JP4504076B2 - Endoscope - Google Patents

Description

  The present invention relates to an endoscope having a bending portion that can be bent by remote operation at an insertion portion.

In recent years, endoscopes and other instruments have been inserted into the abdominal cavity and thoracic cavity through a trocar punctured in the abdominal wall without laparotomy, and surgery has been performed under observation with the endoscope. Endoscopes used in such operations have a rigid insertion section, but recently, a bending section provided with a bending section that can be bent by remote control from the proximal side on the distal end side of the rigid insertion section. An attached rigid endoscope has been used (see Patent Document 1).
JP 2001-37705 A

  When performing surgery while observing the abdominal cavity or chest cavity with an endoscope, the insertion portion of the endoscope is inserted into or removed from the trocar punctured into the body wall. However, when the insertion portion of the rigid endoscope with a bending portion is removed from the trocar, if the bending portion is removed from the trocar while the bending portion is bent, the tip edge of the trocar rubs against the covering member of the bending portion, and the covering member is removed. There is a risk of damaging and impairing durability. In particular, the leading edge of the trocar comes into strong contact with the covering member located in the vicinity of the distal end of the proximal bending piece on the proximal side of the bending portion. In addition, the tip edge of the trocar tends to come into strong contact with the portion of the covering member corresponding to the bending direction side, particularly the upper side (UP side) of the image in the direction of large bending, and the bending portion covering member in that portion is easily damaged.

  The present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to attach a bending portion with a small damage to the covering member of the bending portion even when the endoscope is inserted into or removed from the trocar. It is to provide an endoscope.

The invention according to claim 1, in an endoscope having an insertion portion to be inserted into a body cavity, and a curved portion bendable by remote control provided on the distal end side of the insertion portion, the curved portion, said It comprises a plurality of bending pieces arranged in order from the distal end side to the proximal side of the bending portion, and the outer diameter of the bending piece on the distal end side adjacent to the bending piece arranged closest to the proximal side among the bending pieces is larger than the outer diameter of the other bending pieces. The outer diameter of the portion of the bending portion corresponding to the bending piece on the tip side adjacent to the bending piece arranged closest to the proximal side among the bending pieces is set to It is characterized by being smaller than the outer diameter .

The invention according to claim 2, in an endoscope having an insertion portion to be inserted into a body cavity, and a curved portion bendable by remote control provided on the distal end side of the insertion portion, the curved portion, said A plurality of bending pieces arranged in order from the distal end side to the proximal side of the bending portion, and the outer diameters of the two bending pieces on the distal end side adjacent to the bending piece arranged closest to the proximal side among the bending pieces are outside of the other bending pieces. The outer diameter of the portion in the bending portion corresponding to the two bending pieces is set smaller than the outer diameter of the portion in the bending portion corresponding to the bending piece other than the two bending pieces. And

  According to the present invention, even if the insertion portion of the endoscope is inserted into or removed from the trocar while the bending portion is bent, the covering member of the bending portion is hardly damaged.

[First Embodiment]
An endoscope according to a first embodiment of the present invention will be described with reference to FIGS. 1, 2, and 5.

(Constitution)
FIG. 1 is an explanatory view showing an external structure of an endoscope according to the first embodiment, FIG. 2 is a longitudinal sectional view of an insertion portion in the endoscope, and FIG. 5 is a description of a use state of the endoscope. FIG.

  As shown in FIG. 1, the endoscope 1 according to the present embodiment also serves as an elongated insertion portion 2 that is inserted into a body cavity or the like and a gripping portion that is continuously provided on the proximal end side of the long insertion portion 2. A large-diameter operation unit 3 and a flexible universal cord 4 extending rearward from the operation unit 3 are provided. The insertion portion 2 includes a rigid distal end portion 5 having an objective optical system and the like, a bendable bending portion 6, and a rigid rigid tube portion 7 that are sequentially disposed from the distal end side. In addition, instead of the hard tube portion 7, a soft tube portion may be used.

  The operation portion 3 is provided with a bending lever 8 for remotely bending the bending portion 6. As will be described later, the universal cord 4 includes a light guide fiber for transmitting illumination light, a signal cable for transmitting various signals, and the like. A light guide connector 9 that can be connected to an external light source device is connected to the extended end of the universal cord 4. A video cable 10 is branched from the side of the light guide connector 9, and an extension terminal of the light guide connector 9 is electrically connected to a control device or a signal processor (not shown) such as a video processor. A connectable video connector 11 is connected.

  The internal structure of the insertion portion 2 in the endoscope 1 is configured as shown in FIG. That is, inside the insertion unit 2, a light guide fiber 12 that transmits illumination light supplied to the light source device, and a signal that supplies an electric signal obtained by photoelectrically converting an observation image by the imaging unit 13 to the video processor. A cable 14 and a plurality of bending operation wires 15 for bending the bending portion 6 are disposed. The distal end of the light guide fiber 12 is in contact with an illumination lens 17 provided on the distal end surface of the main body portion 16 of the distal end portion 5. The main body portion 16 is provided with an objective lens 18 at the forefront portion of the imaging unit 13 located near the illumination lens 17. A front end cover 19 is fitted and fixed to the outer periphery of the rear end side of the main body portion 16 of the front end portion 5.

  Further, as shown in FIG. 2, a bending tube 22 having a plurality of bending pieces 21 is provided in the bending portion 6 located on the rear end side of the tip portion 5. As the bending pieces 21, there are a first bending piece 21a, a second bending piece 21b, a third bending piece 21c, a fourth bending piece 21d, a fifth bending piece 21e, and a final bending piece 21f in order from the front end side, and are adjacent to each other. The bending pieces 21 are rotatably connected by a rivet 23. Here, the outer diameter of the final bending piece 21f is set larger than the outer diameters of the other bending pieces 21a to 21e. The first bending piece 21a positioned at the foremost end is fixed to the main body 16 of the distal end portion 5, and the final bending piece 21f positioned at the final end is connected to a rigid rigid tube portion 7 via a joint tube 31 described later. It is fixed to the tip of the.

  The first bending piece 21a of the bending tube 22 is brazed or soldered to the distal end portions of four bending operation wires 15 arranged at the top, bottom, left, and right, with one end fixed to a bending operation portion on the proximal side (not shown). The four fixing portions 25 to be fixed by the above are formed in the vertical and horizontal positions, respectively. By selectively pulling each of these bending operation wires 15, the bending portion 6 can be bent in a predetermined direction.

  Wire receivers 26 are provided on the inner peripheral portions of the bending pieces 21b, 21c, 21d, 21e, and 21f of the bending tube 22 so as to pass the bending operation wires 15 and regulate the position of the bending operation wires 15. . Each wire receiver 26 is fixed to the inner surface of the bending pieces 21b, 21c, 21d, 21e, 21f by brazing or soldering.

  The outside of the bending tube 22 is covered with, for example, a knitted tube (blade) 27 formed by braiding a metal strand or a resin strand into a tubular shape. Both edge portions of the knitted tube 27 are fixed to the most advanced bending piece 21a and the joint tube 31 or the last bending piece 21f by soldering or bonding. The outside of the knitted tube 27 is covered with a curved portion covering member 29 made of, for example, rubber or elastomer.

  As shown in FIG. 2, a joint pipe 31 is provided at the rear end of the bending section 6, and the proximal end of the bending section 6 is the distal end of the rigid pipe section 7 using the joint pipe 31. It is fixed to the part. The bending operation wire 15 is inserted into the inner surface of the joint pipe 31, and the tip of the coil 32 that guides the bending operation wire 15 is fixed by brazing or soldering.

(Function)
Next, an example of using this endoscope 1 will be described. First, as shown in FIG. 5, the insertion portion 2 of the endoscope 1 is inserted into or removed from the body cavity through the trocar 35 punctured in the body wall.

  In general, when the insertion portion 2 of the endoscope 1 is to be removed from the trocar 35 in a state where the bending operation is performed, if the bending portion 6 is bent, the bending portion of the bending portion 6 is connected to the distal end portion 35a of the trocar 35. The covering member 29 is easy to contact. In particular, the distal end portion 35a of the trocar 35 easily comes into contact with the portion of the bending portion covering member 29 of the bending portion 6 located near the distal end side of the final bending piece 21f or in the bending direction and the upper side (UP side) of the image. This is because, when the insertion portion 2 of the endoscope 1 moves in the trocar 35 and the bending portion 6 is bent, the outer peripheral surface of the bending portion covering member 29 comes close to the shoulder at the distal end portion 35 a of the trocar 35. Because. As a result, when the insertion portion 2 of the endoscope 1 is inserted and removed, the outer peripheral surface of the bending portion covering member 29 is rubbed by the vicinity of the shoulder opening at the distal end portion 35a of the trocar 35.

  However, in the present embodiment, since the outer diameter of the final bending piece 21f is larger than the outer diameters of the other bending pieces 21a to 21e, the outer diameter of the portion corresponding to the final bending piece 21f is other than that. Bigger than the part. Therefore, the portion corresponding to the final bending piece 21f inserted into the trocar 35 is guided so as to be positioned at the center of the inner hole of the trocar 35, and the bending portion on the front side of the portion corresponding to the final bending piece 21f. The covering member 29 is difficult to hit. That is, a portion in front of the portion of the bending portion covering member 29 located in the vicinity of the distal end side of the final bending piece 21f is unlikely to contact the distal end portion 35a of the trocar 35.

(effect)
According to this embodiment, since the outer diameter of the final bending piece 21f is larger than the outer diameters of the other bending pieces 21a to 21e, the outer diameter of the portion of the bending portion 6 corresponding to the final bending piece 21f is also the same. It becomes larger than the part located near the tip side. The portion of the bending portion 6 corresponding to the final bending piece 21f is positioned at the center of the trocar 35, and the distal end portion 35a of the trocar 35 is difficult to contact the bending portion covering member 29 located near the distal end side of the final bending piece 21f. Therefore, the tip portion 35a of the trocar 35 contacts the bending portion covering member 29 and does not cause damage.

[Modification of First Embodiment]
Various modifications of the first embodiment described above will be given. 3 and 4 are longitudinal sectional views of the insertion portion showing different modifications.

  In the modification shown in FIG. 3, except for the final bending piece 21f, the outer diameters of all the other bending pieces 21 are formed to be equal, and from the fourth bending piece 21d to the fifth bending piece 21e and the final bending piece 21f. The thickness A of the portion of the bending portion covering member 29 that is externally mounted on these portions is greater than the thickness B of the portion of the bending portion covering member 29 that is covered by the portions of the other bending pieces 21a, 21b, and 21c. The outer diameter of the portion is increased to be thicker. The outer diameter of the final bending piece 21f may be formed in the same manner as the outer diameters of the other bending pieces 21.

  In the modification shown in FIG. 3, as in the case of the first embodiment described above, the outer diameter near the distal end side of the final bending piece 21f where the distal end portion 35a of the trocar 35 is easy to come into contact is particularly distal. Since the wall thickness A of the curved covering member 29 is set to be larger than the wall thickness B by the same positioning regulating action as described above, the outer diameter of the trocar 35 is brought into contact with the tip 35a. The strength against this is increased, and damage to the bending portion covering member 29 when the insertion portion 2 is inserted into and removed from the trocar 35 can be avoided.

  In the modification shown in FIG. 4, in the configuration of the bending portion 6 of the first embodiment described above, the thickness C of only the portion located in the bending direction of the bending portion covering member 29 and particularly on the upper side (UP side) of the image. Formed larger than the wall thickness D of the other part. In the modified example shown in FIG. 4, the bending direction of the bending portion covering member 29 where the tip portion 35a of the trocar 35 is easy to contact and the thickness of the portion located above the image are set large. Due to the positioning restriction action, the strength against the bending direction and the portion of the bending portion covering member 29 located on the upper side of the image coming into contact with the distal end portion 35a of the trocar 35 is increased. It is hard to receive damage.

  In the modification shown in FIGS. 3 and 4, for example, a metal blade, a metal plate, a resin blade, or a resin member may be formed on a portion of the bending portion covering member 29 that is thicker than other portions. The fiber blade may be enclosed. Moreover, you may form the hardness of the part which made thickness thicker than the other part of the curved part coating | coated member 29 higher (harder) than the hardness of another part. By doing so, the strength against the contact of the tip 35a of the trocar 35 is further increased, and the bending portion covering member 29 is not easily broken.

  Further, in the configuration of the first embodiment or the modification thereof, a plurality of convex portions are partially provided on the outer peripheral surface of the final bending piece 21f in the bending portion 6, and the outer diameter of the portion is the other bending piece 21a. It may be made larger than the outer diameter of ˜21e. Also in this case, it can be seen that the outer diameter of the final portion of the bending portion 6 corresponding to the final bending piece 21f is larger than the outer diameter of other portions. As a method for forming the convex portion in this case, for example, a convex member may be fixed on the outer peripheral surface of the bending piece 21f, or the convex portion may be formed by partially deforming the member of the bending piece 21f. You may make it form. Desirably, at least three protrusions may be provided on the outer peripheral surface of the bending piece 21f at equal intervals in the circumferential direction.

  In addition, each of the bending tubes 22 of the above-described form is an example in which the bending pieces 21 are connected by the rivets 23. For example, the front end portion and the rear end portion of the adjacent bending pieces 21 without the rivets 23 being provided. A configuration in which the adjacent bending pieces 21 are rotatably connected to each other by contacting each other, or a configuration in which a plurality of slits are inserted in at least one elongated tubular member so that the tubular member can be bent. It may be.

[Second Embodiment]
An endoscope according to a second embodiment of the present invention will be described with reference to FIG.

(Constitution)
FIG. 6 is a longitudinal sectional view of the insertion portion in the endoscope according to the present embodiment. In the present embodiment, in addition to the same configuration as the first embodiment described above, the configuration described below is different.

  That is, as shown in FIG. 6, the bending tube 22 in the bending portion 6 includes the first bending piece 41a, the second bending piece 41b, the third bending piece 41c, the fourth bending piece 41d, and the fifth arranged in order from the distal end side. A bending piece 41e and a final bending piece 41f are provided, and each bending piece 41 is sequentially connected by a rivet 23 so as to be freely rotatable.

  The outer diameter of the fifth bending piece 41e adjacent to the final bending piece 41f is set smaller than the outer diameter of the other bending pieces 41. Here, not only the fifth bending piece 41e but also the outer diameter of the fourth bending piece 41d located on the distal end side thereof is set smaller than the outer diameters of the other bending pieces 41. In addition, you may make it set the outer diameter of the other bending piece 41 located in an intermediate part small.

(Function)
In the case of this embodiment, the same operation as that of the first embodiment described above can be obtained. That is, since at least the outer diameter of the fifth bending piece 41e is smaller than the outer diameter of the other bending piece 41, the distal end portion 35a of the trocar 35 is attached to the bending portion covering member 29 located near the distal end side of the final bending piece 41f. Since it is difficult to contact, it is difficult to damage the bending portion covering member 29. In addition, the outer diameter of the final bending piece 41f can be configured as the same part as the outer diameter of the other main bending pieces 41.

(effect)
According to the present embodiment, in addition to the same effects as in the first embodiment, the outer diameter of the final bending piece 41f can be made the same as the outer diameter of the other bending pieces 41, so the outer diameter of the intermediate portion of the insertion portion 2 can be reduced. it can.

[Third Embodiment]
Various modified examples of the external sheath used by being attached to the endoscope will be described with reference to FIGS. 7 to 9 are external views showing different external sheaths.

(Constitution)
The external sheath of the present embodiment is intended to be fitted to an insertion portion in an endoscope including the endoscope as described above, and to protect the bending portion of the insertion portion.

  An example of the external sheath 50 shown in FIG. 7 is provided on a distal end frame 51 made of a cylindrical member and on the rear end side of the distal end frame 51, and the internal sheath 50 is attached to the insertion portion 2 of the endoscope 1. A flexible soft member 52 located at the curved portion 6 of the mirror 1, an insertion pipe 53 made of a tubular member provided on the rear end side of the soft member 52, and a rear end side of the insertion pipe 53. And a main body 54.

The flexible member 52 of the external sheath 50 is formed by, for example, stacking a plurality of resin sheets, forming a sheet including a metal blade, or forming a sheet including a resin blade. And formed by a sheet in which a fiber blade is enclosed.
The main body 54 is formed with a groove 55 that engages with the operation unit 3 of the endoscope 1 when the main body 54 is attached to the insertion unit 2 of the endoscope 1.

  In the external sheath 60 of the example shown in FIG. 8, the flexible member 52 is formed of, for example, a metal knitted tube, a resin knitted tube, or a fiber knitted tube. The other structure is the same as that of the external sheath 50 shown in FIG.

  The outer sheath 70 of the example shown in FIG. 9 is formed of a tubular member whose flexible member 52 is, for example, substantially cylindrical and has a plurality of notches 71 penetrating the outer peripheral surface and the inner peripheral surface. This tubular member is made of, for example, a resin or metal member. The other structure is the same as that of the external sheath 50 shown in FIG. The provision of the plurality of notches 71 increases flexibility.

  These external sheaths 50, 60 and 70 are detachably attached to the insertion portion 2 of the endoscope 1.

(Action / Effect)
When the endoscope 1 is used, any one of the external sheaths 50, 60, and 70 is selected and inserted into the insertion portion 2 of the endoscope 1 and attached. Since the portion of the flexible member 52 of the external sheath 50, 60, 70 is located in the bending portion 6 of the endoscope 1, when inserted into the trocar 35, the distal end portion 35 a of the trocar 35 is the bending portion of the endoscope 1. It is possible to avoid damaging the curved portion covering member 29 without directly contacting the portion of the covering member 29.

  The present invention is not limited to the embodiment described above, and can be applied to other forms. Further, according to the above description, the invention of the following items or a combination of these items can be obtained.

<Appendix>
1. In an endoscope having an elongated insertion portion that is inserted into a body cavity, and a bending portion that can be bent by remote operation provided on the distal end side of the insertion portion,
The bending portion includes a plurality of bending pieces made of an annular member, and an outer diameter of the bending piece arranged closest to the proximal side among the bending pieces is larger than an outer diameter of another bending piece arranged on the distal end side of the bending piece. Endoscope characterized by.
2. In an endoscope having an elongated insertion portion that is inserted into a body cavity, and a bending portion that can be bent by remote operation provided on the distal end side of the insertion portion,
The bending portion includes a plurality of bending pieces made of an annular member, and the outer diameter of the bending piece arranged on the distal end side of the last bending piece arranged closest to the proximal side among the bending pieces is smaller than the outer diameter of the other bending pieces. Endoscope characterized by.
3. In an endoscope having an elongated insertion portion that is inserted into a body cavity, and a bending portion that can be bent by remote operation provided on the distal end side of the insertion portion,
The bending portion includes a plurality of bending pieces made of an annular member, and
The final bending piece arranged on the most proximal side among the bending pieces,
A second bending piece disposed on the distal end side of the final bending piece, and a third bending piece disposed on the distal end side of the second bending piece,
An endoscope characterized in that the outer diameters of the second bending piece and the third bending piece are smaller than the outer diameters of the other bending pieces.
4). 4. The endoscope according to claim 1, 2 or 3, wherein a portion other than the bending portion of the insertion portion is rigid.

5). An external sheath is sheathed on the insertion portion of the endoscope, and at least a portion of the external sheath that is sheathed on the curved portion of the endoscope is formed by overlapping a plurality of resin sheets.
6). In the external sheath sheathed on the insertion portion of the endoscope, at least a portion sheathed on the curved portion of the endoscope of the external sheath is formed by encapsulating a metal mesh tube in a resin sheet.
7). In the external sheath sheathed on the insertion portion of the endoscope, at least a portion sheathed on the curved portion of the endoscope of the external sheath is formed by encapsulating a resin mesh tube in a resin sheet.
8). In the external sheath sheathed on the insertion portion of the endoscope, at least a portion sheathed on the curved portion of the endoscope of the external sheath is formed by encapsulating a fiber mesh tube in a resin sheet.
9. An external sheath sheathed on an insertion portion of an endoscope, wherein at least a portion sheathed on a curved portion of the endoscope of the external sheath is formed of a metal mesh tube.
10. In the external sheath sheathed on the insertion portion of the endoscope, at least a portion sheathed on the curved portion of the endoscope of the external sheath is formed of a resin mesh tube.
11. An external sheath sheathed on an insertion portion of an endoscope, wherein at least a portion sheathed on a curved portion of the endoscope of the external sheath is formed of a fiber mesh tube.
12 In the external sheath that is externally mounted on the insertion portion of the endoscope, at least one cutout portion that is substantially cylindrical and penetrates the outer peripheral surface and the inner peripheral surface at least a portion of the external sheath that is externally mounted on the curved portion of the endoscope Formed of a resin member having

13. An endoscope having a bending portion that can be bent by remote operation on the distal end side of an elongated insertion portion to be inserted into a body cavity;
An external sheath that is detachably attached to the endoscope and has a configuration in which at least a portion exteriored to the bending portion can be bent;
A trocar capable of inserting and removing the insertion portion of the endoscope,
An endoscope system, wherein the external sheath is attached to the endoscope when the endoscope is inserted into the trocar and used.

It is explanatory drawing which shows the external appearance structure of the endoscope which concerns on 1st Embodiment of this invention. It is a longitudinal section of an insertion part in an endoscope concerning a 1st embodiment of the present invention similarly. It is a longitudinal cross-sectional view of the insertion part in the endoscope which concerns on the modification of the said 1st Embodiment. It is a longitudinal cross-sectional view of the insertion part in the endoscope which concerns on the other modification of the said 1st Embodiment. It is explanatory drawing which shows the use condition of the endoscope which concerns on 1st Embodiment of this invention. It is a longitudinal cross-sectional view of the insertion part in the endoscope which concerns on 2nd Embodiment of this invention. It is an external view which shows the external sheath used for an endoscope. It is an external view which shows the other external sheath used for an endoscope. It is an external view which shows the other external sheath used for an endoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Insertion part, 3 ... Operation part, 5 ... Tip part, 6 ... Bending part, 7 ... Hard tube part 15 ... Bending operation wire, 16 ... Main part, 21 ... Bending piece, 22 ... Bending Tube 27 ... Braided tube 29 ... Cover member 35 ... Trocker.

Claims (2)

In an endoscope having an insertion portion to be inserted into a body cavity and a bending portion that can be bent by remote operation provided on the distal end side of the insertion portion,
The bending portion includes a plurality of bending pieces arranged in order from the distal end side to the proximal side of the bending portion, and the outer diameter of the bending piece on the distal end side adjacent to the bending piece disposed closest to the proximal side among the bending pieces is different. The outer diameter of the bending portion corresponding to the bending piece on the tip side adjacent to the bending piece arranged closest to the proximal side among the above bending pieces is set to be smaller than the outer diameter of the bending piece. An endoscope characterized in that it is smaller than the outer diameter of the portion in the bending portion. In an endoscope having an insertion portion to be inserted into a body cavity and a bending portion that can be bent by remote operation provided on the distal end side of the insertion portion,
The bending portion includes a plurality of bending pieces arranged in order from the distal end side to the proximal side of the bending portion, and outer diameters of two bending pieces on the distal end side adjacent to the bending piece arranged closest to the proximal side among the bending pieces. Is set to be smaller than the outer diameters of the other bending pieces, and the outer diameter of the portion of the bending portion corresponding to the two bending pieces is larger than the outer diameter of the portion of the bending portion corresponding to the bending piece other than the two bending pieces. An endoscope that is characterized by its small size.

Images