JP2011224047A - Endoscope apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope apparatus which permits an endoscope bending in the bendable portion to be easily inserted into Vater's papilla.SOLUTION: The endoscope apparatus 1 includes a first over tube 10 having the endoscope E having the bendable portion Ea at the tip and a side opening 13 opened in the side wall of the tip and interpolating the endoscope E and a second over tube 20 having an opening 22 at the tip and interpolating the first over tube 10. The first over tube 10 can be projected from the opening 22 of the second over tube 20 and has an expandable first balloon 14 on the outside periphery nearer to the tip side than the side opening 13. The second over tube 20 has an expandable second balloon 24 on the outside periphery of the tip. The endoscope E can be projected from the side opening 13 by bending the bendable portion Ea with the side opening 13 of the first over tube 10 exposed from the opening 22 of the second over tube 20.

Description

  The present invention relates to an endoscope apparatus including an endoscope and an overtube for inserting the endoscope.

  As a method for inspecting the human biliary tract (gallbladder and bile duct) and pancreatic duct, a method of observing by inserting an endoscope having a bendable portion at the distal end into the fermenter papilla which is the exit of bile and pancreatic juice is known. Yes.

  In such an observation method, as shown in FIG. 4, an endoscope E having a bendable portion Ea at the distal end portion, and an overtube that inserts the endoscope E and assists insertion of the endoscope E into the body. 51, a side opening 52 that opens to the side wall of the distal end of the overtube 51, and an annular balloon 53 that is provided on the distal end side of the side opening 52 of the overtube 51 and that can be expanded and contracted. A mirror device 54 is used (see, for example, Patent Document 1).

  When observing with the endoscope device 54, first, the endoscope E is inserted into the overtube 51 from the proximal end 51a of the overtube 51, and in this state, the overtube 51 is inserted into the duodenum from the mouth side of the patient. To do. Next, after the distal end Eb of the endoscope E protrudes from the distal end 51b of the overtube 51 and the furter papilla is confirmed by the endoscope E, the overtube 51 is rotated to move the side mouth portion 52 to the furter papilla. It arrange | positions in the position facing a part.

  Next, the balloon 53 is inflated into an annular shape, and the balloon 53 is brought into close contact with the inner wall of the duodenum, thereby holding the overtube 51 at a position where the side mouth portion 52 faces the papilla papilla.

  Next, the distal end Eb of the endoscope E is retracted to a position facing the side opening 52 of the overtube 51. Next, the endoscope E is rotated so that the bending direction of the bendable portion Ea matches the side mouth portion 52. Next, the endoscope E is bent at the bendable portion Ea, so that the tip Eb protrudes from the side mouth portion 52, and the tip Eb is inserted into the furter papilla.

  The position and shape of this puffer papilla vary depending on the individual, the caliber is small, and the side mouth of the puffer papilla where the endoscope E is inserted is oriented perpendicular to the duodenum from the patient's anal direction. It is suitable. Therefore, the endoscope E inserted from the mouth side of the patient inserts the tip Eb into the furter papilla while being bent in a J shape by the bendable portion Ea.

JP-A-62-26233

  However, in the endoscope apparatus 54, when the endoscope E is rotated and bent by the bendable portion Ea, and the distal end Eb is protruded from the side opening 52 of the overtube 51, the endoscope E is side-mounted. A force acts on the mouth portion 52 and the overtube 51. As a result, the side mouth portion 52 is deformed or the overtube 51 is bent, so that it may be difficult to protrude the distal end Eb of the endoscope E from the side mouth portion 52.

  Further, in the endoscope apparatus 54, the state in which the endoscope E is bent in a J shape is anticipated, and the balloon 53 must be inflated and fixed by aligning the positions of the side mouth portion 52 and the furter papilla. Don't be. Therefore, depending on the position where the balloon 53 is fixed, the positions of the tip Eb of the endoscope E and the furter papilla may not match, and it may be difficult to insert the tip Eb into the puffer papilla.

  SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide an endoscope apparatus in which such an inconvenience is solved and an endoscope can be easily inserted into a furter papilla.

  In order to achieve the above object, an endoscope apparatus according to the present invention includes an endoscope having a bendable portion at a distal end portion, an opening portion at a distal end portion, and a side mouth portion opening at a side wall of the distal end portion. An endoscope apparatus comprising: a first overtube having an endoscope inserted therein; and a second overtube having an opening at a distal end and having the first overtube inserted therein, wherein the first overtube Can protrude from the opening of the second overtube so that the side opening of the first overtube is exposed, and the first overtube expands and contracts from the side opening to the outer peripheral surface on the tip side. The second overtube has a second balloon that can be inflated and deflated on the outer peripheral surface of the distal end portion, and the endoscope has an opening of the second overtube With the side mouth of the first overtube exposed, Characterized in that it projects from the side opening by bending the bendable part.

  In the endoscope apparatus of the present invention, the endoscope is inserted into the first overtube from the base end of the first overtube, and the first overtube is inserted into the second overtube from the base end of the second overtube. Then, the second overtube is inserted into the duodenum from the patient's mouth.

  Next, after making the distal end of the endoscope project from the opening of the first overtube and confirming the furter papilla with the endoscope, the distal end of the second overtube is moved to a position closer to the proximal end than the farther papilla. Deploy.

  Then, the second balloon is inflated and brought into close contact with the inner wall of the duodenum, so that the second overtube is held at a position closer to the proximal end than the furter papilla.

  Next, the tip of the first overtube is protruded from the opening of the second overtube, and the side opening of the first overtube is disposed at a position facing the furter papilla.

  Then, the first balloon is inflated and brought into close contact with the inner wall of the duodenum, whereby the first overtube is held at a position where the side mouth portion faces the furter papilla.

  Next, after retracting the tip of the endoscope to the position of the side mouth of the first overtube, the tip is projected from the side mouth by bending the endoscope at the bendable portion, and the tip is Insert into the nipple papilla.

  Accordingly, in the endoscope apparatus of the present invention, the second balloon is inflated and the second overtube is held on the inner wall of the duodenum, and the side mouth of the first overtube is placed on the farther papilla to the distal end of the endoscope. Can be placed at a position suitable for insertion.

  In the endoscope apparatus of the present invention, the first overtube protrudes from the opening of the second overtube so that the side opening of the first overtube is exposed, and the first overtube The first balloon of the tube is provided on the distal end side from the side mouth portion, and the second balloon is provided on the distal end portion of the second balloon. Therefore, the side mouth is sandwiched between both balloons in the axial direction and is firmly held. Therefore, even when the endoscope is in contact with the side opening and the overtube and a force is applied, the deformation of the side opening and the bending of the overtube can be prevented.

  As a result, according to the endoscope apparatus of the present invention, the position of the side mouth portion of the first overtube can be easily adjusted, and the distal end of the endoscope can be reliably protruded from the side mouth portion. As a result, the endoscope can be easily inserted into the papilla.

  In the endoscope apparatus according to the present invention, it is preferable that the first balloon is a part of the outer peripheral surface of the first overtube and is provided on the same side as the side opening.

  In the endoscope apparatus having the above-described configuration, the first balloon is inflated in the opening direction of the side mouth portion of the first overtube and comes into contact with the duodenal inner wall on the side facing the side mouth portion. As a result, the first overtube is held eccentrically from the central axis of the duodenum to the side away from the papilla.

  Therefore, in the endoscope apparatus according to the present invention, the first overtube having the side mouth portion is positioned eccentrically toward the side farther from the furter papilla than the central axis of the duodenum. A large space can be ensured between the side mouth and the nipple papilla when inserted into the.

  As a result, according to the endoscope apparatus of the present invention, the distal end of the endoscope can be operated in this wide space to align the distal end with the furter papilla. It can be easily inserted into the part.

  By the way, in the endoscope apparatus of the present invention, the endoscope inserted in the first overtube may rotate in the first overtube. In this case, the position of the side mouth portion of the first overtube and the bending direction of the bendable portion of the endoscope are shifted, and it becomes difficult to bend the endoscope and protrude the tip from the side mouth portion. Sometimes.

  In the endoscope apparatus of the present invention, when the first overtube is rotated so that the side mouth is opposed to the furter nipple, the first overtube is twisted and the side mouth is opposed to the furter nipple. It may not be possible to

  Therefore, in the endoscope apparatus according to the present invention, the first overtube includes an inner peripheral surface having an elliptical shape in a cross-sectional view, and the endoscope has at least one protruding in the major axis direction of the elliptical shape. It is preferable to provide a rotation preventing member on the proximal end side of the bendable portion.

  According to the above configuration, the rotation of the inserted endoscope can be restricted by the at least one detent member coming into contact with the inner peripheral surface of the side wall of the first overtube. Thereby, it can prevent that the position of the side opening part of a 1st overtube and the bending direction of the bending | flexion possible part of an endoscope shift | deviate.

  Further, according to the above configuration, when the side mouth portion of the first overtube is to be opposed to the furter papilla, the endoscope is provided at least by rotating the endoscope together with the first overtube. The rotational force of the first overtube can be transmitted to the periphery of the side opening through one rotation prevention member.

  Therefore, according to the endoscope device including the anti-rotation member projecting in the major axis direction of the elliptical shape of the present invention, the endoscope having the bendable portion at the distal end portion is bent and the distal end is located on the first overtube side. While being able to protrude more reliably from a mouth part, a side mouth part can be reliably made to face a fater nipple.

  Moreover, although the said rotation prevention member may be one, it is also possible to make a pair.

  According to the endoscope apparatus including the anti-rotation member protruding in the major axis direction of the elliptical shape of the present invention, the rotation of the inserted endoscope is further ensured by including the pair of anti-rotation members. Can be regulated.

  In the endoscope apparatus of the present invention, the first overtube includes an inner peripheral surface having a bowl shape in which a cross section is formed by combining a large circle and a small circle, and the endoscope includes the first overtube. An anti-rotation member that is located inside the large circle portion of the 1 overtube and protrudes into the small circle portion may be provided on the proximal end side of the bendable portion.

  According to the said structure, rotation of the endoscope inserted can be controlled because an anti-rotation member contact | abuts to the internal peripheral surface of the side wall of the small circle part of a 1st overtube. Thereby, it can prevent that the position of the side opening part of a 1st overtube and the bending direction of the bending | flexion possible part of an endoscope shift | deviate.

  Therefore, according to the endoscope apparatus including the rotation preventing member protruding inside the small circle portion of the present invention, the endoscope having the bendable portion at the distal end portion is bent, and the distal end is the side opening of the first overtube. It can project more reliably from the part.

  Alternatively, in the endoscope apparatus according to the present invention, the first overtube includes a guide member on an inner peripheral surface closer to the base end side than the side opening, and the endoscope slides along the guide member. A sliding member that can be engaged may be provided on the proximal end side of the bendable portion.

  According to the said structure, rotation of the endoscope inserted can be reliably controlled by sliding a sliding member along a guide member. Thereby, the position of the side mouth part of the first overtube and the bending direction of the bendable part of the endoscope can be matched.

  Therefore, according to the endoscope apparatus including the guide member and the sliding member of the present invention, the endoscope having a bendable portion at the distal end portion is bent, and the distal end is extremely surely secured from the side mouth portion of the first overtube. Can be projected.

Fig.1 (a) is explanatory sectional drawing of the endoscope apparatus of this embodiment, FIG.1 (b) is BB sectional drawing of the overtube which concerns on the endoscope apparatus shown to Fig.1 (a). . Explanatory drawing which shows the usage method of the endoscope apparatus of this embodiment. Explanatory drawing which shows the modification of the endoscope apparatus of this embodiment. Explanatory drawing which shows the endoscope apparatus of a prior art.

  Next, the endoscope apparatus 1 according to the present embodiment will be described with reference to FIG.

  As shown in FIG. 1A, an endoscope apparatus 1 includes an endoscope E having a bendable portion Ea at a distal end portion, a first overtube 10 for inserting the endoscope E, and a first overtube. A second overtube 20 is provided which inserts the tube 10 and assists the insertion of the endoscope E into the body.

  The first overtube 10 is formed of a cylindrical body having an inner peripheral surface 11 (see FIG. 1B) having an elliptical shape in cross section. The first overtube 10 has a first opening 12 that opens at the tip and an opening at the side wall of the tip. And a first balloon 14 that can be inflated and contracted.

  The second overtube 20 is formed of a cylindrical body having an inner peripheral surface (see FIG. 1B) that has a circular shape in a cross-sectional view. The second overtube 20 has a second opening 22 that opens at the tip, and a second balloon that can expand and contract. 24.

  The first balloon 14 is a part of the outer peripheral surface on the distal end side of the side mouth portion 13 of the first overtube 10 and is provided on the same side as the side mouth portion 13.

  The first balloon 14 is connected to the balloon operation unit 16 via a fluid passage 15 disposed in the side wall of the first overtube 10. The first balloon 14 is expanded or contracted in a spherical shape in the opening direction of the side mouth portion 13 by operating the balloon operation portion 16 to supply or discharge the fluid through the fluid passage 15. Yes.

  The second balloon 24 is provided on the outer peripheral surface of the distal end portion of the second overtube 20.

  The second balloon 24 is connected to the balloon operation unit 26 via a fluid passage 25 disposed in the side wall of the second overtube 20. The second balloon 24 is inflated or contracted in an annular shape by supplying or discharging a fluid via the fluid passage 25 by operating the balloon operation unit 26.

  A cylindrical member 30 is attached to the outer peripheral surface of the proximal end side of the bendable portion Ea of the endoscope E. On the outer peripheral surface of the cylindrical member 30, a pair of anti-rotation members 31, 31 protruding in the major axis direction of the elliptical shape of the first overtube 10 are provided. As shown in FIG. 1B, the pair of detent members 31 and 31 has a total length L of the protruding length and the diameter of the endoscope E shorter than the length La of the long axis of the elliptical shape. And it is formed to be longer than the length Lb of the short axis.

  Next, a method for using the endoscope apparatus 1 according to the present embodiment will be described with reference to FIG. Specifically, a case will be described in which the endoscope E is used to observe the biliary tract and the pancreatic duct by inserting the endoscope E into the phater nipple 40.

  In the endoscope apparatus 1, first, the endoscope E is inserted into the first overtube 10 from the proximal end 17 of the first overtube 10, and the first overtube 10 is inserted into the proximal end 27 of the second overtube 20. To the second overtube 20. In this state, the endoscope apparatus 1 is inserted into the duodenum.

  Next, after the distal end Eb of the endoscope E protrudes from the first opening 12 of the first overtube 10 and the furter papilla 40 is confirmed by the endoscope E, the second overtube 20 is advanced or The second balloon 24 is retracted and disposed at a position closer to the proximal end than the fatter papilla 40.

  Next, as shown in FIG. 2 (a), by operating the balloon operation unit 26, fluid is supplied to the second balloon 24 and inflated, thereby bringing the second balloon 24 into close contact with the inner wall of the duodenum. As a result, the second balloon 24 holds the second overtube 20 at a position closer to the proximal end side than the furter papilla 40.

  Next, after making the 1st overtube 10 protrude from the 2nd opening part 22 of the 2nd overtube 20, it is rotated and the side opening part 13 of a 1st overtube is arrange | positioned in the position which opposes the fatter papilla 40 To do.

  At this time, in the endoscope apparatus 1 of the present embodiment, the pair of anti-rotation members 31 and 31 provided in the endoscope E are rotated by rotating the endoscope E together with the first overtube 10. Since the rotational force of the first overtube 10 can be transmitted to the periphery of the side mouth portion 13 through the side mouth portion 13, the side mouth portion 13 can be reliably opposed to the fatter papilla 40.

  In addition, in the endoscope apparatus 1 of this embodiment, although the rotation prevention member 31 is provided with a pair, ie, two, the rotation prevention member may be one.

  Next, as shown in FIG. 2 (b), by operating the balloon operation unit 16, fluid is supplied to the first balloon 14 and inflated, thereby bringing the first balloon 14 into close contact with the duodenal inner wall. As a result, the first balloon 14 holds the first overtube 10 at a position closer to the distal end side than the fatter papilla 40.

  Next, the distal end Eb of the endoscope E is retracted to a position facing the side opening 13 of the first overtube 10, and the bending direction of the bendable part Ea is matched with the side opening 13.

  At this time, in the endoscope apparatus 1 according to the present embodiment, the pair of detent members 31 provided on the proximal end side of the bendable portion Ea of the endoscope E includes the inner periphery of the side wall of the first overtube 10. By contacting the surface 11, the rotation of the inserted endoscope E is restricted.

  Therefore, in the endoscope apparatus 1 according to the present embodiment, it is possible to prevent the position of the side opening 13 of the first overtube 10 from deviating from the bending direction of the bendable portion Ea of the endoscope E.

  As a result, in the endoscope apparatus 1 of the present embodiment, the bending direction of the bendable portion Ea is set to the side only by retracting the distal end Eb of the endoscope E to a position facing the side opening 13 of the first overtube 10. It can be matched with the mouth portion 13.

  Next, the endoscope E is bent at the bendable portion Ea, so that the tip Eb is protruded from the side mouth portion 13. Then, as shown in FIG. 2 (c), the distal end Eb is inserted into the nipple papilla 40 while the endoscope E is further bent by the bendable portion Ea and maintained in a J shape.

  At this time, as shown in FIG. 2 (c), the outer peripheral surface of the bendable portion Ea of the endoscope E is brought into contact with the first balloon 14, and the endoscope E is formed in a J shape with the first balloon 14 as a fulcrum. Can be inserted to the deep part.

  As described above, in the endoscope apparatus 1 of the present embodiment, the first overtube 10 is inserted into the second overtube 20, and the first overtube 10 includes the second overtube 20. The side mouth 13 can be arranged at a position facing the papilla papilla 40 while being held on the inner wall of the duodenum by the second balloon 24 provided at the distal end (see FIG. 2B).

  Therefore, in the endoscope apparatus 1 of the present embodiment, the side mouth portion 13 of the first overtube 10 is inserted into the furter papilla 40 with the second overtube 20 held on the duodenal inner wall by the second balloon 24. Since it can arrange | position very easily in the position suitable for inserting the front-end | tip Eb of the endoscope E, the endoscope E can be inserted in the furter papilla 40 easily.

  In addition, after the second overtube 20 is held on the duodenal inner wall by the second balloon 24, the placement of the side mouth portion 13 of the first overtube 10 is temporarily determined, and then the endoscope E is bent. The distal end Eb is protruded from the side mouth 13 by bending it, and after confirming whether or not it can be inserted into the furter papilla 40, the first balloon 14 is inflated to bring the first balloon 14 into close contact with the duodenal inner wall. You can also.

  Further, after the first balloon 14 is inflated and the first balloon 14 is brought into close contact with the inner wall of the duodenum, the position of the side mouth portion 13 is not appropriate, and the distal end Eb of the endoscope E is inserted into the furter papilla 40. If this is difficult, the first balloon 14 is deflated while the second overtube 20 is held by the second balloon 24, and the position of the side mouth portion 13 of the first overtube 10 is readjusted. can do.

  Also from the above, the endoscope apparatus 1 of the present embodiment is in a position suitable for inserting the side mouth portion 13 of the first overtube 10 into the distal part Eb of the endoscope E into the fermenter papilla 40. Since it can arrange | position very easily, the endoscope E can be easily inserted in the furter papilla 40.

  Further, in the endoscope apparatus 1 of the present embodiment, in addition to the first balloon 14 provided on the distal end side of the side mouth portion 13 of the first overtube 10, the second over is present with the side mouth portion 13 interposed therebetween. By providing the second balloon 24 provided at the distal end portion of the tube 20, the side mouth portion 13 is firmly held at a position facing the furter papilla 40 (see FIG. 2B). .

  Therefore, even when the endoscope E is in contact with the side mouth portion 13 and the first overtube 10 and a force acts, the deformation of the side mouth portion 13 and the bending of the first overtube 10 can be prevented. .

  As a result, the endoscope apparatus 1 according to the present embodiment can bend the endoscope E with the bendable portion Ea and reliably project the distal end Eb from the side opening 13 of the first overtube 10. In addition, the insertion into the feter nipple 40 can be facilitated.

  In the endoscope apparatus 1 of the present embodiment, the first balloon 14 expands in a spherical shape in the opening direction of the side mouth portion 13 and comes into contact with the duodenal inner wall on the side facing the side mouth portion 13. The 1 overtube 10 is positioned eccentrically from the central axis of the duodenum toward the side away from the fermenter papilla 40 (see FIG. 2B).

  Therefore, when the endoscope E is inserted into the furter papilla 40, a wide space can be ensured between the side opening 13 and the furter papilla 40.

  As a result, the endoscope apparatus 1 according to the present embodiment can easily insert the endoscope E into the furter papilla 40.

  In order to secure a wide space between the side mouth portion 13 and the furter nipple portion 40, the first overtube 10 and the second overtube are formed when the second balloon 24 is inflated into a spherical shape. Since the second balloon 24 is rotatable with respect to 20, unlike the first balloon 14, it can be considered that the second balloon 24 expands in a direction other than the opening direction of the side mouth portion 13.

  In this case, since pressure acts on the first overtube 10 and the second overtube 20 from different directions on the side surface of the duodenum, the side mouth portion 13 may be deformed.

  Therefore, in the endoscope apparatus 1 according to the present embodiment, the second balloon 24 is inflated in an annular shape to prevent the side mouth portion 13 from being deformed, and the distal end Eb is reliably secured from the side mouth portion 13 of the first overtube 10. The first balloon 14 is expanded in a spherical shape in the opening direction of the side mouth portion 13 and a wide space can be ensured between the side mouth portion 13 and the furter papilla 40.

  In addition, there is no portion where the tube abuts and there is no portion where the tube abuts against the inner wall of the duodenum, and only the balloon abuts against the inner wall of the duodenum holds the tube more firmly against the inner wall of the duodenum. be able to. Accordingly, the holding force of the annular balloon is higher than that of the spherical balloon.

  Therefore, in the endoscope apparatus 1 according to the present embodiment, the second balloon 24 is inflated in an annular shape so that the second overtube 20 is firmly held in contact with the inner wall of the duodenum, and the first balloon 14 is moved to the side opening. By expanding in a spherical shape in the opening direction of the portion 13, the holding force of the second overtube 20 against the inner wall of the duodenum and securing of the space between the side mouth portion 13 of the first overtube 10 and the furter papilla 40 Can be made compatible.

  Next, with reference to FIG. 3, a modified example of the rotation preventing member of the endoscope apparatus 1 of the present embodiment will be described.

  As shown in FIG. 3 (a), in the first modification, the endoscope apparatus 1 of the present embodiment includes a cylindrical body having an inner peripheral surface 11b in which the first overtube 10 has an elliptical shape in cross section. Except for this, it has the same configuration as the first overtube 10 of the endoscope apparatus 1 shown in FIG. In the elliptical shape, the major axis direction corresponds to the opening direction of the opening 13.

  Then, as shown in FIG. 3A, a C-shaped member 32 that is open downward in a cross-sectional view is attached to the outer peripheral surface of the proximal end side of the bendable portion Ea of the endoscope E. Yes. On the outer peripheral surface of the member 32 that faces the side opening 13, one anti-rotation member 33 that protrudes in the major axis direction of the elliptical shape of the inner peripheral surface 11 b of the first overtube 10 is provided.

  As shown in FIG. 3A, the rotation preventing member 33 has a total length L of the protruding length and the diameter of the endoscope E shorter than the length La of the major axis of the elliptical shape and the length of the minor axis. It is formed to be longer than the length Lb.

  In the first modification, the configuration of the other parts is the same as that of the endoscope apparatus 1 shown in FIG.

  In the endoscope apparatus 1 according to the modified example 1, since the rotation prevention member 33 is provided on the proximal end side of the bendable portion Ea of the endoscope E, the rotation prevention member 33 is provided on the side wall of the first overtube 10. By abutting on the inner peripheral surface 11b, the rotation of the inserted endoscope E can be restricted. Thereby, since the relationship between the position of the side mouth portion 13 of the first overtube 10 and the bending direction of the bendable portion Ea of the endoscope E can be matched, the endoscope E can be easily applied to the furter papilla 40. Can be inserted into.

  As shown in FIG. 3B, in the second modification, the endoscope apparatus 1 of the present embodiment includes a first overtube 10 having a large circular portion 11d and a small circular portion 11e in a cross-sectional view. It has the same configuration as the first overtube 10 of the endoscope apparatus 1 shown in FIG. 1 except that it is formed of a cylindrical body having an inner peripheral surface 11c having a flange shape formed by joining. In the ridge shape, the major axis direction corresponds to the opening direction of the side opening 13.

  The endoscope E is located inside the large circular portion 11d having a bowl shape in a cross-sectional view of the first overtube 10. On the outer peripheral surface of the proximal end side of the bendable portion Ea of the endoscope E, as shown in FIG. 3B, a member 34 having a C shape that opens downward in a cross sectional view is attached. On the outer peripheral surface of the member 34 facing the side opening 13, a single detent member 35 that protrudes into the inside of the bowl-shaped small circle portion 11 e of the first overtube 10 is provided.

  In the second modification, the configuration of the other parts is the same as that of the endoscope apparatus 1 shown in FIG.

  In the endoscope apparatus 1 according to the modified example 2, since the rotation prevention member 35 is provided on the proximal end side of the bendable portion Ea of the endoscope E, the rotation prevention member 35 is a small circle of the first overtube 10. By abutting on the inner peripheral surface 11c of the portion 11e, the rotation of the inserted endoscope E can be restricted. Thereby, since the relationship between the position of the side mouth portion 13 of the first overtube 10 and the bending direction of the bendable portion Ea of the endoscope E can be matched, the endoscope E can be easily applied to the furter papilla 40. Can be inserted into.

  As shown in FIG.3 (c), in the 3rd modification, the endoscope apparatus 1 of this embodiment is from the cylinder which has the internal peripheral surface 11f in which the 1st overtube 10 makes | forms a cross sectional view circular shape. The endoscope apparatus shown in FIG. 1 except that the guide member 36 provided along the length direction is provided on the inner peripheral surface 11f on the base end side of the side opening 13 with respect to the length direction. 1 has the same configuration as the first overtube 10.

  Then, as shown in FIG. 3C, a sliding member 37 that is slidably engaged along the guide member 36 is mounted on the outer peripheral surface of the proximal end side of the bendable portion Ea of the endoscope E. Has been.

  In the third modification, the configuration of the other parts is the same as that of the endoscope apparatus 1 shown in FIG.

  In the endoscope apparatus 1 according to the modified example 3, the sliding member 37 provided on the proximal end side of the bendable portion Ea of the endoscope E is inserted by sliding along the guide member 36. The rotation of the endoscope E can be restricted. Thereby, since the relationship between the position of the side mouth portion 13 of the first overtube 10 and the bending direction of the bendable portion Ea of the endoscope E can be made to coincide with each other, the endoscope E can be moved to the furter papilla 40. Can be easily inserted into.

DESCRIPTION OF SYMBOLS 1 ... Endoscope apparatus, 10 ... 1st overtube, 11 ... Inner peripheral surface, 12 ... 1st opening part, 13 ... Side opening part, 14 ... 1st balloon, 20 ... 2nd overtube, 22 ... 2nd Opening 24, 2nd balloon, 31 ... Anti-rotation member, 33 ... Anti-rotation member, 35 ... Anti-rotation member, 36 ... Guide member, 37 ... Sliding member, E ... Endoscope, Ea ... Bendable part.

Claims (6)

An endoscope having a bendable portion at the distal end, a first overtube having an opening at the distal end and a side opening opening in a side wall of the distal end, and the endoscope inserted therein, and an opening at the distal end And a second overtube having the first overtube inserted therein,
The first overtube can protrude from the opening of the second overtube so that the side opening of the first overtube is exposed,
The first overtube has a first balloon that can be inflated and deflated on the outer peripheral surface on the tip side from the side opening,
The second overtube has a second balloon that can be inflated and deflated on the outer peripheral surface of the tip,
The endoscope can protrude from the side mouth portion by bending the bendable portion in a state where the side mouth portion of the first overtube is exposed from the opening portion of the second overtube. Endoscopic device.   The endoscope apparatus according to claim 1, wherein the first balloon is a part of an outer peripheral surface of the first overtube and is provided on the same side as the side opening. The first overtube includes an inner peripheral surface having an elliptical shape in cross section,
The endoscope apparatus according to claim 1, wherein the endoscope includes at least one detent member protruding in the major axis direction of the elliptical shape on a proximal end side of the bendable portion.   The endoscope apparatus according to claim 3, wherein the endoscope includes a pair of the rotation preventing members. The first overtube includes an inner peripheral surface having a bowl shape in which a cross section is formed by combining a large circle and a small circle,
2. The endoscope according to claim 1, further comprising: a rotation preventing member that is positioned inside the large circle portion of the first overtube and protrudes into the small circle portion on a proximal end side of the bendable portion. The endoscope apparatus according to 1 or 2. The first overtube includes a guide member on an inner peripheral surface on a base end side from the side opening,
The endoscope apparatus according to claim 1, wherein the endoscope includes a sliding member that slidably engages with the guide member on a proximal end side of the bendable portion.

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