JP2017189457A - Treatment tool insertion tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment tool insertion tool having a configuration where a treatment tool guide part may be easily rotated and workability of the treatment tool is improved by a feature that a moving direction of a treatment tool operation part is identical with a moving direction of the treatment tool on a treatment tool insertion path.SOLUTION: A treatment tool insertion tool comprises: a pipe 21 guiding a treatment tool 31 into a subject via an insertion part 2; a treatment tool holding part 22 which is arranged along the insertion part 2 and arranged on one end 21a of the pipe 21; a treatment tool operation part 23 movably arranged along an extending direction E onto the treatment tool holding part 22; and a moving direction turning over part 24 which is arranged in the treatment tool holding part 22, onto which the treatment tool operation part 23 is connected, and which moves the treatment tool 31 in the pipe 21 to a direction opposite to a movement direction of the treatment tool operation part 23 along extending direction E in a linked manner with movement of the treatment tool operation part 23.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a treatment instrument insertion tool that is attached to an insertion portion of an insertion device that is inserted into a subject and inserts a treatment instrument into the subject.

  In recent years, an insertion device inserted into a subject, for example, an endoscope, has been widely used in the medical field.

  An endoscope used in the medical field observes an organ in a body cavity by inserting a long and thin insertion portion into a body cavity as a subject, and in a treatment instrument insertion path provided in the endoscope as necessary. Various treatments can be performed on a target site of an organ in a body cavity (hereinafter referred to as a treatment target site) using the inserted treatment tool.

  When observing the body cavity, the operator, for example, grasps the insertion portion of the endoscope with the right hand and performs various operations of the insertion portion while observing the endoscope image, A technique for performing various operations on the operation unit of the mirror is common.

  Further, when performing treatment on the treatment target site in the body cavity, the operator once removes the right hand from the insertion portion, and then grasps the treatment tool with the right hand to open the treatment tool insertion passage provided in the operation portion. Generally, a procedure is performed in which a treatment tool is inserted into the treatment tool insertion passage through the treatment tool, and the treatment tool is protruded into the subject from the distal end opening of the treatment tool insertion passage formed at the distal end of the insertion portion. is there.

  Here, when performing various treatments on the treatment target site in the body cavity using the treatment tool, the operator inserts the treatment target site while observing the endoscopic image in order to perform appropriate treatment. This necessitates fine adjustment of the distal end position of the section and the distal end position of the treatment instrument.

  However, as described above, the surgeon selectively performs various operations on the insertion portion and various operations on the treatment tool with the right hand, so that the distal end position of the insertion portion and the distal end position of the treatment tool with respect to the treatment target site are minute. There was a problem that it was difficult to make adjustments at the same time.

  In addition, as described above, since the operator must perform various operations of the treatment tool performed with the right hand while moving the right hand away from the insertion portion, the operator performs fine adjustment of the distal end position of the treatment tool with respect to the treatment target site. There is also a problem that the position of the distal end of the insertion portion with respect to the treatment target site is shifted.

  In view of such a problem, Patent Document 1 discloses a cylindrical treatment instrument guide section whose other end is detachable from an opening of a treatment instrument insertion path provided in an operation section, and one end of the treatment instrument guide section. And a treatment tool holding part configured to hold the treatment tool and to be held by the operator together with the insertion part of the endoscope. A treatment instrument insertion tool to be inserted into the device is disclosed.

  In the treatment instrument insertion tool disclosed in Patent Document 1, the treatment instrument holding portion is attached to a portion of the insertion portion located outside the subject, and the other end of the treatment instrument guide portion is attached to the opening of the treatment instrument insertion passage. In this state, the treatment instrument is inserted into the treatment instrument insertion path via the insertion opening of the treatment instrument holding part and the treatment instrument guide part. Thereafter, in a state where the treatment tool protrudes from the distal end opening at the distal end of the insertion portion into the subject, the operator operates the treatment tool such as a slider provided on the treatment tool holding portion with the right hand while holding the insertion portion with the right hand. The position of the treatment tool is adjusted using the unit. From this, the surgeon can simultaneously fine-tune the distal end position of the insertion portion and the distal end position of the treatment tool with respect to the treatment target site only with the right hand.

International Application Publication No. WO2013 / 065509

  Here, in the treatment instrument insertion tool disclosed in Patent Document 1, in order to make the movement direction of the treatment instrument in the treatment instrument insertion path along the extending direction of the insertion portion coincide with the movement direction of the treatment instrument operation portion. The one end of the treatment instrument guide part is on the side in the insertion direction of the insertion part (hereinafter referred to as the front) with respect to the treatment instrument holding part mounted on the insertion part (hereinafter referred to as the distal end side of the treatment instrument holding part). It is connected to the. That is, the treatment instrument is inserted into the insertion opening of the treatment instrument holding portion from the opposite direction to the front (hereinafter referred to as rear) side toward the front.

  Therefore, in the configuration in which one end of the treatment instrument guide unit is connected to the distal end side of the treatment instrument holding unit, the opening of the treatment instrument insertion path to which the other end of the treatment instrument guide unit is attached is located behind the treatment instrument holding unit. Since it is located, the treatment instrument guide part has to be formed long, and not only a large loop shape can be formed, but also there is a problem that the treatment instrument guide part is poorly handled.

  In view of such a problem, one end of the treatment instrument guide portion is connected to the rear side of the treatment instrument holding portion (hereinafter referred to as a proximal end side of the treatment instrument holding portion), the treatment instrument guide portion is shortened, and the treatment instrument is provided. A configuration that improves the handling of the treatment instrument guide portion by arranging the guide portion along the insertion portion is also conceivable.

  However, in this configuration, since the insertion port of the treatment tool is directed forward in the treatment tool holding portion, the treatment tool has to be inserted from the front toward the rear with respect to the insertion port. Therefore, since the movement direction of the treatment instrument in the treatment instrument insertion path along the extending direction is opposite to the movement direction of the treatment instrument operation unit, the surgeon uses the treatment instrument operation unit to intuitively There was a problem that it was not possible to perform a proper operation of moving the treatment tool.

  Specifically, when the treatment instrument operation unit is moved forward, the treatment instrument moves rearward in the treatment instrument insertion path, and when the treatment instrument operation unit is moved rearward, the treatment instrument moves forward in the treatment instrument insertion path. Since it moves, the movement direction of the treatment tool operation part and the movement direction of the treatment tool in the treatment tool insertion path do not coincide with each other, and there is a problem that the surgeon feels uncomfortable.

  The present invention has been made in view of the above-described problems. The treatment instrument guide unit is easy to handle, and the treatment tool operating unit moves in the same direction as the treatment instrument in the treatment instrument insertion path. An object of the present invention is to provide a treatment instrument insertion tool having a configuration in which the operability of the instrument is improved.

  In order to achieve the above object, a treatment instrument insertion tool according to one aspect of the present invention is provided along an insertion portion of an insertion device to be inserted into a subject, and the treatment instrument insertion tool for inserting a treatment tool into the subject. The treatment instrument is provided along the insertion section and a treatment instrument guide section for guiding the treatment instrument into the subject through the insertion section, and provided at one end of the treatment instrument guide section. A treatment instrument holding section that holds the treatment instrument, a treatment instrument operation section that is provided to be movable along the extending direction of the insertion section with respect to the treatment instrument holding section, and a treatment instrument holding section. The treatment instrument operating unit is connected to the treatment instrument guide unit in the direction opposite to the direction in which the treatment instrument operation unit moves along the extending direction as the treatment instrument operation unit moves. A moving direction reversing unit for moving .

  According to the present invention, the operativeness of the treatment instrument is improved by the handling of the treatment instrument guide and the movement direction of the treatment instrument operation unit being coincident with the movement direction of the treatment instrument in the treatment instrument insertion path. It is possible to provide a treatment instrument insertion tool comprising:

The figure which shows the treatment tool penetration tool of 1st Embodiment with an endoscope The figure which shows schematically the connection part which attaches a treatment tool guide part with respect to the insertion part of FIG. The figure which shows the cross section of the treatment tool penetration tool along the III-III line in FIG. 1 with a treatment tool schematically The figure which shows the cross section of the treatment tool penetration tool along the IV-IV line in FIG. 3 with a treatment tool. The figure which shows schematically the cross section of the structure of the modification of the treatment tool penetration tool of FIG. 3 with a treatment tool. The figure which shows the cross section of the treatment tool penetration tool along the VI-VI line in FIG. 5 with a treatment tool. The figure which shows schematically the cross section of the structure of the modification different from FIG. 5 of the treatment tool penetration tool of FIG. 3 with a treatment tool. The partial perspective view which shows the moving direction inversion part of FIG. 7 with a treatment tool The figure which shows the cross section of the moving direction inversion part along the IX-IX line in FIG. 8 with a treatment tool. The figure which shows the cross section of the treatment tool penetration tool of 2nd Embodiment with a treatment tool schematically The figure which shows the cross section of the treatment tool insertion tool along the XI-XI line in FIG. 10 with a treatment tool. The figure which shows the cross section of the treatment tool penetration tool of 3rd Embodiment with a treatment tool schematically The figure which shows the cross section of the treatment tool penetration tool along the XIII-XIII line in FIG. 12 with a treatment tool. The figure which shows schematically the cross section of the modification which comprised the roller in the moving direction inversion part of the treatment tool insertion tool of FIG. 13 from the gear with a treatment tool.

  Embodiments of the present invention will be described below with reference to the drawings. In the embodiment described below, the insertion device will be described using an endoscope as an example.

(First embodiment)
FIG. 1 is a view showing the treatment instrument insertion tool of the present embodiment together with an endoscope, and FIG. 2 is a view schematically showing a connection portion for attaching a treatment tool guide portion to the insertion portion of FIG.

  As shown in FIG. 1, an endoscope 1 as an insertion device includes an insertion portion 2 to be inserted into a subject, a proximal end side in the extending direction E of the insertion portion 2 (hereinafter simply referred to as a proximal end side). The main part is composed of an operation unit 3 provided continuously to the operation unit 3, a universal cord 8 extending from the operation unit 3, and a connector 9 provided at an extension end of the universal cord 8. ing. Note that the endoscope 1 is electrically connected to an external device such as a control device or a lighting device via the connector 9.

  The operation section 3 is provided with an up / down bending operation knob 4 for bending the bending section 2w of the insertion section 2 in the up / down direction and a left / right bending operation knob 6 for bending the bending section 2w in the left / right direction.

  Further, the operation unit 3 is provided with a fixed lever 5 that fixes the rotation position of the up / down bending operation knob 4 and a fixed knob 7 that fixes the rotation position of the left / right bending operation knob 6. The operation unit 3 is provided with various known operation switches.

  The various knobs 4, 6, 7, lever 5, various switches and the like provided in the operation unit 3 are operated by the left hand of the operator, for example.

  The insertion portion 2 includes a distal end portion 2s, a bending portion 2w, and a flexible tube portion 2k in order from the distal end side in the extending direction E (hereinafter simply referred to as the distal end side), and is formed in an elongated shape. ing. The insertion unit 2 is operated by, for example, the operator's right hand.

  Contrary to the above, various operations of the insertion unit 2 may be performed with the left hand of the operator and various operations of the operation unit 3 may be performed with the right hand of the operator.

  The bending portion 2w is bent in, for example, four directions, up, down, left, and right, by a turning operation of the up / down bending operation knob 4 or the left / right bending operation knob 6, so that an imaging unit (not shown) provided in the distal end portion 2s. The observation direction can be changed, or the insertability of the tip 2s in the subject can be improved. Furthermore, the flexible tube portion 2k is connected to the proximal end side of the bending portion 2w.

  Further, a treatment instrument insertion passage 10 is provided in the insertion portion 2 and the operation portion 3. One end of the treatment instrument insertion path 10 is opened as a distal end opening 10a at the distal end surface of the distal end portion 2s, and the other end is opened as an insertion opening 10b in the operation unit 3.

  In addition, since the structure of the other endoscope 1 is the same as the structure of a general endoscope, the detailed description is abbreviate | omitted.

  The treatment tool insertion tool 20 is attached to the insertion portion 2 and allows a treatment tool 31 for treating the inside of the subject to be inserted into the subject.

  In the present embodiment, the case where there is only one treatment instrument is shown as an example. However, the treatment instrument insertion instrument 20 selectively inserts a plurality of treatment instruments or a plurality of types of treatment instruments into the subject. It doesn't matter if you do it.

  The treatment instrument insertion tool 20 includes a tube 21 that is a treatment instrument guide, a treatment instrument holding section 22 for holding the treatment instrument, a treatment instrument operating section 23, and a moving direction reversing section 24. Is configured.

  The tube 21 is a cylindrical member that guides the treatment instrument 31 into the subject, and is made of a resin such as Teflon (registered trademark).

  Specifically, the tube 21 is detachable from the insertion port 10 b of the treatment instrument insertion path 10 provided at the other end 21 b of the operation unit 3, and one end 21 a is connected to the proximal end side of the treatment instrument holding unit 22. ing.

  After the connection, the tube 21 guides the treatment tool 31 inserted into the tube 21 from the treatment tool holding portion 22 into the subject through the treatment tool insertion path 10 from the distal end opening 10a into the subject. To do.

  As shown in FIG. 2, the tube 21 is inserted by the connecting portion 30 so as to extend from the treatment instrument holding portion 22 along the insertion portion 2, that is, along the insertion portion 2. It may be attached to the flexible tube portion 2k.

  As a result, the tube 21 is prevented from being loosened away from the insertion portion 2. In this case, the connection portion 30 is attached to the insertion portion 2 so as to be movable in the extending direction E.

  The treatment instrument holding portion 22 is provided on the one end 21 a side of the tube 21. Further, the treatment instrument holding unit 22 is provided, for example, at a site 2z shown in FIG. 1 that is located outside the subject in the flexible tube portion 2k of the insertion unit 2 when the insertion unit 2 is inserted into the subject. .

The treatment instrument holding portion 22 is provided along the insertion portion 2 (adjacent to the insertion portion 2) so as to be detachable from the site 2z.
With this configuration, the operator can grasp the treatment instrument holding portion 22 together with the insertion portion 2. In addition, the treatment instrument holding unit 22 is configured not to drop off from the part 2z after being attached to the part 2z located outside the subject.

  Furthermore, the treatment instrument holding portion 22 communicates with the inside of the tube 21 inside, and a space 22i described later (see FIG. 3) in which the treatment instrument 31 passes and a part of the treatment instrument operation portion 23 and the moving direction reversing portion 24 are located. ), And the tip of the space 22i constitutes the insertion port 22p of the treatment instrument 31 into the space 22i. In other words, the insertion port 22p is directed to the front E1, which is the insertion direction of the insertion section 2 into the subject in the extending direction E when the treatment instrument holding section 22 is attached to the insertion section 2.

  Next, the configuration of the treatment instrument operation unit 23 and the moving direction reversing unit 24 will be described with reference to FIGS. 3 and 4.

  3 is a diagram schematically showing a cross section of the treatment instrument insertion tool along the line III-III in FIG. 1 together with the treatment instrument, and FIG. 4 is a treatment instrument insertion tool along the line IV-IV in FIG. It is a figure which shows the cross section of along with a treatment tool.

  As shown in FIGS. 3 and 4, the treatment instrument operation unit 23 is partially located in the treatment instrument holding unit 22, and a part located in the treatment instrument holding unit 22 is a moving direction reversing unit 24. The other part is extended out of the treatment tool holding part 22 through a slit 22s formed in the treatment tool holding part 22 along the extending direction E.

  The treatment instrument operation unit 23 is provided so as to be movable along the extending direction E with respect to the treatment instrument holding unit 22, and a part thereof is movable along the extending direction E within the treatment instrument holding unit 22. It has become.

  In other words, the treatment tool operation unit 23 is configured to be movable in the extending direction E by the operator in a state where the part extended from the treatment tool holding unit 22 through the slit 22s is gripped by the operator. Has been.

  The moving direction reversing unit 24 is provided in the treatment instrument holding unit 22 and the treatment instrument operation unit 23 is connected as described above.

  The moving direction reversing unit 24 moves the treatment tool 31 in the tube 21 in the direction opposite to the direction in which the treatment tool operation unit 23 moves along the extending direction E as the treatment tool operation unit 23 moves. .

  Specifically, the moving direction reversing unit 24 includes two rotating wheels 41 provided in the space 22 i and a belt-like member 42 that rotates between the two rotating wheels 41.

  The band-like member 42 has a treatment instrument operating portion 23 connected to an outer surface 42 a on one end side, and an outer surface 42 b on the other end side contacts a cylindrical fixture 32 fixed to the outer peripheral surface of the treatment instrument 31. It has a configuration.

  In addition, in order to increase the frictional force with respect to the fixing tool 32 of the outer surface 42b, the outer surface 42b may be subjected to anti-slip processing or may have an uneven shape.

  Accordingly, as described above, the treatment tool 31 is inserted from the front E1 toward the rear E2 through the insertion port 22p on the distal end side with respect to the space 22i of the treatment tool holding portion 22. When the treatment instrument operation unit 23 is moved to the front E1, the treatment instrument 31 in contact with the outer surface 42b moves to the rear E2 in the tube 21. Further, when the treatment instrument operation unit 23 is moved to the rear E2, the treatment instrument 31 that is in contact with the outer surface 42b moves to the front E1 in the tube 21.

  Further, since the other end of the tube 21 is attached to the insertion port 10b, the moving direction along the extending direction E of the treatment instrument 31 in the tube 21 and the extension of the treatment instrument 31 in the treatment instrument insertion passage 10 are provided. The direction of movement along the current direction E is reversed. For this reason, the direction in which the treatment instrument operation unit 23 moves along the extending direction E coincides with the direction in which the treatment instrument 31 moves in the treatment instrument insertion path 10.

  From the above, the surgeon inserts, for example, with the right hand while observing the endoscopic image in a state where the distal end 31s of the treatment instrument 31 protrudes from the distal end opening 10a into the subject as shown in FIG. The position of the distal end side of the treatment instrument 31 protruded into the subject by moving the treatment instrument operation unit 23 back and forth in the extension direction E with the right hand along the extending direction E while holding the part 2 Can be fine-tuned.

  Specifically, the surgeon moves the treatment tool operation unit 23 to the front E1 while holding the treatment tool holding unit 22 together with the insertion unit 2, thereby leading the distal end side of the treatment tool 31 protruding into the subject. The position can be moved forward E1 to finely adjust the position. Further, by moving the treatment instrument operation unit 23 to the rear E2, the position of the distal end side of the treatment instrument 31 protruding into the subject can be moved to the rear E2, and the position can be finely adjusted.

  Further, at the same time, the operator can finely adjust the position of the distal end portion 2s of the insertion portion 2 with the right hand while observing the endoscopic image.

  In addition, since the structure of the other treatment tool insertion tool 20 is the same as the past, the description is abbreviate | omitted.

  Thus, in this Embodiment, it showed that the one end 21a of the tube 21 by which the other end 21b was mounted | worn with the insertion port 10b was connected to the base end side of the treatment tool holding | maintenance part 22.

  According to this, the length of the tube 21 can be shortened as compared with the configuration in which the one end 21a of the tube 21 is connected to the distal end side of the treatment instrument holding portion 22 as in the prior art. Since the tube 21 can be positioned along, the handling property of the tube 21 can be improved.

  In the present embodiment, a treatment instrument operation unit 23 is connected to the treatment instrument holding unit 22, and the tube 21 is moved in the direction opposite to the direction in which the treatment instrument operation unit moves as the treatment instrument operation unit 23 moves. The movement direction reversing unit 24 for moving the treatment instrument 31 is provided.

  According to this, one end 21a of the tube 21 is connected to the proximal end side of the treatment instrument holding unit 22, and the treatment instrument 31 is moved from the front E1 to the rear E2 with respect to the space 22i of the treatment instrument holding unit 22 and the inside of the tube 21. Even if the treatment instrument insertion tool 20 has a configuration to be inserted toward the end, the movement direction reversing unit 24 causes the movement direction of the treatment instrument operation unit 23 in the extending direction E and the movement of the treatment instrument 31 in the tube 21. The direction can be reversed.

  For this reason, since the movement direction of the treatment tool operation part 23 in the extending direction E and the movement direction of the treatment tool 31 in the treatment tool insertion path 10 can be matched, the surgeon performs the movement operation of the treatment tool 31. Since it can perform intuitively, the operativity of the treatment tool 31 improves.

  As described above, the configuration in which the operability of the treatment instrument 31 is improved by the handling of the tube 21 being good and the movement direction of the treatment instrument operation unit 23 and the movement direction of the treatment instrument 31 in the treatment instrument insertion path 10 coincide with each other. The treatment instrument insertion tool 20 provided can be provided.

  Hereinafter, a modification will be described with reference to FIGS. FIG. 5 is a diagram schematically showing a cross section of a modified example of the treatment instrument insertion tool of FIG. 3 together with the treatment instrument, and FIG. 6 is a sectional view of the treatment instrument insertion tool taken along line VI-VI in FIG. It is a figure shown with a treatment tool.

  As shown in FIG. 5, the fixing tool 32 fixed to the outer peripheral surface of the treatment tool 31 has a length substantially equal to the outer surface 42 b along the extending direction E, and the treatment tool holding portion 22. You may form in the magnitude | size and shape which contact the bottom face 22t.

  Further, as shown in FIG. 6, the fixing member 32 may be formed on the flat surface 32 d at a portion that contacts the outer surface 42 b. Other configurations are the same as those of the present embodiment described above.

  According to such a configuration, the contact area with the outer surface 42b is increased when the portion that contacts the outer surface 42b of the fixture 32 is formed on the flat surface 32d rather than having a circular arc shape. The frictional force between the outer surface 42b and the fixture 32 can be increased.

  Furthermore, since the fixing tool 32 is in contact with the bottom surface 22t, the treatment tool 31 is not shifted to the bottom surface 22t side in the space 22i by the fixing tool 32. Therefore, the outer surface 42b is more reliably disposed on the flat surface 32d. Can be contacted.

  From the above, the moving direction reversing unit 24 is more reliable than the present embodiment in the direction opposite to the direction in which the treatment instrument operation unit 23 moves along the extending direction E as the treatment instrument operation unit 23 moves. The treatment tool 31 can be moved in the region 21.

  In addition, as shown in FIG. 5, you may prescribe | regulate the movement range in the extending direction E of the fixing tool 32 by making a part of the fixing tool 32 contact | abut on the step part 22d provided in the bottom face 22t. That is, it is needless to say that the movement range in the extending direction E of the treatment instrument 31 may be defined. Other effects are the same as those of the present embodiment described above.

  Hereinafter, modified examples will be described with reference to FIGS. 7 is a diagram schematically showing a cross section of the configuration of the modified example of the treatment instrument insertion tool of FIG. 3 different from that of FIG. 5 together with the treatment instrument, and FIG. 8 is a diagram showing the moving direction reversing unit of FIG. FIG. 9 is a partial perspective view showing, and FIG. 9 is a view showing a cross section of the moving direction reversing portion along the line IX-IX in FIG.

  As shown in FIGS. 7 to 9, the moving direction reversing unit 24 includes four rotating wheels 41 and two belt-like members 42 that rotate between the four rotating wheels 41. It doesn't matter.

  In this configuration, of the four rotating wheels 41, the two rotating wheels 41 and a part of the belt-like member 42 are located on the bottom surface 22t side of the treatment instrument 31 in the space 22i.

  In addition, the fixing device 32 fixed to the outer peripheral surface of the treatment device 31 has a leg portion 32v connected to a portion 42t on the bottom surface 22t side of the belt-like member 42.

  Furthermore, the treatment tool operation unit 23 is connected to a part 42j on the opposite side of the part 42t from the treatment tool 31 in the space 22i. Other configurations are the same as those of the present embodiment described above.

  According to such a configuration, when the treatment tool operation unit 23 is moved along the extending direction E, the fixing tool 32 connected to the portion 42t moves in the opposite direction to the treatment tool operation unit 23. Since the treatment tool 31 also moves in the opposite direction, the same effect as that of the present embodiment described above can be obtained.

(Second Embodiment)
10 is a diagram schematically showing a cross section of the treatment instrument insertion tool of the present embodiment together with the treatment instrument, and FIG. 11 is a cross section of the treatment instrument insertion tool along the line XI-XI in FIG. FIG.

  The configuration of the treatment instrument insertion tool of the second embodiment is different from that of the treatment instrument insertion tool of the first embodiment shown in FIGS.

  Therefore, only this difference will be described, the same reference numerals are given to the same components as those in the first embodiment, and the description thereof will be omitted.

  As shown in FIGS. 10 and 11, in the present embodiment, the moving direction reversing unit 24 has one end 52 connected to the treatment instrument operating unit 23 and a bifurcated other end 53 across a predetermined rotation shaft 51. Is composed of a link mechanism that contacts a fixture 32 fixed to the outer peripheral surface of the treatment instrument 31.

  The rotating shaft 51 may be joined to the treatment instrument holding unit 22 in advance, or may be configured to be detachable from a hole formed in the treatment instrument holding unit 22.

  The link mechanism reverses the moving direction of the one end 52 and the moving direction of the other end 53 in the extending direction E by rotating around the rotating shaft 51.

  As a result, when the treatment instrument operation unit 23 is moved to the front E1, the treatment instrument 31 that is in contact with the other end 53 of the link mechanism moves the other end 53 to the rear E2 due to the clockwise rotation of the rotation shaft 51. As a result, the tube 21 moves backward E2.

  Further, when the treatment instrument operation unit 23 is moved to the rear E2, the treatment instrument 31 that is in contact with the other end 53 of the link mechanism moves the other end 53 to the front E1 due to the counterclockwise rotation of the rotation shaft 51. Along with this, the tube 21 moves forward E1.

  Other configurations are the same as those in the first embodiment described above. Therefore, even if the moving direction reversing unit 24 is configured by a link mechanism in this way, the same effects as those of the first embodiment described above can be obtained.

(Third embodiment)
12 is a diagram schematically showing a cross section of the treatment instrument insertion tool of the present embodiment together with the treatment instrument, and FIG. 13 is a cross section of the treatment instrument insertion tool along the line XIII-XIII in FIG. FIG.

  The configuration of the treatment instrument insertion tool of the third embodiment is the same as that of the treatment instrument insertion tool of the first embodiment shown in FIGS. 1 to 4 and the second embodiment shown in FIGS. Compared with the treatment instrument insertion tool, the configuration of the moving direction reversing unit is different.

  Therefore, only this difference will be described, the same reference numerals are given to the same components as those in the first and second embodiments, and the description thereof will be omitted.

  As shown in FIGS. 12 and 13, in the present embodiment, the moving direction reversing unit 24 is a predetermined frictional force that contacts the treatment tool operation unit 23 and the fixture 32 fixed to the outer peripheral surface of the treatment tool 31. The main part is comprised from the roller 60 which has these, and the rotating shaft 61 of this roller 60. As shown in FIG.

  The rotating shaft 61 may be joined to the treatment instrument holding unit 22 in advance, or may be configured to be detachable from a hole formed in the treatment instrument holding unit 22.

  The roller 60 reverses the movement direction of the treatment instrument operating unit 23 and the movement direction of the treatment instrument 31 by rotation about the rotation shaft 61.

  As a result, when the treatment instrument operation unit 23 is moved to the front E1, the treatment instrument 31 in contact with the roller 60 is moved to the rear E2 in the tube 21 by the clockwise rotation of the roller 60. In addition, when the treatment instrument operation unit 23 is moved to the rear E2, the other end 53 of the treatment instrument 31 with which the roller 60 contacts is moved to the front E1 in the tube 21 due to the counterclockwise rotation of the rotation shaft 51.

  Other configurations are the same as those of the first and second embodiments described above. Therefore, even if the moving direction reversing unit 24 is composed of the roller 60 as described above, the same effects as those of the first embodiment described above can be obtained.

  Hereinafter, a modification will be described with reference to FIG. FIG. 14 is a view schematically showing a cross section of a modified example in which a roller in the moving direction reversing portion of the treatment instrument insertion tool of FIG.

  As shown in FIG. 14, the roller 60 of the moving direction reversing unit 24 may be constituted by a gear.

  The gear is meshed with the first rack 23r provided in the treatment instrument operation section 23 and the second rack 32r provided in the fixture 32, so that the gear extends along the extending direction E by rotation. The moving direction of the first rack 23r and the moving direction of the second rack 32r are reversed.

  Even with such a configuration, the same effect as that of the present embodiment described above can be obtained.

  In the first to third embodiments described above, the treatment instrument operation unit 23 is shown to be operated by the operator when moving the treatment instrument 31 in the front-rear direction of the extending direction E.

  The present invention is not limited to this, and it is needless to say that the treatment tool 31 may be used for turning operation by being turned by a predetermined treatment tool turning mechanism.

  Moreover, although the endoscope 1 has been described by taking the endoscope 1 as an example, it is needless to say that the present invention is not limited to this and can be applied to an insertion device that is inserted into another subject together with a treatment instrument. .

1 ... Endoscope (insertion device)
DESCRIPTION OF SYMBOLS 2 ... Insertion part 2z ... The part located outside the subject of an insertion part 3 ... Operation part 10 ... Treatment tool insertion path 10b ... Insertion opening (opening) of treatment tool insertion path
21 ... Tube (treatment instrument guide)
21a ... One end of the tube 21b ... The other end of the tube 22 ... Treatment tool holding part 22p ... Insertion port of the treatment tool holding part 23 ... Treatment tool operation part 23r ... First rack 24 ... Moving direction reversing part 30 ... Connection part 31 ... Treatment instrument 32r ... second rack 41 ... rotating wheel 42 ... band member 42a ... outer surface on one end side of band member 42b ... outer surface on the other end side of band member 51 ... rotating shaft 52 of link mechanism 52 ... of link mechanism One end 53 ... The other end of the link mechanism 60 ... Roller (gear)
E ... Extension direction E1 ... Forward (insertion direction)

Claims (11)

A treatment instrument insertion tool that is provided along an insertion portion of an insertion device to be inserted into a subject, and inserts a treatment instrument into the subject,
A treatment instrument guide for guiding the treatment instrument into the subject through the insertion section;
A treatment instrument holding portion that is provided along the insertion portion and that is provided at one end of the treatment instrument guide portion and holds the treatment instrument;
A treatment instrument operation section provided movably along the extending direction of the insertion section with respect to the treatment instrument holding section;
The treatment tool operation unit is connected to the treatment tool holding unit, and the treatment tool operation unit moves in the direction opposite to the direction in which the treatment tool operation unit moves along the extending direction as the treatment tool operation unit moves. A moving direction reversing unit for moving the treatment tool in the treatment tool guide,
A treatment instrument insertion tool characterized by comprising:   The treatment instrument insertion according to claim 1, wherein the treatment instrument holding portion is attached to a portion of the insertion portion that is located outside the subject when the insertion portion is inserted into the subject. Ingredients.   The treatment instrument insertion tool according to claim 1, wherein a part of the treatment instrument operation unit is provided to be movable in the treatment instrument holding unit.   The treatment instrument insertion tool according to claim 1, further comprising a connection portion attached to the insertion portion so that the treatment tool guide portion extends from the treatment tool holding portion along the insertion portion.   The other end of the treatment instrument guide section is detachable from an opening of a treatment instrument insertion path provided in an operation section connected to the insertion section in the insertion device. Treatment tool insertion tool. The treatment instrument holding part is configured with an insertion port for the treatment instrument to the treatment instrument guide part,
6. The treatment instrument insertion tool according to claim 5, wherein the insertion port is oriented in a direction in which the insertion portion is inserted into the subject in the extending direction.   The treatment instrument insertion according to claim 6, wherein a direction in which the treatment instrument operation unit moves along the extending direction coincides with a direction in which the treatment instrument moves in the treatment instrument insertion path. Ingredients. The moving direction reversing unit is
Two rotating wheels,
A belt-like member that rotates between the two rotating wheels, an outer surface on one end side is connected to the treatment instrument operation section, and an outer surface on the other end side is in contact with the treatment instrument;
The treatment instrument insertion tool according to claim 1, comprising: The moving direction reversing unit is configured by a link mechanism in which one end is connected to the treatment instrument operation unit and the other end is in contact with the treatment instrument with a predetermined rotation axis interposed therebetween.
The link mechanism reverses the moving direction of the one end of the link mechanism in the extending direction and the moving direction of the other end of the link mechanism by rotating around the rotating shaft. The treatment instrument insertion tool according to claim 1. The moving direction reversing unit is
A roller in contact with the treatment instrument operation section and the treatment instrument;
2. The treatment instrument insertion tool according to claim 1, wherein the roller reverses a movement direction of the treatment tool operation unit and a movement direction of the treatment tool along the extending direction by rotation. The moving direction reversing unit is
There is a gear that is provided between a first rack provided in the treatment instrument operation section and a second rack attached to the treatment instrument and meshes with the first rack and the second rack. And
The treatment instrument insertion tool according to claim 1, wherein the gear reverses the moving direction of the first rack and the moving direction of the second rack along the extending direction by turning. .

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