserted. The catheter 20 is passed through the treatment instrument insertion channel 3 of the endoscope, and the distal end portion of the catheter 20 protruded from the outlet opening 3 b of the treatment instrument insertion channel 3 toward the pancreaticobiliary duct 100 is inserted into the pancreaticobiliary duct 100. The catheter 20 has a general circular cross-sectional shape.

そして、手元側でガイドワイヤ30を動かないように押さえてカテーテル20だけを引き出す操作を行うことにより、図6に示されるように、ガイドワイヤ30の先端部分が膵胆管100内に残った状態でカテーテル20だけが処置具挿通チャンネル3内に引き戻される。   Then, by performing an operation of pulling out only the catheter 20 while holding the guide wire 30 so as not to move on the hand side, the distal end portion of the guide wire 30 remains in the pancreaticobiliary duct 100 as shown in FIG. Only the catheter 20 is pulled back into the treatment instrument insertion channel 3.

そこで、カテーテル20が処置具挿通チャンネル3の出口開口3bの内側まで退避した状態になったら、図7に示されるように、押圧固定部材6を前方に押し出す操作を行う。すると、図8及びその斜視図である図9に示されるように、ガイドワイヤ30が押圧固定部材6により処置具起上片4に押し付けられてそこに押圧固定された状態になるので、ガイドワイヤ30の保持にさほど気をつかうことなく、膵胆管100内にガイドワイヤ30の先端を残した状態でカテーテル20だけをスムーズに処置具挿通チャンネル3から抜去することができる。   Therefore, when the catheter 20 is retracted to the inside of the outlet opening 3b of the treatment instrument insertion channel 3, as shown in FIG. 7, an operation of pushing the pressing and fixing member 6 forward is performed. Then, as shown in FIG. 8 and FIG. 9 which is a perspective view thereof, the guide wire 30 is pressed against the treatment instrument raising piece 4 by the pressing and fixing member 6 and is pressed and fixed there. Only the catheter 20 can be smoothly withdrawn from the treatment instrument insertion channel 3 with the distal end of the guide wire 30 left in the pancreaticobiliary duct 100 without taking much care in holding 30.

そして、ガイドワイヤ30の先端を膵胆管100内に保持するための阻止力は内視鏡側の部材である処置具起上片4と押圧固定部材6に加わって膵胆管100に加わらないので、膵胆管100の損傷、閉塞或いはガイドワイヤ30が膵胆管100から抜去不能になる等のリスクがない。   Since the blocking force for holding the distal end of the guide wire 30 in the pancreaticobiliary duct 100 is added to the treatment instrument raising piece 4 and the pressing fixing member 6 that are members on the endoscope side, it does not enter the pancreaticobiliary duct 100. There is no risk that the pancreaticobiliary duct 100 is damaged, occluded, or the guide wire 30 cannot be removed from the pancreaticobiliary duct 100.

本発明の実施例の内視鏡の先端部の側面断面図である。It is side surface sectional drawing of the front-end | tip part of the endoscope of the Example of this invention. 本発明の実施例の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 of the Example of this invention. 本発明の実施例の内視鏡の全体構成を示す側面図である。1 is a side view showing an overall configuration of an endoscope according to an embodiment of the present invention. 本発明の実施例の内視鏡の使用状態を例示する略示図である。It is a schematic diagram which illustrates the use condition of the endoscope of the example of the present invention. 本発明の実施例の内視鏡の使用状態を例示する略示図である。It is a schematic diagram which illustrates the use condition of the endoscope of the example of the present invention. 本発明の実施例の内視鏡の使用状態を例示する略示図である。It is a schematic diagram which illustrates the use condition of the endoscope of the example of the present invention. 本発明の実施例の内視鏡の使用状態を例示する略示図である。It is a schematic diagram which illustrates the use condition of the endoscope of the example of the present invention. 本発明の実施例の内視鏡の使用状態を例示する略示図である。It is a schematic diagram which illustrates the use condition of the endoscope of the example of the present invention. 本発明の実施例の内視鏡の先端部にガイドワイヤが固定された状態の斜視図である。It is a perspective view in the state where the guide wire was fixed to the tip part of the endoscope of the example of the present invention.

符号の説明Explanation of symbols

1 挿入部
2 先端部本体(挿入部の先端)
2a 収納孔
3 処置具挿通チャンネル
3b 出口開口
4 処置具起上片
6 押圧固定部材
7 操作ワイヤ
10 操作部
12 固定部材操作レバー
20 カテーテル
30 ガイドワイヤ(通過物)
100 膵胆管
1 Insertion section 2 Tip body (tip of insertion section)
2a accommodation hole 3 treatment instrument insertion channel 3b outlet opening 4 treatment instrument raising piece 6 pressure fixing member 7 operation wire 10 operation portion 12 fixing member operation lever 20 catheter 30 guide wire (passage)
100 pancreaticobiliary duct

Claims (5)

内視鏡の挿入部の先端に配置された処置具挿通チャンネルの出口開口付近に、上記処置具挿通チャンネルの出口開口を通過している通過物を押圧固定するための押圧固定部材を、上記挿入部の基端側からの遠隔操作で進退駆動することができるように配置したことを特徴とする内視鏡の先端部。   A pressure fixing member for pressing and fixing a passing object passing through the outlet opening of the treatment instrument insertion channel is inserted in the vicinity of the outlet opening of the treatment instrument insertion channel disposed at the distal end of the insertion portion of the endoscope. A distal end portion of an endoscope, wherein the distal end portion is arranged so that it can be driven back and forth by remote operation from the proximal end side of the portion. 上記処置具挿通チャンネルの出口開口が上記挿入部の先端の側面に配置されていて、上記押圧固定部材が上記処置具挿通チャンネルの出口開口の後端側から前端側に向かって進退自在である請求項1記載の内視鏡の先端部。   An outlet opening of the treatment instrument insertion channel is disposed on a side surface of a distal end of the insertion portion, and the pressing and fixing member is movable forward and backward from a rear end side to a front end side of the outlet opening of the treatment instrument insertion channel. Item 1. The distal end portion of the endoscope according to Item 1. 上記押圧固定部材の後端に連結された操作ワイヤが上記挿入部の基端側から押し込み操作されることにより上記押圧固定部材が前方に移動して上記通過物を押圧固定し、上記操作ワイヤが上記挿入部の基端側から牽引操作されると上記押圧固定部材が後方に移動して上記通過物を押圧しない位置に退避する請求項1又は2記載の内視鏡の先端部。   When the operation wire connected to the rear end of the pressing and fixing member is pushed in from the proximal end side of the insertion portion, the pressing and fixing member moves forward to press and fix the passing material. The distal end portion of the endoscope according to claim 1 or 2, wherein when the pulling operation is performed from the proximal end side of the insertion portion, the pressing fixing member moves rearward and retracts to a position where the passing material is not pressed. 上記押圧固定部材の少なくとも上記通過物に当接する部分が弾力性のある部材で形成されている請求項1、2又は3記載の内視鏡の先端部。   The distal end portion of the endoscope according to claim 1, 2, or 3, wherein at least a portion of the pressing and fixing member that is in contact with the passing material is formed of an elastic member. 上記処置具挿通チャンネルの出口開口の内側に上記通過物の突出方向を制御するための処置具起上片が配置されていて、上記押圧固定部材が上記通過物を上記処置具起上片に押し付けて固定する請求項1、2、3又は4記載の内視鏡の先端部。   A treatment instrument raising piece for controlling the protruding direction of the passing object is disposed inside the outlet opening of the treatment instrument insertion channel, and the pressing fixing member presses the passage article against the treatment instrument raising piece. 5. The distal end portion of the endoscope according to claim 1, 2, 3, or 4 to be fixed.
JP2005064713A 2005-03-09 2005-03-09 Distal end part of endoscope Withdrawn JP2006246984A (en)

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002034905A (en) * 2000-04-17 2002-02-05 Olympus Optical Co Ltd Endoscope, and its endoscope system
JP2003305002A (en) * 2002-04-17 2003-10-28 Olympus Optical Co Ltd Endoscope
JP2004057814A (en) * 2002-06-07 2004-02-26 Olympus Corp Treatment instrument for endoscope and endoscope unit

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002034905A (en) * 2000-04-17 2002-02-05 Olympus Optical Co Ltd Endoscope, and its endoscope system
JP2003305002A (en) * 2002-04-17 2003-10-28 Olympus Optical Co Ltd Endoscope
JP2004057814A (en) * 2002-06-07 2004-02-26 Olympus Corp Treatment instrument for endoscope and endoscope unit

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