JP2014183926A - Endoscope distal end hood - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope distal end hood capable of being mounted on a tip of an endoscope insertion part without blocking nasal usage which is an advantage of a transnasal endoscope.SOLUTION: This invention includes an endoscope insertion part tip holding part 2 for pressing and holding a tip of an endoscope insertion part by enclosing and expanding fluid inside while the tip of the endoscope insertion part is inserted into an inner peripheral side of a cylindrical body 1. A fluid supply tube 3 supplying the fluid to the inside of the endoscope insertion part tip holding part is connected to the endoscope insertion part tip holding part 2. Direction adjustment means 4 adjusting a direction of the body is connected to the body.

Description

  The present invention relates to an endoscope distal end hood that is used by being attached to the distal end of an endoscope insertion portion.

Endoscopes are roughly classified into oral endoscopes that are used by being inserted into the body from the oral cavity, and transnasal endoscopes that are used by being inserted into the body through the nasal cavity.
Since the diameter of the insertion part inserted into the body is about 10 mm and the diameter is relatively large in the oral endoscope, the insertion part has to be inserted into the body from the oral cavity. When using an oral endoscope, when inserting an endoscope insertion part from the oral cavity, the tongue or throat is often touched to cause a pharyngeal reflex, which poses a problem of causing pain to the subject.
On the other hand, since the diameter of the insertion part is about 5 mm and the diameter is small, the transnasal endoscope can be inserted into the body from the nasal cavity. When a transnasal endoscope is used, it is less likely to irritate the tongue and throat during insertion and it is difficult to cause pharyngeal reflexes, so the pain of the subject can be reduced.

By the way, in an operation using an endoscope, an endoscope tip hood is attached to the tip of the endoscope insertion portion in order to ensure a good field of view and a working space near the tip of the endoscope insertion portion. Is generally used.
Since the endoscope tip hood is attached to the tip of the endoscope insertion portion so as to cover the tip portion, its diameter must be larger than the diameter of the endoscope insertion portion. Absent. For this reason, when the endoscope front hood is attached to the distal end of the endoscope insertion portion, the diameter of the distal end of the insertion portion is increased by the thickness of the distal end hood. Even if the diameter of the mirror insertion portion itself is small, it cannot pass through the nasal cavity with the tip hood attached.

Here, it is assumed that the conventional endoscope tip hood is inserted into the body of the subject together with the endoscope insertion portion in a state where it is attached to the tip of the endoscope insertion portion in advance. Therefore, when inserting the endoscope insertion part with the endoscope tip hood attached into the body, the diameter of the distal end of the endoscope insertion part increases by the thickness of the attached endoscope tip hood. Therefore, it must be inserted through the oral cavity regardless of whether it is an oral endoscope or a transnasal endoscope.
That is, when a conventional endoscope distal end hood is attached and used, there is a problem that even a transnasal endoscope having a small diameter of the insertion portion itself must be used orally.

On the other hand, with respect to conventional endoscope tip hoods, for example, as proposed in Japanese Patent Application Laid-Open No. 2010-69206, one that can be attached to an endoscope insertion portion having a different outer diameter size is also proposed. Has been.
However, the endoscope tip hood of the present invention has an outer diameter of the endoscope tip hood itself that is larger than the outer diameter of the endoscope insertion portion, so when this is attached to a nasal endoscope, Again, the nasal endoscope cannot be used nasally.
JP 2010-69206 A

  It is an object of the present invention to obtain an endoscope tip hood that can be attached to the tip of an endoscope insertion portion without obstructing nasal use, which is an advantage of a nasal endoscope. .

  The endoscope front hood according to the present invention is formed by enclosing and inflating a fluid inside the endoscope body with the distal end of the endoscope insertion section inserted into the inner peripheral side of the cylindrical main body. An endoscope insertion portion distal end holding portion that presses and holds the distal end, and a fluid supply tube that supplies the fluid into the endoscope insertion portion distal end holding portion is connected to the endoscope insertion portion distal end holding portion; The main body is configured by connecting direction adjusting means for adjusting the direction of the main body.

The endoscope insertion portion distal end holding portion is formed in a hollow shape by using a material that can be expanded by enclosing a fluid therein, and is provided in an annular shape along the inner peripheral surface of the main body or divided at equal intervals. It is conceivable to provide a plurality of them.
The fluid supply tube is preferably a flexible tube capable of supplying the fluid into the endoscope insertion portion distal end holding portion.
As the fluid supplied to the endoscope insertion portion distal end holding portion, gas, liquid, or sol can be used.
The direction adjusting means is a configuration for adjusting the direction of the endoscope tip hood inserted into the body by an operation from outside the body, and can use various wires, tubes, etc., and is connected to the inner peripheral surface of the main body. Or you may connect to an outer peripheral surface. When a tube is used as the direction adjusting means, a treatment that can insert various treatment tools such as forceps is provided by disposing the opening on the inner peripheral side of the distal end side from the distal end holding portion of the endoscope insertion portion. It can also be used as a drainage channel for discharging body fluid or the like accumulated in the working channel in the instrument channel or the endoscope tip hood to the outside of the body (claim 3).

The cylindrical main body may be composed of a hard material such as transparent plastic or an elastic material such as transparent silicon rubber.
When the cylindrical main body is made of an elastic material, the direction adjusting means is connected to the base end side of the main body, and the base end side edge of the main body is connected to the connection side of the direction adjusting means. By projecting in the axial direction and forming it obliquely toward the other side, inserting the direction adjusting means into an outer tube having a smaller diameter than the main body, and operating the direction adjusting means in the axial direction of the outer tube, The main body may be configured to be detachable from the outer tube (claim 2). In this case, the body can be inserted into and removed from the body while the body is housed in an outer tube having a smaller diameter than the body, and the body can be pushed out from the outer tube in the body and attached to the distal end of the endoscope insertion portion. It can be.
The outer tube may have any diameter that is smaller than the main body and can be accommodated inside with the main body made of an elastic material in an elastically deformed state. The diameter is preferable.
In this invention, the base end side of the main body refers to the side on which the distal end of the endoscope insertion portion of the main body is inserted.

According to the present invention, the distal end of the endoscope insertion portion is pressed on the inner peripheral side of the cylindrical main body by enclosing and inflating the fluid while the distal end of the endoscope insertion portion is inserted. An endoscope insertion portion distal end holding portion for holding the fluid, and a fluid supply tube for supplying the fluid into the endoscope insertion portion distal end holding portion is connected to the endoscope insertion portion distal end holding portion; Since the direction adjustment means for adjusting the orientation of the main body is connected, the endoscope insertion portion and the endoscope front end hood are separately inserted into the body, and the body is adjusted using the direction adjustment means in the body. By inserting the end of the endoscope insertion section into the main body while adjusting the orientation, and encapsulating the fluid in the endoscope insertion section distal end holding section with the endoscope insertion section distal end inserted and inserted, this is expanded. Can be pressed and held.
In other words, since the distal end of the endoscope insertion portion can be attached to the endoscope distal end hood in the body, when using a nasal endoscope, the nasal endoscope with the endoscope distal end hood not attached is used. Can be inserted into the body separately from the nasal cavity and the endoscope tip hood from the oral cavity, respectively, without obstructing nasal use, which is an advantage of nasal endoscope, at the distal end of the endoscope insertion part An endoscope tip hood can be attached.

According to the invention of claim 2, the main body is formed of an elastic material, the direction adjusting means is connected to the base end side of the main body, and the base end side edge of the main body is the axis of the main body. The body is formed in an oblique shape projecting in the direction, the direction adjusting means is inserted into an outer tube having a diameter smaller than that of the main body, and the direction adjusting means is operated in the axial direction of the outer tube to thereby remove the main body. Since the tube can be inserted into and removed from the tube, the endoscope can be easily inserted into and removed from the body while the body is inserted into the outer tube, and the body is pushed out of the outer tube and removed from the body. The insertion portion tip can be put into a mountable state.
If the outer diameter of the outer tube is set to a size that allows passage through the nasal cavity, the endoscope tip hood can be taken in and out of the nasal cavity by inserting the main body into the outer tube.
Here, since the base end side edge of the main body is formed in an oblique shape in which the connection side of the direction adjusting means protrudes in the axial direction of the main body, the direction adjusting means is pulled to accommodate the main body in the outer tube. In this case, the proximal end edge can be smoothly accommodated without being caught by the outer tube.

  According to the invention of claim 3, the direction adjusting means is constituted by a tube, and the opening of the tube is disposed on the inner peripheral side closer to the distal end side than the endoscope insertion portion holding portion. It can also be used as a treatment instrument channel or a drainage channel.

The figure which shows the outline | summary of 1st Example of this invention Figure showing how to wear it in the body Figure showing the wearing state The figure which shows the outline | summary of 2nd Example of this invention The figure which shows the state where the main body was similarly accommodated in the outer tube Figure showing how to wear it in the body Figure showing the wearing state

1A and 1B are diagrams (A) is an axial sectional view, and (B) is a diagram viewed from the base end side, showing an outline of a first embodiment of the present invention.
On the proximal end side of the inner peripheral surface 11 of the cylindrical main body 1 made of transparent hard plastic, an endoscope insertion portion distal end holding portion 2 that is formed of silicon rubber and is hollow inside is an inner peripheral surface. 11 is provided in a ring shape.
The endoscope insertion portion distal end holding portion 2 is connected to a fluid supply / discharge machine (not shown), and is connected to a fluid supply tube 3 that draws fluid into and out of the endoscope insertion portion distal end holding portion 2. The endoscope insertion portion distal end holding portion 2 can be expanded by supplying a fluid to the inside via the fluid supply tube 3 and can be contracted by discharging the fluid to the outside.

  Further, the direction adjusting means 4 is attached to the outer peripheral surface 12 of the main body 1 such that the opening 41 is located on the distal end side of the endoscope insertion portion distal end holding portion 2. This direction adjusting means 4 is composed of a flexible tube and is used as a treatment instrument channel through which various treatment instruments such as forceps can be inserted, or connected to a suction machine or the like in the endoscope distal end hood (in the work area). It can be used as a drainage channel for discharging the body fluid and the like outside the body.

  Further, the endoscope insertion portion to be attached is prevented from further entering the distal end side on the inner peripheral surface 11 between the endoscope insertion portion distal end holding portion 2 and the opening 41 of the direction adjusting means 4. A stopper 5 is provided.

Next, a method for attaching an endoscope distal end hood to the distal end of the endoscope insertion portion will be described using the first embodiment of the present invention.
First, the main body 1 is inserted into the body from the oral cavity of the subject. At this time, as a method of inserting the main body 1 into the body of the subject, the subject can swallow it as it is, or a waisted wire or the like is inserted into the tube-like direction adjusting means 4 to the direction adjusting means 4. It is conceivable to insert it into the body with the waist.
When the main body 1 passes through the throat and the insertion into the body is completed, the insertion portion S of the nasal endoscope is inserted into the body from the nasal cavity according to a normal usage.
While confirming the image obtained by the nasal endoscope, the insertion part S of the nasal endoscope is inserted to the place of the main body 1 inserted into the body, and when reaching the main body 1, the endoscope insertion part S Prepare to attach the tip. That is, since the fluid supply tube 3 and the direction adjusting means 4 are connected to the main body 1, the direction of the main body 1 is adjusted by moving these two members in arbitrary directions, respectively, and the endoscope insertion portion The tip of S is adjusted to a position where it can be easily inserted into the base end side of the main body 1 (see FIG. 2).
After the position adjustment of the main body 1 is completed, the distal end of the endoscope insertion portion S is inserted into the proximal end side of the main body 1. At this time, the distal end of the endoscope insertion portion S can be reliably inserted into the main body 1 by pulling the fluid supply tube 3 and the direction adjusting means 4 toward the front side. Further, the stopper 5 provided in the main body 1 prevents further insertion of the endoscope insertion portion S toward the distal end side.

When the distal end of the endoscope insertion portion S is inserted into the main body 1, fluid is supplied into the endoscope insertion portion distal end holding portion 2 using a fluid supply / discharge device (not shown). When fluid supply into the endoscope insertion portion distal end holding portion 2 is started, the endoscope insertion portion distal end holding portion 2 formed of an elastic material gradually expands, and the inserted endoscope insertion portion. The tip of S is pressed and held by the endoscope insertion portion tip holding portion 2 (see FIGS. 3A and 3B).
Since the pressing and holding state of the distal end of the endoscope insertion portion S is maintained by a known means such as pressure adjustment by a fluid supply / discharge machine, the mounting state of the main body 1 is not released during the treatment. .

  When the endoscopic insertion section S and the endoscope distal end hood are taken out of the body after the endoscopic treatment, the fluid in the endoscope insertion section distal end holding section 2 is discharged to the outside through the fluid supply tube 3. Discharge. As a result, the endoscope insertion portion distal end holding portion 2 contracts and the pressing and holding of the distal end of the endoscope insertion portion S is released, so that the endoscope insertion portion S and the main body 1 of the endoscope distal end hood are connected. They are separated and can be taken out of the body separately.

  As described above, when the endoscope tip hood of the present invention is used, the endoscope tip hood can be attached to the tip of the endoscope insertion portion without inhibiting the nasal use of the nasal endoscope.

FIGS. 4A and 4B are diagrams (a) viewed from the front end side and (b) a sectional view in the axial direction) showing the outline of the second embodiment of the present invention.
A tubular direction adjusting means 4 is attached to the proximal end side of the inner peripheral surface 11 of the cylindrical main body 1 made of transparent silicon rubber. In this direction adjusting means 4, the connection portion with the main body 1 is made of a hard material, and the other portions are made of a flexible material.
The opening 41 of the direction adjusting means 4 is disposed closer to the distal end side of the main body 1 than an endoscope insertion portion distal end holding portion 2 described later, and serves as a treatment instrument channel through which various treatment instruments such as forceps can be inserted. It is the same as in the first embodiment in that it can be used as a drainage channel that is connected to a suction machine or the like and discharges body fluid in the endoscope tip hood (in the work area) to the outside of the body. .

At the proximal end side of the inner peripheral surface 11 of the main body 1, an endoscope insertion portion distal end holding portion 2 that is formed of silicon rubber and is hollow inside is provided along the inner peripheral surface 11 excluding the direction adjusting means 4 portion. Are provided in a substantially annular shape.
The endoscope insertion portion distal end holding portion 2 is connected to a fluid supply tube 3 that draws fluid into and out of the endoscope insertion portion distal end holding portion 2, and fluid is supplied to the inside through the fluid supply tube 3. The point which can be expanded by supplying, and can be contracted by discharging the fluid to the outside is the same as in the first embodiment.

The base end side edge of the main body 1 is formed in an oblique shape in which the connection side of the direction adjusting means 4 protrudes in the axial direction of the main body 1 from the endoscope insertion portion distal end holding portion 2.
A plurality of ribs 6 are formed along the axial direction of the main body 1 on the distal end side of the inner peripheral surface 11 of the main body 1.
Further, the fluid supply tube 3 and the direction adjusting means 4 are inserted through the outer tube 7. The outer tube 7 is made of a flexible material, but the outer diameter thereof is smaller than that of the main body 1, and the outer tube 7 is about 5 mm even when the elastically deformed main body 1 is housed inside. The length of the outer tube 7 may be such that the other side remains outside the body when the body 1 is pushed out of the outer tube 7 after passing through the throat and inserted into the body, and is about 50 cm.

Next, a method for attaching an endoscope distal end hood to the distal end of the endoscope insertion portion will be described using the second embodiment of the present invention.
In this embodiment, first, the main body 1 is accommodated in an outer tube 7 having a diameter smaller than that of the main body 1 (see FIGS. 5A and 5B). Since the main body 1 is formed of an elastic material, it can be elastically deformed. The fluid supply tube 3 and the direction adjusting means 4 are inserted into the outer tube 7 and the fluid supply tube 3 and direction are pressed while holding the outer tube 7. When the adjusting means 4 is pulled, the main body 1 is elastically deformed and accommodated in the outer tube 7. At this time, since the base end side edge of the main body 1 is formed in an oblique shape in which the direction adjusting means 4 side on which the tension acts is projected, when the direction adjusting means 4 is pulled, the outer tube 7 smoothly follows the inclination. Can be housed inside. In addition, a plurality of axial ribs 6 are provided on the inner peripheral surface on the front end side of the main body 1. Since the portions other than the ribs 6 are relatively thin fragile portions, the fragile portions are elastically deformed. It is easy. The outer diameter of the outer tube 7 is about 5 mm even when the main body 1 is accommodated.

Next, the outer tube 7 in which the main body 1, the fluid supply tube 3 and the direction adjusting means 4 are accommodated is inserted into the body from the nasal cavity of the subject. At this time, since the main body 1, the fluid supply tube 3, and the direction adjusting means 4 are accommodated in the outer tube 7, the outer tube 7 has a certain amount of waist and can be inserted into the body relatively easily. be able to.
When the distal end of the outer tube 7 passes through the throat and the insertion into the body is completed, the body 1 is pushed out from the outer tube 7 by pushing the direction adjusting means 4 in the axial direction of the outer tube 7 while pressing the outer tube 7. Let go. At this time, if the waist of the direction adjusting means 4 is weak, it is only necessary to insert a waisted wire or the like into the tube-shaped direction adjusting means 4 so that the direction adjusting means 4 holds the waist.
When the main body 1 is pushed out from the outer tube 7, the main body 1 that has been elastically deformed and stored returns to its original cylindrical shape. Since the outer tube 7 is used again when the main body 1 is taken out from the body after the operation, the other side is left as it is exposed outside the body.

When the detachment of the main body 1 from the outer tube 7 is completed, the insertion portion S of the nasal endoscope is inserted into the body from the nasal cavity where the outer tube 7 is not inserted according to a normal usage.
While confirming the image obtained by the nasal endoscope, the insertion portion S of the nasal endoscope is inserted to the place of the main body 1 inserted into the body, and when reaching the main body 1, the fluid supply tube 3 and The direction of the main body 1 is adjusted using the direction adjusting means 4, and the distal end of the endoscope insertion portion S is adjusted to a position where it can be easily inserted into the proximal end side of the main body 1 (see FIG. 6).
After the position adjustment of the main body 1 is completed, the distal end of the endoscope insertion portion S is inserted into the proximal end side of the main body 1. At this time, the distal end of the endoscope insertion portion S can be reliably inserted into the main body 1 by pulling the fluid supply tube 3 and the direction adjusting means 4 toward the front side. Further, the stopper 5 provided in the main body 1 prevents the endoscope insertion portion S from further entering the distal end side.

When the distal end of the endoscope insertion portion S is inserted into the main body 1, fluid is supplied into the endoscope insertion portion distal end holding portion 2 to expand the endoscope insertion portion distal end holding portion 2 and inserted. Further, the point of pressing and holding the distal end of the endoscope insertion portion S is the same as in the first embodiment (see FIGS. 7A and 7B).
In the second embodiment, since the main body 1 is made of an elastic material, the strength of the main body 1 is slightly inferior to that of the first embodiment, but the tip of the inner peripheral surface 11 of the main body 1 is reduced. Since the plurality of ribs 7 are provided on the side, the strength of the main body 1 in the axial direction can be increased. In addition, since the tension is applied in the circumferential direction by the endoscope insertion portion distal end holding portion 2 that is expanded by supplying a fluid, strength in the circumferential direction of the main body 1 can also be obtained.

When the operation by the nasal endoscope is finished and the endoscope insertion portion S and the endoscope front end hood are taken out of the body, first, the fluid in the endoscope insertion portion front end holding portion 2 is passed through the fluid supply tube 3. To the outside. Thereby, the endoscope insertion portion distal end holding portion 2 contracts, the pressing and holding of the distal end of the endoscope insertion portion S is released, and the endoscope insertion portion S and the endoscope distal end hood main body 1 are separated. . In this state, the insertion part S of the transnasal endoscope is pulled out from the nasal cavity.
On the other hand, the endoscope tip hood is taken out by housing the main body 1 in the outer tube 7. That is, the direction adjusting means 4 is pulled forward while pressing the outer tube 7 through which the direction adjusting means 4 and the fluid supply tube 3 are inserted. Thereby, the main body 1 formed of an elastic material is elastically deformed and accommodated in the outer tube 7. At this time, since the base end side edge of the main body 1 is formed in an oblique shape in which the direction adjusting means 4 side where the tension acts is projected, when the direction adjusting means 4 is pulled, it follows the inclination of the base end side edge. And smoothly accommodated in the outer tube 7. Further, the portion other than the rib 6 on the inner peripheral surface of the front end side of the main body 1 is a relatively thin fragile portion, and is easily elastically deformed in the fragile portion. Can be accommodated.
When the housing of the main body 1 in the outer tube 7 is completed, the outer tube 7 in a state where the main body 1 is housed is pulled out from the nasal cavity and taken out of the body. At this time, since the outer diameter of the outer tube 7 in the state where the main body 1 is accommodated is about 5 mm, the nasal cavity can be passed through without difficulty.

  As described above, when the endoscope tip hood of the present invention is used, the endoscope tip hood can be attached to the tip of the endoscope insertion portion without inhibiting the nasal use of the nasal endoscope. In particular, in the second embodiment, the endoscope tip hood itself can also be used nasally, so that it is not necessary to insert a tube or the like from the oral cavity, and the subject does not cause pharyngeal reflexes.

  The present invention relates to an endoscope distal end hood attached to the distal end of an endoscope insertion portion, and has industrial applicability.

DESCRIPTION OF SYMBOLS 1 Main body 11 Inner peripheral surface 12 Outer peripheral surface 2 Endoscope insertion part front-end | tip holding part 3 Fluid supply tube 4 Direction adjustment means 41 Opening part 5 Stopper 6 Rib 7 Outer tube

Claims (3)

Endoscope insertion in which the distal end of the endoscope insertion portion is pressed and held by enclosing and inflating a fluid inside the insertion end of the endoscope insertion portion on the inner peripheral side of the cylindrical main body A front end holding part,
A fluid supply tube for supplying the fluid into the endoscope insertion portion tip holding portion is connected to the endoscope insertion portion tip holding portion,
Direction adjustment means for adjusting the orientation of the main body is connected to the main body.
Endoscope tip hood. The body is made of elastic material,
The direction adjusting means is connected to the base end side of the main body,
The base end edge of the main body is formed in an oblique shape in which the connection side of the direction adjusting means protrudes in the axial direction of the main body,
The direction adjusting means is inserted into an outer tube having a smaller diameter than the main body,
By operating the direction adjusting means in the axial direction of the outer tube, the main body can be inserted into and removed from the outer tube.
The endoscope tip hood according to claim 1. The direction adjusting means is composed of a tube, and the opening of the tube is disposed on the inner peripheral side of the distal end side than the endoscope insertion portion holding portion.
The endoscope tip hood according to claim 1 or 2.

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