JP2014079425A - Endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope having a structure where a liquid can be accurately, securely, and intensively supplied to a part to be treated while securing an observation visual field without moving a distal end surface.SOLUTION: An endoscope includes: an opening for channel 14s formed on a distal end surface 3s of a distal end portion at a tip of an insertion section to be inserted into a subject; a liquid feed opening 15s formed into an elongated shape on the distal end surface 3s; a liquid feed pipe 16 formed along the inserting direction in the distal end portion and disposed so that a distal end opening 16s is displaceable along the extending direction E of the liquid feed opening 15s in a hole having the liquid feed opening 15s at a tip; a drive mechanism which causes the distal end opening 16s to be displaced along the extending direction E. The extending direction E of the liquid feed opening 15s is set to overlap with an opening for channel 14s when the liquid feed opening 15s is extended along the extending direction E on the distal end surface 3s.

Description

  The present invention relates to an endoscope including an insertion portion that is inserted into a subject.

  In recent years, endoscopes inserted into a subject have been widely used in the medical field and the industrial field. The endoscope can observe the inside of the subject by inserting an elongated insertion portion into the subject.

  Further, the distal end portion located on the distal end side in the insertion direction of the insertion portion of the endoscope (hereinafter simply referred to as the distal end side) is provided with a distal end hard member made of a hard metal, An imaging unit for imaging the inside of the subject is provided.

  In the distal end rigid member, a treatment instrument insertion conduit for supplying the treatment instrument into the subject, a forward water supply conduit for supplying the liquid into the subject, and an observation window described later of the imaging unit are provided. Inside the insertion section for supplying illumination light to the illumination window while the distal end side of each known various pipeline inserted through the insertion section such as an air / water supply pipe for supplying gas or liquid is formed along the insertion direction The leading end side of the light guide inserted through is inserted along the insertion direction.

  In addition, the distal end surface of the distal end rigid member has an objective lens (observation window) positioned closest to the distal end among a plurality of objective lenses constituting the imaging unit, and illumination transmitted from the light guide to the subject. The distal end opening of the treatment instrument insertion conduit for projecting the illumination window for supplying light and the treatment instrument inserted into the treatment instrument insertion conduit forward of the distal end surface in the insertion direction (hereinafter simply referred to as the front) A channel opening, a liquid feed opening that is the front opening of the front water supply pipe that supplies liquid forward from the front end surface, a nozzle that is attached to the front opening of the air / water feed pipe, and the like. Yes.

  Here, Patent Document 1 has a configuration in which a swingable nozzle tip that changes the liquid feeding direction of the liquid fed from the liquid feeding opening is provided at a position facing the front end opening of the forward water feeding pipeline. It is disclosed.

JP 2009-153927 A

  By the way, after inserting the insertion portion into the subject, the surgeon performs various treatments, for example, incision treatments, using a treatment tool projected from the channel opening with respect to the treatment site, for example, under the observation window. After that, when observing bleeding at the treatment site through the observation window, in order to confirm the bleeding site (hereinafter referred to as bleeding point), a liquid, for example, water is fed from the liquid delivery opening to the treatment site. Blood that has been bleed from the site is washed away, and then the bleeding point that has been confirmed is stopped by known clipping or cauterization using a hemostatic treatment tool that protrudes from the channel opening.

  However, the front water supply pipe line is formed in parallel to the treatment instrument insertion pipe line with respect to the distal end rigid member, and usually when performing various treatments on the treatment site, the distal end of the insertion part Since the distance between the surface and the treatment site is very close to, for example, 1 cm, the liquid cannot be intensively supplied with high positional accuracy to the treatment site simply by supplying the liquid from the liquid delivery opening, and bleeding from the treatment site. This makes it difficult for the surgeon to check the bleeding point.

  Therefore, usually, the surgeon observes bleeding after incision treatment of the treatment site, for example, and then the liquid is concentrated on the treatment site with high positional accuracy by bending the bending portion provided in the insertion portion. After moving to the liquid supply position supplied to the treatment site, supplying the liquid to the treatment site through the liquid supply opening and washing away the blood, the position of the distal end surface is again returned to the treatment position where the treatment instrument performed the incision treatment. The bleeding point was confirmed, and the bleeding point was treated with hemostasis using a hemostatic treatment tool.

  However, in the case of sudden bleeding during treatment such as when performing known ESD (Endoscopic submucosal dissection) treatment, it is easier to predict the bleeding point if the position of the treatment tool and observation field of view are not changed. If the bleeding point can be confirmed without changing the position of the distal end surface, the hemostasis process can be performed efficiently. For this reason, the position of the distal end surface during bleeding is not desired to be moved as much as possible.

  In addition, bleeding from the treatment site continues while the tip surface is moved from the treatment position to the liquid delivery position and from the liquid delivery position to the treatment position. However, if the time to return was long, the surgeon lost the bleeding point again. Therefore, if the surgeon loses sight of the bleeding point, it must repeat the movement of the distal end surface between the treatment position and the liquid feeding position until the bleeding point can be confirmed, and the hemostasis process becomes slow. There was also.

  In view of such circumstances and problems, it is also possible to use a nozzle tip disclosed in Patent Document 1 to change the liquid supply direction, thereby supplying liquid to the treatment site without moving the distal end surface. The nozzle tip of Patent Document 1 has a problem in that the liquid cannot be supplied with high positional accuracy toward the treatment site because the swinging direction coincides with the direction connecting the liquid delivery opening and the observation window. .

  The present invention has been made in view of the above-described problems, and includes a configuration that can reliably and intensively supply liquid to a treatment site while ensuring an observation field of view without moving a distal end surface. An object is to provide an endoscope.

  In order to achieve the above object, an endoscope according to one aspect of the present invention is formed on a distal end surface of a distal end portion located at a distal end in an insertion direction of an insertion portion to be inserted into a subject. A channel opening for projecting the treatment tool forward in the insertion direction; a liquid supply opening formed in a slender shape on the distal end surface for supplying liquid to the front side of the distal end surface; and the insertion direction in the distal end portion And the tip opening for discharging the liquid is disposed so as to be displaceable along the extending direction of the liquid feeding opening in the hole having the liquid feeding opening at the tip in the insertion direction. And a driving mechanism for displacing the tip opening of the liquid feeding pipe along the extending direction, and the extending direction of the liquid feeding opening is at the tip surface at the tip surface. How to extend the liquid delivery opening When extended along, it is set in a direction overlapping the channel opening.

  ADVANTAGE OF THE INVENTION According to this invention, the endoscope which comprises the structure which can supply a liquid accurately and reliably to a treatment site | part can be provided, ensuring an observation visual field, without moving a front end surface.

The perspective view which shows the endoscope of this Embodiment 1 is a plan view of the distal end portion of the insertion portion of FIG. 1 viewed from the II direction in FIG. Partial sectional view schematically showing the distal end side of the insertion portion along the line III-III in FIG. 2 together with the operation portion Enlarged view of the liquid delivery pipe at the site surrounded by line IV in Fig. 3 The perspective view which expands and shows the connection part of FIG. The fragmentary sectional view which shows the state which displaced the front-end | tip opening of the liquid feeding pipe of FIG. 3 to the channel opening side along the extension direction of the liquid feeding opening. The fragmentary sectional view which shows the state which displaced the front-end | tip opening of the liquid feeding pipe of FIG. 3 to the outer peripheral surface side of the front-end | tip part along the extension direction of the opening for liquid feeding. The figure which shows schematically the state which sent the liquid from the opening for liquid feeding of FIG. 2 to the treatment site | part in a subject.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 is a perspective view showing an endoscope according to the present embodiment, FIG. 2 is a plan view of the distal end portion of the insertion portion of FIG. 1 as viewed from the direction II in FIG. 1, and FIG. 3 is III in FIG. It is the fragmentary sectional view which showed roughly the front end side of the insertion part in alignment with -III line with the operation part.

  4 is an enlarged view of a liquid feeding pipe in a portion surrounded by line IV in FIG. 3, and FIG. 5 is an enlarged perspective view showing a connecting portion in FIG.

  6 is a partial cross-sectional view showing a state in which the tip opening of the liquid feeding pipe of FIG. 3 is displaced toward the channel opening side along the extending direction of the liquid feeding opening, and FIG. It is a fragmentary sectional view which shows the state which displaced the front-end | tip opening of the liquid feeding pipe to the outer peripheral surface side of the front-end | tip part along the extension direction of the opening for liquid feeding.

  As shown in FIG. 1, an endoscope 1 is connected to an insertion portion 2 to be inserted into a subject and a proximal end in the insertion direction S of the insertion portion 2 (hereinafter simply referred to as a proximal end). The main part is configured by including an operation unit 6, a universal cord 7 extending from the operation unit 6, and a connector 8 provided at an extended end of the universal cord 7.

  Since the connector 8 can be connected to a known light source device (not shown), a video processor, or the like, the endoscope 1 can be connected to a peripheral device.

  The insertion portion 2 includes a distal end portion 3, a bending portion 4, and a flexible tube portion 5 in order from the distal end side, and a main portion is configured.

  The bending portion 4 is operated by bending operation knobs 6 a and 6 b provided in the operation portion 6, for example, in four directions of up, down, left and right, and is provided between the distal end portion 3 and the flexible tube portion 5. ing.

  Further, as shown in FIG. 3, the distal end portion 3 includes a distal end rigid member 3c made of a hard metal, and an imaging unit (not shown) that images the inside of the subject in the distal end rigid member 3c. Is fixed.

  Further, in the distal end rigid member 3c, the treatment instrument insertion conduit 14 (see FIG. 8) for supplying the treatment instrument 60 (see FIG. 8) into the subject, or the liquid R (see FIG. 8) in the subject. Each of which is inserted into the insertion portion 2, such as a front water supply pipe 15 for supplying a gas) or a liquid (not shown) for supplying gas or liquid to an observation window 10 (see FIG. 2) to be described later of the imaging unit. Lights (not shown) inserted into the insertion portion 2 for supplying illumination light to illumination windows 12 and 13 (see FIG. 2) to be described later, while the distal ends of various known conduits are formed along the insertion direction S. The distal end side of the guide is inserted along the insertion direction.

  Further, on the distal end surface 3s of the distal end portion 3, as shown in FIG. 2, an observation window 10 that is located on the most distal side among the plurality of lenses constituting the imaging unit described above and that observes the inside of the subject, Illumination windows 12 and 13 for supplying illumination light transmitted from the light guide described above to the inside of the subject are provided.

  Further, as shown in FIG. 2, the distal end surface 3s has a treatment instrument 60 inserted into the treatment instrument insertion conduit 14 from the treatment instrument insertion port 6i (see FIG. 1) provided in the operation section 6. A channel opening 14s that is the distal end opening of the treatment instrument insertion conduit 14 that projects forward from the surface 3s, and a liquid feed that is the distal end opening of the front water supply conduit 15 that supplies the liquid R forward from the distal end surface 3s. 15s for use, the nozzle 11 etc. which were mounted | worn with the front-end | tip opening of front-end surface 3s of the air / water supply pipe line mentioned above are provided.

  From the channel opening 14s, mucus, blood, and the like in the body cavity are collected through the treatment instrument insertion conduit 14 by a button operation of a suction operation button (not shown) provided in the operation unit 6.

  Next, the configuration of the liquid supply opening 15s and the forward water supply conduit 15 will be described.

  As shown in FIG. 2, the liquid supply opening 15 s is formed so as to extend in a slender shape on the distal end surface 3 s.

  Note that the direction (hereinafter referred to as the extending direction) E in which the liquid supply opening 15s extends (hereinafter, referred to as an extending direction) E is set so that the liquid supply opening 15s extends in the extending direction E on the tip surface 3s, as shown by a one-dot chain line in FIG. When extending along, the direction is set to overlap the channel opening 14s.

  That is, the liquid supply opening 15s is formed in an elongated shape at a position overlapping the channel opening 14s when extending in the extending direction E on the distal end surface 3s. Therefore, the elongated liquid-feeding opening 15s is not limited to the position shown in FIG. 2 as long as it overlaps the channel opening 14s when extending along the extending direction E. It may be formed.

  Further, the liquid supply opening 15s does not necessarily need to completely overlap the channel opening 14s when extending in the extending direction E on the distal end surface 3s, and is elongated at a position where at least a part thereof overlaps the channel opening 14s. It suffices if it is formed.

  The length in the extending direction E of the liquid feeding opening 15s is larger than the outer diameter of the tip opening 16s of the liquid feeding pipe 16, which will be described later, and the outer peripheral edge of the channel opening 14s and the outer peripheral edge of the tip surface 3s. It is set to be smaller than the length of connecting. Further, the width D orthogonal to the extending direction E of the liquid feeding opening 15s is formed to be slightly larger than the outer diameter of the tip opening 16s of the liquid feeding pipe 16 described later.

  Further, as shown in FIG. 3, the liquid supply opening 15s is an opening at the tip in the insertion direction S (hereinafter simply referred to as the tip) of the hole 17 formed along the insertion direction S with respect to the tip hard member 3c. Is configured.

  The hole 17 is positioned substantially in the first half of the midway position in the insertion direction S, and has a large diameter portion 17a having the same size as the liquid-feeding opening 15s in the extending direction E and the width direction D, and is positioned substantially in the second half. In addition, the small-diameter portion 17b communicated with the large-diameter portion 17a and further smaller in diameter than the large-diameter portion 17a constitutes a part of the forward water supply conduit 15. Therefore, the opening at the tip of the large diameter portion 17a constitutes the liquid feeding opening 15s.

  An inward flange 17bf that protrudes circumferentially in the inner diameter direction is provided at the tip of the small diameter portion 17b, and a hole 17bi in the inward flange 17bf also communicates with the large diameter portion 17a. The hole 17bi has a smaller diameter than the small diameter portion 17b and a larger diameter than the liquid feeding pipe 16 described later.

  A liquid feed pipe 16 is inserted in the hole 17 along the insertion direction S. The liquid supply pipe 16 constitutes a part of the forward water supply conduit 15.

  The tip opening 16s located at the tip of the liquid feeding pipe 16 discharges the liquid R, and is behind the liquid feeding opening 15s in the large diameter portion 17a in the insertion direction S (hereinafter simply referred to as the rear). Is located.

  Further, as shown in FIG. 4, a circumferential groove 16m is formed on the outer peripheral surface in the middle of the insertion direction S of the liquid feeding pipe 16, and a rubber member 35 such as an O-ring is fitted into the groove 16m. Match.

  The rubber member 35 is in contact with the inner peripheral surface 17bn of the small diameter portion 17b, and is in contact with the surface on the proximal end side (hereinafter referred to as the proximal end side) of the inward flange 17bf in the insertion direction S. The liquid feeding pipe 16 is press-fitted into the hole 17 in a state where the rubber member 35 is pressed forward on the surface toward the proximal end side of the inward flange 17bf.

  Further, the rubber member 35 prevents the liquid that has entered the large diameter portion 17a from entering the small diameter portion 17b through the liquid feeding opening 15s.

  Further, the rubber member 35 supports the liquid feeding pipe 16 in the hole 17. Specifically, in the large-diameter portion 17a, the rubber member 35 is configured such that the tip opening 16s of the liquid feeding pipe 16 can be displaced along the extending direction E of the liquid feeding opening 15s by a driving mechanism 50 described later. I support it.

  More specifically, the liquid feeding pipe 16 has a position where a groove 16m serving as an intermediate position in the insertion direction S is formed by a driving mechanism 50 described later, that is, a position where the rubber member 35 contacts the inner peripheral surface 17bn. As shown in FIGS. 6 and 7, the fulcrum 16p is supported on the inner peripheral surface 17bn of the small diameter portion 17b so that the liquid feeding pipe 16 can swing along the extending direction E in the hole 17. .

  Further, since the rubber member 35 is fitted in the groove 16m on the outer peripheral surface of the liquid feeding pipe 16, the rubber member 35 is placed on the outer peripheral surface of the liquid feeding pipe 16 as the liquid feeding pipe 16 swings. On the other hand, it is prevented from moving back and forth in the insertion direction S.

  In addition, the distal end side of the liquid feeding tube 18 is fixed to the outer periphery of a portion on the base end 16 k side that protrudes rearward from the small diameter portion 17 b in the hole 17 in the liquid feeding pipe 16.

  The liquid feeding tube 18 is inserted into the insertion section 2, the operation section 6, the universal cord 7, and the connector 8, and a base end is fixed to a liquid feeding base (not shown) provided in the connector 8. Therefore, when the liquid R is supplied from a liquid feeding device (not shown) connected to the liquid feeding base, the liquid R is introduced into the liquid feeding tube 18, and inside the liquid feeding pipe 16 on the distal end side of the insertion portion 2. And then supplied into the subject through the tip opening 16s and the liquid supply opening 15s. The liquid supply tube 18 also constitutes a part of the forward water supply line 15.

  Further, a connecting portion 30 is provided on the outer periphery of the portion of the liquid supply pipe 16 where the distal end side of the liquid supply tube 18 is fixed, that is, on the outer periphery on the distal end side of the liquid supply tube 18.

  Specifically, as shown in FIG. 5, the connecting portion 30 includes a cylindrical fixing portion 30a and a wire attachment portion 30b that is a standing piece that rises from a part of the outer peripheral surface of the fixing portion 30a. Is configured.

  The fixing portion 30a is inserted into the interior 30i through the proximal end 16k side of the liquid feeding pipe 16 and the distal end side of the liquid feeding tube 18, and the outer peripheral surface of the distal end side of the liquid feeding tube 18 is fixed to the inner peripheral surface by, for example, bonding. It is a part to be done. As a result, the connecting portion 30 is provided on the base end 16 k side of the liquid feeding pipe 16.

  The wire attachment part 30b is a part where a tip 40s of a wire 40 described later is fixed to the hole 30h.

  Next, the drive mechanism 50 that displaces the tip opening 16s of the liquid feeding pipe 16 in the extending direction E within the large diameter portion 17a of the hole 17, that is, the drive mechanism 50 that swings the liquid feeding pipe 16 within the hole 17 will be described. .

  As shown in FIGS. 1 and 3, the drive mechanism 50 is provided in the operation unit 6 and operated in the operation unit 6, which is rotatable in the directions F <b> 1 and F <b> 2 that are operation members provided in the operation unit 6. A link mechanism 41 that converts the rotational force of the operation lever 20 connected to the rotation shaft 20j of the lever 20 into a force in the front-rear direction in the insertion direction S is inserted into the insertion unit 2 and the operation unit 6, and A main portion is configured by including a wire 40 having a distal end 40 s fixed to the hole 30 h of the wire attachment portion 30 b of the connecting portion 30 and a proximal end 40 k connected to the link mechanism 41.

  Therefore, when the operating lever 20 is rotated in the direction F1 from the position shown by the two-dot chain line in FIG. 3 to the position shown by the solid line in FIG. In addition, when the operation lever 20 is rotated in the direction F2 from the position indicated by the solid line in FIG. 3 to the position indicated by the two-dot chain line in FIG. 3, the wire 40 is relaxed forward via the link mechanism 41. It has become.

  When the wire 40 is pulled and relaxed back and forth in the insertion direction S, the connecting portion 30 to which the distal end 40s of the wire 40 is fixed is fixed to the base end 16k side of the liquid supply pipe 16, and in addition, the liquid supply tube Since the tip end side of 18 is composed of a flexible member, the portion of the liquid feed tube 18 located behind the connecting portion 30 on the tip end side bends, so that the liquid feed pipe 16 in the hole 17 is bent. Is swung in the extending direction E. That is, the liquid feeding pipe 16 fixed to the connecting portion 30 swings along the extending direction E as shown in FIGS. 6 and 7 around the fulcrum 16p as the connecting portion 30 swings. .

  In other words, the tip opening 16s of the liquid feeding pipe 16 is freely displaceable in the large diameter portion 17a along the extending direction E.

  Specifically, when the wire 40 is pulled backward by the rotation operation of the operation lever 20 in the direction F1, as shown in FIG. 6, the liquid feeding pipe 16 positioned in the large diameter portion 17a is moved. The part moves to the channel opening 14s side in the extending direction E, and the part of the liquid feeding pipe 16 located in the small diameter part 17b is on the outer peripheral surface side of the tip part 3 in the extending direction E together with the connecting part 30. Move to.

  That is, as shown in FIGS. 1 and 6, the tip opening 16 s is in a state where the tip opening 16 s shown in FIG. 3 and the liquid feeding opening 15 s are parallel to each other in the large diameter portion 17 a or the tip opening 3 shown in FIG. 7. From the state displaced toward the outer peripheral surface side, the channel is displaced along the extending direction E toward the channel opening 14s.

  As shown in FIG. 6, the displacement of the tip opening 16s toward the channel opening 14s is such that the position on the rear side of the fulcrum 16p of the liquid feeding pipe 16 is on the outer peripheral side of the tip portion 3 behind the small diameter portion 17b. This is done until it touches the open end.

  On the other hand, when the wire 40 is loosened forward by the rotation operation of the operation lever 20 in the direction F2, the portion of the liquid feeding pipe 16 located in the large diameter portion 17a extends as shown in FIG. In the direction E, the portion of the liquid feeding pipe 16 that moves to the outer peripheral surface side of the distal end portion 3 and is located in the small diameter portion 17b moves to the channel opening 14s side in the extending direction E together with the connecting portion 30.

  That is, as shown in FIGS. 1 and 7, the tip opening 16s is in a state where the tip opening 16s shown in FIG. 3 and the liquid feed opening 15s are parallel to each other in the large diameter portion 17a or the channel opening 14s shown in FIG. From the displaced state, it is displaced toward the outer peripheral surface side of the tip portion 3 along the extending direction E shown in FIG.

  As shown in FIG. 7, the displacement of the tip opening 16s toward the outer peripheral surface side of the tip opening 3 is such that the position behind the fulcrum 16p of the liquid feeding pipe 16 is the channel opening 14s behind the small diameter portion 17b. This is done until it touches the open end of the side.

  Next, the effect | action of this Embodiment is demonstrated using FIGS. 1-7 mentioned above and FIG. FIG. 8 is a diagram schematically showing a state in which the liquid is supplied from the liquid supply opening of FIG. 2 to the treatment site in the subject.

  When an operator performs, for example, an incision treatment on the treatment site Q in the subject, first, the operator moves the insertion portion 2 back and forth in the insertion direction S in the observation field of view of the observation window 10 and also moves the bending portion 4. By bending the bending operation knobs 6a and 6b (see FIG. 1) provided in the operation unit 6 to bend, the distal end surface 3s is brought close to the treatment site Q and observed as shown in FIG. The treatment site Q is positioned within the observation field of view of the window 10.

  Next, the surgeon inserts the treatment instrument 60 for incision, for example, inserted into the treatment instrument insertion line 14 from the treatment instrument insertion port 6i (see FIG. 1) provided in the operation section 6 into the channel opening 14s. Then, the incision treatment is performed using the projected treatment tool 60 in the observation visual field of the observation window 10 after projecting forward from the distal end surface 3s via the, and in other words, to the treatment site Q side. In addition, bleeding occurs from the treatment site Q along with the incision treatment.

  Therefore, the surgeon depresses a front water supply button (not shown) provided on the operation unit 6 in order to confirm the bleeding point V of the treatment site Q. Thereby, the liquid R in the liquid feeding device (not shown), for example, water, is supplied forward of the front end surface 3s via the front water feeding line 15 and the liquid feeding opening 15s.

  When the operating lever 20 is not operated by the surgeon, as shown in FIG. 3, the tip opening 16s of the liquid feeding pipe 16 and the liquid feeding opening 15s are positioned substantially in parallel. Since the liquid R ejected forward from the liquid opening 15s is fed in a direction substantially orthogonal to the liquid feeding opening 15s, the liquid R cannot be intensively supplied to the treatment site Q.

  Therefore, the surgeon rotates the operation lever 20 in the direction F1. As a result, since the wire 40 is pulled rearward, as described above, the portion in the large diameter portion 17a of the liquid feeding pipe 16 extends in the extending direction E around the fulcrum 16p as shown in FIG. Along the channel opening 14s side. That is, the tip opening 16s is displaced toward the channel opening 14s along the extending direction E in the large diameter portion 17a.

  As a result, the discharge direction of the liquid R discharged forward from the tip opening 16s is also changed to the channel opening 14s side, so that the liquid R protrudes forward from the channel opening 14s, that is, the treatment. It is reliably and intensively supplied to the site Q with high positional accuracy, and blood that bleeds from the treatment site Q is washed away.

  Since the supply of the liquid R to the treatment site Q is performed within the observation field of view of the observation window 10, with the supply of the liquid R, the operator sets the bleeding point V of the treatment site Q where the blood has been washed away. It can be easily confirmed.

  Further, the displacement of the tip opening 16s toward the channel opening 14s along the extending direction E may be performed while the liquid R is discharged from the tip opening 16s, or the liquid R is discharged from the tip opening 16s. You can go before you do.

  After confirming the bleeding point V, the operator pulls out the incision treatment instrument 60 from the treatment instrument insertion conduit 14 via the treatment instrument insertion port 6i (see FIG. 1), and then the treatment instrument insertion port 6i (see FIG. 1). 1), the hemostasis treatment instrument inserted into the treatment instrument insertion conduit 14 is projected forward of the distal end surface 3s through the channel opening 14s, that is, toward the treatment site Q side. In the observation visual field of the observation window 10, hemostasis treatment at the bleeding point V is performed using the protruded treatment tool for hemostasis.

  When it is necessary to supply the liquid R to the outer peripheral surface side of the distal end portion 3 during the supply of the liquid R from the distal end opening 16s, the operator moves the operation lever 20 to the direction F2 side as described above. By rotating, the portion in the large-diameter portion 17a of the liquid feeding pipe 16 is moved to the outer peripheral surface side of the tip portion 3 along the extending direction E as shown in FIG. Just do it. That is, the tip opening 16s may be displaced along the extending direction E toward the outer peripheral surface of the tip portion 3.

  As described above, in the present embodiment, the liquid supply opening 15s is elongated at the position overlapping the channel opening 14s when extending along the extending direction E on the distal end surface 3s. .

  Further, the liquid feed pipe 16 has the position where the groove 16m, which is an intermediate position in the insertion direction S, as a fulcrum 16p, and the liquid feed pipe 16 extends in the hole 17 as shown in FIGS. Since the tip opening 16s is supported by the inner peripheral surface 17bn of the small diameter portion 17b so as to be swingable along E, the tip opening 16s extends in the liquid feeding opening 15s, that is, in the large diameter portion 17a. E indicates that it is freely displaceable.

  Further, when the liquid R is fed from the distal end opening 16s to the treatment site Q in the subject through the liquid feeding opening 15s, the operation lever 20 is rotated in the direction F1 to move the wire 40 backward. It has been shown that the tip opening 16s is displaced toward the channel opening 14s in the extending direction E within the large diameter portion 17a by being pulled.

  According to this, the liquid R discharged from the distal end opening 16s can be observed without moving the distal end surface 3s by bending the bending portion 4 or moving the insertion portion 2 back and forth in the insertion direction S. In the observation visual field of the window 10, the treatment tool 60 protruding forward from the channel opening 14s is intensively supplied to the treatment site Q to be treated in a reliable and accurate manner. Since it can be washed out reliably, the bleeding point V of the treatment site Q can be easily confirmed, and the hemostatic treatment of the bleeding point V can be immediately performed.

  From the above, it is possible to provide the endoscope 1 having a configuration capable of accurately and reliably supplying the liquid R to the treatment site Q while ensuring the observation visual field without moving the distal end surface 3s. .

DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Insertion part 3 ... Tip part 3s ... Tip surface 6 ... Operation part 14s ... Channel opening 15s ... Liquid feed opening 16 ... Liquid feed pipe 16p ... Supporting point 16s ... Tip opening 17 ... Hole 17bn ... Small diameter Inner peripheral surface 20 of the unit: Operation lever (operation member)
DESCRIPTION OF SYMBOLS 30 ... Connection part 40 ... Wire 40s ... Wire tip 40k ... Wire proximal end 50 ... Drive mechanism 60 ... Treatment tool E ... Extension direction S ... Insertion direction

Claims (4)

A channel opening formed on the distal end surface of the distal end portion located at the distal end in the insertion direction of the insertion portion to be inserted into the subject, and projecting the treatment instrument forward of the insertion direction from the distal end surface;
An opening for feeding liquid that is formed in an elongated shape on the tip surface, and supplies the liquid to the front of the tip surface;
In the hole formed in the tip portion along the insertion direction and having the liquid feeding opening at the tip in the insertion direction, the tip opening for discharging the liquid is along the extending direction of the liquid feeding opening. Liquid feeding pipes arranged to be freely displaceable,
A drive mechanism for displacing the tip opening of the liquid feeding pipe along the extending direction;
Comprising
The extending direction of the liquid-feeding opening is set in a direction overlapping the channel opening when the liquid-feeding opening is extended along the extending direction on the distal end surface. Endoscope.   The drive mechanism extends when the liquid is supplied from the distal end opening to the treatment site in the subject treated by the treatment tool protruding from the channel opening through the liquid supply opening. The endoscope according to claim 1, wherein the distal end opening is displaced toward the channel opening side in a direction. The liquid feeding pipe is set at a midway position in the insertion direction, and a fulcrum is set on the inner peripheral surface of the hole so that the liquid feeding pipe can swing along the extending direction. A connection portion connected to the drive mechanism is provided at the proximal end in the insertion direction,
The connecting portion is swung along the extending direction around the fulcrum by the driving mechanism, so that the tip opening of the liquid feeding pipe is displaceable along the extending direction. The endoscope according to claim 1 or 2, wherein the endoscope is configured as described above. The drive mechanism is configured such that an operation member provided in an operation unit connected to a proximal end in the insertion direction of the insertion unit, and a distal end in the insertion direction inserted into the insertion unit are connected to the connection unit, A proximal end of the insertion direction comprises a wire connected to the operating member;
The endoscope according to claim 3, wherein the connecting portion swings in the extending direction when the wire is pulled or loosened by the operation member.

Images