JP2008253774A - Endoscope apparatus - Google Patents

Endoscope apparatus Download PDF

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JP2008253774A
JP2008253774A JP2008093675A JP2008093675A JP2008253774A JP 2008253774 A JP2008253774 A JP 2008253774A JP 2008093675 A JP2008093675 A JP 2008093675A JP 2008093675 A JP2008093675 A JP 2008093675A JP 2008253774 A JP2008253774 A JP 2008253774A
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bending
bending portion
bent
distal end
endoscope apparatus
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Japanese (ja)
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Yasuta Ishibiki
康太 石引
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Olympus Corp
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Olympus Corp
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Priority to JP2008093675A priority Critical patent/JP2008253774A/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/00078Insertion part of the endoscope body with stiffening means

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope apparatus, which even if a bending section thereof in a bent state is pressed against the intestinal wall upon being passed through a bent portion of the intestine, allows a second bending section to be securely bent before a flexible tube is started to be bent, and is therefore easily passed through a complex bent portion such as the sigmoiditis. <P>SOLUTION: A bending section 16 has a first bending section 39 at the distal end side and a second bending section 40 connected thereto and having rigidity against bending in the axial direction higher than that of the first bending section 39. The first bending section 39 and the second bending section 40 are each formed by connecting a plurality of bend pieces. An end part of a traction wire is fixed to one of bend pieces of the first bending section 39. In a state where the bending section 16 is bent more than almost 90° by traction operation of the traction wire by a bending operation knob, an insertion tube 7 has rigidity against bending in the axial direction of the second bending section 40 lower than that in the axial direction of a flexible tube part 15. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

本発明は、管腔内に挿入される挿入部の先端側に湾曲部が配設された内視鏡装置に関する。   The present invention relates to an endoscope apparatus in which a bending portion is disposed on a distal end side of an insertion portion that is inserted into a lumen.

一般に、内視鏡の挿入部の先端側に配設された湾曲部に2つの湾曲部を直列に接続させた構成の内視鏡装置が知られている。例えば、特許文献1には図17(A)に示すように内視鏡の挿入部に配設された細長い可撓管部aの先端側に4方向に湾曲可能な節輪構造を備えた第1湾曲部bが配設され、この第1湾曲部bの後端部に第1湾曲部bと略同じ節輪構造を備えた第2湾曲部cを連接させた構成の湾曲管装置が示されている。   In general, an endoscope apparatus having a configuration in which two bending portions are connected in series to a bending portion disposed on a distal end side of an insertion portion of an endoscope is known. For example, in Patent Document 1, as shown in FIG. 17 (A), a nodal ring structure that can be bent in four directions is provided on the distal end side of an elongated flexible tube portion a disposed in an insertion portion of an endoscope. A bending tube apparatus having a configuration in which one bending portion b is disposed and a second bending portion c having a nodal ring structure substantially the same as the first bending portion b is connected to the rear end portion of the first bending portion b is shown. Has been.

また、図17(A)に示す2つの湾曲部b、cを直列に接続させた構成の内視鏡の挿入部を例えば大腸dの直腸eとS状結腸fとの間の境界の屈曲部gなどを通過させる場合には第1湾曲部bの湾曲操作によってこの第1湾曲部bの部分を屈曲部gを通過させたのち、可撓管部aを押込むことにより、第2湾曲部cおよび可撓管部aの部分を続いて通過させる操作が行われている。
実公平1−22641号公報
In addition, an insertion portion of an endoscope having a configuration in which two curved portions b and c shown in FIG. When passing g or the like, the second bending portion is formed by pushing the flexible tube portion a after passing the portion of the first bending portion b through the bending portion g by the bending operation of the first bending portion b. The operation of passing the portion of c and the flexible tube portion a in succession is performed.
No. 1-222641

特許文献1では、第2湾曲部cにそれ自身の伸縮量が少ないステーコイルが内蔵されているため、第2湾曲部cに外力が与えられた際に第2湾曲部cが自由に曲がることができず、湾曲部を湾曲操作手段により湾曲をかけた際には、湾曲によりステーコイルが圧縮ないし伸張させられたことによるステーコイルの復元力が発生することにより、第2湾曲部cは外力によっては更に曲がり難くなってしまい、曲げに対する硬さの変化が大きい変化点が第2湾曲部cにできたり、第2湾曲部cの曲げに対する硬さが、接続された近傍の可撓管の曲げに対する硬さよりも硬くなってしまう。このため、挿入において、湾曲をかけた状態で可撓管を押し込むと、図17(C)に示すように可撓管が撓んで挿入困難となる。   In Patent Document 1, since the second bending portion c has a built-in stay coil with a small amount of expansion and contraction, the second bending portion c bends freely when an external force is applied to the second bending portion c. When the bending portion is bent by the bending operation means, a restoring force of the stay coil is generated by the compression or extension of the stay coil due to the bending, so that the second bending portion c has an external force. Depending on the condition, the second bending portion c may have a changing point where the change in hardness with respect to bending is large, or the bending bending of the second bending portion c may be caused by the bending of the adjacent flexible tube. It becomes harder than the hardness against bending. For this reason, in insertion, when the flexible tube is pushed in in a curved state, the flexible tube is bent as shown in FIG.

本発明は上記事情に着目してなされたもので、その目的は、腸の屈曲部の通過の際に、湾曲部を湾曲させた状態で腸壁に押し当てても、可撓管が撓み始める前に第2湾曲部を確実に曲げることができ、S状結腸等の複雑な屈曲部を通過させる作業を容易に行うことができる内視鏡装置を提供することにある。   The present invention has been made paying attention to the above circumstances, and its purpose is to allow the flexible tube to bend even when it is pressed against the intestinal wall in a curved state when passing through the bent portion of the intestine. An object of the present invention is to provide an endoscope apparatus that can reliably bend the second bending portion before and can easily perform a work of passing a complicated bending portion such as the sigmoid colon.

請求項1の発明は、先端部と、この先端部の基端に接続された湾曲部と、この湾曲部の基端に接続された可撓管とからなる軟性の挿入部の基端部に操作部が連結され、前記湾曲部を湾曲操作する操作ワイヤを牽引操作する湾曲操作手段が前記操作部に設けられた内視鏡装置において、前記湾曲部は先端側に設けられた第1湾曲部と、この第1湾曲部の基端側に連接され、前記第1湾曲部よりも軸方向の曲げに対する硬さが硬く形成された第2湾曲部とを具備し、前記第1湾曲部と第2湾曲部はそれぞれ複数の節輪部材を回動自在に連結した湾曲管部材にて形成され、かつ前記第1湾曲部の節輪部材の少なくとも1つに前記操作ワイヤの端部が固定され、前記挿入部は、前記湾曲操作手段による前記操作ワイヤの牽引操作によって前記湾曲部を略90°以上湾曲させた状態で、前記第2湾曲部の軸方向の曲げに対する硬さを前記可撓管の軸方向の曲げに対する硬さよりも小さくされており、前記第1湾曲部を最大湾曲状態に湾曲操作した際にも、第2湾曲部はほとんど湾曲しないとともに前記第2湾曲部の前記節輪部材どうしは当接せず、前記第2湾曲部に外力が加わった場合には、前記第2湾曲部が湾曲するようにしたことを特徴とする内視鏡装置である。   According to a first aspect of the present invention, there is provided a proximal end portion of a soft insertion portion including a distal end portion, a bending portion connected to the proximal end of the distal end portion, and a flexible tube connected to the proximal end of the bending portion. In an endoscope apparatus in which an operation unit is connected and bending operation means for pulling an operation wire for bending operation of the bending unit is provided in the operation unit, the bending unit is a first bending unit provided on a distal end side. And a second bending portion connected to a proximal end side of the first bending portion and formed to be harder to bend in the axial direction than the first bending portion, the first bending portion and the first bending portion Each of the two bending portions is formed of a bending tube member that rotatably connects a plurality of node ring members, and an end portion of the operation wire is fixed to at least one of the node ring members of the first bending portion, The insertion portion is configured to move the bending portion by pulling operation of the operation wire by the bending operation means. In a state where the second bending portion is bent by 90 ° or more, the hardness of the second bending portion with respect to the bending in the axial direction is smaller than the hardness with respect to the bending of the flexible tube in the axial direction, and the first bending portion is in the maximum bending state. When the bending operation is performed, the second bending portion hardly bends and the nodal members of the second bending portion do not contact each other. When an external force is applied to the second bending portion, the second bending portion An endoscope apparatus characterized in that two bending portions are bent.

請求項2の発明は、前記湾曲部は前記第2湾曲部を被覆する弾性膜部と、前記第1湾曲部と前記弾性膜部を被覆する弾性外皮部材とを有し、前記弾性外皮部材は、前記第1湾曲部を被覆する部分、前記第1湾曲部と前記第2湾曲部の境界部を被覆する部分、前記第2湾曲部を被覆する部分の順に硬さを増して形成されていることを特徴とする請求項1記載の内視鏡装置である。   According to a second aspect of the present invention, the bending portion includes an elastic film portion that covers the second bending portion, and an elastic skin member that covers the first bending portion and the elastic film portion. , A portion covering the first bending portion, a portion covering the boundary portion between the first bending portion and the second bending portion, and a portion covering the second bending portion are formed in increasing order. The endoscope apparatus according to claim 1.

請求項3の発明は、前記挿入部は、前記湾曲操作手段による前記操作ワイヤの牽引操作によって湾曲させることが可能な前記湾曲部の最大湾曲状態で、前記第2湾曲部の軸方向の曲げに対する硬さを前記可撓管の軸方向の曲げに対する硬さよりも小さくしたことを特徴とする請求項1または2に記載の内視鏡装置である。   According to a third aspect of the present invention, the insertion portion is in a maximum bending state of the bending portion that can be bent by a pulling operation of the operation wire by the bending operation means, and is adapted to bend in the axial direction of the second bending portion. The endoscope apparatus according to claim 1 or 2, wherein the hardness is smaller than the hardness against bending of the flexible tube in the axial direction.

請求項4の発明は、前記湾曲操作手段による前記操作ワイヤの牽引操作によって湾曲させることが可能な前記湾曲部の湾曲状態で、前記第1湾曲部の前記複数の節輪部材が回動した際に当接する当接部の間隔よりも、前記第2湾曲部の前記複数の節輪部材が回動した際に当接する当接部の間隔が広いことを特徴とする請求項1〜3の何れか1項に記載の内視鏡装置である。   According to a fourth aspect of the present invention, when the plurality of node ring members of the first bending portion are rotated in a bending state of the bending portion that can be bent by a pulling operation of the operation wire by the bending operation means. The interval between the contact portions that contact when the plurality of node members of the second bending portion rotate is wider than the interval between the contact portions that contact the contact portion. The endoscope apparatus according to claim 1.

請求項5の発明は、前記弾性外皮部材は、前記第1湾曲部を被覆する部分、前記第1湾曲部と前記第2湾曲部の境界部を被覆する部分、前記第2湾曲部を被覆する部分の順に肉厚を増して形成されていることを特徴とする請求項1〜4の何れか1項に内視鏡装置である。   According to a fifth aspect of the present invention, the elastic skin member covers the portion that covers the first bending portion, the portion that covers the boundary portion between the first bending portion and the second bending portion, and the second bending portion. The endoscope apparatus according to any one of claims 1 to 4, wherein the endoscope apparatus is formed by increasing the thickness in the order of the portions.

請求項6の発明は、前記弾性膜部と前記弾性外皮部材とは相互に滑るようにされてなる請求項4〜5の何れか1項に記載の内視鏡装置である。   The invention according to claim 6 is the endoscope apparatus according to any one of claims 4 to 5, wherein the elastic film portion and the elastic skin member are slidable with respect to each other.

請求項7の発明は、前記第2湾曲部の境界部を被覆する部分は、5mm〜15mmであることを特徴とする請求項4〜6の何れか1項記載の内視鏡装置である。   The invention according to claim 7 is the endoscope apparatus according to any one of claims 4 to 6, wherein a portion covering a boundary portion of the second bending portion is 5 mm to 15 mm.

本発明によれば、腸の屈曲部の通過の際に、湾曲部を湾曲させた状態で腸壁に押し当てても、可撓管が撓み始める前に第2湾曲部を確実に曲げることができ、腸の屈曲部の通過を確実に行なうことができる。   According to the present invention, even when the bending portion is pressed against the intestinal wall while passing through the bent portion of the intestine, the second bending portion can be reliably bent before the flexible tube starts to bend. And the passage of the bent portion of the intestine can be performed reliably.

以下、本発明の第1の実施の形態を図1乃至図8を参照して説明する。図1は本実施の形態の内視鏡装置1の全体の概略構成を示すものである。この内視鏡装置1は撮像手段を備えた内視鏡2と、この内視鏡2に着脱自在に接続されて内視鏡2内に設けられたライトガイドに照明光を供給する光源装置3と、内視鏡2と信号ケーブル4を介して接続されて内視鏡2の撮像手段を制御すると共に撮像手段から得られた信号を処理するビデオプロセッサ5と、このビデオプロセッサ5から出力される被写体像に対応する映像を表示するモニタ6とから主に構成されている。   Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows an overall schematic configuration of an endoscope apparatus 1 according to the present embodiment. The endoscope apparatus 1 includes an endoscope 2 having an imaging unit, and a light source apparatus 3 that is detachably connected to the endoscope 2 and supplies illumination light to a light guide provided in the endoscope 2. A video processor 5 connected to the endoscope 2 via the signal cable 4 to control the imaging means of the endoscope 2 and process a signal obtained from the imaging means, and output from the video processor 5 It is mainly composed of a monitor 6 that displays an image corresponding to a subject image.

また、内視鏡2には可撓性を有する細長の挿入部7と、この挿入部7の基端側に接続された操作部8と、この操作部8の側部から延出した可撓性を有する連結コード9と、この連結コード9の端部に設けられたコネクタ部10とが設けられている。そして、コネクタ部10は光源装置3と着脱自在に接続されるようになっている。さらに、コネクタ部10の側部には電気コネクタ部11が設けられている。この電気コネクタ部11にはビデオプロセッサ5と接続された信号ケーブル4が着脱自在に接続可能になっている。なお、電気コネクタ部11には内視鏡2の内部と外部とを連通する図示しない通気部が設けられている。   Further, the endoscope 2 has a flexible elongated insertion portion 7, an operation portion 8 connected to the proximal end side of the insertion portion 7, and a flexible portion extending from the side portion of the operation portion 8. A connecting cord 9 having the characteristics and a connector portion 10 provided at an end portion of the connecting cord 9 are provided. The connector unit 10 is detachably connected to the light source device 3. Furthermore, an electrical connector portion 11 is provided on the side portion of the connector portion 10. A signal cable 4 connected to the video processor 5 can be detachably connected to the electrical connector portion 11. The electrical connector portion 11 is provided with a ventilation portion (not shown) that communicates the inside and the outside of the endoscope 2.

挿入部7と操作部8との接続部にはこの接続部の急激な曲がりを防止する弾性部材を有する挿入部側折れ止め部材12が設けられている。さらに、操作部8と連結コード9との接続部には同様の操作部側折れ止め部材13、連結コード9とコネクタ部10との接続部には同様のコネクタ部側折れ止め部材14がそれぞれ設けられている。   The connecting portion between the inserting portion 7 and the operating portion 8 is provided with an inserting portion side folding preventing member 12 having an elastic member for preventing a sudden bending of the connecting portion. Further, a similar operation part side folding member 13 is provided at the connection part between the operation part 8 and the connecting cord 9, and a similar connector part side folding member 14 is provided at the connection part between the connection cord 9 and the connector part 10. It has been.

また、挿入部7は可撓性を有する柔軟な可撓管部15と、この可撓管部15の先端側に設けられた操作部8の操作により湾曲可能な湾曲部16と、先端に設けられ図示しない観察光学系、照明光学系などが配設された先端部17とから構成されている。   The insertion portion 7 includes a flexible flexible tube portion 15 having flexibility, a bending portion 16 that can be bent by operation of the operation portion 8 provided on the distal end side of the flexible tube portion 15, and a distal end. The distal end portion 17 is provided with an observation optical system, an illumination optical system, and the like (not shown).

先端部17には送気操作、送水操作によって図示しない観察光学系の外表面の光学部材に向けて洗滌液体や気体を噴出するための送気送水ノズル18と、挿入部7に配設された処置具を挿通したり体腔内の液体を吸引するための図示しない処置具チャンネルの先端側の開口である吸引口19が設けられている。また、観察対象物に向けて開口した液体を噴出するための送液口20とが設けられている。   An air supply / water supply nozzle 18 for ejecting a cleaning liquid or gas toward the optical member on the outer surface of the observation optical system (not shown) by an air supply operation and a water supply operation and an insertion portion 7 are disposed at the distal end portion 17. A suction port 19 that is an opening on the distal end side of a treatment tool channel (not shown) for inserting the treatment tool or sucking the liquid in the body cavity is provided. In addition, a liquid supply port 20 for ejecting the liquid that is opened toward the observation object is provided.

コネクタ部10の端面には光源装置3に内蔵された図示しない気体供給源と着脱自在に接続される気体供給口金21と、ライトガイド接続部Lとが突設されている。さらに、コネクタ部10の外周面には液体供給源である送水タンク22と着脱自在に接続される送水タンク加圧口金23及び液体供給口金24とが設けられているとともに、先端部17の吸引口19より吸引を行うための図示しない吸引源と接続される吸引口金25と、送液口20より送水を行うための図示しない送水手段と接続される注入口金26と、高周波処置等を行った際に内視鏡2に高周波漏れ電流が発生した場合に漏れ電流を高周波処置装置に帰還させるためのアース端子口金27とが設けられている。   A gas supply base 21 detachably connected to a gas supply source (not shown) built in the light source device 3 and a light guide connection portion L project from the end face of the connector portion 10. Further, a water supply tank pressure cap 23 and a liquid supply cap 24 that are detachably connected to a water supply tank 22 that is a liquid supply source are provided on the outer peripheral surface of the connector portion 10, and a suction port of the tip end portion 17 is provided. When performing a high-frequency treatment, a suction base 25 connected to a suction source (not shown) for suctioning from 19, an injection base 26 connected to a water supply means (not shown) for feeding water from the liquid feeding port 20 Further, an earth terminal base 27 is provided for returning the leakage current to the high-frequency treatment device when a high-frequency leakage current is generated in the endoscope 2.

また、操作部8には送気操作、送水操作をそれぞれ操作する送気送水操作ボタン28と、吸引操作を操作するための吸引操作ボタン29と、湾曲部16の湾曲操作を行うための湾曲操作ノブ30と、ビデオプロセッサ5を遠隔操作する複数のリモートスイッチ31と、処置具チャンネルに連通した開口である処置具挿入口32とが設けられている。   The operation unit 8 includes an air / water supply operation button 28 for operating an air supply operation and a water supply operation, a suction operation button 29 for operating the suction operation, and a bending operation for performing the bending operation of the bending unit 16. A knob 30, a plurality of remote switches 31 for remotely operating the video processor 5, and a treatment instrument insertion port 32 which is an opening communicating with the treatment instrument channel are provided.

なお、内視鏡2の電気コネクタ部11にはこの電気コネクタ部11を液密にシールするための防水キャップ33が着脱自在に接続可能である。   A waterproof cap 33 for sealing the electrical connector part 11 in a liquid-tight manner can be detachably connected to the electrical connector part 11 of the endoscope 2.

また、本発明の要部である、湾曲部16について説明する。図2に示すように内視鏡2の挿入部7の先端部17にはステンレス(SUS303)等の金属材料で形成された先端部本体34が配置されている。この先端部本体34の先端部及び外周部は樹脂等の絶縁材料からなる絶縁カバー部材35で覆われている。   Moreover, the bending part 16 which is the principal part of this invention is demonstrated. As shown in FIG. 2, a distal end portion body 34 made of a metal material such as stainless steel (SUS303) is disposed at the distal end portion 17 of the insertion portion 7 of the endoscope 2. The distal end portion and the outer peripheral portion of the distal end portion main body 34 are covered with an insulating cover member 35 made of an insulating material such as resin.

さらに、湾曲部16には挿入部7の軸方向に沿って略リング状の複数の湾曲駒37を並設させた管状の湾曲管36が配設されている。この湾曲管36を構成している複数の湾曲駒37はリベット38によって互いに回動自在に連結されている。   Further, the bending portion 16 is provided with a tubular bending tube 36 in which a plurality of substantially ring-shaped bending pieces 37 are arranged in parallel along the axial direction of the insertion portion 7. A plurality of bending pieces 37 constituting the bending tube 36 are connected to each other by rivets 38 so as to be rotatable.

また、湾曲部16の湾曲管36を構成する複数の湾曲駒37の最先端に位置する先端側湾曲駒37aは先端部本体34の基端部に固定ねじ等により連結固定されている。さらに、湾曲管36の基端部に位置する基端側湾曲駒37bは可撓管部15の先端部に設けられた先端側口金43に固定ねじ等により連結固定されている。   Further, the distal end side bending piece 37a located at the forefront of the plurality of bending pieces 37 constituting the bending tube 36 of the bending portion 16 is connected and fixed to the proximal end portion of the distal end portion main body 34 by a fixing screw or the like. Further, the proximal-side bending piece 37b located at the proximal end portion of the bending tube 36 is connected and fixed to a distal end side cap 43 provided at the distal end portion of the flexible tube portion 15 by a fixing screw or the like.

また、湾曲管36の外周面は細い金属素線を編んで筒状に形成された管状の網状管41によってこの湾曲管36全体が被嵌されている。ここで、網状管41の先端と基端は先端側湾曲駒37aと基端側湾曲駒37bにそれぞれ、半田、ロー付け、接着等の手段により固定されている。   The entire outer surface of the bending tube 36 is fitted by a tubular mesh tube 41 formed into a tubular shape by knitting a thin metal wire. Here, the distal end and the proximal end of the mesh tube 41 are fixed to the distal end-side bending piece 37a and the proximal-side bending piece 37b by means of soldering, brazing, adhesion, or the like.

さらに、網状管41の外周には、フッ素ゴム等の弾性部材からなる弾性外皮部材42が被覆されている。この弾性外皮部材42の先端側は先端部本体34の基端部に被覆され、基端側は先端側口金43に被覆されている。そして、この弾性外皮部材42における先端側の先端部本体34の被覆部分および基端側の先端側口金43の被覆部分は外周に巻回した図示しない固定用糸によって緊縛され、先端部本体34、先端側口金43にそれぞれ固定されている。さらに、固定用糸の外周側を覆う様に接着剤45が塗布されてこれらが強固に固定され、これらの境界部分は水蜜的に封止されている。   Further, the outer circumference of the mesh tube 41 is covered with an elastic skin member 42 made of an elastic member such as fluororubber. The distal end side of the elastic skin member 42 is covered with the proximal end portion of the distal end portion main body 34, and the proximal end side is covered with the distal end side base 43. The covering portion of the distal end side main body 34 and the covering portion of the distal end side base 43 in the elastic outer skin member 42 are bound by a fixing thread (not shown) wound around the outer periphery, Each is fixed to the distal end side cap 43. Further, an adhesive 45 is applied so as to cover the outer peripheral side of the fixing yarn, and these are firmly fixed, and the boundary portions are sealed in a hydrated manner.

また、各湾曲駒37には内方向に半田やロー付けで固定されたワイヤガイド49が設けられている。これらのワイヤガイド49には操作部8から延出された牽引ワイヤ50が挿通されている。この牽引ワイヤ50の先端部は先端側湾曲駒37aに半田やロー付け等により固定されている。   Each bending piece 37 is provided with a wire guide 49 fixed inward by soldering or brazing. A pulling wire 50 extending from the operation unit 8 is inserted through these wire guides 49. The tip of the puller wire 50 is fixed to the tip-side bending piece 37a by soldering or brazing.

さらに、可撓管部15には牽引ワイヤ50が挿通された密巻きコイル等からなる可撓性を有するガイドパイプ44がワイヤガイド49に相対して配設されている。このガイドパイプ44の先端部は先端側口金43に半田やロー付け等により固定されている。   Further, a flexible guide pipe 44 made of a tightly wound coil or the like through which the pulling wire 50 is inserted is disposed in the flexible tube portion 15 so as to be opposed to the wire guide 49. The distal end portion of the guide pipe 44 is fixed to the distal end side base 43 by soldering or brazing.

また、本実施の形態の湾曲管36には先端側に配設された第1の湾曲部39と、この第1の湾曲部39の基端側に連接され、第1の湾曲部39よりも軸方向の曲げに対する硬さが硬くなる状態に設定された第2の湾曲部40とが設けられている。なお、図2中で、B1は第1の湾曲部39の範囲、B2は第2の湾曲部40の範囲である。ここで、挿入部7の先端部17の先端面と第1の湾曲部39の後端位置との間の長さYは例えば90〜120mm程度の長さに設定されている。そして、第1の湾曲部39の基端側の湾曲駒37と、第2の湾曲部40の最先端の湾曲駒37との間はリベット38により回動自在に連結されている。   In addition, the bending tube 36 of the present embodiment is connected to the first bending portion 39 disposed on the distal end side and the proximal end side of the first bending portion 39, and is more than the first bending portion 39. A second bending portion 40 is provided which is set in a state where the hardness against bending in the axial direction is increased. In FIG. 2, B <b> 1 is a range of the first bending portion 39, and B <b> 2 is a range of the second bending portion 40. Here, the length Y between the distal end surface of the distal end portion 17 of the insertion portion 7 and the rear end position of the first bending portion 39 is set to a length of about 90 to 120 mm, for example. The bending piece 37 on the proximal end side of the first bending portion 39 and the most advanced bending piece 37 of the second bending portion 40 are connected to each other by a rivet 38 so as to be freely rotatable.

また、各湾曲駒37の隣合う湾曲駒37が回動した際に互いに当接する当接部の間隔tは第1の湾曲部39を構成する大部分の湾曲駒37間の当接部の間隔t1と、第2の湾曲部40の湾曲駒37間の当接部の間隔t2との関係がt1>t2になるように設定されている。   Further, the interval t between the abutting portions that abut each other when the adjacent bending pieces 37 of each bending piece 37 are rotated is the interval between the abutting portions between most of the bending pieces 37 constituting the first bending portion 39. The relationship between t1 and the distance t2 of the contact portion between the bending pieces 37 of the second bending portion 40 is set so that t1> t2.

さらに、図3に示すように第2の湾曲部40を構成する部分の網状管41の外周には、シリコン系接着剤等の弾性接着剤や、充填剤を塗布したり、ポリウレタン等の弾性を有する樹脂チューブ等を熱融着することによって、網状管41を形成する金属素線の網目の中に、これらの弾性体を浸透させて形成された弾性膜部46が形成されている。   Further, as shown in FIG. 3, an elastic adhesive such as a silicon-based adhesive or a filler is applied to the outer periphery of the portion of the mesh tube 41 constituting the second bending portion 40, and elasticity such as polyurethane is applied. By heat-sealing the resin tube or the like, the elastic film portion 46 formed by infiltrating these elastic bodies is formed in the mesh of the metal wire forming the mesh tube 41.

また、弾性外皮部材42には先端側に厚さが例えば0.5mmの薄肉部47が形成されている。そして、この弾性外皮部材42の薄肉部47の部分が第1の湾曲部39に配設されている。   The elastic skin member 42 is formed with a thin portion 47 having a thickness of, for example, 0.5 mm on the tip side. A portion of the thin portion 47 of the elastic skin member 42 is disposed on the first curved portion 39.

さらに、弾性外皮部材42の基端側には第2の湾曲部40に配設される厚さが例えば1mmの厚肉部48が形成されている。なお、薄肉部47の部分と厚肉部48との境界にはテーパ状に滑らかに肉厚が変化する肉厚変化部48aが形成されている。そして、厚肉部48は網状管41の弾性膜部46が形成された部分と、弾性膜部46が形成されていない部分との境界から5〜15mm程度(Z1)、基端側に配置されている。   Further, a thick wall portion 48 having a thickness of, for example, 1 mm is formed on the base end side of the elastic skin member 42. It should be noted that a thickness changing portion 48a in which the thickness smoothly changes in a tapered shape is formed at the boundary between the thin portion 47 and the thick portion 48. The thick portion 48 is disposed on the proximal end side about 5 to 15 mm (Z1) from the boundary between the portion of the mesh tube 41 where the elastic membrane portion 46 is formed and the portion where the elastic membrane portion 46 is not formed. ing.

また、網状管41の弾性膜部46の外周面には二硫化モリブデン等の減摩剤が塗布されている。これにより、弾性膜部46の外面と弾性外皮部材42の内面との間が滑るようになっている。   Further, a lubricant such as molybdenum disulfide is applied to the outer peripheral surface of the elastic film portion 46 of the mesh tube 41. Thereby, the space between the outer surface of the elastic film portion 46 and the inner surface of the elastic skin member 42 can be slid.

また、弾性外皮部材42の長さ(自然長)は組付け位置に対して例えば5〜15mm程度、長く形成されており、組付けられた状態では自然長に対して圧縮されるか、弛んだ状態となっている。この際、厚肉部48は肉厚が厚いため、ほとんど弛まず、薄肉部47の部分が弛むこととなる。   Further, the length (natural length) of the elastic skin member 42 is formed to be long, for example, about 5 to 15 mm with respect to the assembly position, and in the assembled state, it is compressed or loosened with respect to the natural length. It is in a state. At this time, since the thick portion 48 is thick, the thin portion 47 is hardly loosened and the thin portion 47 is loosened.

さらに、挿入部7の先端部17の先端面と第2の湾曲部40の後端位置との間の長さXは略15cm以上に形成されている。例えば18〜21cm程度に設定されている。これにより、第2の湾曲部40の後端位置は挿入部7の先端部から略15cm以上の長さに配置されている。   Further, the length X between the distal end surface of the distal end portion 17 of the insertion portion 7 and the rear end position of the second bending portion 40 is formed to be approximately 15 cm or more. For example, it is set to about 18 to 21 cm. Thereby, the rear end position of the second bending portion 40 is arranged at a length of about 15 cm or more from the distal end portion of the insertion portion 7.

なお、図4は一般的な人体の大腸の構造を示すものである。ここで、H1は直腸、H2はS状結腸、H3は下行結腸、H4は横行結腸、H5は上行結腸である。さらに、H6はRs屈曲部(直腸H1とS状結腸H2との境界部)、H7はSD屈曲部(S状結腸H2と下行結腸H3との境界部)、H8は脾湾曲部(下行結腸H3と横行結腸H4との境界部)、H9は肝湾曲部(横行結腸H4と上行結腸H5との境界部)、H10は脾湾曲部H8と肝湾曲部H9との間の横行結腸H4の略中央に位置する横行結腸中央屈曲部である。   FIG. 4 shows the structure of a general human large intestine. Here, H1 is the rectum, H2 is the sigmoid colon, H3 is the descending colon, H4 is the transverse colon, and H5 is the ascending colon. Further, H6 is an Rs bend (a boundary between the rectum H1 and the sigmoid colon H2), H7 is an SD bend (a boundary between the sigmoid colon H2 and the descending colon H3), and H8 is a splenic curve (the descending colon H3). H9 is the liver curvature (boundary between the transverse colon H4 and the ascending colon H5), and H10 is the approximate center of the transverse colon H4 between the splenic curvature H8 and the liver curvature H9. Is the central flexion of the transverse colon.

また、文献「臨床消化器内科1999Vol.14No.1」日本メディカルセンター発行の「一人法の基本的手技」田村智 著の「I.大腸の走行」には大腸の最深部である上行結腸H5の長さL1は15cm〜20cmであることが示されている。   In addition, the literature “Clinical Gastrointestinal Internal Medicine 1999 Vol.14 No.1” “Basic Techniques for One Person Method” published by Japan Medical Center, “I. Running of the Large Intestine” written by Satoshi Tamura, shows the ascending colon H5, the deepest part of the large intestine. The length L1 is shown to be between 15 cm and 20 cm.

さらに、文献「大腸内視鏡挿入法 ビギナーからベテランまで」工藤著 医学書院発行には大腸挿入時に腸を過度に伸展させない場合の内視鏡の挿入長、すなわち肛門からの長さLとして、以下のデータが示されている。   In addition, the literature “Intestinal Endoscopy Insertion from Beginner to Veteran” written by Kudo Medical School published the length of insertion from the anus when the intestine does not extend excessively, that is, length L from the anus. Data is shown.

Rs屈曲部H6までの長さL2は15cm、SD屈曲部H7までの長さは30cmである。これより、Rs屈曲部H6から次の屈曲部であるSD屈曲部H7までの長さL3は略15cmである。   The length L2 to the Rs bent portion H6 is 15 cm, and the length to the SD bent portion H7 is 30 cm. Accordingly, the length L3 from the Rs bent portion H6 to the SD bent portion H7 which is the next bent portion is approximately 15 cm.

また、脾湾曲部H8までの長さは40cm、肝湾曲部H9までの長さは60cm。これより、脾湾曲部H8と肝湾曲部H9との間の横行結腸H4の略中央に位置する横行結腸中央屈曲部H10は脾湾曲側、肝湾曲側の何れかに偏っていた場合、中央屈曲部H10と脾湾曲部H8との間の距離L4及び中央屈曲部H10と肝湾曲部H9との距離L5は10cm以上となる。   Moreover, the length to the splenic curved part H8 is 40 cm, and the length to the liver curved part H9 is 60 cm. As a result, when the central bending portion H10 of the transverse colon located at the approximate center of the transverse colon H4 between the splenic bending portion H8 and the liver bending portion H9 is biased to either the splenic bending side or the liver bending side, the central bending is performed. The distance L4 between the portion H10 and the splenic curved portion H8 and the distance L5 between the central bent portion H10 and the liver curved portion H9 are 10 cm or more.

これらを考慮して、本発明における挿入部7の先端部17の先端面と第2の湾曲部40の後端位置との間の長さXは以下の理由により15cm以上に設定されている。   Considering these, the length X between the distal end surface of the distal end portion 17 of the insertion portion 7 and the rear end position of the second bending portion 40 in the present invention is set to 15 cm or more for the following reason.

1.挿入部7を上行結腸H5へ挿入する作業中に、挿入部7の先端部17の先端が上行結腸H5の深部に到達するまで、可撓管部15が肝湾曲部H9に到達しないようにする。   1. During the operation of inserting the insertion portion 7 into the ascending colon H5, the flexible tube portion 15 is prevented from reaching the liver bending portion H9 until the distal end of the distal end portion 17 of the insertion portion 7 reaches the deep portion of the ascending colon H5. .

2.挿入部7を直腸H1に挿入している作業中に、可撓管部15が直腸H1に入らないようにする。   2. During the operation of inserting the insertion portion 7 into the rectum H1, the flexible tube portion 15 is prevented from entering the rectum H1.

3.挿入部7をS状結腸H2に挿入している作業中に、可撓管部15がRs屈曲部H6に到達しないようにする。   3. During the operation of inserting the insertion portion 7 into the sigmoid colon H2, the flexible tube portion 15 is prevented from reaching the Rs bent portion H6.

4.挿入部7を横行結腸中央屈曲部H10へ挿入する作業中に可撓管部15が脾湾曲部H8に到達しないようにする。なお、ここで横行結腸中央屈曲部H10が肝湾曲部H9側に偏っている場合には、L4が10cm以上になる場合もあるため、15cm程度とする。   4). The flexible tube portion 15 is prevented from reaching the splenic curved portion H8 during the operation of inserting the insertion portion 7 into the transverse colon central bent portion H10. Here, when the transverse colon central bent portion H10 is biased toward the hepatic curved portion H9, L4 may be 10 cm or more, so it is about 15 cm.

5.挿入部7を肝湾曲部H9へ挿入する際に可撓管部15が横行結腸中央湾曲部H10に到達しないようにする。   5. When the insertion portion 7 is inserted into the liver bending portion H9, the flexible tube portion 15 is prevented from reaching the transverse colon central bending portion H10.

以上の理由により、挿入部7の先端部17の先端面と第2の湾曲部40の後端位置との間の長さXは略15cm以上に設定されている。なお、望ましくはXは18cm〜21cm程度に設定する。大腸の形態には個人差があるが、この場合には大部分の症例において、上記の関係が成り立つことになる。   For the above reasons, the length X between the distal end surface of the distal end portion 17 of the insertion portion 7 and the rear end position of the second bending portion 40 is set to approximately 15 cm or more. Desirably, X is set to about 18 cm to 21 cm. There are individual differences in the form of the large intestine, but in this case, the above relationship is established in most cases.

また、湾曲部16は術者が湾曲操作ノブ30を操作することで、牽引ワイヤ50が牽引操作され、湾曲管36に内蔵された図示しない処置具挿通用チャンネル、送気送水管路、撮像素子に接続されたケーブル等の内蔵物の抵抗や、湾曲管36に被嵌している網状管41、弾性外皮部材42の抵抗に抗して、複数の湾曲駒37が回動して湾曲部16が湾曲する構成となっている。ここで、湾曲部16の基端側の第2の湾曲部40は、網状管41の弾性膜部46、弾性外皮部材42の厚肉部48の抵抗により、第1の湾曲部39よりも、曲がり難くなっている。なお、第1の湾曲部39は上記に加えて、薄肉部47が弛んでいることで、第2の湾曲部40よりも曲がり易い。   The bending portion 16 is operated by the operator operating the bending operation knob 30 so that the pulling wire 50 is pulled, and a treatment instrument insertion channel (not shown), an air / water supply conduit, an image sensor, which are built in the bending tube 36, are provided. A plurality of bending pieces 37 are rotated against the resistance of a built-in object such as a cable connected to the cable, the resistance of a mesh tube 41 fitted to the bending tube 36, and the resistance of the elastic skin member 42, and the bending portion 16 is rotated. Is configured to bend. Here, the second bending portion 40 on the base end side of the bending portion 16 is more resistant than the first bending portion 39 due to the resistance of the elastic film portion 46 of the mesh tube 41 and the thick portion 48 of the elastic skin member 42. It is difficult to bend. In addition to the above, the first bending portion 39 is easier to bend than the second bending portion 40 because the thin portion 47 is slack.

また、湾曲部16の湾曲操作時には湾曲により、弛んだ薄肉部47が伸びた後、厚肉部48に張力がかかり、厚肉部48が伸び始めても、弾性膜部46と弾性外皮部材42との滑りが良いため、ある範囲までは弾性膜部46と厚肉部48との間が滑り、弾性膜部46に力を与えないので、更に第2の湾曲部40は曲がり難い状態で保持される。以上のようにして、第2の湾曲部40は曲げに対する硬さが、第1の湾曲部39よりも硬くなるように形成されている。   In addition, when the bending portion 16 is bent, the thinned portion 47 that is slackened due to the bending is stretched, and then the thick portion 48 is tensioned. Even if the thick portion 48 begins to stretch, the elastic film portion 46 and the elastic skin member 42 Since the sliding of the elastic film portion 46 and the thick-walled portion 48 slips to a certain extent and does not apply force to the elastic film portion 46, the second bending portion 40 is further held in a state where it is difficult to bend. The As described above, the second bending portion 40 is formed so as to be harder to bend than the first bending portion 39.

また、図5(A)〜(D)は操作部8の湾曲操作ノブ30の操作により、湾曲部16を湾曲動作させた際の湾曲部16の湾曲形状の設定状態を示すものである。本実施の形態では湾曲操作の際に図5(A)〜(D)に示す形状となるように、各湾曲駒37の当接部の間隔(t1、t2)、網状管41の弾性膜部46の材質、厚さ、弾性外皮部材42の材質、厚さ、及び牽引ワイヤ50の牽引量等の各要素を適宜調整して設定されている。   5A to 5D show the setting state of the bending shape of the bending portion 16 when the bending portion 16 is bent by the operation of the bending operation knob 30 of the operation portion 8. In the present embodiment, the distance (t1, t2) between the contact portions of the bending pieces 37 and the elastic film portion of the mesh tube 41 so that the shapes shown in FIGS. Each element such as the material 46 and the thickness 46, the material and thickness of the elastic skin member 42, and the pulling amount of the pulling wire 50 is appropriately adjusted and set.

まず、湾曲部16の湾曲動作の初期は湾曲部16の基端側の第2の湾曲部40は、第1の湾曲部39よりも曲がり難いため、湾曲動作を行うと先端側の第1の湾曲部39のみが先に湾曲し、図5(A)に示す状態となる。   First, since the second bending portion 40 on the proximal end side of the bending portion 16 is less likely to bend than the first bending portion 39 at the initial stage of the bending operation of the bending portion 16, when the bending operation is performed, the first bending portion 16 on the distal end side. Only the bending portion 39 is bent first, and the state shown in FIG.

更に湾曲操作ノブ30を回転操作して湾曲をかけると、第2の湾曲部40の先端側も曲がり始め、図5(B)に示す状態となる。このとき、挿入部7の先端部17の先端面の向きは挿入部7の中心線Oの方向に対する回転角度θ1が略90°回転させた状態になっている。   When the bending operation knob 30 is further rotated to bend, the distal end side of the second bending portion 40 begins to bend, and the state shown in FIG. 5B is obtained. At this time, the direction of the distal end surface of the distal end portion 17 of the insertion portion 7 is in a state where the rotation angle θ1 with respect to the direction of the center line O of the insertion portion 7 is rotated by approximately 90 °.

また、図5(B)の状態から更に湾曲をかけ、挿入部7の先端部17の先端面の向きが略180゜の方向を向く状態に湾曲させると図5(C)の状態となる。さらに、牽引ワイヤ50を最大に牽引すると図5(D)の状態となる。   Further, when the curve is further applied from the state of FIG. 5B and the distal end surface of the distal end portion 17 of the insertion portion 7 is bent in the direction of about 180 °, the state of FIG. 5C is obtained. Further, when the pulling wire 50 is pulled to the maximum, the state shown in FIG.

この図5(D)の状態では第1の湾曲部39は、先端側を除くほとんどの隣合う湾曲駒37間が当接した状態となる。このとき、第2の湾曲部40は隣合う湾曲駒37間が当接しないように各湾曲駒37の当接部の間隔t2と曲がり難さが設定されている。   In the state of FIG. 5D, the first bending portion 39 is in a state where most adjacent bending pieces 37 except for the distal end side are in contact with each other. At this time, in the second bending portion 40, the interval t2 between the contact portions of the bending pieces 37 and the difficulty of bending are set so that the adjacent bending pieces 37 do not contact each other.

次に、上記構成の本実施の形態の内視鏡装置1の作用について説明する。ここでは、図6(A)〜(F)、図7(A)〜(G)を参照して内視鏡2の挿入部7を大腸へ挿入する作業について説明する。   Next, the operation of the endoscope apparatus 1 of the present embodiment having the above configuration will be described. Here, an operation of inserting the insertion portion 7 of the endoscope 2 into the large intestine will be described with reference to FIGS. 6 (A) to (F) and FIGS. 7 (A) to (G).

まず、肛門から挿入された挿入部7は、直腸H1に挿入される。この際、内視鏡2の挿入部7の先端が直腸H1の深部に到達するまで、可撓管部15は直腸H1にほとんど挿入されない。そのため、挿入途中で、湾曲操作ノブ30の湾曲操作により湾曲部16を湾曲させて直腸H1のほぼ全長の形状をコントロールすることができる。そして、図6(A)に示すように、直腸H1からS状結腸H2への移行部であるRs屈曲部H6に達する。   First, the insertion portion 7 inserted from the anus is inserted into the rectum H1. At this time, the flexible tube portion 15 is hardly inserted into the rectum H1 until the distal end of the insertion portion 7 of the endoscope 2 reaches the deep portion of the rectum H1. Therefore, during the insertion, the bending portion 16 can be bent by the bending operation of the bending operation knob 30 to control the shape of the almost full length of the rectum H1. Then, as shown in FIG. 6A, it reaches an Rs bent portion H6 that is a transition portion from the rectum H1 to the sigmoid colon H2.

続いて、図6(A)の状態で、湾曲操作ノブ30の湾曲操作により湾曲部16を湾曲させて、図6(B)に示すように挿入部7の先端部17、第1の湾曲部39をS状結腸H2に導入する。   Subsequently, in the state of FIG. 6A, the bending portion 16 is bent by the bending operation of the bending operation knob 30, so that the distal end portion 17 of the insertion portion 7 and the first bending portion as shown in FIG. 6B. 39 is introduced into the sigmoid colon H2.

その後、湾曲部16の基端部若しくは可撓管部15を把持して可撓管部15、湾曲部16を挿入部7の押込み方向に押圧操作する。このとき、図6(C)に示すように湾曲部16がRs屈曲部H6の外側の腸壁に押し当てられることで第1の湾曲部39、第2の湾曲部40が曲がりながら、先端部17が前進する。この作業中、第2の湾曲部40は腸壁との接触によって容易に曲がるため、腸壁に力がかからず、図6(C)中に点線で示すように腸壁を伸展させることがない。また、可撓管部15が撓んでしまうこともない。   Thereafter, the proximal end portion of the bending portion 16 or the flexible tube portion 15 is grasped, and the flexible tube portion 15 and the bending portion 16 are pressed in the pushing direction of the insertion portion 7. At this time, as shown in FIG. 6 (C), the bending portion 16 is pressed against the intestinal wall outside the Rs bending portion H6, so that the first bending portion 39 and the second bending portion 40 are bent while the distal end portion is bent. 17 moves forward. During this operation, the second bending portion 40 is easily bent by contact with the intestinal wall, so that no force is applied to the intestinal wall, and the intestinal wall can be extended as shown by a dotted line in FIG. Absent. Further, the flexible tube portion 15 is not bent.

図6(C)の状態から、更に湾曲部16を押し込み方向に押圧操作すると、図6(D)に示すように挿入部7の先端部17がS状結腸H2から下行結腸H3への移行部であるSD屈曲部H7に到達する。ここで、湾曲操作ノブ30の湾曲操作により湾曲部16を湾曲させて、図6(E)に示すように先端部17および第1の湾曲部39を下行結腸H3に導入する。この際、湾曲部16と可撓管部15との接続部は直腸H1からS状結腸H2への移行部であるRs屈曲部H6に近接していないので、この状態まで、腸壁に力がかかることがなく、腸壁の伸展や可撓管部15の撓みを防止できる。   When the bending portion 16 is further pressed in the pushing direction from the state of FIG. 6C, the distal end portion 17 of the insertion portion 7 is a transition portion from the sigmoid colon H2 to the descending colon H3 as shown in FIG. 6D. The SD bent portion H7 is reached. Here, the bending portion 16 is bent by the bending operation of the bending operation knob 30, and the distal end portion 17 and the first bending portion 39 are introduced into the descending colon H3 as shown in FIG. 6 (E). At this time, since the connecting portion between the bending portion 16 and the flexible tube portion 15 is not close to the Rs bending portion H6 that is a transition portion from the rectum H1 to the sigmoid colon H2, force is applied to the intestinal wall until this state. This prevents the intestinal wall from extending and the flexible tube portion 15 from bending.

この状態で、湾曲を戻して湾曲部16を略直線状に戻すか、湾曲操作ノブ30が自由に回動可能な状態にして、可撓管部15、湾曲部16を引くと、図6(F)に示すように湾曲部16が直線化される。これにより、直腸H1からS状結腸H2までの部分は湾曲部16に沿ってほぼ、直線化される。   In this state, when the bending portion 16 is returned and the bending portion 16 is returned to a substantially linear shape or the bending operation knob 30 is freely rotatable and the flexible tube portion 15 and the bending portion 16 are pulled, FIG. As shown in F), the bending portion 16 is linearized. As a result, the portion from the rectum H1 to the sigmoid colon H2 is substantially linearized along the curved portion 16.

続いて、この状態で可撓管部15を把持して押し進めれば、挿入部7は容易に下行結腸H3を前進していく。そして、図7(A)に示すように挿入部7の先端部17が下行結腸H3から横行結腸H4への移行部である脾湾曲部H8に到達する。   Subsequently, if the flexible tube portion 15 is grasped and pushed in this state, the insertion portion 7 easily advances the descending colon H3. Then, as shown in FIG. 7A, the distal end portion 17 of the insertion portion 7 reaches a splenic curved portion H8 that is a transition portion from the descending colon H3 to the transverse colon H4.

さらに、図7(A)の状態で、湾曲操作ノブ30の湾曲操作により湾曲部16を湾曲させて、図7(B)に示すように挿入部7の先端部17、第1の湾曲部39を横行結腸H4に導入する。続いて、可撓管部15を把持して押すと、図7(C)に示すように湾曲部16が脾湾曲部H8の外側の腸壁に押し当てられることで第1の湾曲部39及び第2の湾曲部40が曲がりながら、前進する。この際、第2の湾曲部40が容易に曲がるので、図7(D)に示すように腸壁に力がかからず、図7(D)中に点線で示すように腸壁を伸展させることがない。また、可撓管部15が撓んでしまうこともない。   Further, in the state of FIG. 7A, the bending portion 16 is bent by the bending operation of the bending operation knob 30, and the distal end portion 17 of the insertion portion 7 and the first bending portion 39 as shown in FIG. 7B. Is introduced into the transverse colon H4. Subsequently, when the flexible tube portion 15 is gripped and pressed, the bending portion 16 is pressed against the intestinal wall outside the splenic bending portion H8 as shown in FIG. The second bending portion 40 moves forward while bending. At this time, since the second bending portion 40 is easily bent, no force is applied to the intestinal wall as shown in FIG. 7D, and the intestinal wall is extended as shown by a dotted line in FIG. 7D. There is nothing. Further, the flexible tube portion 15 is not bent.

そして、可撓管部15をさらに押していくと、図7(E)に示すように横行結腸H4の中央屈曲部H10に到達する。ここで、湾曲操作ノブ30の湾曲操作により湾曲部16を湾曲させて、図7(F)に示すように横行結腸H4の中央屈曲部H10より深部に挿入部7の先端部17、第1の湾曲部39を導入する。この際、湾曲部16と可撓管部15との間の接続部は下行結腸H3から横行結腸H4への移行部である脾湾曲部H8に近接していないので、この状態まで、腸壁に力がかかることがなく、腸壁の伸展や可撓管部15の撓みを防止できる。   Then, when the flexible tube portion 15 is further pushed, it reaches the central bent portion H10 of the transverse colon H4 as shown in FIG. 7 (E). Here, the bending portion 16 is bent by the bending operation of the bending operation knob 30, and as shown in FIG. 7 (F), the distal end portion 17 of the insertion portion 7 and the first portion are deeper than the central bending portion H10 of the transverse colon H4. The bending portion 39 is introduced. At this time, the connecting portion between the bending portion 16 and the flexible tube portion 15 is not close to the splenic bending portion H8 which is a transition portion from the descending colon H3 to the transverse colon H4. No force is applied, and the extension of the intestinal wall and the bending of the flexible tube portion 15 can be prevented.

そして、可撓管部15を押して、更に挿入部7を押し進める。この際、可撓管部15を押してもよいが、湾曲部16の湾曲を戻して直線化するか、湾曲操作ノブ30が自由に回動可能な状態にして可撓管部15を引くことにより、図7(G)に示すように湾曲部16が直線化される。これにより、横行結腸H4は湾曲部16に沿ってほぼ、直線化された状態で挿入部7の挿入が可能となる。   And the flexible tube part 15 is pushed and the insertion part 7 is further pushed forward. At this time, the flexible tube portion 15 may be pushed. However, the bending portion 16 may be returned to be linearized or the bending operation knob 30 may be freely rotated to pull the flexible tube portion 15. As shown in FIG. 7G, the bending portion 16 is linearized. Accordingly, the insertion portion 7 can be inserted while the transverse colon H4 is substantially linearized along the curved portion 16.

なお、次の屈曲部である肝湾曲部H9の通過については図示しないが同様の作用で、内視鏡2の挿入部7が挿入される。   In addition, although passing through the liver bending part H9 which is the next bending part is not shown in figure, the insertion part 7 of the endoscope 2 is inserted by the same effect | action.

そして、大腸の最深部で最もコントロールし難く、可撓管部15を押した力が最も伝わり難くなる、上行結腸H5への挿入時には、挿入部7の先端部17が上行結腸H5の深部に到達するまで、湾曲部16と、可撓管部15との接続部が肝湾曲部H9に到達しないため、腸に力を与えず、腸の過度な伸展や、可撓管部15の撓みを防止できる。   The distal end portion 17 of the insertion portion 7 reaches the deep portion of the ascending colon H5 at the time of insertion into the ascending colon H5. Until this is done, the connecting portion between the bending portion 16 and the flexible tube portion 15 does not reach the liver bending portion H9, so that force is not applied to the intestine, and excessive intestinal extension or bending of the flexible tube portion 15 is prevented. it can.

また、図8は湾曲操作ノブ30による湾曲操作で湾曲部16を単一方向へ湾曲させ、湾曲操作ノブ30を固定した状態を示すものである。ここで、湾曲操作ノブ30の操作により、湾曲部16に角度θaの湾曲をかけると挿入部7の先端部17はaの状態で保持される。   FIG. 8 shows a state where the bending operation knob 30 is bent in a single direction by the bending operation of the bending operation knob 30 and the bending operation knob 30 is fixed. Here, when the bending portion 16 is bent at an angle θa by the operation of the bending operation knob 30, the distal end portion 17 of the insertion portion 7 is held in the state of a.

この状態において、第2の湾曲部40の各湾曲駒37は互いに当接していないため、湾曲部16に図8中の矢印Fの外力が与えられると、第2の湾曲部40の各湾曲駒37が回動して更に湾曲し、挿入部7の先端部17をb、cの状態に曲げることができる。ここで、湾曲操作ノブ30の回動位置を動かさない場合には、牽引ワイヤ50の牽引量は変わらないことから、b、cの状態に曲げた場合の挿入部7の先端部17の向き(湾曲角度)θbとθcはθaとほぼ変わらず、第2の湾曲部40が外力により曲がった角度とほぼ同一の量だけ第1の湾曲部39の湾曲駒37が湾曲が戻る方向に回動して、第1の湾曲部39の湾曲は解除され、第1の湾曲部39は軸方向に伸びる。これにより、挿入部7の先端部17は視野方向、すなわち進行したい方向にほぼ、直線的に移動する。   In this state, since the bending pieces 37 of the second bending portion 40 are not in contact with each other, when the external force indicated by the arrow F in FIG. 37 is rotated and further curved, and the distal end portion 17 of the insertion portion 7 can be bent into the states of b and c. Here, when the turning position of the bending operation knob 30 is not moved, the pulling amount of the pulling wire 50 does not change, so the direction of the distal end portion 17 of the insertion portion 7 when bent to the state of b and c ( (Bending angle) θb and θc are substantially the same as θa, and the bending piece 37 of the first bending portion 39 is rotated in the direction in which the bending is returned by the same amount as the angle at which the second bending portion 40 is bent by the external force. Thus, the bending of the first bending portion 39 is released, and the first bending portion 39 extends in the axial direction. Thereby, the front-end | tip part 17 of the insertion part 7 moves substantially linearly in the visual field direction, ie, the direction which wants to advance.

これにより、図6(C)および図7(D)に示す状態の際に腸壁に湾曲部16を押し付けて、湾曲部16を変形させることにより、特別な湾曲操作をすることなく、視野を確保しながら自動的に視野方向に先端部17を前進させることができる。   Accordingly, the bending portion 16 is pressed against the intestinal wall in the state shown in FIGS. 6C and 7D, and the bending portion 16 is deformed, so that the visual field can be reduced without performing a special bending operation. The tip 17 can be automatically advanced in the visual field direction while ensuring.

そこで、上記構成のものにあっては次の効果を奏する。すなわち、本実施の形態の内視鏡装置1では内視鏡2の湾曲部16に先端側の第1の湾曲部39と、この第1の湾曲部39の基端側に連接され、第1の湾曲部39よりも軸方向の曲げに対する硬さが硬くなる状態に設定された第2の湾曲部40とを設け、第2の湾曲部40の後端位置を挿入部7の先端部から略15cm以上の長さに配置したので、湾曲部16の全長が長いにも関わらず、湾曲操作ノブ30の操作による湾曲動作時には、第1の湾曲部39のみを主に湾曲させ、第2の湾曲部40はほとんど湾曲しない状態で保持させることができる。そのため、湾曲部16の通過の際に可撓管部15の押し操作をして、湾曲部16を腸壁に押し付けた際に、容易に第2の湾曲部40が曲がるため、腸壁が過度に伸展することを防止することができる。このとき、可撓管部15が撓まないので、先端部17の進行方向に力が確実に伝わり、屈曲部の通過が容易になる。   Therefore, the above configuration has the following effects. That is, in the endoscope apparatus 1 according to the present embodiment, the first bending portion 39 on the distal end side is connected to the bending portion 16 of the endoscope 2 and the proximal end side of the first bending portion 39 is connected to the first bending portion 39. The second bending portion 40 is set so as to be harder in bending in the axial direction than the bending portion 39, and the rear end position of the second bending portion 40 is substantially from the distal end portion of the insertion portion 7. Since the length of the bending portion 16 is long, only the first bending portion 39 is mainly bent during the bending operation by the operation of the bending operation knob 30 even though the entire length of the bending portion 16 is long. The part 40 can be held in a state of hardly bending. For this reason, when the flexible tube portion 15 is pushed when passing through the bending portion 16 and the bending portion 16 is pressed against the intestinal wall, the second bending portion 40 easily bends, so that the intestinal wall is excessive. Can be prevented from extending to the surface. At this time, since the flexible tube portion 15 does not bend, the force is reliably transmitted in the traveling direction of the tip portion 17 and the passage of the bent portion is facilitated.

さらに、図5(D)に示すように湾曲操作ノブ30の操作による湾曲動作で湾曲部16を最大湾曲状態に湾曲操作した際にも、第2の湾曲部40の各湾曲駒37は当接していないため、どの様な湾曲動作状態においても、第2の湾曲部40に外力が加わった場合には、図5(D)の点線で示すように、更に第2の湾曲部40を湾曲させることができる。また、湾曲部16が長いにもかかわらず、湾曲操作ノブ30の操作では湾曲部40はほとんど湾曲しないので、湾曲形状がコンパクトで、狭い腸管の中でも操作性が良い。   Further, as shown in FIG. 5D, each bending piece 37 of the second bending portion 40 also comes into contact when the bending portion 16 is bent to the maximum bending state by the bending operation by the operation of the bending operation knob 30. Therefore, in any bending operation state, when an external force is applied to the second bending portion 40, the second bending portion 40 is further bent as shown by the dotted line in FIG. be able to. Even though the bending portion 16 is long, the bending portion 40 hardly bends when the bending operation knob 30 is operated. Therefore, the bending shape is compact, and the operability is good even in a narrow intestine.

また、湾曲部16と可撓管部15との間の接続部のように曲がらない硬質部分が大腸内のRs屈曲部H6のような屈曲部に近接する前に先端部17、第1の湾曲部39を次の屈曲部であるSD屈曲部H7に導入することができるので、この状態で湾曲部16の形状を変えることで、腸管を直線化し、挿入部7の挿入を容易にすることができる。   Further, before the hard portion that does not bend like the connection portion between the bending portion 16 and the flexible tube portion 15 approaches the bent portion such as the Rs bent portion H6 in the large intestine, the distal end portion 17 and the first bent portion Since the portion 39 can be introduced into the SD bent portion H7, which is the next bent portion, changing the shape of the curved portion 16 in this state can straighten the intestinal tract and facilitate the insertion of the insertion portion 7. it can.

さらに、本実施の形態では大腸内の屈曲部の通過の際に内視鏡2の視野を確保しながら、挿入できるため、挿入部7の挿入が容易となる。以上により、本実施の形態では大腸内の屈曲部の通過時における腸の過伸展やステッキ現象が防止でき、大腸への挿入部7の挿入を容易に行うことができる。   Furthermore, in the present embodiment, the insertion portion 7 can be easily inserted because the insertion can be performed while ensuring the visual field of the endoscope 2 when passing through the bent portion in the large intestine. As described above, according to the present embodiment, it is possible to prevent intestinal overextension and a sticking phenomenon when passing through a bent portion in the large intestine, and the insertion portion 7 can be easily inserted into the large intestine.

また、本実施の形態では、湾曲部16の網状管41と弾性外皮部材42と湾曲管36とを組み合わせた状態において、湾曲部16の曲げに対する硬さが次の表1に示す関係となるようにそれぞれ形成されている。

Figure 2008253774
Further, in the present embodiment, the bending resistance of the bending portion 16 is in the relationship shown in the following Table 1 in a state where the mesh tube 41, the elastic skin member 42, and the bending tube 36 of the bending portion 16 are combined. Are formed respectively.
Figure 2008253774

そして、図3に示すように網状管41の弾性膜部46のある部分と無い部分の境界部分よりも基端側に弾性外皮部材42の厚肉部48を位置させて、弾性膜部46の部分と薄肉部47とが組み合わされた上記表1の3の組み合わせ部分のように、曲げに対する硬さが中間の硬さの部分を設けている。   Then, as shown in FIG. 3, the thick portion 48 of the elastic skin member 42 is positioned closer to the base end side than the boundary portion between the portion where the elastic membrane portion 46 is present and the portion where the elastic membrane portion 46 is not present. Like the combination part of 3 of the said Table 1 with which the part and the thin part 47 were combined, the part with the hardness with respect to bending is provided in the middle.

この場合には湾曲部16の途中部分に硬さが急激に変化する部分がないので、湾曲部16の湾曲操作時の湾曲形状がスムーズな形状となる。さらに、図6(C)や、図7(D)に示す状態の際に腸壁に湾曲部16を押し付けても、第1の湾曲部39と第2の湾曲部40との接続部に、急激に屈曲する部分が生じず、曲げに対する硬さが急激に変化する部分がないので、可撓管部15の押し操作をした際に、第1の湾曲部39と第2の湾曲部40との途中部分に力が集中して、腸壁に力を与えることがない。このため、腸壁が伸展せず、可撓管部15が撓まない。さらに、湾曲部16の湾曲時に湾曲部16の外表面に急激な段差が生じない効果もある。   In this case, since there is no portion where the hardness changes suddenly in the middle portion of the bending portion 16, the bending shape during the bending operation of the bending portion 16 becomes a smooth shape. Furthermore, even if the bending portion 16 is pressed against the intestinal wall in the state shown in FIG. 6C or 7D, the connection portion between the first bending portion 39 and the second bending portion 40 is Since there is no portion that suddenly bends and there is no portion in which the hardness against bending suddenly changes, when the flexible tube portion 15 is pushed, the first bending portion 39 and the second bending portion 40 The force concentrates on the middle part of the stomach and does not give power to the intestinal wall. For this reason, the intestinal wall does not extend and the flexible tube portion 15 does not bend. Furthermore, there is also an effect that no sharp step is generated on the outer surface of the bending portion 16 when the bending portion 16 is bent.

また、第1の湾曲部39と第2の湾曲部40との間の接続部の部分を、曲げに対する硬さが比較的軟らかい構成としたので、湾曲操作を行った際に、第1の湾曲部39の基端部が曲がり易く、コンパクトな形状となる。   In addition, since the portion of the connecting portion between the first bending portion 39 and the second bending portion 40 is configured to have a relatively soft hardness against bending, the first bending is performed when the bending operation is performed. The base end portion of the portion 39 is easy to bend and has a compact shape.

そこで、上記構成のものにあっては次の効果を奏する。すなわち、湾曲部16の通過時における腸の過伸展やステッキ現象が防止でき、大腸への挿入が容易な内視鏡2を提供できる。第2の湾曲部40を曲がり難くするための抵抗として、網状管41と弾性外皮部材42とを用いているので、実公平1−22641号公報の構成のような不具合がない。   Therefore, the above configuration has the following effects. That is, it is possible to provide an endoscope 2 that can prevent intestinal overextension and a sticking phenomenon when passing through the bending portion 16 and can be easily inserted into the large intestine. Since the mesh tube 41 and the elastic skin member 42 are used as the resistance for making the second bending portion 40 difficult to bend, there is no problem as in the configuration of Japanese Utility Model Publication No. 1-22641.

さらに、本実施の形態の内視鏡装置1では湾曲部16の第1の湾曲部39の形状がコンパクトで従来の一般的な内視鏡と同様であり、大腸への挿入において湾曲操作によって先端部17および第1の湾曲部39を大腸の腸壁にひっかけて、湾曲部16の湾曲動作によって腸管をたたみ、短縮させる動作が容易に行える。また、先端部17および第1の湾曲部39を大腸のひだにかけて、湾曲操作によりひだをかきわける動作がし易くなり、ひだの裏側の観察性が良い。   Furthermore, in the endoscope apparatus 1 of the present embodiment, the shape of the first bending portion 39 of the bending portion 16 is compact and is the same as that of a conventional general endoscope. By hooking the portion 17 and the first bending portion 39 on the intestinal wall of the large intestine, the bending operation of the bending portion 16 can be used to easily collapse and shorten the intestinal tract. In addition, the distal end portion 17 and the first bending portion 39 are placed on the folds of the large intestine, and the operation of breaking the folds by the bending operation is facilitated, and the observability on the back side of the folds is good.

また、大腸への内視鏡2の挿入方法には大別して2つの方法がある。第1の方法は可撓管部15を把持し、押し込む動作を主体として、挿入部7の先端を深部に押し進める挿入方法である。また、第2の方法は可撓管部15を押し込む動作と共に、湾曲操作によって先端部17を大腸の腸壁にひっかけて、湾曲部16の湾曲動作によって腸管をたたみ、短縮させる動作を主体として、挿入部7の先端部17を深部へ導く挿入方法である。   There are two main methods of inserting the endoscope 2 into the large intestine. The first method is an insertion method in which the distal end of the insertion portion 7 is pushed deeper with the flexible tube portion 15 held and pushed in as a subject. The second method mainly includes an operation of pushing the flexible tube portion 15, hooking the distal end portion 17 to the intestinal wall of the large intestine by a bending operation, and folding and shortening the intestinal tract by the bending operation of the bending portion 16. This is an insertion method in which the distal end portion 17 of the insertion portion 7 is guided to the deep portion.

そして、上記の構成の本実施の形態の内視鏡装置1によれば、第1の方法で発生し易い腸の過伸展や、ステッキ現象を防止することができると共に、第2の方法においても操作性を損なうことがない。   According to the endoscope apparatus 1 of the present embodiment having the above-described configuration, it is possible to prevent intestinal hyperextension and sticky phenomenon that are likely to occur in the first method, and also in the second method. There is no loss of operability.

また、本実施の形態では第2の湾曲部40の曲げに対する硬さは、可撓管部15との接続部近傍の可撓管部15の曲げに対する硬さよりも小さくなるように、湾曲部16、先端部17内部に配置された内蔵物の曲げに対する硬さや、内蔵物の湾曲部16、先端部17に対する充填率、湾曲部16、可撓管部15の各要素を構成している。   In the present embodiment, the bending portion 16 is so bent that the bending strength of the second bending portion 40 is smaller than the bending hardness of the flexible tube portion 15 in the vicinity of the connection portion with the flexible tube portion 15. The bending strength of the built-in object disposed inside the tip end portion 17, the filling portion of the built-in object bending portion 16, the filling rate of the tip end portion 17, the bending portion 16, and the flexible tube portion 15 are configured.

そして、図5(B)に示すように湾曲操作ノブ30の操作により湾曲部16を90゜以上湾曲させた状態においても、可撓管部15と、湾曲部16の硬さの関係が上記と同様に構成されている。   5B, even when the bending portion 16 is bent by 90 ° or more by the operation of the bending operation knob 30, the relationship between the hardness of the flexible tube portion 15 and the bending portion 16 is as described above. It is constituted similarly.

なお、湾曲部16の湾曲角度が90゜程度に屈曲された状態は、腸の屈曲部を越える際に、次の管腔に挿入部7の先端部17を入れるために通常、必要な最低の角度である。そして、内視鏡2の挿入部7を大腸内に挿入する作業中、内視鏡2の湾曲部16を腸の屈曲部を通過させる際に、湾曲部16の湾曲角度が90゜以上の角度がついた状態で可撓管部15を押す場合には、内視鏡2に力を加える方向と、挿入部7の先端部17が向いた方向、すなわち挿入部7の先端部17を進める方向とが異なることとなる。90°を越えると逆方向になる。   The state where the bending angle of the bending portion 16 is bent to about 90 ° is usually the minimum necessary for putting the distal end portion 17 of the insertion portion 7 into the next lumen when the bending portion of the intestine is exceeded. Is an angle. During the operation of inserting the insertion portion 7 of the endoscope 2 into the large intestine, when the bending portion 16 of the endoscope 2 is passed through the bending portion of the intestine, the bending angle of the bending portion 16 is an angle of 90 ° or more. When the flexible tube portion 15 is pushed in a state with a mark, the direction in which force is applied to the endoscope 2 and the direction in which the distal end portion 17 of the insertion portion 7 faces, that is, the direction in which the distal end portion 17 of the insertion portion 7 is advanced. Will be different. If it exceeds 90 °, the direction is reversed.

このため、この状態で可撓管部15を押込み操作した場合には従来構成の内視鏡では図17(B)に示すように、湾曲部cが腸壁を押す方向にしか力が加わらないので、押した方向に腸壁が過度に伸展したり、可撓管部15が撓んでしまい、所謂ステッキ現象が起こってしまう。   Therefore, when the flexible tube portion 15 is pushed in this state, a force is applied only in the direction in which the bending portion c pushes the intestinal wall as shown in FIG. Therefore, the intestinal wall excessively extends in the pushed direction, or the flexible tube portion 15 is bent, so-called sticky phenomenon occurs.

なお、本実施の形態においては図5(D)における湾曲操作ノブ30の操作による最大湾曲状態においても、可撓管部15と湾曲部16の硬さの関係も上記と同様に構成されている。そのため、内視鏡2の挿入部7を大腸内に挿入する作業中に、大腸内の屈曲部においてどの様な大きさの湾曲をかけた状態でも、可撓管部15に力を加えると、湾曲部16が腸壁と滑らない状態でも、可撓管部15が撓み始める前に湾曲部16の第2の湾曲部40が変形し、確実に先端部17を前進させることができる。   In the present embodiment, even in the maximum bending state by the operation of the bending operation knob 30 in FIG. 5D, the relationship between the hardness of the flexible tube portion 15 and the bending portion 16 is configured in the same manner as described above. . Therefore, during the operation of inserting the insertion portion 7 of the endoscope 2 into the large intestine, if a force is applied to the flexible tube portion 15 in any state of bending at the bending portion in the large intestine, Even in a state where the bending portion 16 does not slide with the intestinal wall, the second bending portion 40 of the bending portion 16 is deformed before the flexible tube portion 15 starts to bend, and the distal end portion 17 can be reliably advanced.

そこで、上記構成のものにあっては次の効果を奏する。すなわち、本実施の形態では内視鏡2の挿入部7を大腸内に挿入する作業中に、大腸内の屈曲部において可撓管部15が撓んで、先端部17に力が伝わらなくなることがないので、内視鏡2の挿入部7を大腸内の屈曲部を通過させる際の作業性が良い。   Therefore, the above configuration has the following effects. That is, in the present embodiment, during the operation of inserting the insertion portion 7 of the endoscope 2 into the large intestine, the flexible tube portion 15 is bent at the bent portion in the large intestine, and the force is not transmitted to the distal end portion 17. Therefore, workability when passing the insertion portion 7 of the endoscope 2 through the bent portion in the large intestine is good.

なお、可撓管部15の湾曲部16との接続部近傍部分を軟性部51とし、この基端側に軟性部51よりも長手方向の曲げに対する硬さを硬くした図示しない硬性部を設けても良い。   A portion near the connection portion of the flexible tube portion 15 with the bending portion 16 is a soft portion 51, and a hard portion (not shown) is provided on the base end side, which is harder than the soft portion 51 in bending in the longitudinal direction. Also good.

また、図9(A),(B)および図10(A)〜(D)は第1の実施の形態(図1乃至図8参照)の内視鏡装置1の第1の変形例を示すものである。本変形例は内視鏡2の湾曲部16の構成を次の通り変更したものである。   FIGS. 9A and 9B and FIGS. 10A to 10D show a first modification of the endoscope apparatus 1 according to the first embodiment (see FIGS. 1 to 8). Is. In this modification, the configuration of the bending portion 16 of the endoscope 2 is changed as follows.

図9(A)は湾曲部16の単一方向への湾曲操作時に牽引ワイヤ50の動作ストロークにより湾曲させることが可能な最大湾曲状態を示すものである。そして、本変形例ではこの湾曲部16の最大湾曲状態時に、第2の湾曲部40の先端部の軸線S1と可撓管部15の中心線S2との間の角度α1を略45゜以下とし、第1の湾曲部39の先端部の軸線S3と第2の湾曲部40の先端部の軸線S1との間の角度α2を略180゜以上の角度を有するように、湾曲部16の湾曲駒37、網状管41、弾性膜部46及び牽引ワイヤ50のストロークを設定したものである。ここで、本変形例ではα1を20゜、α2を180゜にそれぞれ設定し、可撓管部15の中心線S2に沿う略直線状の自然状態に対しては合計200゜の湾曲がかかるように形成されている。   FIG. 9A shows a maximum bending state in which the bending portion 16 can be bent by the operation stroke of the pulling wire 50 when the bending portion 16 is bent in a single direction. In this modification, when the bending portion 16 is in the maximum bending state, the angle α1 between the axis S1 of the distal end portion of the second bending portion 40 and the center line S2 of the flexible tube portion 15 is set to about 45 ° or less. The bending piece of the bending portion 16 so that the angle α2 between the axis S3 of the distal end portion of the first bending portion 39 and the axis S1 of the distal end portion of the second bending portion 40 is approximately 180 ° or more. 37, strokes of the mesh tube 41, the elastic membrane portion 46, and the pulling wire 50 are set. Here, in this modification, α1 is set to 20 ° and α2 is set to 180 °, respectively, so that a substantially straight natural state along the center line S2 of the flexible tube portion 15 is bent by a total of 200 °. Is formed.

なお、内視鏡2による大腸検査時には直腸H1において、直腸内反転視と呼ばれている肛門H11付近の観察が行われる場合がある。これは、内視鏡2の挿入部7を肛門H11から直腸H1に挿入した際に、挿入方向に向いている挿入部7の先端部17を湾曲操作ノブ30の湾曲操作によって湾曲部16を180゜以上湾曲させることで、図9(A)に示すように内視鏡2の視野方向を挿入方向に対してほぼ正反対に向けて観察を行うものである。   When the colon 2 is inspected by the endoscope 2, there is a case where observation of the vicinity of the anus H11 referred to as endorectal reverse vision is performed in the rectum H1. This is because when the insertion portion 7 of the endoscope 2 is inserted into the rectum H1 from the anus H11, the distal end portion 17 of the insertion portion 7 facing the insertion direction is bent by the bending operation of the bending operation knob 30. By bending the angle by more than 0 °, observation is performed with the visual field direction of the endoscope 2 almost opposite to the insertion direction as shown in FIG. 9A.

ここで、湾曲部16の最大湾曲状態時に、第2の湾曲部40の先端部の軸線S1と可撓管部15の中心線S2との間の角度α1を45゜以上とした場合には図9(B)に示すように、観察したい肛門付近を正面側から観察することができない。そこで、本変形例のように湾曲部16の最大湾曲状態時に、第2の湾曲部40の先端部の軸線S1と可撓管部15の中心線S2との間の角度α1を45゜以下に設定したことにより、図9(A)に示すように肛門H11付近を正面側から観察することができる。   Here, when the angle α1 between the axis S1 of the distal end portion of the second bending portion 40 and the center line S2 of the flexible tube portion 15 is 45 ° or more when the bending portion 16 is in the maximum bending state, FIG. As shown in FIG. 9B, the vicinity of the anus to be observed cannot be observed from the front side. Therefore, when the bending portion 16 is in the maximum bending state as in this modification, the angle α1 between the axis S1 of the distal end portion of the second bending portion 40 and the center line S2 of the flexible tube portion 15 is set to 45 ° or less. By setting, the vicinity of the anus H11 can be observed from the front side as shown in FIG.

次に、図9(A)に示す湾曲部16の最大湾曲状態から、この湾曲方向と直交する方向へ更に湾曲をかけた際の湾曲動作について図10(A)〜(D)を参照して説明する。図10(A),(B)は図9(A)と同様の湾曲部16の最大湾曲状態を示すものである。この状態では第1の湾曲部39は、ほとんどの隣り合う湾曲駒37の当接部間が当接している。このとき、第2の湾曲部40は、ほとんどの隣り合う湾曲駒37の当接部間は当接していない。   Next, with reference to FIGS. 10A to 10D, the bending operation when the bending portion 16 shown in FIG. 9A is further bent in the direction orthogonal to the bending direction from the maximum bending state of the bending portion 16 will be described. explain. FIGS. 10A and 10B show the maximum bending state of the bending portion 16 similar to FIG. 9A. In this state, the first bending portion 39 is in contact between the contact portions of most adjacent bending pieces 37. At this time, the second bending portion 40 is not in contact between the contact portions of most adjacent bending pieces 37.

この状態から、湾曲部16に図10(B)に示すように湾曲がかけられている方向と直交する方向である矢印R、矢印Lの方向に更に湾曲をかけると、第1の湾曲部39は湾曲駒37が当接して固定状態にあるため、ほとんど、形状が変化しない。一方、第2の湾曲部40では各湾曲駒37が当接していないため、新たに湾曲をかけた方向に湾曲駒37が回動し、図10(C)、図10(D)に示す湾曲形状にそれぞれ変形される。   From this state, when the bending portion 16 is further bent in the directions of arrows R and L, which are orthogonal to the direction in which the bending is applied, as shown in FIG. Since the bending piece 37 is in contact and in a fixed state, the shape hardly changes. On the other hand, since the bending pieces 37 are not in contact with each other in the second bending portion 40, the bending piece 37 is rotated in the newly bent direction, and the bending shown in FIGS. 10C and 10D is performed. Each is transformed into a shape.

そこで、本変形例では、肛門H11付近を観察する際、図10(A),(B)の状態から、図10(C)、図10(D)の状態に変形させても先端部17と観察対象物との距離を大きく変化させることがなく、図10(A),(B)の状態で観察していた対象物の周辺を観察できる。さらに、本変形例では第1の湾曲部39の部分の湾曲角度がほとんど増加しないので、湾曲部16の内蔵物にダメージを与えない効果もある。   Therefore, in this modified example, when observing the vicinity of the anus H11, even if the state shown in FIGS. 10A and 10B is changed to the state shown in FIGS. It is possible to observe the periphery of the object observed in the state of FIGS. 10A and 10B without greatly changing the distance to the observation object. Further, in the present modification, the bending angle of the first bending portion 39 is hardly increased, so that there is an effect that the built-in object of the bending portion 16 is not damaged.

なお、図9(A)に示す湾曲部16の最大湾曲状態において、第2の湾曲部40の先端部の軸線S1と可撓管部15の中心線S2との間の角度α1を45゜以上とした場合でも90゜以下に設定するのが望ましい。   In the maximum bending state of the bending portion 16 shown in FIG. 9A, the angle α1 between the axis S1 of the distal end portion of the second bending portion 40 and the center line S2 of the flexible tube portion 15 is 45 ° or more. Even in this case, it is desirable to set it to 90 ° or less.

なお、図5(B)に示すように、湾曲操作ノブ30の湾曲操作により、湾曲部16を自然状態(挿入部7の中心線Oの方向)に対して略90゜の回転角度θ1に湾曲させる際の湾曲操作時に、第1の湾曲部39が90゜まで湾曲する前に、第2の湾曲部40が湾曲し始める構成にしている。   As shown in FIG. 5B, the bending portion 16 is bent at a rotation angle θ1 of approximately 90 ° with respect to the natural state (the direction of the center line O of the insertion portion 7) by the bending operation of the bending operation knob 30. During the bending operation, the second bending portion 40 starts to be bent before the first bending portion 39 is bent to 90 °.

ここで、大腸の屈曲部、例えば図11(A),(B)に示すRs屈曲部H6や、図12(A),(B)に示す脾湾曲部H8などは通常、90゜以下の鋭角である。そのため、内視鏡2の挿入部7を大腸へ挿入する操作時には、Rs屈曲部H6や、脾湾曲部H8などを通過させる際に、挿入部7の先端部17の視野を屈曲部の先の管腔方向に向けるため、湾曲部16を少なくとも、90゜以上の角度に湾曲させる必要がある。このとき、湾曲部16は第2の湾曲部40が湾曲することにより、図11(B)、図12(B)に示すように、腸壁を第2の湾曲部40が押すことで屈曲部が鈍角になり、湾曲部16の通過が容易になる。   Here, the bent part of the large intestine, for example, the Rs bent part H6 shown in FIGS. 11A and 11B and the spleen curved part H8 shown in FIGS. It is. Therefore, at the time of the operation of inserting the insertion portion 7 of the endoscope 2 into the large intestine, the visual field of the distal end portion 17 of the insertion portion 7 is moved beyond the bending portion when the Rs bending portion H6, the splenic bending portion H8, or the like is passed. In order to face the lumen, it is necessary to bend the bending portion 16 at an angle of 90 ° or more. At this time, when the second bending portion 40 is bent, the bending portion 16 is bent when the second bending portion 40 pushes the intestinal wall as shown in FIGS. 11 (B) and 12 (B). Becomes an obtuse angle and the curved portion 16 can be easily passed.

さらに、図6(C)、図7(D)に示す状態で、腸壁に湾曲部16を押し付ける際に、既に第2の湾曲部40が第1の湾曲部39と同方向に曲がっている為、図13に示すように第2の湾曲部40が第1の湾曲部39の湾曲方向と逆の方向に曲がってしまうことがない。   Further, in the state shown in FIGS. 6C and 7D, when the bending portion 16 is pressed against the intestinal wall, the second bending portion 40 is already bent in the same direction as the first bending portion 39. Therefore, as shown in FIG. 13, the second bending portion 40 does not bend in the direction opposite to the bending direction of the first bending portion 39.

また、図14は第1の実施の形態(図1乃至図8参照)の内視鏡装置1の第2の変形例を示すものである。本変形例は内視鏡2の湾曲部16の構成を次の通り変更したものである。   FIG. 14 shows a second modification of the endoscope apparatus 1 according to the first embodiment (see FIGS. 1 to 8). In this modification, the configuration of the bending portion 16 of the endoscope 2 is changed as follows.

すなわち、本変形例では図14に示すように、湾曲操作ノブ30の操作による最大湾曲角度(挿入部7の中心線Oの方向に対する回転角度θ2)を180゜に設定し、この範囲までは第2の湾曲部40が曲がり始めないように設定したものである。   That is, in this modification, as shown in FIG. 14, the maximum bending angle (rotation angle θ2 with respect to the direction of the center line O of the insertion portion 7) by the operation of the bending operation knob 30 is set to 180 °. The second bending portion 40 is set so as not to start bending.

この場合は、従来、広く用いられている一般的な第2の湾曲部40のない内視鏡と、全く、湾曲形状が変わらないので、内視鏡の湾曲操作時の操作感覚が変わらず、従来の操作方法に慣れている術者に対して違和感がない。   In this case, since the curved shape does not change at all with the conventional widely used endoscope without the second bending portion 40, the operation feeling during the bending operation of the endoscope does not change, There is no sense of incongruity for the surgeon accustomed to the conventional operation method.

また、図5(C)に示すように湾曲操作ノブ30の操作により、湾曲部16を自然状態に対して略180゜湾曲させた状態において、挿入部7の先端部17は湾曲部16と可撓管部15との接続部よりも、先端側に位置する形状に設定してもよい。   Further, as shown in FIG. 5C, in the state where the bending portion 16 is bent by approximately 180 ° with respect to the natural state by the operation of the bending operation knob 30, the distal end portion 17 of the insertion portion 7 can be connected to the bending portion 16. You may set to the shape located in the front end side rather than the connection part with the flexible tube part 15. FIG.

この場合には挿入部7の挿入口である、肛門H11に近いS状結腸H2の通過及び、S状結腸H2と下行結腸H3との移行部であるSD屈曲部H7の通過において各屈曲部を通過させるために、通常、湾曲部16は180゜以上は曲げる必要がない。このため、湾曲部16を曲げた場合でも、湾曲部16の基端部分を把持することができる。   In this case, each bending portion is inserted in the passage of the sigmoid colon H2 close to the anus H11, which is the insertion port of the insertion portion 7, and in the passage of the SD bending portion H7 which is a transition portion between the sigmoid colon H2 and the descending colon H3. In order to pass through, it is usually not necessary for the bending portion 16 to be bent over 180 °. For this reason, even when the bending portion 16 is bent, the proximal end portion of the bending portion 16 can be gripped.

そして、これらの部位の挿入において、第2の湾曲部40を把持し、曲げることにより第2の湾曲部40及び第1の湾曲部39の湾曲形状を任意に変えることができる。例えば、湾曲操作ノブ30にて湾曲をかけ、湾曲操作ノブ30を保持した状態で、把持した手で第2の湾曲部40を曲げれば、前述した図8に示す作用により、第1の湾曲部39は角度が鈍角になり、第2の湾曲部40を鈍角にすれば、第1の湾曲部39は鋭角に湾曲形状が変化する。特に、肛門H11から直腸H1までは上記操作が行えるし、腸壁をたたみ、腸管を短縮化しながら挿入すれば、S状結腸H2から下行結腸H3への移行部まで、上記操作が行える。   And in insertion of these parts, the curved shape of the 2nd curved part 40 and the 1st curved part 39 can be changed arbitrarily by grasping and bending the 2nd curved part 40. For example, if the second bending portion 40 is bent with a gripped hand while the bending operation knob 30 is bent and the bending operation knob 30 is held, the first bending is performed by the action shown in FIG. The angle of the part 39 becomes an obtuse angle, and if the second bending part 40 is made an obtuse angle, the curved shape of the first bending part 39 changes to an acute angle. In particular, the above operation can be performed from the anus H11 to the rectum H1, and the above operation can be performed from the sigmoid colon H2 to the descending colon H3 by inserting the wall of the bowel while shortening the bowel.

そこで、上記構成のものにあっては次の効果を奏する。すなわち、湾曲部16の形状を挿入部7を把持した手で、挿入部7の押し引き操作と連動して湾曲形状を調整できるので、操作性が良く、挿入性が良くなる。また、前述した直腸内反転視の際も観察視野の調整がし易くなる効果がある。   Therefore, the above configuration has the following effects. That is, since the curved shape can be adjusted in conjunction with the push-pull operation of the insertion portion 7 with the hand holding the insertion portion 7, the operability is good and the insertion property is good. In addition, there is an effect that the observation visual field can be easily adjusted also in the above-described intrarectal reversal vision.

また、図15および図16は本発明の第2の実施の形態を示すものである。本実施の形態は第1の実施の形態(図1乃至図8参照)の内視鏡装置1の内視鏡2における湾曲部16の構成を次の通り変更したものである。   FIGS. 15 and 16 show a second embodiment of the present invention. In the present embodiment, the configuration of the bending portion 16 in the endoscope 2 of the endoscope apparatus 1 according to the first embodiment (see FIGS. 1 to 8) is changed as follows.

すなわち、本実施の形態の湾曲部16では図15に示すように、第1の実施の形態とは逆に第1の湾曲部39の外周面の弾性外皮部材42の薄肉部47の部分の後端部側に弾性外皮部材42の厚肉部48を延設させたものである。ここで、弾性外皮部材42の厚肉部48は網状管41の弾性膜部46のある部分と無い部分との境界部分よりも適宜の長さ先端側まで延出されている。この弾性外皮部材42の厚肉部48の延出部分の長さZ2は例えば5mm〜15mm程度に設定されている。そして、この弾性外皮部材42の厚肉部48の延出部分の長さZ2の部分に弾性膜部46がない部分と厚肉部48とが組み合わされた、曲げに対する硬さが中間の硬さの部分(表1の2に相当する)が形成されている。   That is, in the bending portion 16 of the present embodiment, as shown in FIG. 15, contrary to the first embodiment, after the portion of the thin portion 47 of the elastic skin member 42 on the outer peripheral surface of the first bending portion 39. A thick part 48 of the elastic skin member 42 is extended on the end side. Here, the thick part 48 of the elastic skin member 42 is extended to the distal end side by an appropriate length from the boundary part between the part with and without the elastic film part 46 of the mesh tube 41. The length Z2 of the extended portion of the thick portion 48 of the elastic skin member 42 is set to about 5 mm to 15 mm, for example. And the hardness with respect to a bending | hardening with which the part which does not have the elastic film part 46, and the thick part 48 are combined in the part of the length Z2 of the extension part of the thick part 48 of this elastic skin member 42, and the hardness with respect to bending is intermediate | middle hardness (Corresponding to 2 in Table 1) is formed.

そして、本実施の形態では湾曲部16の第1の湾曲部39と第2の湾曲部40との接続部に曲げに対する硬さが比較的硬い長さZ2の中間の硬さの部分を設けたので、湾曲操作を行った際には、第1の湾曲部39の基端部が曲がり難くなり、第2の湾曲部40の先端側が曲がり易く、図16に示す湾曲形状となる。   In the present embodiment, the connecting portion between the first bending portion 39 and the second bending portion 40 of the bending portion 16 is provided with an intermediate hardness portion of the length Z2 that is relatively hard to bending. Therefore, when a bending operation is performed, the proximal end portion of the first bending portion 39 is difficult to bend, and the distal end side of the second bending portion 40 is easily bent, resulting in a curved shape shown in FIG.

そのため、大腸の屈曲部において、湾曲操作により、湾曲部16に湾曲をかけると腸の屈曲部の形状が第1の実施形態よりも、更に鈍角な形状となるので、可撓管部15を押した際に、加えた力が挿入部7の先端部17に伝わり易く、挿入部7の先端部17が挿入方向に推進し易くなる。   Therefore, when the bending portion 16 is bent by the bending operation in the bending portion of the large intestine, the shape of the bending portion of the intestine becomes a more obtuse shape than in the first embodiment. In this case, the applied force is easily transmitted to the distal end portion 17 of the insertion portion 7, and the distal end portion 17 of the insertion portion 7 is easily propelled in the insertion direction.

そこで、本実施の形態では大腸の屈曲部に内視鏡2の挿入部7を挿入する際に大腸の屈曲部に挿入部7の先端部17を通過させる操作がさらに容易となり、挿入性が向上する効果がある。   Therefore, in the present embodiment, when the insertion portion 7 of the endoscope 2 is inserted into the bent portion of the large intestine, the operation of passing the distal end portion 17 of the insertion portion 7 through the bent portion of the large intestine becomes easier, and the insertability is improved. There is an effect to.

さらに、本発明は上記実施の形態に限定されるものではなく、本発明の要旨を逸脱しない範囲で種々変形実施できることは勿論である。
次に、本出願の他の特徴的な技術事項を下記の通り付記する。

(付記項1) 先端部と先端部の基端に接続された湾曲部と湾曲部の基端に接続された可撓管とからなる軟性の挿入部とを有する内視鏡装置において、前記湾曲部の長さを先端から略15cm以上に形成し、前記湾曲部は先端側に設けられた第1湾曲部と、第1湾曲部の基端側に連接した第1湾曲部よりも軸方向の曲げに対する硬さが硬く形成された第2湾曲部とを具備する内視鏡装置。
Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) In an endoscope apparatus including a distal end portion, a bending portion connected to a proximal end of the distal end portion, and a flexible insertion portion connected to a proximal end of the bending portion, the bending The length of the portion is formed to be approximately 15 cm or more from the distal end, and the bending portion has a first bending portion provided on the distal end side and a first bending portion connected to the proximal end side of the first bending portion in an axial direction. An endoscope apparatus comprising: a second bending portion that is hard to bend.

(付記項2) 前記第1湾曲部と第2湾曲部は複数の節輪部材を回動自在に連結した湾曲管部材を具備し、湾曲管部材に第1湾曲部と第2湾曲部の軸方向の曲げに対する硬さを異ならせる抵抗部材を外嵌したことを特徴とする付記項1の内視鏡装置。   (Additional Item 2) The first bending portion and the second bending portion each include a bending tube member that rotatably connects a plurality of node ring members, and the bending tube member is provided with shafts of the first bending portion and the second bending portion. The endoscope apparatus according to appendix 1, wherein a resistance member that varies the hardness against bending in a direction is externally fitted.

(付記項3) 前記湾曲部は湾曲管部材の外周を被嵌する被嵌部材と、被嵌部材の外周を被覆する弾性外皮部材とからなり、前記被嵌部材は湾曲部の軸方向の曲げに対する硬さの異なる先端側の軟質部と基端側の硬質部を有し、弾性外皮部材は湾曲部の軸方向の曲げに対する硬さの異なる先端側の軟質部と基端側の硬質部を具備する付記項2の内視鏡装置。   (Additional Item 3) The bending portion includes a fitting member that fits the outer periphery of the bending tube member and an elastic skin member that covers the outer periphery of the fitting member, and the fitting member is bent in the axial direction of the bending portion. The elastic skin member has a soft portion on the distal end side and a hard portion on the proximal end side having different hardnesses against bending in the axial direction of the bending portion. The endoscope apparatus according to additional item 2 provided.

(付記項4) 前記被嵌部材の硬質部と軟質部との硬度変化位置と、弾性外皮部材の硬質部と軟質部との硬度変化位置とを湾曲部の軸方向の異なる位置に設けたことを特徴とする付記項3の内視鏡装置。   (Additional Item 4) The hardness change positions of the hard part and the soft part of the fitting member and the hardness change positions of the hard part and the soft part of the elastic skin member are provided at different positions in the axial direction of the bending part. The endoscope apparatus according to appendix 3, characterized by:

(付記項5) 弾性外皮部材の硬度変化位置を被嵌部材の硬度変化位置よりも先端側に設けた付記項4の内視鏡装置。   (Additional Item 5) The endoscope apparatus according to Additional Item 4, wherein the hardness change position of the elastic skin member is provided on the distal end side of the hardness change position of the fitted member.

(付記項6) 弾性外皮部材の硬度変化位置を被嵌部材の硬度変化位置よりも基端側に設けた付記項4の内視鏡装置。   (Additional Item 6) The endoscope apparatus according to Additional Item 4, wherein the hardness change position of the elastic skin member is provided on the base end side with respect to the hardness change position of the fitted member.

(付記項7) 湾曲操作手段による操作ワイヤの牽引操作によって、湾曲部を少なくとも略90°以上湾曲させた状態において、第2湾曲部の軸方向の曲げに対する硬さを第2湾曲部に接続された可撓管の軸方向の曲げに対する硬さよりも小さく形成した付記項1の内視鏡装置。   (Additional Item 7) In the state where the bending portion is bent at least approximately 90 ° or more by the pulling operation of the operation wire by the bending operation means, the hardness of the second bending portion with respect to the axial bending is connected to the second bending portion. The endoscope apparatus according to Additional Item 1, wherein the endoscope apparatus is formed to be smaller than the hardness against bending in the axial direction of the flexible tube.

(付記項8) 湾曲操作手段による湾曲操作によって湾曲させることが可能な湾曲部の最大湾曲状態において、第2湾曲部の軸方向の曲げに対する硬さを第2湾曲部に接続された可撓管の軸方向の曲げに対する硬さよりも小さく形成した付記項1の内視鏡装置。   (Additional Item 8) In the maximum bending state of the bending portion that can be bent by the bending operation by the bending operation means, the flexible tube connected to the second bending portion with respect to the bending strength in the axial direction of the second bending portion. The endoscope apparatus according to additional item 1, wherein the endoscope apparatus is formed to be smaller than the hardness against bending in the axial direction.

(付記項9) 前記湾曲部が、略180°曲げられたときに、先端部の位置が湾曲部と可撓管との接続部よりも軸方向先端側に位置するよう湾曲部を形成した付記項1の内視鏡装置。   (Additional Item 9) Additional note in which the bending portion is formed so that when the bending portion is bent by approximately 180 °, the position of the distal end portion is located on the axial front end side with respect to the connection portion between the bending portion and the flexible tube. The endoscope apparatus according to Item 1.

(付記項10) 先端部と先端部の基端に接続された湾曲部と湾曲部の基端に接続された可撓管とからなる軟性の挿入部を有する内視鏡装置において、前記湾曲部は先端側に設けられた第1湾曲部と、第1湾曲部の基端側に連接した第1湾曲部よりも軸方向の曲げに対する硬さが硬く形成された第2湾曲部とを具備し、第1湾曲部と第2湾曲部は複数の節輪部材を回動自在に連結した湾曲管部材にて形成し、第1湾曲部の節輪部材の少なくとも1つに端部が固定された操作ワイヤを有し、湾曲操作手段による操作ワイヤの牽引操作によって湾曲部を略90°以上湾曲させた状態において、第2湾曲部の軸方向の曲げに対する硬さを第2湾曲部に接続された可撓管の軸方向の曲げに対する硬さよりも小さく形成したことを特徴とする内視鏡装置。   (Additional Item 10) In an endoscope apparatus including a distal end portion, a bending portion connected to a proximal end of the distal end portion, and a flexible tube connected to the proximal end of the bending portion, the bending portion Comprises a first bending portion provided on the distal end side, and a second bending portion formed to be harder in bending in the axial direction than the first bending portion connected to the proximal end side of the first bending portion. The first bending portion and the second bending portion are formed by a bending tube member in which a plurality of node ring members are rotatably connected, and an end portion is fixed to at least one of the node ring members of the first bending portion. In the state where the bending portion is bent by approximately 90 ° or more by the pulling operation of the operation wire by the bending operation means, the hardness of the second bending portion against bending in the axial direction is connected to the second bending portion. An endoscope apparatus characterized in that it is formed to be smaller than the hardness against bending in the axial direction of the flexible tube.

(付記項11) 湾曲操作手段による操作ワイヤの牽引操作によって湾曲させることが可能な湾曲部の最大湾曲状態において第2湾曲部の軸方向の曲げに対する硬さを第2湾曲部に接続された可撓管の軸方向の曲げに対する硬さよりも小さく形成したことを特徴とする付記項10の内視鏡装置。   (Additional Item 11) In the maximum bending state of the bending portion that can be bent by the pulling operation of the operation wire by the bending operation means, the hardness of the second bending portion with respect to the bending in the axial direction can be connected to the second bending portion. The endoscope apparatus according to Additional Item 10, wherein the endoscope apparatus is formed to be smaller than a hardness against bending in an axial direction of the flexible tube.

(付記項1〜11の従来技術) 実公平1−22641号公報。   (Prior Art of Additional Items 1-11) Japanese Utility Model Publication No. 1-22641.

(付記項1が解決しようとする課題) 実公平1−22641号公報では、第2湾曲部の長さについては考慮されていないため、第2湾曲部と、可撓管との接続部である中継管が体腔内屈曲部に近接すると、図17(A)に示す状態から、可撓管を押し込むと、力が中継管に集中して図17(B)に示すように、腸壁を押し、腸を過伸展させてしまう。更に可撓管を押し込むと、図17(C)に示すように可撓管がたわんでしまい、挿入が困難となり、湾曲を戻す協調動作を行わないと、視野が腸壁の方向を向き、視野が確保できない。   (Problem to be solved by Supplementary Item 1) In Japanese Utility Model Publication No. 1-22641, the length of the second bending portion is not taken into consideration, and therefore, it is a connection portion between the second bending portion and the flexible tube. When the relay tube comes close to the bent part in the body cavity, when the flexible tube is pushed from the state shown in FIG. 17A, the force concentrates on the relay tube and pushes the intestinal wall as shown in FIG. 17B. , Overextending the intestines. When the flexible tube is further pushed in, as shown in FIG. 17C, the flexible tube is bent, insertion becomes difficult, and if the cooperative operation for returning the curvature is not performed, the visual field is directed toward the intestinal wall, Cannot be secured.

(付記項9が解決しようとする課題) 実公平1−22641号公報の構成では、大腸への挿入の際に、挿入部を把持する手の押し引きやねじり操作と、アングル操作を協調させる必要があり、S状結腸等の複雑な屈曲を通過するのは困難であった。   (Problem to be solved by Supplementary Item 9) In the configuration of the Japanese Utility Model Publication No. 1-22641, it is necessary to coordinate the angle operation with the push-pull or twist operation of the hand holding the insertion portion when inserting into the large intestine. And it was difficult to go through complicated bends such as the sigmoid colon.

(付記項10が解決しようとする課題) 実公平1−22641号公報では、第2湾曲部にそれ自身の伸縮量が少ないステーコイルが内蔵されているため、第2湾曲部に外力が与えられた際に第2湾曲部が自由に曲がることができず、湾曲部を湾曲操作手段により湾曲をかけた際には、湾曲によりステーコイルが圧縮ないし伸張させられたことによるステーコイルの復元力が発生することにより、第2湾曲部は外力によっては更に曲がり難くなってしまい、曲げに対する硬さの変化が大きい変化点が第2湾曲部にできたり、第2湾曲部の曲げに対する硬さが、接続された近傍の可撓管の曲げに対する硬さよりも硬くなってしまう。このため、挿入において、湾曲をかけた状態で可撓管を押し込むと、図15(C)に示すように可撓管が撓んで挿入困難となる。   (Problem to be solved by Supplementary Item 10) In Japanese Utility Model Publication No. 1-222641, a stay coil with a small amount of expansion and contraction is incorporated in the second bending portion, so that an external force is applied to the second bending portion. When the bending portion is bent by the bending operation means, the restoring force of the stay coil due to the compression or extension of the stay coil due to the bending is not obtained. Due to the occurrence, the second bending portion becomes more difficult to bend depending on the external force, a change point having a large change in hardness with respect to bending can be formed in the second bending portion, or the hardness of the second bending portion with respect to bending is It becomes harder than the bending resistance of the connected flexible tube. For this reason, when the flexible tube is pushed in a curved state during insertion, the flexible tube is bent as shown in FIG. 15C, making insertion difficult.

(付記項1の作用) 湾曲操作手段の操作により、湾曲部を湾曲させた際に第1湾曲部が湾曲し易く、第2湾曲部は湾曲し難いので第2湾曲部はほとんど湾曲しない。このため、湾曲した状態において、外力による曲げが加えられると、第2湾曲部は湾曲することができる。これにより、大腸挿入時の屈曲部の通過の際に、湾曲部を湾曲した状態で腸壁に押し当てても第2湾曲部が湾曲することにより、腸壁に力がかからない。更に硬質部である湾曲部と可撓管との接続部が屈曲部に近接した際には、先端部は次の屈曲に導入される。   (Operation of Additional Item 1) When the bending portion is bent by the operation of the bending operation means, the first bending portion is easy to bend and the second bending portion is difficult to be bent. Therefore, the second bending portion is hardly bent. For this reason, when the bending by an external force is applied in the curved state, the second bending portion can be curved. As a result, when the bent portion is passed through the large intestine, even if the bent portion is pressed against the intestinal wall in a bent state, the second bent portion is bent, so that no force is applied to the intestinal wall. Further, when the connecting portion between the bending portion, which is a hard portion, and the flexible tube approaches the bending portion, the tip portion is introduced into the next bending.

(付記項9の作用) 肛門から直腸における、腸の屈曲部の通過の為に湾曲部を湾曲させた状態でも第2湾曲部の一部が把持出来る。これを把持して、把持した手で第2湾曲部を曲げれば、第1湾曲部の湾曲形状がこれに連動して変化するので、湾曲操作手段の操作をすることなく第1湾曲部の湾曲形状を調整できる。   (Operation of Supplementary Item 9) A part of the second bending portion can be grasped even in a state where the bending portion is bent for passage of the bent portion of the intestine from the anus to the rectum. If this is gripped and the second bending portion is bent with the gripped hand, the bending shape of the first bending portion changes in conjunction with this, so the first bending portion of the first bending portion can be changed without operating the bending operation means. The curved shape can be adjusted.

(付記項10の作用) 腸の屈曲部の通過の際に、湾曲部を湾曲させた状態で腸壁に押し当てても、可撓管が撓み始める前に第2湾曲部が確実に曲がるので、腸壁に力がかからない。   (Operation of Additional Item 10) When the bent portion of the intestine passes through, even if it is pressed against the intestinal wall in a curved state, the second bent portion is reliably bent before the flexible tube starts to bend. There is no power on the intestinal wall.

本発明の第1の実施の形態の内視鏡装置の全体の概略構成図。1 is an overall schematic configuration diagram of an endoscope apparatus according to a first embodiment of the present invention. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の内部構成を示す縦断面図。The longitudinal cross-sectional view which shows the internal structure of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の第1の湾曲部と第2の湾曲部との接続部分を示す要部の縦断面図。The longitudinal cross-sectional view of the principal part which shows the connection part of the 1st bending part and 2nd bending part of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 一般的な人体の大腸の構造を示す概略構成図。The schematic block diagram which shows the structure of the common large intestine of a human body. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の動作を説明するための説明図。Explanatory drawing for demonstrating operation | movement of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 第1の実施の形態の内視鏡装置における内視鏡の挿入部を大腸の直腸、S状結腸、下行結腸内に挿入する操作を説明するための説明図。Explanatory drawing for demonstrating operation which inserts the insertion part of the endoscope in the endoscopic apparatus of 1st Embodiment into the rectum of the large intestine, the sigmoid colon, and the descending colon. 第1の実施の形態の内視鏡装置における内視鏡の挿入部を大腸の下行結腸から横行結腸内に挿入する操作を説明するための説明図。Explanatory drawing for demonstrating operation which inserts the insertion part of the endoscope in the endoscope apparatus of 1st Embodiment from the descending colon of the large intestine into the transverse colon. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の第1の湾曲部と第2の湾曲部の動作を説明するための説明図。Explanatory drawing for demonstrating operation | movement of the 1st bending part and the 2nd bending part of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の第1の変形例の作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action of the 1st modification of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 第1の変形例の内視鏡の湾曲部の作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action of the bending part of the endoscope of a 1st modification. 内視鏡の挿入部を大腸の直腸からS状結腸へ挿入する作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action which inserts the insertion part of an endoscope from the rectum of a large intestine to a sigmoid colon. 内視鏡の挿入部を大腸の下行結腸から横行結腸へ挿入する作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action which inserts the insertion part of an endoscope from the descending colon of the large intestine to the transverse colon. 第2の湾曲部が第1の湾曲部の湾曲方向と逆の方向に曲がった状態を説明するための説明図。Explanatory drawing for demonstrating the state which the 2nd bending part bent in the direction opposite to the bending direction of a 1st bending part. 第1の実施の形態の内視鏡装置における内視鏡の湾曲部の第2の変形例を示す正面図。The front view which shows the 2nd modification of the bending part of the endoscope in the endoscope apparatus of 1st Embodiment. 本発明の第2の実施の形態の内視鏡装置における内視鏡の湾曲部を示す要部の縦断面図。The longitudinal cross-sectional view of the principal part which shows the curved part of the endoscope in the endoscope apparatus of the 2nd Embodiment of this invention. 第2の実施の形態の内視鏡装置における内視鏡の湾曲部の作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action of the bending part of the endoscope in the endoscope apparatus of 2nd Embodiment. 従来の内視鏡装置における内視鏡の湾曲部の作用を説明するための説明図。Explanatory drawing for demonstrating the effect | action of the bending part of the endoscope in the conventional endoscope apparatus.

符号の説明Explanation of symbols

2…内視鏡、7…挿入部、8…操作部、15…可撓管部、16…湾曲部、17…先端部(先端構成部)、30…湾曲操作ノブ(湾曲操作手段)、37…湾曲駒(節輪部材)、39…第1の湾曲部、40…第2の湾曲部、50…牽引ワイヤ(操作ワイヤ)。     DESCRIPTION OF SYMBOLS 2 ... Endoscope, 7 ... Insertion part, 8 ... Operation part, 15 ... Flexible tube part, 16 ... Bending part, 17 ... Tip part (tip constituent part), 30 ... Bending operation knob (bending operation means), 37 ... bending piece (node ring member), 39 ... first bending portion, 40 ... second bending portion, 50 ... pulling wire (operation wire).

Claims (7)

先端部と、この先端部の基端に接続された湾曲部と、この湾曲部の基端に接続された可撓管とからなる軟性の挿入部の基端部に操作部が連結され、前記湾曲部を湾曲操作する操作ワイヤを牽引操作する湾曲操作手段が前記操作部に設けられた内視鏡装置において、
前記湾曲部は先端側に設けられた第1湾曲部と、この第1湾曲部の基端側に連接され、前記第1湾曲部よりも軸方向の曲げに対する硬さが硬く形成された第2湾曲部とを具備し、
前記第1湾曲部と第2湾曲部はそれぞれ複数の節輪部材を回動自在に連結した湾曲管部材にて形成され、かつ前記第1湾曲部の節輪部材の少なくとも1つに前記操作ワイヤの端部が固定され、
前記挿入部は、前記湾曲操作手段による前記操作ワイヤの牽引操作によって前記湾曲部を略90°以上湾曲させた状態で、前記第2湾曲部の軸方向の曲げに対する硬さを前記可撓管の軸方向の曲げに対する硬さよりも小さくされており、
前記第1湾曲部を最大湾曲状態に湾曲操作した際にも、第2湾曲部はほとんど湾曲しないとともに前記第2湾曲部の前記節輪部材どうしは当接せず、前記第2湾曲部に外力が加わった場合には、前記第2湾曲部が湾曲するようにしたことを特徴とする内視鏡装置。
An operation unit is coupled to a proximal end portion of a soft insertion portion including a distal end portion, a bending portion connected to a proximal end of the distal end portion, and a flexible tube connected to the proximal end of the bending portion, In an endoscope apparatus in which a bending operation means for pulling an operation wire for bending the bending portion is provided in the operation portion,
The bending portion is connected to a first bending portion provided on the distal end side and a proximal end side of the first bending portion, and is formed to have a higher hardness with respect to bending in the axial direction than the first bending portion. A curved portion,
Each of the first bending portion and the second bending portion is formed by a bending tube member in which a plurality of node ring members are rotatably connected, and the operation wire is connected to at least one of the node ring members of the first bending portion. The end of the
The insertion portion is configured to set the hardness of the second bending portion with respect to the axial bending of the flexible tube in a state where the bending portion is bent by approximately 90 ° or more by a pulling operation of the operation wire by the bending operation means. Less than the hardness against axial bending,
Even when the first bending portion is bent to the maximum bending state, the second bending portion hardly bends and the nodal members of the second bending portion do not come into contact with each other, and an external force is applied to the second bending portion. An endoscope apparatus characterized in that the second bending portion is bent when the is added.
前記湾曲部は前記第2湾曲部を被覆する弾性膜部と、前記第1湾曲部と前記弾性膜部を被覆する弾性外皮部材とを有し、前記弾性外皮部材は、前記第1湾曲部を被覆する部分、前記第1湾曲部と前記第2湾曲部の境界部を被覆する部分、前記第2湾曲部を被覆する部分の順に硬さを増して形成されていることを特徴とする請求項1記載の内視鏡装置。   The curved portion includes an elastic membrane portion that covers the second curved portion, an elastic skin member that covers the first curved portion and the elastic membrane portion, and the elastic skin member includes the first curved portion. It is formed by increasing the hardness in the order of a covering portion, a portion covering a boundary portion between the first bending portion and the second bending portion, and a portion covering the second bending portion. The endoscope apparatus according to 1. 前記挿入部は、前記湾曲操作手段による前記操作ワイヤの牽引操作によって湾曲させることが可能な前記湾曲部の最大湾曲状態で、前記第2湾曲部の軸方向の曲げに対する硬さを前記可撓管の軸方向の曲げに対する硬さよりも小さくしたことを特徴とする請求項1または2に記載の内視鏡装置。   The insertion portion has a maximum bending state of the bending portion that can be bent by a pulling operation of the operation wire by the bending operation means, and the flexible tube has a hardness against bending in the axial direction of the second bending portion. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is smaller than a hardness against bending in the axial direction. 前記湾曲操作手段による前記操作ワイヤの牽引操作によって湾曲させることが可能な前記湾曲部の湾曲状態で、前記第1湾曲部の前記複数の節輪部材が回動した際に当接する当接部の間隔よりも、前記第2湾曲部の前記複数の節輪部材が回動した際に当接する当接部の間隔が広いことを特徴とする請求項1〜3の何れか1項に記載の内視鏡装置。   A contact portion that contacts when the plurality of node ring members of the first bending portion rotate in a bending state of the bending portion that can be bent by a pulling operation of the operation wire by the bending operation means; The inner space according to any one of claims 1 to 3, wherein an interval between the contact portions that contact when the plurality of node members of the second bending portion rotate is wider than an interval. Endoscopic device. 前記弾性外皮部材は、前記第1湾曲部を被覆する部分、前記第1湾曲部と前記第2湾曲部の境界部を被覆する部分、前記第2湾曲部を被覆する部分の順に肉厚を増して形成されていることを特徴とする請求項1〜4の何れか1項に内視鏡装置。   The elastic skin member increases in thickness in the order of a portion covering the first bending portion, a portion covering a boundary portion between the first bending portion and the second bending portion, and a portion covering the second bending portion. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is formed. 前記弾性膜部と前記弾性外皮部材とは相互に滑るようにされてなる請求項4〜5の何れか1項に記載の内視鏡装置。   The endoscope apparatus according to any one of claims 4 to 5, wherein the elastic film portion and the elastic skin member are configured to slide relative to each other. 前記第2湾曲部の境界部を被覆する部分は、5mm〜15mmであることを特徴とする請求項4〜6の何れか1項記載の内視鏡装置。   The endoscope apparatus according to any one of claims 4 to 6, wherein a portion covering the boundary portion of the second bending portion is 5 mm to 15 mm.
JP2008093675A 2008-03-31 2008-03-31 Endoscope apparatus Pending JP2008253774A (en)

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WO2019019937A1 (en) * 2017-07-27 2019-01-31 先健科技(深圳)有限公司 Adjustable curved sheath and medical instrument
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