JP2010063628A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To accurately control a direction when leading out a treatment instrument from a treatment instrument lead-out section and suppressing damage of a treatment instrument insertion channel. <P>SOLUTION: A pressing force is distributed by increasing sliding sections with respect to a treatment instrument insertion channel 34 at positions in the front/rear of a pivot pin 23 located at a site where a treatment instrument insertion channel 34 comes into slide contact with a crest part when curvingly operated, out of four pivot pins 23 provided circumferentially in the interior of a curving tube 2b. Therefore, the sliding sections, which are formed of cut/narrowed portions 40 formed by inward recessing a pair of front/rear cut portions formed in the circumferential direction of a curved ring 22, are provided. The cut/narrowed portions 40 are disposed between the pivot pins 23 and 23 disposed in the front/rear, at sites from the intermediate section to the distal end side of the curved tube 2b where the curved tube 2b is acutely bent and is strongly pressed toward the pivot pins 23. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention is an insertion portion of an endoscope provided with a bending tube portion connected to the distal end hard portion in order to change the direction of the distal end hard portion, and a treatment for inserting a treatment instrument such as a forceps The present invention relates to an endoscope in which a tool insertion channel is provided and durability of the treatment tool insertion channel is improved.

  Endoscopes usually have an insertion portion that is provided with a bending tube portion connected to the distal end of the flexible tube portion, and a distal end hard portion that is connected to the distal end of the bending tube portion. The proximal end side of the flexible tube portion is connected to the main body operation portion. The distal end hard portion is provided with an endoscope observation means including an illumination window and an observation window, and the bending tube portion is configured to be remotely operated so that the distal end hard portion faces a desired direction. The bending tube portion is constructed by sequentially pivoting the bending rings. In order to be able to bend in the four directions of up and down and left and right, the front and rear bending rings are pivoted in order of up and down and left and right.

  By bending the bending tube portion, the distal end hard portion can be directed in a desired direction, but the distal end hard portion can be bent at a large angle in order to increase the observation field of view. In particular, when the insertion unit side is viewed from the main body operation unit connected to the insertion unit, the operation of bending upward is 180 degrees or more so that it can be bent at a very large angle. It is common to configure.

  A bending operation means is attached to the main body operation portion, and the bending tube portion is bent in a desired direction by remote operation by the operation of the bending operation means. For this purpose, an operation wire is inserted into the bending tube portion, and the distal end of the operation wire is fixed to the distal end portion of the bending ring. In the case where it can be bent in four directions, four operation wires are provided, and these operation wires are positioned at every 90 degrees in the bending tube portion and extend into the flexible tube portion. Further, it is led out from the flexible tube portion into the main body operation portion. Inside the bending tube portion, a wire insertion member is provided to position the operation wire in the circumferential direction. As the wire insertion member, the front and rear curved rings are pivotally attached to the curved pipe portion with pivot pins, and through holes are provided in these pivot pins, or a cut-off portion is formed in the curved ring, and the operation wire is I try to let it pass.

  The bending operation means includes an operation knob and an operation lever that are connected to the bending pulley, and each operation wire is wound around the bending pulley. In the case of bending in two directions, one bending pulley is provided. When the bending pulley is rotated, one operation wire is drawn into the bending pulley, and the other operation wire is drawn out from the bending pulley. In the case of the one that can be bent in four directions, two bending pulleys are provided, and the upper and lower operation wires and the left and right operation wires are respectively paired and wound around each bending pulley. Will be turned.

  In addition to the endoscope observation means, a treatment instrument lead-out portion at the distal end of the treatment instrument insertion channel is opened in the distal end hard part of the endoscope. The treatment instrument insertion channel is made of a tube material that is flexible in the bending direction, and extends from the insertion section to the treatment instrument introduction section provided in the main body operation section. The treatment instrument insertion channel is used for inserting forceps and other treatment instruments into the inside, and is led out from the treatment instrument derivation section at the distal end to perform treatment including incision, cell collection, hemostasis, and the like. Therefore, at least the illumination window, the observation window, and the treatment instrument lead-out portion are provided on the distal end surface of the distal end hard portion, but the observation window is disposed in the central portion as much as possible, and the illumination window is arranged in this observation window. It is common to arrange on the left and right sides of the window. The treatment instrument deriving unit is disposed at a position directly below or obliquely below the observation window.

  By the way, since the insertion portion is inserted into a body cavity, a reduction in diameter is required. For example, there are those that are inserted toward narrow spaces. For example, in a nasal endoscope, the inside of the nasal cavity is used as an insertion route, so there is a narrow portion in the middle of the insertion route. It is required to reduce the diameter. As described above, in order to reduce the diameter of the insertion portion, the treatment instrument insertion channel is thinned so as to reduce the outer diameter, and further, the space in the internal space of the insertion portion is minimized. There is a need.

  From the above, the treatment instrument insertion channel connected to the treatment instrument lead-out section located below the observation window is disposed at a position close to the inner surface of the insertion section. Inside the bending tube portion, a wire insertion member for inserting the operation wire is provided so as to protrude inward. Therefore, when the bending tube portion is bent, the treatment instrument insertion channel is pressed against the wire insertion member and slides in this state. In particular, the bending tube portion is most frequently bent in the up direction, and the bending angle is the largest in this direction. For this reason, the treatment instrument insertion channel slides in a state in which it is strongly pressed against the wire insertion member. Therefore, if the bending operation is repeatedly performed, the treatment instrument insertion channel may be damaged. In particular, when the thickness of the treatment instrument insertion channel is reduced to reduce the diameter of the insertion portion, the risk of damage is further increased.

In order to avoid the above situation, Patent Document 1 discloses a configuration in which the treatment instrument insertion channel is not pressed against the wire insertion member. In this patent document 1, the observation part and the treatment instrument insertion channel are arranged up and down, and the operation wire for bending operation and the wire insertion member through which the operation wire is inserted are offset from the upper and lower center lines to the left and right. It is set as the structure provided in a position.
JP 2000-23908 A

  As described above, if the operation wire and the wire insertion member are arranged in a positional relationship that does not interfere with the treatment instrument insertion channel, the treatment instrument insertion channel slides and wears in a state of being strongly pressed against the wire insertion member. Can be relaxed. However, with this configuration, the operability of the bending operation is impaired. That is, the observation window is arranged at the center or a position close to the center on the distal end surface of the distal end hard portion, and the front of the insertion portion in the insertion direction is the center of the observation visual field by the observation window. The treatment instrument derivation unit opens at a position below or obliquely below the observation window, and operations such as sniping the affected area by deriving the treatment instrument from the treatment instrument derivation unit are performed.

  The endoscope is operated by grasping the main body operation unit. When the main body operation unit is grasped by hand, the endoscope has directionality in the bending direction of the bending tube portion in the insertion portion. When the bending operation is performed, the bending tube portion bends in the vertical and horizontal directions. When the bending tube portion is bent, the center line in the vertical direction of the bending tube portion coincides with the line connecting the center of the observation window and the center of the treatment instrument derivation portion, or the angle therebetween can be as small as possible. The smaller one is desirable for operating the treatment instrument. However, in Patent Document 1, the line connecting the operation wires that make a pair in the bending tube portion is greatly inclined with respect to the vertical center line at the time of the bending operation. Even if the affected part is discovered in the up and down direction, the bending tube part does not bend in the up and down direction (or left and right direction) even if the bending operation is performed in the up and down direction. Therefore, when an affected part is found in a state of being inserted into a body cavity, it is extremely difficult to control the direction of the treatment tool from the treatment tool deriving unit and accurately aiming at the affected part. It has the fault of becoming.

  The present invention has been made in view of the above points, and an object of the present invention is to accurately control the direction of the treatment instrument when the treatment instrument is derived from the treatment instrument deriving unit. The object is to be able to suppress damage to the instrument insertion channel.

  In order to achieve the above-described object, the present invention provides a bending tube portion disposed in the vicinity of the distal end of the insertion portion, and a distal end hard portion is connected to the distal end of the bending tube portion. A treatment instrument lead-out part is provided together with an endoscope observation means comprising an observation window, and a treatment tool insertion channel having flexibility in the bending direction is connected to the treatment tool lead-out part, and the bending tube part has a plurality of bending rings. An endoscope that is sequentially pivotally attached and extended in a state where an operation wire for bending operation is positioned in a circumferential direction by being inserted through a wire insertion member, and when the bending tube portion is bent Further, the present invention is characterized in that a slidable contact portion on which the outer surface of the treatment instrument insertion channel can abut is formed between front and rear wire insertion members provided at least at the most curved portion.

  The insertion portion has a distal end side portion constituted by a bending tube portion and a distal end hard portion. In general, a flexible tube part with a soft structure is provided between the bending tube part and the main body operation part, but it may also be configured as a rigid part made of a hard pipe material. A combination of a flexible tube portion and a hard portion may be used. The bending direction of the bending tube portion can be two directions, up and down, or four directions, up and down and left and right. In particular, in order to improve the controllability of the direction control of the hard tip portion, it is desirable to have a configuration that can be bent in four directions.

  Due to the arrangement of the observation windows, the treatment instrument lead-out portion is not located at the center of the distal end surface of the insertion portion, but is biased to any position. In particular, it is preferable that an observation window is placed at or near the center position of the distal end surface, and the treatment instrument lead-out portion is preferably located immediately below the observation window. However, in order to reduce the diameter of the insertion portion, the position is slightly shifted left and right. May be provided. In any case, a mechanism for positioning the operation wire in the circumferential direction includes a pivot pin formed with a through hole. In the operation wire thus positioned, the line connecting the upper and lower pairs of operation wires is matched with the vertical curve center line, or the angle between them is made as small as possible. As a result, when the bending operation in the up / down direction is performed, the direction becomes close to the center line of the bending in the up / down direction.

  Here, no member is disposed in the front and back portions of the portion where the wire insertion member is provided. In addition to the wire insertion member, a sliding contact portion that contacts the outer surface of the treatment instrument insertion channel is formed in this space, and the pressing force of the treatment instrument insertion channel is distributed to the wire insertion member and the sliding contact portion. Thus, the surface pressure in each part is reduced by increasing the number of contact portions to the outer surface of the treatment instrument insertion channel on the inner surface of the bending tube portion to disperse the pressing force. As a result, the durability of the treatment instrument insertion channel is improved, and the insertion portion is not enlarged by providing the sliding contact portion. The sliding contact portion may have a configuration in which an operation wire such as a pin, a cut diaphragm, or a ring-shaped member can be inserted, and a configuration in which protrusions are provided on both the left and right sides of the operation wire. In any case, the height position of the sliding contact portion is substantially the same as the height position of the wire insertion member.

  When the treatment tool is led out from the treatment tool lead-out portion, the direction of the treatment tool can be accurately controlled, and damage to the treatment tool insertion channel can be suppressed, thereby improving durability.

    Hereinafter, embodiments of the present invention will be described with reference to the drawings. First, FIG. 1 shows an overall configuration of an endoscope showing an embodiment of the present invention. In the figure, 1 is a main body operation unit, 2 is an insertion unit, and 3 is a universal cord. The insertion portion 2 is inserted into the body cavity of the subject and is connected to the main body operation portion 1, and most of the length from the connection portion to the main body operation portion 1 is a flexible tube portion. The bending tube portion 2b is connected to the distal end of the flexible tube portion 2a, and the distal end rigid portion 2c is provided at the distal end of the bending tube portion 2b.

  As shown by the phantom line in FIG. 1, the bending portion 2b of the insertion portion 2 is operated to bend, and this bending operation is performed from the main body operation portion 1 side. For this purpose, the main body operation unit 1 is provided with a pair of bending operation knobs coaxially. The operation knob 4a is for bending the bending tube portion 2b in the vertical direction, and the operation knob 4b is for bending the bending tube portion 2b in the left-right direction. The bending operation of the bending tube portion 2b is mainly performed so that the distal end hard portion 2c is directed in a desired direction.

  The distal end surface of the distal end hard portion 2c has the configuration shown in FIG. In FIG. 2, the direction indicated by the arrow U is upward, the direction indicated by the arrow D is downward, and the direction indicated by the arrows R and L is the left-right direction. Note that the left and right directions are viewed from the main body operation unit 1 connected to the insertion unit 2. Illumination windows 10 and 10 and an observation window 11 as endoscope observation means are provided on the distal end surface of the distal end rigid portion 2c. The observation window 11 is substantially at the center of the tip surface and slightly upward. The illumination windows 10 are arranged on both the left and right sides of the observation window 11. A treatment instrument outlet 12 is open at a lower position of the observation window 11. Here, a line V-F connecting the center V of the observation window 11 and the center F of the treatment instrument deriving unit 12 is inclined by an angle θ with respect to the vertical curve center line UL. In the figure, reference numeral 13 denotes a cleaning nozzle for supplying cleaning liquid and pressurized air toward the observation window 11.

  Next, FIG. 3 shows a cross section of the distal end portion of the insertion portion 2. The curved tube portion 2b has a node ring structure 20 as a structural member. The outer periphery of the node ring structure 20 is covered with an outer skin layer 21, and the outer skin layer 21 is formed of a member having elasticity such as rubber. Has been. The node ring structure 20 includes a predetermined number of curved rings 22, and the front and rear curved rings 22 are sequentially pivoted. In the configuration shown in FIG. 3, they are pivotally mounted using pivot pins 23 alternately such as front and rear and left and right. The distal end rigid portion 2c is composed of a distal end portion main body 24 and a distal end cap 25. The distal end portion main body 24 has a through-hole that forms an illumination window 10, an observation window 11, a treatment instrument outlet portion 12, and a cleaning fluid supply path. A cylindrical extending portion 24a is connected to the distal end portion body 24, and the extended portion 24a is pivotally attached to the distal end ring 22a constituting the bending tube portion 2b by a pivot pin 23. Has been.

  Various insertion members are inserted into the bending tube portion 2b and the flexible tube portion 2a. That is, the insertion member is connected to the illumination window 10, the observation window 11, the treatment instrument outlet 12, and the cleaning nozzle 13 provided in the distal end hard portion 2 c. As shown in FIG. 4, the light guide 30 is provided in the illumination window 10, and the solid-state image pickup means 15 (see FIG. 3) provided at the imaging position of the objective optical system 14 (see FIG. 3) attached to the observation window 11. Are connected to the main body operation unit 1 and further into the universal cord 3. A fluid supply tube 32 is connected to the cleaning nozzle 13, and this fluid supply tube 32 also extends from the insertion portion 2 through the main body operation portion 1 into the universal cord 3.

  As is apparent from FIG. 3, a connection pipe 33 is connected to the treatment instrument lead-out portion 12, and a portion of the connection pipe 33 drawn from the distal end main body 24 into the extension portion 24 includes: A treatment instrument insertion channel 34 is connected, and this treatment instrument insertion channel 34 is connected to the treatment instrument introduction section 5 provided in the main body operation section 1.

  Further, in order to bend the bending tube portion 2b, operation knobs 4a and 4b are provided. A pulley is connected to each of the operation knobs 4a and 4b. When the operation knobs 4a and 4b are operated, The pulley will rotate. The pulley is well known in the art and is not shown. An operation wire 35 is wound around each of the pair of pulleys provided. The operation wires 35 are provided in the upper and lower and left and right positions in the bending tube portion 2b. The upper and lower pairs of operation wires 35 and 35 are provided on one pulley, and the left and right pair of operation wires 35 and 35 are provided on the other side. Is wound around a pulley. The four operation wires 35 are respectively inserted into the contact coils inside the flexible tube portion 2a. In the bending tube portion 2b, the operation wires 35 are extended over the entire length of the bending tube portion 2b in a state where the operation wires 35 are positioned in the circumferential direction so as to have a positional relationship of 90 degrees. The distal end is fixed to the extending portion 24a of the distal end portion main body 24 to be configured.

  In order to position each operation wire 35 in the circumferential direction in the bending tube portion 2b, a pivot pin 23 that pivots the front and rear bending rings 22 is used. As shown in FIG. 5, the pivot pin 23 has a head portion 23b connected to a shaft portion 23a. The shaft portion 23a is inserted into the bending ring 22 and fixed by means such as caulking. It has become. A through hole 23c is formed in the head 23b, and the operation wire 35 is inserted through the through hole 23c. As a result, by operating one or both of the operation knobs 4a and 4b, the bending tube portion 2b is bent in an arbitrary direction. Here, the top of the head 23b of the pivot pin 23 is not rounded, and when various insertion members in the bending tube portion 2b come into contact with the head 23b of the pivot pin 23, they are not damaged. It has a configuration.

  In FIG. 4, the following subscripts are used to distinguish the operation wires 35 inserted through the four wires and the pivot pins 23 through which they are inserted. First, the operation wire located on the upper side is indicated by 35U, the operation wire located on the lower side is indicated by 35D, and the operation wires located on the left and right are indicated by 35L and 35R, respectively. Then, the pivoting pin through which the operation wire 35U is inserted is 23U, the pivoting pin through which the manipulation wire 35D is inserted is 23D, and the pivoting pins through which the manipulation wires 35L and 35R are inserted are 23L and 23R. .

  Now, assuming that a pair of upper and lower operation wires 35U and 35D are wound around a pulley connected to the operation knob 4a, the operation knob 4a is operated to pull the upper operation wire 35U to the pulley side. When the lower operation wire 35D is drawn out from the pulley, the bending tube portion 2b is bent upward as shown in FIG. The treatment instrument outlet 12 is positioned below the observation window 11, and the treatment instrument insertion channel 34 connected to the treatment instrument outlet 12 is in an unconstrained state in the bending tube portion 2b. It is bent so that it is pressed against the pivot pin 23D through which the lower operation wire 35D is inserted from the middle of the bending operation. Moreover, during this time, the outer surface of the treatment instrument insertion channel 34 slides with respect to the pivot pin 23D. When the bending angle of the bending tube portion 2b increases, the pressing force of the treatment instrument insertion channel 34 increases accordingly. Therefore, if the bending operation is frequently repeated, the treatment instrument insertion channel 34 may be deformed or worn. In particular, in order to reduce the diameter of the insertion portion 2, when the treatment instrument insertion channel 34 is made thin and flexible to reduce rigidity, the deformation and wear further progress. become.

  From the above points, according to the present invention, in the treatment instrument insertion channel 34, of the pivot pins 23 provided at four positions in the circumferential direction, the pivot pins 23 at the portions where the tops sliding at the time of the bending operation are in sliding contact with each other. The sliding contact portions with respect to the treatment instrument insertion channel 34 are increased at the front and rear positions to distribute the pressing force, thereby reducing the pressing force by each sliding contact portion. In the configuration shown in FIG. 4, the treatment instrument insertion channel 34 is a lower position in the bending tube portion 2 b, and is inclined obliquely to the left. Therefore, the number of sliding contact portions is increased at least in the lower position in the bending tube portion 2b. Further, the sliding contact portion may be increased at the left position. However, the upper pivot pin 23U and the right pivot pin 23R do not have the possibility of sliding contact with the treatment instrument insertion channel 34, so there is no need to increase the sliding contact portion.

  The slidable contact portion to be increased includes a cut-off portion 40 formed on the curved ring 22. The cut-off portion 40 is formed by forming a pair of front and rear cut portions formed in the circumferential direction in the curved ring 22 so as to be recessed inward, thereby forming a tunnel-like portion through which the operation wire 35 is inserted. The cut and drawn portion 40 is bent to the height position of the top of the pivot pin 23, and its width dimension is substantially the same as the width dimension of the pivot pin 23.

  Here, when the bending tube portion 2b is bent upward, the connecting portion to the flexible tube portion 2a bends gently, and bends at a steep angle from the intermediate portion to the connecting portion to the distal end hard portion 2c. In particular, the bending curvature is maximized at the intermediate portion of the bending tube portion 2b and the vicinity thereof. For this reason, the treatment instrument insertion channel 34 is not strongly pressed against the pivot pin 23D from the proximal end side, that is, from the connection side to the flexible tube portion 2a to the middle position, but from the intermediate portion to the distal end side, that is, The connecting side to the distal end hard portion 2c is bent sharply and is strongly pressed against the pivot pin 23D. Therefore, the cut-and-throttle portion 40 is disposed from the middle portion having the large curvature toward the tip side. In particular, as shown by C in FIG. 6, when the bending tube portion 2 b is bent at the maximum bending angle, the one or more bending rings 22 positioned in the middle portion of the bending tube portion 2 b that bends most rapidly are provided. The cut and draw part 40 is mounted together with the pivot pin 23D.

  When the bending tube portion 2b is bent upward, the treatment instrument insertion channel 34 is bent, and the treatment tool insertion channel 34 is bent so as to be pressed against the outer peripheral side of the bending tube portion 2b. At the site where the strongest pressing force is sometimes applied, not only is it in sliding contact with the pivot pin 23D, but it is also in sliding contact with the notch 40 provided between the front and rear pivot pins 23D, 23D. As a result, the treatment instrument insertion channel 34 is prevented from being deformed or worn. And although the cut-out part 40 is provided, it is a part between the front and rear pivot pins 23D, 23D, and this part is a space part in which no member is provided. It is not an element that reduces the internal volume.

  Here, the sliding contact portion to be increased can be configured by a pin member 41 having the same configuration as the pivot pin 23 as shown in FIG. When this pin member 41 is mounted, the pivot pin 23 is connected to the front and rear curved rings 22, 22, whereas the pin member 41 is attached to one curved ring 22. Furthermore, as shown in FIG. 9, the sliding contact portion can also be configured by the short ring member 42. The ring member 42 can be fixed to the inner surface of the curved ring 22 by means such as welding. Regardless of whether the pin member 41 or the ring member 42 is used, the height of the top of the pin member 41 is made substantially the same as the height of the pivot pin 23. As a result, when the treatment instrument insertion channel 34 is pressed against the pivot pin 23 by bending the bending tube portion 2b, the pin member 41 and the ring member 42 also come into contact with each other. Similarly, the number of sliding portions with respect to the treatment instrument insertion channel 34 can be increased, and the pressing load can be distributed.

1 is a schematic configuration diagram of an endoscope showing an embodiment of the present invention. It is a front view which shows the front-end | tip part of the insertion part of the endoscope of FIG. FIG. 2 is a cross-sectional view of the distal end portion of the insertion portion of the endoscope of FIG. 1, omitting a part of an internal insertion member, left and right operation wires, and a pivot pin for inserting these operation wires. It is sectional drawing in the XX position of FIG. It is a principal part expanded sectional view which shows the structure of the pivot pin which connects the front and back curved ring. It is sectional drawing similar to FIG. 3 which shows the state which curved the bending pipe part. It is a principal part enlarged view of FIG. 6 shown with a treatment tool penetration channel. It is principal part sectional drawing which shows 2nd Embodiment of a wire penetration member and a sliding contact part. It is principal part sectional drawing which shows 3rd Embodiment of a wire penetration member and a sliding contact part.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Main body operation part 2 Insertion part 2a Flexible pipe part 2b Curved pipe part 2c Hard tip part 12 Treatment instrument derivation part 22 Curved ring 23 Pivoting pin 34 Treatment tool insertion channel 35 Operation wire 40 Cutting part 41 Pin member 42 Ring member

Claims (4)

A bending tube portion is disposed near the distal end of the insertion portion, a distal end hard portion is connected to the distal end of the bending tube portion, and a treatment instrument is derived together with an endoscope observation means including an illumination window and an observation window at the distal end hard portion. A treatment instrument insertion channel having flexibility in the bending direction is connected to the treatment instrument lead-out section, and the bending tube section sequentially pivotally attaches a plurality of bending rings and is inserted into the wire insertion member. In the endoscope in which the operation wire for bending operation is extended in a state of being positioned in the circumferential direction,
When the bending tube portion is bent, a sliding contact portion is formed in which the outer surface of the treatment instrument insertion channel can be brought into contact between the front and rear wire insertion members provided at least at the most bent portion. Features an endoscope. In the bending tube portion, the operation wire is inserted at four positions at intervals of 90 degrees in the circumferential direction so that the bending operation can be performed in four directions of up and down and left and right, and the treatment instrument insertion channel is at least one of them. The sliding contact portion is provided at a position close to the insertion portion of one operation wire and arranged at one or a plurality of positions before and after the wire insertion member to be pressed in a curved state. Item 1. The endoscope according to Item 1. The endoscope according to claim 1, wherein an insertion portion for the operation wire is formed in the sliding contact portion. The slidable contact portion is configured by any one of a cut and drawn portion formed on the curved ring, a pin member for inserting a wire, or a pipe member, and the height of the slidable contact portion is the same as the height of the wire inserted member. The endoscope according to claim 1, wherein the endoscope is configured as follows.

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