JP3560931B2 - Endoscope insertion aid - Google Patents

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an endoscope insertion aid that assists insertion of an endoscope into a body cavity.
[0002]
[Prior art]
Insertion of the endoscope into the gastrointestinal tract is difficult if the gastrointestinal tract is narrow due to the presence of a lesion, scarring after surgery, recurrence, or even a congenital patient. The skilled artisan is required for the insertion operation of the endoscope in the above. In order to remove such obstruction of the gastrointestinal tract (hereinafter simply referred to as a stenosis) and reduce the pain of the patient, a procedure for dilating the stenosis was required.
[0003]
In the case of examining and treating a site having a stenosis using an endoscope, conventionally, measures have been taken to forcibly expand the stenosis using a balloon that supplies and expands gas or liquid. When using such an inflation balloon, insert the inflation balloon in a narrowed state before inserting the endoscope into the stenosis, then introduce a gas or liquid to apply pressure, Inflating the balloon dilates the stenosis. Thereafter, it was necessary to remove the dilatation balloon from the body and insert the endoscope into the body cavity again to perform examination and treatment.
[0004]
Means for improving the insertability of an endoscope without using an expansion balloon include, for example, a visual field securing device disclosed in JP-A-49-45519. This field-of-view securing device inserts into the body cavity a cage with a bud-shaped pre-shaped thin wire attached to the end of the endoscope, and expands the cage while pushing the endoscope into the stenosis. Thus, the insertion property of the endoscope is improved.
[0005]
However, the field-of-view securing device of this type expands by contacting the thin lines constituting the cage with the mucous membrane. For this reason, the endoscope cannot be inserted smoothly, and the cage itself has a drawback that the observation field of view of the endoscope is narrowed.
[0006]
As another means for improving the insertability of the endoscope, for example, there is one disclosed in JP-A-64-80335. In Japanese Patent Application Laid-Open No. 64-80335, the end cap for an endoscope is made of a transparent material, and the tip of the tip cap is formed in a hemispherical shape to improve insertability.
[0007]
However, in the method using the distal end cap, the insertability of the endoscope was insufficient, and a large force was required to push the distal end of the endoscope into the stenosis, and the pain of the patient was great. . Further, since the distal end cap completely covers the distal end of the endoscope, treatment means through the endoscope is limited to energy irradiation means such as a laser beam that passes through a transparent distal end cap. There was a drawback that it would.
[0008]
In addition, for example, Japanese Patent Application Laid-Open No. 9-66019 proposes a means of attaching a transparent substantially cylindrical hood to secure a full field of view seen from an endoscope, and performing a treatment through the endoscope. I have. However, since the hood has a substantially cylindrical shape similar to the endoscope distal end, it is extremely difficult to insert the hood into a lumen narrower than the outer diameter of the hood.
[0009]
As described above, when the balloon is inflated, the pressure must be controlled so that the balloon is not destroyed while maintaining the inflated shape of the balloon against the internal pressure. Absent. Therefore, the muscular tissue of the dilated portion tends to contract after the treatment, and it is difficult to maintain the expanded diameter for a long time. In balloon dilatation, the stenosis is temporarily expanded to perform observation, treatment, and placement of a stent. Is a suitable, but not sufficient, measure to provide permanent expansion.
[0010]
Therefore, in order to permanently maintain the dilatation position without the indwelling object and eliminate the obstruction, in conjunction with the dilatation balloon, the stenosis is subjected to high-frequency ablation or expansion by indwelling the body such as a stent. Needed to be maintained.
[0011]
On the other hand, as a treatment without a dilatation balloon for maintaining a permanent opening, dilatation using a dilatation device as described below is performed in order to break the connection between cells so as not to cause tissue contraction after surgery. Is valid. That is, it is a bougienage that uses an extension device called a so-called Bougie in a body lumen. Bougies are roughly classified into olive (Eder-Puestow) type and Savary-Gillard type (see, for example, Japanese Patent Publication No. 60-501295).
[0012]
Here, a conventional technique of stenosis dilatation using a bougie will be described, taking esophageal dilation as an example. The olive-type bougie is a type that expands by fixing a hard transparent plastic cap made of a soft egg-shaped polycarbonate or the like to the end of the endoscope, and simultaneously inserting it into the stenosis while observing. It has the same structure as the above-mentioned tip cap for ensuring mirror insertion.
[0013]
However, in this structure, since the tip of the tip cap is substantially spherical, performing a stretch at a stretch increases the resistance during insertion, causes a great deal of pain for the patient, and also increases the burden on the surgeon. Difficulties have already been mentioned. Therefore, to expand irreversibly to the stenosis, to solve the passage obstruction, prepare a plurality of olive-shaped bougies with different shapes and outer diameters of the tip sphere, gradually replace them with larger ones, gradually to a predetermined size. The stenosis needed to be dilated. Along with this, there is a problem in that the treatment time becomes longer, inefficient, and the burden on both the patient and the operator is not sufficiently reduced.
[0014]
On the other hand, the Sabaley-Gillard type bougie is a tapered soft plastic tube having a tip with an inclined shape of 1 to 10 ° and a tip having a pointed shape, and a guide wire is inserted through the entire length. Has a structure in which a central path is provided. Further, an X-ray marker is provided at the distal end to provide an X-ray opaque function, and under X-ray observation, a guide wire is gradually inserted from the elongated distal end of the bougie into which the guide wire is inserted, thereby expanding the affected part. Things.
However, since the dilatation procedure can be performed only under X-ray transmission, it is necessary to insert the endoscope into the affected area and observe again after removing the bougie in order to accurately grasp the degree of dilation of the stenosis. there were. As a result, when it was determined that the dilation of the stenosis was insufficient, a bougie was inserted again, and the treatment and observation had to be repeated.
[0015]
Further, Japanese Patent Application Laid-Open No. 11-56753 proposes an endoscope mounting tool comprising a transparent tube having a tapered tip and a through hole for inserting a treatment tool at the tip. This endoscope mounting device expands a stenosis portion while fitting the endoscope mounting device on the endoscope.
[0016]
According to this endoscope mounting tool, the stenosis can be released under the endoscope, so that the stenosis can be reliably expanded.
[0017]
However, in this method, since the insertion of the treatment tool is limited to the through hole, the treatment property is not high, and to perform an endoscopic treatment at a position beyond the stenosis, after removing the endoscope wearing tool. The endoscope had to be inserted again into the affected area.
[0018]
In other words, stenosis dilation using an olive type, a Sabaley Gillard type bougie, and an endoscope wearing device can achieve dilation enough to solve a permanent passage obstruction, but the operation is complicated and the procedure is difficult. It lacked certainty and was inefficient.
[0019]
[Problems to be solved by the invention]
As described above, endoscopic examination and endoscopic examination should be performed if the gastrointestinal tract is stenotic due to the presence of a lesion, scars after surgical operation, or recurrence of the lesion, or due to the patient's congenital reasons. In endoscopic procedures or operations, it is particularly difficult to insert an endoscope, and the insertion operation of the endoscope requires skill. Further, according to the conventional technique, it is easy to insert an instrument such as an endoscope into a narrow lumen in a body cavity, and simultaneously with insertion of an instrument such as an endoscope or continuously with insertion of an instrument such as an endoscope. There is no means to satisfy the two demands of performing treatment.
[0020]
SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and enables easy insertion of an endoscope, dilation treatment of a stenosis of a body lumen such as a digestive tract, and endoscopic examination of a stenosis. Provided is an endoscope attachment that facilitates insertion of a mirror and that can perform treatment operations such as biopsy, resection, puncture, and hemostasis simultaneously with or continuously with insertion of an endoscope. The purpose is.
[0021]
[Means for Solving the Problems]
The present invention relates to an endoscope insertion aid having a guide conduit through which an insertion portion of an endoscope is inserted, and a distal end portion having a substantially conical tapered shape. A slit is provided which can be opened and closed until the insertion portion is formed into a shape that can be inserted, and a reinforcing member made of hard metal or resin is provided along the slit.
[0022]
For example, the endoscope insertion aid of the present invention is made of a soft and transparent resin, has a hollow through which the endoscope can be inserted, has a shape that tapers smoothly in the distal direction, and has It is composed of a tube member provided with a slit that allows the endoscope to be inserted by pushing and expanding with an endoscope.
ADVANTAGE OF THE INVENTION According to the endoscope insertion assistance tool of this invention, while dilatation of a body lumen including a gastrointestinal tract can be performed by inserting into a stenosis part in a body cavity, immediately after the dilation procedure, it can be performed at a position beyond the stenosis part. Enables endoscopic observation and treatment.
[0023]
BEST MODE FOR CARRYING OUT THE INVENTION
<First example>
A first example of the endoscope insertion aid will be described with reference to FIGS.
[0024]
(Constitution)
In FIGS. 1A and 1B, reference numeral 1 denotes a transparent and soft resin-made substantially tube-shaped endoscope insertion aid. The inner diameter of the endoscope insertion aid 1 is larger than the maximum outer diameter of an insertion portion 5 of an endoscope to be inserted therein, which will be described later. The distal end portion 1a of the endoscope insertion aid 1 is formed in a tapered conical shape. The length of the insertion portion of the endoscope insertion aid 1 is substantially shorter than the effective length of the endoscope insertion portion and has a length sufficient to exceed the intended stenosis, for example, the length from the mouth to the gastric cardia. are doing. The endoscope insertion aid 1 communicates from the proximal side to the distal end by the inside thereof, and forms a guide channel 2 through which the insertion section 5 of the endoscope is inserted.
[0025]
A slit 3 is provided in the distal end portion 1a of the endoscope insertion aid 1 so as to reach the inside and outside of the endoscope insertion aid 1 along the longitudinal direction of the guide conduit 2. The slit 3 is usually closed. In addition, a treatment tool insertion pipe 4 that communicates the guide pipe 2 with the outside of the endoscope insertion aid 1 is provided at the forefront of the distal end portion 1a of the endoscope insertion aid 1.
[0026]
The tube material constituting the endoscope insertion aid 1 is a transparent and sufficiently flexible soft resin made of a material such as silicone rubber, polyurethane elastomer, vinyl chloride, or vinyl chloride vinyl acetate copolymer; When the endoscope insertion aid 1 is inserted into a stenosis, the endoscope has sufficient transparency to facilitate clear observation of the visual field by the endoscope.
[0027]
(Action)
Next, the operation of the endoscope insertion aid 1 of this embodiment will be described with reference to FIGS. FIG. 2 shows a state in which the insertion section 5 of the endoscope, which has been inserted through the guide conduit 2 of the endoscope insertion aid 1, expands the distal end slit 3 and projects outside the endoscope insertion aid 1. Is shown. FIGS. 3A and 3B show steps of actually inserting the endoscope insertion aid 1 into a body cavity.
[0028]
First, as shown in FIG. 3 (A), the insertion section 5 of the endoscope protrudes forward from the slit 3 at the distal end 1a of the endoscope insertion aid 1, and in this state, the insertion section 5 of the endoscope is inserted. Is inserted into the body cavity.
[0029]
In this example, the endoscope insertion assisting tool 1 is moved to the vicinity of the stopper 6 on the hand side of the insertion section 5 of the endoscope, so that the insertion section 5 of the endoscope is inserted at the time of insertion into the pharynx. The insertion operation can be performed while grasping. Further, when passing through the pharynx or the like, it is preferable to insert the endoscope into the body cavity while bending the insertion section 5.
[0030]
When the insertion section 5 of the endoscope has passed through the pharynx, the endoscope insertion aid 1 is moved to the distal end side of the insertion section 5 of the endoscope as shown in FIG. Is inserted into the endoscope insertion aid 1. In this state, the endoscope insertion aid 1 and the insertion section 5 of the endoscope are inserted to the vicinity of the affected part. Here, since the endoscope insertion aid 1 is formed of a transparent tube, the endoscope insertion aid 1 and the endoscope can be inserted while the lumen of the esophagus is visually observed.
[0031]
Subsequently, as shown in FIG. 4A, a guide wire 7 for guiding an instrument inserted through a channel in the endoscope is inserted from a position short of the stenosis 8 to a position beyond the stenosis 8.
[0032]
Then, as shown in FIG. 4B, the endoscope insertion assisting tool 1 is pushed in along the guide wire 7 while expanding the stenosis portion 8. At this time, since the insertion is performed while confirming the lumen surface of the stenosis part 8 with the endoscope through the endoscope insertion aid 1, the insertion operation is not forcibly performed, and the burden on the patient is reduced. Can be.
[0033]
As shown in FIG. 4 (B), when the distal end portion 1a of the endoscope insertion assisting tool 1 has passed the stenosis portion 8, as shown in FIG. While pushing the slit 3 open, the insertion section 5 of the endoscope is further advanced, and the distal end portion of the insertion section 5 of the endoscope is projected forward from the endoscope insertion aid 1.
[0034]
With the insertion section 5 of the endoscope protruding ahead of the distal end of the endoscope insertion aid 1 in this manner, endoscopic observation and live viewing of the diseased part 9 at a position beyond the stenosis part 8 are performed. A procedure such as a biopsy with the forceps 10 is performed.
[0035]
(effect)
According to the endoscope insertion aid 1 of this example, the stenosis 8 can be released under direct observation by the endoscope, and the stenosis 8 is released immediately after the stenosis 8 is released. Can be observed or treated endoscopically.
[0036]
<One embodiment of the present invention>
FIG. 5 shows an embodiment of the present invention. In the present embodiment, an endoscope having a diameter smaller than the outer diameter of the insertion portion 5 of the endoscope is provided in the grip portion 12 provided on the hand side of the endoscope insertion aid 11 as the first example described above. A valve member 14 having an insertion hole 13 and made of an elastic body such as rubber was provided. Further, a reinforcing member 16 made of a hard resin, metal, or the like is provided along a slit 15 provided in the distal end portion 11a of the endoscope insertion aid 11.
[0037]
The endoscope insertion assisting tool 11 of this configuration is provided with the grip portion 12 so that the operability such as pushing and pulling and twisting of the endoscope insertion assisting tool 11 is improved, and the endoscope insertion assisting tool 11 has the valve member 14. Thus, leakage of fluid to the outside is eliminated, and the body cavity such as the esophagus expanded by the insufflation from the endoscope does not collapse. Further, by providing the reinforcing member 16 along the slit 15, when the endoscope insertion aid 11 is pushed into the esophageal stenosis or the like, the distal end portion 11a is reliably expanded without being crushed by the hardness of the stenosis. It becomes possible.
[0038]
FIGS. 6A and 6B show another modification of the above embodiment. In this modification, a plurality of slits 18 are provided in the distal end portion 17a of the endoscope insertion aid 17. Here, two slits 18 are provided. Increasing the number of slits 18 makes it easier to pass the insertion portion of the endoscope through the distal end portion 17a.
[0039]
That is, according to the endoscope insertion auxiliary tool 17 of this modification, the endoscope can be protruded from the distal end of the endoscope insertion auxiliary tool 17 by expanding the slit 18 with a smaller pushing force.
[0040]
<Second example>
An endoscope insertion aid as a second example will be described with reference to FIG.
[0041]
(Constitution)
FIG. 7 is a longitudinal sectional view showing the distal end portion of the endoscope insertion aid 19 as the second example. The distal end portion 19a of the endoscope insertion aid 19 is provided with a slit 20 along the longitudinal direction. The slit 20 has a gap d substantially equal to the outer diameter of a treatment tool such as a guide wire. In addition, on the inner surface of the distal end side of the endoscope insertion assisting tool 19, the surface of the portion abutting on the distal end of the insertion portion 22 of the endoscope and the surface of the portion abutting on the outer periphery of the insertion portion 22 of the endoscope have smooth curved surfaces. It is formed by the protruding member 21 drawn.
[0042]
(Action)
When the endoscope insertion aid 19 of this example is used, as shown in FIG. 7B, the endoscope insertion portion 22 that has passed through the lumen of the endoscope insertion aid 19 is attached to the endoscope. When projecting from the distal end of the insertion aid 19, the projection member 21 contacts the distal end of the insertion portion 22 of the endoscope, and then contacts the outer periphery of the insertion portion 22 of the endoscope. The tip of 19 opens. When the insertion section 22 of the endoscope is advanced or retracted with respect to the endoscope insertion aid 19, the smooth surface of the projection member 21 comes into contact with the outer peripheral surface of the insertion section 22 of the endoscope and slides. The endoscope can be smoothly advanced and retracted without exerting an excessive force on the rubber member of the insertion portion 22, particularly the curved portion 23.
[0043]
In addition, an insertion aid such as a guide wire can be inserted through the gap d of the slit 20 to be used as an aid for insertion into a stenosis.
[0044]
(effect)
The endoscope can be easily advanced and retracted with respect to the endoscope insertion aid 19 without imposing an unreasonable burden on the insertion portion 22 of the endoscope, particularly the rubber member constituting the bending portion 23.
[0045]
<Third example>
With reference to FIG. 8, an endoscope insertion aid as a third example will be described.
[0046]
(Constitution)
FIG. 8 is a longitudinal sectional view showing a distal end portion of the endoscope insertion aid 24 as the third example. A slit 25 is provided in the distal end portion 24a of the endoscope insertion aid 24 along the longitudinal direction. The slit 25 forms a treatment tool insertion conduit 26 that communicates the inner hole of the endoscope insertion aid 24 with the outside. In addition, a protruding portion 27 which is in contact with the insertion portion 28 of the endoscope inside the slit 25 and is thick from the tip of the slit 25 to the proximal side thereof is formed.
[0047]
(Action)
As shown in FIG. 8 (B), when the insertion portion 28 of the endoscope is made to protrude forward from the endoscope insertion aid 24, the distal end portion of the projection member 27 contacts the insertion portion 28 of the endoscope. The distal end portion 24a is pushed outward, and the distal end portion 24a expands outward to a greater extent than the outer diameter of the insertion portion of the endoscope insertion aid 24.
[0048]
(effect)
The distal end portion 24a of the endoscope insertion assisting tool 24 is greatly opened outside the outer diameter of the insertion portion, thereby preventing the endoscope insertion assisting tool 24 from falling off.
[0049]
<Fourth example>
A fourth example of the endoscope insertion aid will be described with reference to FIG.
(Constitution)
The endoscope insertion assisting tool 29 of this embodiment has a slit 30 formed in the distal end portion 29a along the longitudinal direction, and a guide member having a treatment instrument insertion conduit 32 so as to protrude from the distal end of the distal end portion 29a. 31 were provided. The treatment instrument insertion conduit 32 of the guide member 31 communicates with the slit 30, and the guide wire 33 can be inserted from the slit 30 to the treatment instrument insertion conduit 32 of the guide member 31 as shown in FIG. It has become.
[0050]
Further, as shown in FIG. 9A, the guide member 31 is provided so as to protrude forward from the distal end of the distal end portion 29a of the endoscope insertion aid 29, as shown in FIG. 9B. It bends elastically and retreats laterally from the tip of the endoscope insertion aid 29, and can bend so as not to hinder the insertion portion 34 of the endoscope from projecting from the tip of the slit 30. Also, itself can be elastically bent. It is desirable that the guide member 31 has an outer diameter of 10 mm or less in order to ensure the insertability into the stenosis.
[0051]
(Action)
When the endoscope insertion assisting tool 29 is inserted through the stenotic portion 8, as shown in FIG. 9A, the guide member 32 is inserted through the stenotic portion 8 following the guide wire 33, and then the endoscope insertion assisting device is inserted. The distal end 29 a of the tool 29 is pushed into the stenosis 8. By providing the guide member 32 protruding forward of the distal end of the endoscope insertion assisting tool 29, the center position of the endoscope insertion assisting tool 29 is guided to the center of the stenosis 8 by the guide wire 33, The endoscope insertion aid 29 can be inserted into the stenosis 8 while pressing the distal end portion 29a of the endoscope insertion aid 29 against the site. Then, as shown in FIG. 9 (B), the insertion part 34 of the endoscope is made to protrude from the distal end of the endoscope insertion assisting tool 29 at the point of time when the stenosis 8 is exceeded.
[0052]
(effect)
According to this example, since the endoscope insertion assisting tool 29 can be inserted while the center position thereof is aligned with the center of the stenosis portion 8, the pushing force can be transmitted to the end of the endoscope insertion assisting tool 29 without waste. The insertability of the endoscope insertion aid 29 is improved.
[0053]
<Modification of the fourth example>
FIG. 10 shows a modification of the fourth example. In this modification, a hollow guide member 36 having a small diameter and a predetermined length, which protrudes forward, is provided continuously to the distal end portion 35a of the endoscope insertion aid 35. The guide member 36 is provided with a treatment instrument insertion conduit 37. In addition, a slit 38 is provided from the distal end 35 a of the endoscope insertion aid 35 to the distal end of the guide member 36.
[0054]
According to this modification, when projecting the insertion portion of the endoscope forward, both the distal end portion 35a of the endoscope insertion assisting tool 35 and the guide member 36 are separated by the slit 38 so as to spread, and the endoscope insertion assisting device is extended. It can protrude from the tip of the tool 35. The endoscope insertion aid 35 does not need to retract the guide member 36 to one side as in the fourth embodiment as one example of the first example, so that the guide member 36 can be used even in a narrow lumen. Does not become a hindrance, and the endoscope insertion aid 35 can be inserted smoothly.
[0055]
<Fifth example>
A fifth example of the endoscope insertion aid will be described with reference to FIG.
(Constitution)
The endoscope insertion aid of this embodiment includes an outer tube 39 and an inner tube 40, and a distal end portion 39a of the outer tube 39 is formed in a tapered conical shape. The distal end portion 39a is provided with a slit 41 extending in the longitudinal direction. The inner tube 40 is disposed in the inner space of the outer tube 39 and is able to move forward and backward, and has a guide channel 43 through which the insertion portion 42 of the endoscope is inserted.
[0056]
(Action)
When the endoscope insertion aid of this example is used, the inner tube 40 is advanced at a stage where the distal end portion 39a of the outer tube 39 has passed over a stenosis portion (not shown), and the distal end of the inner tube 40 is moved from the distal end of the outer tube 39 to the distal end. Then, the insertion section 42 of the endoscope is projected from the tip of the inner tube 41.
[0057]
(effect)
When projecting the insertion portion 42 of the endoscope from the endoscope insertion aid, first, the distal end portion 39a of the outer tube 39 of the endoscope insertion aid is expanded by the endoscope guide inner tube 40, and the inner tube is opened. Since the insertion portion 42 of the endoscope is made to protrude through the guide conduit 43 of 40, no load is applied to the endoscope.
[0058]
<Modification of Fifth Example>
FIG. 12 shows an endoscope insertion aid 44 as a modification of the above-described fifth example, and the endoscope insertion aid 44 has a slit 45 at a distal end portion 44a. On the wall of the endoscope insertion aid 44, two opening guides located on two planes perpendicular to the arrangement surface of the slits 45 and opposite to the center of the endoscope insertion aid 44. A conduit 46 is provided. Each opening guide channel 46 is provided with a substantially rod-shaped opening 47 made of hard metal or resin as a tip opening means so as to be able to move back and forth. Each opening tool guide channel 46 is disposed up to a tip end 44 a provided with a slit 45.
[0059]
When the endoscope insertion assisting tool 44 is used, after the distal end portion 44a of the endoscope insertion assisting tool 44 is inserted beyond the stenosis in the state shown in FIG. The guide tube 46 is inserted up to the distal end side. Then, as shown in FIG. 12 (B), the distal end portion 44a of the endoscope insertion auxiliary tool 44 is opened, and then the endoscope insertion portion 48 is projected from the opened end of the endoscope insertion auxiliary tool 44. Will be able to do that.
[0060]
By providing the end opening means in the endoscope insertion aid 44, the endoscope can be protruded and retracted from the endoscope insertion aid without placing a burden on the endoscope.
[0061]
<Sixth example>
A description will be given of an endoscope insertion aid as a sixth example with reference to FIG.
(Constitution)
The endoscope insertion assisting tool 49 of this example has a conical member 50a and a conical member 50b that are substantially conical when combined with each other, thereby forming a conical tip portion 49a having a tapered shape. The conical member 50a and the conical member 50b are formed of substantially hollow conical members whose bottom surface and thickness are substantially the same as the outer diameter and thickness of the endoscope insertion aid 49. The conical member 50a and the conical member 50b have a shape divided into two at the center position of the cone, and each is fixed to the distal end of the endoscope insertion assisting tool 49 so as to be rotatable about the link member 51. At the same time, the leaf spring member 52 normally keeps the conical members 50a and 50b closed.
[0062]
(Action)
When the insertion section 53 of the endoscope is advanced after the endoscope insertion assisting tool 49 has been inserted into the body beyond the stenosis (not shown), the distal end of the insertion section 53 is placed on the inner surfaces of the conical members 50a and 50b. Abut Thereafter, as shown in FIG. 13B, the conical members 50a and 50b are pushed open against the leaf spring member 52, as shown in FIG.
[0063]
Further, when the insertion portion 53 of the endoscope is retracted into the endoscope insertion assisting tool 49, the conical members 50a and 50b are re-established by the urging force of the leaf spring member 52 as shown in FIG. Closed.
[0064]
(effect)
Since the endoscope insertion assisting tool 49 of this embodiment closes the conical members 50a and 50b by the urging force of the leaf spring member 52, the endoscope insertion assisting tool 49 does not impose a large burden on the endoscope. The endoscope can be inserted and removed from the tip of the camera.
[0065]
<Modification of sixth example>
FIG. 14 shows a modification of the sixth example. The endoscope insertion aid 49 has an opening / closing member 54 provided in the inner space thereof, and the opening / closing member 54 is formed of a flexible contact coil or the like, and its tip is formed of a conical member 50a and a conical member 50b. It is connected to the pivot end. The proximal side of the opening / closing member 54 extends to the outside of the proximal side of the endoscope insertion aid (not shown).
[0066]
Then, by pushing out the opening / closing member 54, as shown in FIG. 14, the conical members 50a and 50b are pushed out, and the distal end portion 49a of the endoscope insertion assisting tool 44 is opened.
[0067]
Note that the present invention is not limited to the description of each example described above, but can be applied to other embodiments.
[0068]
[Appendix]
According to the above description, the following items and items obtained by arbitrarily combining the items listed below can be obtained.
[0069]
1. An endoscope insertion aid having a guide conduit for inserting the insertion portion of the endoscope and having a tip portion having a substantially conical tapered shape,
An endoscope insertion aid characterized in that it is openable and closable so that it can be deformed from a shape in which the distal end is closed to a shape in which an insertion portion of the endoscope can be inserted.
2. 2. The endoscope insertion aid according to claim 1, wherein the member of the endoscope insertion aid is made of a soft, transparent, or soft and transparent resin material.
3. It has means for changing the shape of the distal end of the endoscope insertion aid, and this means is provided at the tip of the endoscope insertion aid, and has a slit communicating the inside and the outside of the endoscope insertion aid. Item 2. The endoscope insertion aid according to Item 1, wherein the device has at least one.
[0070]
4. 4. The endoscope insertion aid according to claim 3, wherein the slit is provided along the longitudinal direction from the distal end portion to a portion having the maximum diameter of the endoscope insertion aid.
5. 2. The endoscope insertion aid according to claim 1, wherein the endoscope insertion aid has at least one or more treatment instrument insertion conduits penetrating from the inside to the outside at the distal end of the endoscope insertion aid.
6. An additional feature, wherein a grip portion is provided at a hand side of the endoscope insertion auxiliary tool and a valve member for keeping the inside of the endoscope insertion auxiliary tool airtight from the outside with the insertion of the endoscope is provided in the grip portion. 2. The endoscope insertion aid according to 1.
[0071]
8. 7. The endoscope insertion aid according to claim 6, wherein the valve member is made of an elastic member having a hole whose diameter is substantially smaller than the outer diameter of the insertion portion of the endoscope.
9. 2. The endoscope insertion aid according to claim 1, further comprising a reinforcing member made of a hard metal or resin provided along a slit provided at a distal end of the endoscope insertion aid.
10. In the distal end portion of the endoscope insertion assisting tool, an additional item characterized in that it has a projection member that draws a smooth curved surface and abuts on the insertion portion of the endoscope that has passed through the inside of the endoscope insertion assisting tool. 2. The endoscope insertion aid according to 1.
11. 2. The endoscope insertion aid according to claim 1, wherein the protrusion occupies almost half of the inner space of the endoscope insertion aid.
12. A distal end portion has a conical shape, has a slit communicating the inside and the outside of the endoscope insertion aid in a form that divides the cone, has a predetermined length from the distal end of the cone, and has a tube for inserting a treatment tool. 2. The endoscope insertion aid according to claim 1, further comprising a guide member having a path.
[0072]
13. A distal end portion having a conical shape and a slit having a slit communicating the inside and the outside of the endoscope insertion aid in a form of dividing the cone; and an inner tube of the outer tube that can move forward and backward and is substantially less than the outer tube. 2. The endoscope insertion aid according to claim 1, comprising an inner tube having a long guide tube for the endoscope.
[0073]
【The invention's effect】
As described above, according to the present invention, a stenosis in a body can be easily expanded, and endoscopic observation and treatment can be performed immediately after dilation of the stenosis.
[Brief description of the drawings]
FIG. 1A is a longitudinal sectional view of the vicinity of a distal end of an endoscope insertion aid as a first example, and FIG. 1B is a side view of the vicinity of the distal end of the endoscope insertion aid.
FIG. 2 is an explanatory view showing the vicinity of a distal end portion of the endoscope insertion aid as a first example in use.
FIG. 3 is an explanatory view showing a use state of the endoscope insertion aid as the first example.
FIG. 4 is an explanatory view showing a use state of the endoscope insertion aid as the first example.
FIG. 5 is an explanatory view of an endoscope insertion aid according to one embodiment of the present invention.
FIG. 6 is an explanatory view of a modification of the endoscope insertion aid according to one embodiment of the present invention.
FIG. 7A is a vertical cross-sectional view of the vicinity of the distal end of the endoscope insertion aid as a second example, and FIG. 7B is a side view of the use state near the distal end of the endoscope insertion aid. FIG.
FIG. 8A is a vertical cross-sectional view near the distal end of the endoscope insertion aid as a third example, and FIG. 8B is a side view of the use state near the distal end of the endoscope insertion aid as well. FIG.
FIG. 9 is an explanatory diagram of a use state of an endoscope insertion aid as a fourth example.
FIG. 10 is a longitudinal sectional view of the vicinity of the distal end of an endoscope insertion aid according to a modified example of the fourth example.
FIG. 11A is a longitudinal sectional view showing a vicinity of a distal end portion of an endoscope insertion assisting tool as a fifth example, and FIG. FIG.
FIG. 12A is a longitudinal sectional view of the vicinity of a distal end of a modification of the endoscope insertion assisting tool as a fifth example, and FIG. The side view of a use state.
FIG. 13A is a longitudinal sectional view showing a vicinity of a distal end of an endoscope insertion assisting device as a modification of the sixth example, and FIG. The side view of a state.
FIG. 14 is a side view of the use state of the vicinity of the distal end of the endoscope insertion aid as a modification of the sixth example.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Endoscope insertion assistance tool, 1a ... Tip part, 2 ... Guide channel
3 ... Slit, 5 ... Endoscope insertion part, 16 ... Reinforcing member.

Claims (1)

An endoscope insertion aid having a guide conduit for inserting the insertion portion of the endoscope and having a tip portion having a substantially conical tapered shape,
A slit that can be opened and closed until the insertion portion of the endoscope can be inserted from the state where the distal end is closed is provided, and a reinforcing member made of a hard metal or resin is provided along the slit. Endoscope insertion aid.

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