JP2009056055A - Endoscope guiding tube device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope guiding tube device of which the shape is changed passively and very smoothly in accordance with change in the shape of an insertion unit of a flexible endoscope and which can stably maintain the shape, is light and easy to use and of which the diameter can be easily reduced and which therefore is easily inserted from a mouth together with the insertion unit of the flexible endoscope. <P>SOLUTION: Bending shape holding wires 15 whose tip ends are connected to the tip portion of bending portions 11, 12 and 13 are inserted to be freely moved forward and backward in an axial direction inside a flexible guide pipe 17 whose tip end is fixed to the inner peripheral part near the rear ends of the bending portions 11, 12 and 13. The proximal ends of the bending shape holding wires 15 and the proximal end of the guide pipe 17 are each arranged to be freely moved forward and backward in the axial direction in an operation unit 2, and the operation unit 2 is provided with wire locking operation units 22 and 27 capable of freely fixing and unfixing the proximal ends of the bending shape holding wires 15 and guide locking operation units 22 and 27 capable of freely fixing and unfixing the proximal end of the guide pipe 17. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope guide tube that is inserted into a body cavity together with an insertion portion of a flexible endoscope and thereafter functions to keep the posture and orientation of the insertion portion of the flexible endoscope in a stable state. Relates to the device.

  Intra-abdominal surgery such as cholecystectomy was previously performed by so-called laparotomy in which the abdomen is incised. Recently, a few centimeters of holes are made in the abdomen, and then a rigid endoscope is used. Laparoscopic surgery in which treatment is performed by inserting a laparoscope, a surgical treatment tool, or the like is widely performed. However, even in such a laparoscopic operation, it takes a certain amount of time for the patient who has undergone the operation to recover, and even though it is small, a wound remains on the patient's body surface.

  Therefore, a flexible endoscope is inserted into the stomach through the mouth, and a hole is made in the stomach wall with a treatment instrument passed through the treatment instrument insertion channel of the flexible endoscope, and then transendoscopically ( That is, a technique for performing intra-abdominal surgery (through a treatment instrument insertion channel of an endoscope) has attracted attention. The hole made in the stomach wall is closed with an endoscopic clip after the operation is completed.

  However, it is difficult for the insertion portion of the flexible endoscope to stabilize the posture and orientation of the tip for a long time during the operation, and the posture and orientation of the insertion portion tip during the operation are contrary to the operator's will. If changed, transendoscopic abdominal surgery cannot be performed smoothly.

  Therefore, a flexible tubular body that can be inserted through the insertion portion of the flexible endoscope and passively changes its shape in response to a change in shape of the insertion portion of the flexible endoscope, and the tubular body It is conceivable to use an endoscope guide tube device provided with a shape holding means for holding the shape in combination with a flexible endoscope.

Such an endoscope guide tube device for a flexible endoscope has not been devised so far for the purpose of transendoscopic abdominal surgery, Several insertion aids for insertion into the large intestine have been devised (for example, Patent Documents 1 and 2).
Special table 2006-512935 JP 2005-318956 A

  In the conventional endoscope guide tube devices described in Patent Documents 1 and 2, etc., the framework of the flexible insertion tube in which the endoscope guide channel is inserted and arranged near the axial position has a through hole in the center. It is configured by superposing a large number of bowl-shaped joints in series, and by pulling a wire or a mesh tube arranged around the joint to the base end side and applying a frictional resistance between the joints, The bent shape can be maintained.

  However, in such a configuration, a traction mechanism for strongly pulling a wire, a mesh tube, etc. to the proximal end side is necessary, so that the configuration becomes sturdy, heavy and large, and between a large number of joints. Since the shape is held by frictional resistance, slippage may occur between the joints due to the action of some external force, and the holding shape may change, and sufficient frictional force is obtained while ensuring the diameter of the guide pipe line. For this purpose, the outer diameter of the bowl-shaped joint must be increased in order to increase the contact area, so that it is extremely difficult to apply to a device inserted into the body through the mouth.

  The present invention can passively very smoothly change shape corresponding to the shape change of the insertion portion of the flexible endoscope and can stably hold the shape, and is lightweight and easy to use. It is another object of the present invention to provide an endoscope guide tube device that can be easily reduced in diameter and can be easily inserted from a mouth together with an insertion portion of a flexible endoscope.

  In order to achieve the above object, an endoscope guide tube device according to the present invention has a flexible endoscope guide tube that can be inserted through a insertion portion of a flexible endoscope and can be inserted into and removed from a body cavity. An endoscope guide tube device having a structure inserted and arranged in a flexible insertion tube, wherein a plurality of short cylindrical joint rings are adjacent to the entire flexible insertion tube or a portion near the tip. A bending portion having a framework that is connected in series with a connecting shaft so as to be rotatable relative to a joint ring that is configured to be bent in all directions as a whole is provided, and the bending portion is an endoscope guide tube The tip of the bending shape holding wire is passively changeable in response to the shape change of the insertion portion of the flexible endoscope inserted into the path, and the tip of the bending portion is the tip of the bending portion. The curved shape holding wire is connected to the portion, and a flexible gage whose tip is fixed to the inner peripheral portion near the rear end of the curved portion. In the operation part which is inserted into the pipe pipe so as to be able to advance and retract in the axial direction and is arranged on the proximal end side of the flexible insertion tube, the proximal end part of the curved shape holding wire and the proximal end part of the guide pipe are respectively axially arranged. A wire lock operating device that can be fixed and unfixed to the base end portion of the curved shape holding wire, and a guide lock operating device that can fix and release the base end portion of the guide pipe. It is what has been.

  The guide pipe may be a coil pipe formed by tightly winding a metal wire with a constant diameter. The wire lock operating device and the guide lock operating device may be configured by a single mechanism, in which case the proximal end portion of the curved shape holding wire and the proximal end portion of the guide pipe are simultaneously fixed and released. You may make it do.

  In addition, it is preferable that at least three curved shape holding wires are provided, and are arranged at intervals between each other so that there is no gap of 180 ° or more around the axis of the bending portion. Most of the pipe line may be formed of a flexible tube that is inserted and disposed near the axial position of the flexible insertion tube.

  An annular seal member for sealing a gap between the insertion portion of the flexible endoscope passed through the proximal end opening of the endoscope guide conduit may be disposed. The curved portion may be covered with an elastic skin tube.

  In addition, a plurality of bending portions are connected in series, and the guide lock operating device can freely fix and release the base end portions of all the guide pipes connected to the vicinity of the rear ends of each of the plurality of bending portions. In the case where the bending portion is provided near the distal end of the flexible insertion tube, a portion other than the bending portion of the flexible insertion tube is inserted into the endoscope guide conduit. Alternatively, the flexible endoscope may be a flexible tube portion that is passively changeable in shape corresponding to the shape change of the insertion portion of the flexible endoscope and has no shape retention.

  Further, the guide lock operating device has a fixed seat having a tapered conical outer surface along the proximal end portion of the curved shape holding wire, and an inner surface tapered hole facing the conical surface of the fixed seat. A taper cylinder that is disposed so as to be movable back and forth in the direction, and an operation member for driving the taper cylinder to advance and retreat in the axial direction. When the taper cylinder is moved rearward by the operation member, the guide pipe When the proximal end portion of the guide pipe is fixed between the tapered tube body and the fixed seat and the proximal end portion of the guide pipe is fixed to the operation portion, and the tapered tubular body is moved forward, the proximal end portion of the guide pipe is moved in the axial direction. You may make it become a movable state.

  In that case, the inner peripheral surface of the tapered cylindrical body may be formed of an elastic member, and is sandwiched between the tapered cylindrical body and the fixed seat near the proximal end of the curved shape holding wire. The wire base end cap that is fixed to the base plate may be fixed.

  Further, the base end portion of the wire base and the base end portion of the guide pipe may have the same outer diameter and may be sandwiched between the tapered cylinder and the fixed seat at the same time. The linear guide groove for guiding the proximal end portion of the guide pipe so as to freely advance and retract in the axial direction may be formed with a depth smaller than the diameter of the proximal end portion of the guide pipe.

  In addition, a plurality of guide shafts for guiding the taper cylinder so as to be movable forward and backward in the axial direction may be provided in the operating portion, and the operating female screw ring in which the operating member is disposed in the operating portion so as to be rotatable around the axis. In this case, the taper cylinder may be formed with a male screw that is screwed with the operation female screw ring, and the taper cylinder may be moved in the axial direction by rotating the operation female screw ring about the axis.

  According to the present invention, the proximal end portion of the curved shape holding wire whose distal end is connected to the distal end portion of the bending portion and the proximal end portion of the guide pipe through which the curved shape holding curve is inserted can move forward and backward in the axial direction. Due to the arrangement, the bending portion can passively very smoothly change shape corresponding to the shape change of the insertion portion of the flexible endoscope inserted into the endoscope guide conduit. And a wire lock operating device that can fix and release the proximal end portion of the curved shape holding wire, and a guide lock operation device that can fix and release the proximal end portion of the guide pipe. The bending shape of the bending portion can be stably held, and it is not necessary to pull the bending shape holding wire, and it is sufficient to provide a mechanism for simply fixing, so it is lightweight and easy to use. Short cylinder Because it is constituted by wheels, readily achieves the special effects such as can be easily inserted from the mouth with insertion of the smaller diameter to a flexible endoscope.

  Endoscope guide tube having a configuration in which a flexible endoscope guide channel that can be inserted through an insertion portion of a flexible endoscope is inserted into a flexible insertion tube that can be inserted into and removed from a body cavity. In the apparatus, a plurality of short cylindrical joint rings are connected in series with a connecting shaft so as to be rotatable relative to adjacent joint rings on the entire flexible insertion tube or a portion near the tip. A bending portion having a skeleton that is configured to be freely bent in all directions is provided as a whole, and the bending portion can change the shape of the insertion portion of the flexible endoscope inserted into the endoscope guide conduit. Correspondingly, the shape can be passively changed, and the tip of the curved shape holding wire for holding the shape is connected to the tip portion of the curved portion, so that the curved shape holding wire is located near the rear end of the curved portion. Inserted into a flexible guide pipe whose tip is fixed to the inner circumference so that it can advance and retract in the axial direction. The proximal end portion of the curved shape holding wire and the proximal end portion of the guide pipe are disposed so as to be movable back and forth in the axial direction, and the proximal end portion of the curved shape holding wire There are provided a wire lock operating device capable of fixing and releasing the guide and a guide lock operating device capable of fixing and releasing the base end portion of the guide pipe.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows an overall configuration of an endoscope guide tube apparatus according to an embodiment of the present invention. The endoscope guide tube apparatus is flexible so that it can be bent in any direction and can be inserted into and removed from a body cavity as a whole. The insertion tube 1 and the operation unit 2 connected to the proximal end of the flexible insertion tube 1 are configured.

  The connecting portion between the base end of the flexible insertion tube 1 and the operation portion 2 has a tapered tapered cylindrical shape in order to prevent the vicinity of the base end of the flexible insertion tube 1 from being bent suddenly and buckled. A crease stopper 3 made of an elastic rubber material or the like formed on is attached.

  A state near the tip of the flexible insertion tube 1 is a state in which a first bending portion 11, a second bending portion 12, and a third bending portion 13, which can be bent in any direction, are connected in series. The portion near the base end of the flexible insertion tube 1 is a flexible tube portion 14 that can be bent in any direction.

  The difference between each of the bending portions 11, 12, 13 and the flexible tube portion 14 is that the bending portions 11, 12, 13 each have a bent shape arranged on the operation portion 2 (operation member). However, the flexible tube portion 14 cannot hold the bent shape, which will be described later in detail.

  It should be noted that the flexible tube portion 14 is not necessarily provided depending on the use or procedure of the endoscope guide tube device. In that case, the entire flexible insertion tube 1 becomes a curved portion. In addition, the number of connecting portions of the bending portion can be selected as appropriate according to the use or technique of the endoscope guide tube device, such as only one or a plurality other than three, and the plurality of bending portions 11, 12, There may be a short flexible tube portion 14 or a hard portion between 13.

  In the flexible insertion tube 1, a flexible endoscope guide conduit 4 that can be inserted through an insertion portion of a flexible endoscope (not shown) is disposed in the vicinity of the axial position over the entire length. The proximal end opening 4a of the endoscope guide conduit 4 is disposed on the rear end surface of the operation unit 2, and the endoscope guide conduit is provided on the distal end face of the distal end cap 10 provided at the foremost end of the flexible insertion tube 1. Four tip openings 4b are arranged.

  As a result, an insertion portion (not shown) of the flexible endoscope is inserted into the endoscope guide duct 4 from the proximal end opening 4a, and the distal end portion of the insertion portion is arbitrarily moved forward from the distal end opening 4b. Can be plunged.

  FIG. 2 shows the configuration of the flexible insertion tube 1. The distal end cap 10 is formed in a substantially cylindrical shape by a metal or a hard plastic material or the like and is connected to the distal end portion of the first bending portion 11 to form most of the endoscope guide conduit 4, for example, tetrafluoride. A distal end portion of a flexible tube made of an ethylene resin tube or the like is bonded and fixed to the distal end cap 10 in a watertight manner from the rear. The flexible tube can be flexibly bent together with the insertion portion of the flexible endoscope inserted into the flexible tube.

  The endoscope guide conduit 4 is not shown in FIG. 2 except for the vicinity of the most distal portion. However, the flexible tube forming the endoscope guide conduit 4 is inserted through the entire length of the flexible insertion tube 1, and the base end thereof is located in the operation unit 2.

  In addition, in order to improve the buckling resistance of the flexible tube forming the endoscope guide conduit 4, as illustrated in FIG. 3, along the spiral groove 4c formed on the outer periphery of the flexible tube. Further, a reinforcing structure such as winding the coil spring 4d may be adopted.

  Returning to FIG. 2, the first bending portion 11 includes a plurality of (for example, about 5 to 30) short cylindrical joint rings 7 that protrude from each joint ring 7 in both the front and rear directions. It has a skeleton that is connected in series with a connecting shaft 8 so as to be rotatable relative to the adjacent articulation ring 7 and is bent in all directions as a whole. Since the articulation ring 7 only needs to have a thickness of about 0.3 to 0.4 mm, the outer diameter can be reduced.

  FIG. 4 illustrates a state in which the framework of the first bending portion 11 is bent to the maximum extent, and such a configuration and function are the same as the framework of the bending portion of a general endoscope. In addition, the arrangement of the connecting shaft 8 is changed by 90 ° at the front and rear positions of each joint ring 7. However, other angle changes (for example, 60 °, etc.) may be used.

  Returning again to FIG. 2, the tip of the first curved shape holding wire 15 </ b> A is fixedly connected to the inner peripheral portion of the most advanced joint ring 7 of the first bending portion 11. As the first curved shape holding wire 15A, a stainless steel stranded wire similar to a bending operation wire of a general endoscope can be used.

  In the first bending portion 11, the first curved shape holding wire 15 </ b> A is passed through the wire guide holes 9 that protrude inward from the inner peripheral portions of the plurality of joint rings 7 and are arranged at appropriate intervals. Although only one is shown in FIG. 2 for the purpose of clearly illustrating the structure of the other members that are guided, as shown in FIG. Four first curved shape holding wires 15A are arranged around the axis of the curved portion 11 at approximately 90 ° intervals, and the respective distal end portions thereof are fixed to the inner peripheral portion of the most advanced joint ring 7. It is connected.

  As shown in FIG. 2, each first curved shape holding wire 15 </ b> A has a flexible first guide pipe 17 </ b> A whose tip is fixed to the inner peripheral portion near the rear end of the first curved portion 11. It is inserted in the shaft so as to be movable back and forth in the axial direction.

  Each of the four first guide pipes 17A is not fixed to other members except for the distal end portion, and is arranged around the axis of the first bending portion 11 in accordance with the arrangement of the first bending shape holding wire 15A. Are arranged in the flexible insertion tube 1 in a direction parallel to the axis with an interval of approximately 90 °. Then, the base end of each first guide pipe 17 </ b> A reaches the operation unit 2.

  In this embodiment, a coil pipe in which a metal wire such as a stainless steel wire is closely wound with a constant diameter is used as the first guide pipe 17A. However, other pipes can be used as long as they are flexible pipes excellent in compression resistance in the axial direction.

  The first bending portion 11 is covered with a flexible and elastic outer tube 16 such as a rubber tube in a watertight manner so that the outer tube 16 is not sandwiched between the adjacent joint rings 7. A mesh tube is disposed inside the tube 16.

  In this embodiment, the entire flexible insertion tube 1 is continuously covered with one outer tube 16, but the first bending portion 11, the second bending portion 12, and the third bending portion. 13 and the flexible tube portion 14 may be covered with separate outer tube, or only the flexible tube portion 14 may be covered with a synthetic resin tube slightly harder than rubber.

  The first bending portion 11 configured as described above is configured so that the four first bending shape holding wires 15A are not fixed except at the distal end and are movable in the axial direction. The shape of the flexible endoscope inserted through the guide duct 4 can be passively changed in response to the change in shape of the insertion portion. When the proximal ends of all the first curved shape holding wires 15A and the proximal ends of the first guide pipes 17A are respectively fixed to the operation unit 2, the shape of the first curved portion 11 cannot be changed. The bent shape is maintained.

  In order to prevent the first bending portion 11 from changing its shape by fixing the base ends of all the first bending shape holding wires 15A, there are at least three first bending shape holding wires 15A. That's fine. However, it is necessary to arrange the first curved shape holding wires 15 </ b> A at intervals between each other in a positional relationship in which there is no gap of 180 ° or more around the axis of the first curved portion 11.

  Further, even when four first curved shape holding wires 15A are provided as in this embodiment, each first curved shape holding wire 15A is 180 ° or more around the axis of the first curved portion 11. If they are arranged in a positional relationship where there is no gap, it is not always necessary to arrange them at equal intervals.

  The configuration of the second bending portion 12 is the same as the configuration of the first bending portion 11, and the plurality of joint rings 7 are connected in series by the connecting shaft 8 so as to be rotatable relative to the adjacent joint rings 7. As a whole, it has a framework that can be bent in any direction.

  The distal end of the second curved shape holding wire 15B is fixedly connected to the inner peripheral portion of the most advanced joint ring 7 of the second curved portion 12, and is aligned with the second curved shape holding wire 15B. Each of the second curved shape holding wires 15B can be moved forward and backward in the axial direction in a flexible second guide pipe 17B whose tip is fixed to the inner peripheral portion near the rear end of the second curved portion 12. It is inserted. The second guide pipe 17 </ b> B is not fixed to the other members except for the distal end portion, and the base end thereof reaches the operation portion 2.

  FIG. 6 shows a cross section (VI-VI cross section in FIG. 2) perpendicular to the axis of such a second bending portion 12, and the four second curved shape holding wires 15B are the first bending. The second bending portion 12 is disposed at substantially 90 ° intervals around the axis of the second bending portion 12 at a position displaced with respect to the shape holding wire 15A.

  The second bending portion 12 configured as described above is also configured so that the four second bending shape holding wires 15B are movable in the axial direction without being fixed except at the distal ends. The shape of the flexible endoscope inserted through the guide duct 4 is passively changeable in response to the shape change of the insertion portion, and the base ends of the second curved shape holding wires 15B and the second When the base ends of the guide pipes 17B are respectively fixed to the operation unit 2, the shape of the second bending portion 12 cannot be changed and the shape thereof is maintained.

  The configuration of the third bending portion 13 is also the same as the configuration of the first and second bending portions 11 and 12, and is shown in FIG. 7 illustrating a cross section perpendicular to the axis (VII-VII cross section in FIG. 2). As described above, the four third curved shape holding wires 15C are displaced around the axis of the third curved portion 13 at a position displaced from the first curved shape holding wires 15A and the second curved shape holding wires 15B. They are arranged at approximately 90 ° intervals.

  Then, as shown in FIG. 2, a flexible third of which the tip is fixed to the inner peripheral portion near the rear end of the third bending portion 13 in alignment with the third bending shape holding wire 15C. Each of the third curved shape holding wires 15C is inserted into the guide pipe 17C so as to be movable back and forth in the axial direction. The third guide pipe 17 </ b> C is also not fixed to other members except for the distal end portion, and its proximal end reaches the operation portion 2. If the flexible tube portion 14 is not provided, the third guide pipe 17C may be omitted.

  As a result, the third bending portion 13 is also in a state where the four third bending shape holding wires 15C are movable in the axial direction without being fixed except for the distal ends, so that the endoscope guide conduit The shape of the insertion portion of the flexible endoscope inserted through 4 is passively changeable in response to the shape change, and the base ends of all the third curved shape holding wires 15C and the third guide pipes When the base ends of 17C are respectively fixed to the operation unit 2, the shape change of the third bending portion 13 becomes impossible and the shape thereof is held.

  In this way, the first bending portion 11, the second bending portion 12, and the third bending portion 13 connected in series are passively independent of the bending shape and bending direction of the other bending portions, respectively. Since the shape can be freely changed, the bent shape can be accurately traced by the first bending portion 11, the second bending portion 12, and the third bending portion 13 even in a three-dimensionally winding organ. Moreover, since the guide pipes 17A, 17B, and 17C for guiding the curved shape holding wires 15A, 15B, and 15C are freely movable in the axial direction except for the tip portions, the curved portions 11, 12, and 13 are provided. The flexible tube portion 14 can be bent smoothly with extremely small resistance.

  If the base ends of all the curved shape holding wires 15A, 15B, and 15C and the base ends of all the guide pipes 17A, 17B, and 17C are fixed to the operation unit 2, the bending of all the curved portions 11, 12, and 13 is performed. The shape can be maintained as it is, and all the curved portions 11, 12, and 13 are stably held without being affected by each other in a bent state (or in a straight state) on different planes. be able to.

  The flexible tube portion 14 has the same configuration as an insertion portion of a general flexible endoscope, and its framework is formed by a helical tube 18. The spiral tube 18 is formed by spirally winding a stainless steel strip or the like with a constant diameter. For example, the spiral tube 18 is configured by overlapping two spiral tubes having different winding directions.

  The outer periphery of the spiral tube 18 is covered with a mesh tube for preventing extension and twisting, and the outermost layer is covered with an outer tube 16. However, a configuration in which a short cylinder similar to the joint ring 7 is connected instead of the spiral tube may be employed.

  As shown in FIG. 8 illustrating a VIII-VIII cross section, the endoscope guide conduit 4 is disposed in the vicinity of the axial position in the flexible tube portion 14, and 12 curved shape holding wires are disposed around the endoscope guide conduit 4. 15A, 15B, and 15C are in a state of being disposed through the guide pipes 17A, 17B, and 17C.

  The flexible tube portion 14 configured in this way corresponds to the change in shape of the insertion portion of the flexible endoscope inserted into the endoscope guide conduit 4, and each bending portion 11, 12, 13. Regardless of the bending shape and the bending direction, the shape can always be passively changed, and the shape is not retained.

  9 and 10 show the operation unit 2, FIG. 9 is a side sectional view, and FIG. 10 is an XX sectional view thereof. However, FIG. 9 illustrates different cross-sections (IX-O-IX cross-section in FIG. 10) in the upper half and the lower half.

  As shown in FIG. 9, the insertion tube connecting member 21 to which the base end cap 14 a of the flexible tube portion 14 is screwed and the flexible tube forming the endoscope guide line 4 is the axis. A fixed seat 22 that passes through the position is connected and fixed by four guide shafts 23. As shown in FIG. 10, the guide shaft 23 is arranged in parallel with the axis at 90 ° intervals around the axis of the endoscope guide conduit 4. 3 is the above-mentioned folding stop.

  The proximal end of the flexible tube forming the endoscope guide conduit 4 is sandwiched between a tube fixing member 24 fixed to the fixing seat 22 with screws and the fixing seat 22, and is fixed in a watertight manner there. In addition, the proximal end opening 4 a of the endoscope guide conduit 4 is formed in the endoscope insertion base portion 25 that is formed to protrude rearward from the tube fixing member 24. Note that the fixing seat 22, the tube fixing member 24, and other members arranged in the operation unit 2 may be divided into a plurality of parts according to the convenience of parts manufacture and assembly.

  An annular seal valve 26 (seal member) made of a resilient rubber material or the like is detachably attached to the endoscope insertion base portion 25. The seal valve 26 is formed with an endoscope passage hole having an inner diameter slightly smaller than the outer diameter of the insertion portion of the flexible endoscope passed therethrough, and the outer surface of the insertion portion of the flexible endoscope. By being in pressure contact with each other, the flexible endoscope has a function of sealing so that gas or liquid does not pass through the gap between the insertion portion without hindering the advancement / retraction operation and rotation operation of the flexible endoscope.

  The outer peripheral surface of the fixed seat 22 is formed in a conical surface shape whose outer diameter gradually decreases toward the tip side, and the tapered cylindrical body 27 formed with an inner surface-shaped tapered hole facing the conical surface is 4 The guide shaft 23 is supported so as to be slidable in the front-rear direction.

  The inner peripheral surface of the tapered cylindrical body 27 that faces the conical surface on the outer periphery of the fixed seat 22 is formed by an elastic pressure contact member 28. Specifically, a pressure contact member 28 made of a rubber material having elasticity and a certain degree of hardness is formed on the inner peripheral surface portion of the tapered cylindrical body 27 formed of a metal member by a lining or the like. 27 is attached in an integrated state.

  The male screw formed on the outer peripheral portion of the tapered cylindrical body 27 is screwed with the female screw formed on the inner peripheral portion of the operating female screw ring 5. Reference numeral 30 denotes the screwing portion. Although the internal thread 5 for operation is rotatably arranged around the axis, the movement in the axial direction is restricted by a cover cylinder 31 fixed to the insertion tube connecting member 21 with screws. Therefore, by rotating the internal thread ring 5 for operation around the axis, the tapered cylindrical body 27 screwed together is driven to advance and retreat in the axial direction along the guide shaft 23.

  A linear guide groove 32 having a constant width and a constant depth is formed in the conical surface on the outer periphery of the fixed seat 22 so as to be straight in the slope direction, and the proximal end portion of the curved shape holding wire 15 and the proximal end portion of the guide pipe 17 are formed. Are guided in the straight guide groove 32. In addition, although the code | symbol of the curved shape holding wire 15 and the guide pipe 17 is "15A, 15B, 15C" and "17A, 17B, 17C" correctly, it is abbreviated as "15" and "17" below. .

  A hard wire base end cap 33 having the same outer diameter as the outer diameter of the guide pipe 17 is fixed to the base end or the vicinity of the base end of each curved shape holding wire 15, and the linear guide groove 32 is shown in FIG. Thus, the number corresponding to the number of guide pipes 17 (here, 12) is formed on the outer peripheral portion of the fixed seat 22 at equal intervals.

  Each linear guide groove 32 is provided so that the proximal end portion of the guide pipe 17 and the proximal end portion of the wire can be guided without resistance when the proximal end portion of the guide pipe 17 and the wire proximal end cap 33 are moved in the axial direction. It is formed to have a width slightly larger than the outer diameter of the gold 33.

  The depth of the straight guide groove 32 is slightly smaller than the diameter of the base end portion of the guide pipe 17 and the wire base end cap 33 (for example, 1/2 to the diameter of the base end portion of the guide pipe 17 and the wire base end cap 33). About 3/4). Therefore, the base end portion of the guide pipe 17 and the wire base end cap 33 are loosely stored in the linear guide groove 32 in a state of protruding slightly from the surface of the conical surface of the fixed seat 22.

  It should be noted that a sealing O-ring or the like is appropriately attached to the boundary between the members constituting the operation unit 2, and the internal space in which the curved shape holding wire 15 or the like is disposed is watertight to the outside. It is sealed. Such an internal space is connected from the distal end portion of the flexible insertion tube 1 to the inside of the operation unit 2.

  Therefore, when the endoscope guide tube device is housed in a sterilizer or the like after use and placed in an environment close to a vacuum, the flexible outer tube 16 that sheathes the flexible insertion tube 1 may swell. There is sex. Therefore, a check valve that opens when the pressure in the internal space of the endoscope guide tube device is higher than the external pressure by a certain level or communicates between the internal space and the outside. If an open valve or the like (not shown) that can be maintained at this position is disposed in the operation unit 2, such a phenomenon can be prevented.

  In the endoscope guide tube device of the embodiment configured as described above, all the 12 curved shape holding wires 15 and the guide pipe 17 are freely moved in the axial direction except that their tips are fixed. The operation unit 2 is not provided with any drive means for pushing and pulling the proximal end portions of the curved shape holding wire 15 and the guide pipe 17 in the axial direction to drive them forward and backward.

  As shown in FIG. 9, the base end portion of the guide pipe 17 and the base end portion of the curved shape holding wire 15 to which the wire base end cap 33 is attached are linear guide grooves formed in the fixed seat 22. Each is arranged in the axial direction so as to be able to advance and retreat in the axial direction, and the press contact member 28 of the tapered cylindrical body 27 faces from the side with a slight gap therebetween.

  Therefore, in this state, when the flexible insertion tube 1 is bent at each portion, the proximal end portion of each curved shape holding wire 15 and the proximal end portion of the guide pipe 17 correspond to the position, size and direction of the bending. The first bending portion 11, the second bending portion 12, the third bending portion 13, and the flexible tube portion 14 can be inserted into the endoscope guide conduit 4 respectively. The shape changes passively in response to the shape change of the insertion portion of the flexible endoscope.

  Then, as shown in FIG. 11, when the operation female screw ring 5 is rotated to move the taper cylinder 27 rearward (rightward in the figure), it is provided on the inner peripheral surface of the taper cylinder 27. The pressure contact member 28 is pressed against the guide pipe 17 and the wire base end cap 33, and the base end portion of the guide pipe 17 and the wire base end cap 33 are sandwiched between the tapered cylindrical body 27 and the fixed seat 22 and fixed. It will be in the state.

  At this time, since the elastic pressure contact member 28 is provided on the inner peripheral surface of the tapered cylindrical body 27, the base ends of the twelve guide pipes 17 are provided even if there is a slight variation in the dimensions of each member. The portion and the wire base end cap 33 are all pressed and fixed together between the tapered cylinder 27 and the fixed seat 22. Note that the pressure contact member 28 may be provided not on the inner peripheral surface of the tapered cylindrical body 27 but on the bottom surface side of the linear guide groove 32.

  As a result, the first bending portion 11, the second bending portion 12, and the third bending portion 13 substantially maintain the bent shape that they had immediately before being fixed, and the three bending portions 11, 12 and 13 are fixed to the independent bend magnitude and direction, so that the bend state can be maintained even in a complicated three-dimensional shape, and the bend shape is lost even if some external force is applied. Not.

  Then, when the female thread for operation 5 is rotated in the reverse direction to move the tapered cylinder 27 forward (leftward in the figure), the original state shown in FIG. All of the portions and the wire base end cap 33 can be freely moved in the axial direction, and the shapes of all the curved portions 11, 12, 13 are the insertion portions of the flexible endoscope in the endoscope guide conduit 4. In response to the shape change, the shape is passively changed.

  As described above, in this embodiment, the base end portions of all the curved shape holding wires 15 can be fixed and released together, and the base end portions of all the guide pipes 17 can be fixed and released. The guide lock operating device is composed of a single mechanism including a fixed seat 22 and a tapered cylindrical body 27. However, the wire lock operating device and the guide lock operating device may be configured separately. In that case, the curved shape holding wire 15 may be directly pressed and fixed without providing the wire base end cap 33.

  FIG. 12 shows an example of the state of use of the endoscope guide tube device. First, the distal end 51a of the insertion portion 51 of the flexible endoscope 50 inserted through the endoscope guide conduit 4 is allowed to pass. It protrudes from the distal end of the flexible insertion tube 1 and is inserted into the stomach from the patient's mouth A via the esophagus in a state in which the curved portions 11, 12, and 13 passively change shape.

  Then, the distal end of the flexible insertion tube 1 is projected from the hole B formed in the stomach wall to the back side of the stomach, and the distal end 51a of the insertion portion 51 of the flexible endoscope 50 faces the gallbladder C or the like of the surgical target. Then, the bending shape of the bending portions 11, 12, 13 is fixed by operating the operating female screw ring 5.

  Accordingly, the bent shape of each of the bending portions 11, 12, 13 is maintained as it is, so that the treatment for the gallbladder C is performed by the endoscope treatment tool 60 or the like inserted through the treatment tool insertion channel of the flexible endoscope 50. The operation can be performed safely and smoothly, while the endoscope guide tube device is left as it is, and the flexible endoscope 50 can be replaced as quickly as necessary. Can do. Reference numeral 60 a denotes a distal end portion of the endoscope treatment tool 60.

  Note that the present invention is not limited to the above-described embodiments.For example, the wire lock operating device and the guide lock operating device are not limited to a mechanism that moves the tapered hole facing the conical surface in the axial direction. Various mechanisms can be applied.

It is a side view which shows the whole structure of the endoscope guide tube apparatus of the Example of this invention. It is side surface sectional drawing of the flexible insertion tube of the endoscope guide tube apparatus of the Example of this invention. It is a side surface fragmentary sectional view of the endoscope guide channel of the endoscope guide tube apparatus of the Example of this invention. It is a single-piece | unit perspective view of the state in which the framework of the bending part of the endoscope guide tube apparatus of the Example of this invention was bent. It is VV sectional drawing in FIG. 2 of the endoscope guide tube apparatus of the Example of this invention. It is VI-VI sectional drawing in FIG. 2 of the endoscope guide tube apparatus of the Example of this invention. It is VII-VII sectional drawing in FIG. 2 of the endoscope guide tube apparatus of the Example of this invention. It is VIII-VIII sectional drawing in FIG. 2 of the endoscope guide tube apparatus of the Example of this invention. It is side surface sectional drawing of the operation part of the endoscope guide tube apparatus of the Example of this invention. It is XX sectional drawing in FIG. 9 of the endoscope guide tube apparatus of the Example of this invention. It is side surface sectional drawing of the operation part of the state which hold | maintained the shape of the bending part in the endoscope guide tube apparatus of the Example of this invention. It is a schematic diagram which shows an example of the use condition of the endoscope guide tube apparatus of the Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Flexible insertion tube 2 Operation part 4 Endoscope guide conduit 4a Base end opening 4b End opening 5 Internal thread ring for operation (operation member)
7 joint ring 8 connecting shaft 9 outer tube 11 first bending portion 12 second bending portion 13 third bending portion 14 flexible tube portion 15 bending shape holding wire 15A first bending shape holding wire 15B second bending Shape holding wire 15C Third curved shape holding wire 17 Guide pipe 17A First guide pipe 17B Second guide pipe 17C Third guide pipe 22 Fixed seat (wire lock operating device, guide lock operating device)
23 Guide shaft 26 Seal valve (seal member)
27 Tapered cylinder (wire lock operating device, guide lock operating device)
28 pressure contact member 30 screwing portion 32 linear guide groove 33 wire base end cap 50 flexible endoscope 51 insertion portion

Claims (17)

Endoscope guide tube having a configuration in which a flexible endoscope guide channel that can be inserted through an insertion portion of a flexible endoscope is inserted into a flexible insertion tube that can be inserted into and removed from a body cavity. A device,
A plurality of short cylindrical joint rings are connected in series with a connecting shaft so as to be relatively rotatable with the adjacent joint rings in the whole of the flexible insertion tube or a portion near the distal end. A bending portion having a framework configured to be freely bent in a direction,
The bending portion is passively changeable in response to a change in shape of the insertion portion of the flexible endoscope inserted through the endoscope guide conduit, and maintains the shape. In the flexible guide pipe, the distal end of the curved shape holding wire is coupled to the distal end portion of the curved portion, and the curved shape retaining wire is fixed to the inner peripheral portion near the rear end of the curved portion. Is inserted in the axis direction so that it can freely advance and retract.
In the operation portion disposed on the proximal end side of the flexible insertion tube, a proximal end portion of the curved shape holding wire and a proximal end portion of the guide pipe are disposed so as to be movable forward and backward in the axial direction, respectively. A wire lock operation device capable of fixing and releasing the base end portion of the curved shape holding wire, and a guide lock operation device capable of fixing and releasing the base end portion of the guide pipe are provided. Endoscope guide tube device.   The endoscope guide tube apparatus according to claim 1, wherein the guide pipe is a coil pipe formed by tightly winding a metal wire with a constant diameter.   The endoscope guide tube apparatus according to claim 1 or 2, wherein the wire lock operating device and the guide lock operating device are configured by a single mechanism.   The endoscope guide tube device according to claim 3, wherein a proximal end portion of the curved shape holding wire and a proximal end portion of the guide pipe are simultaneously fixed and released.   5. The apparatus according to claim 1, wherein at least three curved shape holding wires are provided and are spaced apart from each other in a positional relationship in which there is no gap of 180 ° or more around the axis of the curved portion. An endoscope guide tube device according to any one of the above items.   The most part of the said endoscope guide pipe line is formed of the flexible tube penetrated and arrange | positioned by the axial position vicinity of the said flexible insertion pipe | tube. Endoscope guide tube device.   The annular seal member for sealing the clearance gap between the insertion part of the flexible endoscope passed through to the proximal-end opening part of the said endoscope guide conduit is arrange | positioned. The endoscope guide tube device according to any one of Items 6 to 6.   The endoscope guide tube device according to any one of claims 1 to 7, wherein the curved portion is covered with a flexible outer tube.   A plurality of the bending portions are connected in series, and the guide lock operating device fixes and releases the base end portions of all the guide pipes connected near the rear ends of the plurality of bending portions together. The endoscope guide tube device according to any one of claims 1 to 8, which is free.   In the case where the bending portion is provided at a portion near the tip of the flexible insertion tube, a portion other than the bending portion of the flexible insertion tube is inserted into the endoscope guide conduit. The flexible tube portion according to any one of claims 1 to 9, wherein the flexible endoscope portion is passively changeable in shape in response to a change in shape of the insertion portion of the flexible endoscope and has no shape retaining property. The endoscope guide tube device described. The guide lock operating device is formed with a fixed seat having a tapered conical outer surface along which the proximal end portion of the curved holding wire is formed, and an inner tapered hole facing the conical surface of the fixed seat. A tapered cylindrical body disposed so as to freely advance and retract in the axial direction, and an operation member for driving the tapered cylindrical body to advance and retract in the axial direction;
When the tapered cylinder is moved rearward by the operating member, the proximal end portion of the guide pipe is sandwiched between the tapered cylindrical body and the fixed seat, and the proximal end portion of the guide pipe is in the operating portion. The endoscope guide tube device according to any one of claims 1 to 10, wherein a base end portion of the guide pipe is movable in an axial direction when the tapered cylindrical body is fixed and moved forward.   The endoscope guide tube device according to claim 11, wherein an inner peripheral surface of the tapered cylindrical body is formed of a resilient member.   13. A wire base end cap, which is sandwiched between the tapered cylindrical body and the fixed seat and is fixed thereto, is fixed near the base end of the curved shape holding wire. The endoscope guide tube device described.   The endoscope guide tube according to claim 13, wherein the wire base end cap and the base end portion of the guide pipe are formed to have the same outer diameter and are sandwiched simultaneously between the tapered cylindrical body and the fixed seat. apparatus.   A linear guide groove for guiding the proximal end portion of the guide pipe so as to advance and retreat in the axial direction is formed in the conical surface of the fixed seat at a depth smaller than the diameter of the proximal end portion of the guide pipe. Item 15. The endoscope guide tube device according to Item 14.   The endoscope guide tube device according to any one of claims 12 to 15, wherein a plurality of guide shafts for guiding the tapered cylindrical body so as to freely advance and retract in an axial direction are provided in the operation portion.   The operating member is an operating internal thread ring disposed in the operating section so as to be rotatable about an axis, and the external threaded screw ring is formed on the tapered tubular body so as to be screwed with the operating internal thread ring. The endoscope guide tube apparatus according to claim 16, wherein the tapered cylinder moves in the axial direction by rotating the shaft around the axis.

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