JP2011156269A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope having a configuration to bend bending pieces in multiple stages in a plurality of directions at one bending part without enlarging the outer diameter of the curved part with a simple configuration. <P>SOLUTION: The endoscope includes an insertion part having the bending part bendable in multiple directions, by obtaining a configuration where a plurality of joint pieces are turnably connected in the insertion direction S of the insertion part. The plurality of joint pieces includes: a first piece body 41 where a plurality of four-way pieces 41a-41j turnable in four directions are connected along the insertion direction S; a second piece body 43 where a plurality of two-way pieces 43a-43g turnable in two directions are connected along the insertion direction S; and an intermediate piece 42 for connecting the first piece body 41 to the second piece body 43 along the insertion direction S. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope in which a plurality of joint pieces are rotatably connected along an insertion direction of an insertion portion, and a bending portion that can be bent in a plurality of directions is provided in the insertion portion.

  In recent years, endoscopes are widely used in the medical field and the industrial field. Endoscopes used in the medical field observe an organ in a body cavity by inserting a long and thin insertion portion into a body cavity as a subject, and insert a channel for a treatment tool provided in the endoscope as necessary Various treatments can be performed using the treatment tool inserted in the inside.

  In addition, endoscopes used in the industrial field are used to observe wounds and corrosion of a region to be examined by inserting a long and thin insertion portion of the endoscope into a jet engine or a subject such as a factory pipe. And various treatments can be inspected.

  Here, a configuration in which a bending portion that can be bent in a plurality of directions is provided in an insertion portion of an endoscope is well known. The bending portion improves the progress of the insertion portion at the bending portion in the duct, and also changes the observation direction of the observation optical system provided at the distal end of the insertion portion in the insertion direction.

  Usually, in a medical field, a curved portion provided in an insertion part of an endoscope inserted into a digestive organ or the like, or in an industrial field, insertion of an endoscope inserted into a subject having a large channel diameter The bending portion provided in the section is configured to be bendable in four directions, up, down, left and right, but an endoscope inserted into a subject having a small duct diameter, for example, in the medical field, In the bronchoscope to be inserted into the body, it is necessary to make the outer diameter of the bending portion as small as possible. Therefore, the bending portion has a configuration that can be bent in two directions, for example, up and down or left and right.

  This is because, when a four-direction piece used in a bending portion of an endoscope inserted into the digestive tract is used for a bronchoscope, the four-direction pieces are connected to each other along the insertion direction. Since the four rivets with different 90 ° positions in the circumferential direction and the four pulling wires for bending the four-direction piece vertically and horizontally are positioned coaxially, the radial thickness of the rivet piece and the inside of the piece Since the space in the four-direction piece is narrowed by the pulling wire inserted into the four-way piece, the outer diameter of the bending portion must be increased in order to sufficiently secure the space in the four-direction piece. is there.

  However, since the bronchi has a complicated shape, it is originally desirable that the bending portion of the bronchoscope can be bent in four directions, up, down, left and right, because the insertion property of the insertion portion is improved.

  In view of such circumstances, Patent Document 1 discloses that the outer diameter of the curved portion is increased by shifting the positions of the four pulling wires by 45 degrees in the circumferential direction with respect to the positions of the four rivets. There is also disclosed an endoscope having a curved portion that can sufficiently secure a space in a piece.

JP 2000-23908 A

  However, in the configuration of the bending portion disclosed in Patent Document 1, for example, the distal end side of the bending portion is bent rightward or leftward in a state where the bending portion is bent upward or downward. Since the above cannot be performed, there is a problem that, for a bronchus or the like having a complicated shape, it is difficult to view the test site from the front depending on the test site. This problem is the same even when a four-direction piece in which the rivet and the bending wire are coaxially used is used for the bending portion.

  In view of such a problem, two bending portions are provided along the insertion direction on the distal end side of the insertion portion, for example, the bending portion positioned on the rear side is bent upward or downward, and then the bending positioned on the front side. Although the structure which curves a part to the right direction or the left direction is also known, in this structure, there existed a problem that the structure of a bending part will become complicated.

  The present invention has been made in view of the above problems, and with a simple configuration, a bending piece can be bent in multiple stages in a plurality of directions at one bending portion without increasing the outer diameter of the bending portion. It is an object of the present invention to provide an endoscope having a configuration that can be used.

  In order to achieve the above object, an endoscope according to the present invention is configured such that a plurality of joint pieces are rotatably connected along the insertion direction of the insertion portion, so that the bending portion that can be bent in a plurality of directions is An endoscope provided in an insertion unit, wherein the plurality of joint pieces include a first piece body in which a plurality of four-direction pieces rotatable in four directions are connected along the insertion direction, and 2 A plurality of two-way pieces that are rotatable in the direction, the second piece body connected in the insertion direction, the first piece body, and the second piece body along the insertion direction. And an intermediate piece to be connected.

  According to the present invention, an endoscope having a configuration in which a bending piece can be bent in a plurality of directions in a plurality of directions with one bending portion without increasing the outer diameter of the bending portion with a simple configuration. Can be provided.

The fragmentary perspective view which shows the endoscope of this Embodiment The perspective view which shows the structure of the bending piece provided in the bending part of FIG. Sectional drawing which shows the bending piece in alignment with the III-III line | wire in FIG. 2 with the net tube covered with the outer periphery of this bending piece 3 is a plan view of the bending piece of FIG. 3 viewed from the IV direction in FIG. Sectional view of the bending piece along the line V-V in FIG. Sectional view of the bending piece along line VI-VI in Fig. 3 3 is a plan view of the bending piece of FIG. 3 viewed from the direction of VII in FIG. 2 is a plan view of the bending piece of FIG. 2 as seen from the direction VIII in FIG. Partial perspective view showing a four-way piece in which a conventional wire and a rivet are coaxially positioned A plan view of the four-direction piece in FIG. 9 as seen from the X direction. The figure which shows simply the state by which the 1st piece body in the bending piece of FIG. 2 was bent 90 degrees in the R direction within the bronchus Sectional view of the distal end side of the insertion part of the endoscope The front view which looked at the front-end | tip part of the insertion part of FIG. 12 from the XIII direction in FIG.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 is a partial perspective view showing the endoscope of the present embodiment.
As shown in FIG. 1, an endoscope 1 includes an insertion portion 2 that is elongated and flexible in the insertion direction S, and a proximal end side (hereinafter simply referred to as a proximal end side) of the insertion portion 2 in the insertion direction S. Connected to an unillustrated image processing device and a light source device, etc., provided at the extending end of the universal cord, the universal cord 5 extending from the operating portion 3, and the universal cord 5. The main part is composed of a connector (not shown).

  The insertion portion 2 includes, in order from the distal end side in the insertion direction S (hereinafter simply referred to as the distal end side), a hard distal end portion 11 provided with an observation optical system (not shown) and the like, and a proximal end side of the distal end portion 11. It is mainly composed of a provided bending portion 12 that can be bent in a plurality of directions, for example, four directions of up, down, left and right, and a flexible flexible tube portion 13 provided on the base end side of the bending portion 12. The part is composed.

Further, on the base end side of the operation unit 3, a remote switch 14 for instructing image control such as freeze and release, a bending operation lever 15 for operating the bending of the bending unit 12, and a suction operation are performed. A suction button 16 for use, a suction base 17 communicating with a suction channel (not shown) provided in the insertion portion 2 and the like are provided.
Furthermore, a treatment instrument insertion port 18 for inserting a treatment instrument such as forceps is provided at the distal end side of the operation unit 3, and a forceps plug 19 is detachably attached to the treatment instrument insertion port 18. Yes.

  Next, the structure of the bending part 12 is demonstrated using FIGS. 2 is a perspective view showing the configuration of the bending piece provided in the bending portion of FIG. 1, and FIG. 3 is a cross-sectional view showing the bending piece along the line III-III in FIG. 2 together with the net tube covered on the outer periphery of the bending piece. 4 is a plan view of the bending piece of FIG. 3 as viewed from the IV direction in FIG. 3, FIG. 5 is a sectional view of the bending piece along the line VV in FIG. 3, and FIG. FIG. 7 is a cross-sectional view of the bending piece taken along line VI, and FIG. 7 is a plan view of the bending piece of FIG. 3 viewed from the direction of VII in FIG.

  8 is a plan view of the bending piece of FIG. 2 as viewed from the direction VIII in FIG. 2, and FIG. 9 is a partial perspective view showing a four-way piece in which a conventional wire and rivet are coaxially positioned. 10 is a plan view of the four-direction piece of FIG. 9 as viewed from the X direction, and FIG. 11 is a simplified view of the first piece of the bending piece of FIG. 2 bent 90 degrees in the R direction in the bronchus. FIG.

  As shown in FIG. 3, the bending portion 12 includes a bending piece 70 whose outer periphery is covered with a net tube 55. As shown in FIG. 2, the bending piece 70 includes a plurality of joint pieces 41 a to 41-. 41j, 42, 43a-43g is comprised in the length of b in the insertion direction S by being connected along the insertion direction S so that rotation is possible.

  Specifically, in the bending piece 70, a plurality of joint pieces 43a to 43g, which are two-way pieces rotatable in two directions, for example, up and down directions (hereinafter referred to as UD directions), are connected along the insertion direction S. A plurality of joint pieces 41a to 41j, which are four-way pieces rotatable in the left and right direction (hereinafter referred to as LR direction) in addition to the second piece body 43, for example, in the UD direction, are connected along the insertion direction S. The main part is configured by the first piece body 41, the second piece 43, and the intermediate piece 42 that connects the first piece body 41 along the insertion direction S. Note that the first piece body 41 is located closer to the tip than the second piece body 43.

  As shown in FIGS. 2, 3, and 7, the second piece body 43 is configured such that one joint piece and the other joint piece adjacent in the insertion direction S are mutually connected in the circumferential direction R of the bending piece 70. The two rivets 52 positioned 180 ° apart from each other are connected so as to be rotatable in the UD direction.

  Specifically, the second piece 43 includes a joint piece 43a and a joint piece 43b, a joint piece 43b and a joint piece 43c, a joint piece 43c and a joint piece 43d, a joint piece 43d and a joint piece 43e, and a joint piece 43e and a joint. The piece 43f, the joint piece 43f, and the joint piece 43g are connected by two rivets 52 so as to be rotatable in the UD direction.

  As shown in FIGS. 2 to 5, the first piece body 41 includes a first joint piece that is adjacent in the insertion direction S, and a second joint piece that is proximal to the first joint piece. Are connected so as to be rotatable by two first rivets 51a positioned 180 ° apart from each other in the circumferential direction R, and the second joint piece adjacent in the insertion direction S and the second In the circumferential direction R, the first joint piece proximal to the joint piece is connected so as to be rotatable by two second rivets 51b that are shifted from each other by 180 °. In the insertion direction S, the length is a so as to be rotatable in the LR direction and the UD direction.

  Specifically, the first piece body 41 includes a joint piece 41a and a joint piece 41b, a joint piece 41c and a joint piece 41d, a joint piece 41e and a joint piece 41f, a joint piece 41g and a joint piece 41h, and a joint piece 41i and a joint. The piece 41j is connected to be rotatable by the two first rivets 51a, the joint piece 41b and the joint piece 41c, the joint piece 41d and the joint piece 41e, the joint piece 41f and the joint piece 41g, The piece 41h and the joint piece 41i are connected by two second rivets 51b so as to be rotatable.

  Note that, as shown in FIG. 11 described later, the length c from the distal end of the distal end portion 11 to the proximal end of the first piece 41 when the first piece 41 is bent in the LEFT direction or the RIGHT direction. Is set smaller than the pipe diameter x (c <x).

  Further, the length a in the insertion direction S of the first piece body 41 is preferably set to be smaller than a duct diameter x of a bronchi 90 (see FIG. 11) described later, for example (a <x). It is not necessary to set it smaller than the pipe diameter x.

  As shown in FIGS. 1 to 7, the first rivet 51 a and the second rivet 51 b are located 45 ° apart from the rivet 52 in the circumferential direction R. The rivet 52 may be provided coaxially with the first rivet 51a or the second rivet 51b.

  As described above, the intermediate piece 42 connects the second piece 43 and the first piece 41 having different rivet positions in the insertion direction S, as shown in FIGS. 2, 3, and 6. As described above, the joint piece 41j of the first piece body 41 is rotatably connected to the intermediate piece 42 via the two second rivets 51b, and the joint of the second piece body 43 is connected. The piece 43 a is rotatably connected via two rivets 52. As shown in FIG. 6, the second rivet 51 b is located 45 ° away from the rivet 52 in the circumferential direction R.

  As shown in FIGS. 2 to 7, the bending piece 70 includes an inner peripheral surface 43 n of the second piece body 43, an inner peripheral face 42 n of the intermediate piece 42, and an inner peripheral face of the first piece body 41. Four pulling wires 31 to 34 for bending the bending piece 70 in the LR direction and the UD direction are inserted along 41n, and the pulling wires 31 to 34 are respectively connected to the inner peripheral surfaces 41n and 43n. The string guides 71 to 74 provided so as to be different from each other by 90 ° in the circumferential direction R are held movably in the insertion direction S. As shown in FIG. 6, the string guides 71 to 74 are not provided in the intermediate piece 42. That is, the pulling wires 31 to 34 are not held in the intermediate piece 42.

  In the present embodiment, the pulling wire 32 is held by the string guide 71 in the UP direction, the pulling wire 31 is held by the string guide 72 in the DOWN direction, and the string guide 73 is held in the LEFT direction. Thus, the pulling wire 33 is held, and the pulling wire 34 is held by the string guide 74 in the RIGHT direction.

  Further, the tip ends of the pulling wires 31 to 34 are respectively fixed to the joint pieces 41 a located on the most tip side of the first piece body 41.

  Further, in the first piece body 41, the two first rivets 51a and the two second rivets 51b described above are circular with respect to the pulling wires 31 to 34 as shown in FIGS. They are located 45 ° apart from each other in the circumferential direction R.

  As shown in FIG. 8, in the first piece body 41, two first rivets 51 a and two second rivets 51 b are respectively arranged in the circumferential direction R with respect to the pulling wires 31 to 34. As shown in FIGS. 9 and 10, the two first rivets 151 a and the two second rivets 151 b have the pulling wires 31 to 34 as shown in FIGS. This is because a larger volume of space in the bending piece 70 can be ensured than when the structure is located on the same axis as (R1> R2). That is, it is for securing a large space in the bending piece 70 while keeping the bending portion 12 in a small diameter.

  When the bending piece 70 configured as described above is bent, first, when the bending piece 70 is bent in the UP direction or the DOWN direction, the rivet 2 or the traction wire 31 is pulled, so that two rivets are used. 52 and the two first rivets 51a and the two second rivets 51b, the entire bending piece 70 from the base end of the second piece 43 with the second piece 43 as a starting point. Is curved in the UP direction or the DOWN direction.

  In this state, when the distal end side of the bending piece 70, that is, the first piece body 41 is bent in the LEFT direction or the RIGHT direction, the two first pieces are pulled together with the pulling wire 33 or the pulling wire 34 being pulled. As the rivet 51a and the two second rivets 51b rotate, the first piece body 41 is bent in the LEFT direction or the RIGHT direction.

  At this time, since the second piece 43 is not provided with a rivet for rotating the second piece 43 in the LEFT direction or the RIGHT direction, the traction wire 33 or the traction wire 34 is pulled. The second frame 43 is not bent in the LEFT direction or the RIGHT direction. That is, only the first frame 41 is bent in the LEFT direction or the RIGHT direction.

  As shown in FIG. 11, the trachea 90 that a person usually has is said to have a diameter x of about 20 mm, but the bending portion 12 is longer than 20 mm in the insertion direction S. In general, it is formed (x <b).

  Therefore, even if the entire bending portion 12 is to be bent in the trachea 90, the bending portion 12 cannot be bent by 90 ° and the test site 91 may not be viewed from the front. However, in the present embodiment, as shown in FIG. 11 to be described later, the first piece 41 is bent from the tip of the tip 11 when the first piece 41 is bent in the LEFT direction or the RIGHT direction. Since the length c to the base end is set smaller than the pipe diameter x (c <x), only the first piece 41 is curved in the LEFT direction or the RIGHT direction, as shown in FIG. As described above, the observation optical system provided at the distal end portion 11 can be viewed from the front with respect to the site to be examined. Therefore, only the first frame body 41 has a configuration that can be bent in the LEFT direction or the RIGHT direction.

  In addition, the operation when the first piece body 41 is bent in the LEFT direction or the RIGHT direction is the same even when there is no bending in the UP direction or the DOWN direction.

  As described above, in the present embodiment, the bending piece 70 constituting the bending portion 12 is configured by the first piece body 41 whose distal end side can be bent in four directions, and the proximal end side via the intermediate piece 42, It is shown that it is composed of a second piece 43 that can be bent in two directions.

  According to this, when the bending piece 70 is bent in the UP direction or the DOWN direction, the entire bending piece 70 is bent starting from the second piece body 43, and when the bending piece 70 is bent in the LEFT direction or the RIGHT direction, Since only the first piece body 41 can be bent in the LEFT direction or the RIGHT direction, the bending piece 70 is bent in the UP direction or the DOWN direction with a simple configuration of the single bending piece 70. The distal end side of the bending piece 70 can be bent in the LEFT direction or the RIGHT direction.

  In the present embodiment, in the first piece body 41, the two first rivets 51a and the two second rivets 51b are 45 in the circumferential direction R with respect to the pulling wires 31 to 34, respectively. It was shown that it had a structure that was positioned off.

  According to this, the first two rivets 51 a and the two second rivets 51 b have a space in the bending piece 70 rather than having a structure positioned coaxially with the pulling wires 31 to 34. Can be secured large (R1> R2). That is, a large space in the bending piece 70 can be secured while the bending portion 12 remains in a small diameter.

  From this, it is possible to view the bronchial wall to be the test site 91 from the front, for example, when used for a bronchoscope without losing the convenience compared to an endoscope having a conventional curved portion structure. In addition to being able to easily take the tissue of the test site 91 with forceps or the like, the insertion property to the peripheral lung region is improved, so that the observation property and the treatment property to the test site can be improved.

  As described above, it is possible to provide an endoscope having a configuration in which a bending piece can be bent in multiple stages in a plurality of directions with one bending portion without increasing the outer diameter of the bending portion with a simple configuration. Can do.

Hereinafter, modifications will be described.
In the present embodiment, the second piece body 43 can be bent in the UP direction or the DOWN direction, and the first piece body 41 is bent in the UP direction or the DOWN direction, in the LEFT direction or the RIGHT direction. In contrast to this, the second piece 43 is moved in the LEFT direction or RIGHT by changing the position of the rivet 52 by 90 ° in the circumferential direction R from the present embodiment. The first piece 41 may be bent in the UP direction or the DOWN direction in a state where the first piece body 41 is bent in the LEFT direction or the RIGHT direction.

  2 and 3, the first piece body 41 is composed of ten joint pieces 41a to 41j, and the second piece body 43 is composed of seven joint pieces 43a to 43g. Of course, the number of joint pieces is not limited to the above-mentioned number.

  Further, in the present embodiment, in the bending piece 70, the first piece body 41 is located on the distal end side, and the second piece body 43 is located on the proximal end side via the intermediate piece 42. However, conversely, the second piece 43 may be located on the distal end side, and the first piece 41 may be located on the proximal end side via the intermediate piece 42.

  Furthermore, in the present embodiment, the endoscope has been illustrated by taking a bronchoscope having the bending operation lever 15 in the operation unit 3 as an example, but the present invention is not limited thereto, and the operation unit 3 causes the bending unit 12 to bend. Needless to say, the present invention can be applied to, for example, an endoscope for digestive organs or an industrial endoscope provided with a bending operation knob.

  By the way, conventionally, the distal end portion 11 of the endoscope 1 has an illumination lens and an objective optical system bonded and fixed to the distal end hard portion constituting the distal end portion 11, and the outer peripheral surface and the distal end surface of the distal end hard portion. In general, a resin-made front end cover is coated for the purpose of preventing the illumination lens from falling off and insulating the front end portion 11.

  The tip cover is provided with a claw portion that catches on a chamfered portion provided on the illumination lens in order to prevent the illumination lens from slipping from the tip hard portion. There has been a demand for a configuration that can prevent the sliding of the illumination lens from the portion. In particular, when applied to a small-diameter endoscope such as a bronchoscope, a configuration of a tip portion that prevents the increase in diameter as much as possible has been desired.

  Hereinafter, the configuration of the distal end portion of the insertion portion of the endoscope in view of these circumstances will be described with reference to FIGS. 12 and 13. 12 is a cross-sectional view of the distal end side of the insertion portion of the endoscope, and FIG. 13 is a front view of the distal end portion of the insertion portion of FIG. 12 viewed from the XIII direction in FIG.

  As shown in FIG. 12, a distal end hard member 105 is provided in the distal end portion 11 of the insertion portion, and a channel 101 penetrating along the insertion direction S is provided in the distal end hard member 105. In the bending portion 12, a plurality of joint pieces 41a, 41b,... Are rotatably connected along the insertion direction S via rivets 51a and other rivets. The bending portion 12 has a configuration that can be bent in, for example, four directions by four pulling wires (only the pulling wire 32 is shown in FIG. 12) whose tip is fixed to the joint piece 41a.

  A distal end cover 100 made of a transparent resin, for example, polysulfone, is coated on the outer periphery and the distal end surface of the distal end rigid member 105 and fixed by a known fixing mechanism. Although not shown, the tip cover 100 is formed with a hole in which the objective optical system is disposed and a hole for the channel 101.

  Further, an illumination lens 100 a is formed integrally with the tip cover 100 at a position where the tip of the light guide cable 106 abuts on the tip cover 100 or on the outer surface of the tip cover 100 facing the light guide cable 106. Yes. The illumination lens 100a is not limited to a spherical shape, and may be a crescent shape or an oval shape, or the lens surface may be formed in a grain shape.

  Furthermore, the tip cover 100 prevents the tip cover 100 from slipping by making the diameter of the hole in which the objective optical system provided in the tip cover 100 is disposed smaller than the outer diameter of the objective optical system. It doesn't matter.

  According to such a configuration, since the parts constituting the tip portion 11 can be reduced as compared with the prior art, the tip portion 11 can be reduced in diameter, the assembly workability is improved, and the lighting Since the lens 100a is formed integrally with the distal end cover 100, it is possible to prevent the illumination lens from sliding off.

DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Insertion part 12 ... Bending part 31-34 ... Pulling wire 41 ... 1st piece body 41a-41j ... Joint piece (4 direction piece)
41n ... inner peripheral surface 42 ... joint piece (intermediate piece)
42n ... inner peripheral surface 43 ... second piece 43a-43g ... joint piece (two-way piece)
43n ... inner peripheral surface 51a ... first rivet 51b ... second rivet 52 ... rivet S ... insertion direction

Claims (4)

An endoscope in which a plurality of joint pieces are rotatably connected along the insertion direction of the insertion portion, and a bending portion that can be bent in a plurality of directions is provided in the insertion portion,
The plurality of joint pieces are:
A plurality of four-direction pieces rotatable in four directions, a first piece body connected in plural along the insertion direction;
A plurality of two-way pieces that are rotatable in two directions, and a plurality of second pieces connected along the insertion direction;
An intermediate piece for connecting the first piece and the second piece along the insertion direction;
An endoscope characterized by comprising:   The endoscope according to claim 1, wherein the first piece body is located closer to the distal end side in the insertion direction than the second piece body. In the second piece body, one joint piece and the other joint piece adjacent to each other in the insertion direction can be rotated in two directions by two rivets positioned 180 degrees apart from each other in the circumferential direction. Are connected,
In the first piece body, the first joint piece adjacent in the insertion direction and the second joint piece on the proximal side in the insertion direction with respect to the first joint piece are 180 ° in the circumferential direction. Two first rivets that are displaced and connected so as to be rotatable in two directions, and the second joint piece adjacent in the insertion direction and the insertion direction more than the second joint piece The first joint piece on the base end side is positioned by the two second rivets which are located 180 ° apart from each other in the circumferential direction and 90 ° in the circumferential direction from the first rivet. 3. The second piece body is rotatable in four directions by being connected so as to be rotatable in two directions different from the direction. Endoscope. The bending portion is bendable in a plurality of directions with the pulling of a plurality of wires connected to the joint piece located on the most distal side in the insertion direction among the plurality of the joint pieces,
In the first piece body, the first rivet and the second rivet are each 45 ° in a circumferential direction with respect to the plurality of wires inserted along the inner peripheral surfaces of the plurality of joint pieces. The endoscope according to claim 3, wherein the endoscope is displaced.

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