JP2012070854A - Surgical endoscopic device - Google Patents

Surgical endoscopic device Download PDF

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JP2012070854A
JP2012070854A JP2010216990A JP2010216990A JP2012070854A JP 2012070854 A JP2012070854 A JP 2012070854A JP 2010216990 A JP2010216990 A JP 2010216990A JP 2010216990 A JP2010216990 A JP 2010216990A JP 2012070854 A JP2012070854 A JP 2012070854A
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flexible
endoscope
trocar
distal end
length
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JP5570370B2 (en
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Yasunobu Fujita
泰伸 藤田
Masayasu Sato
雅康 佐藤
Tomohiro Kawano
友裕 川野
Shusuke Takushima
秀典 宅島
Yoshitaka Shibahara
祥孝 柴原
Akira Sugiyama
章 杉山
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Hoya Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00071—Insertion part of the endoscope body
    • A61B1/00078—Insertion part of the endoscope body with stiffening means

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Abstract

PROBLEM TO BE SOLVED: To smoothly perform the observation and surgical operation of an operating region by avoiding the interference of a soft endoscope with an operating device in the body in a surgical endoscopic device wherein the region near the tip side of a flexible tube part is formed so as to become softer than the region near the base side thereof.SOLUTION: The flexible tube part 11 is constituted so that the region 11s near the tip side thereof becomes softer than the region 11h near on the base end side thereof from the flexible transfer part 11x formed on the way of the flexible tube part 11 and the length (Ls) from the tips of the flexible insertion parts 11, 12 and 13 to the flexible transfer part 11x is formed so as to become larger the preset protrusion length (C) of the flexible insertion parts 11, 12 and 13 protruded from the tip of a trocar 30 for an endoscope.

Description

この発明は、腹腔鏡手術（又は胸腔鏡手術）等の際に体内の手術部位を観察するための内視鏡と、その内視鏡を体内に案内するために体壁部に突き刺された状態に配置されるトラカールとを備えた手術用内視鏡装置に関する。   The present invention relates to an endoscope for observing a surgical site in the body at the time of laparoscopic surgery (or thoracoscopic surgery) and the like, and a state where the endoscope is stabbed into a body wall part to guide the endoscope into the body The present invention relates to an endoscopic apparatus for surgery provided with a trocar disposed on the endoscope.

腹腔鏡手術等の際に体内の手術部位を観察するための内視鏡としては、挿入部が硬性で屈曲しないいわゆる硬性内視鏡が広く用いられている（例えば、特許文献１）。硬性内視鏡は、軟性内視鏡に比べて取り扱いが容易で耐久性も優れている等の長所がある。   A so-called rigid endoscope in which the insertion portion is rigid and does not bend is widely used as an endoscope for observing a surgical site in the body during laparoscopic surgery or the like (for example, Patent Document 1). Rigid endoscopes have advantages such as easy handling and superior durability compared to flexible endoscopes.

腹腔鏡手術等においては近年、患者の肉体的負担を極力小さくするために、内視鏡を案内する内視鏡用トラカールと手術デバイスを案内するデバイス用トラカールとを、体壁（例えば臍）にあけた同じ孔に差し込む術式が試みられている。   In recent years, in laparoscopic surgery, in order to minimize the physical burden on a patient, an endoscope trocar for guiding an endoscope and a device trocar for guiding a surgical device are provided on a body wall (for example, an umbilicus). Attempts have been made to insert it into the same hole.

ただし、そのようにすると、術式や使用する手術デバイスの種類等によっては、体内で内視鏡と手術デバイスとが干渉してしまったり、内視鏡が観察に都合のよい位置取りができなかったりする場合がある。   However, if you do so, depending on the surgical procedure and the type of surgical device used, the endoscope may interfere with the surgical device in the body, or the endoscope cannot be positioned conveniently for observation. Sometimes.

しかし、内視鏡用トラカールの先端から体内に突出する硬性内視鏡の挿入部を変位させるのは困難なので、内視鏡と手術デバイスとが干渉すると、手術部位の観察及び手術操作自体に支障をきたすことになる。   However, since it is difficult to displace the insertion part of the rigid endoscope that protrudes into the body from the distal end of the endoscope trocar, if the endoscope and the surgical device interfere with each other, the observation of the surgical site and the surgical operation itself are hindered. Will come.

そこで、硬性内視鏡に代えて可撓性挿入部を備えた軟性内視鏡を使用することが考えられる。軟性内視鏡の可撓性挿入部なら、体内で手術用デバイスと干渉したときに無理なく変位して、手術部位の観察及び手術操作を問題なく継続することができる（例えば、特許文献２）。   Therefore, it is conceivable to use a flexible endoscope provided with a flexible insertion portion instead of the rigid endoscope. If it is a flexible insertion part of a flexible endoscope, when it interferes with a surgical device in the body, it can be displaced without difficulty and observation of a surgical site and a surgical operation can be continued without any problems (for example, Patent Document 2). .

特開平５−２６９０７９JP-A-5-269079 特開平６−３８９２３JP-A-6-38923

軟性内視鏡の可撓性挿入部は一般に、可撓性のある可撓管部と、遠隔操作により屈曲させることができるように可撓管部の先端に連結された湾曲部と、観察窓が配置されて湾曲部の先端に連結された先端部本体により構成されている。   The flexible insertion portion of a flexible endoscope generally includes a flexible flexible tube portion, a curved portion connected to the distal end of the flexible tube portion so that it can be bent by remote control, and an observation window. Is disposed and connected to the tip of the bending portion.

そして、可撓管部において、先端側のごく短い領域は体腔内で小さな曲率半径で曲がることができるように柔軟に形成され（柔軟部）、それ以外の大半の領域は、術者による押し引き操作等の際に撓みすぎて操作力が逃げてしまわないように、ある程度以上の硬さに形成されている（低柔軟部）。   In the flexible tube portion, a very short region on the distal end side is formed flexibly so as to bend with a small radius of curvature in the body cavity (flexible portion), and most of the other regions are pushed and pulled by the operator. In order to prevent the operating force from escaping due to excessive bending during operation or the like, it is formed with a certain degree of hardness (low flexible portion).

しかし、軟性内視鏡の可撓性挿入部をそのように構成すると、低柔軟部がトラカールの先端から体内に差し込まれてしまった場合に、硬性内視鏡と同様に、術式や使用する手術デバイスの種類等によっては、体内で軟性内視鏡と手術デバイスとが干渉してしまったり、内視鏡が観察に都合のよい位置取りができなかったりする場合が発生する。   However, when the flexible insertion portion of the flexible endoscope is configured as such, when the low flexible portion has been inserted into the body from the distal end of the trocar, it is operated and used in the same manner as the rigid endoscope. Depending on the type of the surgical device, the flexible endoscope and the surgical device may interfere with each other in the body, or the endoscope may not be positioned conveniently for observation.

本発明は、可撓管部の先端側寄りの領域が基端側寄りの領域より柔軟に形成された手術用内視鏡装置を用いる場合に、体内において軟性内視鏡と手術デバイスが干渉するのを回避して、手術部位の観察及び手術操作等をスムーズに行うことができる手術用内視鏡装置を提供することを目的とする。   In the present invention, when a surgical endoscope apparatus in which a region closer to the distal end side of the flexible tube portion is formed more flexibly than a region closer to the proximal end side, the flexible endoscope and the surgical device interfere in the body. Therefore, an object of the present invention is to provide an endoscopic apparatus for surgery that can smoothly perform observation of a surgical site, surgical operation, and the like.

上記の目的を達成するため、本発明の手術用内視鏡装置は、可撓性のある可撓管部の先端に、遠隔操作により屈曲させることができる湾曲部が連結されて、観察窓が配置された先端部本体が湾曲部の先端に連結された構成の可撓性挿入部を備えた軟性内視鏡と、その軟性内視鏡の可撓性挿入部を体内に案内するための内視鏡用トラカールとが設けられた手術用内視鏡装置であって、可撓管部において、その途中に形成された可撓性変移部より基端側寄りの領域と比較して先端側寄りの領域の方が柔軟に形成されていて、可撓性挿入部の先端から可撓性変移部までの長さ（Ｌｓ）が、内視鏡用トラカールの先端から突出する可撓性挿入部の予め設定された突出長（Ｃ）より大きく形成されているものである。   In order to achieve the above object, the surgical endoscope apparatus according to the present invention has a bending portion that can be bent by a remote operation connected to a distal end of a flexible flexible tube portion, and has an observation window. A flexible endoscope having a flexible insertion portion configured such that the arranged distal end body is connected to the distal end of the bending portion, and an inner portion for guiding the flexible insertion portion of the flexible endoscope into the body. An endoscopic apparatus for surgery provided with a trocar for endoscope, wherein the flexible tube portion is closer to the distal end side than the region closer to the proximal end side than the flexible transition portion formed in the middle of the flexible tube portion. The length (Ls) from the distal end of the flexible insertion portion to the flexible transition portion is such that the length of the flexible insertion portion protrudes from the distal end of the endoscope trocar. It is formed larger than the preset protrusion length (C).

なお、可撓管部の表面であって、可撓性挿入部が予め設定された突出長（Ｃ）だけ内視鏡用トラカールの先端から突出した状態の時に内視鏡用トラカールの基端に位置する部分に基準位置表示指標が設けられていてもよい。   It should be noted that when the flexible insertion portion protrudes from the distal end of the endoscope trocar by a preset protrusion length (C) on the surface of the flexible tube portion, A reference position display index may be provided in the position.

また、可撓管部の表面であって、可撓性変移部の位置よりトラカールの長さ（Ｔ）と同じ長さ（Ｍ）だけ基端側の位置に限界位置表示指標が設けられていてもよい。   In addition, a limit position display index is provided on the surface of the flexible tube portion at the base end side by the same length (M) as the trocar length (T) from the position of the flexible transition portion. Also good.

本発明によれば、可撓性挿入部が内視鏡用トラカールに通されて内視鏡手術が行われる状態では、殆どのケースで可撓管部の先端側寄りの柔軟な領域がそのトラカールの先端から体内に入っていて、基端側寄りの柔軟性の低い領域は体内に飛び出さないので、体内において軟性内視鏡と手術デバイスとが干渉しそうになっても、可撓管部の柔軟な部分が容易に変位して干渉が回避され、手術部位の観察及び手術操作等をスムーズに行うことができる。   According to the present invention, in a state where the flexible insertion portion is passed through the endoscope trocar and endoscopic surgery is performed, in most cases, the flexible region near the distal end side of the flexible tube portion is the trocar. Since the region of low flexibility near the proximal end does not jump into the body from the distal end of the flexible tube, even if the flexible endoscope and the surgical device are likely to interfere with each other in the body, The flexible portion is easily displaced to avoid interference, and the observation of the surgical site and the surgical operation can be performed smoothly.

本発明の実施例に係る手術用内視鏡装置の一部を断面で示す側面図である。It is a side view which shows a part of surgical endoscope apparatus which concerns on the Example of this invention in a cross section. 本発明の実施例に係る手術用内視鏡装置が使用される内視鏡手術の状態を示す略示図である。It is a schematic diagram which shows the state of the endoscopic surgery in which the endoscope apparatus for operation which concerns on the Example of this invention is used.

以下、図面を参照して本発明の実施例を説明する。
図２は、本発明の手術用内視鏡装置を用いて腹腔鏡手術が行われる状態を略示している。 Embodiments of the present invention will be described below with reference to the drawings.
FIG. 2 schematically shows a state in which laparoscopic surgery is performed using the surgical endoscope apparatus of the present invention.

腹部等の体内にある患部Ａの手術を行うために、体壁の一か所（例えば臍等）に形成された一つの小さな切開孔Ｂから体内に、内視鏡用トラカール３０とデバイス用トラカール４０が差し込まれている。   In order to perform an operation on the affected part A in the body such as the abdomen, an endoscope trocar 30 and a device trocar are introduced into the body through one small incision hole B formed in one part of the body wall (for example, the navel). 40 is plugged in.

内視鏡用トラカール３０は軟性内視鏡１０を体内に案内するためのガイド筒であり、内視鏡用トラカール３０に外側から軟性内視鏡１０が挿入されている。デバイス用トラカール４０は内視鏡用鉗子や電気メス等のような内視鏡手術用の手術デバイス５０を体内に案内するためのガイド筒であり、デバイス用トラカール４０に外側から手術デバイス５０が挿入されている。   The endoscope trocar 30 is a guide tube for guiding the flexible endoscope 10 into the body, and the flexible endoscope 10 is inserted into the endoscope trocar 30 from the outside. The device trocar 40 is a guide tube for guiding an endoscopic surgical device 50 such as an endoscopic forceps or an electric knife into the body, and the surgical device 50 is inserted into the device trocar 40 from the outside. Has been.

軟性内視鏡１０の可撓性挿入部は、可撓性のある可撓管部１１と、基端側からの操作で任意に屈曲させることができるように可撓管部１１の先端に連結された湾曲部１２と、観察窓や照明窓等が先端面１３ａに配置されて湾曲部１２の先端に連結された先端部本体１３により構成されている。   The flexible insertion portion of the flexible endoscope 10 is connected to the flexible tube portion 11 and the distal end of the flexible tube portion 11 so as to be arbitrarily bent by an operation from the proximal end side. The curved portion 12 and the distal end main body 13 are arranged on the distal end surface 13 a and connected to the distal end of the curved portion 12.

可撓管部１１の基端に連結された操作部１４には、湾曲部１２を遠隔操作して屈曲させることができる湾曲操作ノブ１５等のような各種操作部材が配置されている。１６は、可撓管部１１が操作部１４への連結部付近で急激に曲がって座屈するのを防止するための折れ止め部材であり、可撓性挿入部には含まれない。   Various operation members such as a bending operation knob 15 that can be bent by remotely operating the bending portion 12 are disposed on the operation portion 14 connected to the proximal end of the flexible tube portion 11. Reference numeral 16 denotes a bend preventing member for preventing the flexible tube portion 11 from abruptly bending and buckling in the vicinity of the connecting portion to the operation portion 14 and is not included in the flexible insertion portion.

本発明の手術用内視鏡装置は、軟性内視鏡１０と内視鏡用トラカール３０とを含むものであり、図１はその構成を略示している。ただし、軟性内視鏡１０の操作部１４は図１からはみ出した位置に存在しており、内視鏡用トラカール３０は断面を図示してある。   The surgical endoscope apparatus of the present invention includes a flexible endoscope 10 and an endoscope trocar 30, and FIG. 1 schematically shows the configuration thereof. However, the operation unit 14 of the flexible endoscope 10 is present at a position protruding from FIG. 1, and the endoscope trocar 30 is shown in cross section.

図１は、各部の径方向に対して長さ方向を圧縮して図示してある。内視鏡用トラカール３０は、内径Ｄが例えば１２ｍｍ程度で、長さＴが２０±５ｃｍ程度の筒状体である。内視鏡用トラカール３０の基端側には、体内に潜ってしまうのを防ぐための鍔状部３１が突出形成されている。   FIG. 1 shows the length direction compressed with respect to the radial direction of each part. The endoscope trocar 30 is a cylindrical body having an inner diameter D of, for example, about 12 mm and a length T of about 20 ± 5 cm. On the proximal end side of the endoscope trocar 30, a hook-like portion 31 is formed so as to protrude from the body.

軟性内視鏡１０の可撓性挿入部１１，１２，１３は、外径ｄが内視鏡用トラカール３０内を緩く通過できる太さ（例えば、１０〜１１ｍｍ程度）で、長さＬが６０±１０ｃｍ程度に形成されている。そのうち湾曲部１２の長さは、例えば７±３ｃｍ程度である。   The flexible insertion portions 11, 12, and 13 of the flexible endoscope 10 have a thickness (for example, about 10 to 11 mm) that allows the outer diameter d to pass loosely through the endoscope trocar 30 and a length L of 60. It is formed to be about ± 10 cm. Of these, the length of the curved portion 12 is, for example, about 7 ± 3 cm.

可撓性挿入部１１，１２，１３を構成する可撓管部１１（有効長Ｚ）は、公知の内視鏡の可撓管部と同様のものであり、例えばばね性を備えた金属帯材製の螺旋管の外面に網状管が被覆され、さらにその外面に、合成樹脂材の外皮が押出成形等で被覆された可撓管により外装されている。   The flexible tube portion 11 (effective length Z) constituting the flexible insertion portions 11, 12, and 13 is the same as the flexible tube portion of a known endoscope, for example, a metal strip having spring properties. The outer surface of the spiral tube made of material is covered with a mesh tube, and further, the outer surface is covered with a flexible tube in which the outer skin of a synthetic resin material is covered by extrusion molding or the like.

ただし可撓管部１１は、その途中に形成された可撓性変移部１１ｘより基端側寄りの領域（低柔軟部１１ｈ）と比較して、先端側寄りの領域（柔軟部１１ｓ）の方が柔軟に形成されている。   However, the flexible tube portion 11 has a region closer to the distal end side (soft portion 11s) than a region closer to the proximal end side (low flexible portion 11h) than the flexible transition portion 11x formed in the middle thereof. Is formed flexibly.

即ち、可撓性変移部１１ｘは低柔軟部１１ｈと柔軟部１１ｓとの境界部である。低柔軟部１１ｈと柔軟部１１ｓは、例えば外皮を形成する合成樹脂材の硬度を適宜に選択することで各々所望の可撓性に形成することができる。   That is, the flexible transition portion 11x is a boundary portion between the low flexible portion 11h and the flexible portion 11s. The low flexible portion 11h and the flexible portion 11s can be formed to have desired flexibility by appropriately selecting the hardness of the synthetic resin material forming the outer skin, for example.

湾曲部１２も公知の内視鏡の湾曲部と同様のものであり、例えば複数の関節輪がリベット等で回動自在に連結されて構成された骨組体の外面に網状管が被覆され、さらにその外面に、柔軟なゴムチューブ等が被覆された湾曲管により外装され、湾曲部１２の先端部分に連結された操作ワイヤを操作部１４側から牽引操作することにより屈曲する。   The bending portion 12 is also the same as the bending portion of a known endoscope. For example, a reticulated tube is coated on the outer surface of a skeleton that is configured by a plurality of articulated rings being rotatably connected by rivets or the like. The outer surface is covered with a bending tube covered with a flexible rubber tube or the like, and is bent by pulling the operation wire connected to the distal end portion of the bending portion 12 from the operation portion 14 side.

このように構成された実施例の手術用内視鏡装置において、可撓性挿入部１１，１２，１３の先端（即ち、先端部本体１３の先端位置）から可撓性変移部１１ｘまでの長さＬｓが、内視鏡用トラカール３０の先端から突出する可撓性挿入部１１，１２，１３の予め設定された突出長Ｃより大きく形成されている。   In the surgical endoscope apparatus according to the embodiment thus configured, the length from the distal end of the flexible insertion portion 11, 12, 13 (that is, the distal end position of the distal end portion main body 13) to the flexible transition portion 11x. The length Ls is formed to be larger than a preset protruding length C of the flexible insertion portions 11, 12, 13 protruding from the distal end of the endoscope trocar 30.

可撓性挿入部１１，１２，１３の予め設定された突出長Ｃとは、その軟性内視鏡１０の機種の使用目的に対応して実際の症例の状態等を参考にして設定されるものであり、湾曲部１２と先端部本体１３を合わせた長さはその予め設定された突出長Ｃより短く形成されている。   The preset protrusion length C of the flexible insertion portions 11, 12, and 13 is set with reference to the actual case state corresponding to the purpose of use of the flexible endoscope 10 model. The combined length of the bending portion 12 and the tip portion main body 13 is shorter than the preset protruding length C.

その結果、可撓性挿入部１１，１２，１３が内視鏡用トラカール３０に通されて内視鏡手術が行われる状態では、可撓性挿入部１１，１２，１３を体内のよほど奥まで挿入せざるを得ないような特殊な症例を除いて、内視鏡用トラカール３０の先端から柔軟部１１ｓが体内に入っていて、低柔軟部１１ｈは内視鏡用トラカール３０の先端から体内に飛び出さない。   As a result, in a state in which the flexible insertion portions 11, 12, and 13 are passed through the endoscope trocar 30 and endoscopic surgery is performed, the flexible insertion portions 11, 12, and 13 are moved far into the body. Except for special cases where it is necessary to insert the endoscope, the flexible portion 11s enters the body from the distal end of the endoscope trocar 30 and the low flexible portion 11h enters the body from the distal end of the endoscope trocar 30. Don't jump out.

したがって、図２に示されるように、内視鏡用トラカール３０に通された軟性内視鏡１０とデバイス用トラカール４０に通された手術デバイス５０とが、体壁に形成された一つの切開孔Ｂから体内に差し込まれる術式において、体内で軟性内視鏡１０と手術デバイス５０とが干渉しそうになっても、柔軟部１１ｓが容易に変位して干渉が回避され、手術部位の観察及び手術操作等をスムーズに行うことができる。   Therefore, as shown in FIG. 2, the flexible endoscope 10 passed through the endoscope trocar 30 and the surgical device 50 passed through the device trocar 40 form one incision hole formed in the body wall. In the surgical method inserted into the body from B, even if the flexible endoscope 10 and the surgical device 50 are likely to interfere with each other in the body, the flexible portion 11s is easily displaced and the interference is avoided. Operations can be performed smoothly.

可撓管部１１の表面であって、可撓性挿入部１１，１２，１３が予め設定された突出長Ｃだけ内視鏡用トラカール３０の先端から突出した状態の時に内視鏡用トラカール３０の基端に位置する部分には、基準位置表示指標１８が形成されている。   Endoscope trocar 30 on the surface of flexible tube 11 when flexible inserts 11, 12, and 13 protrude from the distal end of endoscope trocar 30 by a preset protrusion length C. A reference position display index 18 is formed at a portion located at the base end of the reference position.

基準位置表示指標１８は、例えば可撓管部１１の表面の全周に形成された線状の指標、或いは可撓管部１１の表面色をその前後で相違させたもの（即ち、表面色の変化部）等により形成することができる。   The reference position display index 18 is, for example, a linear index formed on the entire circumference of the surface of the flexible tube portion 11 or a surface color of the flexible tube portion 11 that is different before and after (that is, the surface color). For example, a change portion).

術者は、この基準位置表示指標１８が内視鏡用トラカール３０の入口にあることを見て、可撓性挿入部１１，１２，１３が予め設定された突出長Ｃだけ内視鏡用トラカール３０の先端から突出した状態であることを認識することができる。   The surgeon sees that the reference position display index 18 is at the entrance of the endoscope trocar 30, and the flexible insertion portions 11, 12, and 13 have the projection length C set in advance, and the endoscope trocar. It can be recognized that it is in a state of protruding from the tip of 30.

また、可撓管部１１の表面であって、可撓性変移部１１ｘの位置より内視鏡用トラカール３０の長さ（Ｔ）と同じ長さ（Ｍ）だけ基端側の位置に限界位置表示指標１９が形成されている。   Further, the limit position is located on the surface of the flexible tube portion 11 at the base end side by the same length (T) as the length (T) of the endoscope trocar 30 from the position of the flexible transition portion 11x. A display index 19 is formed.

限界位置表示指標１９も、例えば可撓管部１１の表面の全周に形成された線状の指標、或いは可撓管部１１の表面色をその前後で相違させたもの（即ち、表面色の変化部）等により形成することができる。内視鏡用トラカール３０の入口から限界位置表示指標１９までの長さが、内視鏡用トラカール３０内に潜っている柔軟部１１ｓの長さに相当する。   The limit position display index 19 is also, for example, a linear index formed on the entire circumference of the surface of the flexible tube portion 11 or a surface color of the flexible tube portion 11 that is different before and after (that is, the surface color). For example, a change portion). The length from the entrance of the endoscope trocar 30 to the limit position display index 19 corresponds to the length of the flexible portion 11 s that is submerged in the endoscope trocar 30.

したがって、可撓性挿入部１１，１２，１３が予め設定された突出長Ｃより余計に内視鏡用トラカール３０の先端から突出されても、限界位置表示指標１９が内視鏡用トラカール３０内に入らないように操作を行えば、低柔軟部１１ｈが内視鏡用トラカール３０の先端から突出せず、体内での軟性内視鏡１０と手術デバイス５０の干渉がスムーズに回避される。   Therefore, even if the flexible insertion portions 11, 12, and 13 are protruded from the distal end of the endoscope trocar 30 more than the preset protrusion length C, the limit position display indicator 19 is in the endoscope trocar 30. If the operation is performed so as not to enter, the low flexible portion 11h does not protrude from the distal end of the endoscope trocar 30, and interference between the flexible endoscope 10 and the surgical device 50 in the body can be avoided smoothly.

１０ 軟性内視鏡
１１ 可撓管部（可撓性挿入部）
１１ｈ 低柔軟部（基端側寄りの領域）
１１ｓ 柔軟部（先端側寄りの領域）
１１ｘ 可撓性変移部
１２ 湾曲部（可撓性挿入部）
１３ 先端部本体（可撓性挿入部）
１８ 基準位置表示指標
１９ 限界位置表示指標
３０ 内視鏡用トラカール
４０ デバイス用トラカール
５０ 手術デバイス 10 flexible endoscope 11 flexible tube part (flexible insertion part)
11h Low flexible part (region closer to the base end)
11s flexible part (region near the tip)
11x flexible transition part 12 bending part (flexible insertion part)
13 Tip body (flexible insertion part)
18 Reference position display index 19 Limit position display index 30 Endoscope trocar 40 Device trocar 50 Surgical device

Claims (3)

可撓性のある可撓管部の先端に、遠隔操作により屈曲させることができる湾曲部が連結されて、観察窓が配置された先端部本体が上記湾曲部の先端に連結された構成の可撓性挿入部を備えた軟性内視鏡と、その軟性内視鏡の可撓性挿入部を体内に案内するための内視鏡用トラカールとが設けられた手術用内視鏡装置であって、
上記可撓管部において、その途中に形成された可撓性変移部より基端側寄りの領域と比較して先端側寄りの領域の方が柔軟に形成されていて、
上記可撓性挿入部の先端から上記可撓性変移部までの長さ（Ｌｓ）が、上記内視鏡用トラカールの先端から突出する上記可撓性挿入部の予め設定された突出長（Ｃ）より大きく形成されていることを特徴とする手術用内視鏡装置。 It is possible to have a configuration in which a bending portion that can be bent by remote operation is connected to the distal end of a flexible flexible tube portion, and a distal end portion body on which an observation window is arranged is connected to the distal end of the bending portion. A surgical endoscope apparatus provided with a flexible endoscope provided with a flexible insertion portion and an endoscope trocar for guiding the flexible insertion portion of the flexible endoscope into the body. ,
In the flexible tube portion, the region closer to the distal end side is formed more flexibly than the region closer to the proximal end side than the flexible transition portion formed in the middle,
The length (Ls) from the distal end of the flexible insertion portion to the flexible transition portion is a preset projection length (C) of the flexible insertion portion that projects from the distal end of the endoscope trocar. ) Endoscopic apparatus for surgery characterized by being formed larger. 上記可撓管部の表面であって、上記可撓性挿入部が上記の予め設定された突出長（Ｃ）だけ上記内視鏡用トラカールの先端から突出した状態の時に上記内視鏡用トラカールの基端に位置する部分に基準位置表示指標が設けられている請求項１記載の手術用内視鏡装置。   The endoscope trocar when the flexible insertion portion protrudes from the distal end of the endoscope trocar by the preset protrusion length (C) on the surface of the flexible tube portion. The surgical endoscope apparatus according to claim 1, wherein a reference position display index is provided at a portion located at the proximal end of the surgical endoscope. 上記可撓管部の表面であって、上記可撓性変移部の位置より上記トラカールの長さ（Ｔ）と同じ長さ（Ｍ）だけ基端側の位置に限界位置表示指標が設けられている請求項１又は２記載の手術用内視鏡装置。   A limit position display index is provided on the surface of the flexible tube portion at a base end side by the same length (M) as the length (T) of the trocar from the position of the flexible transition portion. The surgical endoscope apparatus according to claim 1 or 2.
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