JP2006271500A - Insertion assisting tool and endoscope apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an insertion assisting tool capable of easily inserting the insertion part of an endoscope even when it is a curved shape by providing a shape holding means in the insertion assisting tool, an endoscope apparatus and an operation method of the endoscope apparatus. <P>SOLUTION: The insertion assisting tool 70 for inserting and guiding the insertion part 12 of an endoscope 10 is provided with a main body tube 73, and insertion holes 73A, 73A,... are formed in an axial direction on the main body tube 73. A wire 71 is inserted and arranged in each insertion hole 73A and the distal end of each wire 71 is fixed to the main body tube 73. A locking member 75 for locking the proximal end part of the wire 71 is provided on the proximal end part of the insertion assisting tool 70. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an insertion assisting tool, and more particularly to an insertion assisting tool used in a double balloon type endoscope apparatus for observing a deep digestive tract such as a small intestine or a large intestine.

  When inserting the insertion part of the endoscope into the deep digestive tract such as the small intestine, simply pushing the insertion part makes it difficult for force to be transmitted to the distal end of the insertion part due to the complicated bending of the intestinal tract. Have difficulty. For example, if excessive bending or bending occurs in the insertion portion, the insertion portion cannot be inserted further deeper. Therefore, a method has been proposed in which an insertion aid is put on the insertion portion of the endoscope and inserted into the body cavity, and the insertion portion is guided by this insertion aid to prevent excessive bending or bending of the insertion portion. Yes.

  For example, Patent Document 1 discloses an endoscope apparatus in which a first balloon is provided at a distal end portion of an insertion portion of an endoscope and a second balloon is provided at a distal end portion of an insertion assisting tool (also referred to as an overtube or a sliding tube). Is described. By inflating the first balloon and the second balloon, the insertion portion and the insertion aid can be fixed in the intestinal tract such as the small intestine. Accordingly, by alternately inserting the insertion portion and the insertion assisting tool while repeatedly expanding and contracting the first balloon and the second balloon, the insertion portion can be inserted into a deep portion of the intestinal tract that is bent in a complicated manner, such as the small intestine. .

By the way, when inserting the double-balloon endoscope described above into the portal vein, a method has been proposed in which the insertion portion of the endoscope is pushed in with a simple loop shape by using an insertion assisting tool. ing.
JP 2002-301019 A

  However, this method has a certain amount of stiffness in the insertion portion of the endoscope. Therefore, when the endoscope is inserted into the insertion assisting tool, the loop portion of the insertion assisting tool becomes the stiffness of the insertion portion of the endoscope. There was a problem that it was pressed from the inside by the elastic restoring force due to bulge and swelled outside. Thus, if the loop portion of the insertion assisting tool expands, when inserting the endoscope, it is difficult for force to be transmitted to the distal end of the insertion portion, and insertion into the deep part of the body cavity may be difficult. It was.

  The present invention has been made in view of such circumstances, and an insertion aid that can easily push the insertion portion of the endoscope into a curved shape such as a loop shape, and the insertion aid. It aims at providing the endoscope apparatus which has this. It is another object of the present invention to provide a method for operating an endoscope apparatus provided with such an insertion assisting tool.

  In order to achieve the above-mentioned object, the insertion assisting device for guiding and inserting the insertion portion of the endoscope in order to achieve the above object, the tube that is configured to be bent while the insertion portion is inserted; A plurality of wires which are provided in the tube and are arranged in the axial direction of the tube and whose distal ends are fixed to the tube; and a base end portion of the tube; And a locking means for locking the end portion.

  According to the first aspect of the present invention, the tube can be held in a curved shape by locking the proximal end portions of the plurality of wires with the locking means in a state where the tube is bent. Therefore, for example, a loop shape can be formed with a tube and the shape can be maintained. Therefore, when the insertion portion is pushed into the tube, force is easily transmitted to the distal end of the insertion portion, and the insertion operability of the insertion portion can be improved.

  The invention according to claim 2 is characterized in that, in the invention according to claim 1, a plurality of insertion holes are formed in the tube in the axial direction, and the wires are inserted into the insertion holes.

  According to a third aspect of the present invention, in the first aspect of the present invention, the tube is formed in a double tube structure including an inner cylinder and an outer cylinder, and a plurality of axial tubes are provided between the inner cylinder and the outer cylinder. A plurality of ring members having a plurality of holes are arranged at intervals in the axial direction, and the wires are inserted into the holes of the plurality of ring members.

  According to a fourth aspect of the present invention, in the invention according to any one of the first to third aspects, an inflatable / deflatable balloon is attached to the outer peripheral surface of the distal end of the tube. According to the invention of claim 4, since the balloon is mounted on the outer peripheral surface of the distal end of the tube, the distal end of the tube can be fixed to the intestinal tract or the like in the body cavity by inflating the balloon. Therefore, according to the invention of claim 4, the tube can be fixed in the body cavity, and the tube can be held in a curved shape.

  The invention according to claim 5 is an endoscope apparatus comprising the insertion assisting tool according to claim 4, and an endoscope having a balloon that is inflatable / contractable on the outer peripheral surface of the distal end of the insertion portion. . INDUSTRIAL APPLICABILITY The present invention is particularly effective in a double-balloon type endoscope apparatus that repeatedly inserts an insertion portion of an endoscope and an insertion aid and inserts the distal end of the insertion portion into a deep portion of the intestinal tract.

  In order to achieve the above object, the invention according to claim 6 is an endoscope in which a first balloon that can be expanded and contracted is mounted on the outer peripheral surface of the distal end of the insertion portion, and the insertion portion is inserted and guided, In the operation method of the endoscope apparatus provided with a second balloon that is inflatable and inflatable on the outer peripheral surface of the distal end, and an insertion assisting tool having shape holding means for holding the shape, the first balloon is deflated, In addition, with the insertion aid inserted through the insertion portion fixed to the body cavity, the insertion portion is inserted into the body cavity, and the first balloon is inflated to insert the insertion portion into the body cavity. A fixing operation for fixing the insertion part to the body cavity, and the insertion assisting tool is pushed in along the insertion part fixed to the body cavity in a state where the second balloon is deflated and the shape retention of the insertion assisting tool is released. Push-in operation, By inflating a balloon, a gripping operation for gripping the body cavity with the tip of the inserted insertion assisting tool, a hand feeding operation for gripping the insertion assisting tool while gripping the body cavity, and the insertion assisting that has been handed back The shape holding operation for holding the shape of the tool by the shape holding means is repeatedly performed.

  According to the sixth aspect of the invention, since the insertion portion of the endoscope is inserted and pushed in after the shape of the insertion assisting tool is maintained, the force is easily transmitted to the distal end of the insertion portion, and the insertion operation of the insertion portion is performed. Can be improved.

  The invention according to claim 7 is the invention according to claim 6, wherein the insertion assisting tool is formed in a loop shape by the hand-drawing operation, and the loop of the insertion assisting tool is fixed by the shape holding operation. .

  According to the present invention, since the insertion portion of the endoscope can be inserted while maintaining the shape of the insertion assisting tool, force is easily transmitted to the distal end of the insertion portion, and the insertion operability of the insertion portion is improved. be able to.

  Preferred embodiments of an insertion aid, an endoscope apparatus, and an operation method of an endoscope apparatus according to the present invention will be described below in detail with reference to the accompanying drawings.

  FIG. 1 is a system configuration diagram showing an embodiment of an endoscope apparatus to which an insertion assisting tool according to the present invention is applied. As shown in FIG. 1, the endoscope apparatus mainly includes an endoscope 10, an insertion assisting tool 70, and a balloon control device 100.

  The endoscope 10 includes a hand operation unit 14 and an insertion unit 12 that is connected to the hand operation unit 14 and is inserted into a body cavity. A universal cable 16 is connected to the hand operation unit 14, and an LG connector 18 is provided at the tip of the universal cable 16. The LG connector 18 is detachably connected to the light source device 20, thereby sending illumination light to an illumination optical system 54 (see FIG. 2) described later. In addition, an electrical connector 24 is connected to the LG connector 18 via a cable 22, and the electrical connector 24 is detachably coupled to the processor 26.

  The hand operation unit 14 is provided with an air / water supply button 28, a suction button 30, a shutter button 32, and a function switching button 34, and a pair of angle knobs 36 and 36. A balloon air supply port 38 is formed at the proximal end portion of the hand operation unit 14 by a tube bent in an L shape. By supplying or sucking fluid such as air to the balloon air supply port 38, the first balloon 60 described later can be inflated or deflated.

  The insertion portion 12 is composed of a flexible portion 40, a bending portion 42, and a distal end portion 44 in order from the hand operation portion 14 side. The bending portion 42 is remotely controlled by rotating the angle knobs 36, 36 of the hand operation portion 14. Bending operation. Thereby, the front-end | tip part 44 can be turned to a desired direction.

  As shown in FIG. 2, an observation optical system 52, illumination optical systems 54 and 54, an air / water supply nozzle 56, and a forceps port 58 are provided on the distal end surface 45 of the distal end portion 44. A CCD (not shown) is disposed behind the observation optical system 52, and a signal cable (not shown) is connected to a substrate that supports the CCD. The signal cable is inserted into the insertion portion 12, the hand operating portion 14, the universal cable 16, and the like of FIG. 1, extends to the electrical connector 24, and is connected to the processor 26. Therefore, the observation image captured by the observation optical system 48 is formed on the light receiving surface of the CCD and converted into an electric signal, and this electric signal is output to the processor 26 via the signal cable and converted into a video signal. Is done. Thereby, an observation image is displayed on the monitor 50 connected to the processor 26.

  An exit end of a light guide (not shown) is disposed behind the illumination optical systems 54 and 54 in FIG. The light guide is inserted through the insertion portion 12, the hand operating portion 14, and the universal cable 16 of FIG. 1, and an incident end is disposed in the LG connector 18. Therefore, by connecting the LG connector 18 to the light source device 20, the illumination light emitted from the light source device 20 is transmitted to the illumination optical systems 54 and 54 via the light guide, and irradiated forward from the illumination optical systems 54 and 54. Is done.

  The air / water supply nozzle 56 in FIG. 2 is connected to a valve (not shown) operated by the air / water supply button 28 in FIG. 1, and this valve is also connected to the air / water supply connector provided in the LG connector 18. 48 is communicated. An air / water supply means (not shown) is connected to the air / water connector 48 to supply air and water. Therefore, by operating the air / water supply button 28, air or water can be ejected from the air / water supply nozzle 56 toward the observation optical system 52.

  The forceps port 58 in FIG. 2 communicates with the forceps insertion portion 46 in FIG. Therefore, by inserting a treatment tool such as a forceps from the forceps insertion portion 46, the treatment tool can be led out from the forceps port 58. The forceps port 58 communicates with a valve (not shown) operated by the suction button 30, and this valve is further connected to the suction connector 49 of the LG connector 18. Therefore, by connecting a suction means (not shown) to the suction connector 49 and operating the valve with the suction button 30, a lesioned part or the like can be sucked from the forceps opening 58.

  A first balloon 60 made of an elastic material such as rubber is attached to the outer peripheral surface of the insertion portion 12. The first balloon 60 is formed in a substantially cylindrical shape with both ends narrowed. After the insertion portion 12 is inserted and the first balloon 60 is disposed at a desired position, the first balloon 60 is disposed as shown in FIG. The first balloon 60 is fixed to the insertion portion 12 by fitting rubber fixing rings 62 and 62 into both ends of the 60.

  A vent hole 64 is formed on the outer peripheral surface of the insertion portion 12 where the first balloon 60 is attached. The ventilation hole 64 communicates with a balloon air supply port 38 provided in the hand operation unit 14 of FIG. 1, and is connected to the balloon control device 100 via a tube 110 described later. Therefore, the first balloon 60 can be inflated and deflated by supplying and sucking air by the balloon control device 100. The first balloon 60 is inflated into a substantially spherical shape by supplying air, and sticks to the outer surface of the insertion portion 12 by sucking air.

  On the other hand, the insertion assisting tool 70 shown in FIG. 1 is composed of a cylindrical and rigid gripping portion 72 provided on the proximal end side, and a main body tube 73 attached to the distal end of the gripping portion 72. The insertion portion 12 of the endoscope 10 is inserted into the main body tube 73 from the grip portion 72.

  The main body tube 73 has a flexible resin tube made of urethane or the like as a base material, and an outer peripheral surface and an inner peripheral surface of the base material are coated with a hydrophilic coating material (lubricating coating material). As the hydrophilic coating material, for example, polyvinylpyrrolidone, acrylic resin, or silicon resin is used.

  A second balloon 80 is attached in the vicinity of the distal end of the main body tube 73. The second balloon 80 is formed in a substantially cylindrical shape with both ends narrowed, and is attached in a state where the insertion assisting tool 70 is penetrated, and is fixed by winding a thread (not shown). A tube 74 attached to the outer peripheral surface of the insertion assisting tool 70 is communicated with the second balloon 80, and a connector 76 is provided at the proximal end portion of the tube 74. A tube 120 is connected to the connector 76, and is connected to the balloon control device 100 via the tube 120. Therefore, the second balloon 80 can be inflated and deflated by supplying and sucking air with the balloon control device 100. The second balloon 80 is expanded into a substantially spherical shape by supplying air, and is attached to the outer peripheral surface of the insertion assisting tool 70 by sucking air.

  An injection port 78 is provided on the proximal end side of the insertion assisting tool 70. The injection port 78 communicates with an opening (not shown) formed on the inner peripheral surface of the insertion assisting tool 70. Therefore, the lubricant can be supplied into the insertion aid 70 by injecting the lubricant (for example, water) from the injection port 78 with a syringe or the like. Therefore, when the insertion portion 12 is inserted into the insertion assisting tool 70, the friction between the inner peripheral surface of the insertion assisting tool 70 and the outer peripheral surface of the insertion portion 12 can be reduced, and the relative relationship between the insertion portion 12 and the insertion assisting tool 70 can be reduced. Movement can be performed smoothly.

  As shown in FIGS. 3 and 4, the insertion assisting tool 70 of the present invention is provided with a shape holding means for holding the shape of the main body tube 73. That is, four insertion holes 73A, 73A... Are formed in the body tube 73 in the axial direction. The insertion holes 73A are formed vertically and horizontally at 90 ° intervals, and the wires 71 are inserted into the insertion holes 73A. Similarly, holes 72A, 72A,... Are formed in the grip portion 72 at four locations, up, down, left, and right, in the axial direction, and the wire 71 is inserted into the holes 72A. Each wire 71 has its tip fixed to the tip of the main tube 73 by an adhesive or the like.

  The grip portion 72 is provided with a lock member 75 that locks the proximal end of the wire 71. The lock member 75 is formed in a cylindrical shape by a hard member such as resin, and is attached to the grip portion 72 so as to be rotatable. That is, the groove 72B is formed in the circumferential direction on the outer peripheral surface of the grip 72, and the protrusion 75B that engages with the groove 72B is formed on the inner peripheral surface of the lock member 75. The member 75 can be rotated with respect to the grip portion 72. Further, holes 75A, 75A,... Are formed in the lock member 75 at four locations on the top, bottom, left, and right, and the base end portion of the wire 71 is inserted into each hole 75A.

  In a state where the locking by the locking member 75 is not performed, the positions of the hole 75A of the locking member 75 and the hole 72A of the grip portion 72 coincide with each other in the circumferential direction. Therefore, the base end portion of each wire 71 can move freely in the axial direction, and the main body tube 73 can be freely curved. That is, by bending the main body tube 73, the position of the proximal end portion of each wire 71 moves in the axial direction. For example, when the main body tube 73 is bent upward, the lower wire 71 is pulled and its proximal end moves to the distal end side, and the upper wire 71 is pushed out and its proximal end moves to the proximal end side. Moving. Similarly, when the main body tube 73 is bent downward, the upper wire 71 is pulled and its proximal end moves to the distal end side, and the lower wire 71 is pushed out and its proximal end is proximal. Move to the side. Further, when the main body tube 73 is bent to the right side, the proximal end portion of the left wire 71 moves to the distal end side, and the proximal end portion of the right wire 71 moves to the proximal end side. Conversely, when the main body tube 73 is bent to the left side, the proximal end portion of the right wire 71 moves to the distal end side, and the proximal end portion of the left wire 71 moves to the proximal end side. Further, the base end portion of each wire 71 also moves when the body tube 73 is bent in the middle of the four directions of up, down, left, and right.

  When the lock member 75 is rotated in a state where the base ends of the respective wires 71 are moved in this manner, the position of the base end portion of each wire 71 can be locked and the curved shape of the main body tube 73 can be maintained. it can. That is, when the lock member 75 is rotated with respect to the grip portion 72, the position of the hole 75A of the lock member 75 and the position of the hole 72A of the grip portion 72 are shifted in the circumferential direction, and the base end portion of each wire 71 is locked to the lock member. 75 and the grip 72 are clamped and fixed. Thereby, the base end portion of each wire 71 cannot move, and the length of each wire 71 on the distal end side from the lock position is fixed. Therefore, the curvature of the main body tube 73 is determined by the difference in length of each wire 71, and the curved shape of the main body tube 73 is maintained.

  As described above, the insertion assisting tool 70 of the present embodiment can lock the proximal end portion of each wire 71 by rotating the lock member 75, and can maintain the curved shape of the main body tube 73. In addition, what is necessary is just to rotate the locking member 75 in the opposite direction to the time of locking, when releasing a lock | rock.

  The balloon control device 100 of FIG. 1 is a device that supplies and sucks fluid such as air to the first balloon 60 and supplies and sucks fluid such as air to the second balloon 80. The balloon control device 100 mainly includes a device main body 102 and a hand switch 104 for remote control.

  On the front surface of the apparatus main body 102, a power switch SW1, a stop switch SW2, a first pressure display unit 106, a second pressure display unit 108, a first function stop switch SW3, and a second function stop switch SW4 are provided. The first pressure display unit 106 and the second pressure display unit 108 are panels for displaying the pressure values of the first balloon 60 and the second balloon 80, respectively. When an abnormality such as balloon breakage occurs, the pressure display units 106 and 108 are displayed. An error code is displayed.

  The first function stop switch SW3 and the second function stop switch SW4 are switches for turning on / off the functions of an endoscope control system A and an insertion assisting tool control system B, which will be described later. When only one of the two balloons 80 is used, the function stop switches SW3 and SW4 which are not used are operated to turn off the function. In the control system A or B in which the function is turned off, air supply and suction are completely stopped, and the pressure display unit 106 or 108 of the system is also turned off. The function stop switches SW3 and SW4 can be set to an initial state by turning off both of them. For example, the calibration with respect to the atmospheric pressure is performed by turning off both function stop switches SW3 and SW4 and simultaneously pressing all the switches SW5 to SW9 of the hand switch 104.

  A tube 110 that supplies and sucks air to the first balloon 60 and a tube 120 that supplies and sucks air to the second balloon 80 are connected to the front surface of the apparatus main body 102. The connection portions between the tubes 110 and 120 and the apparatus main body 102 are provided with backflow prevention units 112 and 122 for preventing backflow of body fluid when the first balloon 60 or the second balloon 80 is torn. The backflow prevention units 112 and 122 are configured by incorporating a gas-liquid separation filter in a hollow disk-like case (not shown) that is detachably attached to the apparatus main body 102. The filter prevents the liquid from flowing in.

  In addition, the pressure display units 106 and 108, the function stop switches SW3 and SW4, and the backflow prevention units 112 and 122 are always arranged in a constant manner for the endoscope 10 and the insertion assisting tool 70. That is, the pressure display unit 106 for the endoscope 10, the function stop switch SW3, and the backflow prevention unit 112 are respectively connected to the pressure display unit 108, the function stop switch SW4, and the backflow prevention unit 122 for the insertion assisting tool 70. Are arranged on the right side.

  On the other hand, the hand switch 104 includes a stop switch SW5 similar to the stop switch SW2 on the apparatus main body 102 side, an ON / OFF switch SW6 for instructing the pressurization / decompression of the first balloon 60, and the pressure of the first balloon 60. A pause switch SW7 for holding, an ON / OFF switch SW8 for instructing pressurization / depressurization of the second balloon 80, and a pause switch SW9 for holding the pressure of the second balloon 80 are provided. The hand switch 104 is electrically connected to the apparatus main body 102 via the cord 130. Although not shown in FIG. 1, the hand switch 104 is provided with a display unit that indicates an air supply state or an exhaust state of the first balloon 60 or the second balloon 80.

  The balloon control device 100 configured as described above supplies air to the balloons 60 and 80 to inflate them and controls the air pressure to a constant value to hold the balloons 60 and 80 in an inflated state. In addition, air is sucked from each balloon 60 and 80 and contracted, and the air pressure is controlled to a constant value to hold each balloon 60 and 80 in a contracted state.

  The balloon control device 100 is connected to the balloon dedicated monitor 82 and displays the pressure value and the inflated / deflated state of the balloons 60 and 80 on the balloon dedicated monitor 82 when the balloons 60 and 80 are inflated and deflated. . The pressure values and the inflated / deflated states of the balloons 60 and 80 may be superimposed on the observation image of the endoscope 10 and displayed on the monitor 50.

  Next, an operation method of the endoscope apparatus configured as described above will be described with reference to FIGS.

  First, the insertion part 12 is inserted into the intestinal tract (large intestine) 90 from the anus 90A as shown in FIG. 5A with the insertion assisting tool 70 inserted through the insertion part 12 (insertion operation). At this time, the first balloon 60 and the second balloon 80 are deflated. Moreover, the lock of the wire 71 of the insertion assisting tool 70 is released, and the main body tube 73 is allowed to be freely bent.

  Next, as shown in FIG. 5A, the first balloon 60 is inflated with the distal end of the insertion portion 12 reaching the sigmoid colon 90B, and the distal end of the insertion portion 12 is fixed to the intestinal tract 90 (fixing operation).

  Next, the insertion assisting tool 70 is pushed in to be inserted along the insertion portion 12 (pushing operation). Then, as shown in FIG. 5B, after the distal end portion of the insertion assisting tool 70 is brought to the vicinity of the first balloon 60, air is supplied to the second balloon 80 to be inflated. As a result, the second balloon is fixed to the intestinal tract 90, and the intestinal tract 90 is held by the insertion assisting tool 70 via the second balloon 80.

  Next, as shown in FIG. 5 (c), the insertion assisting tool 70 is pulled together to eliminate excessive bending and bending of the intestinal tract 90 (hand feeding operation).

  Next, air is sucked from the first balloon 60 and the first balloon 60 is deflated. Then, as shown in FIG. 5D, the insertion portion 12 is inserted into the deep portion of the intestinal tract 90 (for example, up to the bent portion at the upper end of the descending colon 90C) (insertion operation). Then, as described above, after performing a fixing operation for inflating the first balloon 60 and a pushing operation for pushing the insertion assisting tool 70 along the insertion portion 12, the second balloon 80 is inflated to perform a gripping operation and inserted. A hand drag operation by the assisting tool 70 is performed. Thereby, as shown in FIG.5 (e), the excess bending | flexion and bending of the intestinal tract 90 are removed.

  By repeatedly performing such a series of operations (insertion operation, fixing operation, push-in operation, gripping operation, and hand-feeding operation), the distal end of the insertion portion 12 can be gradually inserted into the deep portion of the intestinal tract 90. Further, the insertion assisting tool 70 can remove excessive bending of the intestinal tract 90.

  For example, FIG. 5 (f) shows a state in which the distal end of the insertion portion 12 is inserted to the end of the transverse colon 90D, and the insertion assisting tool 70 is operated to remove excess bending of the intestinal tract 90. FIG. 5G shows a state in which the distal end of the insertion portion 12 is further inserted and inserted into the ileum 90E of the small intestine, and excessive bending of the intestinal tract 90 is removed. FIG. 5 (h) shows a state in which the distal end of the insertion portion 12 is inserted into a deeper portion of the small intestine, and the excessive bending of the intestinal tract 90 is removed.

  When such an operation is repeated and the distal end of the insertion portion 12 is inserted into the deep part of the small intestine, the insertion assisting tool 70 forms a loop shape as shown in FIG. Therefore, by inserting the insertion portion 12 as shown in FIG. 5 (j), the insertion portion can be inserted further into the intestinal tract 90.

  By the way, as shown in FIG. 5 (j), when the insertion portion 12 is pushed into the loop-shaped insertion assisting tool 70 (main body tube 73), the elastic restoring force due to the elasticity of the insertion portion of the endoscope is As indicated by the dashed line, the loop portion of the insertion assisting tool 70 may swell greatly outward. If the insertion assisting tool 70 bulges outward as described above, the force is not sufficiently transmitted to the distal end of the insertion portion 12, and the problem arises that the insertion operability is deteriorated. Furthermore, since the insertion part 12 cannot be inserted smoothly, friction between the inner peripheral surface of the insertion assisting tool 70 and the outer peripheral surface of the insertion part 12 is locally increased, and the hydrophilic coating on the inner peripheral surface of the insertion assisting tool 70 May peel off and the insertability may further deteriorate.

  Therefore, in the present embodiment, the shape holding operation of the insertion assisting tool 70 is performed immediately before the insertion operation of FIG. 5 (j), that is, after the hand dragging operation of FIG. 5 (i). That is, the lock member 75 is rotated to lock the proximal end portion of the wire 71. Thereby, the shape of the main body tube 73 of the insertion assisting tool 70 is maintained. Therefore, when the insertion portion 12 is pushed in, the loop portion of the main body tube 73 does not swell greatly outward, so that force is easily transmitted to the tip of the insertion portion 12, and the insertion portion 12 can be easily inserted.

  As described above, according to the present embodiment, since the shape holding means is provided in the insertion assisting tool 70, the insertion operability of the insertion portion 12 of the endoscope 10 can be improved. In particular, the endoscope apparatus of the present embodiment is a double balloon type endoscope apparatus for the small intestine, and the insertion portion 12 is inserted many times and the insertion assisting tool 70 is long. The effect of holding and improving the operability of the insertion portion 12 is great.

  The shape holding operation of the insertion assisting tool 70 may be performed every time after the hand feeding operation of the insertion assisting tool 70 is performed, or may be performed as necessary.

  In addition, the configuration of the shape holding means of the insertion assisting tool 70 is not limited to the above-described embodiment, and any configuration that mechanically holds the shape of the main body tube 73 using the wire 71 may be used. Therefore, the number and arrangement of the wires 71 are not limited to the above-described embodiment, and at least two wires 71, preferably three or more wires 71 may be arranged in the circumferential direction.

  FIG. 6 is a cross-sectional view schematically showing an insertion assisting tool 92 having another configuration. The insertion assisting tool 92 shown in the figure has a double tube structure in which a main body tube 94 is composed of an outer cylinder 94A and an inner cylinder 94B. The outer cylinder 94A and the inner cylinder 94B are made of a flexible resin tube, and the outer peripheral surface of the outer cylinder 94A and the inner peripheral surface of the inner cylinder 94B are coated with a hydrophilic coating material (lubricant coating material). The

  A plurality of ring members 96 are provided between the outer cylinder 94A and the inner cylinder 94B. The ring members 96, 96... Are arranged at a constant interval in the axial direction, and are fixed to the outer cylinder 94A and the inner cylinder 94B. In addition, as shown in FIG. 7, each ring member 96 has through holes 96A, 96,... The wire 71 is inserted and disposed in the through hole 96 </ b> A of each ring member 96. The tip of the wire 71 is bonded to the most distal ring member 96 as shown in FIG. 6 and is fixed to the main body tube 94 via the ring member 96.

  A lock member 75 having the above-described configuration is provided on the base end side of the main body tube 94. By rotating the lock member 75, the base end portion of the wire 71 can be locked. Yes. However, the configuration of the locking means for locking the proximal end portion of the wire 71 is not particularly limited, and any configuration that can lock the proximal end portion of the wire 71 may be used.

  According to the insertion assisting tool 92 configured as described above, the wire 71 is inserted and guided through the through hole 96A of the ring member 96, so that the wire 71 contacts the main body tube 94 when the main body tube 94 is bent. Without sliding, it slides on the ring member 96 and bends smoothly. Therefore, the flexibility of the main body tube 94 can be improved.

  In the case of the insertion assisting tool 92 configured as described above, the main body tube 94 is held in a curved shape by locking the proximal end portion of the wire 71 with the lock member 75 while the main body tube 94 is bent. can do. Thereby, it becomes easy to transmit force to the front-end | tip of the insertion part 12, and the insertion / extraction operativity of the insertion part 12 can be improved.

  In the above-described embodiment, the double balloon endoscope apparatus in which the first balloon 60 is attached to the insertion portion 12 of the endoscope 10 and the second balloon 80 is attached to the distal ends of the insertion assisting tools 70 and 92. However, in the present invention, the insertion aids 70 and 92 can be used alone (or in combination with a normal endoscope or treatment instrument without the first balloon 60). The present invention can also be used as the insertion aids 70 and 92 without the second balloon 80.

  Moreover, although embodiment mentioned above showed the example which inserts the insertion part 12 and the insertion auxiliary tools 70 and 92 of the endoscope 10 via the portal gate, this invention is applied also when inserting orally. Can do. Also in this case, since the insertion assisting tools 70 and 92 can be held in a curved shape, the insertion / removal operability of the insertion portion 12 can be improved.

System configuration diagram of an endoscope apparatus according to the present invention The perspective view which shows the front-end | tip part of the insertion part of an endoscope Sectional drawing which shows the structure of an insertion auxiliary tool typically The disassembled perspective view which shows the structure of the base end part of the insertion auxiliary tool of FIG. Explanatory drawing which shows the operating method of the endoscope apparatus which concerns on this invention Sectional drawing which shows the structure of the insertion auxiliary tool different from FIG. The perspective view which shows the ring member of FIG.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 20 ... Light source device, 26 ... Processor, 50 ... Monitor, 60 ... First balloon, 70 ... Insertion aid, 71 ... Wire, 72 ... Gripping part 73 ... Main body tube, 75 ... Lock member, 80 ... Second balloon, 100 ... Balloon control device, 102 ... Device main body, 104 ... Hand switch

Claims (7)

In an insertion aid that guides through an insertion portion of an endoscope,
The insertion portion is inserted, and a tube configured to be bendable;
A plurality of wires provided on the tube and disposed in the axial direction of the tube, the tip of which is fixed to the tube;
A locking means provided at a proximal end portion of the tube and locking the proximal end portions of the plurality of wires;
An insertion aid characterized by comprising:   The insertion assisting device according to claim 1, wherein a plurality of insertion holes are formed in the tube in the axial direction, and the wires are inserted into the insertion holes.   The tube has a double tube structure including an inner cylinder and an outer cylinder, and a plurality of ring members having a plurality of axial holes are provided between the inner cylinder and the outer cylinder at intervals in the axial direction. The insertion assisting tool according to claim 1, wherein the insertion assisting tool is disposed, and the wire is inserted and disposed in holes of the plurality of ring members.   The insertion assisting tool according to any one of claims 1 to 3, wherein a balloon that can be expanded and contracted is attached to an outer peripheral surface of the distal end of the tube. An insertion aid according to claim 4,
An endoscope in which an inflatable balloon is mounted on the outer peripheral surface of the distal end of the insertion portion;
An endoscope apparatus comprising: An endoscope in which a first balloon that can be inflated and retracted is attached to the outer peripheral surface of the distal end of the insertion portion, and the second balloon that is inflatable and inflatable is attached to the outer peripheral surface of the distal end that is guided through the insertion portion In an operation method of an endoscope apparatus provided with an insertion assisting tool having shape holding means for holding the shape,
An insertion operation for inserting the insertion portion into the body cavity in a state in which the first balloon is deflated and the insertion assisting tool inserted through the insertion portion is fixed to the body cavity;
A fixing operation for fixing the insertion portion inserted into the body cavity by inflating the first balloon;
A pushing operation of pushing the insertion aid along the insertion portion fixed to the body cavity in a state where the second balloon is deflated and the shape retention of the insertion aid is released;
A gripping operation of gripping the body cavity with the tip of the inserted insertion aid by inflating the second balloon;
A hand pulling operation for pulling the insertion aid in a state of gripping the body cavity,
A shape holding operation for holding the shape of the insertion assisting tool that has been dragged by the shape holding means;
The operation method of the endoscope apparatus characterized by repeatedly performing the above.   The operation method of the endoscope apparatus according to claim 6, wherein the insertion assisting tool is formed in a loop shape by the hand feeding operation, and the loop of the insertion assisting tool is fixed by the shape holding operation.

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