JP3191981B2 - Endoscope insertion guide tube - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an insertion guide tube for an endoscope which is used for assisting insertion of an insertion portion of the endoscope into a body cavity.

[0002]

2. Description of the Related Art In recent years, laparoscopic cholecystectomy in which a plurality of puncture holes are formed in the abdomen of a patient and abnormal gallbladder is removed by inserting a laparoscope or forceps through the puncture hole has been widely used. .

In such an endoscope operation, an insertion guide tube for assisting the insertion of an insertion portion of an endoscope into a human body cavity is known from Japanese Utility Model Publication No. 57-27441. ing. The insertion guide tube is composed of a tube body having appropriate flexibility, and a hand portion provided at the rear end of the tube body. The insertion guide tube is mounted behind the insertion portion of the endoscope. By inserting only the insertion portion into the body cavity and further pushing the insertion portion using the insertion guide tube as insertion guide, the endoscope insertion portion is inserted deep into the body cavity.

[0004] As shown in FIG. 9 , an insertion portion 2 of a flexible endoscope is inserted through an incision 4 provided in a gall bladder duct 3 and is advanced to the inside of a common bile duct 5. Removal of calculi has also been attempted.

In this method of inserting the endoscope, the gall bladder 7 is fixed with forceps 6 so that the gall bladder 3 is not shaken, and the incision 4 is provided in the gall bladder 3. Next, the guide wire 8 is inserted into the channel inside the endoscope insertion section 2, and the guide wire 8 is inserted into the incision 4 of the gall bladder duct 3.

Then, the guide wire 8 is advanced from the gall bladder duct 3 to the common bile duct 5. The insertion portion 2 is pushed into the incision 4 of the gall bladder duct 3 using the guide wire 8 as a guide. Then, the endoscope is further pushed to advance the bile duct 3 to the common bile duct 5.

[0007]

As described above, in the conventional insertion guide tube for an endoscope, the endoscope to be inserted into the gall bladder tube 3 is designed such that the channel is located at the radial center of the insertion portion 2 by design. It is difficult to do that. Therefore, the guide wire 8 inserted into the channel has to be extended from a position apart from the center of the diameter of the insertion section 2.

Further, since the endoscope has a built-in component such as an image guide fiber, the outer diameter of the endoscope is correspondingly large.
Therefore, the endoscope insertion portion with the guide wire 8 extended from the distal end has a step with an outer diameter at the distal end.

Therefore, the guide wire 8 does not play the role of a guide for inserting the insertion portion 2, and as shown in FIG. 10 , the incision 4 of the gall bladder tube 3 into which the endoscope insertion portion 2 can be inserted.
However, there is a problem in that the insertion end 2 is caught by the opening of the incision 4 and cannot be inserted smoothly. SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an endoscope insertion guide tube that improves the insertability of an endoscope into a thin tube.

[0010]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides a tube having an opening at the distal end of an endoscope insertion portion.
A guide wire that is inserted into the channel and protrudes from the opening
And the end of the endoscope insertion section
The guide wire and the endoscope are inserted and closed in the natural state.
Small-diameter portion of the elastic body with a small hole at the center
And the endoscope connected to the proximal end side of the distal-side narrow diameter portion.
A tube having an inner diameter larger than the outer diameter of the insertion portion.
To the outer diameter of the tube body from the distal small diameter portion
It is featured that it is formed in a tapered shape by an elastic body.
In the endoscope insertion guide tube to be featured.

[0011]

According to the insertion guide tube for an endoscope constructed as described above, a small hole through which a guide wire can be inserted is provided, and a portion from the small diameter portion to the outer diameter of the insertion guide tube is formed in a tapered shape. With the elastic tapered member, the guide wire extending eccentrically from the distal end of the endoscope in the insertion guide tube is aligned,
Since the distal end of the insertion guide tube has an acute tapered shape, the distal end of the insertion portion can be smoothly inserted into the gall bladder without being caught by the incision.

[0012]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show a first embodiment, in which an endoscope insertion portion 1 inserted into an abdominal cavity 9 via a trocar 10 is shown.
1 shows a sheath 12 as an insertion guide tube for an endoscope.

The trocar 10 is similar to a generally used known trocar, and includes an outer tube 13 and an inner needle (not shown). The mantle tube 13 includes a tubular portion 14 from the distal end, a trumpet valve portion 15 and a seal portion 16 on the proximal end side.
A conduit 17 through which the inner needle is inserted is provided in the longitudinal direction of the outer tube 13.

The tubular portion 14 is a portion penetrating the abdominal wall 9. The trumpet valve portion 15 prevents the sheath 12 and the inner needle inserted into the conduit 17 from moving in the longitudinal direction of the conduit 17. The piston 18 orthogonal to the pipe 17 is provided with a hole 19 having the same shape as the pipe 17, and the piston 18 is moved to the left in the drawing by a longitudinal extension of a spring 20 provided on the right of the piston 18 in the drawing. Has been energized. That is, when nothing is normally inserted into the pipe 17, the piston 18 is pushed toward the left side of the trumpet valve section 15 in the drawing, and
Is closed.

A button 21 is provided at an end of the piston 18. When the button 21 is pushed to the right in the drawing against the tension of the spring 20, the hole 19 provided in the piston 18 is lowered and the conduit 17 is opened. That is, FIG.
The sheath 12 is inserted through the conduit 17 as shown in FIG.
Therefore, the sheath 12 is always subjected to the shearing force due to the tension of the spring 20. A donut-shaped elastic member 22 is provided in the seal portion 16 on the proximal end side of the outer tube 13 to seal a gap between the endoscope 11 to be inserted and the conduit 17.

The sheath 12 is inserted through the conduit 17. The sheath 12 has an inner diameter through which the endoscope insertion section 11 can be inserted. An elastic member 23 is provided at the base end to seal a gap between the inner periphery of the sheath 12 and the insertion section 2.

In the figure, reference numeral 24 denotes a flexible tube, and a hard tubular member 25 is provided on a part of the outer surface of the tube 24. This tube body 24 is made of a resin such as polyethylene and ethylene tetrafluoride. When the sheath 12 is inserted into the conduit 17, the tubular member 25 comes into contact with the piston 18, and the piston 1
8 is located. That is, when the distal end of the sheath 12 is the same as the distal end of the mantle tube 13, the piston 1
When the sheath 12 is fully inserted into the mantle tube 13 from the position where the sheath 8 biases the sheath 12, the piston 18
The tubular member 25 is provided in at least a part of the position up to the position where the member is biased.

FIG. 2 shows the distal end of the sheath 12. An elastic tapered member 30 made of, for example, silicon rubber or polyurethane is fixed to the tip of the tube body 24 by an adhesive or the like.

The elastic tapered member 30 has a substantially conical shape,
It is composed of a large diameter portion 31, a tapered portion 32, and a small diameter portion 33 from the base end side. As shown in FIG. 2, the large diameter portion 31 is
It has substantially the same outer diameter as. The tapered part 32 is the small diameter part 3
In the transition portion up to 3, the diameter is smoothly reduced to a tapered shape. The small diameter portion 33 is provided with a small hole 34 extending from the inner peripheral surface of the large diameter portion 31 or the tapered portion 32 in the longitudinal direction. A guide wire 35 extending from a channel of the endoscope insertion portion 11 is inserted into the small hole 34. As shown in FIG. 2, this small hole 34 is usually
It is closed.

According to the insertion guide tube for an endoscope configured as described above, as shown in FIG. 3, the guide wire 35 is made to protrude from the distal end of the elastic tapered member 30 so that the endoscope insertion portion 1 is formed.
1 is inserted into the sheath 12. The guide wire 35 extending from a position eccentric from the center of the insertion portion 11 is centered on the inner peripheral surface of the tapered portion 32 and guided to the small hole 34. Subsequently, the guide wire 35 pushes and spreads the small hole 34 while the sheath 12
It is extended from the tip of. FIG.
It is in the state pushed further in. Insertion into the gall bladder incision 36 is performed in the state shown in FIGS.

First, the guide wire 35 is inserted into the gall bladder incision 36. Then, using the guide wire 35 as a guide,
The sheath 12 with the insertion section 11 therein is pushed forward.
Since the guide wire 35 is located at the center of the sheath 12 and has a smooth taper from the guide wire 35 to the tube body 24, the sheath 12 is smoothly inserted into the gall bladder incision 36. After inserting the sheath 12 into the gall bladder incision 36, the guide wire 35 is inserted into the insertion portion 11
Then, only the insertion portion 11 is pushed further. Then, the small hole 34 provided in the tapered portion 32 or the small-diameter portion 33 is pushed open to protrude the endoscope insertion portion 11 from the distal end of the sheath 12, and the insertion portion 12 is inserted into the gall bladder duct 3 and the common bile duct 5. To go.

Therefore, the guide wire 35 eccentrically protruding from the endoscope is located at the center of the endoscope sheath 12 and the portion from the small diameter portion 33 to the outer diameter of the sheath 12 is smoothly tapered. Insertion of the endoscope into the narrow tube of the gall bladder duct 3 is facilitated. By improving the insertability of the endoscope, the operation time can be reduced, and the effect of reducing the burden on the operator and the patient can be obtained.

Next, a second embodiment of the present invention will be described with reference to FIGS.
It will be described based on. 6, the distal end of the sheath 12 is shown similarly to FIG. A conical projection 37 is provided at the tip of the small diameter portion 33 of the elastic tapered member 30 in the first embodiment.
Is provided. In the center of the diameter of the projection 37, a small hole 3
4 are provided.

According to the insertion guide tube for an endoscope thus constructed, the guide wire 35 is projected from the distal end in the same manner as in the first embodiment in FIG.
The sheath 12 housed in the tube 4 is inserted into the gall bladder incision 3
6, the insertion portion 11 is pushed forward with respect to the sheath 12. Then, the projection 37 is locked on the inner peripheral surface near the gall bladder incision 36.

Therefore, since the projection 37 is locked on the inner peripheral surface of the gall bladder tube 3, the sheath 12 is opened when the insertion portion 11 is further advanced or withdrawn from the gall bladder tube 3. No more than 36 drops. Therefore, FIG.
As in the conventional method shown in (1), the gallbladder 7 or the gallbladder tube 3 on the gallbladder side is fixed with the forceps 6 in order to resist the force for pushing the insertion portion 11 until the insertion portion 11 reaches the common bile duct 5. You don't have to. That is, the insertion portion 11
Once the insertion part 11 can be inserted into the gall bladder incision 36, the insertion part 11 can be fed smoothly without fixing the gall bladder 7 or the gall bladder duct 3 with the forceps 6.

A third embodiment of the present invention will be described with reference to FIG. As shown in FIG. 8, the tubular member 40 is interposed between the insertion portion 11 and the inner peripheral surface of the sheath 12. The tubular member 40 has an inner diameter through which the insertion portion 11 can be inserted, and an outer diameter through which the inside of the sheath 12 can be inserted. A conical projection 37 is provided at the tip of the small diameter portion 33 of the elastic tapered member 30. This projection 3
At the center of the diameter of 7, a small hole 34 is provided.

According to the endoscope insertion guide tube of the third embodiment thus constructed, the guide wire 35 is projected from the distal end, and the elastic taper in a state where the insertion portion 11 is housed in the tube body 24. The shaped member 30 is inserted into the gall bladder incision 36. Thereafter, the tubular member 40 is advanced with respect to the sheath 12 to advance to the small diameter portion 33. Then, similarly to the second embodiment, the projection 37 is locked on the inner peripheral surface near the gall bladder incision 36. Thereafter, the insertion section 11 is advanced into the gall bladder duct 3 and the common bile duct 5.

Therefore, since the insertion portion 11 is not squeezed on the inner peripheral surface of the tapered portion 32 or the small diameter portion 33 of the elastic tapered member 30, no extra load is applied to the endoscope insertion portion 11.

If the tubular member 40 is positioned inside the small diameter portion 33, the sheath 12 will not fall out of the gall bladder incision 36 regardless of the presence or absence of the insertion portion 11 in the sheath 12. Therefore, the endoscope insertion portion 11 is connected to the sheath 12
After the tube is removed from the tube, the tube other than the endoscope can be easily advanced to the common bile duct 5 by replacing the tube with a contrast tube or a washing tube.

[0030]

As described above, according to the present invention, the guide wire projecting eccentrically from the endoscope is positioned at the center of the endoscope sheath, and is moved from the small diameter portion to the outer diameter of the insertion guide tube. The endoscope has a smooth tapered shape, so that the endoscope can be easily inserted into the tubule of the gall bladder. By improving the insertability of the endoscope, the operation time can be reduced, and the effect of reducing the burden on the operator and the patient can be obtained.

[Brief description of the drawings]

FIG. 1 is a sectional view of an insertion guide tube for an endoscope according to a first embodiment of the present invention.

FIG. 2 is a sectional view of the elastic tapered member of the embodiment.

FIG. 3 is a sectional view showing a state where a guide wire is projected from the elastic tapered member of the embodiment.

FIG. 4 is a cross-sectional view showing a state in which the endoscope is inserted inside the sheath of the embodiment.

FIG. 5 is a cross-sectional view showing a state where the endoscope according to the embodiment is inserted into a gall bladder duct;

FIG. 6 is a sectional view of an elastic tapered member according to a second embodiment of the present invention.

FIG. 7 is a cross-sectional view showing a state where the endoscope according to the embodiment is inserted into a gall bladder duct;

FIG. 8 is a cross-sectional view showing a state in which the endoscope according to the third embodiment of the present invention is inserted into a gall bladder duct.

FIG. 9 is a perspective view of a conventional insertion guide tube for an endoscope.

FIG. 10 is a side view of a conventional insertion guide tube for an endoscope.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 11 ... Endoscope insertion part, 12 ... Sheath, 24 ... Tube body, 25 ... Hard tubular member, 30 ... Elastic taper member, 3
3: small diameter portion, 34: small hole, 35: guide wire.

Claims (1)

(57) [Claims] 1. An endoscope having an opening at an end of an endoscope insertion portion.
A guide wire that is inserted into the channel and protrudes from the opening
And the end of the endoscope insertion section
The guide wire and the endoscope are inserted and closed in the natural state.
Small-diameter portion of the elastic body with a small hole at the center
And the endoscope connected to the proximal end side of the distal-side narrow diameter portion.
A tube having an inner diameter larger than the outer diameter of the insertion portion.
To the outer diameter of the tube body from the distal small diameter portion
An insertion guide tube for an endoscope, wherein the guide tube is formed in a tapered shape by an elastic body .