JP2007260278A - Endoscope insertion aid and endoscope instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope insertion aid and an endoscope instrument which permit a smooth insertion of the insertion portion of an endoscope into the deep side of a lumen such as a large intestine, and the attainment of the shortening or the like of a test period. <P>SOLUTION: The endoscope instrument 1 has a first endoscope insertion aid 4 having a first balloon 6 and into which the insertion portion 3 of an endoscope 2 can be inserted, a second endoscope insertion aid 5 having a second balloon 7 and into which the insertion portion 3 of the endoscope 2 can be inserted. The first and second balloons 6 and 7 are expanded or contracted by fluid supply and discharge control by a balloon control devices 8a and 8b. Consequently, with the second balloon 7 expanded and held and fixed in the lumen, the first balloon 6 can move to the front side with great strokes where the balloon can be captured within a visual range of the endoscope 2 by advancing and withdrawing a shaft 21 by hand, the endoscope 2 can be smoothly inserted into the deep side of the intestinal duct. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope insertion aid suitable for smoothly inserting an insertion portion of an endoscope, for example, transanally or orally into a lumen such as the large intestine and small intestine, and an endoscope apparatus. About.

In general, an endoscope includes an operation unit that is held by an operator and performs various operations, and an insertion unit. The insertion unit is a long and thin tube extending from the operation unit and has a flexibility. And a bending portion that is connected to the tip of the flexible portion and can be bent in the left and right or up and down directions by operation of the operation portion, and a hard tip configuration portion that is connected to the tip of the bending portion. Has been.
The surgeon inserts the insertion portion of such an endoscope into the body cavity transanally, orally, or nasally, observes and diagnoses a predetermined site, or performs a treatment while observing. Is going.

By the way, in order to insert the insertion portion of the endoscope into the body cavity, conventionally, a method has been used in which the endoscope is mainly pushed from outside the patient's body by applying a force.
However, in such a push-in method, when the endoscope insertion portion is inserted transanally or rostrally into the large intestine or small intestine, these intestinal tracts have a narrow lumen inner diameter and are long and complicatedly bent. On the other hand, since the intestinal tract is not firmly fixed and is flexible, even if it moves or compresses in the advancing direction by pushing the insertion part of the endoscope, if the pushing force is released, the reaction force is almost It will be pushed back to its original position. For this reason, the endoscope insertion part does not progress easily, and its return is particularly remarkable as it reaches the deep part of the intestinal tract. Therefore, with such a pushing method, especially when the endoscope insertion part is inserted deeply, the inspection is performed. The time was long and difficult.

  Therefore, in view of such problems, in the conventional technology, in order to enable insertion into the intestinal tract without simply pushing the endoscope insertion portion from outside the patient's body, for example, Japanese Patent Laid-Open No. 2000- An endoscope insertion aid described in Japanese Patent No. 23909 and Japanese Patent Application Laid-Open No. 2004-358222 has been proposed.

  The endoscope insertion aid described in Japanese Patent Laid-Open No. 2000-23909 includes a first balloon fixed to the distal end portion of the endoscope insertion portion, and a perspective movement that protrudes from the distal end portion of the endoscope. A second balloon that is capable of inflating and deflating the first and second balloons to push the endoscope insertion portion while holding and releasing the intestinal tract; Is to be inserted deep into the intestinal tract.

In addition, an endoscope insertion aid described in the publication of Japanese Patent Application Laid-Open No. 2004-358222 includes a first balloon fixed to a distal end portion of an endoscope insertion portion, and an overhang placed on the endoscope insertion portion. A second balloon fixed to the distal end of the tube, and inflating and deflating the first and second balloons, respectively, to push the endoscope insertion portion while holding and releasing the intestinal tract The distal end portion of the endoscope is inserted into the deep part of the intestinal tract.
JP 2000-23909 A JP 2004-358222 A

  However, in the conventional endoscope insertion aids described in JP 2000-23909 A and JP 2004-358222 A, the first and second balloons are inflated and deflated, respectively. Even if the endoscope insertion portion is pushed forward while holding and releasing, only one balloon is movable with respect to the endoscope, so that the movement distance (stroke) of the movable balloon is one stroke. Cannot be made large, and therefore it takes time to insert the endoscope. Further, in the conventional example, it is difficult to perform observation or treatment by freely moving the endoscope back and forth within the intestinal tract held by the first and second balloons.

  In particular, in the conventional example described in the publication of Japanese Patent Application Laid-Open No. 2004-358222, the maximum stroke between two balloons is approximately the total length of the insertion portion of the endoscope minus the total length of the overtube. If the total length of the tube is set to 2 m and the maximum stroke is set to 1 m, the insertion length of the endoscope needs to be 3 m. In other words, the longer the maximum stroke of the two balloons, the longer the length of the insertion portion of the endoscope must be formed. Therefore, an endoscope such as a bending operation or a twisting operation of the insertion portion is required. The operability of the mirror itself will be adversely affected.

  Further, in the conventional example described in Japanese Patent Laid-Open No. 2000-23909, since the first balloon has to pass through the entire length of the forceps channel from the proximal side of the endoscope, only a small balloon can be actually mounted. For this reason, when the first balloon is inflated, the holding force of the intestinal tract is very weak and easy to shift, making it very difficult to smoothly insert the endoscope into the deep part of the intestinal tract.

  Therefore, the present invention has been made in view of the above problems, and when the insertion portion of the endoscope is inserted into a lumen of the large intestine, small intestine, or the like, for example, transanally or orally, on the deep side. An object of the present invention is to provide an endoscope insertion aid and an endoscope apparatus that can be smoothly inserted and can improve the operability of the endoscope.

  An endoscope insertion aid of the present invention transmits a first balloon member having a first hollow portion that can be inserted through an endoscope insertion portion, and a forward and backward movement operation on the hand side to the first balloon member. And a second balloon member having a second hollow portion that can be inserted through the endoscope insertion portion, and a first balloon member that transmits a forward and backward movement operation on the hand side to the second balloon member. Supply of fluid into the first balloon member and the second balloon member to inflate or deflate the two transmission members, the first balloon member, and the second balloon member. Control means for controlling the exhaust.

  In addition, an endoscope apparatus according to the present invention includes an endoscope provided with an elongated insertion portion that can be inserted into a body cavity, and an endoscope insertion aid configured in combination with the endoscope. The endoscope insertion assisting tool has a first balloon member having a first hollow portion that can be inserted through the insertion portion, and a first balloon member that transmits a forward and backward movement operation to the first balloon member. A second balloon member having a second hollow portion that can be inserted through the insertion portion, a second transmission member that transmits a proximal side advance / retreat operation to the second balloon member, Control means for controlling supply and discharge of fluid into the first balloon member and into the second balloon member so as to inflate or deflate the first balloon member and the second balloon member. And have.

  According to the present invention, when the insertion part of the endoscope is inserted transluminally or orally into a lumen of the large intestine, small intestine or the like, it can be smoothly inserted deeply, and the operation of the endoscope There is an advantage that the performance can be improved.

Embodiments of the present invention will be described below with reference to the drawings.
Example 1
FIGS. 1 to 13 relate to the first embodiment of the present invention, FIG. 1 is a configuration diagram showing the overall configuration of the endoscope apparatus in the first embodiment, and FIG. 2 shows a first endoscope insertion aid that can be moved forward and backward. FIG. 3 is a perspective view showing a part of the distal end portion of the endoscope that is attached and pulled most proximally, FIG. 3 is a longitudinal sectional view of the first endoscope insertion aid of FIG. 4 to 12 show that the intestinal tract is squeezed while inflating and deflating the first balloon of the first endoscope insertion aid and the second balloon of the second endoscope insertion aid. FIG. 5 is an explanatory diagram for explaining the state in which the distal end is advanced to the deep part of the intestinal tract, and FIG. 5 is a flowchart for explaining the operation of this embodiment, and shows the respective states from FIG. 4 to FIG. is there.

  As shown in FIG. 1, an endoscope apparatus 1 according to a first embodiment of the present invention is inserted into a body cavity (lumen) or the like, and is used for endoscopy, and the endoscope. A first endoscope insertion assisting tool 4 that is mounted so as to be movable forward and backward from the distal end side of the insertion section 3; and a second that is mounted so as to be able to advance and retract over the entire length of the insertion section 3 of the endoscope 2. Supplying fluid to the endoscope insertion assisting tool 5 and the first balloon 6 and the second balloon 7 provided in the first and second endoscope insertion assisting tools 4 and 5, respectively, or And balloon control devices 8a and 8b for controlling to be sucked and discharged. The first balloon 6 constitutes a part of the first balloon member, and the second balloon 7 constitutes a part of the second balloon member.

  The endoscope 2 includes an elongated insertion portion 3 that is inserted into a body cavity or the like, an operation portion 9 provided at the proximal end of the insertion portion 3, and a universal cable 10 that extends from a side portion of the operation portion 9. And have. A connector (not shown) is provided at the end of the universal cable 10, and the universal cable 10 is detachably connected to a light source device and a signal processing device (not shown) by the connector (not shown).

  The insertion portion 3 is elongated and flexible, and is connected to the distal end of the flexible tube portion 11, the bendable bending portion 12, and the distal end of the bending portion 12. And a tip portion 13.

  FIG. 1 shows a state when the endoscope 2 is inserted into the body cavity. In the present embodiment, as shown in FIG. 1, the insertion portion 3 is covered with a first endoscope insertion aid 4 and a second endoscope insertion aid 5 so as to freely advance and retract. Specific configurations of the first endoscope insertion assisting tool 4 and the second endoscope insertion assisting tool 5 will be described later.

FIG. 2 shows an enlarged view of the distal end portion 13 to which the first endoscope insertion aid 4 is attached.
As shown in FIG. 2, the distal end portion 13 is provided with an observation window 14 near the center of the front end face, for example, and an illumination window 15 and an air / water supply nozzle 16 are provided on both sides thereof.
A light guide (not shown) for transmitting illumination light is inserted inside the illumination lens attached to the illumination window 15. This light guide (not shown) is inserted through the insertion portion 3 and the like, and is detachably connected to the light guide connector of the light source device. The illumination light generated by the light source device is transmitted by the light guide and emitted from the illumination window 15 so as to illuminate the inside of the body cavity that becomes the visual field range (indicated by θ in FIG. 7) of the observation window 14. It has become.

  Although not shown, an objective lens is attached to the observation window 14, and a CCD (not shown), for example, is disposed as an imaging element at the image formation position. The CCD (not shown) photoelectrically converts an optical image in the body cavity formed on the imaging surface.

  Although not shown, the CCD is connected to a signal cable, and the signal cable is inserted through the insertion portion 3 and the like, and is electrically connected to the signal processing device. The signal processing device performs signal processing on the image signal captured by the CCD, generates a video signal, outputs the image signal to the monitor, and displays an optical image in the body cavity imaged by the CCD on the display surface of the monitor.

  Further, as shown in FIG. 2, on both sides of a direction in which the air / water supply nozzle 16, the observation window 14, and the illumination window 15 are arranged, for example, in a direction substantially orthogonal to the first channel 17, A first channel opening 19 and a second channel opening 20 are provided to form openings of the second channels 18 respectively.

  The first channel opening portion 19 is opened from the front surface to the side surface of the tip portion 13. Further, a shaft (shaft body) 21 constituting the first endoscope insertion aid 4 is inserted through the first channel opening 19. The shaft 21 is a first transmission member that transmits the forward / backward movement on the hand side, and at the same time, a first fluid supply / exhaust fluid into the first balloon 6 that constitutes the first endoscope insertion aid 4. The fluid supply / discharge line is configured.

  As shown in FIG. 1, the first channel 17 and the second channel 18 provided along the longitudinal direction of the insertion portion 3 are inserted into the first channel provided near the front end of the operation portion 9 shown in FIG. The port 23 and the second channel insertion port 24 communicate with each other.

Further, as shown in FIG. 1, a grip portion 25 is provided in a portion near the front end of the operation portion 9. Further, bending operation knobs 26 and 26 a are provided on the rear end side of the operation unit 9 with respect to the grip unit 25. With this configuration, the operator can operate the bending operation knobs 26 and 26 a provided in the operation unit 9 by holding the grip unit 25.
That is, since the operation unit 9 is provided with the bending operation knobs 26 and 26a on the rear end side with respect to the grasping unit 25, the operator operates the bending operation knob 26 with the finger of one hand grasping the grasping unit 25. , 26a can be rotated, and by this rotation operation, the bending portion 12 can be bent in any direction, up and down, left and right.
The bending portion 12 is formed by connecting a plurality of annular bending pieces so as to be rotatable in the longitudinal direction of the bending portion 12, and the bending portion 12 is connected via a bending wire by turning operation of the bending operation knobs 26 and 26 a. Can be bent.

Further, as shown in FIG. 1, an air / water supply button 27 and a suction button 28 for performing a suction operation are provided on a surface adjacent to the surface on which the bending operation knobs 26 and 26a are provided in the operation unit 9. . With this configuration, the surgeon can operate the air / water supply button 27 to supply air or water with the air / water supply nozzle 27 provided at the distal end portion 13. In addition, by operating the suction button 28, the surgeon can suck body fluid or other fluid from the second channel opening 20 through the second channel 18 of the distal end portion 13. ing.
The second channel 18 can be used as a conduit through which the treatment instrument is inserted, and can also be used as a suction conduit for sucking fluid. For this reason, the rear end side of the second channel 18 is branched in the vicinity of the front end in the operation portion 9 into a conduit communicating with the second channel insertion port 24 and a suction conduit extending to the rear end side of the operation portion 9. (Not shown).
Then, by inserting the treatment instrument from the second channel insertion port 24, the distal end side of the treatment instrument inserted from the second channel opening 20 of the distal end portion 13 is projected through the second channel 18 inside thereof, A biopsy and other treatments can be performed under observation through the observation window 14.

  In the present embodiment, the shaft 21 constituting the first endoscope insertion aid 4 is inserted from the first channel opening 19 side and guided to the outside through the first channel insertion port 23 of the operation unit 9. It has come to be. Further, a balloon serving as a control means (specifically, a first fluid supply / discharge means) is connected to a proximal end portion of the shaft 21 guided to the outside from the first channel insertion port 23 via a first connection tube 29. A control device 8a is connected.

  The length of the shaft 21 from the first channel insertion port 23 to the first connection tube 29 is formed with a sufficient length. In this case, the shaft 21 can form a loop of any size or a loop of any number of turns on the shaft 21 using a holding member 30 such as a clip as shown in FIG. . Thereby, although the internal structure of the shaft 21 will be described later, the hardness of the shaft 21 can be arbitrarily adjusted by forming a loop in the shaft 21.

  The surgeon or an assistant grasps the portion (first operation portion) of the shaft 21 led out from the operation portion 9 and moves forward and backward to move the distal end of the first endoscope insertion assisting tool 4. The provided first balloon 6 can be freely positioned in front of or behind the field of view.

  The balloon control device 8a connected to the proximal end side of the shaft 21 is connected to a first foot switch 31a as an instruction means. The balloon control device 8a controls supply / discharge of fluid to / from the first balloon 6 of the first endoscope insertion aid 4 based on an instruction operation by the first foot switch 31a. As a result, the first balloon 6 can be freely inflated and deflated.

  On the other hand, as shown in FIG. 1, the second endoscope insertion aid 5 includes a flexible hollow tube body 32 and a second balloon 7 provided on the distal end side of the tube body 32. And a proximal gripping portion 33 (second operation portion) provided on the proximal end side of the tube body 32. Further, the inner diameter formed over the entire length of the second endoscope insertion aid 5 has an inner diameter slightly larger than the outer diameter of the insertion portion 3 of the endoscope 2. In addition, the said tube body 32 comprises the 2nd transmission member, and the said hand side holding | gripping part 33 comprises the 2nd operation part.

  The tube body 32 is made of, for example, a biocompatible material such as silicon and has, for example, permeation. At least the inner surface of the tube body 32 is subjected to, for example, hydrophilic lubrication treatment. With this configuration, the insertion property of the insertion portion 3 of the endoscope 2 in the second endoscope insertion aid 5 is improved.

  A second balloon 7 is disposed on the distal end side of the second endoscope insertion aid 5. The second balloon 7 is formed using an elastic body such as rubber, and is fitted on the outer periphery of the tube body 32. In addition, the second balloon 7 is bonded and fixed to the tube body 32 at both ends in an airtight manner.

  Further, the tube body 32 is formed with a second fluid supply / discharge conduit (not shown) that communicates with the inner surface of the second balloon 22 from the vicinity of the hand grip portion 33. The second fluid supply / discharge conduit (not shown) has a second fluid supply / discharge connection tube 35 connected to the proximal side of the tube body 32, and the second fluid supply / discharge connection tube 35 It extends from the tube body 32.

A balloon control device 8b as a control means is connected to the proximal end portion of the second fluid supply / discharge connection tube 35 via a second connection tube 36.
In the present embodiment, the second endoscope insertion assisting tool 5 has the insertion part 3 of the endoscope 2 opened the opening of the hand side gripping part 33 prior to the first endoscope insertion assisting tool 4. It is inserted and inserted through. Further, the distal end portion of the second endoscope insertion assisting tool 5 is formed to have an inner and outer diameter dimension so as to contact the end portion of the balloon holding member 37.

  The balloon control device 8b is also connected with a second foot switch 31b as instruction means. The balloon control device 8b controls supply / discharge of fluid to / from the second balloon 7 of the second endoscope insertion aid 5 based on an instruction operation by the second foot switch 31b. As a result, the second balloon 7 can be freely expanded and contracted.

  The balloon control device 8b, the second fluid supply / discharge conduit, the second fluid supply / discharge connection tube 35, and the second connection tube 36 constitute a second fluid supply / discharge means.

  Next, the configuration of the first endoscope insertion aid 4 in FIG. 1 will be described with reference to FIG. In addition, the 1st balloon 6 shown with the dashed-two dotted line in FIG. 3 has shown an example of the shape at the time of expansion | swelling.

As shown in FIG. 3, the first endoscope insertion assisting tool 4 is mounted so as to cover the distal end portion 13 of the insertion portion 3, and is formed into a hollow shape so as to expand and contract (balloon). The first balloon 6 as a member), a balloon holding member 37 for holding the first balloon 6, and a supply / exhaust pipe through which fluid such as air for inflating / deflating the first balloon 6 is passed. At the same time, it is mainly composed of the first balloon 6 and the shaft 21 that moves the balloon holding member 37 so as to advance and retreat.
The first endoscope insertion aid 4 may be a disposable product that is discarded after one-time use, or a reuse product that is reused after cleaning, disinfection, and sterilization after use. It may be.

  The balloon holding member 37 is connected and fixed to the tip portion of the shaft 21 by a connecting member 38. The balloon holding member 37 fixes and holds the first balloon 6 so as to be covered with the first balloon 6. The balloon holding member 37 and the connecting member 38 constitute a part of the first balloon member.

  In this case, balloon fixing portions 45 a and 45 b are provided on the front and rear outer peripheral surfaces of the balloon holding member 37. Both ends of the first balloon 6 are hermetically bonded and fixed to the balloon fixing portions 45a and 46b.

  The balloon holding member 37 is formed in a hollow shape so as to be covered with the distal end portion 13 of the endoscope 2 from the distal end side, and is an electrically insulating resin member such as Teflon (registered trademark). It is formed using the fluororesin.

  On the outer peripheral surface of the balloon holding member 37, a hole 40 for fixing the fixing pin 39 and a hole for fixing the supply / discharge nozzle 42 communicating with the first fluid supply / discharge pipe 41 inside the shaft 21. 43 and a balloon contact prevention groove 44 provided on the front side of the opening of the supply / discharge nozzle 42 are provided.

  The hole 40 and the hole 43 are formed from the outer peripheral surface of the balloon holding part 37 to the internal connecting member 38. The balloon holding member 37 and the connecting member 38 are connected and fixed by fitting a fixing pin 39 into the hole 43.

  The balloon contact prevention groove 44 is in close contact with the opening of the supply / discharge nozzle 42 even when the first balloon 6 is completely contracted by the supply / discharge of fluid from the supply / discharge nozzle 42. Thus, a part of the prevention mechanism for preventing the blockage is formed.

The first balloon 6 that expands and contracts by supplying and discharging fluid is formed into a hollow bag shape with a member having elasticity, for example, latex. In this case, when the first balloon 6 is deflated, the first balloon 6 has a substantially cylindrical shape. The inner peripheral surface of the first balloon 6 is held by the balloon holding member 37 and is detachably attached to the outer peripheral surface in the vicinity of the distal end portion 13. The
Note that the first balloon 6 may be detachably mounted on the outer peripheral surface in the vicinity of the distal end portion 13 of the insertion portion 3 without using the balloon holding member 37. In this case, when the first balloon 6 is deflated, a cylindrical and hollow inner peripheral surface may be formed so that the outer peripheral surface near the distal end portion 13 of the insertion portion 3 can be easily attached and detached. good.

  After the first balloon 6 is covered with the balloon holding member 37, both ends corresponding to the balloon fixing portions 45a and 45b are hermetically bonded by, for example, thread winding portions 46a and 46b that are bonded to each other by a thread winding and an adhesive.

  The front thread winding portion 46a is formed to the vicinity of the supply / discharge nozzle 42 at the same time as the first balloon 6 is adhered and fixed to the balloon fixing portion 45a, so that the supply / discharge nozzle 42 is prevented from coming off from the hole 43. It also has a function to prevent.

  The first balloon 6 is inflated and deflated by the fluid supplied and discharged through the supply and discharge nozzle 42. In the present embodiment, since the distal end portion 13 of the endoscope 2 is covered with a balloon holding member 37 that is thicker than the distal end portion 13, the first balloon 6 has a thick intestinal tract holding power. A large balloon member having a diameter can be used.

  As shown in FIG. 3, the shaft 21 connected and fixed to the balloon holding member 37 by the connecting member 38 covers a long and flexible coil member 47 and the entire length of the coil member 47 so as to provide electrical insulation. The outer skin member 48, the wire 49 disposed inside the coil member 47, and the first fluid supply / discharge pipe 41 provided over the entire length of the coil member 47 are configured. .

  The outer skin member 48 is made of, for example, a fluororesin having a good sliding property. Further, the coil member 47 is formed, for example, by being wound so that a stainless steel wire having a square cross-sectional shape comes into close contact therewith.

  The first base member 50 and the second base member 51 are fixed to both ends of the coil portion 47 with, for example, an adhesive. A wire 49 is inserted inside the coil member 47, and the first terminal member 52 and the second terminal member 53 are fixed to both ends of the wire 49 with, for example, an adhesive. . In addition, a first groove 54 and a second groove 55 that constitute a part of the first fluid supply / discharge pipe 41 are formed on a part of the outer peripheral surface of the first terminal member 52 and the second terminal member 53. And are formed respectively.

  The outer skin member 48 is covered after the wire 49 is inserted into and fixed to the coil member 47. The both end portions of the coil member 47 are hermetically bonded and fixed on the first base member 50 and the second base member 51.

A screw portion 56 is formed on the front side of the first base member 50. The shaft 21 can be hermetically fixed to the connecting member 38 by screwing the screw portion 56 into a screw portion formed at a corresponding position of the connecting member 38.
The shaft 21 is not limited in material and structure as long as it has flexibility. For example, the shaft 21 may be a coil formed using a stainless steel material as an alternative member. In addition to the shaft 21, the coil member 47, the wire 49 and the like constitute a first transmission member, and the shaft 21, the holding member 30 and the like constitute a first operation portion. Furthermore, the balloon control device 8a, the first fluid supply / discharge conduit 41, and the first connection tube 29 constitute first fluid supply / discharge means.

Next, the assembly procedure of the first endoscope insertion aid 4 will be described. In this embodiment, the unit in which the connecting member 38 is fixed to the shaft 21 is moved from the rear end side of the balloon holding member 37. The connecting member 38 and the balloon holding member 37 are hermetically bonded and fixed, and the fixing pin 39 and the supply / discharge nozzle are inserted and fixed from the side surface of the balloon holding member 37.
As a result, even if the shaft 21 is vigorously advanced and retracted, the shaft 21 and the balloon member 37 do not come out, and the shaft 21 can be smoothly advanced and retracted.

  Finally, the first balloon 6 is fixed and held on the balloon holding member 37 so that the first balloon 6 covers the balloon holding member 37.

  Thereafter, as shown in FIG. 3, the first connection tube 29 extending from the balloon control device 8 a is expanded and connected to the rear end portion of the shaft 21, so that the first fluid supply / discharge conduit 41 is formed. It is formed.

  That is, the fluid supplied and controlled by the balloon control device 8a passes through the second groove 55, the gap between the coil member 47 and the wire 49 constituting the first fluid supply / exhaust conduit 41, and further to the first groove 54 and the balloon. The supply / discharge nozzle 42 supplies and discharges the internal space of the first balloon 6 through the internal space 57 of the holding member 37.

  The balloon control device 8a controls the supply / discharge of fluid to / from the first balloon 6 of the first endoscope insertion aid 4 based on an instruction operation by the first foot switch 31a. By operating the first foot switch 31a, a fluid such as air is supplied from the balloon control device 8a to the internal space of the first balloon 6 via the first fluid supply / discharge pipe 41. The first balloon 6 can be inflated, or the first balloon 6 can be deflated by sucking or discharging a fluid.

  Further, the balloon control device 8b controls the supply and discharge of the fluid to and from the second balloon 7 of the second endoscope insertion aid 5 based on the instruction operation by the second foot switch 31b. By operating the second foot switch 31b, a fluid such as air is supplied from the balloon control device 8b to the internal space of the second balloon 7 via the second fluid supply / discharge conduit 34. The second balloon 7 can be inflated or the second balloon 7 can be deflated by sucking or discharging fluid.

In the endoscope apparatus 1 having the above-described configuration, an observation window 14 is provided on the distal end surface of the endoscope 2, and the first balloon 6 and the second balloon will be described below under the observation through the observation window 14. 7 to move the first balloon 6 to the front side of the distal end portion 13 so that the operation of inserting the insertion portion 3 into the deep side of the body cavity can be performed smoothly and in a short time. ing.
That is, the endoscope apparatus 1 of the present embodiment has the first balloon 6, the first endoscope insertion aid 4 that can be inserted through the insertion portion 3 of the endoscope 2, and the second balloon. 7 and the second endoscope insertion assisting tool 5 that can be inserted through the insertion portion 3 of the endoscope 2, the moving distance (stroke) of the first balloon 6 by one stroke is thereby increased. Can be bigger. That is, by using the second balloon 7 of the second endoscope insertion aid 5, the first balloon 6 can be moved with a large stroke to the front side that can be captured within the visual field range of the endoscope 2. Thus, as will be described below, it is possible to facilitate the auxiliary work of inserting the endoscope.

  Further, by mounting the first balloon 6 on the outer peripheral surface in the vicinity of the distal end portion 13 of the insertion portion 3, the first balloon 6 is inflated with a fluid so that the first balloon 6 having a large size can be mounted. In this case, the intestinal tract is held with a large holding force so that the endoscope 2 can be reliably moved forward.

With reference to FIGS. 4 to 13, description will be given of the operation when the endoscope 2 in the present embodiment having such a configuration is inserted into a body cavity to perform an endoscopic examination.
FIGS. 4 to 13 illustrate the operation of the present embodiment. FIG. 4 is a diagram showing a state in which the first and second balloons are deflated and inserted and advanced only by moving the endoscope forward and backward. 5 is a view showing a state in which the second balloon is moved from the state shown in FIG. 4 to the distal end side of the endoscope, and FIG. 6 is a state in which the second balloon is inflated from the state shown in FIG. FIG. 7 shows a state in which the endoscope is pushed in with a maximum stroke, FIG. 7 shows a state in which the shaft is pushed in and the first balloon is inserted into the deep part of the intestinal tract in the state of FIG. FIG. 9 is a diagram showing a state in which the first balloon is inflated and the intestinal tract is held in the state of FIG. 9, and FIG. 9 is a state of FIG. FIG. 10 is a view showing the state of being pushed forward, and FIG. 10 is a state of FIG. FIG. 11 is a diagram showing a state in which the tube is securely held by the first and second balloons. FIG. 11 is a state in which the first and second endoscope insertion aids and the insertion part are pulled in the state of FIG. FIG. 12 shows a state in which the first balloon is deflated from the state of FIG. 11 and the insertion portion and the first endoscope insertion aid 4 are respectively pushed deep into the intestinal tract. FIG. FIG. 13 is a flowchart of the operation of this embodiment.

Before the inspection for performing the endoscopic inspection, the insertion portion 3 of the endoscope 2 is inserted through the opening of the proximal gripping portion 33 of the tube body 32 of the second endoscope insertion aid 5 as shown in FIG. .
Then, the shaft 21 of the first endoscope insertion assisting tool 4 is inserted from the first channel opening 19 which is the distal end side opening of the first channel 17, and the first endoscope insertion assisting tool 4 is inserted inside. The endoscope 2 is mounted near the outer peripheral surface of the distal end portion 13 (in the vicinity of the outer peripheral surfaces of the distal end portion 13 and the bending portion 12 in FIG. 1).
Further, the rear end side of the shaft 21 is led out from the first channel insertion port 23 as shown in FIG. 1, and the operator can hold the shaft 21 and perform an operation of moving the shaft 21 back and forth. become able to.

  When inspecting the inside of a body cavity, as shown in FIG. 4, the first and second balloons 6 and 7 are inserted into the body cavity from the distal end side of the endoscope 2 in a contracted state. Go. However, after that, the operation method of the present embodiment when the distal end portion 13 of the endoscope 2 does not readily advance in the body cavity will be described with reference to FIGS.

  First, as shown in FIG. 5, the surgeon grasps the proximal-side grasping portion 33 of the second endoscope insertion aid 5 and pushes the tube body 32 to visually observe the second balloon 7 in the contracted state. The mirror 2 is moved toward the tip 13 side.

Then, as shown in FIG. 6, the surgeon operates the second foot switch 31b to cause the balloon control device 8b to pass the fluid through the second fluid supply / discharge conduit 34 into the second balloon 7. , The second balloon 7 is inflated, and the second endoscope insertion aid 5 is held in the intestinal tract 100.
Thereafter, as shown in FIG. 6, the surgeon uses the second endoscope insertion assisting tool 5 held as an intestinal tract as an insertion guide to insert the insertion portion 3 of the endoscope 2 into the second endoscope. Push in the mirror insertion aid 5 with the maximum stroke.
At this time, the hand side state is such that the hand side gripping portion 33 of the second endoscope insertion portion assisting tool 5 is located on the entire hand end of the insertion portion 3 of the endoscope 2. ing.

Then, as shown in FIG. 7, the surgeon pushes the shaft 21 that is led out from the first channel opening 19 of the operation unit 9, and moves the first balloon 7 from above the distal end portion 13 and the bending portion 12. Move to the front of the field of view.
In FIG. 7, θ represents the visual field range of the observation window 14. When the shaft 21 is pushed in and the first balloon 6 is moved to the front side of the distal end portion 13 as shown in FIG. 7, the observation window 14 at the distal end portion 14 of the endoscope 2 is in the visual field range θ, and the observation is performed. The insertion operation can be performed.

  At this time, the surgeon freely adjusts the hardness of the shaft 21 by forming a loop with an arbitrary size and an arbitrary number of windings on the rear side of the proximal side of the shaft 21 using the holding member 30. May be. That is, the insertion property when the first balloon 6 is pushed forward from the distal end portion 13 of the endoscope 2 can be freely changed according to the operator's preference and site. Insertion operation can be performed.

  Next, as shown in FIG. 8, the surgeon operates the first foot switch 31a to cause the balloon controller 8a to supply fluid via the first fluid supply / discharge conduit 41 to the first balloon 6. Then, the first balloon 6 is inflated, and the first balloon 6 is held and fixed in the intestinal tract 100.

  Thereafter, as shown in FIG. 9, the surgeon operates the second foot switch 31b, whereby the balloon control device 8b causes the fluid in the second balloon 7 to pass through the second fluid supply / discharge conduit 34. And the second balloon 7 is deflated. Thereafter, the surgeon uses the second endoscope insertion assisting tool 5 and the distal end portion 13 of the endoscope 2 as a guide for insertion of the shaft 21 of the first endoscope insertion assisting tool 4 to the deep part of the intestinal tract 100. Push forward. In this way, the second balloon 7 was deflated, and the second endoscope insertion aid 5 and the distal end portion 13 of the endoscope 2 were pushed again toward the first endoscope insertion aid 4 side. The state is shown in FIG.

  In this case, in this embodiment, in the state shown in FIG. 8 to the state shown in FIG. 9, the operator can visually observe the first balloon 6 by the endoscopic image, so that the intestinal tract 100 is in the first state. The insertion portion 3 of the endoscope 2 can be carefully advanced so as not to be sandwiched between the balloon 6 and the distal end portion 13 of the endoscope 2.

  In the present embodiment, when the intestinal tract 100 is folded, for example, the bending portion 12 of the endoscope 2 is pushed forward while being bent, and at the same time, the distal end portion 13 of the endoscope 2 is moved in the visual field direction. The first balloon 6 can be moved while sliding on the shaft 21. Thus, the distal end portion 13 of the endoscope 2 and the second endoscope insertion aid 5 can be reliably moved to the first balloon 6 side. In addition, since the 1st balloon 6 can be made into a big size, the retention strength of the 1st balloon 6 can be enlarged and the endoscope 2 can be advanced reliably.

  Next, as shown in FIG. 10, the surgeon operates the second foot switch 31b to cause the balloon control device 8b to pass the fluid through the second fluid supply / discharge conduit 34 to the second balloon 7. And the second balloon 7 is inflated to hold the second endoscope insertion aid 5 in the intestinal tract 100. That is, as shown in FIG. 10, the first and second endoscope insertion assisting tools 4 and 5 can be reliably held in the intestinal tract 100 by the first balloon 6 and the second balloon 7.

  Thereafter, as shown in FIG. 11, the surgeon keeps the first balloon 6 and the second balloon 7 inflated by the fluid in close proximity to each other, and the first and second endoscopes. An operation of slowly pulling in the insertion assisting tools 4 and 5 and the insertion portion 3 of the endoscope 2 is performed, and the intestinal tract 100 is drawn by the first and second balloons 6 and 7 inflated with fluid.

  Then, as shown in FIG. 12, the surgeon operates the first foot switch 31a, whereby the fluid in the first balloon 6 is passed through the first fluid supply / discharge conduit 41 by the balloon control device 8a. Is sucked to deflate the first balloon 6. Thereafter, the surgeon goes to the deep part of the intestinal tract 100 using the first endoscope insertion assisting tool 4 and the distal end portion 13 of the endoscope 2 as a guide of the tube body 32 of the second endoscope insertion assisting tool 5. Then, the endoscope 2 is advanced. This state is the same as the state shown in FIG. 7 as described above.

  Further, at this time, in the present embodiment, the intestinal tract 100 that has been drawn is not pushed back because the second balloon 7 on the hand side is inflated and held, and the above-described operation is repeated. Thus, the distal end portion 13 of the endoscope 2 can be advanced to the deep portion of the intestinal tract 100 in a short time and reliably.

In the present embodiment, although not shown, the first and second balloons 6 and 7 are occasionally inflated with the distal end side of the endoscope 2 inserted into the deep part of the splenic curve in the large intestine. In a state of being fixed in the intestinal tract, both the endoscope 2 and the shaft 21 of the first endoscope insertion aid 4 and the tube body 32 of the second insertion aid 5 are slowly pulled out together. By performing the operation, the intestinal tract portion such as the sigmoid colon portion can be linearized. By positively straightening the intestinal tract in this way, not only can the force be easily transmitted to the distal end of the endoscope 2, but also the shaft 21 functions as an insertion guide for the endoscope 2, so that the intestinal tract can only be squeezed. In addition, the distal end of the endoscope 2 can be advanced to the deep part of the intestinal tract also by the advance of the endoscope 2.
Then, by combining these intestinal squeezing and intestinal linearization and repeating these several times, the endoscope 2 is finally inserted to the deepest part of the intestinal tract.

An outline of the insertion assisting method for the insertion section 3 shown in FIGS. 4 to 12 is shown in a flowchart in FIG.
In the first step S1, the surgeon attaches the first endoscope insertion assisting tool 4 and the second endoscope insertion assisting tool 5 to the insertion portion 3 of the endoscope 2 as described above.
Then, as shown in step S2, the surgeon inserts the insertion portion 3 of the endoscope 2 into the body cavity, for example, from the anus, into the intestinal tract of the large intestine from the distal end portion 13 side.
When it is difficult to insert by inserting the insertion portion 3, the operator pushes the second balloon 7 toward the distal end side of the endoscope 2 and inflates it as shown in step S3, as shown in FIG. In this manner, the second balloon 7 is held and fixed in the intestinal tract.

  In the next step S4, as shown in FIG. 7, the surgeon pushes both the endoscope 2 and the first balloon 6 forward to the full stroke, and then expands the first balloon 6. The first balloon 6 is held and fixed in the intestinal tract (see FIG. 8).

  In the next step S5, as shown in FIG. 9, the operator contracts the second balloon 7 and moves the second endoscope insertion aid 5 forward while using the endoscope 2 as an insertion guide. Further, the endoscope 2 is pushed forward while the shaft 21 is used as an insertion guide.

  Then, in the next step S6, as shown in FIG. 10, the surgeon inflates the second balloon 7, and withdraws it so that it is slowly withdrawn together with the already inflated first balloon 6. To go around the intestinal tract (see FIG. 11).

  In the next step S7, as shown in FIG. 12, the operator contracts the first balloon 6 and pushes both the endoscope 2 and the first balloon 6 forward to the full stroke. One balloon 6 is inflated to hold and fix the first balloon 6 in the intestinal tract.

Thereafter, the process returns to step S5, and the operator moves the endoscope 2 forward so as to perform a series of operations for dragging the intestine again.
In this way, the endoscope 2 can be smoothly inserted into the deep side of the intestinal tract.
Therefore, according to the present embodiment, since the first balloon 6 and the second balloon 7 can be individually moved with respect to the endoscope 2, the length of the insertion portion 3 of the endoscope 2. It is possible to lengthen the maximum stroke length (maximum distance between the first balloon 6 and the second balloon 7) in one stroke (one time) to draw the intestinal tract without increasing the length. That is, the insertion portion 3 of the endoscope 2 can increase the stroke length for one stroke of the intestinal tract even if the length of the insertion portion 3 is substantially the same as that of the conventional one. It can be inserted and the inspection time can be shortened.

  In addition, since the endoscope 2 can be advanced and retracted in a state where both the first balloon 6 and the second balloon 7 are inflated and the intestinal tract is held, without being affected by the peristaltic movement of the intestine, The intestinal inner wall between the two first and second balloons 6 and 7 can be observed and treated stably.

  Further, since the shaft 21 of the first endoscope insertion assisting tool 4 is flexible and has a small radius of curvature in the same manner as a normal treatment instrument, the first endoscope can be easily used even at a bent portion having a small radius of curvature in the body cavity. There exists an advantage that it is easy to let the balloon 6 pass.

  In addition, since the first balloon 6 can be visually confirmed by an endoscopic image, the operator can perform the operation of inflating or deflating the first balloon 6 with more peace of mind. Further, since the tube body 32 of the second endoscope insertion portion 5 is transparent, the transparent tube body can be obtained by positioning the distal end portion 13 of the endoscope 2 closer to the hand side than the second balloon 7. The state of the intestinal tract wall of the entire length of the insertion portion 3 and the second balloon 7 can be visually observed through 32.

  Moreover, since the first balloon 6 can be moved out of the field of view by completely pulling the shaft 21 into the insertion portion 3 of the endoscope 2, observation or treatment is not hindered. Furthermore, since the shaft 21 is made of a flexible member as described above, even if the first balloon 6 is housed outside the distal end portion 13 of the endoscope 2, the shaft 21 can be used without any trouble. The bending operation of the endoscope 2 can be performed.

  In addition, since the first balloon 6 is mounted on the balloon holding member 37 that is at least thicker than the distal end portion 13, for example, compared to a balloon such as a balloon catheter that is used by inserting the first channel from the proximal side, It is possible to use a large balloon having a large fixing force to the intestinal tract.

  Further, since the bending operation of the endoscope 2 is possible even in a state where the first balloon 6 is pushed forward of the endoscope 2, the position of the first balloon 6 can be delicately controlled by the bending operation. Can be inserted deeper into the intestinal tract.

Furthermore, since the tip of the second endoscope insertion assisting tool 5 is dimensioned so as to contact the end of the balloon holding member 37, The first balloon 6 is not damaged at the tip.
By having the above effects, in this embodiment, it is possible to obtain the endoscope apparatus 1 with excellent operability.

  Note that the endoscope apparatus 1 according to the first embodiment may be configured based on Modification 1 shown in FIG. 14 described later or Modification 2 shown in FIG. Such modifications 1 and 2 are shown below.

FIG. 14 relates to a first modification of the first embodiment, and is an enlarged view of the distal end portion 13 of the endoscope 2 to which the first endoscope insertion aid 4 is attached, and FIG. 15 is a second modification of the first embodiment. FIG. 4 is an enlarged view of the distal end portion 13 of the endoscope 2A to which the first endoscope insertion aid 4A is attached.
The endoscope apparatus 1 according to the first embodiment may use an endoscope 2 </ b> A illustrated in FIG. 14 instead of the endoscope 2. As shown in FIG. 14, the endoscope 2 </ b> A is configured to have only the second channel 18 without the first channel 17.

  The insertion portion 3 of the endoscope 2 </ b> A has a clearance (clearance) between the shaft 21 and the second channel 18. Therefore, the suction function in the endoscope 2 can be ensured by using a gap (clearance) provided between the shaft 21 and the second channel 18. Further, when using a treatment instrument, the gap may be inserted so that the treatment instrument protrudes from the second channel opening 20 into the body cavity.

  Further, since the endoscope 2A does not require a dedicated pipe line (first channel) only for operating the first endoscope insertion assisting tool 4, the suction performance and the treatment performance are described in the first embodiment. Although it is somewhat inferior to the endoscope 2 of this type, it can be used in place of a normal one-channel endoscope, and the adaptation range can be widened.

  In the first modification, the first endoscope insertion assisting tool 4 and the second endoscope insertion assisting tool 5 are provided for each of the endoscope 2 having a thick insertion portion 3 and the endoscope 2A having a small thickness. It may be configured to be a common insertion aid.

  Further, the first endoscope insertion assisting tool 4 and the second endoscope insertion assisting tool 5 are suitable for the thickness of the insertion portion 3 of each endoscope, as shown in Modification 2 in FIG. A first endoscope insertion aid 4A, which is configured by providing a plurality of types of endoscope insertion aids of different sizes, and is equipped with a balloon having a size corresponding to the operator's preference or observation site, and the second The endoscope insertion aid (not shown) may be appropriately selected.

  However, as shown in FIG. 14, in the case where an endoscope having a thickness different from that of the first endoscope insertion assisting tool 4 can be used in common, the shortest distance L between the channel opening and the outer periphery of the distal end. (Refer to FIG. 3) needs to be substantially the same for each endoscope.

In the second modification, the endoscope 2 may be inserted into the body cavity by performing an operation method described later. Such an operation method will be described with reference to FIGS.
16 to 19 are diagrams for explaining another operation method using the endoscope 2A of the second modification shown in FIG. 15 and the first and second endoscope insertion aids 4A and 5A. .

  In this operation method, first, as shown in FIG. 16, the operator performs a thin endoscope with one channel 2A, a thin first endoscope insertion aid 4A suitable for the endoscope, and a thin second endoscope. The insertion aid 5A is inserted into the deep part of the intestinal tract 100 in a combined state.

  Thereafter, as shown in FIG. 17, the surgeon inflates the first balloon 6A to hold and fix the inside of the intestine 100, leaving the first endoscope insertion aid 4A in that state in the intestine 100, The endoscope 2B and the second endoscope insertion aid 5A are removed from the intestinal tract 100.

  Next, as shown in FIG. 18, the operator inserts the endoscope 2 with two channels into the intestinal tract 100 while sliding the shaft 21 inserted through the first channel 17 as an insertion guide, and As shown in FIG. 19, the treatment tool 60 is inserted through the second channel 18, and the treatment tool 60 is protruded from the second channel opening 20 to treat or treat the deep lumen in the intestinal tract 100. To do.

That is, the operation method is performed by using the thin endoscope 2A that is easy to insert and the thin first endoscope insertion aid 4A for the deep insertion of the first intestinal tract 100 as described above. This is a method of replacing the thick endoscope 2 dedicated to treatment, for example, the endoscope 2 with two channels, and such an operation method can also be performed in the second modification.
Other configurations, operations, and effects are substantially the same as those of the first embodiment.

  In the first embodiment, the first endoscope insertion assisting tool 4C shown in the third modification of FIG. 20 may be used. FIG. 20 is a longitudinal sectional view of the first endoscope insertion aid according to the third modification of the first embodiment.

  As illustrated in FIG. 20, the first endoscope insertion assisting tool 4 </ b> B of the third modification has an insertion axis of the distal end portion 13 rather than the balloon holding member 37 in the first endoscope insertion assisting tool 4 of the first embodiment. A balloon holding member 37A formed long in the direction is provided, and a larger first balloon 6B is provided on the balloon holding member 37A.

  A plurality of recesses 61 are formed in a portion corresponding to the bending portion 12 of the endoscope 2 when the shaft 21 is drawn to the maximum on the outer periphery on the proximal side of the balloon holding member 37A. That is, the balloon holding member 37 </ b> A has flexibility by forming a plurality of recesses 61.

  For this reason, even if the bending portion 12 of the endoscope 2 is bent, the proximal side of the balloon holding member 37 </ b> A covered on the distal end portion 13 is bent freely, so that the bending operation of the endoscope 2 is inhibited. However, the bending operation of the bending portion 12 can be smoothly operated, and at the same time, the insertion property of the endoscope 2 using the bending operation can be improved.

Moreover, according to the modification 3, since the 1st balloon 6B is provided, the retention strength of an intestinal tract can be made higher than the 1st balloon 6 of Example 1. FIG.
In the third modification, the flexible structure of the balloon holding member 37A is not limited to the plurality of recesses 61, and any other structure can be used as long as the structure can provide flexibility. You may do it.
Other configurations, operations, and effects are substantially the same as those of the first embodiment.

(Example 2)
Next, Embodiment 2 of the present invention will be described with reference to FIG.
FIG. 21 is a longitudinal sectional view of the first and second endoscope insertion aids according to the second embodiment of the present invention. In FIG. 21, the same components as those of the first embodiment are denoted by the same reference numerals, description thereof is omitted, and only different portions are described.

As shown in FIG. 21, the endoscope apparatus 1 according to the second embodiment is provided with a first endoscope insertion aid 4C and a second endoscope insertion aid 5B.
The first endoscope insertion assisting tool 4C is advanced and retracted via a third channel 62 provided in the second endoscope insertion assisting tool 5B.

  As the endoscope 2 inserted through the first and second endoscope insertion aids 4C and 5B, a normal thin one-channel endoscope is used in the same manner as the endoscope 2A shown in FIG. ing.

  The shaft 21A of the first endoscope insertion assisting tool 4C is inserted into the third channel 62 through the channel opening on the distal end side in substantially the same manner as in the first embodiment, and the first channel insertion port 23 of the operation unit 9 is inserted. It extends to the outside.

In the present embodiment, the third channel 62 may be formed within the thickness of the tube body 32, and a thin tube is bonded and fixed to the outer surface or the inner surface of the tube body 32. You may comprise so that it may form.
Other configurations, operations, and effects are substantially the same as those in the first embodiment.

  The invention described in the above embodiments is not limited to the embodiments and modifications, and various modifications can be made without departing from the scope of the invention in the implementation stage. Further, the embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements.

  For example, even if some constituent elements are deleted from all the constituent elements shown in the embodiment, the problems described in the column of problems to be solved by the invention can be solved, and the effects described in the effects of the invention can be obtained. In such a case, a configuration in which this configuration requirement is deleted can be extracted as an invention.

BRIEF DESCRIPTION OF THE DRAWINGS The block diagram which shows the whole structure of the endoscope apparatus in Example 1 of this invention. The perspective view which shows a part of front-end | tip part of the endoscope in the state which the 1st endoscope insertion auxiliary tool which can advance / retreat freely was mounted | worn, and was pulled in to the nearest hand side. Sectional drawing of the longitudinal direction of the 1st endoscope insertion assistance tool of FIG. The figure which shows the state which inserted and advanced only by the advance / retreat of an endoscope in the state which contracted the 1st, 2nd balloon. The figure which shows the state which moved the 2nd balloon to the front-end | tip part side of an endoscope from the state shown in FIG. FIG. 6 is a view showing a state where the endoscope is pushed in with a maximum stroke after the second balloon is inflated and held in the intestine from the state of FIG. 5. The figure which shows the state which pushed in the shaft and inserted the 1st balloon in the deep part of the intestinal tract in the state of FIG. The figure which shows the state which expanded the 1st balloon in the state of FIG. 7, and hold | maintained the intestinal tract. The figure which shows the state which advanced the 2nd endoscope insertion auxiliary tool and the extension insertion part to the deep part of the intestinal tract in the state of FIG. The figure which shows the state which expanded the 2nd balloon in the state of FIG. 9, and hold | maintained the intestinal tract reliably with the 1st, 2nd balloon. FIG. 11 is a diagram showing a state in which the first and second endoscope insertion aids and the insertion portion are pulled and the intestinal tract is squeezed in the state of FIG. 10. The figure which deflates the 1st balloon from the state of FIG. 11, and shows the state which advanced the insertion part and the 1st endoscope insertion auxiliary tool 4 to the intestine deep part, respectively. FIG. 13 is a flowchart for explaining the operation of the present embodiment and showing each state from FIG. 4 to FIG. 12 in time series. The enlarged view of the front-end | tip part 13 of the endoscope 2 which mounted | wore with the 1st endoscope insertion auxiliary tool of the modification 1 of Example 1. FIG. The enlarged view of the front-end | tip part of the endoscope with which the 1st endoscope insertion auxiliary tool of the modification 2 of Example 1 was mounted | worn. The figure which shows the state inserted in the intestine in the state which combined the endoscope of the modification 2, and the 1st, 2nd endoscope insertion auxiliary tool. The figure which shows the state which extracted the endoscope and the 2nd endoscope insertion auxiliary tool from the state of FIG. The figure which shows the state which inserted the endoscope with 2 channels in the state of FIG. The figure which shows the state which penetrated the treatment tool through the channel of the endoscope with 2 channels in the state of FIG. Sectional drawing of the longitudinal direction of the 1st endoscope insertion auxiliary tool which concerns on the modification 3 of Example 1. FIG. Sectional drawing of the longitudinal direction of the 1st and 2nd endoscope insertion assistance tool in Example 2 of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope apparatus 2 ... Endoscope 3 ... Insertion part 4 ... 1st endoscope insertion assistance tool 5 ... 2nd endoscope insertion assistance tool 6 ... 1st balloon 7 ... 2nd balloon 8a 8b ... Balloon control device 9 ... Operation part 12 ... Bending part 13 ... Tip part 14 ... Observation window 17 ... First channel 18 ... Second channel 19 ... First channel opening part 20 ... Second channel opening part 21 ... Shaft 21 ... 1st channel insertion port 22 ... 2nd channel insertion port 25 ... Endoscope holding part 29 ... 1st connection tube 30 ... Holding member 32 ... Tube body 34 ... 2nd fluid supply / exhaust conduit 36 ... 1st 2 connection tubes 41 ... 1st fluid supply and exhaust line

Claims (6)

A first balloon member having a first hollow part through which an endoscope insertion part can be inserted;
A first transmission member for transmitting a proximal side advance / retreat operation to the first balloon member;
A second balloon member having a second hollow part through which the endoscope insertion part can be inserted;
A second transmission member for transmitting a proximal side advance / retreat operation to the second balloon member;
Control means for controlling supply and discharge of fluid into the first balloon member and into the second balloon member so as to inflate or deflate the first balloon member and the second balloon member. When,
An endoscope insertion aid characterized by comprising: The control means includes
A first fluid supply / discharge means connected to the first balloon member and provided with a conduit for inflating or deflating the first balloon member by supplying / discharging the fluid into the first balloon member;
A second fluid supply / discharge means connected to the second balloon member and provided with a conduit for inflating or deflating the second balloon member by supplying / discharging the fluid into the second balloon member; The endoscope insertion aid according to claim 1, wherein the endoscope insertion aid is provided. On the proximal side of the first transmission member, there is a first operation part for operating the first transmission member,
3. The inner side according to claim 1, wherein a second operation portion for operating the second transmission member is provided on a proximal side of the second transmission member. 4. Endoscope insertion aid.   An endoscope provided with an endoscope insertion portion for observing the first balloon member and the lumen held by the second balloon member so as to be capable of moving forward and backward includes the first balloon member and the first balloon member. The endoscope insertion aid according to claim 1, which is configured in combination with two balloon members. The first transmission member is
The endoscope insertion aid according to claim 1, wherein the endoscope insertion aid is configured to have elasticity or flexibility that can be bent in accordance with a bending operation of a bending portion provided in the endoscope insertion portion. An endoscope having an elongated insertion portion that can be inserted into a body cavity;
An endoscope insertion aid configured in combination with the endoscope,
The endoscope insertion aid is
A first balloon member having a first hollow portion through which the insertion portion can be inserted;
A first transmission member for transmitting a proximal side advance / retreat operation to the first balloon member;
A second balloon member having a second hollow part through which the insertion part can be inserted;
A second transmission member for transmitting a proximal side advance / retreat operation to the second balloon member;
Control means for controlling supply and discharge of fluid into the first balloon member and into the second balloon member so as to inflate or deflate the first balloon member and the second balloon member. When,
An endoscope apparatus characterized by comprising:

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