JP2007111541A - Endoscope apparatus and connecting device for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope apparatus and a connecting device for an endoscope, which allow one doctor to operate the endoscope and a catheter at the same time, and improves the operability. <P>SOLUTION: The connecting device has an endoscope connecting part removably connected to an endoscope 1, and a catheter connecting part (treatment tool connecting part) 53 removably connected to a guide catheter (treatment tool) 13. An adapter 51 removably connecting between the endoscope 1 and the guide catheter 13 is provided, and a holding member 63 removably holding an insertion part of the guide catheter 13 is provided at the adapter 51. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to an endoscope apparatus and an endoscope connection apparatus that are inserted into a body cavity and used for the operation of performing high-frequency incision on a living tissue, for example, a duodenal papilla, or indwelling an indwelling tube in a stenosis part such as a bile duct About.

  In general, as a technique for treating the inside of a patient using an endoscope, for example, a high-frequency incision or an indwelling tube is placed in a body cavity. In the high-frequency incision, an endoscope is inserted into a body cavity in advance, and then a high-frequency knife is inserted into the body cavity through the treatment instrument channel of the endoscope. Subsequently, a high-frequency current is applied to the high-frequency knife, so that the living tissue in the body cavity is incised by the high-frequency knife.

  Further, when the indwelling tube is indwelled in the body cavity, a guide wire is inserted into the narrowed part of the living tissue through the treatment instrument channel of the endoscope. Subsequently, the indwelling tube is inserted into the body cavity using this guide wire as a guide. Then, a treatment such as placing an indwelling tube in the stenosis and draining it is performed.

  For example, Patent Document 1 discloses a high-frequency incision device for an endoscope. This is a device that performs a procedure of cutting a living tissue, for example, a luminal exit of a duodenal papilla by high-frequency current.

  In this device, a conductive wire is inserted through an elongated sheath having flexibility. A high-frequency knife is provided at the distal portion of the sheath. The high frequency knife is electrically connected to the distal end of the conductive wire. An operation part is provided in the proximal part of the sheath. The operation portion is provided with an electric plug and a liquid feeding base that are electrically connected to the conductive wire.

  When this apparatus is used, a high-frequency knife is inserted into the body cavity through the treatment instrument channel of the endoscope that has been previously inserted into the body cavity. A high-frequency knife is used to approach the lumen exit of the duodenal papilla, and a high-frequency current is passed through the high-frequency knife to make an incision.

  Patent Document 2 discloses a biliary catheter. The catheter is provided with a guide wire lumen. A proximal portion of the catheter is provided with a base through which an elongated guide wire is inserted and a liquid feeding base. Then, the catheter is inserted into the body cavity via the treatment instrument channel of the endoscope. Further, a guide wire is inserted through the guide wire lumen of the catheter. Liquid feeding or the like can be performed in a state where the distal end portion of the guide wire approaches the bile duct.

The catheter is also used when performing a procedure for discharging bile and the like accumulated in the bile duct. When performing this procedure, the indwelling tube is guided to the stenosis of the bile duct through the channel of the endoscope. Then, the indwelling tube is placed in the stenosis, and the bile collected in the bile duct is drained through the lumen of the indwelling tube.
JP-A-8-71081 US Pat. No. 5,921,971

  The endoscope is provided with an operation portion at the base end portion of the elongated insertion portion. The operation section is provided with a treatment instrument insertion port. The proximal end portion of the treatment instrument channel is connected to the treatment instrument insertion port. And the insertion part of treatment tools, such as the high frequency incision apparatus of patent document 1, and the catheter apparatus disclosed by patent document 2, is inserted in a treatment tool channel from the treatment tool insertion port of the operation part of an endoscope. At this time, the insertion portion of the treatment instrument has flexibility so as to bend following the bending of the insertion portion of the endoscope. Therefore, the insertion portion of the treatment instrument hangs down unless it is held by a hand, such as a portion protruding outward from the treatment instrument insertion port, for example, a base portion disposed at the base end portion of the insertion portion or an operation portion.

  Therefore, when performing incision using a high-frequency incision procedure or indwelling treatment of an indwelling tube, a doctor usually holds the operation part of the endoscope, and an assistant such as a nurse holds a treatment tool such as a guide wire or a catheter. Many examples are used. In this case, the doctor instructs the assistant while watching the monitor, and the assistant operates the treatment instrument according to the instructions of the doctor.

  However, when it is difficult to operate the treatment tool and the assistant cannot handle it, the doctor may also operate the treatment tool by itself while holding the operation part of the endoscope. In this case, the doctor sometimes holds the operation part of the endoscope under the armpit and operates the operation part of the treatment tool with both hands. However, in this case, there is a problem that operability is poor.

  This invention was made paying attention to the above circumstances, and its purpose is to be able to hold the proximal portion of the catheter fixedly to the proximal portion of the endoscope so that the doctor can operate the endoscope. An object of the present invention is to provide an endoscope apparatus and an endoscope connecting apparatus capable of simultaneously operating a catheter and improving operability.

  According to the first aspect of the present invention, an operation portion is disposed at a proximal end portion of an elongated insertion portion to be inserted into a lumen, and the insertion portion of the insertion portion is inserted into a treatment instrument insertion port projecting in a vicinity of the operation portion. An endoscope having a channel opening that communicates with the proximal end of a treatment instrument insertion channel disposed therein, and an elongated treatment instrument insertion section that is inserted into the treatment instrument insertion channel from the channel opening. An endoscope apparatus that is used in combination with a treatment instrument having a treatment instrument operation unit disposed at a proximal end portion of the treatment instrument insertion unit, and is detachably connected to the endoscope. An adapter that includes an endoscope connecting portion and a treatment instrument connecting portion that is detachably connected to the treatment instrument, and is provided with an adapter that detachably connects the endoscope and the treatment instrument; A holding member for detachably holding the treatment instrument insertion portion is provided. An endoscope apparatus.

  According to a second aspect of the present invention, in the endoscope connecting portion, a concave engagement groove into which the treatment instrument insertion port is inserted is formed in a flat base plate, and the treatment instrument insertion port is formed in the engagement groove. Is attached to the treatment instrument insertion port in a state of being inserted, and the treatment instrument connection portion has two sandwiching members arranged to be spaced apart from each other, and at least one of the two sandwiching members is an elastic member The endoscope apparatus according to claim 1.

  According to a third aspect of the present invention, the treatment instrument connecting portion is formed with an inclined surface in which a width between the two holding members gradually increases toward one end portion of the two holding members. The endoscope apparatus according to claim 2, wherein the endoscope apparatus is provided.

  According to a fourth aspect of the present invention, the holding member includes an insertion hole set to be smaller in diameter than an outer diameter of the treatment instrument insertion portion, and a narrow slit provided in a peripheral wall portion of the insertion hole, and the insertion The distal end portion of the treatment instrument insertion portion is inserted into the hole in a press-fitted state, and the distal end portion of the treatment instrument insertion portion is detachably engaged and fixed by the holding member. The endoscope apparatus described in 1.

  According to a fifth aspect of the present invention, an operation portion is disposed at a proximal end portion of an elongated insertion portion to be inserted into a lumen, and a treatment instrument insertion port projecting in the vicinity of the operation portion is provided with the insertion portion of the insertion portion. An endoscope having a channel opening that communicates with the proximal end of a treatment instrument insertion channel disposed therein, and an elongated treatment instrument insertion section that is inserted into the treatment instrument insertion channel from the channel opening. And an adapter for detachably connecting a treatment instrument having a treatment instrument operation part disposed at a proximal end portion of the treatment instrument insertion part, and the treatment instrument insertion part can be attached to and detached from the adapter. An endoscope connecting device, characterized in that a holding member for holding is provided.

  According to a sixth aspect of the present invention, the adapter includes an endoscope connecting portion that is detachably connected to the endoscope, and a treatment instrument connecting portion that is detachably connected to the treatment instrument. In the endoscope connecting portion, a concave engagement groove into which the treatment instrument insertion port is inserted is formed in a flat base plate, and the treatment instrument is inserted in a state where the treatment instrument insertion port is inserted into the engagement groove. 6. The treatment instrument connecting portion, which is attached to a mouth body, has two holding members that are spaced apart from each other, and at least one of the two holding members is an elastic member. This is an endoscope connecting apparatus.

  According to a seventh aspect of the present invention, the treatment instrument connecting portion is formed with an inclined surface in which the width between the two holding members gradually increases toward one end of the two holding members. The endoscope connecting device according to claim 6, wherein the endoscope connecting device is characterized in that:

  In the invention according to claim 8, the holding member has an insertion hole set to be smaller in diameter than an outer diameter of the treatment instrument insertion portion, and a narrow slit provided in a peripheral wall portion of the insertion hole, 6. The distal end portion of the treatment instrument insertion portion is inserted into the hole in a press-fitted state, and the distal end portion of the treatment instrument insertion portion is detachably engaged and fixed by the holding member. It is the connection apparatus for endoscopes as described in 1 ..

  According to the present invention, the proximal portion of the catheter can be fixedly held in the proximal portion of the endoscope, and one doctor can simultaneously perform the operation of the endoscope and the operation of the catheter. There is an effect that can be improved.

  Embodiments of the present invention will be described below with reference to the drawings. 1 and 2A and 2B show a first embodiment. FIG. 1 is a side view showing a usage state of the endoscope apparatus, FIG. 2A is a perspective view showing an operation part of the endoscope, and FIG. 2B is a longitudinal sectional view of the operation part.

  As shown in FIG. 1, the endoscope 1 has an operation unit 2 disposed outside the body and an insertion unit 3 inserted into the body. The insertion portion 3 includes an elongated flexible tube portion 4, a bending tube portion 5, and a tip configuration portion 6. The operation unit 2 is provided with a gripping unit 7, an operation knob 8, an operation lever 9, and a treatment instrument insertion port 10a. The operation knob 8 performs a bending operation on the bending tube portion 5. The operation lever 9 operates a forceps raising base (not shown). The treatment instrument insertion port 10 a is provided to be inclined with respect to the axis of the insertion portion 2. The treatment instrument insertion port 10 a is provided with a channel opening 10 on the proximal end side that communicates with the proximal end of the treatment instrument insertion channel 11 inserted in the insertion portion 3.

  A distal end side channel opening 12 is formed in the distal end configuration portion 6. The distal end portion of the treatment instrument insertion channel 11 is communicated with the channel port 12.

  And the guide catheter 13 which is a treatment tool is inserted in the channel opening part 10 of the treatment tool insertion port 10a, and it guide | induces in the treatment tool penetration channel 11. FIG. Further, the guide catheter 13 in the treatment instrument insertion channel 11 is protruded to the outside from the channel port 12 of the distal end component 6.

  The catheter 13 is formed of a flexible synthetic resin material, for example, a fluorine resin or a nylon resin. A guide wire lumen is formed over the entire length of the guide catheter 13. A guide catheter cock 14 is provided at the proximal end of the guide catheter 13. The guide catheter cock 14 has a guide wire opening 14a communicating with the guide wire lumen and a liquid feeding base 14b.

  An engaging projection 15 is provided on the side wall near the distal end of the guide catheter cock 14. The engaging protrusion 15 has an enlarged portion 15a having a tapered portion at the distal end, and a reduced diameter portion 15b at the proximal end. This engagement protrusion 15 functions as an adapter that is a connection device that detachably engages between the operation portion 2 of the endoscope 1 and the catheter cock 14.

  As shown in FIG. 2A, the operation portion 2 of the endoscope 1 is provided with an engagement hole 16 in the vicinity of the treatment instrument insertion port 10a. The engagement projection 16 of the guide catheter cock 14 is engaged with the engagement hole 16 so as to be detachable. The diameter of the enlarged portion 15 a of the engagement protrusion 15 is set larger than the diameter of the engagement hole 16. Then, the engagement protrusion 15 is pushed into the engagement hole 16 with the guide catheter cock 14 as shown by an arrow in FIG. At this time, the enlarged portion 15a of the engagement protrusion 15 is elastically deformed and inserted into the engagement hole 16, and the engagement protrusion 15 and the engagement hole 16 are elastically engaged. Thus, a connection device is formed in which the guide catheter cock 14 is connected to the operation unit 2 with one touch.

  In a state in which the engagement protrusion 15 and the engagement hole 16 are engaged, the guide catheter cock 14 has an axial center of the engagement portion between the engagement protrusion 15 and the engagement hole 16 as indicated by an arrow in FIG. As shown in FIG. Therefore, the direction of the guide wire opening 14a of the guide catheter cock 14 can be matched with the direction of the channel opening 10 of the treatment instrument insertion port 10a, or the direction of the guide wire opening 14a can be changed according to the preference of the doctor. .

  Further, by pulling the engagement protrusion 15 away from the engagement hole 16 with the guide catheter cock 14, the engagement between the engagement protrusion 15 and the engagement hole 16 can be easily released. Thereby, the guide catheter cock 14 can be removed from the operation unit 2 with one touch.

  Next, the operation of the first embodiment will be described. FIG. 1 shows a usage state of the endoscope apparatus of the present embodiment. When using the endoscope apparatus of the present embodiment, the doctor holds the holding part 7 of the operation part 2 of the endoscope 1 with one hand and holds the insertion part 3 of the endoscope 1 with the other hand. Then, the insertion part 3 is inserted into the body cavity. At the time of this insertion work, the insertion work is performed while observing the endoscopic image, and if necessary, the operation knob 8 of the operation unit 2 is operated with fingers to bend the bending portion 5. Thereby, the insertion part 3 of the endoscope 1 is introduced into the body cavity (duodenum a). And the front-end | tip structure part 6 is made to approach the teat b vicinity of the duodenum a.

  Thereafter, an operation of guiding the guide wire 17 into the body cavity (duodenum a) through the treatment instrument insertion channel 11 of the endoscope 1 is performed. At the time of this operation, first, the doctor holds the guide wire 17 with the hand opposite to the hand holding the operation unit 2 of the endoscope 1, and this guide wire 17 is moved from the treatment instrument insertion port 10 a to the treatment instrument insertion channel 11. insert. At this time, when the guide wire 17 is pushed forward by a hand operation, the distal portion of the guide wire 17 protrudes from the channel port 12 of the tip constituting portion 6.

  Subsequently, the operation lever 9 is operated as necessary while observing the distal portion of the guide wire 17 with a monitor. By operating the operation lever 9, the forceps raising base is rotated to control the direction of the distal portion of the guide wire 17. Then, the distal portion of the guide wire 17 is inserted into the bile duct c from the nipple b. At this time, the doctor holds the proximal portion of the guide wire 17 and pushes it, moves it backward, or rotates it to insert it into the target site while controlling the movement of the distal portion of the guide wire 17. Can do.

  With the distal portion of the guide wire 17 inserted into the bile duct c as described above, next, an operation of inserting the guide catheter 13 into the body using the guide wire 17 as a guide is performed. At the time of this operation, first, the guide catheter cock 14 is set in a state of being connected to the operation unit 2. At this time, the doctor holds the guide catheter cock 14 and pushes the engagement protrusion 15 into the engagement hole 16 of the operation unit 2. Accordingly, the guide catheter cock 14 is connected to the operation unit 2 by elastically engaging the engagement protrusion 15 and the engagement hole 16.

  Thereafter, the guide catheter 13 is fitted to the guide wire 17 in a state where the proximal end of the guide wire 17 protruding outward from the treatment instrument insertion port 10 a is inserted into the distal end of the guide catheter 13. In this state, the guide catheter 13 is pushed forward. At this time, the guide catheter 13 is inserted into the treatment instrument insertion channel 11 while moving using the guide wire 17 as a guide.

  When the guide catheter 13 is further pushed forward, the distal portion of the guide catheter 13 protrudes from the channel port 12 of the tip constituting portion 6. And it is inserted into the bile duct c from the nipple b. At this time, the doctor moves the distal portion of the guide catheter 13 while controlling the movement of the distal portion of the guide wire 17 by pushing, retracting, or rotating the proximal portion of the guide wire 17. Lead the distal end to the target site. At this time, the guide catheter cock 14 is fixed to the operation unit 2 of the endoscope 1. Therefore, the guide catheter 13 can be operated with one hand of the opposite hand holding the operation unit 2.

  In addition, after inserting the guide catheter 13 into the target site, for example, a contrast medium is injected from the liquid feeding base 14 b of the guide catheter cock 14. Thereby, the inside of the bile duct c can be imaged. Therefore, the insertion position of the guide catheter 13 can be finely adjusted while confirming the position of the distal portion of the guide wire 17 under X-ray observation.

  Therefore, the above configuration has the following effects. That is, in this embodiment, the guide catheter cock 14 can be attached to the operation unit 2 of the endoscope 1. Therefore, the doctor can operate the endoscope 1 by holding the operation part 2 of the endoscope 1 with one hand, and can insert and remove the guide wire 17 and the guide catheter 13 with the other hand, Injection is also possible. Therefore, there is an effect that it is possible to operate by one doctor without helping an assistant such as a nurse.

  Further, when the doctor operates the two with the help of an assistant, by pulling the guide catheter cock 14 away from the operation section 2, the engagement protrusion 15 comes out of the engagement hole 16, and the guide catheter cock 14 can be separated from the operation unit 2.

  In the above-described embodiment, the guide catheter cock 14 is provided with the engagement protrusion 15 and the operation portion 2 is provided with the engagement hole 16. On the contrary, the guide catheter cock 14 is provided with the engagement hole 16 and the operation portion 2 may be provided with an engaging protrusion 15.

  3A and 3B show the second embodiment. FIG. 3A is a side view of the peripheral portion of the treatment instrument insertion port of the operation portion of the endoscope, and FIG. 3B is a front view of the same. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

  In the present embodiment, an adapter 18 as a connecting device is provided on the outer peripheral surface of the cylindrical portion 10b of the treatment instrument insertion port 10a provided in the operation portion 2 of the endoscope 1. The adapter 18 is formed by forming a cylindrical portion 20 with a pair of arc-shaped members 19 made of a synthetic resin material or a metal material facing the concave surfaces. A slit 19 a through which the guide catheter 13 can pass is formed between the pair of arcuate members 19.

  Accordingly, when the guide catheter cock 14 is attached to the adapter 18, the guide catheter 13 is passed through the slit 19 a between the pair of arcuate members 19, and the guide catheter cock 14 is held from above the tubular portion 20. The guide catheter cock 14 is inserted between the arcuate members 19. Thereby, the guide catheter cock 14 can be attached to the adapter 18.

  When removing the guide catheter cock 14 from the adapter 18, it can be removed by lifting the guide catheter cock 14 upward and extracting the guide catheter 13 from the slit 19a.

  The operations and effects of this embodiment are the same as those of the first embodiment, and a description thereof will be omitted.

  FIGS. 4A, 4B and 5 show a third embodiment. 4A is a side view of the peripheral portion of the treatment instrument insertion port of the operation portion of the endoscope, FIG. 4B is a view in the direction of the arrow A in FIG. 4A, and FIG. 5 is the guide catheter cock. It is a side view of the operation part of the endoscope in a state where is attached. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

  In the present embodiment, the operation unit 2 of the endoscope 1 is provided with an adapter 21 as a connection device. The adapter 21 is integrally formed of a synthetic resin material or the like. An arcuate attachment portion 22 that is elastically fitted to the cylindrical portion 2 a of the operation portion 2 is provided at the lower end portion of the adapter 21. The attachment portion 22 is provided with a support member 23 that protrudes obliquely upward in parallel along the treatment instrument insertion port 10a. A cylindrical portion 24 is formed on the upper end portion of the support member 23 with the concave surfaces facing each other. As shown in FIG. 4A, two cylindrical portions 24 are provided apart from each other in the vertical direction. As shown in FIG. 4B, the cylindrical portion 24 is formed with a slit 24a through which the guide catheter 13 can pass.

  Therefore, when the guide catheter cock 14 is attached to the adapter 21, the guide catheter cock 14 is inserted from above the tubular portion 24 with the guide catheter cock 14 being passed through the slit 24a. Can be installed.

  When removing the guide catheter cock 14 from the adapter 21, it can be removed by lifting the guide catheter cock 14 upward and extracting the guide catheter 13 from the slit 24a.

  The operations and effects of this embodiment are the same as those of the first embodiment, and a description thereof will be omitted.

  FIGS. 6A and 6B show a fourth embodiment. FIG. 6A is a side view of the operation portion of the endoscope with the guide catheter cock attached, and FIG. 6B is an arrow view seen from the direction of arrow A in FIG. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

  In the present embodiment, an adapter 25 as a connection device is provided integrally with the treatment instrument insertion port 10a of the operation unit 2. As shown in FIG. 6B, the adapter 25 is formed with a holding ring 26 adjacent to the cylindrical portion 10b of the treatment instrument insertion port 10a. Two holding rings 26 are provided apart from each other in the vertical direction. Slits 26 a through which the guide catheter 13 can pass are formed on the side portions of these holding rings 26.

  Therefore, when the guide catheter cock 14 is attached to the adapter 25, first, the guide catheter 13 is passed through the slit 26a with the guide catheter cock 14. Then, the guide catheter cock 14 is inserted into the holding ring 26 from above. Thereby, the guide catheter cock 14 can be attached to the adapter 25.

  When removing the guide catheter cock 14 from the adapter 25, the guide catheter cock 14 can be lifted upward and the guide catheter 13 can be removed from the slit 26a.

  FIG. 7 shows a modification of the fourth embodiment. In this modification, a slit 26 b is provided in the front portion of the holding ring 26. The operations and effects of this embodiment are the same as those of the first embodiment, and a description thereof will be omitted.

  8A and 8B show a fifth embodiment. 8A is a top view before the adapter 27 is attached to the treatment instrument insertion port body 10a, and FIG. 8B is a top view of the adapter 27 attached to the treatment instrument insertion port body 10a. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

  In the present embodiment, an adapter 27 as a connection device is detachably provided to the treatment instrument insertion port 10a of the operation unit 2. The adapter 27 is integrally formed of a synthetic resin material. The adapter 27 is formed with a cylindrical portion 28 into which the guide catheter cock 14 is inserted. A slit 28 a through which the guide catheter 13 can pass is formed on the side of the cylindrical portion 28.

  Further, a pair of clamping pieces 29 capable of clamping the cylindrical portion 10b of the treatment instrument insertion port body 10a are integrally projected on the back portion of the cylindrical portion 28. A claw portion 30 that is opposed to each other is provided at the tip of each sandwiching piece 29. On the other hand, an engagement recess 31 that engages with the claw portion 30 is provided in the cylindrical portion 10b of the treatment instrument insertion port 10a.

  Therefore, by pushing the pair of holding pieces 29 of the adapter 27 into the tube portion 10b of the treatment instrument insertion port body 10a, the claw portion 30 engages with the engagement recess 31 and the adapter 27 is inserted into the tube of the treatment device insertion port body 10a. It can be attached to the part 10b.

  When the guide catheter cock 14 is attached to the adapter 27, the guide catheter cock 14 is inserted from above the tubular portion 28 with the guide catheter cock 14 passing through the slit 28a. Can be installed.

  When removing the guide catheter cock 14 from the adapter 27, it can be removed by lifting the guide catheter cock 14 upward and extracting the guide catheter 13 from the slit 28a.

  The operations and effects of this embodiment are the same as those of the first embodiment, and a description thereof will be omitted.

  FIGS. 9A and 9B show a sixth embodiment. FIG. 9A is a side view of the operation portion of the endoscope, and FIG. 9B is an arrow view seen from the direction of arrow B in FIG. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

  In the present embodiment, an adapter 33 is shown as a connection device for attaching the high-frequency cutting tool 32 to the operation unit 2 of the endoscope 1. First, the high frequency cutting tool 32 will be described. The incision tool main body 34 is provided with a substantially Y-shaped connecting member 35. A common coupling portion 35 a is provided on the distal end side of the coupling member 33. A pair of branch connecting portions 35b and 35c are provided on the rear end side of the connecting member 35. And the base end part of the guide catheter 36 is connected with the common connection part 35a.

  In addition, an operation unit main body 37 is fixed to one of the branch connection portions 35b. A slider 38 is provided in the operation portion main body 37 so as to be movable in the longitudinal direction of the operation portion main body 37. A proximal end portion of a conductive wire 39 is fixed to the slider 38 via a conductive operation pipe 40 and a plug 41. The guide wire 17 is inserted through the other branch connecting portion 35c.

  The adapter 33 is formed in an annular shape from a synthetic resin material. The adapter 33 is detachably fitted to the tube portion 2a of the operation portion 2 of the endoscope 1 as shown in FIG. 9B. A slit 42 is obliquely provided on a part of the circumference of the adapter 33. A cylindrical portion 43 is formed obliquely and continuously with the slit 42. A common connecting portion 35 a of the high-frequency cutting tool 32 is inserted into the cylindrical portion 43.

  Therefore, when attaching the high frequency incision tool 32 to the adapter 33, the common connecting portion 35 a is inserted from above the tubular portion 43 while holding the operation portion main body 37 and passing the guide catheter 36 through the slit 42. Can be installed.

  When removing the high-frequency incision tool 32 from the adapter 33, the operation section body 37 can be lifted upward and the guide catheter 36 can be removed from the slit 42.

  According to the present embodiment, when the luminal exit of the duodenal papilla is incised by the high-frequency incision tool 32, the doctor grasps the operation unit 2 of the endoscope 1 with one hand as in the first embodiment. The distal portion of the guide wire 17 can be inserted into the lumen exit of the duodenal papilla with the other hand. Then, by inserting the guide catheter 36 of the high-frequency incision tool 32 using the guide wire 17 as a guide, a high-frequency incision knife part (not shown) can approach the target site to perform high-frequency incision.

  FIGS. 10A to 10C to FIGS. 13A and 13B show a seventh embodiment. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, an external adapter 51 shown in FIG. 10A is detachably provided in order to detachably lock the guide catheter 13 as a treatment tool to the operation section 2 of the endoscope 1. Is. The adapter 51 is provided with an endoscope connecting portion 52, a catheter connecting portion 53, and a catheter tip clamping portion 54. As shown in FIG. 10B, the endoscope connecting portion 52 is formed with a concave engaging groove 56 in a substantially flat base plate 55. The adapter 51 is configured such that the engagement groove 56 of the base plate 55 is attached to the treatment instrument insertion port body 10a disposed in the operation section 2 of the endoscope 1 as shown in FIG. .

  Here, generally, as shown in FIG. 11A, a tubular forceps plug mounting portion 10a2 projects from the forceps plug mounting seat 10a1 at the distal end of the treatment instrument insertion port 10a. And the forceps stopper 10c formed with the rubber-like elastic member is inserted and attached to the forceps stopper attachment part 10a2. Further, the adapter 51 has the base plate 55 inserted between the forceps plug mounting seat 10a1 and the forceps plug 10c of the treatment instrument insertion port 10a and the forceps plug mounting portion 10a2 in the engaging groove 56 of the base plate 55. In the inserted state, it is engaged and fixed so as to be detachable.

  The catheter connecting portion 53 includes a flat plate-like first support plate 57 bent at a substantially right angle from the base plate 55 of the endoscope connecting portion 52 as shown in FIG. 10A, and the first support. A substantially L-shaped bending member 58 having one end connected to the plate 57 is provided. The bending member 58 is provided with a second support plate 59 disposed in parallel with the first support plate 57 at a position facing and separating from the first support plate 57.

  Further, as shown in FIG. 10B, block-shaped elastic members 60 and 61 are attached to the inner surface side of the first support plate 57 and the second support plate 59, respectively. These elastic members 60 and 61 are arranged in parallel at positions facing each other. Then, as shown in FIG. 12C, the guide catheter cock 14 is engaged with the catheter connecting portion 53 in a state where the guide catheter cock 14 of the guide catheter 13 is inserted and held in the gap between the elastic members 60 and 61. It is designed to be detachably engaged and fixed. The outer diameter of the catheter cock 14 is generally about 7 mm. Therefore, the distance between the first support plate 57 and the second support plate 59 is preferably about 10 mm, for example, and the distance between the two elastic members 60 and 61 is preferably about 5 mm, for example.

  Further, as shown in FIG. 10C, the groove width between the two elastic members 60, 61 gradually increases toward one end of the two elastic members 60, 61 of the catheter connecting portion 53. Inclined surfaces 60a and 61a are formed.

  Further, the catheter tip clamping portion 54 is provided with a flat base plate 62 connected to the first support plate 57 of the adapter 51 on the side opposite to the bending member 58 as shown in FIG. . A substantially cylindrical sandwiching member 63 formed of an elastic material is attached to the outer surface of the base plate 62 as shown in FIG. A narrow slit 64 is provided in the cylindrical portion of the clamping member 63. The inner diameter of the cylindrical member 63 is set smaller than the outer diameter of the guide catheter 13. For this reason, as shown in FIG. 13A, the distal end portion of the guide catheter 13 is clamped by the clamping member 63 when the distal end portion of the guide catheter 13 is inserted into the cylinder 65 of the clamping member 63 in a press-fitted state. In the state, it is engaged and fixed so that it can be engaged and disengaged.

  For example, silicon rubber or butyl rubber is used as the elastic material of the two elastic members 60 and 61 of the catheter connecting portion 53 and the holding member 63 of the catheter tip holding portion 54. Further, the first support plate 57 and the elastic member 60, and the second support plate 59 and the elastic member 61 may be integrally formed.

  Next, the operation of the present embodiment having the above configuration will be described. When the adapter 51 of the present embodiment is used, first, the endoscope connection part 52 of the adapter 51 is attached to the treatment instrument insertion port body 10 a arranged in the operation part 2 of the endoscope 1. At this time, as shown in FIG. 11A, the engaging groove 56 provided on the base plate 55 of the endoscope connecting portion 52 is aligned with the position of the forceps plug mounting portion 10a2 in the treatment instrument insertion port body 10a. In this state, the base plate 55 of the endoscope connecting portion 52 is inserted into the gap between the forceps plug mounting seat 10a1 and the forceps plug 10c of the treatment instrument insertion port 10a. Then, in a state where the forceps plug attachment portion 10a2 is inserted into the engagement groove 56 of the base plate 55, the endoscope connection portion 52 is detachably engaged with and fixed to the treatment instrument insertion port body 10a. Thereby, the adapter 51 is fixed to the endoscope 2 as shown in FIG.

  Subsequently, the distal end portion 13 a of the guide catheter 13 is attached to the catheter distal end clamping portion 54 of the adapter 51. When the guide catheter 13 is attached, the distal end portion 13a of the guide catheter 13 is inserted into the cylindrical clamping member 63 of the catheter distal end clamping portion 54 from below as shown in FIG. As a result, the distal end portion 13a of the guide catheter 13 is elastically fixed in a state of being sandwiched by the cylindrical sandwiching member 63. In this state, the proximal end of the guide wire 17 is inserted from the distal end of the guide catheter 13 as indicated by an arrow in FIG. Thereafter, the distal end portion 13a of the guide catheter 13 is removed from the clamping member 63, and the guide catheter 13 is inserted into the treatment instrument insertion channel 11 while moving with the guide wire 17 as a guide, as in the above-described embodiments. It is inserted into the body through the insertion channel 11.

  Thereafter, the guide catheter cock 14 of the guide catheter 36 is attached to the catheter connection portion 53 of the adapter 51. When the guide catheter cock 14 is attached, the guide catheter 13 is held between the two elastic members 60 and 61 of the catheter connection portion 53 as shown in FIG. The guide catheter cock 14 is inserted between the two elastic members 60 and 61 from above the catheter connecting portion 53 as indicated by an arrow in FIG. Thereby, the guide catheter cock 14 is clamped between the two elastic members 60 and 61 and fixed.

  Therefore, the above configuration has the following effects. That is, the catheter connection portion 53 of the adapter 51 of the present embodiment has a structure in which the catheter cock 14 is sandwiched between two block-like elastic members 60 and 61. Therefore, the guide catheter cock 14 of various sizes and shapes that can be inserted between the two block-like elastic members 60 and 61 can be held in the catheter connection portion 53 of the adapter 51 so as to be detachable.

  Moreover, in the adapter 51 of this Embodiment, the catheter front-end | tip clamping part 54 can be provided, and the front-end | tip part 13a of the catheter 13 can be fixed in the state engaged and disengaged by this catheter front-end | tip clamping part 54. In this state, the proximal end of the guide wire 17 can be inserted into the distal end portion 13a of the catheter 13, so that the guide wire 17 can be easily inserted. As a result, when the doctor inserts the proximal end of the guide wire 17 into the distal end of the guide catheter 13 as in the prior art, the endoscope 1, the distal end of the guide catheter 13, and the guide wire 17 Compared with the case where a difficult operation for holding the proximal end separately is required, the operation can be simplified.

  FIGS. 14A to 14E show an eighth embodiment of the present invention. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, an adapter 71 having a configuration different from the adapter 51 of the seventh embodiment (see FIGS. 10A to 10C to 13A and 13B) is provided. The adapter 71 is provided with an endoscope connecting portion 72, a catheter connecting portion 73, and a catheter tip clamping portion 74. As shown in FIG. 14B, the endoscope connecting portion 72 is provided with a substantially U-shaped clamping member 75. The sandwiching member 75 is provided with a pair of holding plates 75a and 75b arranged in a substantially parallel state in a state of being opposed to each other. Block-like elastic members 76 and 77 are attached to the inner surfaces of the holding plates 75a and 75b, respectively. And as for this adapter 71, as shown in FIG.14 (D), the U-shaped clamping member 75 of the endoscope connection part 72 is set to the treatment tool insertion port body 10a arrange | positioned at the operation part 2 of the endoscope 1. As shown in FIG. It is designed to be attached in an externally fitted state.

  Further, as shown in FIG. 14A, the catheter connecting portion 73 has a pair of support plates 78 protruding from the pair of holding plates 75a and 75b on the clamping member 75 of the endoscope connecting portion 72. , 79 are provided.

  Further, as shown in FIG. 14B, block-like elastic members 80 and 81 are attached to the inner surface side of the pair of holding plates 75a and 75b, respectively. These elastic members 80 and 81 are arranged in parallel at positions facing each other. The guide catheter cock 14 is detachably engaged with and fixed to the catheter connecting portion 73 in a state where the guide catheter cock 14 of the guide catheter 13 is inserted and held in the gap between the elastic members 80 and 81. It has become. The outer diameter of the catheter cock 14 is generally about 7 mm. Therefore, the distance between the two holding plates 75a and 75b of the catheter connection portion 73 is preferably about 10 mm, for example, and the distance between the two elastic members 80 and 81 is preferably about 5 mm.

  Further, the catheter tip clamping portion 74 has a substantially cylindrical shape formed of an elastic material as shown in FIG. 14B on the outer surface of one support plate 79 of the adapter 71 as shown in FIG. A clamping member 82 is attached. A narrow slit 83 is provided in the cylindrical portion of the clamping member 82. The inner diameter of the cylinder of the holding member 82 is set to be smaller than the outer diameter of the guide catheter 13. Therefore, when the distal end portion of the guide catheter 13 is inserted into the cylinder 84 of the clamping member 82 in a press-fitted state, the distal end portion of the guide catheter 13 is engaged and fixed in a state where the distal end portion of the guide catheter 13 is sandwiched by the clamping member 82. It has come to be.

  For example, silicon rubber or butyl rubber is used as the elastic material of the two elastic members 80 and 81 of the catheter connecting portion 73 and the holding member 82 of the catheter tip holding portion 74. Further, the sandwiching member 75 and the elastic members 76 and 77, and the support plates 78 and 79 and the elastic members 80 and 81 may be integrally formed.

  Next, the operation of the present embodiment having the above configuration will be described. When the adapter 71 of the present embodiment is used, first, the endoscope connection part 72 of the adapter 71 is attached to the treatment instrument insertion port 10 a arranged in the operation part 2 of the endoscope 1. At the time of this attachment work, the U-shaped clamping member 75 is moved in a direction to be externally fitted to the treatment instrument insertion port 10a as indicated by an arrow in FIG. 14C, and the adapter 71 is moved to the treatment instrument insertion port 10a. Push in. Accordingly, as shown in FIG. 14D, the treatment instrument insertion port 10a is inserted between the elastic members 76 and 77 of the holding plates 75a and 75b, and the treatment tool is inserted between the elastic members 76 and 77 of the holding plates 75a and 75b. The adapter 71 is attached to the treatment instrument insertion port 10a in a state where the insertion port 10a is held. Other operations are the same as those of the seventh embodiment.

  Therefore, even with the above configuration, the same effect as in the seventh embodiment can be obtained.

  FIGS. 15A to 15C show a ninth embodiment of the present invention. Note that the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the present embodiment, an endoscope connection adapter 91 is provided on the guide catheter cock 14. The endoscope connection adapter 91 is provided with a substantially U-shaped holding member 92 as shown in FIG. As shown in FIG. 15 (B), the holding member 92 is provided with a pair of holding plates 92a and 92b which are arranged in parallel and spaced apart from each other. Block-shaped elastic members 93 and 94 are attached to the inner surfaces of these holding plates 92a and 92b, respectively. And as for this endoscope connection adapter 91, as shown in FIG.15 (C), the U-shaped clamping member 92 is externally fitted by the treatment tool insertion port 10a arrange | positioned at the operation part 2 of the endoscope 1. As shown in FIG. It can be attached in a state that

  For example, silicon rubber or butyl rubber is used as the elastic material of the two elastic members 93 and 94 of the endoscope connection adapter 91. Further, the holding member 92 and the elastic members 93 and 94 may be integrally formed.

  Next, the operation of the present embodiment having the above configuration will be described. In the present embodiment, when the guide catheter 13 is used, the endoscope connection adapter 91 of the guide catheter cock 14 is attached to the treatment instrument insertion port 10 a disposed in the operation unit 2 of the endoscope 1 and has a U-shaped holding member 92. Is attached in a state of being externally fitted. Other operations are the same as those in the first embodiment.

  Therefore, the above configuration has the following effects. That is, since the endoscope connection adapter 91 is provided in the guide catheter cock 14 in the present embodiment, when the guide catheter 13 is used, the guide catheter cock 14 is inserted into the treatment instrument insertion port 10a of the operation unit 2 of the endoscope 1. This endoscope connection adapter 91 can be removably locked. Therefore, in this embodiment as well, the doctor can operate the endoscope 1 and the catheter 13 at the same time as in the first embodiment, and the operability of the guide catheter 13 can be improved.

In each of the embodiments described above, the guide catheter for feeding liquid to the bile duct and the like, guiding the lumen exit of the duodenal papilla to the target site using the guide catheter of the high-frequency incision tool as a guide wire, have been described. The present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
According to the embodiment described above, the following configuration is obtained.

  (Supplementary Note 1) In an endoscope apparatus including a catheter used in combination with an endoscope, an endoscope having a treatment instrument insertion channel, and the treatment instrument insertion provided at a proximal portion of the endoscope A channel opening that communicates with the channel; and an operating portion that is provided at a proximal portion of the catheter and has at least one of a guide wire opening or a liquid feeding opening that communicates with the guide wire lumen, or a catheter operating means. An endoscope apparatus comprising a connecting device attached to at least one of a mirror and the catheter so that the channel opening and the operation unit are positioned in the vicinity.

  (Supplementary note 2) The endoscope apparatus according to supplementary note 1, wherein the channel opening and the guide wire opening can be attached in substantially the same direction.

  (Additional remark 3) The endoscope apparatus of Additional remark 1 characterized by being able to install guide wire opening in arbitrary directions with respect to channel opening.

  (Supplementary note 4) The endoscope apparatus according to supplementary note 1, wherein the connection device is detachable from the endoscope or the catheter.

  (Additional remark 5) The endoscope apparatus of Additional remark 1 characterized by the catheter being a catheter for liquid feeding.

  (Supplementary note 6) The endoscope apparatus according to supplementary note 1, wherein the catheter is a catheter for a high-frequency incision tool.

  (Additional remark 7) In the endoscope apparatus which consists of an endoscope and the catheter used in combination, the said endoscope is a channel provided in the treatment tool insertion channel and the said treatment tool insertion channel provided in the proximal part. The catheter has an operation portion having at least one of a guide wire opening or a liquid feeding opening or a catheter operation means communicating with the guide wire lumen in the proximal portion, and the endoscope or the catheter An endoscope apparatus characterized in that a connection device is provided on at least one of the first and second channel openings so that the channel opening and the operation portion are positioned in the vicinity.

  (Additional remark 8) In the endoscope apparatus according to additional remark 7, a connection mechanism to the endoscope is provided in the operation portion of the catheter, and the connection mechanism to the endoscope opposes substantially in parallel 2 An endoscope apparatus comprising two members, wherein at least one of the two members is an elastic member.

  (Additional remark 9) In the endoscope apparatus which consists of an endoscope and the catheter used in combination, the said endoscope is a channel provided in the treatment tool insertion channel and the said treatment tool insertion channel provided in the proximal part. The catheter has an operation portion having at least one of a guide wire opening or a liquid supply opening communicating with the guide wire lumen or an operation means of the catheter at a proximal portion, and the channel opening and the operation portion are An endoscope apparatus comprising an adapter having a connection mechanism with an endoscope and a connection mechanism with a catheter so as to be positioned in the vicinity.

  (Additional remark 10) In the endoscope apparatus according to Additional remark 9, at least one of the connection mechanism with the endoscope and the connection mechanism with the catheter is configured by two members facing each other substantially in parallel. An endoscope apparatus, wherein at least one is an elastic member.

The 1st Embodiment of this invention is shown, and the side view of the use condition of an endoscope apparatus. (A) is a perspective view which shows the periphery site | part of the treatment tool insertion port of the operation part of 1st Embodiment, (B) is a longitudinal cross-sectional view which shows the attachment part of a guide catheter cock. The 2nd Embodiment of this invention is shown, (A) is a side view of the operation part of an endoscope, (B) is a front view similarly. The 3rd Embodiment of this invention is shown, (A) is a side view of the operation part of an endoscope, (B) is an arrow view from the arrow A direction of (A). The side view of the operation part of the endoscope which shows 3rd Embodiment and has attached the guide catheter cock. The 4th Embodiment of this invention is shown, (A) is a side view of the operation part of the endoscope in the state which attached the guide catheter cock, (B) is an arrow view from the arrow A direction. The top view which shows the modification of 4th Embodiment. The 5th Embodiment of this invention is shown, (A) is a top view before attaching an adapter to a treatment tool insertion port, (B) is a top view of the state which attached the adapter to the treatment tool insertion port. The 6th Embodiment of this invention is shown, (A) is a side view of the operation part of an endoscope, (B) is an arrow view from the arrow B direction of (A). The 7th Embodiment of this invention is shown, (A) is a perspective view of an adapter, (B) is a top view, (C) is a top view which shows the taper surface of an elastic member. (A) is a side view showing a state before the adapter is attached to the operation part of the endoscope of the seventh embodiment, and (B) is a side view showing a state where the adapter is attached to the operation part of the endoscope. (C) is a top view which shows the mounting state of an adapter. It shows the use state of the adapter of the operation part of the endoscope of the seventh embodiment, (A) is a side view of the main part for explaining the work of attaching the guide catheter cock to the adapter, (B) The side view of the principal part which shows the mounting state of a guide catheter cock, (C) is the 12 (C) -12 (C) sectional view taken on the line of (B). The use state of the catheter holding part of the adapter of the operation part of the endoscope of 7th Embodiment is shown, (A) is the principal part which shows the state which made the catheter holding part of the adapter hold | maintain the front-end | tip part of a catheter. A side view and (B) are the perspective views. FIG. 10 shows an eighth embodiment of the present invention, where (A) is a perspective view of an adapter, (B) is a plan view thereof, and (C) is a diagram for explaining an operation of mounting the adapter to a treatment instrument insertion portion of an endoscope. (D) is a top view which shows the state which mounted | wore the adapter to the treatment tool insertion part of an endoscope, (E) is a side view which shows the state which mounted | wore the adapter to the treatment tool insertion part of an endoscope. 9 shows a ninth embodiment of the present invention, (A) is a perspective view showing an endoscope connecting portion of a guide catheter cock, (B) is a plan view thereof, and (C) is a guide catheter cock connected to an endoscope. The side view which shows the state made to do.

Explanation of symbols

    DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Operation part, 10 ... Channel opening part, 10a ... Treatment tool insertion port body, 11 ... Treatment tool insertion channel, 13 ... Guide catheter (treatment tool), 14 ... Guide catheter cock, 14a ... Guide Wire opening, 17 ... Guide wire, 51 ... Adapter, 52 ... Endoscope connection part, 53 ... Catheter connection part (treatment instrument connection part), 63 ... Holding member.

Claims (8)

A treatment section is disposed at the proximal end of the elongated insertion section to be inserted into the lumen, and a treatment instrument insertion port projecting at a position near the operation section is disposed inside the insertion section. An endoscope in which a channel opening communicating with the proximal end of the instrument insertion channel is formed;
Used in combination with a treatment instrument having an elongated treatment instrument insertion portion to be inserted into the treatment instrument insertion channel from the channel opening, and having a treatment instrument operation portion disposed at a proximal end portion of the treatment instrument insertion portion An endoscopic device,
An endoscope connecting portion that is detachably connected to the endoscope, and a treatment tool connecting portion that is detachably connected to the treatment instrument, and is attached / detached between the endoscope and the treatment instrument Provide an adapter that can be connected,
An endoscope apparatus, wherein the adapter is provided with a holding member that detachably holds the treatment instrument insertion portion. In the endoscope connecting portion, a concave engagement groove into which the treatment instrument insertion port is inserted is formed in a flat base plate, and the treatment instrument insertion port is inserted into the engagement groove. Attached to the tool insertion port,
The treatment instrument connecting portion has two sandwiching members arranged to be spaced apart from each other,
The endoscope apparatus according to claim 1, wherein at least one of the two holding members is an elastic member.   The treatment instrument connecting portion is formed with an inclined surface in which a width between the two sandwiching members gradually increases toward a distal end side at one side of the two sandwiching members. Item 5. The endoscope apparatus according to Item 2. The holding member has an insertion hole set to be smaller than the outer diameter of the treatment instrument insertion portion, and a narrow slit provided in a peripheral wall portion of the insertion hole,
The distal end portion of the treatment instrument insertion portion is inserted into the insertion hole in a press-fitted state, and the distal end portion of the treatment instrument insertion portion is detachably engaged and fixed by the holding member. The endoscope apparatus according to Item 1. A treatment section is disposed at the proximal end of the elongated insertion section to be inserted into the lumen, and a treatment instrument insertion port projecting at a position near the operation section is disposed inside the insertion section. An endoscope in which a channel opening communicating with a proximal end portion of the instrument insertion channel is formed; and an elongated treatment instrument insertion section to be inserted into the treatment instrument insertion channel from the channel opening, the treatment instrument insertion section An adapter for detachably connecting a treatment instrument having a treatment instrument operation unit disposed at the proximal end of the
An endoscope connecting apparatus, wherein the adapter is provided with a holding member that detachably holds the treatment instrument insertion portion. The adapter includes an endoscope connecting portion that is detachably connected to the endoscope, and a treatment instrument connecting portion that is detachably connected to the treatment instrument,
In the endoscope connecting portion, a concave engagement groove into which the treatment instrument insertion port is inserted is formed in a flat base plate, and the treatment instrument insertion port is inserted into the engagement groove. Attached to the tool insertion port,
The treatment instrument connecting portion has two sandwiching members arranged to be spaced apart from each other,
The endoscope connection device according to claim 5, wherein at least one of the two holding members is an elastic member.   The treatment instrument connecting portion is formed with an inclined surface in which a width between the two sandwiching members gradually increases toward a distal end side at one side of the two sandwiching members. Item 7. The endoscope connection device according to Item 6. The holding member has an insertion hole set to be smaller than the outer diameter of the treatment instrument insertion portion, and a narrow slit provided in a peripheral wall portion of the insertion hole,
The distal end portion of the treatment instrument insertion portion is inserted into the insertion hole in a press-fitted state, and the distal end portion of the treatment instrument insertion portion is detachably engaged and fixed by the holding member. Item 6. The endoscope connection device according to Item 5.

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