JP2019201673A - Movement/retreat aid for treatment instrument and endoscope system - Google Patents

Abstract

To provide a movement/retreat aid for treatment instrument capable of easily moving the treatment instrument in an axial direction in a state of inserting an optional treatment instrument into a channel of an endoscope.SOLUTION: A movement/retreat aid comprises: a base to be attached to an endoscope; a first cylinder having a passage into which the treatment instrument is inserted; a cylinder tip part which is provided on one end side of the first cylinder, penetrates a forceps plug attached to a treatment instrument insertion hole of the endoscope when the base is attached to the endoscope, and which penetrates the treatment instrument insertion hole; and a second cylinder into which the treatment instrument is inserted in a state of holding an external surface of the treatment instrument passed through the passage of the first cylinder, and moves in a direction along a center shaft of the passage to the first cylinder and the base by an external operation.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an advance / retreat assist tool and an endoscope system for assisting the advance / retreat movement of a treatment tool with respect to an endoscope channel.

  For example, Patent Document 1 discloses an endoscopic treatment tool that is inserted into a body cavity through a forceps plug and channel of an endoscope, and collects and excises cells and tissues at a predetermined site in the body cavity. This treatment tool has a structure capable of fixing the treatment tool to the inner peripheral surface of the mouthpiece of the treatment tool insertion opening to which the forceps plug is attached.

JP 2007-159756 A

  There may be a case where it is desired to move the treatment tool along the axial direction in a state where an appropriate treatment tool is inserted into the channel of the endoscope. When moving the treatment tool of patent document 1 along the axial direction, it is necessary to cancel | release the state which fixed the treatment tool with respect to the internal peripheral surface of the nozzle | cap | die of a treatment tool penetration port. Moreover, when moving a treatment tool along the axial direction, sliding resistance is received from a forceps stopper.

  The present invention provides a treatment tool advancing / retreating aid and an endoscope system capable of facilitating movement of a treatment tool along the axial direction in a state where an appropriate treatment tool is inserted into a channel of an endoscope. With the goal.

  According to one aspect of the present invention, the advance / retreat assist tool attached to the proximal end side of the insertion portion of the endoscope and assisting the advance / retreat movement of the treatment instrument inserted into the insertion portion of the endoscope is A base attached to an endoscope, a first tube attached to the base and having a passage through which the treatment instrument is inserted, and provided on one end side of the first tube, the base being the endoscope When passing through the forceps plug attached to the treatment instrument insertion port of the endoscope, and passing through the passage of the first tube and the tube tip passing through the treatment tool insertion port. The treatment instrument is inserted into the inside while holding the outer surface of the treatment instrument, and moved in a direction along the central axis of the passage with respect to the base and the first cylinder by an external operation. Tube and the base are attached to the endoscope In was state, and a holding portion for holding the state of the cylindrical tip has penetrated into the forceps plug.

FIG. 1 is a schematic diagram illustrating an endoscope system according to the first embodiment. FIG. 2 is a schematic perspective view showing an advance / retreat assist tool for a treatment instrument that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 3 is a schematic cross-sectional view showing a state in which the treatment tool is inserted into the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 4 is a schematic cross-sectional view showing an advance / retreat assisting tool that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 5 is a perspective view of the endoscope system according to the first embodiment, in which the treatment tool is fixed to the state shown in FIG. It is a schematic sectional drawing which shows the state which moved. FIG. 6 shows a lineup of the endoscope system according to the first embodiment in which the first cylinder and the cylinder tip used in the advance / retreat assist tool are integrated, and the cylinder tip selected from a plurality of cylinders It is the schematic which shows the state which is going to insert in the forceps stopper of an endoscope. FIG. 7A is a schematic cross-sectional view showing an example of a liquid leakage preventing member used for an advance / retreat assisting tool that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 7B is a schematic cross-sectional view showing an example of a liquid leakage preventing member used in the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 7C is a schematic cross-sectional view showing an example of a liquid leakage preventing member used for the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment. FIG. 8A is a schematic cross-sectional view showing an advance / retreat assisting tool in which a liquid leakage preventing member is arranged at a position different from FIGS. 3 to 5 in an endoscope system according to a modification of the first embodiment. FIG. 8B is a schematic cross-sectional view showing an advance / retreat assisting tool in which a liquid leakage preventing member is arranged at a position different from FIGS. 3 to 5 in an endoscope system according to a modification of the first embodiment. FIG. 9A shows a state in which in the endoscope system according to the modification of the first embodiment, the advancing / retreating assisting tool can be fixed at a predetermined position of the endoscope by using a holding unit different from those in FIGS. 3 to 5. It is a schematic sectional drawing shown. FIG. 9B is a schematic diagram illustrating a state in which the advance / retreat assist tool is fixed at a predetermined position of the endoscope using a holding unit different from that in FIGS. 3 to 5 in the endoscope system according to the modified example of the first embodiment. FIG. FIG. 10 is a schematic cross-sectional view showing an advance / retreat assisting tool that can be attached to an endoscope in the endoscope system according to the second embodiment. FIG. 11A is a schematic diagram illustrating a state where the user holds the operation unit of the endoscope with the left hand and the moving unit of the insertion / retraction assist tool with the right hand in the endoscope system according to the third embodiment. is there. FIG. 11B is a schematic cross-sectional view showing a state in which the treatment tool is inserted into the advance / retreat assist tool attached to the endoscope in the endoscope system according to the third embodiment. FIG. 12 is a schematic cross-sectional view showing a state in which a treatment tool is inserted through an advance / retreat assisting tool attached to an endoscope in the endoscope system according to the fourth embodiment.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. An endoscope of an endoscope system described below is used by being inserted into a hole (lumen) of a examinee (subject). The treatment tool auxiliary tool (advance / retreat aid) 14 applied to the endoscope system 11 finely adjusts the position in the longitudinal direction of the treatment tool 13 passed through the treatment tool insertion channel 26 of the endoscope 12. It is used when doing. The auxiliary tool 14 can finely adjust the position in the longitudinal direction of the treatment tool 13 by the user's operation.

[First Embodiment]
The endoscope system 11 according to the first embodiment will be described with reference to FIGS. 1 to 6.
As shown in FIG. 1, an endoscope system 11 includes an endoscope 12, a treatment instrument 13 that is passed through the endoscope 12, and an advance / retreat assist tool 14 that is detachably attached to the endoscope 12. A controller (image processing unit) 15 that performs image processing based on a subject image captured by the endoscope 12, and a display unit (monitor) 16 that displays a video generated by the image processing in the controller 15. ing.

  The endoscope 12 (insertion device) includes an insertion portion 17 that is inserted along a longitudinal direction L into a duct such as a lumen of a subject, and an operation that is provided at the proximal end of the insertion portion 17 and is gripped by a user. A unit 18 and a universal cord 21 extending from the operation unit 18.

  The insertion portion 17 defines the longitudinal direction L by its distal end and proximal end. As shown in FIG. 1, the insertion portion 17 has a distal end configuration portion 22, a bending portion 23, and a tube portion 24 in order from the distal end to the proximal end. The tube part 24 has flexibility. The bending portion 23 can bend the tip constituting portion 22 in a plurality of directions (for example, up, down, left and right four directions) by a knob 25 of the operation portion 18 by a known mechanism.

  The endoscope 12 includes an illumination optical system, an observation optical system, and a treatment instrument insertion channel 26. In addition, the endoscope has an air / water supply mechanism and a suction mechanism. The air / water supply mechanism has a nozzle at the tip of the insertion portion 17 and is operated by the first button 27 of the operation portion 18. The suction mechanism communicates with the treatment instrument insertion channel 26 and is operated by the second button 28 of the operation unit 18. The treatment instrument insertion channel 26 is branched into a known suction path, for example, inside the insertion portion 17 or inside the operation portion 18. By the pressing operation of the second button 28, the aspirated material is discharged from a later-described opening at the distal end of the treatment instrument insertion channel 26 through the mouthpiece, the tube, the suction path, and the universal cord 21.

  The illumination optical system and the observation optical system are inserted through the insertion portion 17 (the distal end configuration portion 22, the bending portion 23, the tube portion 24), the operation portion 18, and the universal cord 21 of the endoscope 12. The illumination optical system has an illumination window at the distal end configuration portion 22. The observation optical system has an observation window in the tip configuration part 22.

  The distal end of the treatment instrument insertion channel 26 is opened at the distal end constituting portion 22, and the proximal end thereof is opened at the proximal end side of the tube portion 24 or the operation portion 18. An appropriate treatment instrument 13 can be passed inside the treatment instrument insertion channel 26. The treatment tool 13 includes a general treatment tool (surgical instrument) that is passed through the treatment tool insertion channel 26 of the endoscope 12. The treatment tool 13 can perform appropriate treatment within the field of view of the endoscope 12, such as approaching the affected area and incising and excising the living tissue of the affected area. The treatment tool 13 includes a guide wire, a catheter, and the like that are used together with other treatment tools and guide the treatment tool to the affected part.

  Here, the operation unit 18 shown in FIG. 1 is provided with a treatment instrument insertion port 31 (see FIGS. 3 to 5) located at the proximal end of the treatment instrument insertion channel 26. A forceps plug 32 (see FIGS. 3 to 6) is detachably attached to the treatment instrument insertion port 31.

  The auxiliary tool 14 is attached to the proximal end side of the insertion part 17 of the endoscope 12 or the operation part 18, and inserts and removes (insertion and removal) of the treatment tool 13 inserted through the insertion part 17 of the endoscope 12. That is, it is used to assist the advance / retreat movement.

  The auxiliary tool 14 can advance and retract the treatment tool 13 passed through the treatment tool insertion channel 26 of the endoscope 12 along the central axis C thereof. As shown in FIG. 1 to FIG. 3, the auxiliary tool 14 is an endoscope that is attached to a predetermined position of the endoscope 12 and the base 41 is opposed to the treatment instrument insertion port 31 of the endoscope 12. A holding part (attachment part) 42 attached to the mirror 12, a first cylinder 43 attached to the base 41, a cylinder tip 44 provided on one end side of the first cylinder 43, and the center of the first cylinder 43 A second cylinder 45 that moves relative to the first cylinder 43 along the axis C, and an advance / retreat mechanism (movement mechanism) that moves the second cylinder 45 forward / backward along the central axis C relative to the first cylinder 43. 46. The base 41, the first cylinder 43, the cylinder tip 44, and the second cylinder 45 are formed of an appropriate material such as a metal material or a synthetic resin material. When a metal material is used for the base 41, the first cylinder 43, the cylinder tip 44, and the second cylinder 45, it is preferable that an insulating coating is applied. The first cylinder 43 and the cylinder tip 44 may be integrated or separate. The first cylinder 43, the cylinder tip 44, the second cylinder 45, and the advance / retreat mechanism 46 constitute a moving unit 47 for moving the treatment instrument 13 along the central axis C. In addition, the holding | maintenance part 42 is formed with strip | belt-shaped members, such as a binding band, for example. The holding part 42 may be attached to the endoscope 12 at one place or may be attached at a plurality of places.

  Since the treatment instrument 13 needs to pass through the channel 26, the base 41 is attached to the vicinity of the treatment instrument insertion port 31 provided on the proximal end side of the insertion portion 17 in the endoscope 12. Therefore, the base 41 is attached in the vicinity of the forceps plug 32 including the forceps plug 32 attached to the treatment instrument insertion port 31.

  In this embodiment, the base 41 includes a base body 51 and a support member 52 that forms a part of the advance / retreat mechanism 46. Here, the base main body 51 and the substantially cylindrical support member 52 are shown as being connected by screws 53, but it is of course preferable that they are integrated. It is preferable that the base main body 51 is fitted to a base end side of the insertion portion 17 of the endoscope 12 or a predetermined position of the operation portion 18. Specifically, the base body 51 can cover the outside of the forceps plug 32 (see FIGS. 3 to 5). The support member 52 is formed in a substantially cylindrical shape, covers the outside of the first cylinder 43 and the second cylinder 45, and rotates around the central axis C due to the relationship between a cam pin 92 and a restriction groove 93 described later. Suppress.

  The first cylinder 43, the cylinder tip 44, and the second cylinder 45 form a passage 48 through which the treatment instrument 13 is inserted.

  The second cylinder 45 includes a cylindrical main body 61 and a fixing portion 62 that fixes the treatment instrument 13. As shown in FIGS. 3 and 5, the main body 61 can protrude and retract with respect to the support member 52 of the base 41. The fixing portion 62 is formed on an elastically deformable cylindrical body (cylindrical elastic member) 63 such as a rubber material supported on the base end surface 61 a of the main body 61 and a side surface adjacent to the base end surface 61 a of the main body 61. And a cap 64 having a screw part 64a screwed to the screw part 61b. The cylindrical body 63 is elastically denatured between the state shown in FIG. 3 and the state shown in FIG. 4 by a screwing position where the screw part 64a of the cap 64 is screwed into the screw part 61b of the main body 61. Is possible. In the state shown in FIG. 4, the inner peripheral surfaces 63a of the cylindrical body 63 are in close contact with each other, and fluid (gas and liquid) is prevented from passing from the lower side to the upper side of the cylindrical body 63 in FIG. ing. For this reason, the cylindrical body 63 can be used as a liquid leakage preventing member by changing its state. And the cylindrical body 63 can hold | maintain the outer peripheral surface of the treatment tool 13 by operating the cap 64 suitably and changing the internal diameter of the internal peripheral surface 63a. When the treatment tool 13 is held by the inner peripheral surface 63a of the cylindrical body 63, it is possible to prevent liquid and gas from leaking from the lower side to the upper side in FIGS. The cap 64 has an opening 64b. The opening 64b of the cap 64 has an inner diameter through which the treatment tool 13 can be passed. For this reason, the second cylinder 45 is treated inside the first cylinder 43 and the cylinder tip 44 in a state where the outer surface of the treatment instrument 13 that has passed through the passage 48 of the first cylinder 43 is held by the fixing portion 62. The tool 13 is inserted.

  Here, a liquid leakage preventing member 71 is disposed on the outer peripheral surface of the first cylinder 43. As the liquid leakage preventing member 71, for example, an O-ring (ring member) formed of a rubber material is used. The outer peripheral surface of the liquid leakage preventing member 71 is in close contact with the inner peripheral surface of the second cylinder 45. Therefore, the liquid that has passed through the passage 48 of the first cylinder 43 is prevented from leaking to the outside of the second cylinder 45 through the inner peripheral surface of the second cylinder 45. As the liquid leakage preventing member 71, it is also preferable to use a sponge-like member that absorbs liquid instead of using an O-ring. The sponge-like member is also preferably ring-shaped. By absorbing the liquid with the sponge-like member, the liquid that has passed through the passage 48 of the first cylinder 43 is prevented from leaking to the outside of the second cylinder 45 through the inner peripheral surface of the second cylinder 45. be able to. As described above, the liquid leakage prevention member 71 does not necessarily need to use an O-ring unless the liquid leaks from the passage 48.

  As shown in FIGS. 3 to 5, the advance / retreat mechanism 46 includes an arm 81, a dial (rotary body) 82, and a cam that converts the rotation of the dial 82 into an advance / retreat movement of the second tube 45 (treatment instrument 13). And a mechanism 83. The cam mechanism 83 is an example of a conversion mechanism that converts the turning force of the dial 82 into a force that moves the second cylinder 45 forward and backward in the direction along the central axis C of the first cylinder 43.

  The arm portion 81 is formed on the base 41 and extends in a direction away from the central axis C. The dial 82 is supported by the arm portion 81 and is rotatable about a rotation shaft 81a. The rotation shaft 81a extends substantially parallel to the central axis C. The cam mechanism 83 includes a cam groove 91 formed in a spiral shape on the outer peripheral surface of the dial 82, a cam pin 92 projecting radially outward from the main body 51 of the second tube 45 with respect to the central axis C, And a restriction groove 93 provided on the support member 52 of the base 41 for allowing the cam pin 92 to move within a predetermined range along the central axis C and restricting movement in the circumferential direction with respect to the central axis C. .

  The cam pin 92 is engaged with the cam groove 91. The cam pin 92 is preferably formed in the vicinity of the lower end in FIGS. 3 to 5 in the second cylinder 45 in consideration of the assembling property with respect to the support member 52.

  The restriction groove 93 is formed in the support member 52 of the base 41 substantially parallel to the central axis C of the first cylinder 43. The cam pin 92 of the second cylinder 45 protrudes outside the support member 52 so as to be slidable within a predetermined range along the central axis C in the regulation groove 93 of the cylindrical support member 52 of the base 41.

  The advance / retreat mechanism 46 can move the second tube 45 along the central axis C with respect to the first tube 43 by rotating the dial 82 with the user's finger, thereby moving the treatment tool 13 forward and backward. Depending on how the cam groove 91 is formed, for example, the dial 82 is rotated counterclockwise (gripping the hand) when viewed from the arrow E side (the side opposite to the arm 81 side of the dial 82) in FIG. ) And the cam groove 91 moves in a direction away from the first arm portion 81 of the base 41 (upper side in FIGS. 3 to 5). For this reason, the second cylinder 45 moves upward in FIG. 3 to FIG. 5 with respect to the first cylinder 43, and the protruding amount by which the second cylinder 45 protrudes with respect to the support member 52 of the base 41 is large. Become. Similarly, when the dial 82 is rotated clockwise as viewed from the arrow E side in FIG. 3 (the hand is opened), the cam pin 92 approaches the arm portion 81 by the action of the cam groove 91 (FIGS. 3 to 5). Move to the bottom (inside). For this reason, the second cylinder 45 moves downward in FIG. 3 from FIG. 3 with respect to the first cylinder 43, and the projection amount by which the second cylinder 45 projects with respect to the support member 52 of the base 41 is increased. Get smaller. Thus, when the dial 82 is rotated by the user's finger, the amount of protrusion of the second cylinder 45 relative to the first cylinder 43 due to the action of the cam mechanism 83 (the cam groove 91, the cam pin 92, and the restriction groove 93). Can be adjusted. For this reason, the second cylinder 45 moves in the direction along the central axis C of the passage 48 of the first cylinder 43 with respect to the base 41 and the first cylinder 43 by an external operation.

  As shown in FIGS. 3 to 6, a cylindrical tube tip 44 is provided on one end side of the first tube 43 (lower end side in FIGS. 3 to 6). The inner diameter of the tube tip 44 is preferably the same as the inner diameter of the first tube 43. For this reason, there is no step on the inner peripheral surface at the boundary between one end of the first tube 43 and the proximal end (proximal end) of the tube distal end portion 44. On the other hand, a step 43 a is formed on the outer peripheral surface at the boundary between one end of the first tube 43 and the base end (proximal end) of the tube tip 44.

  The tube distal end 44 penetrates the forceps plug 32 attached to the treatment instrument insertion port 31 of the endoscope 12 when the base 41 of the auxiliary tool 14 is attached to the endoscope 12, and the treatment instrument insertion port 31. A distal end 44a extending therethrough. The distal end 44 a has an outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31.

  A male threaded portion 44b projecting radially outward is formed at a position closer to the step 43a at the boundary between the first tube 43 and the tube tip 44 than the distal end 44a in the tube tip 44. ing. Here, the support member 52 of the base 41 is formed with a penetrating fitting portion 52a that supports the step 43a. When the step 43 a is fitted to the fitting portion 52 a, the male screw portion 44 b penetrates the fitting portion 52 a of the support member 52. A nut 49 can be screwed into the male screw portion 44b. For this reason, the support member 52 of the base 41 can be sandwiched between the first tube 43 and the nut 49. Therefore, the first cylinder 43 and the cylinder tip 44 can be fixed to the base 41 at predetermined positions.

  Here, as shown in FIG. 6, the forceps plug 32 of the endoscope 12 is generally treated more than the first valve 32 a closer to the opening edge 31 a of the treatment instrument insertion port 31 and the first valve 32 a. A slit-like second valve 32b located at a position away from the opening edge 31a of the tool insertion port 31. The first valve 32 a and the second valve 32 b are used to prevent liquid leakage through the channel 26 (see FIG. 1) of the endoscope 12 and the treatment instrument insertion port 31. The first valve 32a and the second valve 32b are required to prevent liquid leakage through the channel 26 of the endoscope 12 even when the treatment tool 13 is inserted. Exhibits great sliding resistance when moving along the direction.

  Here, the tube distal end portion 44 provided on one end side of the first tube 43 has the first valve 32 a and the second valve 32 of the forceps plug 32 when the auxiliary tool 14 is appropriately attached to the endoscope 12. It penetrates the valve 32b. Since the treatment tool 13 passes through the inside of the tube tip 44 disposed inside the first valve 32a and the second valve 32b of the forceps plug 32, when the treatment tool 13 is inserted and removed along its axial direction. In addition, friction between the forceps plug 32 and the treatment tool 13 does not occur.

  Since the first valve 32a and the second valve 32b of the forceps plug 32 and the outer peripheral surface of the distal end portion of the tube distal end portion 44 with respect to the male screw portion 44b are in close contact with each other. It is in a dense state. Therefore, fluid (gas and liquid) flows from between the first valve 32 a and the second valve 32 b of the forceps plug 32 and the outer peripheral surface of the tube distal end portion 44 through the treatment instrument insertion port 31 from the endoscope 12. Leakage can be suppressed.

Next, the operation of this embodiment will be described with reference to FIGS.
The user of the endoscope 12 according to the present embodiment holds the operation unit 18 with the left hand and the insertion unit 17 with the right hand. The auxiliary tool 14 is fixed at a predetermined position of the endoscope 12. At this time, the auxiliary tool 14 is assembled and can be used simply by being attached to an appropriate part of the endoscope 12. The distal end 44 a of the tube tip 44 of the auxiliary tool 14 penetrates the forceps plug 32 attached to the treatment instrument insertion port 31 of the endoscope 12 and penetrates the treatment instrument insertion port 31. That is, the second valve 32b and the first valve 32a of the forceps plug 32 are pushed away at the distal end 44a of the tube tip 44, and the distal end 44a is opened to the opening edge of the treatment instrument insertion port 31 of the endoscope 12. It arrange | positions inside the treatment tool penetration port 31 through 31a. For this reason, the outer peripheral surface of the tube distal end portion 44 is in an airtight and liquid-tight state between the forceps plug 32 by the first valve 32 a and the second valve 32 b of the forceps plug 32.

  Then, the base 41 of the auxiliary tool 14 is fitted into a predetermined part of the endoscope 12. The auxiliary tool 14 is fixed to the endoscope 12 by the holding unit 42. For this reason, the holding part 42 holds the state where the tube tip part 44 penetrates the forceps plug 32 in a state where the base 41 is attached to the endoscope 12. The holding unit 42 holds the state where the auxiliary tool 14 is attached to the endoscope 12, and the auxiliary tool 14 is prevented from dropping unintentionally during use of the endoscope 12.

  As shown in FIGS. 3 and 4, the main body 61 and the cap 64 of the second cylinder 45 according to the state of the cylindrical body 63 between the base end 61 a of the main body 61 of the second cylinder 45 and the cap 64. The screwing state between is changed. Then, the distal end of the treatment instrument 13 is passed through the first tube 43 and the passage 48 of the tube distal end portion 44 through the opening 64b of the cap 64, the inner peripheral surface 63a of the tubular body 63, and the main body 61 of the second tube 45. . Further, the treatment tool 13 is passed through the channel 26 (see FIG. 1). For example, while observing the observation image displayed on the display unit 16 of the endoscope 12, the cap 64 is rotated at the maximum projecting position of the treatment tool 13, and the treatment tool 13 is moved on the inner peripheral surface 63 a of the cylindrical body 63. The outer peripheral surface of is held. That is, when the second cylinder 45 is held at the position shown in FIG. 3 with respect to the first cylinder 43 and the outer peripheral surface of the treatment instrument 13 is held using the cylindrical body 63, the endoscope 12 is shown in FIG. 1. It is preferable that the distal end of the treatment instrument 13 protrudes from the distal end of the channel 26.

  In the treatment instrument 13, the outer diameter of the portion protruding from the tip of the channel 26 (see FIG. 1) through the auxiliary instrument 14 is formed smaller than the inner diameter of the passage 48 of the auxiliary instrument 14 and the inner diameter of the channel 26. Just do it. Since the inner peripheral surface 63 a of the cylindrical body 63 is in close contact with the outer peripheral surface of the treatment instrument 13, the first through the second cylinder 45 and the treatment instrument 13 with the treatment instrument 13 inserted through the second cylinder 45. Liquid leakage to the outside of the second cylinder 45 is prevented. Even if the inner peripheral surface 63a of the cylindrical body 63 is in a state where the treatment instrument 13 is removed from the second cylinder 45, the screwed state is adjusted to bring the cylindrical body 63 into the state shown in FIG. Thus, liquid leakage through the second cylinder 45 is prevented.

  When the second cylinder 45 is held at the position shown in FIG. 5 with respect to the first cylinder 43 and the outer peripheral surface of the treatment instrument 13 is held using the cylindrical body 63, the channel 26 shown in FIG. It is preferable that the distal end of the treatment instrument 13 slightly protrudes from the distal end of the channel 26 or that the distal end of the channel 26 is retracted. Although not shown, when the cam pin 92 of the second tube 45 is farthest from the arm portion 81 of the base 41, the distal end of the treatment instrument 13 is drawn into the distal end of the channel 26 of the endoscope 12 and protrudes. Preferably not.

  Here, from the viewpoint of ergonomics, it is easier to move the finger when the hand is held from the open state than when the hand is opened from the held state, and it is easier to apply force to the object. For this reason, when the dial 82 is rotated by moving the finger so as to hold the hand, a force is applied to the dial 82 as compared with the case where the dial 82 is rotated by moving the finger so as to open the hand. easy.

  When it is desired to increase the protruding amount of the treatment instrument 13 with respect to the tip of the channel 26 shown in FIG. 1, with the left hand held the operation unit 18, the left hand is opened (the finger is moved away from the palm of the left hand). The dial 82 is rotated clockwise as viewed from the arrow E side in FIG. 3 (the side of the dial 82 opposite to the arm 81 side). Here, the cam pin 92 is kept engaged with the cam groove 91 by the restriction groove 93. For this reason, the cam pin 92 moves in a direction approaching the treatment instrument insertion port 31 by the action of the cam groove 91 based on the rotation of the dial 82. At this time, the second cylinder 45 moves (advances) toward the distal end side of the channel 26 with respect to the first cylinder 43. Since the treatment tool 13 is fixed to the second tube 45, the distal end of the treatment tool 13 protrudes from the distal end of the channel 26 of the insertion portion 17 of the endoscope 12, or the protrusion amount increases. At this time, the first valve 32 a and the second valve 32 b of the forceps plug 32 do not generate friction with the treatment instrument 13. For this reason, even when moving a finger in a direction away from the palm surface, which is ergonomically difficult to input force, the rotation of the dial 82 and the forward movement of the treatment instrument 13 can be reduced. At this time, the resistance force when the second cylinder 45 slides with respect to the first cylinder 43 includes the frictional force between the first cylinder 43 and the second cylinder 45, and the advance / retreat mechanism (dial 82). Includes at least one of frictional forces applied when the second cylinder 45 is moved forward and backward.

  On the other hand, when the projection amount of the treatment instrument 13 with respect to the tip of the channel 26 (see FIG. 1) is to be reduced, or to be pulled into the channel 26, the left hand is grasped with the operation part 18 being grasped with the left hand ( The finger is moved in a direction in which the finger approaches the palm of the left hand), and the dial 82 is rotated counterclockwise as viewed from the arrow E side in FIG. At this time, the second cylinder 45 moves (retreats) toward the side opposite to the tip side of the channel 26 with respect to the first cylinder 43. Since the treatment tool 13 is fixed to the second tube 45, the protrusion amount of the distal end of the treatment tool 13 with respect to the distal end of the channel 26 of the insertion portion 17 of the endoscope 12 is reduced, or the distal end of the treatment tool 13 is drawn into the channel 26. . At this time, the first valve 32 a and the second valve 32 b of the forceps plug 32 do not generate friction with the treatment instrument 13. For this reason, even when moving a finger in a direction approaching the palm surface, which is an ergonomic direction in which force is easily applied, the rotation of the dial 82 and the backward movement of the treatment instrument 13 can be reduced.

  In addition to the watertightness between the first valve 32 a and the second valve 32 b of the forceps plug 32 and the outer peripheral surface of the tube tip 44, the liquid leakage prevention member 71 and the outer peripheral surface of the first tube 43 Liquid leakage between the inner peripheral surface of the second cylinder 45 is also prevented. Furthermore, even when the treatment tool 13 is not disposed, the fixing portion 62 prevents liquid leakage through the second tube 45.

  As described above, according to the endoscope system 11 according to the first embodiment, the following can be said.

  When the auxiliary tool 14 is attached to a predetermined position of the endoscope 12, the first valve 32 a and the second valve 32 b of the forceps plug 32 can be pushed away by the tube distal end portion 44. Therefore, the auxiliary tool 14 according to the present embodiment can eliminate friction between the first tool 32a and the second valve 32b of the forceps plug 32 and the treatment tool 13. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 44 and the forceps plug 32 between the outer peripheral surface of the tube tip 44 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented. The liquid leakage prevention member 71 between the first cylinder 43 and the second cylinder 45 can prevent liquid from leaking outside from the auxiliary tool 14. Regardless of whether or not the treatment instrument 13 is disposed on the auxiliary instrument 14, the fixing portion 62 can prevent the liquid from leaking out from the auxiliary instrument 14.

  When the treatment instrument 13 is moved using the auxiliary instrument 14, that is, when the second cylinder 45 is moved with respect to the first cylinder 43, the largest resistance is generated on the outer peripheral surface of the first cylinder 43. And the liquid leakage preventing member 71 disposed between the inner periphery of the second cylinder 45. It can be said that the resistance of the liquid leakage preventing member 71 can be made significantly smaller than the resistance between the forceps plug 32 and the treatment instrument 13. For this reason, compared with the past, the force required to move the treatment tool 13 by moving the second cylinder 45 relative to the first cylinder 43 can be reduced.

  For example, when the treatment tool 13 is passed through the second valve 32b and the first valve 32a of the forceps plug 32, the second valve 32b and the first valve 32a of the forceps plug 32 increase as the outer diameter of the treatment tool 13 increases. It is expected that the sliding resistance passing through will increase. On the other hand, in the auxiliary tool 14 according to the present embodiment, the second end 32b and the first valve 32a of the forceps plug 32 are pushed away by the tube tip 44. For this reason, if the treatment instrument 13 has an outer diameter through which the passage 48 can be passed, the first cylinder is ignored even if the outer diameter of the treatment instrument 13 changes, if the presence of the channel 26 (see FIG. 1) is ignored. The sliding resistance for moving the second cylinder 45 relative to 43 can be prevented from changing. Therefore, even when the relative position between the first cylinder 43 and the second cylinder 45 is adjusted ergonomically by moving the hand in a direction that is difficult to move, it is necessary for the operation of the advance / retreat mechanism 46. The auxiliary tool 14 of the treatment tool 13 with improved force and reduced operability can be provided.

  In the present embodiment, the example in which the cylindrical body 63 between the cap 64 and the main body 61 of the second cylinder 45 is elastically deformed as the fixing portion 62 has been described. In addition, it is also preferable to use a valve-like member having a large sliding resistance with respect to the liquid leakage preventing member 71, such as the first valve 32a and the second valve 32b of the forceps plug 32.

  As shown in FIG. 6, the tube tip portion 44 provided in the first tube 43 can be formed in an appropriate shape. The cylinder tip 44 shown in FIG. 6 is selectively used.

  The cylinder tip 44 provided on the leftmost first cylinder 43 in FIG. 6 has been described in the above-described embodiment, and thus the description thereof is omitted.

  A cylinder tip 44 provided on the first cylinder 43 that is second from the left in FIG. 6 is formed with a smaller diameter toward the lower side in FIG. 6. Here, the tube tip 44 is particularly tapered in a portion on the tip side of the male screw portion 44b where one end side (distal end 44a) has a smaller diameter than the other end side (first tube 43 side). Is formed. Although not shown, the inner diameter of the tube tip 44 may be constant, or may be formed with a smaller diameter toward the lower side in FIG.

  The tube tip 44 provided on the third tube 43 from the left (second from the right) in FIG. 6 is a protrusion (radially outwardly protruding) on the outer peripheral surface of the distal end 44a. (Diameter enlarged portion) 44c. The protrusion 44 c has a maximum outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31. The protrusion 44c has a smaller diameter toward the lower side in FIG. In particular, the protrusion 44c is formed in a tapered shape in which one end side (distal end 44a) is smaller in diameter than the other end side (first cylinder 43 side). For this reason, it is possible to facilitate insertion of the tube distal end portion 44 when the first valve 32 a and the second valve 32 b of the forceps plug 32 are pushed away and inserted into the treatment instrument insertion port 31. The protrusion 44c may be formed integrally with the tube tip 44, and may be fixed in the vicinity of the distal end 44a of the tube tip 44 by, for example, screwing or bonding.

  The cylinder tip 44 provided on the fourth cylinder (the rightmost) first cylinder 43 from the left in FIG. 6 is a protrusion (diameter enlarged part) protruding radially outward on the outer peripheral surface of the distal end 44a. ) 44d. The protrusion 44 d has a maximum outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31. The outer peripheral surface of the protrusion 44d is formed into a curved surface like a part of a sphere. Here, the protrusion 44d of the tube tip 44 particularly has an arc-shaped chamfer whose one end side (distal end 44a) is smaller in diameter than the other end side (first tube 43 side). For this reason, it is possible to facilitate insertion of the tube distal end portion 44 when the first valve 32 a and the second valve 32 b of the forceps plug 32 are pushed away and inserted into the treatment instrument insertion port 31. Further, when the tube distal end portion 44 is pulled out through the first valve 32a and the second valve 32b of the forceps plug 32, it is possible to suppress the protrusion 44d from being caught by the first valve 32a and the second valve 32b as much as possible. Can do.

  The protrusions 44c and 44d in FIG. 6 may be formed integrally with the cylinder tip 44, and it is also preferable that the protrusions 44c and 44d are formed separately from, for example, a plastic material or a rubber material. When the protrusions 44c and 44d are separate bodies, the protrusions 44c and 44d are fixed to the cylinder tip 44 by fitting or screw fixing. That is, it is also preferable that the tube tip portion 44 has a separate part that can be attached to and detached from the tube tip portion 44.

  In addition, it is preferable that not only the first tube 43 and the tube tip 44 shown in FIG. 6 are integrated, but also that the forceps plug 32 is integrated with the tube tip 44.

The liquid leakage preventing member 71 is not limited to one having a circular cross section (see FIGS. 6 and 7A).
7B can make the contact area with respect to the inner peripheral surface of the second cylinder 45 smaller than that of the circular cross section shown in FIG. 7A. For this reason, when using the liquid leakage prevention member 71 shown to FIG. 7B, sliding resistance can be made small compared with the case where the thing shown to FIG. 7A is used.

  As described above, the dial 82 according to the present embodiment has a direction that is easy to rotate and a direction that is difficult to rotate due to ergonomic influences. By using another liquid leakage prevention member 71 (see FIG. 7C) instead of the liquid leakage prevention member 71, the dial 82 can be easily rotated and the direction in which it is difficult to rotate while maintaining watertightness and liquidtightness. And can be formed.

  The maximum outer diameter of the liquid leakage preventing member 71 shown in FIG. 7C changes along the axial direction of the central axis C. For this reason, when the second cylinder 45 is moved in the axial direction of the central axis C with respect to the first cylinder 43, it is possible to define a direction that is relatively easy to move and a direction that is difficult to move. . Sliding between the first cylinder 43 and the second cylinder 45 that occurs when the dial 82 is moved in an ergonomically difficult direction by setting the direction of the liquid leakage preventing member 71 shown in FIG. 7C. The resistance can be reduced with respect to the direction in which it is easy to move. Thus, what is used as the liquid leakage prevention member 71 is not limited to a member whose cross section is symmetric with respect to the virtual line T perpendicular to the central axis C. For example, it is also preferable to use a member whose cross section is asymmetric with respect to the imaginary line T, such as the liquid leakage prevention member 71 shown in FIG. In addition, it is also preferable that the liquid leakage preventing member 71 is formed of a plurality of bodies such as two bodies.

Next, a modified example of the position of the liquid leakage preventing member will be described with reference to FIGS. 8A to 8C.
As shown in FIG. 8A, it is also preferable that the liquid leakage prevention member 71 is provided not on the outer peripheral surface of the first tube 43 but on the inner peripheral surface of the second tube 45. As shown in FIG. 8B, the liquid leakage prevention member 71 is also preferably provided on both the outer peripheral surface of the first cylinder 43 and the inner peripheral surface of the second cylinder 45.
Of course, it is preferable to use the liquid leakage prevention member 71 described in FIGS. 7B and 7C instead of the liquid leakage prevention member 71 shown in FIGS. 8A and 8B.

The holding portion 42 for attaching the auxiliary tool 14 to the endoscope 12 can be variously changed.
In the example shown in FIG. 9A, the base 41 can be fixed to the outer shell of the endoscope 12 shown in FIG. 1 with a fixing screw (fixing tool) 42a penetrating the base body 51. Of course, the number of fixing screws 42a is not limited to one, and a plurality of fixing screws 42a is preferable. When the auxiliary tool 14 is fixed to the endoscope 12, it is needless to say that the holding portion 42 shown in FIGS. 2 to 5 may be used together with the fixing screw 42a.
As shown in FIG. 9B, the auxiliary tool 14 may be used as a fixing tool that fixes a flexible band (band-like member) 42 b formed on a base 41 and made of a soft material such as a rubber material to the endoscope 12. good. Moreover, as shown in FIG. 9B, the base 41 preferably includes an arm (fixing tool) 42c having a snap-fit structure that is deformed when the endoscope 12 is attached to the operation unit 18. The arm 42c is formed in a substantially C shape and can be elastically deformed to hold the outer peripheral surface of the operation unit 18.
In this way, various structures are employed for holding the base 41 of the auxiliary tool 14 in a state of being fixed to the endoscope 12.

[Second Embodiment]
With reference to FIG. 10, an endoscope system 11 according to the second embodiment will be described. This embodiment is a modification of the first embodiment including each modification, and the same members or members having the same functions as those described in the first embodiment are denoted by the same reference numerals, and the description will be made. Omitted. The same applies to third and fourth embodiments described later. In the present embodiment, the structures (arrangements) of the first cylinder 143 and the second cylinder 145 are different from those in the first embodiment.

  As shown in FIG. 10, the assisting tool (advance / retreat assisting tool) 114 includes a base 41 attached to a predetermined position of the endoscope 12 (see FIG. 1), and the treatment tool insertion port 31 of the endoscope 12. A holding portion 42 attached to the endoscope 12 so as to face the first tube, a first tube 143 attached to the base 41, a tube tip 44 provided on one end side of the first tube 143, and a first tube A second cylinder 145 that moves relative to the first cylinder 143 along the central axis C of 143, and an advance / retreat mechanism 46 that moves the second cylinder 145 forward and backward along the central axis C relative to the first cylinder 143. With.

  Here, the first cylinder 143 is outside the second cylinder 145. For this reason, the 1st pipe | tube does not necessarily need to be arrange | positioned inside a 2nd pipe | tube. The cam pin 92 extends radially outward from the side surface of the second cylinder 145. The cam pin 92 is disposed in the restriction groove 93 of the base 41.

  In this case, as described in the first embodiment, the tube distal end portion 44 can push away the second valve 32b and the first valve 32a of the forceps plug 32. Therefore, the auxiliary tool 14 according to the present embodiment can eliminate friction between the treatment tool 13 and the first valve 32a and the second valve 32b of the forceps plug 32 shown in FIG. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 44 and the forceps plug 32 between the outer peripheral surface of the tube tip 44 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented.

  A liquid leakage prevention member 71 is disposed between the inner peripheral surface of the first cylinder 143 and the outer peripheral surface of the second cylinder 145. When the treatment tool 13 (see FIG. 3) is moved using the auxiliary tool 14, that is, when the second cylinder 145 is moved with respect to the first cylinder 143, the largest resistance is generated. The liquid leakage prevention member 71 is provided between the inner peripheral surface of the tube 143 and the outer peripheral surface of the second tube 145. It can be said that the resistance of the liquid leakage preventing member 71 can be made significantly smaller than the resistance between the forceps plug 32 and the treatment instrument 13. For this reason, compared with the past, the force required to move the treatment tool 13 by moving the second cylinder 145 relative to the first cylinder 143 can be reduced.

  Note that an appropriate cylinder tip 44 shown in FIG. 6 can be used instead of the cylinder tip 44 according to the present embodiment.

  Of course, instead of the liquid leakage prevention member 71 shown in FIG. 10, an appropriate liquid leakage prevention member 71 shown in FIG. 7B and / or FIG. 7C can be used. Further, the position of the liquid leakage preventing member 71 can be appropriately set as shown in FIGS. 8A and 8B.

  Furthermore, when the auxiliary tool 114 according to the present embodiment is fixed to the endoscope 12 (see FIG. 1), not only the holding portion 42 shown in FIG. 10 is used, but also a fixing screw 42a (see FIG. 9A) and a flexible band 42b. And the arm 42c (refer FIG. 9B) can be used suitably.

[Third Embodiment]
With reference to FIG. 11A and FIG. 11B, the endoscope system 11 concerning 3rd Embodiment is demonstrated. In the assisting tool (advance / retreat assisting tool) 214 according to the present embodiment, the structure for moving the second tube 45 relative to the first tube 43 is different from the assisting device 14 of the first embodiment.

  As shown in FIG. 11A, the auxiliary tool 214 of the present embodiment can adjust the protrusion amount of the treatment tool 13 relative to the tip of the channel 26 with the right hand instead of the user's left hand.

  As shown in FIGS. 11A and 11B, a wire 222 is connected to a second cylinder 45 that is movable with respect to the first cylinder 43 via a moving body 292. The moving body 292 can move within a predetermined range in the direction along the central axis C. The wire 222 is inserted into the guide tube 224 having flexibility. At the distal end of the wire 222, a moving body 222a that is operated by a user with a right hand (for example, a thumb and an index finger) such as a ring shape or a block shape is fixed. Fixed to the distal end of the guide tube 224 is a fixed body 224a that is supported by the user's right hand, such as a fixing ring. With the insertion portion 17 of the endoscope 12 and the fixed body 224a of the guide tube 224 supported by the user's right hand, the movable body 222a of the wire 222 can be moved by the right hand along the axial direction of the wire 222. A moving body 292 is connected to the proximal end of the wire 222 on the side opposite to the moving body 222a. A moving body 292 is put in and out of the proximal end of the guide tube 224.

  When the moving body 222 a of the wire 222 is brought close to the fixed body 224 a of the guide tube 224, the moving body 292 protrudes from the proximal end of the guide tube 224. Since the moving body 292 moves toward the proximal end along the central axis C, the second cylinder 45 moves (retreats) toward the opposite side of the first end of the channel 26 with respect to the first cylinder 43. ) Since the treatment tool 13 is fixed to the second tube 45, the protrusion amount of the distal end of the treatment tool 13 with respect to the distal end of the channel 26 of the insertion portion 17 of the endoscope 12 is reduced, or the distal end of the treatment tool 13 is drawn into the channel 26. . At this time, the first valve 32a and the second valve 32b of the forceps plug 32 are pushed away by the tube tip portion 44, and the treatment tool 13 is inserted inside the tube tip portion 44. No friction is generated between them.

  When the moving body 222 a of the wire 222 is moved away from the fixed body 224 a of the guide tube 224, the moving body 292 is disposed at the proximal end of the guide tube 224. Since the moving body 292 moves toward the distal end side along the central axis C, the second cylinder 45 moves (advances) toward the distal end side of the channel 26 with respect to the first cylinder 43. Since the treatment tool 13 is fixed to the second tube 45, the distal end of the treatment tool 13 protrudes from the distal end of the channel 26 of the insertion portion 17 of the endoscope 12, or the amount of protrusion increases. At this time, the first valve 32a and the second valve 32b of the forceps plug 32 are pushed away by the tube tip portion 44, and the treatment tool 13 is inserted inside the tube tip portion 44. No friction is generated between them. The liquid leakage prevention member 71 between the first cylinder 43 and the second cylinder 45 can prevent liquid from leaking outside from the auxiliary tool 214.

  In the present embodiment, the second cylinder 45 is arranged outside the first cylinder 43. However, as in the second embodiment, the inner side of the first cylinder 143 is described. Of course, it is possible to employ a structure in which the second cylinder 145 is disposed.

[Fourth Embodiment]
An endoscope system 11 according to the fourth embodiment will be described with reference to FIG. In the present embodiment, the structure in which the cam groove 391 is formed on the inner peripheral surface of the dial 382 is different from the dial 82 and the cam groove 91 (see FIGS. 3 and 10) of the first and second embodiments.

  The assisting tool (advance / retreat assisting tool) 314 includes a base 341 attached to a predetermined position of the endoscope 12 (see FIG. 1), and an endoscope so that the base 341 faces the treatment tool insertion port 31 of the endoscope 12. Along the central axis C of the first cylinder 343, a holding part 42a attached to the mirror 12, a first cylinder 343 attached to the base 341, a cylinder tip 344 provided on one end side of the first cylinder 343 A second cylinder 345 that moves relative to the first cylinder 343, and an advance / retreat mechanism 346 that moves the second cylinder 345 forward and backward along the central axis C relative to the first cylinder 343 (moving mechanism). . In the present embodiment, the first cylinder 343 and the cylinder tip 344 are formed as separate bodies. The first cylinder 343 and the cylinder tip 344 are fixed with a fixing screw 349. In the present embodiment, the cylinder tip 344 is fixed to the base 341.

  The advance / retreat mechanism 346 includes a dial 382 and a cam mechanism 383 that converts rotation of the dial 382 into advance / retreat movement of the second cylinder 345 and the treatment instrument 13. The first cylinder 343 and the second cylinder 345 are arranged concentrically. A second cylinder 345 is disposed inside the first cylinder 343. The dial 382 is disposed concentrically with the first cylinder 343 and the second cylinder 345.

  The cam mechanism 383 includes a cam cylinder 391 having a cam groove 391a, a cam pin 392 provided in the second cylinder 345, and a restriction groove 393 provided in the first cylinder 343. The cam cylinder 391 is fixed to the inner peripheral surface of the dial 382.

  A liquid leakage preventing member 371a is disposed between the inner peripheral surface of the first cylinder 343 and the outer peripheral surface of the second cylinder 345. A liquid leakage preventing member 371b is disposed between the tube tip 344 and the first tube 343. Liquid leakage prevention members 371c and 371d are disposed between the outer peripheral surface of the first tube 343 and the dial 382.

  Here, the central axis C of the cylinder tip 344 is inclined with respect to the central axis C of the first cylinder 343 and the second cylinder 345.

Then, the effect | action of the endoscope system 11 of this embodiment is demonstrated easily.
The user of the endoscope 12 of this embodiment fixes the auxiliary tool 314 at a predetermined position of the endoscope 12. At this time, the auxiliary tool 314 is assembled and can be used simply by being attached to an appropriate part of the endoscope 12. The distal end 344 a of the tube tip 344 of the auxiliary tool 314 passes through the forceps plug 32 attached to the treatment tool insertion port 31 of the endoscope 12 and penetrates the treatment tool insertion port 31. That is, the second valve 32b and the first valve 32a (see FIG. 6) of the forceps plug 32 are pushed away at the distal end 344a of the tube tip 344, and the distal end 344a is inserted into the treatment instrument insertion port of the endoscope 12. It arrange | positions in the inside of the treatment tool penetration port 31 through the opening edge part 31a of 31. FIG. For this reason, the outer peripheral surface of the tube tip 344 is in an airtight and liquid-tight state between the forceps plug 32 and the forceps plug 32 by the first valve 32 a and the second valve 32 b of the forceps plug 32.

  Then, the base 341 of the auxiliary tool 314 is fitted into a predetermined part of the endoscope 12. The auxiliary tool 314 is fixed to the endoscope 12 with the mounting screw 42a. For this reason, the attachment screw 42a is used as a holding portion that holds the state where the tube distal end portion 344 penetrates the forceps plug 32 in a state where the base 341 is attached to the endoscope 12. The attachment screw 42a prevents the auxiliary tool 314 from dropping unintentionally during use of the endoscope 12.

  The adjustment of the amount of protrusion of the treatment instrument 13 with respect to the distal end of the channel 26 shown in FIGS. 1 and 11 by rotating the dial 382 has been described in the first embodiment, and thus the description thereof is omitted here.

  In addition to the watertightness between the first valve 32a and the second valve 32b of the forceps plug 32 and the outer peripheral surface of the tube tip 344, the first tube is provided by the liquid leakage prevention members 371a, 371b, 371c, and 371d. Liquid leakage between the outer peripheral surface of 343 and the inner peripheral surface of the second cylinder 345 is also prevented. Further, even when the treatment instrument 13 is not disposed, the fixing portion 62 prevents liquid leakage through the second cylinder 345.

  As described above, according to the endoscope system 11 according to the fourth embodiment, the following can be said.

  When the auxiliary tool 314 is attached to a predetermined position of the endoscope 12, the first valve 32 a and the second valve 32 b of the forceps plug 32 can be pushed away by the tube distal end portion 344. Therefore, the auxiliary tool 314 according to the present embodiment can eliminate friction between the first tool 32 a and the second valve 32 b of the forceps plug 32 and the treatment tool 13. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 344 and the forceps plug 32 between the outer peripheral surface of the tube tip 344 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented. The liquid leakage prevention members 371a to 371d between the first cylinder 343 and the second cylinder 345 can prevent the liquid from leaking from the auxiliary tool 314 to the outside.

  When the treatment tool 13 is moved using the auxiliary tool 314, that is, when the second cylinder 345 is moved with respect to the first cylinder 343, the largest resistance is generated on the outer peripheral surface of the first cylinder 343. And a liquid leakage prevention member 371a disposed between the inner peripheral surface of the second cylinder 345 and the second cylinder 345. It can be said that the resistance of the liquid leakage preventing member 371a can be significantly reduced as compared with the resistance between the forceps plug 32 and the treatment instrument 13. For this reason, compared with the past, the force required to move the treatment instrument 13 by moving the second cylinder 345 relative to the first cylinder 343 can be reduced.

  For example, when the treatment tool 13 is passed through the second valve 32b and the first valve 32a of the forceps plug 32, the second valve 32b and the first valve 32a of the forceps plug 32 increase as the outer diameter of the treatment tool 13 increases. It is expected that the sliding resistance passing through will increase. On the other hand, in the auxiliary tool 314 according to the present embodiment, the second end 32b and the first valve 32a of the forceps plug 32 are pushed away by the tube tip 344. For this reason, if the treatment instrument 13 has an outer diameter through which the passage 48 can pass, the sliding resistance that moves the second cylinder 345 with respect to the first cylinder 343 ignores the presence of the channel 26. Even if the outer diameter of the treatment instrument 13 changes, it can be prevented from changing. For this reason, even when the relative position between the first cylinder 343 and the second cylinder 345 is adjusted by moving the hand in an ergonomically difficult direction, it is necessary for the operation of the advance / retreat mechanism 346. The auxiliary tool 314 of the treatment tool 13 with improved force and reduced operability can be provided.

  The distal end of the tube tip 344 is allowed to have an appropriate shape like the tube tip 44 shown in FIG.

  Further, the holding portion used when fixing the base 341 to the endoscope 12 is not limited to the fixing screw 42a, and an appropriate one can be used.

  Although several embodiments have been specifically described so far with reference to the drawings, the present invention is not limited to the above-described embodiments, and all the embodiments performed without departing from the scope of the invention are not limited thereto. Including.

  DESCRIPTION OF SYMBOLS 13 ... Treatment tool, 14 ... Auxiliary tool, 31 ... Treatment tool insertion port, 31a ... Opening edge part, 32 ... Forceps stopper, 41 ... Base, 42 ... Holding part, 43 ... 1st pipe | tube, 43a ... Level | step difference, 44 ... Tube tip portion, 44a ... distal end, 45 ... second tube, 46 ... advance / retreat mechanism, 47 ... moving unit, 48 ... passage, 49 ... nut, 51 ... base body, 52 ... support member, 52a ... fitting portion 53 ... Screw, 61 ... Main body, 61a ... Base end surface, 61b ... Screw part, 62 ... Fixing part, 63 ... Cylindrical body, 63a ... Inner peripheral surface, 64a ... Screw part, 64 ... Cap, 64b ... Opening, 71 DESCRIPTION OF SYMBOLS ... Prevention member, 81 ... Arm part, 81a ... Rotating shaft, 82 ... Dial, 83 ... Cam mechanism, 91 ... Cam groove, 92 ... Cam pin, 93 ... Restriction groove.

Claims (15)

An advancing / retreating aid that is attached to the proximal end side of the insertion portion of the endoscope and assists the advancing / retreating movement of the treatment instrument that is inserted into the insertion portion of the endoscope,
A base attached to the endoscope;
A first tube attached to the base and having a passage through which the treatment tool is inserted;
The treatment instrument insertion port is provided on one end side of the first tube and penetrates a forceps plug attached to the treatment instrument insertion port of the endoscope when the base is attached to the endoscope. A cylinder tip passing through
The treatment instrument is inserted inside with the outer surface of the treatment instrument having passed through the passage of the first cylinder being held, and the passage with respect to the base and the first cylinder by an external operation A second cylinder that moves in a direction along the central axis of
An assisting tool comprising: a holding portion that holds a state in which the distal end portion of the tube penetrates the forceps plug in a state where the base is attached to the endoscope.   The auxiliary tool according to claim 1, wherein the tube tip portion is in close contact with the forceps plug so as to be in a liquid-tight state with the forceps plug.   2. The auxiliary tool according to claim 1, wherein the cylindrical tip portion has a taper or an arc-shaped chamfer whose one end side has a smaller diameter than the other end side.   2. The auxiliary tool according to claim 1, wherein the cylindrical tip portion has a diameter-enlarged portion whose one end side is larger in diameter than the other end side.   The auxiliary tool according to claim 1, wherein the tube tip portion has a separate part that is detachable from the tube tip portion.   The said 2nd pipe | tube has a liquid leak prevention part which can hold | maintain the outer surface of the said treatment tool, and prevents the liquid leak between the said 2nd pipe | tube and the outer surface of the said treatment tool. The aid described.   The liquid leakage prevention unit holds the outer surface of the treatment tool in a state where the treatment tool is inserted through the second cylinder, and the second leaking part in a state where the treatment tool is removed from the second cylinder. The auxiliary tool according to claim 6, further comprising an elastic member that prevents liquid leakage through the tube.   The auxiliary tool according to claim 1, further comprising a liquid leakage preventing member that suppresses the passage of liquid between the first cylinder and the second cylinder.   The assisting device according to claim 8, wherein the liquid leakage preventing member includes a flexible ring member supported by at least one of the first tube and the second tube.   The auxiliary tool according to claim 1, further comprising a moving mechanism that is provided on the base and moves the second cylinder along the central axis of the passage of the first cylinder by an operation from the outside.   The auxiliary tool according to claim 1, wherein the holding unit is capable of attaching the base to the endoscope.   The auxiliary tool according to claim 11, wherein the holding portion includes a belt-like member that attaches the base to an operation portion of the endoscope.   The auxiliary tool according to claim 11, wherein the holding unit includes a fixture that fixes the base to the treatment instrument insertion port of the endoscope. An endoscope,
An auxiliary instrument for the treatment instrument according to claim 1,
An endoscope system.   The endoscope system according to claim 14, further comprising a treatment tool inserted through the auxiliary tool.