JP2009189703A - Auxiliary instrument for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an auxiliary instrument for an endoscope which permits parts to be commonalized, and to easily have combined functions and reduces manufacturing costs and management time and labor. <P>SOLUTION: The auxiliary instrument for an endoscope has a guide tube which is arranged from the insertion portion to a holding portion and into which the operating wire of the tip treatment portion is inserted. The holding portion is provided with a tube fixing ring having a holding portion through-hole communicating with the guide tube, and an external attachment and detachment portion exposed on the outer surface of the holding portion. The external attachment and detachment portion of the tube fixing ring is provided with an operating portion connecting adapter whose one end is detachabe and the other end has a connector, and having an operating wire insertion hole communicating with the holding portion through-hole formed in a state of attachment to the tube fixing ring. When the tip treatment portion is used, the operating member of the tip treatment portion is connected to the connector of the operation portion connecting adapter and the end of an operating wire projected through the holding portion through-hole of the tube fixing ring and the wire insertion hole of the operating portion connecting adapter via the guide tube is connected to the movable operating portion of the operating member. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope auxiliary instrument that is used by being inserted into a treatment instrument insertion channel of an endoscope.

  Endoscopic treatment tools are provided with a distal treatment section that performs various treatments such as grasping forceps and high-frequency snare at the distal end of the flexible insertion section, and are inserted into the treatment instrument insertion channel of the endoscope. The distal treatment section is projected from the treatment instrument insertion channel and used. The proximal end portion of the insertion portion is provided with a holding portion for gripping, and further includes an operation portion for operating the distal treatment portion.

Such a treatment tool is used by being inserted into the treatment tool insertion channel of the endoscope. When the number of channels is insufficient with only the treatment tool insertion channel of the endoscope body, it is added to the outer peripheral portion of the endoscope body. As an additional treatment tool guide that can be attached to the treatment tool and temporarily increase the number of treatment tool insertion channels, a device such as that disclosed in Patent Document 1 is known. The treatment instrument guide of Patent Document 1 has a function capable of bending a bending portion that constitutes a part of a flexible tube, and when this guide is used, each inserted into the guide is provided. The bending mechanism of the treatment tool can be omitted. In other words, it is possible to simplify the configuration of each treatment tool by providing a common guide tool with some functions of the treatment tool. In addition, if a tube for fluid circulation is inserted into the guide path of the guide tool, suction, water supply, air supply, etc. can be performed on a different path from each channel of the endoscope body.
JP 2004-8367 A

  Conventionally, a part of the function of the treatment tool is shared through a separate guide tool as in Patent Document 1, and the function of the treatment tool and other instruments (for example, a fluid flow channel) is combined. There was a concept, but for each treatment tool inserted in it, for each type of distal treatment section, a single function that was completed as a whole system from the insertion section to the operation section was prepared separately It had been. For example, a treatment instrument in which the distal treatment section is a grasping forceps and a treatment instrument in which the distal treatment section is a snare for high-frequency ablation have been prepared as independent treatment instruments due to factors such as different required operation strokes. . Moreover, since an additional guide tool like patent document 1 may not be used, it is preferable that basically all the functions necessary for the treatment tool itself are mounted without depending on the guide tool. In addition, when using a high-frequency treatment instrument such as a snare, the wire portion through which electricity flows is structured to be inserted into an insulating tube such as PTFE, and the insertion portion has a larger outer diameter than forceps or the like. There is a tendency. A guide instrument provided with a treatment instrument insertion channel for inserting such a treatment instrument has an outer diameter larger than that of the treatment instrument, and the outer diameter is much larger than that of the curved treatment instrument itself. It gets bigger. In addition, since the guide tool is provided outside the endoscope body, and the increase in the outer diameter size affects the insertion workability of the endoscope and the burden on the patient, it is desirable to suppress the guide tool diameter as much as possible. Therefore, the size (diameter) of the treatment tool inserted through the guide tool and the fluid circulation tube is likely to be restricted.

  As described above, there has been a demand to achieve the common mechanism between a plurality of treatment tools and the function enhancement of the treatment tools without depending on a separate guide tool. SUMMARY OF THE INVENTION An object of the present invention is to provide an endoscope auxiliary instrument that can use different types of tip treatment sections while being able to share parts, and that can reduce manufacturing costs and labor. It is another object of the present invention to provide an endoscope auxiliary instrument that can be easily used for a complex application such as fluid circulation in addition to the operation of the distal treatment section.

  The present invention has a flexible insertion portion and a holding portion to which the proximal end portion of the insertion portion is connected, and an operation wire for a distal treatment portion provided at the distal end of the insertion portion from the insertion portion to the holding portion. In an endoscope auxiliary instrument in which a guide tube is inserted, a tube fixing ring having a holding portion through hole communicating with the guide tube and an external detachable portion exposed on the outer surface of the holding portion is provided in the holding portion. An operating wire that has one end detachably attached to the external attachment / detachment portion of the tube fixing ring and that has a connection base at the other end and communicates with the holding portion through hole while being attached to the tube fixing ring. When an operation unit connection adapter with an insertion hole is provided and the distal treatment unit is used, the operation member of the distal treatment unit is connected to the coupling base of the operation unit connection adapter, and the tube fixing ring is held via the guide tube. Through hole and operation End of the operating wire protruding through the wire insertion hole of the part connection adapter, is characterized in that it is connected to the movable operating portion of the operating member.

  The endoscope auxiliary instrument according to the present invention preferably includes a plurality of types of operation unit connection adapters corresponding to a plurality of types of operation members having different operation strokes.

  As one aspect of the operation part connection adapter, a hard connection pipe having an insertion part into an attachment / detachment hole formed in the external attachment / detachment part of the tube fixing ring is provided at one end part, and a coupling base is fixed to the other end part of the rigid connection pipe It can be configured.

  Moreover, as a different aspect of the operation unit connection adapter, a first connection end portion having an insertion portion into an attachment / detachment hole formed in an external attachment / detachment portion of the tube fixing ring, and a second connection end portion to which a coupling base is connected The first and second connection ends may be connected to each other and combined with a flexible connecting pipe having flexibility. The flexible connecting pipe can be constituted by a close-wound coil portion in which a steel wire is wound spirally, for example. In order to prevent buckling during operation, it is preferable to connect a rigid member to the rear end (near the connection portion with the operation member) of the operation wire. However, when the operation unit connection adapter has a soft connection tube, in order not to impair the flexibility of the soft connection tube, the movable range of the rigid member with respect to the wire insertion hole of the operation unit connection adapter is It is preferable to limit to a range that does not enter the flexible connecting pipe.

  The external attachment / detachment part of the tube fixing ring has an outer surface screw on the outer peripheral surface of the cylindrical part surrounding the attachment / detachment hole, and the insertion part of the operation unit connection adapter is prevented from being removed from the attachment / detachment hole by a mounting nut that is screwed to the outer surface screw. It may be configured to do so. It is preferable that the outer surface of the mounting nut and the outer surface of the hard or soft connection pipe constituting the operation unit connection adapter are covered with an insulating member.

  Further, a non-circular cross-sectional hole is formed in at least a part of the attachment / detachment hole of the tube fixing ring, and the rotation of the non-circular cross-sectional hole is restricted and fitted into the insertion part of the operation unit connection adapter. It is preferable to form a circular cross-section cylinder.

  In the endoscope auxiliary instrument of the present invention, an external member attached to the external attachment / detachment portion of the tube fixing ring can be replaced with an operation member for operating the distal treatment portion. For example, an attachment / detachment part to the external attachment / detachment part of the tube fixing ring is provided at one end, and a fluid circulation tube extending from an external fluid control device can be connected to the other end, and the tube is fixed by penetrating between both ends. Provide a flow path connection adapter in which a fluid flow hole communicating with the holding portion through hole of the tube fixing ring is provided in the state of being attached to the ring, and attach this flow path connection adapter in place of the aforementioned operation portion connection adapter. By this, it becomes possible to use the guide tube in the auxiliary instrument for endoscope as a conduit for fluid circulation.

  In addition, the endoscope auxiliary instrument of the present invention has a flexible insertion portion and a holding portion to which the proximal end portion of the insertion portion is connected, and is disposed from the insertion portion to the holding portion. In an endoscope auxiliary instrument having a tube, the holding portion is provided with a tube fixing ring having a holding portion through hole communicating with the tube and an external attaching / detaching portion exposed to the outer surface of the holding portion, and external attachment / detachment of the tube fixing ring. A fluid flow tube extended from an external fluid control device can be connected to the other end of the detachable part with respect to the part, and the tube can be fixed while being attached to the tube fixing ring. It has the flow-path connection adapter in which the fluid circulation hole connected to the holding | maintenance part through-hole of a ring was formed.

  According to the present invention as described above, the distal treatment section and its operation member can be arbitrarily replaced as a part where the insertion section and the holding section incorporating the guide tube can be shared, so that the manufacturing cost and running cost can be kept low. On the other hand, an endoscopic auxiliary instrument that is easy to manage and has high functionality can be obtained. Further, the guide tube inside the auxiliary instrument can be used as an insulating tube when a high-frequency treatment instrument such as a snare is used. Furthermore, since the tube inside the auxiliary instrument can be used as a fluid flow passage instead of the guide means of the operation wire of the distal treatment section, the functionality can be further enhanced.

  FIG. 1 shows the overall structure of an endoscope auxiliary instrument 10 to which the present invention is applied. The endoscope auxiliary instrument 10 has an insertion portion 11 that can be inserted into a treatment instrument insertion channel of an endoscope or a treatment instrument insertion channel of a guide instrument that is additionally attached to the endoscope. The base portion of the insertion portion 11 is connected to the cylindrical holding portion 12. The insertion portion 11 includes a distal treatment portion 13, a bending portion 14, and a flexible tube portion 15. A rear end portion of the holding portion 12 opposite to the insertion portion 11 is used for operating the distal treatment portion 13. A treatment portion operation handle (an operation member for the distal treatment portion) 16 is provided. In addition, a bending operation grip 17 projects from the intermediate portion of the holding portion 12 in a direction substantially orthogonal to the axial direction of the holding portion 12 that connects the insertion portion 11 and the treatment portion operation handle 16. In the following description, the axial direction of the insertion portion 11 means the longitudinal direction, and when the insertion portion 11 is linearly extended as shown in FIG. 1, the axis of the insertion portion 11 and the axis of the holding portion 12. Is almost the same.

  2 and 3 are enlarged views of the vicinity of the distal treatment section 13 and a part thereof as a cross section. The bending portion 14 has a structure in which the outer side of the mesh tube 20 is covered with a covering tube 21 made of an insulator, and a distal end rigid member is provided at the distal end portion thereof. The distal end rigid member includes a synthetic resin wire guide fixing member 22 and a metal frame receiving ring 23. An annular recess 22a is formed at the front end of the wire guide fixing member 22, and an annular projection 23a formed on the frame receiving ring 23 is inserted into the annular recess 22a, and the gap between the annular projection 23a and the annular recess 22a is inserted. It is an end hard member that is fixed by bonding and integrated. The outside of the frame receiving ring 23 is covered with an insulating tube 19. The insulating tube 19 is made of a heat-shrinkable tube, and covers the vicinity of the tip of the covering tube 21 on the curved portion 14 side in addition to the frame receiving ring 23.

  The frame receiving ring 23 is formed with a circular frame support hole 23b having an inner diameter larger than that of the annular protrusion 23a in front of the annular protrusion 23a. An annular ring fitting groove 23c having an inner diameter larger than that of the hole 23b is formed. The opening edge portion of the frame support hole 23b is a partially conical tapered inner peripheral surface 23d that gradually increases in opening diameter as it advances toward the distal end side of the insertion portion 11. The rear end cylindrical portion 24a of the rotatable frame 24 constituting the distal treatment section 13 is inserted into the frame support hole 23b so as to be relatively rotatable. A snap ring 25 that can be elastically expanded and contracted in the radial direction is supported on the outer peripheral surface of the rear end cylindrical portion 24a. When the rear end cylindrical portion 24a is inserted into the frame support hole 23b, the snap ring 25 is moved in the inner diameter direction. In the state where the diameter is reduced, the ring fitting groove 23c is elastically fitted, and the rotatable frame 24 is held against the frame receiving ring 23 in a state where movement in the axial direction is restricted. In the holding state via the snap ring 25, the rotatable frame 24 is allowed to rotate about the axis with respect to the frame receiving ring 23.

  With the rotatable frame 24 attached to the frame receiving ring 23, the wire guide fixing member 22, the frame receiving ring 23, and the rotatable frame 24 have a substantially flush inner cylindrical advance / retreat guide hole 26. It is formed. A slide member 27 is slidably supported by the advance / retreat guide hole 26. The slide member 27 is connected to a wire distal end portion 28 a of the treatment instrument operation wire 28. The wire tip 28a is fixed to the slide member 27 by means such as brazing, soldering, or caulking. The treatment instrument operation wire 28 can be moved forward and backward in the longitudinal direction of the insertion portion 11 and relatively rotated about the longitudinal axis in the guide tube 29 whose distal end portion is fixed to the wire guide fixing member 22. Is inserted. The guide tube 29 is made of an insulating and flexible material such as tetrafluoroethylene resin (PTFE), polyethylene, polyamide, polyurethane, and penetrates the insertion portion 11 to the vicinity of the rear end portion of the holding portion 12. It is extended. The rear end of the treatment instrument operating wire 28 inserted into the guide tube 29 is fixed to a reinforcing pipe (hard member) 44, and the reinforcing pipe 44 protrudes rearward from the rear end of the holding portion 12, thereby fixing the end member 46. Is connected to the treatment section operation handle 16. A connection structure between the treatment portion operation handle 16 and the fixing end member 46 will be described later. Then, by pushing and pulling the treatment instrument operation wire 28, the reinforcing pipe 44, and the fixing end member 46 in the longitudinal direction of the insertion portion 11 through the treatment portion operation handle 16, the slide member 27 is axially moved in the advance / retreat guide hole 26. Can move forward and backward in the direction.

  The distal treatment section 13 ahead of the rotatable frame 24 can be removed by pulling out with a size exceeding the elastic engagement force by the snap ring 25 and the ring fitting groove 23c. Can be exchanged. The distal treatment section 13 attached in FIGS. 1 to 3 is a grasping forceps, and its schematic structure is as follows. The rotatable frame 24 has a pair of base plate portions 24b and 24c facing each other extending from the rear end cylindrical portion 24a to the front. As shown in FIG. 3, the distal end portion of the slide member 27 is inserted between the base plate portions 24 b and 24 c, and a pair of links 31 are interposed via the link support shaft 30 so as to sandwich the distal end portion of the slide member 27. , 32 are rotatably supported. The link support shaft 30 is not fixed with respect to the rotatable frame 24 and can change its position in the forward / backward direction of the slide member 27. The proximal end portions of the pair of forceps members 35 and 36 are rotatably supported at the distal end portions of the links 31 and 32 via connecting shafts 33 and 34, respectively. The forceps member 35 and the forceps member 36 are further opened and closed fixed to the rotatable frame 24 (base plate portions 24b and 24c) by shaft attachment portions 37 and 38 located slightly closer to the tip than the connection position by the connection shafts 33 and 34. The rotary shaft 39 is supported so as to be relatively rotatable. In the rotatable frame 24, both side portions of the base plate portions 24b and 24c are opened, and the link 31 and the link 32 can be protruded sideways as shown in FIG.

  The pair of forceps members 35 and 36 have linear arm portions 35a and 36a extending from the shaft attachment portions 37 and 38 toward the distal end, respectively, and can be engaged with the distal ends of the arm portions 35a and 36a. It has the meshing parts 35b and 36b in which the serrated opposing surface was formed.

  When the slide member 27 is moved in the right-hand direction in FIGS. 2 and 3 through the treatment instrument operation wire 28, the distal treatment section 13 (gripping forceps) described above has axial positions of the link support shaft 30 and the opening / closing rotation shaft 39. The interval increases, and the links 31 and 32 rotate so that the connecting shaft 33 and the connecting shaft 34 approach each other with the link support shaft 30 as the rotation center. Then, according to the position change of the connecting shaft 33 and the connecting shaft 34, the pair of forceps members 35 and 36 rotate relative to each other with the opening and closing rotation shaft 39 as a center in the closing direction in which the engaging portions 35b and 36b at the distal ends are brought closer. Move. FIG. 2 shows a state where the slide member 27 is moved to the maximum in the right hand direction in the drawing and the forceps members 35 and 36 are closed. At this time, the opposing surfaces of the meshing portions 35b and 36b are meshed with each other. On the other hand, when the slide member 27 is moved in the left-hand direction in FIGS. 2 and 3 via the treatment instrument operation wire 28, the link support shaft 30 approaches the opening / closing rotation shaft 39, and the link support shaft 30 is set to the rotation center. As a result, the links 31 and 32 rotate so as to separate the connecting shaft 33 and the connecting shaft 34 from each other. Then, according to the change in the position of the connecting shaft 33 and the connecting shaft 34, the pair of forceps members 35, 36 rotate relative to each other about the opening / closing rotation shaft 39 in the opening direction that separates the engagement portions 35b, 36b at the distal ends. Move.

  As shown in FIGS. 4 to 6, a through hole 18 a is formed in the rear end portion of the holding portion main body 18 constituting the appearance of the holding portion 12, and a tube is fixed in the through hole 18 a via a fixing nut 40. An annulus 41 is attached. Specifically, as shown in FIG. 6, the tube fixing ring 41 is formed with an outward projecting portion (external attaching / detaching portion) 41a projecting from the rear end portion of the holding portion 12, and the outer periphery of the outward projecting portion 41a. An outer surface screw 41b is formed on the surface. An annular hole 18b surrounding the outer surface screw 41b is formed at the rear end portion of the holding portion main body 18 following the through hole 18a, and the annular fixing nut 40 has a threaded portion formed on the inner peripheral surface thereof on the outer surface. While being screwed into the screw 41b, it is tightened until it contacts the bottom of the annular hole 18b. The tube fixing ring 41 moves to the right-hand side in FIG. 6, that is, toward the rear end of the holding portion 12 by bringing a retaining flange 41 c having a larger diameter than the outward projecting portion 41 a into contact with the inner wall portion of the holding portion main body 18. Movement is regulated. Then, by tightening the fixing nut 40, the tube fixing ring 41 is prevented from coming off in the left-hand direction of FIG. 6, that is, inward of the holding portion 12. A part of the tube fixing ring 41 is a rectangular tube part 41d, and a part of the through hole 18a into which the rectangular tube part 41d is fitted has a rectangular hole shape. The relative rotation with respect to the holding body 18 is restricted. Further, the tube fixing ring 41 and the holding portion main body 18 are liquid-tightly closed by the O-ring R1.

  The tube fixing ring 41 projects an inward protruding portion 41e toward the inside of the holding portion 12 opposite to the outward protruding portion 41a. The rear end portion of the guide tube 29 through which the treatment instrument operation wire 28 is inserted is attached to the inward protruding portion 41 e of the tube fixing ring 41 and is fixed by a fixing coil 45. The guide tube 29 has flexibility that can be deformed corresponding to the insertion portion 11, but its distal end portion is fixed to the wire guide fixing member 22 and its rear end portion is relative to the tube fixing ring 41. Since it is fixed, movement in the axial direction and rotation around the axial line are restricted in the insertion portion 11 and the holding portion 12. The tube fixing ring 41 is formed with a central through hole (holding portion through hole) 41f penetrating from the inward protruding portion 41e to the outward protruding portion 41a in the axial direction thereof. In a state where the guide tube 29 is fixed, the central through hole 41 f communicates with the guide tube 29.

  Different external members can be selected and connected to the outward projecting portion 41a of the tube fixing ring 41 depending on the use of the endoscope auxiliary instrument 10. Connected in FIGS. 4 and 5 is a treatment section operation handle 16 for operating the grasping forceps constituting the distal treatment section 13. The attachment structure of the treatment portion operation handle 16 will be described.

  The outward projecting portion 41a is formed with an attaching / detaching hole 41g that communicates with the central through hole 41f and opens toward the rear end side of the holding portion 12. The attachment / detachment hole 41g is composed of a combination of a bottom side square hole (non-circular cross-section hole part) 41g1 communicating with the central through hole 41f and a circular hole 41g2 having a larger diameter and facing the rear end part of the outward projecting part 41a. ing. A first connection pipe (first connection end) 70 is inserted into the attachment / detachment hole 41g. The first connecting pipe 70 has a square tube portion (non-circular cross-section tube portion) 70a that fits into the square hole 41g1 of the attachment / detachment hole 41g, and a cylindrical portion 70b that fits into the circular hole 41g2. As shown in FIG. 7, the relative rotation of the first connection pipe 70 with respect to the tube fixing ring 41 is restricted by the fitting relationship between the square hole 41 g 1 and the square tube portion 70 a. The space between the cylindrical portion 70b and the circular hole 41g2 is liquid-tightly closed by an O-ring R2. An annular flange 70c is formed in the first connecting pipe 70 following the cylindrical portion 70b, and the insertion of the flange 70c against the end of the outward projecting portion 41a is restricted. When the mounting nut 71 is screwed to the outer surface screw 41b of the outward projecting portion 41a, the flange 70c is prevented from being detached by the mounting nut 71, and the first connecting pipe 70 is connected and fixed to the tube fixing ring 41. The A central through hole (operation wire insertion hole) 70d is formed in the central portion of the first connection pipe 70 in the axial direction. In this connection fixed state, the central through hole 70d is the central through hole of the tube fixing ring 41. It communicates with 41f. The outer periphery of the mounting nut is covered with an insulating member 71a such as fluorine rubber.

  The first connection tube 70 has a coil connection tube 70e to which a closely wound coil tube (operation wire insertion hole) 72 is connected on the opposite side to the distal end insertion portion 70a in the axial direction. The closely wound coil tube 72 is formed by closely winding a steel wire in a spiral manner so that adjacent coil portions are in close contact with each other, and has flexibility. A central through hole (operation wire insertion hole) 72 a penetrating in the axial direction is formed inside the densely wound coil tube 72. As shown in FIG. 5, the other end of the densely wound coil tube 72 is connected to a coil connection cylinder 73 a of a second connection tube (second connection end) 73. The second connecting pipe 73 is formed with a central through hole (operation wire insertion hole) 73b that communicates with the central through hole 72a of the closely wound coiled pipe 72 so as to penetrate in the axial direction.

  The second connection pipe 73 is fixed to the connection cap 43 by a fixing screw 42. The connection cap 43 includes a connection tube surrounding portion 43a that surrounds the second connection tube 73 and has a support hole for the fixing screw 42, a flat flange portion 43b that contacts the end of the second connection tube 73, and the flange portion 43b. A central through hole (operation wire insertion hole) 43d that has a protruding insertion cylinder portion 43c and penetrates the flange portion 43b and the insertion cylinder portion 43c and communicates with the central through hole 73b of the second connection pipe 73 is formed. ing. The entire densely wound coil tube 72 and the connection tube surrounding portion 43a of the connection cap 43 are covered with a covering tube 74 made of an insulator.

  The first connection tube 70, the closely coiled coil tube 72, the second connection tube 73, and the coupling cap 43 constitute an operation unit connection adapter M1 interposed between the holding unit 12 and the treatment unit operation handle 16. . The treatment section operation handle 16 is provided with a mechanism for attaching to and detaching from the operation section connection adapter M1. As shown in FIG. 5, a distal end portion of the treatment portion operation handle 16 is provided with a cylindrical base connector 50 in which a plurality of slits are formed along the axial direction, and surrounds the outer side of the base connector 50. The fastening ring 51 is rotatably supported. Although not shown, the outer shape of the base connector 50 has a cross-sectional shape that combines two oval shapes, and the fastening ring 51 has an inner surface shape that combines two oval shapes to correspond to this. ing. In the center of the base connector 50, a central opening 50a is formed whose shape is changed by expansion and contraction of the slit. Thereby, according to the rotation operation of the fastening ring 51 around the axis, the detachable state in which the slit of the base coupling body 50 is opened and the central opening 50a is enlarged, and the slit is narrowed and the central opening 50a is opened. It can be made the fastening state diameter-reduced. An operation portion extending from the connection base 43 to the first connection pipe 70 by rotating the fastening ring 51 in a state where the insertion tube portion 43c of the connection base 43 is inserted into the central opening 50a of the base connection body 50. The treatment unit operation handle 16 is connected to the holding unit 12 via the connection adapter M1. In this fastened state, the base connection body 50 is restricted from moving in the axial direction with respect to the connection base 43, but is freely rotatable. Conversely, by rotating the fastening ring 51 to the detachable position with the insertion tube portion 43 c of the connection base 43 inserted into the central opening 50 a of the base connection body 50, the connection between the connection base 50 and the connection base 43 is performed. The treatment section operation handle 16 can be detached from the holding section 12 by releasing the operation section.

  In the operation unit connection adapter M1 including the first connection pipe 70, the closely coiled coil pipe 72, the second connection pipe 73, and the connection cap 43, the central through holes 70d, 72a, 73b, and 43c formed in these members are used. An operation wire insertion hole penetrating in the axial direction is formed. In the state where the operation unit connection adapter M1 is connected to the tube fixing ring 41 as shown in FIG. 5, this series of operation wire insertion holes passes through the central through hole (holding unit through hole) 41f of the tube fixing ring 41. Via the guide tube 29 in the holding part 12. The treatment instrument operation wire 28 is inserted into the central through holes 41f, 70d, 72a, 73b, and 43c following the guide tube 29, and a reinforcing pipe 44 that is a rigid member is connected to the rear end thereof. As shown in FIG. 5, a part of the front end side of the reinforcing pipe 44 is inserted into the operation wire insertion hole (the central through hole 43d of the connection cap 43) of the operation unit connection adapter M1. The reinforcing pipe 44 protrudes rearward from the connection base 43, and a fixing end member 46 is attached to the rear end thereof. In the vicinity of the rear end surface of the fixing end member 46, a small diameter portion 46a with which an inner diameter side end portion 55a of a side terminal 55 described later comes into contact is provided. The treatment instrument operation wire 28 and the rigid member 44, the reinforcing pipe 44 and the fixing end member 46 are fixed by a method such as brazing, soldering, and caulking, respectively. The entire structure up to 28 has conductivity.

  As shown in FIGS. 4 and 5, a cylindrical body 52 constituting the main body of the treatment section operation handle 16 is fixed to the rear end of the base connector 50. A long groove 52a (FIG. 1) is formed in the cylindrical body 52 in the axial direction, and a part of the wire connecting member 53 is slidably fitted in the long groove 52a in the axial direction. Further, a slider (movable operation unit) 54 having a flange-like finger-hanging portion 54 a on the outer surface is supported on the outside of the cylindrical body 52. A side terminal 55 protrudes from the wire connecting member 53 in a radial direction orthogonal to the axis of the cylindrical body 52, and the slider 54 is connected to the wire connecting member 53 by engaging with the base of the side terminal 55. It is integrated with the member 53. In other words, the slider 54 and the wire connecting member 53 operate integrally in both the axial direction of the cylindrical body 52 and the rotational direction around the axial line. Since the base connection body 50 provided at the front end of the cylindrical body 52 is rotatably connected to the connection base 43, the entire treatment section operation handle 16 is in a connected state between the base connection body 50 and the connection base 43. It becomes possible to rotate around the axis with respect to the holding unit 12 and the operation unit connection adapter M1 (coupling base 43). In addition, the cylindrical body 52 is integrated with the wire connecting member 53 and the slider 54 in the rotational direction, but relative movement of the wire connecting member 53 and the slider 54 is allowed in the axial direction by a long groove 52a. . A finger ring 56 is provided at the end of the cylindrical body 52.

  The wire connecting member 53 is formed with a wire end support hole 53a into which the fixing end member 46 is inserted. The side terminal 55 is a terminal to which a high-frequency current is input from an external power supply unit when using an electric treatment instrument such as a high-frequency snare, and is screw-coupled to the wire connecting member 53 so that the operation ring 55b is properly connected. By rotating in reverse, the inner diameter side end portion 55a of the side terminal 55 changes the amount of protrusion into the wire end portion support hole 53a. At the time of assembly, the protruding portion of the inner diameter side end portion 55a into the wire end portion supporting hole 53a is increased, and the fixed portion end member 46 is supported on the wire end portion while contacting the small diameter portion 46a of the fixed portion end member 46. Press against the side of the hole 53a. At this time, since the inner diameter side end portion 55a of the side terminal 55 is in contact with the small diameter portion 46a of the fixing end member 46, the fixing end member 46 is in contact with the wire end portion support hole 53a. It is prevented from coming off.

  As described above, the connection of the treatment portion operation handle 16 to the rear portion of the holding portion 12 is completed via the operation portion connection adapter M1. Since the operation part connection adapter M1 is flexible in the intermediate part where the closely wound coil tube 72 is provided, the orientation of the treatment part operation handle 16 relative to the holding part 12 can be changed in this connected state. And excellent operability can be obtained. Further, since the outer peripheral surfaces of the mounting nut 71 and the densely wound coiled tube 72 are respectively covered with the insulating member 71a and the covering tube 74, there is no electric shock even if they are accidentally contacted during high frequency energization.

  As described above, the guide tube 29 is a guide member having one end and the other end fixed to the wire guide fixing member 22 and the tube fixing ring 41, and the treatment instrument operation wire 28 is inserted into the guide tube 29. Has been. The treatment instrument operation wire 28 is slidable in the longitudinal direction with respect to the guide tube 29, and is relatively inserted inside the guide tube 29. Therefore, as shown by the arrow S in FIG. 1, the treatment instrument operation wire 28 is moved via the wire connecting member 53 by moving the slider 54 forward and backward in the axial direction with respect to the cylindrical body 52 in the treatment section operation handle 16. The guide tube 29 is advanced and retracted in the longitudinal direction. The advance / retreat operation of the treatment instrument operation wire 28 is transmitted to the slide member 27 on the distal treatment section 13 (gripping forceps) side, and the pair of forceps members 35 and 36 perform an opening / closing operation via the link mechanism described above. At this time, the treatment section operation handle 16 can be operated in an arbitrary manner. For example, the treatment section operation handle 16 may be operated by passing a thumb through the finger ring 56 and placing an index finger and a middle finger on the finger hook section 54a of the slider 54.

  4 and 5 show the position of the slider 54 when the forceps members 35 and 36 constituting the distal treatment section 13 are closed. At this time, the slider 54 is located at the moving end farthest from the holding section 12. is there. When the forceps members 35 and 36 are opened, the slider 54 is moved from the position of FIGS. 4 and 5 to the left in the drawing to push the treatment instrument operation wire 28 toward the holding portion 12. At this time, the reinforcement pipe 44 and the fixing end member 46 are also moved together with the treatment instrument operation wire 28, and the reinforcement pipe 44 increases the amount of insertion of the operation unit connection adapter M1 into the operation wire insertion hole. The reinforcing pipe 44 is formed as a rigid tube in order to prevent the treatment instrument operation wire 28 from buckling in the cylindrical body 52. However, when the slider 54 is moved to the left in FIG. The reinforcing pipe 44 is set to a length that does not enter the densely wound coil tube 72 of the operation unit connection adapter M1. In other words, the movable range of the distal end portion of the reinforcing pipe 44 is limited to the central through hole 43 d of the connection cap 43, or at most, to the central through hole 73 b of the second connection pipe 73. Therefore, the reinforcing pipe 44 made of a hard tube does not impair the flexibility of the closely coiled coil tube 72 when the treatment instrument operation wire 28 is advanced or retracted.

  Further, as indicated by an arrow D in FIG. 1, the treatment instrument operation wire 28 is guided to the guide tube 29 via the wire connecting member 53 and the like by rotating the treatment section operation handle 16 with respect to the cylindrical body 52 about the axis. Within the relative rotation. As described above, the rotatable frame 24 in the distal treatment section 13 is coupled to the frame receiving ring 23 at the distal end of the insertion section 11 while being prevented from being detached by the snap ring 25 and allowed to rotate around the axis. Yes. Therefore, when the treatment instrument operation wire 28 is rotated, the rotational force is transmitted to the slide member 27 to which the wire distal end portion 28a is connected, and the distal end treatment portion 13 as a whole from the rotatable frame 24 and the slide member 27 is centered on the axis. Rotating operation is performed.

  As described above, the distal treatment section 13 is subjected to an opening / closing operation (treatment operation) in response to the longitudinal force of the insertion section 11 via the treatment instrument operation wire 28 and a rotation operation about the axis. Can be done. In order to make it difficult to twist with respect to this rotational operation, the treatment instrument operation wire 28 is formed of a triple-wrapped wire cable wound in opposite directions or a super elastic wire.

  The endoscope auxiliary instrument 10 is further provided with a bending operation mechanism for bending the bending portion 14. As shown in FIGS. 2 and 3, the bending portion 14 is provided with a plurality of short cylindrical node rings 60 that are positioned inside the covering tube 21 and are coupled to each other by a rivet 61 so as to be relatively rotatable. ing. Two adjacent node rings 60 are connected by a pair of rivets 61 provided at symmetrical positions in the radial direction of the bending portion 14. A plurality of node rings 60 are connected so that the paired rivets 61 have different circumferential phases by 90 degrees. As a result, the bending portion 14 can be operated to bend forward and backward in two directions perpendicular to each other with respect to the axis.

  Four coil tubes 64 are arranged from the flexible tube portion 15 to the bending operation grip 17 (FIG. 4). Four coil tubes 64 are provided in the flexible tube portion 15 so as to surround the guide tube 29 of the treatment instrument operation wire 28 at an equal angle of 90 degrees in the circumferential direction. Each coil tube 64 has a bending operation wire. 66 (FIGS. 2 and 3) is inserted. As shown in FIGS. 2 and 3, the bending operation wires 66 protrude from the coil tube 64 in the bending portion 14 and are arranged at an equal angle of 90 degrees in the circumferential direction so as to surround the guide tube 29 of the treatment instrument operation wire 28. The distal end portion of the bending operation wire 66 is fixed to the wire stopper member 67. The wire stopper member 67 is a member that is locked to the distal node ring 60 a that is located closest to the front end side of the insertion portion 11 among the plurality of node rings 60. The other end of each bending operation wire 66 protrudes from the coil tube 64 in the bending operation grip 17 and is connected to a pulley wire (not shown). The pulley wire is wound around a shaft portion of a pulley (not shown) that is rotatably supported in the bending operation grip 17. Two pulleys are provided corresponding to two pairs (four) of bending operation wires 66. When one pulley is rotated, one of a specific pair of bending operation wires 66 is pulled and the other is relaxed, The plurality of node rings 60 in the bending portion 14 relatively rotate about the rivet 61, and the bending portion 14 is bent in a predetermined direction. When the other pulley is rotated, one of the other pair of bending operation wires 66 is pulled and the other is relaxed, the node ring 60 is relatively rotated, and the bending portion 14 is bent in a direction orthogonal to the above. The bending operation grip 17 is provided with bending operation levers 62 and 63 (FIG. 1) for rotating the two pulleys 69 forward and backward.

  The distal treatment section 13 (gripping forceps) shown in FIGS. 1 to 3 can be removed from the distal end of the insertion section 11 by reducing the diameter of the snap ring 25. A wire distal end portion 28a of a treatment instrument operating wire 28 is fixed to the distal treatment section 13, and the treatment instrument operating wire 28 is pulled out together with the removal of the distal treatment section 13. Therefore, when the distal treatment section 13 is removed, on the treatment section operation handle 16 side, the fastening to the fixing end member 46 by the side terminal 55 is loosened, and the fastening of the fixing end member 46 and the wire connecting member 53 is released. Let me. Then, along the guide tube 29, the treatment instrument operation wire 28, the reinforcing pipe 44, and the fixing end member 46 can be pulled forward from the distal end side of the insertion portion 11 (the frame support hole 23b of the frame receiving ring 23). become. Note that the reinforcing pipe 44 and the fixing end member 46 fixed to the rear end side of the treatment instrument operation wire 28 have an outer diameter that can pass through the flexible guide tube 29. It can be pulled out without interfering with the guide tube 29.

  In the endoscope auxiliary instrument 10, various types of distal treatment sections can be attached to the distal end of the insertion section 11. FIG. 8 shows a state where a high-frequency snare is attached as a distal treatment section 113 as a distal treatment section 113 that replaces the grasping forceps. The distal treatment section 113 includes a wire connection section 113a connected to the wire distal end section 28a of the treatment instrument operation wire 28, and an annular loop wire section 113b. The wire connecting portion 113a has a smaller diameter than the advance / retreat guide hole 26 formed by the wire guide fixing member 22 and the inner peripheral surface of the frame receiving ring 23, and moves to the right from the position shown in FIG. It is possible to enter. The size (opening) of the opening of the loop wire portion 113b is controlled by the vicinity of the base end portion of the loop wire portion 113b coming into contact with the tapered inner peripheral surface 23d of the frame receiving ring 23. For example, when the wire connecting portion 113a is moved in the right-hand direction from the position of FIG. 8, the loop wire portion 113b is drawn inward of the insertion portion 11, and the contact position with respect to the tapered inner peripheral surface 23d is changed. As a result, the opening diameter of the loop wire portion 113b is reduced, and the treatment object can be sandwiched. In addition, the contact part with the loop wire part 113b in the frame receiving ring 23 is a partially conical tapered inner peripheral surface 23d whose opening diameter is gradually increased toward the tip side, so that the loop wire part 113b moves forward and backward. Resistance and wear are suppressed, and operability and durability are improved.

  When the tip treatment section 113 is replaced, the treatment section operation handle 16 shown in FIGS. 1 and 4 is used as it is if conditions such as an operation stroke (advancing / retreating amount of the treatment instrument operation wire 28 during operation) are met. You can also However, generally, since the high-frequency snare has a longer operation stroke than the grasping forceps, it is preferable to replace the operation unit with one corresponding to this. 9 and 10 show a treatment portion operation handle 116 suitable for a distal treatment portion having a long operation stroke, and an operation portion connection adapter M2 for mounting the treatment portion operation handle 116. The treatment portion described above is shown in FIGS. Parts that are common to the operation handle 16 and the operation unit connection adapter M1 are omitted, and the schematic structure will be described.

  The operation unit connection adapter M2 has a connection pipe 75 in which the first connection pipe 70 and the second connection pipe 73 described above are integrated. The connection pipe 75 is a rigid tube body that does not have flexibility like the above-described closely wound coil pipe 72. On the distal end side of the connecting pipe 75, a distal end insertion portion 75a to be inserted into the attachment / detachment hole 41g of the tube fixing ring 41 and an annular flange 75b having a diameter larger than that and abutting against the end of the outward projection 41a are formed. If the mounting nut 71 is screwed onto the outer surface screw 41b of the outward projecting portion 41a, the flange 75b is prevented from being detached and coupled to the tube fixing ring 41. The distal end insertion portion 75a has a square tube portion (non-circular cross-section tube portion) 75a1 that fits into the square hole 41g1 of the attachment / detachment hole 41g, and a cylindrical portion 75a2 that fits into the circular hole 41g2, and the square hole 41g1 and the square tube The relative rotation with respect to the tube fixing ring 41 is restricted by the fitting relationship of the portion 75a1. The protruding end 75 c of the connection pipe 75 is inserted into the connection pipe surrounding part 43 a of the connection base 43 and is fixed to the connection base 43 by a fixing screw 42. The connection tube surrounding portion 43a of the connection tube 75 and the connection cap 43 is covered with a covering tube 76 made of an insulator. Further, the outer peripheral surface of the mounting nut 71 is covered with an insulating member 71a, and the outer surface of the operation unit connection adapter M2 is provided with insulation along with the covering tube 76.

  As described above, the operation unit connection adapter M <b> 2 including the connection pipe 75 and the connection base 43 is coupled to the tube fixing ring 41. A central through hole 75d is formed in the central portion of the connection pipe 75 in the axial direction, and together with the central through hole 43d of the connection cap 43, a series of operation wire insertion holes in the operation unit connection adapter M2 is configured. . When the connecting pipe 75 is attached to the tube fixing ring 41, the central through hole 75d communicates with the central through hole 41e of the tube fixing ring 41, and a series of through passages extending to the guide tube 29 is formed. . A reinforcing pipe (rigid member) 144 connected to the treatment instrument operating wire 28 is inserted into the through-passage, and the fixing end member 46 connected to the rear end of the reinforcing pipe 144 has a structure as described above. It is fastened to the wire connecting member 53 of the part operation handle 116.

  The treatment portion operation handle 116 has substantially the same structure as the treatment portion operation handle 16 described above, except that the axial length of the cylindrical body 152 is longer than that of the previous cylindrical body 52. 9 and 10 show a state in which the slider 54 is moved to the maximum in the right hand direction in the drawing. At this time, the reinforcing pipe 144 through which the treatment instrument operation wire 28 is inserted and fixed passes through the central through holes 43d and 75d of the operation unit connection adapter M2 (the coupling base 43 and the connection pipe 75) and the central through hole 41f of the tube fixing ring 41. It penetrates and the front end part protrudes in the holding part 12 and is inserted in the guide tube 29. In the operation unit connection adapter M2, since the connection tube 75 is made of a rigid tube and is not bent like the densely wound coil tube 72, the reinforcing pipe 144 also made of a rigid tube penetrates the operation unit connection adapter M2. There is no problem even if it protrudes into the holding portion 12. When the slider 54 is operated in the left-hand direction from the position of FIGS. 9 and 10, the reinforcing pipe 144 is pushed into the holding unit 12 side together with the treatment instrument operation wire 28, and the amount of protrusion into the guide tube 29 is increased. The length of the reinforcing pipe 144 is set so as not to reach the flexible tube portion 15 of the insertion portion 11 even when the slider 54 is moved to the maximum in the pushing direction to the holding portion 12. 11 is not likely to be hindered by the reinforcing pipe 144.

  As described above, in the endoscope auxiliary instrument 10, different distal treatment sections 13 and 113 can be used while the insertion section 11 and the holding section 12 incorporating the guide tube 29 are shared. It is possible to select and attach the treatment unit operation handles 16 and 116 suitable for the 13, 113. Further, since the treatment tool operation wire 28 to which a high frequency is energized is insulated by the guide tube 29 or the like, it is not necessary to provide a dedicated insulation tube. Thereby, the auxiliary instrument 10 for endoscope can be obtained at a low cost while having high functionality, and is managed as compared with a case where different treatment tools are prepared for different types of distal treatment sections. Is also easy.

  Furthermore, in the endoscope auxiliary instrument 10, the guide tube 29 can be used as a fluid flow path with the distal treatment sections 13 and 113 removed. In this case, instead of the operation handle connection adapters M1 and M2 for attaching the operation handle, a connection adapter corresponding to the application is attached to the outward projecting portion 41a of the tube fixing ring 41.

  FIG. 11 shows a state where the flow path connection adapter N1 including the suction nipple 80 and the connection pipe 81 is attached to the outward projecting portion 41a. The connecting pipe 81 has the same structure as the connecting pipe 75 described above except that the length in the axial direction is different, and the tube fixing ring 41 is attached to and detached from the distal end side of the connecting pipe 81. A distal end insertion portion 81a to be inserted in a state in which relative rotation is restricted with respect to the hole 41g, and an annular flange 81b having a diameter larger than this and abutting against the end of the outward projection 41a are formed. When the mounting nut 71 is screwed to the outer surface screw 41b of the protruding portion 41a, the flange 81b is prevented from coming off and coupled to the tube fixing ring 41. The protruding end portion 81c of the connecting pipe 81 is inserted into the connecting pipe surrounding portion 80a of the suction nipple 80, and is fixed by means such as adhesion or soldering. In this fixed state, the central through hole 81d that passes through the connecting pipe 81 in the axial direction and the central through hole 80b that passes through the suction nipple 80 in the axial direction are communicated with each other, and the fluid flows through the flow path connection adapter N1 in the axial direction. A hole is formed.

  When the treatment instrument operation wire 28 is removed from the guide tube 29 and the flow path connection adapter N1 having the suction nipple 80 is attached as described above, the guide tube 29, the central through hole 41f of the tube fixing ring 41, the flow path The fluid flow hole (the suction nipple 80 and the central through holes 80b and 81d of the connection pipe 81) of the connection adapter N1 serves as a continuous fluid flow path. Therefore, an end of a suction tube (fluid circulation tube) extended from a suction device (fluid control device) (not shown) is connected to the suction nipple 80, and a suction force is applied to the distal end of the insertion portion 11 via the guide tube 29. Can be exerted. Although not shown, when the endoscope auxiliary instrument 10 is used as a suction device in this manner, a suction nozzle may be attached to the distal end portion of the insertion portion 11, specifically, the frame receiving ring 23.

  FIG. 12 shows a mode in which a flow path connection adapter N2 having a luer base 82 for water supply is attached in place of the suction nipple 80. The connection pipe 81 constituting the flow path connection adapter N2 has the structure as described above, and is fixed to the tube fixing ring 41 side by a mounting nut 71. An end 81c of the connection pipe 81 is inserted into the connection pipe surrounding part 82a of the luer base 82 and fixed by means such as adhesion or soldering. The luer base 82 has a cylindrical portion 82b that protrudes in a direction opposite to the connection pipe surrounding portion 82a. A tapered inner peripheral surface 82c is formed on the inner side of the cylindrical portion 82b. The tapered inner peripheral surface 82c gradually decreases in inner diameter size as it advances toward the connection pipe 81. In addition, a pair of flanges 82d projecting radially outward is formed near the tip of the cylindrical portion 82b. In the luer base 82, there is formed a central through hole 82e that communicates with the central through hole 81d of the connection pipe 81 and constitutes a fluid circulation hole that penetrates the flow path connection adapter N2 in the axial direction. When the flow path connection adapter N2 is attached to the tube fixing ring 41 as shown in FIG. 12, the guide tube 29, the central through hole 41f of the tube fixing ring 41, the fluid flow hole (the luer mouthpiece and the connection pipe 81 of the flow connection adapter N2). The central through holes 82e and 81d) form a continuous fluid flow path.

  Connected to the luer base 82 is a luer base receiver provided at the end of a water supply tube (fluid distribution tube) extending from the water supply device (fluid control device). Although not shown, the luer base receiving portion includes a cylindrical taper protrusion having a fluid flow passage therein, and an outer peripheral wall that is substantially concentric with the taper protrusion and surrounds the taper protrusion. The outer peripheral surface of the taper protrusion is formed as a tapered outer peripheral surface that gradually decreases in outer diameter size as it advances toward the tip side, and the taper protrusion can be inserted into the tubular portion 82 b of the luer base 82. Further, a double thread that can be screwed with a pair of flanges 82d of the luer base 82 is formed inside the outer peripheral wall of the luer base receiving part. Then, when the taper protrusion of the luer base receiving part is inserted into the cylindrical part 82b and the double thread is screwed into the pair of flanges 82d, the outer peripheral surface of the taper protrusion and the taper inner peripheral surface 82c are brought into close contact with each other, and the lure base is received. And the luer base 82 are connected. Thereby, the liquid sent out from the water feeding device can be sent into the guide tube 29 via the luer base 82, the connecting pipe 81, and the central through holes 82 e, 81 d and 41 f in the tube fixing ring 41. Although not shown, when the endoscope auxiliary instrument 10 is used as a device for water supply in this way, a water supply nozzle may be attached to the frame receiving ring 23 at the distal end of the insertion portion 11.

  11 and 12 exemplify the suction and water flow path connection adapters N1 and N2, but the air flow path connection adapter is attached to the outward projecting portion 41a of the tube fixing ring 41. You may connect the air supply tube (fluid distribution tube) extended from the air supply apparatus (fluid control apparatus). Accordingly, the endoscope auxiliary instrument 10 can be used as a device for supplying air.

  In this manner, the treatment instrument operation wire 28 is removed from the guide tube 29, and a necessary connection adapter is attached instead of the treatment section operation handle 16 (116), whereby the endoscope auxiliary instrument 10 is used as a fluid circulation instrument. Can be used. Since the endoscope auxiliary instrument 10 includes a mechanism that bends the bending portion 14, the direction of the distal end of the insertion portion 11 can be adjusted with high accuracy when performing suction, water supply, or air supply.

  While the present invention has been described with reference to the illustrated embodiment, the present invention is not limited to the illustrated embodiment. For example, in the embodiment, the grasping forceps type distal treatment section 13 and the high frequency snare distal treatment section 113 are illustrated, but may be replaced with another kind of distal treatment section such as a needle knife.

It is a figure which shows the whole structure of the auxiliary tool for endoscopes to which this invention is applied. FIG. 2 is an enlarged view showing a part of the vicinity of a distal treatment section in the endoscope auxiliary instrument of FIG. 1 as a cross section. FIG. 3 is an enlarged view of the vicinity of the distal treatment section, partly shown as a cross section, viewed from a direction substantially orthogonal to FIG. 2. FIG. 2 is a side sectional view of a holding unit and a treatment instrument operation handle and an operation unit connection adapter that connects the holding unit and the treatment instrument operation handle in the endoscope auxiliary instrument of FIG. FIG. 5 is an enlarged side cross-sectional view showing the vicinity of a connection portion between a holding portion and a treatment instrument operation handle in FIG. 4. FIG. 6 is an enlarged cross-sectional view of the vicinity of the connection portion between the tube fixing ring and the operation portion connection adapter from FIG. It is sectional drawing which follows the VII-VII line of FIG. It is side sectional drawing of the insertion part front-end | tip vicinity of the auxiliary instrument for endoscopes which shows the aspect which replaced the front-end | tip treatment part with the high frequency snare. It is side sectional drawing of the holding | maintenance part of an auxiliary instrument for endoscopes, an operation part connection adapter, and a treatment tool operation handle which shows the state changed to the treatment tool operation handle from which an operation stroke differs. FIG. 10 is an enlarged side cross-sectional view of the vicinity of a connection portion between the holding unit and the treatment instrument operation handle in FIG. 9. It is sectional drawing which shows the aspect which attached to the holding | maintenance part rear end of the auxiliary instrument for endoscopes instead of the treatment tool operation handle the flow-path connection adapter provided with the suction nipple. It is sectional drawing which shows the aspect which attached to the holding | maintenance part rear end of the auxiliary instrument for endoscopes instead of the treatment tool operation handle the flow-path connection adapter provided with the luer mouthpiece for water supply.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Endoscope auxiliary instrument 11 Insertion part 12 Holding part 13 End treatment part 14 Bending part 15 Flexible tube part 16 116 Treatment part operation handle (operation member of the distal treatment part)
17 bending operation grip 18 holding part main body 18a through hole 22 wire guide fixing member 23 frame receiving ring 24 rotatable frame 25 snap ring 28 treatment instrument operation wire 29 guide tube 35 36 forceps member 40 fixing nut 41 tube fixing ring 41a projecting outward Part (external attachment / detachment part)
41b Outer surface screw 41c Stopping flange 41d Square tube portion 41e Inward projecting portion 41f Center through hole (holding portion through hole)
41g Removable hole 41g1 Square hole (Non-circular cross-section hole)
42 Fixing screw 43 Connecting base 43a Connection pipe surrounding part 43b Flange part 43c Insertion cylinder part 43d Center through hole (operation wire insertion hole)
44 144 Reinforcement pipe (hard member)
45 Fixing coil 46 Fixing end member 46a Small diameter part 50 Base connector 51 Fastening ring 52 152 Tube 53 Wire connection member (movable operation part)
53a Wire end support hole 54 Slider (movable operation part)
55 Side terminal 56 Finger ring 60 Node ring 61 Rivet 70 First connection pipe (first connection end)
70a Square tube (non-circular cross-section tube)
70b Cylindrical portion 70c Flange 70d Center through hole (operation wire insertion hole)
70e Coil connection cylinder 71 Mounting nut 71a Insulating member 72 Closely wound coil tube (soft connection tube)
72a Center through hole (operation wire insertion hole)
73 Second connection pipe (second connection end)
73a Coil connection cylinder 73b Central through hole (operation wire insertion hole)
74 76 Coated tube (insulating member)
75 Connection pipe (rigid connection pipe)
75a Tip insertion portion 75a1 Square tube portion (non-circular cross-section tube portion)
75a2 Cylindrical part 75b Flange 75c Projection end part 75d Center through hole (operation wire insertion hole)
80 Suction nipple 80a Connection pipe surrounding part 80b Center through hole (fluid flow hole)
81 Connection pipe 81a Tip insertion part 81b Flange 81c Projection end part 81d Center through hole (fluid flow hole)
82 Luer base 82a Connection pipe surrounding part 82b Cylindrical part 82c Tapered inner peripheral surface 82d Flange 82e Central through hole (fluid flow hole)
113 End treatment part 113a Wire connection part 113b Loop wire part M1 M2 Operation part connection adapter N1 N2 Flow path connection adapter R1 R2 O-ring

Claims (11)

An insertion portion having flexibility and a holding portion to which the proximal end portion of the insertion portion is connected are connected, and an operation wire of a distal treatment portion provided at the distal end of the insertion portion is inserted from the insertion portion to the holding portion. In an endoscope auxiliary instrument in which a guide tube is disposed,
The holding part is provided with a tube fixing ring having a holding part through hole communicating with the guide tube and an external detachable part exposed on the outer surface of the holding part,
One end can be attached to and detached from the external attachment / detachment portion of the tube fixing ring, and the other end portion is provided with a connecting base, and the both ends are penetrated to communicate with the holding portion through hole in the attached state to the tube fixing ring. Provide an operation unit connection adapter with a wire insertion hole,
When using the distal treatment section, connect the operation member of the distal treatment section to the connection base of the operation section connection adapter, and connect the holding section through hole of the tube fixing ring and the wire of the operation section connection adapter via the guide tube. An endoscope auxiliary instrument, wherein an end portion of the operation wire protruding through the insertion hole is connected to a movable operation portion of the operation member. The endoscope auxiliary instrument according to claim 1, further comprising a plurality of types of the operation unit connection adapters corresponding to the plurality of types of the operation members. 3. The endoscope auxiliary instrument according to claim 1, wherein the operation unit connection adapter includes an insertion portion into an attachment / detachment hole formed in an external attachment / detachment portion of the tube fixing ring at one end, and the connection to the other end portion. An auxiliary instrument for an endoscope, comprising a rigid connecting tube to which a base is fixed. 3. The endoscope auxiliary instrument according to claim 1, wherein the operation unit connection adapter includes a first connection end portion having an insertion portion into an attachment / detachment hole formed in an external attachment / detachment portion of the tube fixing ring, and the connection. An auxiliary instrument for an endoscope comprising: a second connecting end portion to which a base is connected; and a flexible connecting tube connecting the first and second connecting end portions and having flexibility. . 5. The endoscope auxiliary instrument according to claim 4, wherein the flexible connecting tube is formed of a closely wound coil portion in which a steel wire is spirally wound. In the endoscope auxiliary instrument according to claim 4 or 5, the rear end of the operation wire includes a rigid member that advances and retreats together with the operation wire and enters the wire insertion hole of the operation unit connection adapter.
The endoscope auxiliary instrument, wherein a movable range of the rigid member is limited within a range that does not enter the flexible connecting pipe. The auxiliary instrument for endoscope according to any one of claims 3 to 6, wherein the external attaching / detaching portion of the tube fixing ring has an outer surface screw on an outer peripheral surface of a cylindrical portion surrounding the attaching / detaching hole. An auxiliary instrument for an endoscope, wherein an insertion portion of the operation unit connection adapter is prevented from coming off from an attachment / detachment hole by a mounting nut screwed onto a screw. The endoscope auxiliary instrument according to claim 7, wherein an outer surface of the mounting nut and the hard or soft connecting tube is covered with an insulating member. The endoscope auxiliary instrument according to any one of claims 3 to 8, wherein a non-circular cross-sectional hole is formed in at least a part of the attachment / detachment hole of the tube fixing ring, and the insertion portion of the operation unit connection adapter is formed. An endoscope auxiliary instrument characterized in that a non-circular cross-section cylindrical portion that is fitted to the non-circular cross-section hole portion while restricting relative rotation is formed. 10. The endoscope auxiliary instrument according to claim 1, wherein an attachment / detachment portion for attaching / detaching the tube fixing ring to / from an external attachment / detachment portion is provided at one end portion, and the other end portion is extended from an external fluid control device. A flow path connection adapter in which a fluid circulation hole is formed, which is connected to the holding hole of the tube fixing ring in a state of being attached to the tube fixing ring. An endoscope auxiliary instrument, characterized in that the flow path connection adapter and the operation section connection adapter are selectively attached to an external detachable section of the tube fixing ring. In an endoscope auxiliary instrument having a flexible insertion portion and a holding portion to which a proximal end portion of the insertion portion is connected, and having a tube disposed from the insertion portion to the holding portion,
The holding part is provided with a tube fixing ring having a holding part through hole communicating with the tube and an external detachable part exposed on the holding part outer surface,
The tube fixing ring has an attachment / detachment portion to the external attachment / detachment portion at one end, and a fluid flow tube extending from an external fluid control device can be connected to the other end portion. An endoscope auxiliary instrument comprising a flow path connection adapter having a fluid flow hole formed in communication with a holding portion through hole of the tube fixing ring in an attached state to the ring.

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