JP2007325794A - Distal end cap for endoscope and endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a distal end cap for an endoscope inexpensively enhancing the insertion capacity of an insertion part into a fine and narrow lumen. <P>SOLUTION: The distal end cap 12 for the endoscope is inserted into a target in the state mounted on the distal end part of the endoscope having the insertion part where an observation means, which has an observation optical system and an illumination optical system, and the treatment appliance insertion channel provided in parallel to the observation means are arranged and equipped with a cap part 172 the leading end surface 172a of which is formed into a tapered form with respect to the circular base end part 172b of the cap part 172, the protrusion part 174 provided to the circular base end part 172b of the cap part 172 and inserted into and taken out of the channel and the locking part 176 provided to the protrusion part 174 and locked with the inner peripheral surface of the channel in a slidable manner. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to an endoscope tip cap for facilitating insertion of an insertion portion of an endoscope into a narrow and narrow lumen such as a urethra, and an inner portion for facilitating insertion of the insertion portion into a narrow and narrow lumen. It relates to the endoscope.

For example, Patent Document 1 discloses an endoscope in which a tapered distal end portion for facilitating insertion of an insertion portion into a narrow and narrow lumen such as a urethra is fixed to the distal end of the insertion portion. A treatment instrument insertion channel, an illumination optical system, and an observation optical system are fixed to the distal end portion. Further, the distal end portion is provided with a guide spatula portion that pushes away the wall portion when inserted into the lumen. For this reason, an insertion part can be easily inserted into a narrow and narrow lumen, and observation and treatment can be easily performed after the insertion.
JP 2004-351138 A

  Although the endoscope disclosed in Patent Document 1 can improve the insertion performance into a narrow and narrow lumen, for example, considering the storage space and cost, purchase the endoscope disclosed in Patent Document 1 It may be difficult to equalize.

  Even in such a case, it is possible to improve the insertion performance of the insertion portion into the narrow and narrow lumen with respect to the conventional endoscope earlier than the endoscope disclosed in Patent Document 1. It is desired.

  The present invention has been made to solve such problems, and an object of the present invention is an endoscope capable of improving the insertion performance of an insertion portion into a narrow and narrow lumen at low cost. An object is to provide a distal end cap and an endoscope.

In order to solve the above-described problems, an endoscope distal end cap according to the present invention includes an observation unit having an illumination optical system and an observation optical system, and a treatment instrument insertion channel arranged in parallel with the observation unit. Among the endoscopes having the inserted portion, the endoscope is used by being attached to the distal end portion of the insertion portion to be inserted into the object. The distal end cap includes a cap portion whose distal end portion is tapered with respect to the proximal end portion, a protruding portion that is provided at the proximal end portion of the cap portion, and that can be inserted into and removed from the channel, and the protruding portion And an engaging portion that slidably engages with the inner peripheral surface of the channel.
By inserting the projection of the endoscope tip cap from the distal end side of the treatment instrument insertion channel and engaging the inner peripheral surface of the channel with the engagement portion, the tip cap is placed at the distal end of the insertion portion of the endoscope. Easy to install. The tip cap can be removed by pulling directly from the tip of the insertion section. The tip cap can also be removed by inserting an appropriate treatment instrument into the treatment instrument insertion channel and pressing the protrusion of the tip cap. Can do.

The cap unit preferably includes light guide means for guiding illumination light emitted from the illumination optical system and guiding a subject image illuminated by the illumination light to the observation optical system. It is.
At the time of insertion of the endoscope, while illuminating the subject from the illumination optical system by the light guide means, the illuminated subject can be guided to the observation optical system by the light guide means to obtain a subject image. Therefore, the affected part or the like can be easily searched.

In addition, it is preferable that the cap unit includes light guide means for guiding a subject image to the observation optical system.
For this reason, when the endoscope is inserted, the subject image can be obtained by guiding the subject image to the observation optical system by the light guiding means. Therefore, the affected part or the like can be easily searched.

In addition, it is preferable that the cap part and the protruding part include a communication path communicating with the channel.
For this reason, air supply, liquid supply, suction, etc. can be performed through the channel and the communication path. In some cases, observation can be performed and treatment can be performed through the treatment tool.

Further, the cap portion has a plurality of inclined surface portions that are asymmetric between the distal end portion and the proximal end portion with respect to the axial direction of the insertion portion, and have different inclinations from the distal end portion toward the proximal end portion. It is preferable to comprise.
For this reason, when inserting an insertion part, since force is applied in the direction which pushes away the wall part in a body cavity with a slope part, insertion performance can be improved. Further, even when the bending portion is bent, the contact area with the wall portion can be increased, so that the wall portion can be pushed more easily.

In addition, the cap portion, the protruding portion, and the engaging portion are water-soluble and biocompatible, and are dissolved in the living body from the outside toward the inside in time. It is preferable to be integrally formed in a solid state with the mixed anesthetic material.
For this reason, for example, after inserting the insertion portion into the urethra, etc., when the tip cap is removed and used, the tip cap dissolves even if the tip cap is left in the body cavity, so that the tip cap can be used with ease of use. .

In order to solve the above problems, an endoscope according to the present invention has a distal end surface orthogonal to the longitudinal direction at the distal end portion, and an illumination optical system, an observation optical system, and a treatment instrument on the distal end surface. The insertion object in which the respective distal ends of the insertion channels are arranged side by side, the operation part provided at the proximal end part of the insertion part and gripped by the operator, and the object in a state of being attached to the distal end surface of the insertion part And a tip cap for insertion. The distal end cap is provided at a proximal end portion of the cap portion with a distal end portion that is tapered with respect to the proximal end portion, and protrudes from the distal end surface side into the channel. And an engaging portion provided on an outer peripheral surface of the projecting portion and slidably engaged with an inner peripheral surface of the channel.
By inserting the projection of the endoscope tip cap from the distal end side of the treatment instrument insertion channel and engaging the inner peripheral surface of the channel with the engagement portion, the tip cap is placed at the distal end of the insertion portion of the endoscope. Easy to install. The tip cap can be removed by pulling directly from the tip of the insertion section. The tip cap can also be removed by inserting an appropriate treatment instrument into the treatment instrument insertion channel and pressing the protrusion of the tip cap. Can do.

Further, at least one of the illumination optical system and the observation optical system protrudes from the distal end surface of the distal end portion of the insertion portion, and the cap portion protrudes from the illumination optical system and the observation optical system. It is preferable that a rotation preventing means that is engaged with the formed portion and prevents rotation with respect to the distal end surface of the insertion portion is provided.
Since the rotation preventing means is provided separately from the treatment instrument insertion channel, the rotation of the tip cap can be prevented.

The cap unit guides the illumination light emitted from the illumination optical system to illuminate the subject, and the observation unit guides the subject image illuminated by the illumination light to the observation optical system. It is preferable that the rotation prevention means is disposed at at least one base end of the illumination light guide and the observation optical system light guide. .
Light from the illumination optical system can be emitted through the illumination optical system light guide of the tip cap to illuminate the subject, and the illuminated subject can be guided to the observation optical system through the observation optical system light guide. For this reason, observation can be performed with the tip cap attached to the tip of the insertion portion.

The insertion portion includes the distal end hard portion having the distal end portion to which the protruding portion of the distal end cap is inserted and removed, and is bent by the operation of the operation portion provided on the proximal end side of the distal end hard portion. A deformed cross section having a curved section and a flexible tube section provided on a proximal end side of the curved section and connected to the operation section, and the channel has a cross section other than a circle at the distal end hard section It is preferable that the protruding portion of the tip cap has a cross section other than a circle along the deformed cross section of the channel at least in part.
For this reason, it can prevent reliably that a front-end | tip cap rotates with respect to the front-end | tip of an insertion part.

  According to the present invention, it is possible to provide an endoscope distal end cap and an endoscope that can improve the insertion performance of an insertion portion into a narrow and narrow lumen at low cost.

The best mode for carrying out the present invention (hereinafter referred to as an embodiment) will be described below with reference to the drawings.
A first embodiment will be described with reference to FIGS.
In the present embodiment, for example, in order to facilitate insertion of an insertion portion 24, which will be described later, into a narrow and narrow lumen such as the urethra, it is combined with the endoscope distal end cap (insertion aid) 12 shown in FIGS. The urinary direct-view flexible endoscope 10 used will be described.

As shown in FIG. 1, the endoscope 10 includes an operation unit 22 that is held and operated by an operator, and a flexible elongated insertion unit 24 that extends from the operation unit 22.
The operation unit 22 includes an operation unit main body 32 having a grip 32a, a bending operation knob 34, a light guide cable 36 of an illumination optical system 92 (see FIGS. 4 to 9) described later, and an observation optical system 94 (FIG. 3, FIG. 3). 5 to 9) and a forceps introducing portion 40 that is an opening on the proximal end side of the treatment instrument insertion channel 96 (see FIGS. 3 to 9).
A bending operation knob 34 is pivotally supported on the operation portion main body 32 so as to be rotatable. When the bending operation knob 34 is turned, a later-described bending portion 44 of the insertion portion 24 is bent. Further, a light guide cable 36 of an illumination optical system 92 described later is disposed on the operation unit main body 32. An endoscope light source device (not shown) for supplying illumination light to the illumination optical system 92 is connected to the end of the light guide cable 36. Further, the eyepiece 38 is disposed on the operation portion main body 32 on the distal side with respect to the grip 32a. Further, the forceps introducing portion 40 is disposed on the grip 32a.

  In the insertion portion 24, the flexible tube portion 42, the bending portion 44, and the distal end hard portion 46 are arranged in a line in order from the proximal end side toward the distal end side. The flexible tube portion 42 is flexibly followed by applying an external force of a certain level or more, and has flexibility having an appropriate restoring property. Since the bending portion 44 is bent in the vertical direction when the bending operation knob 34 of the operation portion 22 is rotated, the direction of the distal end hard portion 46 can be changed.

  As shown in FIG. 3, the bending portion 44 includes a plurality of bending pieces 52 each formed in a cylindrical shape, a blade 54 disposed on the outer periphery of the bending pieces 52 and knitted in a net shape, and an outer side of the blade 54. And an outer skin 56 coated on the surface. In addition, the distal end of the outer skin 56 extends to the distal end hard portion 46 and covers the outer periphery of the distal end hard portion 46 on the base end side. The base end of the outer shell 56 extends to the distal end portion of the flexible tube portion 42 and covers the outer periphery of the flexible tube portion 42 on the distal end side.

The bending piece 52 has a pair of ear pieces 52a facing each other at both ends. Ear pieces 52 a at one end and the other end of the bending piece 52 are formed at the same angle with respect to the central axis O of the insertion portion 24. The adjacent bending pieces 52 are arranged in a line along the direction of the central axis O (longitudinal axis direction) of the insertion portion 24 such that the ear pieces 52a are overlapped with each other. Between the overlapped ear pieces 52a, a shaft member (pivot shaft) 52b is penetrated in a direction orthogonal to the central axis O and riveted (see FIG. 9). Therefore, the adjacent bending pieces 52 can be rotated with respect to each other by the shaft member 52b. For this reason, the bending part 44 can be bent only in two directions of the upward direction and the downward direction in FIG. 3 by turning the bending pieces 52 to each other.
In addition, although the ear piece 52a and the shaft member 52b of the bending piece 52 are not shown, if they are arranged not only in the left and right positions but also in the upper and lower positions, the bending portion 44 is bent not only in the vertical direction but also in the left and right directions. It is possible to make it.

Guide rings 62 are respectively mounted at substantially upper and lower positions inside the bending piece 52 of the bending portion 44. An operation wire 64 is inserted into each of the upper and lower guide rings 62 separately. As shown in FIGS. 8 and 9, the guide ring 62 and the pair of operation wires 64 inserted through the guide ring 62 do not need to be arranged at positions orthogonal to the axial direction of the shaft member 52 b and the central axis O. For example, in order to give priority to the arrangement of a later-described built-in member incorporated in the distal end hard portion 46, the position of the operation wire 64, that is, the guide ring 62 is relative to the axial direction of the shaft member 52b and the direction orthogonal to the central axis O. They are arranged at positions shifted left and right by angles θ ₁ and θ ₂ . Further, the angles θ ₁ and θ ₂ do not need to be equal to each other, and the angles θ ₁ and θ ₂ are allowed to differ depending on the arrangement of the built-in members.

As shown in FIG. 3, the distal end of the operation wire 64 is fixed by soldering or the like while being inserted into the guide ring 62 of the bending piece 52 located at the forefront. The proximal end side of the operation wire 64 is inserted through the upper and lower guide rings 62 of the bending piece 52. A further proximal end side of the operation wire 64 is guided into the operation unit main body 32 through a guide sheath (not shown) arranged in the flexible tube unit 42. The proximal ends of the operation wires 64 are connected to the bending operation knob 34, respectively. For this reason, when the bending operation knob 34 is rotated, the pair of operation wires 64 moves in the opposite directions along the central axis direction of the insertion portion 24. Since the distal end of the operation wire 64 is fixed to the bending piece 52 at the most distal end, when the bending piece at the most distal end receives a force by the operation wire 64, the force is sequentially transmitted to the succeeding bending pieces 52 and adjacent bending pieces. 52 rotate with respect to each other. Then, the bending portion 44 is bent and the distal end hard portion 46 is raised.
The upward bending angle and the downward bending angle of the bending portion 44 can be set as appropriate. Here, for example, the maximum distal bending angle is set to 210 degrees and the downward maximum bending angle is set to 120 degrees, for example, so that the distal end hard portion 46 is largely raised upward. This maximum bending angle is set by, for example, an angle at which the edges of adjacent bending pieces 52 abut each other, or the amount of rotation of the bending operation knob 34 is restricted to restrict the maximum amount of movement of the pair of operation wires 64. Thus, it is regulated by a stopper (not shown) or the like provided on the operation unit main body 32.

  As shown in FIGS. 3 to 8, the distal end rigid portion 46 includes a distal end frame member 72 to which distal ends of built-in members such as an illumination optical system 92, an observation optical system 94, and a treatment instrument insertion channel 96, which will be described later, are fixed. Yes. Here, it is assumed that the distal end of the illumination optical system 92, the observation optical system 94, and the treatment instrument insertion channel 96 is disposed on the distal end hard portion 46.

  As shown in FIGS. 3 to 5, the distal end frame member 72 has a first hole (illumination optical system hole) 74 in which the distal end of the illumination optical system 92 is disposed, and the distal end of the observation optical system 94. Is formed, and a second hole (channel hole) 78 to which the distal end of the treatment instrument insertion channel 96 is connected is formed. .

  As shown in FIG. 4, at the proximal end portion of the distal end frame member 72, the outer diameter thereof is smaller than the outer diameter of the distal end frame member 72, but the first attachment having substantially the same inner diameter. The part 80a and the second attachment part 80b are formed continuously. The first attachment portion 80 a is formed integrally with the proximal end portion of the distal end frame member 72. The second attachment portion 80b is formed integrally with the base end portion of the first attachment portion 80a. The first mounting portion 80a has a larger outer diameter than the second mounting portion 80b, and a step 80c is formed between the first mounting portion 80a and the second mounting portion 80b. The first mounting portion 80a and the second mounting portion 80b are formed in a substantially cylindrical shape, but a notch is formed in a part along the axial direction so as to allow deformation in the circumferential direction. Yes.

  As shown in FIGS. 3 and 6, the outer periphery of the second attachment portion 80 b is covered with the tip of the outer skin 56 extending from the curved portion 44. A thread 82 is wound around the outer peripheral tip of the outer skin 56. The thread 82 is hardened with an adhesive.

  As shown in FIGS. 3 and 4, the bending piece 52 at the most distal end side of the bending portion 44 is fitted into the outer periphery of the second mounting portion 80 b in a close contact state. The distal end of the bending piece 52 on the most distal side is formed in a circumferential shape on the same plane. That is, the ear piece 52 a is not formed at the tip of the bending piece 52. The tip of the bending piece 52 on the most distal end side comes into contact with a step 80 c between the first mounting portion 80 a and the second mounting portion 80 b of the tip frame member 72. For this reason, the bending piece 52 on the most distal end side is prevented from being pushed further toward the distal end side. That is, the axial positional relationship between the distal end frame member 72 of the distal end rigid portion 46 and the bending piece 52 of the bending portion 44 is defined. For this reason, the positional relationship of the axial direction between the front-end | tip hard part 46 and the curved part 44 is prescribed | regulated.

  As shown in FIGS. 3 to 9, the endoscope 10 includes an illumination optical system 92 that illuminates a subject, an observation optical system 94 that observes the illuminated subject, and a procedure for performing treatment while observing the subject. A treatment instrument insertion channel 96 is provided through which a treatment instrument (not shown) such as an injection needle or acupuncture forceps is inserted to guide it to the affected area. Built-in members such as the illumination optical system 92, the observation optical system 94, and the treatment instrument insertion channel 96 are inserted through the insertion portion 24 and extended to the operation portion 22.

As shown in FIG. 4, the illumination optical system 92 includes an illumination window 102, an illumination lens 104, a light guide fiber 106, a cylindrical fixing base 108, and a flexible tube 110. A hard fixing base 108 is fixed to the outer peripheral surface of the distal end portion of the light guide fiber 106 by adhesion. A flexible tube 110 that protects the light guide fiber 106 is disposed on the base end side of the fixing base 108. That is, the light guide fiber 106 is covered with the flexible tube 110.
The light guide fiber 106 is guided from the distal end hard portion 46 to the operation portion main body 32 through the bending portion 44 and the flexible tube portion 42, and further extended to the outside of the operation portion main body 32. A portion of the light guide fiber 106 that extends to the outside of the operation unit main body 32 is covered with the above-described outer sheath 36a (see FIG. 1) for the light guide fiber 106. That is, the light guide cable 36 is formed by the light guide fiber 106 and the outer sheath 36a. When the endoscope 10 is used, a connector (not shown) provided at the end of the light guide cable 36 is connected to an endoscope light source device (not shown).

Here, the structure of the illumination optical system 92 and the distal end hard portion 46 will be described in detail while briefly explaining a method for fixing the illumination optical system 92 to the distal end frame member 72 of the distal end hard portion 46.
The illumination lens 104 is fitted into the first hole 74 of the distal end frame member 72 of the distal end hard part 46 shown in FIGS. 4 and 5 from the rear side of the first hole 74. When the illumination lens 104 is inserted into the first hole 74, the tip of the illumination lens 104 is finally formed at the tip edge of the first hole 74 of the tip frame member 72 of the tip rigid portion 46. It abuts against the inner end of the projection 74a. For this reason, the illumination lens 104 is positioned with respect to the first hole 74 of the distal end frame member 72. Then, the outer peripheral surface of the illumination lens 104 is fixed to the inner peripheral surface on the distal end side of the first hole 74 at the positioned position.

  By the way, as shown in FIG. 4, the protruding amount of the protrusion 74 a inward of the first hole 74 is a small amount that is slightly higher than the chamfered portion of the edge of the illumination lens 104. Since the protrusion 74a is formed by molding together with the distal end frame member 72, its manufacture is easy. The protrusion 74a is formed in a circumferential shape of the first hole portion 74, a circumferential shape with a part missing, or as a plurality of claws. Further, the surface on the distal end side of the protrusion 74a extends toward the proximal end side. That is, the protrusion 74a is formed on a slope inclined in a radial direction extending obliquely from the surface. Here, the outer peripheral surface of the illumination window 102 is formed in a substantially dish shape. The illumination window 102 is fixed to the front end side of the projection 74a by adhesion. In this way, it is possible to prevent the optical function from being impaired even by providing the protrusion 74a.

  Further, the first hole 74 is formed such that the inner diameter at the position where the illumination lens 104 is disposed is smaller than the inner diameter at the position where the fixing base 108 is disposed, and a step 74 b is formed therebetween. ing. For this reason, when the tip of the fixing base 108 is abutted against the step 74b, the position of the fixing base 108, that is, the tip of the light guide fiber 106 is defined. Here, the provision of the step 74b has been described, but it is also preferable to define the position of the fixing base 108 by forming the inner peripheral surface of the first hole 74 in a tapered shape.

As shown in FIG. 3, the observation optical system 94 includes an objective lens system 122, an image guide fiber 124, a cylindrical fixing base 126, first and second flexible tubes 128a and 128b, and the operations described above. And an eyepiece lens (not shown) provided in the eyepiece 38 of the unit 22. A fixing base 126 is fixed to the outer peripheral surface of the distal end portion of the image guide fiber 124 by adhesion. In the outer periphery of the fixing base 126, a first softness is formed at a base end portion of a first lens frame 134, which will be described later, so as to fill a gap between the fixing base 126 and the second hole 76. A tube 128a is provided. A second soft tube 128 b that covers and protects the image guide fiber 124 is disposed on the base end side of the fixing base 126.
The image guide fiber 124 is guided from the distal end hard portion 46 to the operation portion main body 32 through the bending portion 44 and the flexible tube portion 42. The base end of the image guide fiber 124 is fixed to the eyepiece 38.

The objective lens system 122 includes an observation window 132, cylindrical first and second lens frames 134 and 136, and first and second objective lenses 138 and 140.
The first objective lens 138 is a combination lens in which a plurality of lenses are combined. The first objective lens 138 is disposed on the second lens frame 136. The second lens frame 136 on which the first objective lens 138 is disposed is disposed on the distal end side of the first lens frame 134 in a state in which the forward movement is restricted by the protrusion 134a. . The second objective lens 140 is disposed on the first lens frame 134 so as to face the first objective lens 138. Further, the distal end of the image guide fiber 124 is fixed to the first lens frame 134 at the proximal end of the second objective lens 140. The first lens frame 134 is formed in a cylindrical shape from a hard material such as a light-blocking resin material or metal material in order to prevent flare from occurring.

  As shown in FIG. 3, the inner diameter of the first lens frame 134 is the same from the distal end to the proximal end, but the outer diameter is formed thicker at the proximal end than at the distal end. A step 134 b is formed on the outer periphery between the distal end portion and the proximal end portion of the frame 134. On the other hand, the second hole 76 is formed such that the inner diameter at the position where the distal end of the first lens frame 134 of the objective lens system 122 is disposed is smaller than the inner diameter at the position where the proximal end is disposed. A step 76a is formed between them. Therefore, when the step 134 b of the first lens frame 134 is abutted against the step 76 a, the position of the first lens frame 134 with respect to the second hole 76, that is, the objective lens system with respect to the second hole 76. 122 positions are defined.

  A portion of the image guide fiber 124 positioned rearward from the fixing base 126 is covered with a protective soft tube 128. The image guide fiber 124 is guided to the operation unit 22 through the bending portion 44 and the flexible tube portion 42 and connected to the eyepiece portion 38.

Here, the structure of the observation optical system 94 and the distal end hard portion 46 will be described in detail while briefly explaining a method of fixing the observation optical system 94 to the distal end frame member 72 of the distal end hard portion 46.
The fixing base 126 is fixed to the outer peripheral surface of the distal end portion of the image guide fiber 124 shown in FIG. 3, and the flexible tube 128 is covered on the base end portion of the fixing base 126. Then, the second objective lens 140 is fixed to the distal end surface of the image guide fiber 124 and unitized. Further, the first objective lens 138 is fixed to the second lens frame 136 by bonding to form a unit.

  Thereafter, the second lens frame 136 to which the first objective lens 138 is fixed is fitted into the first lens frame 134. The second lens frame 136 is fixed by adhesion at a position where the tip of the second lens frame 136 comes into contact with the protrusion 134a of the first lens frame 134 and stops moving forward.

  Adhesive is applied to the outer peripheral surface of the second objective lens 140 and the outer peripheral surface of the fixing base 126 on which the image guide fiber 124 is disposed, and these are applied to the rear end side of the first objective lens frame 134. Insert from. Then, the second objective lens 140 is focused on the eyepiece 38 while approaching the first objective lens 138. When the focus is achieved, the adhesive on the outer peripheral surface of the second objective lens 140 and the outer peripheral surface of the fixing base 126 on which the image guide fiber 124 is disposed are cured. That is, the second objective lens 140 and the image guide fiber 124 are fixed to the first objective lens frame 134. In this way, the observation optical system 94 has already been optically adjusted. Then, the first objective lens frame 134 of the observation optical system 94 is fixed to the second hole 76 of the distal end hard portion 46 by adhesion.

  As described above, a claw-like protrusion 134a that protrudes inwardly is formed at the tip of the first lens frame 134 shown in FIG. When the second lens frame 136 is inserted through the proximal opening of the first lens frame 134, the tip of the second lens frame 136 is abutted against the protrusion 134 a of the first lens frame 134. The protruding amount of the protrusion 134 a inwardly of the first lens frame 134 is formed to an extent corresponding to the thickness of the tip of the second lens frame 136. Further, the surface on the distal end side of the protrusion 134a extends toward the proximal end side. That is, the protrusion 134a is formed on a slope inclined in a radial direction extending obliquely inward and rearward from the surface (tip). Here, the outer peripheral surface of the observation window 132 is formed in a substantially dish shape. Thus, since the outer surface of the projection 134a is inclined in a radial direction extending obliquely from the surface of the observation window 132, the dish-shaped outer periphery of the observation window 132 is accommodated in the inclined projection 134a of the first lens frame 134. Is done. The observation window 132 is fixed to the front end side of the protrusion 134a by adhesion. By providing the protrusions 134a in this manner, the occurrence of vignetting in the observation field is prevented as much as possible, and the optical function is prevented from being impaired.

Next, the first objective lens 138, the second objective lens 140, and the image guide fiber 124 are disposed in the second hole 76 of the distal end frame member 72.
An adhesive is applied to the outer periphery of the first lens frame 134 and the first lens frame 134 is inserted into the second hole 76 in the distal end frame member 72 of the endoscope 10 from the opening on the rear side. Then, as shown in FIGS. 3 and 5, the step 134 b of the first lens frame 134 hits the step 76 a of the second hole 76, and the mounting position of the first lens frame 134 is determined. The adhesive is hardened at that position, and the first lens frame 134 is fixed to the tip cap 12 at that position. Finally, the outer periphery of the fixing base 126 is filled with an adhesive, and the periphery thereof is hardened.

  The observation window 132 is disposed so as to cover the tip of the first objective lens frame 134. In order to prevent the observation window 132 from being narrowed by the second hole 76 or the first lens frame 134, the distal end hard portion 46, for example, several tens of micrometers to several hundreds of micrometers, will be described later. It protrudes slightly forward from the front end surface of the front end frame member 72.

As shown in FIGS. 3 and 4, the treatment instrument insertion channel 96 includes a connection cap 152, a channel tube 154, a coil sheath 156, and a channel cap (not shown) provided in the forceps introduction unit 40 of the operation unit 22 described above. )).
The third hole 78 of the distal end frame member 72 is formed with a small diameter at the distal end side and a larger diameter at the proximal end side than the distal end side due to the step 78a. The tip of the connection cap 152 is in contact with the step 78a. The inner diameter of the connection base 152 is the same on the distal end side and the proximal end side, but the distal end side is thick and the proximal end side is thin, and the connection base 152 has a step 152 a. The tip of the channel tube 154 is in contact with the step 152a. In other words, the position of the tip of the channel tube 154 is defined by the step 152 a of the connection base 152. Further, the inner peripheral surface of the channel tube 154 is in close contact with the outer peripheral surface of the base end portion of the connection base 152, and part of the outer peripheral surface is the first mounting portion 80 a and the second mounting portion 80 b of the distal end frame member 72. It is held by the inner peripheral surface of the.

  The coil sheath 156 is disposed on the outer periphery of the channel tube 154 and reinforces the channel tube 154. The base end of the channel tube 154 is connected to a channel cap (not shown). For this reason, it opens from the channel mouthpiece of the forceps introduction part 40 of the operation part 22 to the front-end | tip of the insertion part 24, and can insert a treatment tool. As shown in FIG. 1, a forceps plug 40a is disposed in a forceps introduction portion 40 provided with a channel cap.

  The treatment instrument insertion channel 96 can be used not only for insertion of a treatment instrument but also for air supply / water supply. When air / water is supplied using the channel 96, an adapter of an air / water supply device (not shown) is attached to the forceps plug 40 a of the forceps introduction unit 40. It is also preferable to provide an air / water supply operation button (not shown) on the operation unit body 32 and operate the operation button to perform air / water supply operation.

Next, the structure of the endoscope distal end cap 12 that can be attached to and detached from the distal end of the insertion portion 24 of the endoscope 10 will be described with reference to FIGS.
As shown in FIGS. 10 and 11, the distal end cap 12 includes a cap portion (auxiliary tool main body) 172 inserted prior to the distal end rigid portion 46 of the insertion portion 24, and the distal end of the insertion portion 24 of the endoscope 10. And a protrusion 174 to be inserted into the opening of the treatment instrument insertion channel 96. Furthermore, an engaging portion 176 that is engaged with the inner peripheral surface of the treatment instrument insertion channel 96 by friction is disposed on the protruding portion 174.

  The cap portion 172, the projecting portion 174, and the engaging portion 176 of the tip cap 12 maintain a shape outside the living body and are a water-soluble and biocompatible base material that dissolves in the living body (gelatin). , Maltose (malt sugar), polylactic acid, etc.) and anesthetic materials (xylocaine (lidocaine), etc.) are mixed and molded into a solid state. The dissolution time (dissolution rate) of the tip cap 12 is appropriately set depending on the method of use. For example, as will be described later, after the distal end cap 12 is easily guided to the affected part, the shape of the distal end cap 12 is maintained during the treatment when the distal end cap 12 is attached. Since it is necessary, the dissolution time is set to be long (dissolution rate is slow). On the other hand, when the distal end cap 12 is used only to easily guide the insertion part 24 to the affected part, it is only necessary to maintain the shape only for the time to guide the insertion part 24 to the front side of the affected part. The dissolution time is set short. In addition, the set dissolution time varies depending on the distance and time from the opening to the organ, the mode of the lumen until the affected area is reached, and the like.

  The cap portion 172 is formed in a substantially bullet shape so that it can be easily inserted into a narrow and narrow lumen. That is, the distal end portion of the cap portion 172 is tapered with respect to the proximal end portion. As shown in FIG. 12, the front end surface 172a of the cap portion 172 is formed, for example, in a substantially elliptical shape with the vertical direction as the short axis and the horizontal direction as the long axis. On the other hand, the cap portion 172 is formed on a circular base end portion 172b that gradually transitions from a substantially elliptical shape to a substantially circular shape on the front end surface 172a as it goes from the front end surface 172a to the base end portion side. In the distal end surface 172a, the center of the ellipse is shifted downward with respect to the center of the circular base end portion 172b. The outer diameter of the circular base end portion 172b is preferably the same as the outer diameter of the distal end frame member 72 of the distal end rigid portion 46, but may be slightly larger than the outer diameter of the distal end frame member 72. It may be small.

  Between the distal end surface 172a of the distal end portion of the cap portion 172 and the circular proximal end portion 172b of the proximal end portion, the first and second inclined surface portions 192a and 192b having different inclinations on the upper side and the lower side in FIG. The upper and lower sides in FIG. 11 are integrally formed by first and second side surfaces 194a and 194b having substantially the same inclination. Between the first slope part 192a and the first side face part 194a, between the first side face part 194a and the second slope part 192b, and between the second slope part 192b and the second side face part 194b. The second side surface portion 194b and the first inclined surface portion 192a are smoothly connected to each other. That is, the outer peripheral surface of the cap part 172 is formed into a smoothly continuous curved surface. Further, the distal end portion of the cap portion 172, the first inclined surface portion 192a, and the proximal end portion are smooth without a sharp corner or severe unevenness from the edge of the distal end surface 172a of the cap portion 172 to the outer periphery of the proximal end portion. It is formed on the surface. Specifically, the whole is formed into a continuous curved surface from the edge of the substantially elliptical tip surface of the cap portion 172 to the substantially circular outer peripheral surface of the base end portion. The first inclined surface portion 192 a has a relatively large inclination angle (angles α and β described later) with respect to the central axis O of the insertion portion 24. The inclination angle of the first slope 192a is appropriately set, for example, in the range of 20 degrees to 70 degrees.

  Furthermore, as shown in FIG. 10, the first slope portion 192 a is a state in which the first slope portion 192 a is slightly curved and recessed inward (downward) when the tip cap 12 is viewed from the side. Is formed. That is, in the first inclined surface portion 192a, the inclination angle α on the distal end side is gentle (smaller) than the inclination angle β on the proximal end side, and the first slope portion 192a is smoothly continuous therebetween. For this reason, the inclined state of the first inclined surface portion 192a is gentler as it approaches the front end surface 172a, in other words, it is formed more gradually as it approaches the front end surface 172a. Note that the inclination angles α and β are based on the inner peripheral surface close to the observation image transmission hole 186 of the channel communication hole 182 in FIG. Here, the angles α and β are described as different, but the same angle is also preferable.

  The first inclined surface portion 192a is provided in a direction that coincides with the direction in which the bending portion 44 bends upward when the distal end cap 12 is appropriately attached to the distal end of the insertion portion 24, for example. Here, appropriately attaching the distal end cap 12 to the distal end of the insertion portion 24 means that the treatment instrument insertion channel 96 is disposed at a position shifted from the central axis O. A state in which the outer peripheral surface of the base end portion of the cap portion 172 of the distal end cap 12 is, for example, flush.

  As shown in FIG. 10, the second inclined surface portion 192b is inclined in a gentle slope shape from the distal end side toward the proximal end side. The inclination angle of the second inclined surface portion 192b is the same as that of the first inclined surface portion 192a or more gentle than that. That is, the inclination angle of the second slope portion 192b is closer to the inclination direction of the central axis O than the inclination angle of the first slope portion 192a. For this reason, the second inclined surface portion 192b is slightly recessed at the distal end side, but is formed from the distal end surface 172a to the circular proximal end portion 172b in a state of substantially maintaining the wide state.

  Although the first and second slope portions 192a and 192b are illustrated as having different inclinations on the upper side and the lower side in FIG. 10, the upper side is the same as the first and second side surface portions 194a and 194b. It is also preferable that the lower side and the lower side are formed with the same inclination. That is, it is also preferable that the center of the front end surface 172a and the center of the circular base end portion 172b coincide.

  The protrusion 174 is formed in a cylindrical shape. On the outer peripheral surface of the base end portion of the protruding portion 174, an engaging portion 176 that engages with the inner peripheral surface of the third hole 78 of the treatment instrument insertion channel 96 by friction protrudes radially outward. Is formed. Note that the outer diameter of the protrusion 174 is the same as or slightly smaller than the inner diameter of the third hole 78 of the channel 96, so that it slides on the inner peripheral surface of the third hole 78. Is possible. Further, the outer diameter of the engaging portion 176 is formed larger than the inner diameter of the third hole 78 of the channel 96. For this reason, the engaging portion 176 of the protruding portion 174 of the tip cap 12 is elastically deformed and engaged by friction with respect to the inner peripheral surface of the third hole portion 78.

  As shown in FIGS. 10 and 11, the engaging portion 176 has a large outer diameter on the distal end side, a small outer diameter on the proximal end side, and an outer peripheral surface formed in a dish shape. It may be a shape. That is, it is also preferable that the engaging portion 176 has a small outer diameter on the distal end side and a large outer diameter on the proximal end side, and the outer peripheral surface is formed in a dish shape. Moreover, although the engaging part 176 is provided in the base end of the protrusion part 174, it does not necessarily need to be provided in the base end, and also it is suitable that more than one is provided. . In addition, various forms are acceptable as long as the protrusion is configured to be engaged with the inner peripheral surface of the third hole portion 78 by, for example, a protrusion that generates friction on the outer periphery of the protruding portion 174. The

A channel communication hole 182 that communicates with the treatment instrument insertion channel 96 when the distal end cap 12 is attached to the distal end of the insertion portion 24 is formed in the cap portion 172 and the protruding portion 174. The cap portion 172 is formed with an illumination light transmission hole 184 (see FIGS. 2 and 12) through which illumination light emitted from the illumination optical system 92 passes. Further, the cap portion 172 is formed with an observation image transmission hole 186 (see FIGS. 2 and 10 to 12) through which light is transmitted in order to make the optical image incident on the objective lens system 122 of the observation optical system 94. .
Each of the channel communication hole 182, the illumination light transmission hole 184, and the observation image transmission hole 186 has a distal end surface 172a. The channel communication hole 182, the illumination light transmission hole 184, and the observation image transmission hole 186 are the treatment instrument insertion channel 96 and the illumination optical system, respectively, when the distal end cap 12 is appropriately attached to the distal end of the insertion portion 24 as described above. 92 and the observation optical system 94 are formed along the center axis of each tip. In particular, the inner diameter of the channel communication hole 182 is formed to be the same as or larger than the inner diameter of the third hole 78 at the distal end of the treatment instrument insertion channel 96.

  As shown in FIG. 10, the objective lens of the observation optical system 94 protrudes from the distal end surface of the distal end frame member 72 of the distal end hard portion 46 of the insertion portion 24 of the endoscope 10 at the proximal end portion of the observation image transmission hole 186. A recess 186a in which the tip of the first lens frame 134 of the system 122 is disposed is formed. When the tip of the first lens frame 134 is disposed in the recess 186a, the protrusion 174 is disposed in the treatment instrument insertion channel 96, the engagement portion 176 is engaged in the third hole 78, and The first lens frame 134 is disposed in the recess 186 a of the tip cap 12. Therefore, the distal end cap 12 is positioned in a predetermined state at the distal end of the insertion portion 24 of the endoscope 10 and is prevented from rotating at the distal end of the insertion portion 24.

  The illumination light transmission hole 184 and the observation image transmission hole 186 except for the channel communication hole 182 are filled with a transparent member (not shown) made of, for example, gelatin. For this reason, living tissue or the like is prevented from sticking to the illumination window 102 or the observation window 132 when the insertion portion 24 is inserted. The transparent member is preferably disposed, but there is no problem even if it is not disposed.

Next, a usage example in which the insertion portion 24 is inserted into the urethra U in a state where the distal end cap 12 is attached to the distal end of the insertion portion 24 of the endoscope 10 according to the present embodiment will be described.
As shown in FIG. 13, the male urethra U is formed substantially linearly from the external urethral orifice M to a portion immediately before the urethral sphincter S. However, the part (bent part C) from the part immediately before the urethral sphincter S to the bladder B is bent upward. Thus, the urethra U reaches the bladder B through the urethral sphincter S and the prostate P through the bent portion C. The urethral sphincter S fulfills a squeezing function to close the urinary tract, and the urethra U in the vicinity of the prostate P is narrow in a patient in which the prostate P begins to enlarge.

  As shown in FIG. 14, the distal end of the insertion portion 24 of the endoscope 10 is inserted into the urethra U closed from the outer urethral opening M, and further inserted while being pushed into the urethra U. At this time, the curve of the urethra U is anatomically until just before the urethral sphincter S, and the curve of the urethra U is formed substantially linearly. it can.

  However, the path of the urethra U is suddenly bent upward at the bent portion C just before the urethral sphincter S. Further, the bent portion C is closed by a throttling function for closing the urinary tract of the urethral sphincter S. For this reason, the urinary tract in the vicinity is narrow. In particular, in a patient whose prostate P is beginning to enlarge, the urinary tract in the vicinity thereof is further narrowed. Therefore, the procedure when passing through the urinary tract bent upward is the most difficult and painful to the patient.

In the endoscope 10 of the present embodiment, when the distal end portion of the insertion portion 24 is passed through the bent portion C bent upward, the insertion is performed as follows.
The distal end cap 12 is attached to the distal end surface of the insertion portion 24. In this case, the protruding portion 174 of the distal end cap 12 is inserted into the treatment instrument insertion channel 96 opened at the distal end of the insertion portion 24 of the endoscope 10. Then, the engaging portion 176 of the protruding portion 174 of the distal end cap 12 is engaged with the third hole 78 of the distal end frame member 72 of the distal end rigid portion 46. Further, the tip of the first lens frame 134 of the observation optical system 94 that slightly protrudes from the tip surface of the tip frame member 72 is disposed in the recess 186 a of the cap portion 172. Therefore, the distal end cap 12 is attached to the distal end of the insertion portion 24 of the endoscope 10 so as not to rotate. At this time, the outer peripheral surface of the distal end frame member 72 of the distal end hard portion 46 of the insertion portion 24 and the outer peripheral surface of the proximal end portion of the cap portion 172 of the distal end cap 12 are arranged in a flush or substantially flush state. Yes.

  Then, an anesthetic material such as xylocaine is made into a jelly form and applied to the outside of the distal end cap 12 and the outside of the insertion portion 24 of the endoscope 10. In this way, the insertion portion 24 of the endoscope 10 with the distal end cap 12 attached is inserted into the urethra U closed from the outer urethral opening M. The insertion portion 24 is inserted substantially straight up to the bent portion C. As shown in FIG. 14, when inserting into the bent portion C of the urethra U that is bent upward and closed, the bending portion 44 of the insertion portion 24 is bent upward. When the bending portion 44 is bent upward, the distal end hard portion 46 and the distal end cap 12 are raised upward. For this reason, the slope 192a of the cap 172 pushes the urinary tract wall of the urethra U upward. By the pushing-up action of the inclined surface portion 192a, the leading end side of the preceding cap portion 172 and the introduction path of the leading end hard portion 46 are secured without difficulty. Further, when inserting into the urethra U, the bending of the bending portion 44 and the pushing operation of the insertion portion 24 are simultaneously performed, so that the leading protrusion 174 is guided to the back and the distal end hard portion 46 is smoothly followed. .

  In addition, the distal end hard portion 46 and the curved portion 44 that curves upwardly follow the urinary tract of the urethra U after securing the guidance of the cap portion 172 and the introduction path of the distal end hard portion 46. Therefore, the urinary tract wall of the bent portion C can be pushed away by the first inclined surface portion 192a of the cap portion 172. If it does so, the front-end | tip hard part 46 can be easily advanced by combining with the operation which curves the bending part 44. FIG.

  At this time, the inside of the urethra U can be illuminated with illumination light from the illumination optical system 92 through the transparent member of the illumination light transmission hole 184 of the distal end cap 12, and the observation image transmission hole of the distal end cap 12 can be illuminated in the illuminated urethra U. The observation optical system 94 can observe through the transparent member 186. That is, the inside of the urethra U can be observed while illuminating the inside of the urethra U. Further, by passing the elongated treatment tool from the forceps introducing portion 40 of the treatment instrument insertion channel 96, the distal end of the treatment instrument is channeled from the third hole 78 which is the distal end opening of the treatment instrument insertion channel 96 to the channel of the distal end cap 12. It can be led out through the communication hole 182. Therefore, treatment can be appropriately performed while observing the inside of the urethra U. At this time, an appropriate distance can be provided between the observation window 132 of the observation optical system 94 and the object to be observed due to the presence of the tip cap 12, so that the tip cap 12 can be a spacer in the same manner as an endoscope hood or the like. Can act as

The treatment instrument insertion channel 96 and the channel communication hole 182 can be used not only for insertion of the treatment instrument but also for air supply / water supply. When air / water is supplied using the channel 96, an adapter of an air / water supply device (not shown) is attached to the forceps plug 40 a of the forceps introduction unit 40. Then, for example, physiological saline can be fed through the treatment instrument insertion channel 96 and the channel communication hole 182.
Then, after the observation and treatment are completed, the insertion portion 24 of the endoscope 10 is slowly pulled out from the urethra U.

  Here, it has been described that observation and treatment are performed while the distal end cap 12 is attached to the distal end portion of the insertion portion 24 from when the insertion portion 24 of the endoscope 10 is inserted into the urethra to when it is pulled out. However, the distal end cap 12 only needs to be attached when inserted into the urethra U. During treatment, the engagement portion 176 of the distal end cap 12 with respect to the third hole 78 is released through an elongated pusher (not shown) through the treatment instrument insertion channel 96. That is, the distal end cap 12 is removed from the distal end surface of the insertion portion 24 of the endoscope 10. And an appropriate treatment can be performed by pulling out the pusher and inserting another treatment tool. This is allowed by allowing the tip cap 12 to be formed of a water soluble biocompatible material and dissolving over time. For this reason, since the dissolution of the tip cap 12 proceeds with a lapse of an appropriate time after the end of the treatment, it is discharged out of the body together with urine.

As described above, according to this embodiment, the following effects can be obtained.
The protrusion cap 174 of the endoscope distal end cap 12 is inserted from the distal end side of the treatment instrument insertion channel 96, and the inner peripheral surface of the channel 96 and the engaging portion 176 are elastically engaged by friction, whereby the distal end cap 12 can be easily attached to the distal end of the insertion portion 24 of the endoscope 10. Further, the tip cap 12 can be removed by pulling directly from the tip of the insertion portion 24 even after it is once attached.

  Since the channel communication hole 182, the illumination light transmission hole 184, and the observation image transmission hole 186 are formed in the distal end cap 12, the insertion part 24 can be guided to a desired affected part while observing the inside of the lumen. At this time, a desired treatment can be performed on the affected part in a state where the treatment tool or the like is projected from the treatment tool insertion channel 96 through the channel communication hole 182.

  Since the distal end cap 12 is formed of a material that dissolves with time, the distal end cap 12 may be used only to facilitate insertion of the insertion portion 24 of the endoscope 10 or may be treated while attached. it can.

  Moreover, it inserts in the insertion part 24 of the endoscope 10 in the state which apply | coated the anesthetic material, such as a xylocaine, for example to the outer periphery. Furthermore, the tip cap 12 is formed in a solid state with an anesthetic material mixed with a biocompatible material (base material). For this reason, when the tip cap 12 touches the body wall during insertion, an anesthetic material is applied to the touched portion. Then, the anesthesia can be applied to the urethra U from the time of insertion of the insertion portion 24 until the treatment is performed. For this reason, the pain given to the patient can be reduced from when the insertion portion 24 is inserted into the urethra U until treatment is performed.

When the bending portion 44 is bent upward at the time of insertion, the wall surface such as the urinary tract wall can be pressed and pushed away by the first inclined surface portion 192a of the tip cap 12. Further, when the bending portion 44 is bent downward, the wall surface can be pressed and pushed away by the second inclined surface portion 192b of the tip cap 12. That is, when the bending portion 44 is bent, the lumen can be expanded by the first and second slope portions 192a and 192b. For this reason, the insertion performance of the insertion portion 24 can be improved by the tip cap 12. Thus, the pain given to the patient can be reduced by improving the insertion performance.
At this time, in particular, since the first inclined surface portion 192a is formed with an inclination angle steeper than that of the second inclined surface portion 192b, the wall surface can be pushed away more easily. That is, since the substantially elliptical short axis direction of the tip surface 172a of the cap part 172 and the bending direction of the bending part 44 are substantially matched, when the bending operation is performed, a substantially elliptical long axis surface (first And the second inclined surface portions 192a and 192b) can press and push the wall surface, so that the distal end hard portion 46 can be inserted into a lumen such as the urethra U in advance.
In particular, when passing a bent stenosis in the vicinity of the male urethral sphincter S, the distal end hard portion 46 is swung by a bending operation so that the peripheral surface of the distal end hard portion 46 is smooth along the inner wall of the urethra U. Can be inserted. Further, since it is formed by the first and second inclined surface portions 192a and 192b from the circular base end portion 172b of the cap portion 172 to the substantially elliptical distal end surface 172a, the urine of the urethra U of the prostatic hypertrophy that is supposed to be narrowed. When passing through the road portion, it can be inserted more easily. That is, the distal end surface 172a of the distal end cap 12 passes through the wide open portion below the narrowed opening, and then the first and second inclined surface portions 192a and 192b of the cap portion 172, and further the circular proximal end Since the curved surface around the portion 172b gently extends through the narrow portion of the prostate and passes through, the pain given to the patient can be reduced to the minimum.

  Moreover, although the front-end | tip part of the cap part 172 is substantially elliptical shape, the base end part is formed in circular shape. Therefore, the contact area of the cap portion 172 with the distal end surface of the distal end frame member 72 is large, and it is possible to prevent the distal end cap 12 from shifting with respect to the distal end of the insertion portion 24 as much as possible.

  Further, when the insertion portion 24 is inserted into the urethra U or the like, biological tissue or the like may adhere to the transparent member of the illumination light transmission hole 184 or the observation image transmission hole 186 of the tip cap 12, but the transparent member is disposed. Therefore, it is possible to prevent the living tissue and the like from attaching to the illumination window 102 and the observation window 132 of the endoscope 10. Therefore, by removing the tip cap 12 after being inserted into the urethra U or the like, it is possible to prevent the observation of the living window tissue or the observation window 132 from being attached to the illumination window 102 or the observation window 132 when observation is originally desired. it can.

  In this embodiment, the urological endoscope 10 in which the insertion portion 24 of the endoscope 10 is inserted into the male urethra U has been described. However, the endoscope distal end cap according to the present embodiment is described. 12 can also be used for endoscopes for uterus, endoscopes for lower digestive organs, and the like.

  Further, in this embodiment, the configuration in which the eyepiece unit 38 is provided in the operation unit main body 32 and the observation and treatment are performed by looking into the eyepiece unit 38 has been described, but the operation unit main body 32 is used instead of the eyepiece unit 38. It is also possible to use a camera unit (not shown) that can be attached to and detached from the camera. In this case, an image captured by the camera unit is displayed on a monitor (not shown). Therefore, treatment can be performed while observing the image displayed on the monitor.

  Next, a second embodiment will be described with reference to FIGS. 15 and 16. This embodiment is a modification of the first embodiment. The same members as those described in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

  End endoscope caps (endoscope insertion aids) 12 shown in FIGS. 15 and 16 are provided only to facilitate insertion into an insertion target. The tip cap 12 is not provided with the channel communication hole 182, the illumination light transmission hole 184, and the observation image transmission hole 186, and is formed solid. As described in the first embodiment, the tip cap 12 is solidified by mixing an anesthetic material such as xylocaine with a water-soluble and biocompatible base material.

Next, the operation of the endoscope 10 according to this embodiment will be described.
When the distal end cap 12 is attached to the distal end portion of the insertion portion 24 of the endoscope 10, the protruding portion 174 is inserted into the treatment instrument insertion channel 96. Then, the engagement portion 176 formed on the outer periphery of the protruding portion 174 restricts the movement of the protruding portion 174 in the axial direction, and also restricts the rotation of the protruding portion 174 around the central axis. In this state, the insertion portion 24 of the endoscope 10 is inserted into the body cavity of the patient.

With the appropriate length inserted from the distal end of the insertion portion 24 of the endoscope 10 into the body cavity, the proximal end portion of the protruding portion 174 of the distal end cap 12 is pushed by a pusher (not shown) through the treatment instrument insertion channel 96. Press. When a force greater than an appropriate force is applied to the proximal end portion of the protruding portion 174, the distal end cap 12 moves relative to the distal end of the insertion portion 24. When further force is applied, the distal end cap 12 is removed from the distal end of the insertion portion 24 of the endoscope 10 in the body cavity. Since the removed tip cap 12 is water-soluble and biocompatible, it is dissolved to a size that passes through the urethra U (see FIGS. 13 and 14) and then discharged outside the body.
Then, the inside of the body cavity can be observed with the endoscope 10, and the inside of the body cavity can be treated through the treatment instrument insertion channel 96.

  In this embodiment, the observation image transmission hole 186 is not provided. However, it is preferable that the cap portion 172 has a recess 186a (see FIG. 10). When the concave portion 186a is provided, even when a large force is applied to the first inclined surface portion 192a of the distal end cap 12 when the distal end cap 12 is attached to the distal end of the insertion portion 24 and inserted into the body cavity, the distal end It is possible to prevent the cap 12 from rotating around the central axis of the treatment instrument insertion channel 96 as much as possible.

The operation of the endoscope 10 equipped with the distal end cap 12 according to this embodiment is substantially the same as the operation described in the first embodiment.
The distal end cap 12 can also be removed by inserting an appropriate treatment instrument into the treatment instrument insertion channel 96 and pressing the protruding portion 174 of the distal end cap 12 with the insertion portion 24 inserted to a desired position. In such a state, the affected part can be observed and a desired treatment can be performed on the affected part.

  Next, a third embodiment will be described with reference to FIGS. This embodiment is a modification of the first embodiment. The same members as those described in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.

  As shown in FIG. 17, the distal end of the treatment instrument insertion channel 96 of the endoscope 10, that is, the transverse section of the third hole 78 is formed in a rectangular shape such as a square or a rectangle. The third hole 78 has a rectangular hole 278a on the distal end side, a circular hole 278b on the proximal end side, and a step 278c formed therebetween on the same central axis from the distal end side to the proximal end side. Is formed. The base end of the circular hole 278b is formed in the same shape as shown in FIG. Further, the rectangular hole 278a is formed in the distal end surface of the distal end frame member 72 of the distal end rigid portion 46. The rectangular hole 278a has an inner diameter larger than the outer diameter of a circular protrusion 174a (to be described later) of the protrusion 174 because the protrusion 174 of the tip cap 12 is inserted. That is, as shown in FIG. 17, the inner diameter of the circular hole 278b is accommodated in the rectangular hole 278a through the step 278c.

On the other hand, the protrusion 174 of the tip cap 12 includes a circular protrusion 174a and a rectangular protrusion 174b. The rectangular protrusion 174 b is formed on the base end side of the cap part 172, and the circular protrusion 174 a is formed at a position away from the cap part 172. An engaging portion 176 is disposed on the circular protrusion 174a.
The circular protrusion 174a and the rectangular protrusion 174b are disposed on the same axis, and the transverse section of the circular protrusion 174a is stored in the transverse section of the rectangular protrusion 174b. That is, the rectangular protrusion 174b stores the outer diameter of the circular protrusion 174a. The outer diameter of the circular protrusion 174a is the same as or slightly smaller than the inner diameter of the circular hole 278b of the third hole 78. Furthermore, the cross section of the rectangular protrusion 174 b of the protrusion 174 is slightly smaller than the outer periphery of the rectangular hole 278 a of the third hole 78. For this reason, the rectangular protrusion 174b of the protrusion 174 is disposed in the rectangular hole 278a.

  The rectangular protrusion 174b is formed on the side away from the cap 172 shorter than the length of the rectangular hole 278a. Furthermore, the position of the base end of the circular protrusion 174a from the base end of the cap part 172, that is, the length from the base end of the cap part 172 to the engaging part 176 is formed longer than the length of the rectangular hole 278a. . For this reason, the engaging part 176 can engage with the circular hole 278b by friction.

  In this embodiment, the engaging portion 176 is described as being provided on the circular protrusion 174a. However, it is naturally preferable that the engaging portion 176 is provided on the rectangular protrusion 174b. In that case, the circular protrusion 174a is not necessarily provided.

  In this embodiment, the rectangular protrusion 174b, the rectangular hole 278a, and the like have been described as rectangular. However, any shape other than a circle, such as an ellipse, is also preferable.

  Next, a fourth embodiment will be described with reference to FIG. This embodiment is a modification of the first embodiment, and the same member as the member described in the first embodiment, or a member having the same action is denoted by the same reference numeral, Detailed description is omitted.

  In the first embodiment described above, the case where the axial length of the channel communication hole 182 is shorter than the axial length of the observation image transmission hole 186 at least in the cap portion 172 has been described (see FIG. 10). ). However, it is also preferable that the axial length of the channel communication hole 182 in the cap portion 172 is longer than the axial length of the observation image transmission hole 186 as shown in FIG. Even if it is such a shape, the front-end | tip cap 12 can be used similarly to the case where it demonstrated in 1st Embodiment.

  Although several embodiments have been specifically described so far with reference to the drawings, the present invention is not limited to the above-described embodiments, and all the embodiments performed without departing from the gist of the present invention are described. Including implementation.

  According to the above description, the following matters can be obtained. Combinations of the terms are also possible.

[Appendix]
(Additional item 1)
Of an endoscope having an insertion portion in which observation means having an observation optical system and an illumination optical system and a treatment instrument insertion channel arranged in parallel with the observation means are disposed, the endoscope is attached to the distal end portion of the insertion portion An insertion aid for an endoscope that is inserted into an object,
An auxiliary tool body whose tip is tapered with respect to the base, and
A protrusion provided at the base end of the auxiliary tool body, and detachable from the channel;
An insertion assisting tool for an endoscope, comprising: an engaging portion that is provided on the protruding portion and slidably engages with an inner peripheral surface of the channel.

(Appendix 2)
The auxiliary tool body includes light guide means for guiding illumination light emitted from the illumination optical system and guiding a subject image illuminated by the illumination light to the observation optical system. The insertion assisting tool for endoscopes according to additional item 1.

(Additional Item 3)
The endoscope insertion assisting tool according to appendix 1, wherein the assisting tool main body includes light guide means for guiding a subject image to the observation optical system.

(Appendix 4)
The insertion assisting tool for an endoscope according to any one of appendices 1 to 3, wherein the assisting device main body and the projecting portion include a communication passage communicating with the channel.

(Appendix 5)
The auxiliary tool main body has a plurality of inclined surface portions that are asymmetric with respect to the axial direction of the insertion portion between the distal end portion and the proximal end portion and have different inclinations from the distal end portion toward the proximal end portion. The insertion assisting tool for an endoscope according to any one of the additional items 1 to 4, further comprising:

(Appendix 6)
The auxiliary tool body, the protruding portion and the engaging portion are:
A base material that is water-soluble and biocompatible, and melts in vivo from outside to inside over time;
The endoscope insertion aid according to any one of appendices 1 to 5, wherein the anesthetic material mixed with the base material is integrally formed in a solid form.

The schematic diagram of the endoscope which shows the state where the tip cap for endoscopes concerning the 1st embodiment of the present invention was attached to the tip part of the insertion part. The schematic perspective view which shows the state which mounted | wore the front-end | tip cap for endoscopes with the front-end | tip part of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic longitudinal cross-sectional view which shows the front-end | tip part of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic longitudinal cross-sectional view which shows the front-end | tip part of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic cross-sectional view which follows the VV line in FIG. 3 and FIG. 4 of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic cross-sectional view which follows the VI-VI line in FIG. 3 and FIG. 4 of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic cross-sectional view which follows the VII-VII line in FIG. 3 and FIG. 4 of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic cross-sectional view which follows the VIII-VIII line in FIG. 3 and FIG. 4 of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic cross-sectional view which follows the IX-IX line in FIG. 3 of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic longitudinal cross-sectional view which follows the XX line in FIG. 12 of the front-end | tip cap for endoscopes which concerns on 1st Embodiment. The schematic top view which shows the state observed from the arrow XI direction in FIG. 10 and FIG. 12 of the front-end | tip tip cap for endoscopes which concerns on 1st Embodiment. The schematic front view which shows the state observed from the arrow XII direction in FIG. 10 and FIG. 11 of the front-end | tip cap for endoscopes which concerns on 1st Embodiment. Schematic which shows the structure of the male urethra in which the endoscope which has an insertion part equipped with the front-end | tip cap which concerns on 1st Embodiment is inserted. Schematic which shows the state which inserted in the urethra the insertion part which equipped the front-end | tip cap for endoscopes with the front-end | tip of the insertion part of the endoscope which concerns on 1st Embodiment. The schematic longitudinal cross-sectional view which shows the tip cap for endoscopes which concerns on the 2nd Embodiment of this invention. The schematic top view which shows the state observed from the arrow XVI direction in FIG. 15 of the front-end | tip cap for endoscopes which concerns on 2nd Embodiment. The schematic front view which shows the state of the front end surface of the front-end | tip part of the insertion part of the endoscope which concerns on the 3rd Embodiment of this invention. The schematic perspective view which shows the front-end | tip cap for endoscopes which can be mounted | worn to the front-end | tip part of the insertion part of the endoscope shown in FIG. 17 based on 3rd Embodiment. The schematic longitudinal cross-sectional view which shows the tip cap for endoscopes which concerns on the 4th Embodiment of this invention.

Explanation of symbols

  12 ... Endoscope cap for endoscope, 172 ... Cap portion, 172a ... Tip surface, 172b ... Circular base end portion, 174 ... Projection portion, 174a ... Circular projection portion, 174b ... Rectangular projection portion, 176 ... Engagement portion, 182 ... Channel communication hole, 184 ... Illumination light transmission hole, 186 ... Observation image transmission hole, 186a ... Recess, 192a ... First slope part, 192b ... Second slope part

Claims (10)

Of the endoscope having an insertion portion in which observation means having an illumination optical system and an observation optical system and a treatment instrument insertion channel arranged in parallel with the observation means are arranged, the insertion to be inserted into an object End cap for endoscope to be used by attaching to the tip of the part,
A cap portion whose tip is tapered with respect to the base end;
A protrusion provided at the base end of the cap portion, and removable from the channel;
An endoscope distal end cap, comprising: an engaging portion provided on the projecting portion and slidably engaged with an inner peripheral surface of the channel.   The cap portion includes light guide means for guiding illumination light emitted from the illumination optical system and guiding a subject image illuminated by the illumination light to the observation optical system. The endoscope front end cap according to claim 1.   2. The endoscope distal end cap according to claim 1, wherein the cap portion includes light guide means for guiding a subject image to the observation optical system.   The endoscope cap according to any one of claims 1 to 3, wherein the cap portion and the protruding portion include a communication path communicating with the channel.   The cap portion includes a plurality of slope portions between the distal end portion and the proximal end portion that are asymmetric with respect to the axial direction of the insertion portion and have different inclinations from the distal end portion toward the proximal end portion. The endoscope front-end cap according to any one of claims 1 to 4, wherein the endoscope front-end cap is provided. The cap portion, the protruding portion, and the engaging portion are
A base material that is water-soluble and biocompatible and that dissolves in vivo from outside to inside over time;
The endoscope distal end cap according to any one of claims 1 to 5, wherein the endoscope end cap is integrally formed in a solid state with an anesthetic material mixed with the base material. An insertion portion having a distal end surface orthogonal to the longitudinal direction at the distal end portion, and the distal ends of the illumination optical system, the observation optical system, and the treatment instrument insertion channel arranged in parallel on the distal end surface;
An operation unit provided at a base end portion of the insertion unit and gripped by an operator;
A tip cap for inserting into the object in a state of being attached to the tip surface of the insertion portion,
The tip cap is
A cap portion whose tip is tapered with respect to the base end;
Protruding portion provided at the base end portion of the cap portion, detachable from the distal end surface side to the channel,
An endoscope comprising: an engaging portion provided on an outer peripheral surface of the projecting portion and slidably engaged with an inner peripheral surface of the channel. At least one of the illumination optical system and the observation optical system protrudes from the distal end surface of the distal end portion of the insertion portion,
The cap portion includes a rotation preventing unit that is engaged with a protruding portion of the illumination optical system and the observation optical system and prevents rotation with respect to a distal end surface of the insertion portion. The endoscope according to Item 7. The cap part is
A light guide for illumination light that guides illumination light emitted from the illumination optical system to illuminate a subject; and
An observation optical system light guide for guiding a subject image illuminated by illumination light to the observation optical system,
The endoscope according to claim 8, wherein the rotation preventing unit is disposed at a base end portion of at least one of the light guide unit for illumination light and the light guide unit for observation optical system. The insertion portion has a distal end hard portion that has the distal end portion and the protruding portion of the distal end cap is inserted and removed, and a bending portion that is provided on a proximal end side of the distal end hard portion and is curved by an operation of the operation portion. And a flexible tube portion provided on the proximal end side of the bending portion and connected to the operation portion,
The channel includes a deformed cross section having a cross section other than a circle at the distal end hard part,
10. The method according to claim 7, wherein the projecting portion of the tip cap has at least a part of a cross section other than a circle along the deformed cross section of the channel. Endoscope.

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