JP2010000201A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope being excellent in inserting property, which reduces the vomiting reflex induced when the endoscope insertion section is introduced into the body through the oral cavity. <P>SOLUTION: This endoscope 2 includes: the insertion section 10 which has a distal end and an proximal end, and has a curving section 14; the curving section 14 including a first curving section 15a which is constituted to curve at least in the vertical direction on the distal end side, and a second curving section 15b which is connected with the proximal end side of the first curving section 15a and is constituted to curve in the lateral direction being a different direction from the vertical direction; an operation section 11 which is connected with the proximal end side of the insertion section 10, and includes at least a curving section-operating mechanism section 21 having a vertically curving knob 21UD which makes the first curving section 15a curve in the vertical direction. In addition, the endoscope 2 includes a curving motion interlocking section which makes the second curving section 15b curve in the lateral direction by interlocking with the motion for making the first curving section 15a of the vertical curving knob 21UD curve in the vertical direction. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an endoscope that introduces an insertion portion into a body through a throat esophageal stricture from a patient's oral cavity.

  In order to smoothly guide the insertion part into the three-dimensionally bent lumen of the gastrointestinal tract and other living bodies by bending the endoscope at the distal end of the endoscope in the vertical and horizontal directions by remote operation on the hand side The curved portion is provided.

For example, Patent Document 1 discloses an endoscope in which a bending portion is configured by two bending portions, a first bending portion and a second bending portion. In this endoscope, the two bending portions are individually bent, for example, the entire bending portion is bent into an S shape, and the two bending operations are simultaneously performed, so that the entire bending portion is greatly bent in the same direction. You can make it.
Japanese Patent Publication No.47-12398

  However, when the insertion portion of the endoscope is introduced from the oral cavity of the subject into, for example, the stomach, many subjects exhibit nausea (hereinafter referred to as vomiting reflex). When the insertion portion of the endoscope is introduced into the body through the oral cavity, the bending portion is bent and the insertion portion is inserted into the esophagus from the oral cavity. At this time, the distal end portion of the insertion portion comes into contact with the throat stricture portion of the patient. Thereafter, when the insertion portion is further pushed into the stenosis, the curved portion strongly presses the posterior throat wall to induce a vomiting reflex. For this reason, it is thought that the vomiting reflex is formed by a curved portion that strongly presses the posterior throat wall.

  The present invention has been made in view of the above circumstances, and provides an endoscope excellent in insertability that reduces vomiting reflex induced when an endoscope insertion portion is introduced into the body through the oral cavity. The purpose is to do.

  The endoscope of the present invention has a first bending portion having a distal end and a proximal end, and is configured to bend at least in the first direction on the distal end side, and is connected to the proximal end side of the first bending portion. An insertion portion having a bending portion including a second bending portion configured to bend in a second direction that is different from the one direction; and at least a first bending portion that is connected to the proximal end side of the insertion portion. Interlocked with an operation portion including a bending portion operation mechanism portion having a first bending portion operation portion that bends the first bending portion in the first direction, and an operation of bending the first bending portion of the first bending portion operation portion in the first direction. And a bending operation interlocking portion for bending the second bending portion in the second direction.

  According to this configuration, when the insertion portion of the endoscope is introduced into the stomach via the oral cavity, the first bending direction of the bending portion is set to be directed toward the posterior throat wall. When the surgeon operates the first bending portion operating portion to bend the first bending portion in the first direction, the first bending portion is bent in the first direction and the second bending portion is different from the first direction. Curved in conjunction with the second direction. Then, the second bending portion is bent in the second direction, so that the arrangement position of the first bending portion is displaced from the rear throat wall toward the side wall, and the throat rear wall is prevented from being strongly pressed.

  ADVANTAGE OF THE INVENTION According to this invention, the endoscope excellent in the insertion property which reduces the vomiting reflection induced when an endoscope insertion part is introduce | transduced in a body via an oral cavity is realizable.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
1 to 7 relate to a first embodiment of the present invention, FIG. 1 is a diagram illustrating a medical system including an endoscope, FIG. 2 is a diagram illustrating a configuration of an insertion portion of the endoscope, and FIG. FIG. 4 is a view for explaining the relationship between the bending portion operating mechanism portion and the bending wire, FIG. 4 is a view for explaining the configuration of a bending motion interlocking portion for interlocking the first bending portion and the second bending portion, and FIG. The figure explaining the state which penetrated the front end side of the insertion part of a mirror in the oral cavity, FIG. 6 is a figure explaining the effect | action of a bending part when the 1st bending part and the 2nd bending part operate | move interlockingly in the oral cavity. FIG. 7 is a diagram for explaining a state where the distal end portion of the insertion portion of the endoscope is inserted into the esophageal entrance portion.

  As shown in FIG. 1, the medical system 1 of the present embodiment is mainly configured by an endoscope 2, an observation device 3, and a monitor 4 that is a display device. The observation device 3 is a video processor with a built-in light source device function, and is a control unit. The monitor 4 is electrically connected to the observation device 3, and an observation image such as an endoscopic image is displayed on the screen of the monitor 4. Reference numeral 5 denotes a mouthpiece, which is connected to the observation device 3, for example. The mouthpiece 5 is formed of an elastic synthetic resin. The mouthpiece 5 incorporates, for example, an optical sensor that constitutes a position detection unit. This optical sensor outputs a detection signal to the observation device 3 via the communication cable 5a. Reference numeral 5b denotes a cable connector, which is detachably connected to the observation device 3.

  The endoscope 2 includes an insertion portion 10 that is inserted into a site to be observed, an operation portion 11 that also serves as a grip portion on the proximal end side of the insertion portion 10, and a universal cable 12 that extends from a side surface of the operation portion 11. And is configured. A connector portion 12 a is provided at the end of the universal cable 12, and the connector portion 12 a is detachably connected to the observation device 3.

  The insertion portion 10 of the endoscope 2 has a distal end portion 13 on the distal end side thereof, and a bendable bending portion 14 is provided on the proximal end side of the distal end portion 13. In the present embodiment, the bending portion 14 includes a first bending portion 15a disposed on the distal end side, and a second bending portion 15b continuously provided on the proximal end side of the first bending portion 15a. A soft and slender tubular flexible tube 16 is connected to the proximal end side of the bending portion 14.

  In the present embodiment, the first bending portion 15a is configured to bend in the vertical direction, which is the first direction, and is a direction different from the first direction, for example, a second direction substantially orthogonal to the first direction. It is comprised so that it may curve in the left-right direction which is. On the other hand, the 2nd bending part 15b is comprised so that it may curve in the left-right direction which is a 2nd direction. The distal end portion 13 incorporates an image pickup section that includes various image sensors such as a CCD and a CMOS and constitutes an image pickup apparatus. Note that the vertical direction and the horizontal direction correspond to the vertical transfer direction and the horizontal transfer direction of the image of the imaging apparatus. Therefore, the up / down / left / right direction of the endoscopic image photographed by the endoscope 2 matches the up / down / left / right direction in which the bending portion 14 is bent.

  The operation unit 11 includes a vertical bending knob 21UD that is a first bending unit operating unit that causes the first bending unit 15a to bend in a vertical direction that is a first direction, and a horizontal direction that is the first bending unit 15a that is a second direction. There is provided a bending portion operating mechanism portion 21 that is configured by superposing a left and right bending knob 21LR that is bent in a straight line.

The configuration of the bending portion 14 of the present invention will be described with reference to FIG.
As shown in FIG. 2, the bending portion 14 includes a first bending portion 15a that connects a plurality of bending pieces, a second bending portion 15b that connects a plurality of bending pieces, a base end portion of the first bending portion 15a, and a first end portion. The main part is mainly composed of a cover part 17 and a cover part 15 c connecting the tip part of the two bending parts 15 b. The covering portion 17 covers the first bending portion 15a, the collar portion 15c, and the second bending portion 15b. The covering portion 17 includes a net tube 17a that covers a plurality of bending pieces, and a curved rubber 17b that covers the net tube 17a.

  The first bending portion 15a includes a first bending portion tip piece 41, a first bending portion second piece 42, a plurality of first vertical and horizontal bending pieces 43, a plurality of vertical bending pieces 44, and a first bending portion base. It is mainly composed of end pieces 45. That is, the first bending portion 15a is configured to bend in the upward and downward directions, and in the left and right directions.

  On the other hand, the second bending portion 15 b is mainly configured by a second bending portion distal piece 51, a plurality of second left and right bending pieces 52, and a second bending portion base end piece 53. That is, the second bending portion 15b is configured to bend leftward and rightward. The 1st bending part base end piece 45 and the 2nd bending part front piece 51 comprise the jumper part 15c.

  First wire fixing portions 31 corresponding to the vertical and horizontal directions are provided at substantially equal intervals in the circumferential direction at predetermined portions of the first bending portion tip piece 41 constituting the forefront of the first bending portion 15a. Each of the first wire fixing portions 31 includes a first upper bending wire (hereinafter abbreviated as first upper wire) 22U, which is a first bending operation wire, and a first lower bending wire (hereinafter abbreviated as first lower wire). The end of 22D, the first left bending wire (hereinafter abbreviated as first left wire) 22L, and the end of the first right bending wire (hereinafter abbreviated as first right wire) 22R are fixed together by brazing, for example. Has been.

  A pair of connecting projections for connecting the first bending portion second piece 42 so as to be rotatable in the vertical direction are provided at a predetermined position on the proximal side of the first bending portion tip piece 41 in a positional relationship facing each other. . These connecting protrusions are provided with through holes in which rivets 61 as connecting members for pivotally supporting adjacent bending pieces are provided. The straight line connecting the center of the through hole of the connecting projection provided on the right side of the first bending portion tip piece 41 and the center of the through hole of the connecting projection provided on the left side is on the vertical rotation axis. It corresponds.

  The first curved portion second piece 42 is provided with a pair of connecting projections on the distal end side and the proximal end side thereof so as to connect adjacent pieces so as to be rotatable in the vertical direction. . These connecting projections are also provided with through holes in which rivets 61 for pivotally supporting adjacent bending pieces are provided.

  The first up / down / left / right bending piece 43 is composed of, for example, two types. One type of first up / down / left / right bending piece 43 is provided with a pair of connecting protrusions for connecting the adjacent pieces on the distal end side so as to be freely rotatable in the vertical direction. A pair of connecting projections for connecting the adjacent pieces on the side so as to be rotatable in the left-right direction are provided in a positional relationship facing each other.

  On the other hand, the other type of first up / down / left / right bending piece 43 is provided with a pair of connecting protrusions facing each other so that the adjacent pieces on the tip side can be rotated in the left / right direction. In addition, a pair of connecting projections for connecting the adjacent pieces on the base end side so as to be rotatable in the vertical direction are provided in a positional relationship facing each other.

  Each connecting projection is provided with a through hole in which a rivet 61 for pivotally supporting adjacent bending pieces is provided. The straight line connecting the center of the through hole of the connecting projection provided on the upper side surface of the first up / down / left / right bending piece 43 and the center of the through hole of the connecting projection provided on the lower side is relative to the vertical rotation axis. Corresponds to the right and left rotation axis.

  The vertical bending piece 44 has a pair of connecting projections for connecting the adjacent pieces so as to be rotatable in the vertical direction on the distal end side and the proximal end side thereof in a positional relationship facing each other. These connecting projections are provided with through holes in which rivets 61 for pivotally supporting the bending pieces are arranged.

  The first bending portion base end piece 45 is provided with a pair of connecting protrusions for connecting the adjacent pieces on the front end side so as to be rotatable in the vertical direction in a facing relationship. These connecting projections are provided with through holes in which rivets 61 for pivotally supporting the bending pieces are arranged.

  At a predetermined position on the proximal end side of the second bending portion distal piece 51, a pair of connecting projections for connecting the second left and right bending pieces 52 so as to be rotatable in the left-right direction are provided in a positional relationship facing each other. These connecting protrusions are provided with through holes in which rivets 61 as connecting members for pivotally supporting adjacent bending pieces are provided. Moreover, the 2nd wire fixing | fixed part 32 corresponding to the left-right direction is provided in the predetermined site | part of the 2nd bending part front piece 51, respectively. In the present embodiment, for example, the second wire fixing portion 32 corresponding to the right direction has an end portion of a second right bending wire (hereinafter, abbreviated as a second right wire) 23R that is a second bending operation wire. It is fixed together by brazing.

  The second left and right bending pieces 52 are provided with a pair of connecting protrusions facing each other so that the adjacent pieces on the front end side and the base end side are rotatable in the left and right directions in a facing relationship. Each connecting projection is provided with a through hole in which a rivet 61 for pivotally supporting adjacent bending pieces is provided.

  The second bending portion base end piece 53 is provided with a pair of connecting protrusions for connecting the adjacent pieces on the distal end side so as to be turnable in the left-right direction in a positional relationship facing each other. Each connecting projection is provided with a through hole in which a rivet 61 for pivotally supporting adjacent bending pieces is provided.

  The first upper wire 22U and the first lower wire 22D fixed to the first wire fixing portion 31 respectively correspond to the vertical directions of the plurality of bending pieces constituting the first bending portion 15a and the second bending portion 15b. The wire receivers 6U and 6D, which are guide receivers for the first wire arranged in the axial direction, and the coil pipes 7U and 7D provided at positions corresponding to the vertical direction in the flexible tube 16 are inserted into the coils. After extending from the pipes 7U and 7D, as shown in FIG. 3, it is fixed to the vertical sprocket 25UD provided at the end of the vertical shaft portion 24UD of the vertical bending knob 21UD.

  On the other hand, the first left wire 22L and the first right wire 22R, each having its distal end fixed to a predetermined first wire fixing portion 31, respectively, in the left-right direction of the bending pieces constituting the first bending portion 15a and the second bending portion 15b. The wire receivers 6L and 6R arranged in the axial direction at corresponding positions and the coil pipes 7L and 7R provided at positions corresponding to the left and right directions in the flexible tube 16 are inserted through the coil pipes 7L and 7R. After the extension, as shown in FIG. 3, the left and right bending knobs 21LR are respectively fixed to left and right sprockets 25LR provided at the ends of the left and right shaft portions 24LR.

  On the other hand, for example, the second right wire 23 </ b> R is fixed at a predetermined position of the second wire fixing portion 32. The second right wire 23R is a wire receiver 8R which is a guide receiver for the second wire arranged in the axial direction at a position corresponding to the right direction of the bending piece constituting the second bending portion 15b, and the left-right direction in the flexible tube 16 Is inserted through the coil pipe 9R provided at a position corresponding to, and after extending from the coil pipe 9R, as shown in FIG. It is integrally fixed by. Therefore, when the up / down bending knob 21UD is rotated, the first upper wire 22U and the first lower wire 22D are pulled and loosened, and the second upper wire 22U is fixed to the middle portion of the first upper wire 22U. The right wire 23R is also pulled and relaxed.

  Thus, the end portion of the second right wire 23R is integrally fixed to the middle portion of the first upper wire 22U via the wire stopper 26, whereby the first bending portion 15a is rotated by the turning operation of the up and down bending knob 21UD. And the bending action interlocking | linkage part which the 2nd bending part 15b curves in response is comprised. In other words, the second bending portion 15b can be bent in the left-right direction, which is the second direction, without providing the operation portion 11 with a left-right bending knob for bending the second bending portion 15b in the left-right direction.

In the present embodiment, for example, the surgeon rotates the up / down bending knob 21UD as shown by the arrow A as shown in FIG. The wire 22U is pulled as indicated by arrow B, the second right wire 23R is pulled as indicated by arrow C, the first bending portion 15a is bent upward, and the second bending portion 15b is It is configured to bend in the direction.
In addition, by turning the left and right bending knob 21LR, the first left wire 22L and the first right wire 22R are pulled and loosened, and the first bending portion 15a is bent in the left-right direction.

Here, the operation of the endoscope 2 including the bending portion 14 configured as described above will be described.
First, the endoscope 2 is prepared as shown in FIG. Also, place the subject on the bed sideways. At this time, the subject's left flank is placed on the bed side. Then, the subject is made to hold the mouthpiece 5 and the upper endoscopy is started.

  Next, the surgeon inserts the insertion portion 10 of the endoscope 2 into the oral cavity via the mouthpiece 5 and starts the insertion procedure. At this time, for example, the surgeon turns the curved upper direction of the first bending portion 15a toward the lingual side.

  In order to guide the insertion portion 10 inserted into the oral cavity to the esophagus, the surgeon curves the first bending portion 15a while observing the endoscopic image and looks down on the stenosis portion, and the stenosis portion opens during the subject's swallowing exercise In accordance with the timing, the distal end portion 13 of the insertion portion 10 is inserted into the esophageal entrance, and is guided through the stenosis portion into the cervical esophagus.

  When the surgeon starts bending the bending portion 14 and inserting the insertion portion 10 in the oral cavity of the subject, as described above, the first bending portion 15a and the second bending portion 15b are bent in conjunction with each other. . That is, the first bending portion 15a gradually starts to bend upward as shown in FIG. 5, and the second bending portion 15b is gradually bent to the right.

  Then, the curved portion 14 in the oral cavity is located in the center of the oral cavity as shown by the broken line in FIG. 6, and the left throat wall that is the left flank direction of the subject as shown by the two-dot chain line and the solid line Move towards.

  That is, when the distal end portion 13 of the insertion portion 10 is in contact with the narrowed portion that is the esophageal entrance of the subject, the second bending portion 15b is in contact with the right throat wall as shown by the solid line in FIG. Insertion of the insertion part 10 is performed. That is, as shown in FIG. 7, when the insertion portion 10 is pushed through the stenosis portion and pushed into the cervical esophagus, the bending portion 14 presses the side wall of the throat back wall, so that the bending portion 14 compresses the throat back wall. Is reduced.

  As described above, the first bending portion and the second bending portion are provided in the insertion portion of the endoscope, and the bending operation of the second bending portion is linked to the operation of the first bending portion bending in the first direction. It is configured to bend in the direction. Therefore, the insertion procedure for introducing the insertion portion into the esophagus via the oral cavity can be performed by placing the bending portion having the first bending portion and the second bending portion on the left throat wall, which is the side wall of the throat posterior wall. . For this reason, when the distal end portion of the insertion portion passes through the stenosis portion, it is possible to reduce the vomiting reflection felt by the subject by reducing the pressure on the back wall of the throat by the bending portion.

  In the present embodiment, the end portion of the second right wire 23R extended from the coil pipe 9R is integrally fixed to the middle portion of the first upper wire 22U by the wire stopper 26, and the up and down bending knob 21UD is obtained. The first bending portion 15a and the second bending portion 15b are bent in conjunction with the turning operation. However, although not shown, the coil pipe 9R is extended to the vicinity of the vertical sprocket 25UD, and the end portion of the second right wire 23R extending from the coil pipe 9R is directly provided on the vertical bending knob 21UD. The structure fixed to 25UD may be sufficient. Accordingly, the first bending portion 15a and the second bending portion 15b can be bent in the same manner as described above in conjunction with the upward bending operation of the up / down bending knob 21UD.

  Further, a second left wire 23L is disposed instead of the second right wire 23R, and the end of the second left wire 23L extended from the coil pipe 9L (not shown) is connected to the middle portion of the first upper wire 22U. The first bending portion 15a and the second bending portion 15b may be bent in conjunction with the rotation operation of the up / down bending knob 21UD by being integrally fixed by the stopper 26. Note that the second wires 23R and 23L may be integrally fixed to the middle portion of the first wire 22D by a wire stopper 26.

  Furthermore, in the above-described embodiment, the second bending portion 15b is configured to bend in the left-right direction that is the second direction. However, the second bending portion 15b is not limited to the configuration that bends in one left and right direction, and may be configured to bend in the up and down and left and right directions similarly to the first bending portion 15a. And when making the 2nd bending part bendable up and down and right and left, as shown in the following FIG. 8A thru | or FIG. 9B, a 2nd bending part is comprised and the bending operation | movement to the left-right direction of a 2nd bending part is carried out. The second bending portion 15b is configured to be easily bent in the left-right direction in a manner that is higher than the bending operability in the vertical direction.

  Further, the configuration of the bending operation interlocking portion that interlocks the bending operation of the first bending portion 15a and the bending operation of the second bending portion 15b is not limited to the above-described embodiment, and the following FIGS. The configuration shown in FIG.

First, with reference to FIG. 8A thru | or FIG. 9B, the 2nd bending part which can be bent in the up-down-left-right direction similarly to a 1st bending part is demonstrated.
8A and 8B show a first configuration example in which the rotational operability of the bending piece around the left and right rotation axis of the second bending portion that can be bent in the vertical and horizontal directions is made higher than the rotational operability of the bending piece around the vertical rotation axis. FIG. 8A is a diagram illustrating the configuration of the vertical rotation shaft, and FIG. 8B is a diagram illustrating the configuration of the left / right rotation shaft.

As shown in FIGS. 8A and 8B, in the present embodiment, the diameter dUD of the first rivet 61UD constituting the up-and-down rotation axis is different from the diameter dLR of the second rivet 61LR constituting the left-right rotation axis. . Specifically, the diameter dUD of the first rivet 61UD is set larger than the diameter dLR of the second rivet 61LR.
In addition, the hole diameter of the through hole 63 formed in the bending piece 62 through which the rivets 61UD and 61LR are inserted is substantially the same.

Therefore, the clearance between the second rivet 61LR and the through hole 63 is larger than the clearance between the first rivet 61LR and the through hole 63.
In other words, in the present embodiment, the diameter dimension of the rivet that rotatably connects the joint pieces is changed between the vertical rotation axis and the horizontal rotation axis, and the clearance between the rivet and the through-hole is changed, so The rotational operability of the bending piece around the moving axis is made higher than that of the bending piece around the vertical rotation axis. Accordingly, during the insertion procedure for introducing the insertion portion into the esophagus via the oral cavity, the second bending portion is more likely to bend in the left-right direction than in the up-down direction, and compression of the throat posterior wall can be reduced.

  Instead of changing the diameter of the rivet, the shaft portion length L of the rivet 61 is changed as shown in FIG. 9A and FIG. It may be made higher than the rotational operability of the surrounding bending pieces.

  9A and 9B show a second configuration example in which the rotational operability of the bending piece around the left and right rotation axis of the second bending portion that can be bent in the vertical and horizontal directions is made higher than the rotational operability of the bending piece around the vertical rotation axis. FIG. 9A is a diagram illustrating the configuration of the vertical rotation shaft, and FIG. 9B is a diagram illustrating the configuration of the horizontal rotation shaft.

  As shown in FIGS. 9A and 9B, in the present embodiment, the length dimension Lud of the shaft portion 64UD of the first rivet 61UD and the length dimension Llr of the shaft portion 64LR of the second rivet 61LR that constitutes the left-right pivot shaft. Is different. Specifically, the length of the shaft portion 64LR of the second rivet 61LR is set longer than the length of the shaft portion 64UD of the first rivet 61UD.

  The rivets 61UD and 61LR have substantially the same diameter and the thickness of the bending piece 62.

Therefore, the adhesion force for closely attaching the bending pieces by the second rivet 61LR is smaller than the adhesion force for closely attaching the bending pieces by the first rivet 61UD.
That is, in the present embodiment, by changing the length dimension of the rivet that rotatably connects the joint pieces between the up and down rotation shaft and the left and right rotation shaft, the adhesion force between the bending pieces by the rivet is changed, The rotational operability of the bending piece around the left and right rotation axis is made higher than that of the bending piece around the vertical rotation axis.

Next, another embodiment of the bending operation interlocking portion that interlocks the first bending portion 15a and the second bending portion 15b will be described with reference to FIGS.
FIG. 10 is a view for explaining a second embodiment of the bending motion interlocking portion.

  In the present embodiment, the first bending portion 15a and the second bending portion 15b are secured without fixing the end portion of the second right wire 23R or the second left wire 23L to the midway portion of the first upper wire 22U by the wire stopper 26. Is linked to the operation.

  As shown in FIG. 10, in this embodiment, the configuration of the bending portion operation mechanism portion 21 </ b> A is different from that of the bending portion operation mechanism portion 21. In the bending portion operation mechanism portion 21A, a second bending portion left and right sprocket 26LR is integrally fixed to an up and down shaft portion 24UD1 constituting the up and down bending knob 21UD in addition to the up and down sprocket 25UD. That is, the vertical sprocket 25UD is fixed to, for example, a middle portion of the vertical shaft portion 24UD1, and the second bending portion left and right sprocket 26LR is fixed to the end thereof.

  Then, the end portion of the first upper wire 22U extending from the coil pipe 7U is fixed to the vertical sprocket 25UD, and the end portion of the second right wire 23R extending from the coil pipe 9R is fixed to the second bending portion left and right sprocket 26LR. It is fixed to. As a result, when the up / down bending knob 21UD is operated to bend upward, the first upper wire 22U is pulled and the second right wire 23R is pulled, and the first bending portion 15a and the second bending portion 15b are interlocked. Bend.

  That is, the vertical shaft 24UD1 constituting the vertical bending knob 21UD is provided with the vertical sprocket 25UD and the second curved left and right sprocket 26LR, and the vertical sprocket 25UD includes the first upper wire 22U and the first lower wire 22D. Each end portion is fixed, and the end portion of the second right wire 23R is fixed to the second bending portion left and right sprockets 26LR to form a bending operation interlocking portion.

  Thus, without fixing the end portion of the second right wire 23R or the second left wire 23L to the middle portion of the first upper wire 22U by the wire stopper 26, the vertical sprocket 25UD and the second sprocket 25UD are connected to the vertical shaft portion 24UD1. Provided on the left and right sprockets 26LR for the bending portion, the end portions of the first upper wire 22U and the first lower wire 22D are provided on the upper and lower sprockets 25UD, respectively, and the end portion of the second right wire 23R is provided on the second left and right sprockets 26LR for the bending portion. It is fixed. Therefore, by operating the up / down bending knob 21UD and pulling the first upper wire 22U and the second right wire 23R, the first bending portion 15a is moved upward and the second bending portion 15b is moved rightward. Can be curved in conjunction.

In addition, according to this variation, the first upper wire and the first lower wire are appropriately set by appropriately setting the diameters of the second curved left and right sprockets to which the second right wire is fixed and the upper and lower sprockets. By changing the pulling amount and the pulling amount of the second right wire, it is possible to change the bending amount (the angle at the time of bending) of the first bending portion and the bending amount of the second bending portion that are bent in conjunction with each other. Become.
Other configurations, operations, and effects are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

FIG. 11 is a diagram for explaining a third embodiment of the bending motion interlocking portion.
In the present embodiment, the first bending portion 15a and the second bending portion 15b are operated in conjunction with each other without providing the second right wire 23R that is the second bending operation wire.

  As shown in FIG. 11, in the present embodiment, the first upper wire 22U fixed to the first wire fixing portion 31 corresponding to the upper direction is inserted into the wire receiver 6U in the first bending portion 15a, and the first The second bending portion 15b is inserted through the wire receiver 8R. Further, in the flexible tube 16, the first upper wire 22U is inserted into the coil pipe 9R. The first upper wire 22U extended from the coil pipe 9R is fixed to the vertical sprocket 25UD provided at the end of the vertical shaft 24UD of the vertical bending knob 21UD shown in FIG.

  According to this configuration, the first upper wire 22U is inserted into the second right wire receiver 8R at the second bending portion 15b, and the wire receiving 6U corresponding to a predetermined upward direction at the first bending portion 15a. It is inserted in. As a result, when the up / down bending knob 21UD is operated to bend upward, the first bending wire 15R is inserted through the wire receiver 8R, and the first bending portion 15a is inserted through the wire receiver 6U. 22U is pulled, and the first bending portion 15a and the second bending portion 15b are bent in conjunction with each other.

  That is, the first upper wire 22U is inserted into the wire receiver 6U provided in the first bending portion 15a and the wire receiver 8R provided in the second bending portion 15b, and the end portion of the first upper wire 22U is moved up and down. The bending operation interlocking portion is configured by being fixed to the sprocket 25UD for use.

Thus, without providing the second right wire, the first upper wire fixed to the vertical sprocket 25UD is inserted into the right wire receiver at the second bending portion, and into the upper wire receiver at the first bending portion. It is inserted. Therefore, by operating the up / down bending knob 21UD to pull the first upper wire 22U, the first bending portion 15a can be bent in the upward direction and the second bending portion 15b can be bent in the right direction. .
Other configurations, operations, and effects are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

FIG. 12 is a diagram for explaining a fourth embodiment of the bending motion interlocking portion.
In the present embodiment, the bending operation interlocking portion is a connecting cover 70, and the first bending portion 15a and the second bending portion 15b are interlockingly operated by the connecting cover 70.

  As shown in FIG. 12, in the present embodiment, the operation section 11 is provided with a first bending section operating mechanism section 21B and a second bending section operating mechanism section 21C. The first bending portion operating mechanism portion 21B includes a vertical bending knob 21UD that is a first bending portion operating portion that causes the first bending portion 15a to bend in the vertical direction that is the first direction, and the second bending portion 15b in the second direction. And a second bending portion left / right bending knob 28LR which is a second bending portion operating portion that is bent in the left / right direction. On the other hand, the second bending portion operating mechanism portion 21C includes a left / right bending knob 21LR that causes the first bending portion 15a to bend in the left / right direction.

  In the present embodiment, a connecting cover 70 is provided for simultaneously rotating the up / down bending knob 21UD and the second bending portion left / right bending knob 28LR. The connection cover 70 is cylindrical and includes a covering space 71 that integrally covers the up / down bending knob 21UD and the second bending portion left / right bending knob 28LR. The connecting cover 70 includes the up / down bending knob 21UD and the second bending portion left / right bending knob. It is detachable with respect to 28LR.

  In the covering space 71 of the connection cover 70, for example, an annular fixing member 72 is provided that integrally fixes the connection cover 70, the up / down bending knob 21UD, and the second bending portion left / right bending knob 28LR. The fixing member 72 is an elastic member such as rubber.

  A vertical sprocket 25UD is fixed to an end of the vertical shaft 24UD of the vertical bending knob 21UD. The base ends of the first upper wire 22U and the first lower wire 22D are fixed to the vertical sprocket 25UD. A second bending portion left / right sprocket 30LR is fixed to an end of the second bending portion left / right shaft portion 29LR of the second bending portion left / right bending knob 28LR. The second left wire 23L and the base end of the second right wire 23R are fixed to the second curved portion left-right sprocket 30LR. A left and right sprocket 25LR is fixed to the end of the left and right shaft portion 24LR of the left and right bending knob 21LR. The base ends of the first left wire 22L and the first right wire 22R are fixed to the left and right sprockets 25LR, respectively.

  Therefore, in the present embodiment, the second bending portion 15b is moved leftward or rightward as the second left wire 23L and the second right wire 23R are pulled and loosened in accordance with the turning operation of the second bending portion left / right bending knob 28LR. To curve. Further, as described in the above embodiment, the first bending portion 15a is bent in the vertical direction and the horizontal direction in accordance with the turning operation of the vertical bending knob 21UD and the horizontal bending knob 21LR. That is, the first bending portion 15a and the second bending portion 15b are independently bent in accordance with the operation of the knobs 21UD, 21LR, and 28LR.

  According to the present embodiment, the connecting cover 70 is attached to the second bending portion left / right bending knob 28LR and the up / down bending knob 21UD constituting the first bending portion operating mechanism portion 21B, and the connecting cover 70 is rotated. As a result, the first upper wire 22U and the first lower wire 22D are pulled and relaxed, and the second left wire 23L and the second right wire 23R are pulled and relaxed, and the first bending portion 15a and the second bending portion 15b are interlocked. Bend.

That is, the second bending portion left / right bending knob 28LR and the up / down bending knob 21UD are provided in the first bending portion operating mechanism portion 21B provided in the operation portion 11, and the second bending portion left / right bending knob 28LR and the up / down bending knob 21UD are provided. The bending operation interlocking portion is configured by attaching the connecting cover 70 and connecting them together.
As described above, the first bending portion operation mechanism portion 21B including the second bending portion left / right bending knob 28LR and the up / down bending knob 21UD in the operation portion 11 is configured, so that the connection cover 70 can be connected to the second bending portion as necessary. By attaching to the left and right bending knobs and the up and down bending knobs, the bending of the first bending portion 15a in the vertical direction and the bending of the second bending portion 15b in the left and right direction can be interlocked.
Other configurations, operations, and effects are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

  In the above-described embodiment, a configuration in which the connection cover 70 is attached and the second bending portion left / right bending knob 28LR and the up / down bending knob 21UD are integrally connected is shown. However, as shown in FIG. 13, the second bending portion left / right bending knob 28LR1 and the second bending portion left / right shaft portion 29LR are configured to be slidable as shown by the arrow D with respect to the axial direction of the vertical shaft portion 24UD. Thus, the bending operation interlocking portion in which the first bending portion 15a and the second bending portion 15b operate in an interlocking manner may be used. Further, the second bending portion left / right shaft portion 29LR is configured to be slidable also with respect to the second bending portion left / right sprocket 30LR. In this figure, the tip of the second curved portion left / right shaft portion 29LR is projected from the second curved portion left / right sprocket 30LR to represent the movement of the shaft. FIG. 13 is a diagram for explaining a fifth embodiment of the bending motion interlocking portion.

  The second bending portion left / right bending knob 28LR1 shown in FIG. 13 is configured to be separated from the up / down bending knob 21UD1 by a biasing member (not shown). In the present embodiment, the second bending portion left / right bending knob 28LR1 includes, for example, a convex portion 28a serving as a locking portion formed circumferentially on the vertical bending knob 21UD1 side or at a predetermined interval in the circumferential direction. On the other hand, the up and down bending knob 21UD1 is provided with a concave portion 21a which is a locked portion into which the convex portion 28a is engaged.

  According to this configuration, the second bending portion left / right bending knob 28LR1 indicated by the solid line is moved to the vertical bending knob 21UD1 against the urging force of the urging member, and the convex portion 28a is indicated by the concave portion 21a as indicated by the two-dot chain line. Engage with. In this state, for example, by turning the up / down bending knob 21UD1, the bending of the first bending portion 15a in the up-down direction and the bending of the second bending portion 15b in the left-right direction can be interlocked.

  In this manner, the second bending portion left / right bending knob 28LR1 is configured to be slidable with respect to the axial direction of the vertical shaft portion 24UD, and the second bending portion left / right bending knob 28LR1 is provided with a locking portion, while the vertical bending portion By providing the latched portion on the knob 21UD1 and configuring the bending operation interlocking portion, it is possible to eliminate the necessity of attaching and detaching the connecting cover and to eliminate the complexity at the time of inspection.

FIGS. 14 and 15 are diagrams for explaining a sixth embodiment of the bending operation interlocking portion. FIG. 14 is a view for explaining the up and down bending knob and the second bending portion left and right bending knob having a meshing portion. FIG. 14 is a sectional view taken along line XV-XV.
In the present embodiment, the bending operation interlocking portion is a meshing portion that meshes the outer peripheral portion of the up / down bending knob 21UD2 and the outer peripheral portion of the second bending portion left / right bending knob 28LR2.

  As shown in FIG. 14, in the present embodiment, the operation section 11 is provided with a first bending section operating mechanism section 21D and a second bending section operating mechanism section 21E. The first bending portion operation mechanism portion 21D is configured by superposing a vertical bending knob 21UD2 and a left / right bending knob 21LR. On the other hand, the second bending portion operation mechanism portion 21E includes a second bending portion left / right bending knob 28LR2 for bending the second bending portion 15b in the left / right direction which is the second direction.

  In the present embodiment, the second bending portion left / right bending knob 28LR2 is configured to be slidable as shown by an arrow E with respect to the second bending portion left / right shaft portion 29LR1 of the second bending portion operation mechanism portion 21E. ing.

  Accordingly, in the present embodiment, the first bending portion 15a and the second bending portion 15b are independently bent in accordance with the operation of the knobs 21UD2, 21LR, and 28LR2.

  As shown in FIG. 15, the outer peripheral part of the up-and-down bending knob 21UD2 and the outer peripheral part of the second bending part left-right bending knob 28LR2 are each provided with a plurality of gear-shaped parts serving as meshing parts. Specifically, the vertical bending knob 21UD2 is provided with a plurality of first gear-shaped portions (hereinafter referred to as first tooth portions 21b), and the second bending portion left / right bending knob 28LR2 is provided with a plurality of second tooth portions 28b. Are provided.

  According to the present embodiment, the second bending portion left / right bending knob 28LR2 is moved to a predetermined position, and the second tooth portion 28b of the second bending portion left / right bending knob 28LR2 and the first tooth portion 21b of the up / down bending knob 21UD2 are moved. By meshing, the rotation of the up / down bending knob 21UD2 is transmitted to the second bending portion left / right bending knob 28LR2 via the first tooth portions 21b, 28b, and the first bending portion 15a and the second bending portion 15b are interlocked. Bend.

That is, the first bending portion operation mechanism portion 21D including the up / down bending knob 21UD2 and the second bending portion operation mechanism portion 21E including the second bending portion left / right bending knob 28LR2 are provided in the operation portion 11, and the outer periphery of the up / down bending knob 21UD2 The first tooth portion 21b is provided at the portion, the second tooth portion 28b is provided at the outer peripheral portion of the second bending portion left / right bending knob 28LR2, and the first tooth portion 21b and the second tooth portion 28b are engaged with each other to perform a bending operation. The interlocking part is configured.
As described above, the first bending portion operating mechanism portion 21D and the second bending portion operating mechanism portion 21E have the upper and lower bending knobs 21UD1 and the second bending portion left and right bending knobs 28LR2 provided with the first tooth portions 21b and 28b on the outer peripheral portion. And the first bending portion 15a by sliding the second bending portion left / right bending knob 28LR2 and meshing the first tooth portion 21b and the second tooth portion 28b as necessary. Can be interlocked with the bending of the second bending portion 15b in the left-right direction.
Other configurations, operations, and effects are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

FIG. 16 is a view for explaining a seventh embodiment of the bending motion interlocking portion.
In the present embodiment, the bending motion interlocking units are drive motors 81 and 82 and a mode switching button 85 which are driving devices, and the first bending portion 15a and the second bending portion 15b are driven by driving the driving motors 81 and 82 simultaneously. Are linked.

  As shown in FIG. 16, in the present embodiment, the operation unit 11 includes, for example, a first joystick 83 that is a remote switch that constitutes the first bending portion operation mechanism unit and a second joystick 84 that constitutes the second bending portion operation mechanism unit. And a mode switching button 85 are provided. The first joystick 83 is configured to be tiltable in the vertical and horizontal directions, and the second joystick 84 is configured to be tiltable in the horizontal direction. In the operation unit 11, a first drive motor 81, a second drive motor 82, a drive motor (not shown), and a control unit 86 are provided.

  The first drive motor 81 is driven to pull and loosen the first upper wire 22U and the first lower wire 22D based on a rotation signal output to the control unit 86 by tilting the first joystick 83. . The second drive motor 82 is driven to pull and loosen the second left wire 23L and the second right wire 23R based on a rotation signal output to the control unit 86 by tilting the second joystick 83. . A drive motor (not shown) is driven to pull and loosen the first left wire 22L and the first right wire 22R based on a rotation signal output to the control unit 86 by tilting the first joystick 83.

The mode switching button 85 outputs an instruction signal for switching between the independent bending mode and the interlocking bending mode to the control unit 86.
When the mode switching button 85 is in the independent bending mode as shown by the broken line in the figure, the first drive motor 81 and a drive motor (not shown) are driven based on the tilt direction and tilt amount of the first joystick 83, and the second joystick. The second drive motor 82 is driven based on the tilt direction and the tilt amount of 84.

  On the other hand, when the mode switching button 85 is in the interlocking bending mode, the first joystick 84 does not output a rotation signal and only when the first joystick 83 is tilted upward, for example. The drive motor 81 and the second drive motor 82 are driven. When the first joystick 83 is tilted in a direction other than the upward direction, only the first drive motor 81 is driven.

  In this manner, the drive motors 81 and 82 for driving the first bending portion 15a and the second bending portion 15b are provided, and the mode switching button 85 is set to the interlocking bending mode. Accordingly, the upward bending of the first bending portion 15a and the bending of the second bending portion in the right direction can be interlocked by the upward tilting operation of the first joystick 83.

  In the present embodiment, the second bending portion bends in the right direction in conjunction with the upward bending operation of the first bending portion by the upward tilting operation of the first joystick 83. However, the second bending portion may be bent leftward in conjunction with the upward bending operation of the first bending portion by the upward tilting operation of the first joystick 83.

  In addition, by appropriately setting the drive amount of the first drive motor and the drive amount of the second drive motor, the pulling amount of the first upper wire, the lower wire, and the pulling amount of the second right wire can be changed and linked. Thus, it is possible to change the bending amount of the first bending portion and the bending amount of the second bending portion that are bent.

  Furthermore, after the insertion part 10 of the endoscope 2 is introduced into the stomach, for example, the mode switching button 85 is switched from the interlocking bending mode to the independent bending mode, whereby the first bending part 15a is moved in the vertical and horizontal directions in the stomach. In addition, the second bending portion 15b can be bent in the left-right direction to perform inspection, treatment, and the like.

  Further, in an endoscope provided with a plurality of drive motors for bending the bending portion, a plurality of contact sensors 88 are axially arranged on the side surface of the insertion portion 10 that contacts the rear throat wall of the bending portion 14 as shown in FIG. You may make it the structure to arrange in. FIG. 17 is a diagram illustrating a configuration example in which a contact sensor is provided in a bending portion of an endoscope including a drive motor that bends the bending portion.

According to this configuration, when the contact sensor 88 contacts the rear throat wall, a contact detection signal is output to the control unit 86. When receiving the contact detection signal, the control unit 86 outputs a rotation signal to the second drive motor 82, for example, causes the second bending portion 15b to be bent to the right and moves the bending portion 14 to the side wall of the throat rear wall. .
As a result, it is possible to prevent the pressure force that induces the vomiting reflex from being reached.
When the bending portion of the electric bending endoscope is driven to bend, the contact state of the insertion portion is determined from the control current value of the drive motor detected for feedback control or the tension value of the operation wire. You may control.

  18 to 24 relate to a configuration example of an insertion portion of an endoscope in which the bending portion of the insertion portion is J-turned to observe the stomach bottom and the like, and FIG. 18 is an endoscope having one bending portion in the stomach. FIG. 19 is a diagram illustrating an observation image of the stomach bottom observed by J-turning the bending portion in the stomach, and FIG. 20 is a diagram illustrating the first bending portion and the second bending portion. FIG. 21 is an explanatory diagram for explaining a configuration in which the first bending portion and the second bending portion are bent in conjunction with each other after the first bending portion has changed to a predetermined bending angle in the bending portion provided with a portion. FIG. 22 is a diagram illustrating a state in which only the first bending portion of the 20 endoscopes is bent, and FIG. 22 illustrates the first bending portion and the second bending portion after the first bending portion reaches a predetermined bending angle. FIG. 23A is a diagram illustrating a state of bending in conjunction with each other, and FIG. 23A illustrates a bending state of the first bending portion when the left side surface of the bending portion is viewed from the front. FIG. 23B is another side view for explaining the bending state of the first bending portion when the upper bending side surface of the bending portion is viewed from the front, and FIG. 24 is the first bending portion and the first bending portion of the endoscope of FIG. It is a figure which shows the observation image of the stomach bottom part observed by making 2 turn and J-turn.

  When the endoscope is introduced into the stomach to observe the stomach bottom and the small bay side of the upper part of the stomach, the so-called bending portion 101 of the endoscope 100 is bent by 180 ° or more as shown in FIG. The observation is performed in a reversed state. The bending state of the bending portion 101 at this time is called a J-turn state or a U-turn state. When the bending portion 101 is J-turned, an image 111 of the insertion portion itself of the endoscope 100 is reflected in the endoscopic image 110 as shown in FIG. A portion of the upper part that is difficult to observe occurs.

  In the present embodiment, when an endoscope insertion portion is in a J-turn state or a U-turn state, observation can be performed by reducing the image of the insertion portion itself reflected in the endoscope image. Regarding mirrors.

  The endoscope is configured as described in the above-described first embodiment. That is, the endoscope is configured such that the bending portion 14 is bent upward, downward, left and right, and the first bending portion 15a is bent upward. The endoscope 2 includes a second bending portion 15b that bends in the right direction or the left direction in conjunction with the second bending portion 15b.

  In the endoscope 2 of the present embodiment, the maximum bending angle of the upward bending angle of the first bending portion 15a is set to 210 °, for example. In the endoscope 2 of the present embodiment, the first bending portion 15a and the second bending portion are set when the bending angle of the first bending portion 15a reaches a predetermined bending angle (for example, 180 °) set in advance. A stopper 121 and a contact ring 122 are provided so as to start bending in conjunction with the portion 15b.

  As shown in FIG. 20, the stopper 121 is integrally fixed to a predetermined position of the first upper wire 22U, and the contact ring 122 is fixed to the proximal end of the second right wire 23R. The first upper wire 22U is inserted into the contact ring 122.

The operation of the endoscope configured as described above will be described.
After the insertion portion 10 of the endoscope 2 is introduced into the stomach, the operator curves the first bending portion 15a upward in order to make the bending portion 14 J-turned when observing the stomach bottom. . That is, the surgeon rotates the up / down bending knob 21UD to pull the first upper wire 22U in the direction of arrow F. When the pulling of the first upper wire 22U is started, the bending operation of the first bending portion 15a is started. As the first upper wire 22U is pulled in the F direction, the stopper 121 that is integrally fixed to the first upper wire 22U is also moved in the F direction. That is, the stopper 121 moves toward the contact ring 122. And if the 1st bending part 15a curves to 180 degrees set beforehand, the stopper 121 will contact | abut to the contact ring 122. FIG.

  In this contact state, the first upper wire 22U is further pulled in the arrow G direction by further rotating the up / down bending knob 21UD in the same direction. That is, the stopper 121 and the contact ring 122 are integrally moved from the contact position indicated by the broken line to the position indicated by the solid line. At this time, with the movement of the first upper wire 22U, the second right wire 23R is also moved in the same direction.

  Accordingly, the bending angle of the first bending portion 15a is bent so as to further increase from 180 ° as shown in FIG. 23A, and the second bending portion 15b is bent rightward as shown in FIG. 23B. That is, after the bending angle of the first bending portion 15a reaches 180 degrees, the first bending portion 15a and the second bending portion 15b are bent in conjunction with each other.

  As a result, as shown in the endoscopic image 112 of FIG. 24, the endoscopic image of the stomach floor can be obtained in a state where the reflection of the image 113 of the insertion portion itself is reduced in the endoscopic image. Can do.

  In the above-described embodiment, when the bending angle of the first bending portion 15a reaches a predetermined bending angle of 180 °, the first bending portion 15a and the second bending portion 15b bend in conjunction with each other. It is said. However, the bending angle of the first bending portion 15a at which the first bending portion 15a and the second bending portion 15b start bending in conjunction with each other is not limited to 180 °, and even if it is more than that, it is less than that. There may be.

  In the present embodiment, the endoscope 2 is the endoscope of the first embodiment, but the endoscope is not limited to the endoscope having the configuration of the first embodiment. Any of the endoscopes according to the seventh embodiment may be used.

  The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

1 to 7 relate to a first embodiment of the present invention, and FIG. 1 is a diagram for explaining a medical system including an endoscope. The figure explaining the structure of the insertion part of an endoscope The figure explaining the relationship between a bending part operation mechanism part and a bending wire The figure explaining the structure of the bending motion interlocking | linkage part which interlock | cooperates the 1st bending part and the 2nd bending part. The figure explaining the state which penetrated the front end side of the insertion part of an endoscope in the oral cavity The figure explaining the effect | action of a bending part when a 1st bending part and a 2nd bending part operate | move interlockingly in the oral cavity. The figure explaining the state by which the front-end | tip part of the insertion part of an endoscope was inserted in the esophagus entrance part 8A and 8B show a first configuration example in which the rotational operability of the bending piece around the left and right rotation axis of the second bending portion that can be bent in the vertical and horizontal directions is made higher than the rotational operability of the bending piece around the vertical rotation axis. FIG. 8A is a diagram for explaining the configuration of the vertical rotation shaft. The figure explaining the structure of a left-right rotation axis, 9A and 9B show a second configuration example in which the rotational operability of the bending piece around the left and right rotation axis of the second bending portion that can be bent in the vertical and horizontal directions is made higher than the rotational operability of the bending piece around the vertical rotation axis. FIG. 9A is a diagram for explaining the configuration of the vertical rotation shaft. The figure explaining the composition of a right-and-left rotation axis FIGS. 10 to 17 are views for explaining another embodiment of the bending motion interlocking portion that interlocks the first bending portion and the second bending portion, and FIG. 10 shows the second embodiment of the bending motion interlocking portion. Illustration to explain The figure explaining 3rd Embodiment of a bending motion interlocking | linkage part. The figure explaining 4th Embodiment of a bending motion interlocking | linkage part. The figure explaining 5th Embodiment of a bending motion interlocking | linkage part. FIGS. 14 and 15 are diagrams for explaining a sixth embodiment of the bending operation interlocking portion, and FIG. 14 is a diagram for explaining the up and down bending knob and the second bending portion left and right bending knob having a meshing portion. XV-XV sectional view of FIG. The figure explaining 7th Embodiment of a bending motion interlocking | linkage part. The figure which shows the structural example which provided the contact sensor in the bending part of an endoscope provided with the drive motor which bends a bending part. 18 to 24 relate to a configuration example of an insertion portion of an endoscope in which the bending portion of the insertion portion is J-turned to observe the stomach bottom and the like, and FIG. 18 is an endoscope having one bending portion in the stomach. The state explaining the state which made the curved part of J turn The figure which shows the observation image of the stomach bottom part observed by making J turn of the curved part in the stomach In the bending portion including the first bending portion and the second bending portion, the configuration in which the first bending portion and the second bending portion are bent in conjunction with each other after the first bending portion has changed to a predetermined bending angle. Explanatory drawing The figure explaining the state in which only the 1st curved part of the endoscope of FIG. 20 is curved. The figure explaining the state which makes a 1st bending part and a 2nd bending part bend in conjunction after a 1st bending part reaches | attains a predetermined bending angle. One side view explaining the bending state of the first bending portion when the left bending side surface of the bending portion is viewed from the front Other side view explaining the bending state of the first bending portion when the upper bending side surface of the bending portion is viewed from the front The figure which shows the observation image of the stomach bottom part observed by making the 1st bending part and 2nd bending part of the endoscope of FIG. 20 J-turn.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Medical system 2 ... Endoscope 7U ... Coil pipe 9R ... Coil pipe 10 ... Insertion part 11 ... Operation part 14 ... Bending part 15a ... 1st bending part 15b ... 2nd bending part 21 ... Bending part operation mechanism part 21UD ... Vertical bending knob 22U ... first upper wire 23R ... second right wire 25UD ... vertical sprocket

Claims (9)

A first bending portion having a distal end and a proximal end and configured to bend at least in the first direction on the distal end side, and connected to the proximal end side of the first bending portion, and having a direction different from the first direction. An insertion portion having a bending portion including a second bending portion configured to bend in a second direction;
An operation unit including a bending unit operation mechanism unit having a first bending unit operation unit that is connected to the proximal end side of the insertion unit and at least bends the first bending unit in the first direction;
A bending operation interlocking portion for bending the second bending portion in the second direction in conjunction with an operation of bending the first bending portion of the first bending portion operation portion in the first direction;
An endoscope comprising: A first bending operation wire extending from the first bending portion and connected to the first bending portion operating portion in order to bend the first bending portion in the first direction;
A second bending operation wire extending from the second bending portion to bend the second bending portion in the second direction;
The bending operation interlocking portion is configured by integrally fixing a proximal end portion of a second bending operation wire extending from the second bending portion to a middle portion of the first bending operation wire. 1. The endoscope according to 1.   The endoscope according to claim 2, wherein the bending motion interlocking portion is configured by fixing a proximal end portion of the second bending operation wire to a predetermined portion of the first bending portion motion portion. Further, in a configuration including a first bending operation wire that extends from the first bending portion and is connected to the first bending portion operation portion in order to bend the first bending portion in the first direction.
The first bending operation wire is inserted into the first wire guide receivers arranged in the axial direction in the first bending portion so as to correspond to the first direction, while in the second bending portion, the second direction. 2. The endoscope according to claim 1, wherein the bending motion interlocking portion is configured by being inserted into a second wire guide receiver that is arranged in an axial direction in correspondence with the second wire guide receiver. The bending portion operation mechanism unit is configured to perform a first bending portion operation in which a proximal end of a first bending operation wire extending from the first bending portion is coupled to bend the first bending portion in the first direction. And a second bending portion operating portion to which a proximal end of a second bending operation wire extending from the second bending portion is coupled to bend the second bending portion in the second direction on the same axis. It is the composition arranged in,
The bending operation interlocking unit includes a first knob fixed to a rotatable first shaft portion that constitutes a first bending portion operation unit of the bending unit operation mechanism unit, and a first knob that constitutes the bending unit operation mechanism unit. 2. The endoscope according to claim 1, wherein the endoscope is a connecting cover that covers and integrally covers a second knob fixed to a rotatable second shaft portion constituting the two bending portion operating portion. The bending portion operation mechanism unit is configured to perform a first bending portion operation in which a proximal end of a first bending operation wire extending from the first bending portion is coupled to bend the first bending portion in the first direction. And a second bending portion operating portion to which a proximal end of a second bending operation wire extending from the second bending portion is coupled to bend the second bending portion in the second direction on the same axis. It is the composition arranged in,
The bending motion interlocking unit is
A first knob comprising a locking portion fixed to a rotatable first shaft portion constituting the first bending portion operating portion of the bending portion operating mechanism portion;
The locking portion fixed to a rotatable second shaft portion slidably disposed with respect to the first shaft portion, which constitutes a second bending portion operation portion constituting the bending portion operation mechanism portion. A second knob having a locked portion engageable with
The endoscope according to claim 1, further comprising: The operation portion includes a first bending portion operation portion to which a proximal end of a first bending operation wire extending from the first bending portion is coupled to bend at least the first bending portion in the first direction. A second bending portion in which a base end of a second bending operation wire extending from the second bending portion is connected to bend the second bending portion in the second direction. In the configuration comprising the second bending portion operation mechanism unit having a part operation unit,
The bending motion interlocking portion includes an outer peripheral surface of a first knob fixed to a rotatable first shaft portion constituting the first bending portion operation mechanism portion, and a rotation constituting a second bending portion operation mechanism portion. The endoscope according to claim 1, wherein the endoscope is a meshing portion provided so as to be meshable with an outer peripheral surface of the second knob fixed to the second shaft portion. A first bending portion having a distal end and a proximal end and configured to bend at least in the first direction on the distal end side, and a second direction that is a direction different from the first direction on the proximal end side of the first bending portion. An insertion portion continuously connecting the second bending portion configured to be bent
A first bending operation wire extending from the first bending portion to bend the first bending portion in the first direction;
A second bending operation wire extending from the second bending portion to bend the second bending portion in the second direction;
A first driving device for driving the first bending operation wire;
A second driving device for driving the second bending operation wire;
A curve that outputs an instruction signal to the first drive device and the second drive device to bend the second bending portion in the second direction in conjunction with an operation of bending the first bending portion in the first direction. A bending motion instruction unit that also serves as a motion interlocking unit;
An endoscope comprising:   A first mode for bending the second bending portion in the second direction in conjunction with an operation for bending the first bending portion in the first direction when the bending operation instruction portion outputs an instruction signal; A selection switch is provided for selecting a second mode in which the operation of bending the first bending portion in the first direction and the operation of bending the second bending portion in the second direction are not interlocked. The endoscope according to claim 8.