JP4611542B2 - Duodenoscope - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a duodenoscope that is inserted from the mouth into the duodenum via the stomach.
[0002]
[Prior art]
An important role of the duodenoscope is to insert various treatment tools such as a contrast tube into the pancreaticobiliary duct that opens to the duodenum and perform various treatments for gallstones and the like without laparotomy.
[0003]
The duodenoscope used for this purpose is not special compared to a general endoscope, and a bending portion that is bent by a remote operation from the hand side is provided at the distal end portion of the insertion portion flexible tube.
[0004]
And the front-end | tip part main body by which the observation window and the treatment tool protrusion port are arrange | positioned at the side surface is connected with the front-end | tip of a bending part, and the observation optical axis which goes outside from an observation window is facing the upper direction in the bending direction of a bending part. .
[0005]
[Problems to be solved by the invention]
One problem when the duodenoscope is used is that, as shown in FIG. 7, the Farther's papilla 101 with the pancreaticobiliary outlet opening to the duodenum 100 is viewed from the proximal side. That is, it only enters the vicinity of the right end of the observation field A obtained from the observation window 12.
[0006]
This is a restriction that arises from the anatomical shape of the lumen from the mouth where the endoscope is inserted through the stomach to the duodenum. There are many cases where it is difficult to perform smoothly.
[0007]
SUMMARY OF THE INVENTION An object of the present invention is to provide a duodenoscope that can easily and easily perform diagnosis and treatment by looking directly at Mr. Vater's papilla.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the duodenoscope of the present invention is provided with a bending portion that is bent by a remote operation from the hand side at the distal end portion of the insertion portion flexible tube, and has an observation window and a treatment instrument protrusion on the side surface. In the duodenoscope in which the distal end body where the bending portion is arranged is connected to the distal end of the bending portion, the observation optical axis directed outward from the observation window when viewed from the hand side is directed upward in the bending direction of the bending portion. It is tilted clockwise.
[0009]
Note that the observation optical axis is preferably inclined by 10 ° to 45 ° with respect to the upward direction in the bending direction of the bending portion.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 3 shows the overall structure of the duodenoscope, and the distal end body 11 in which the bending portion 3 is connected to the distal end of the insertion portion flexible tube 2 connected to the operation portion 1 and an observation window is arranged. Is connected to the tip of the bending portion 3.
[0011]
In the upper half of the operation unit 1, a bending operation knob 5 (5UD, 5RL) for bending the operation wire 4 in an arbitrary direction by an arbitrary angle by remote control is disposed on a side surface, and an air / water supply operation button 6 is provided. And a suction operation button 7 are arranged on the front surface. Further, an inlet 8 of the treatment instrument insertion channel is provided at the lower end portion of the operation unit 1 so as to project obliquely upward.
[0012]
The vertical bending operation knob 5UD includes base ends of an upward operation wire 4U and a downward operation wire 4D, the distal ends of which are connected to the distal end portion of the bending portion 3 so as to bend the bending portion 3 in the vertical direction. Are connected, and the bending portion 3 can be bent at any angle in the vertical direction by rotating the vertical bending operation knob 5UD.
[0013]
Note that the "up" in the bending direction of the bending portion 3 is the "UP" direction shown by the arrows in FIG. 3, a direction corresponding to the front side of the operating portion 1.
[0014]
The left and right direction bending operation knob 5RL disposed so as to overlap the up and down direction bending operation knob 5UD has a left direction operation wire having a distal end coupled to the distal end portion of the bending portion 3 so as to bend the bending portion 3 in the left and right directions. 4L and the proximal end of the right operation wire 4R (shown in FIG. 6) are connected, and the bending portion 3 can be bent at any angle in the left and right directions by rotating the left and right bending operation knob 5RL. Can be made.
[0015]
FIG. 4 is a side cross-sectional view of the distal end portion of the bending portion 3 and the distal end portion main body 11. However, although the bending section 3 is shown in a vertical section, the tip body 11 is shown in a section including the observation optical axis X.
[0016]
The tip portion main body 11 is formed in a shape obtained by scraping one side of a round bar-like material into a flat shape, and an observation window 12 and an illumination window 13 are arranged side by side on the flat portion 11a, and the tip is smooth. It is rounded.
[0017]
An exit end face of the illumination light guide fiber bundle 17 is disposed inside the illumination window 13, and the subject is illuminated by illumination light radiated outward from the illumination window 13.
[0018]
The observation optical axis X directed outward from the observation window 12 is oriented in a direction perpendicular to the observation window 12, and the observation light image of the subject incident from the observation window 12 is bent at a right angle by the right-angle roof prism 14. The objective lens 15 forms an image on the incident end face of the image guide fiber bundle 16.
[0019]
The bending portion 3 is a known one configured by rotatably connecting a plurality of node rings 31 with rivets or the like, and is pulled from the operation portion 1 side among the four operation wires 4U, 4D, 4L, and 4R. Bends in the direction in which the manipulated wire is positioned.
[0020]
FIG. 5 shows a state in which the flat portion 11a on which the observation window 12 and the illumination window 13 are arranged is viewed from the front, and the treatment instrument protrusion 21 which is an outlet opening of the treatment instrument insertion channel is formed by the observation window 12 and the illumination window. 13, a treatment instrument raising piece 22 for controlling the protruding direction of the treatment instrument is arranged in the treatment instrument protrusion 21.
[0021]
FIG. 6 is a perspective view of the vicinity of the connecting portion between the bending portion 3 and the distal end portion main body 11 as seen from the hand side (that is, the operation portion 1 side), and the operation wires 4U, 4D, 4L, The relationship between the attachment position of the tip of 4R and the observation optical axis X is shown.
[0022]
As shown in FIG. 6, the tip of the upward operation wire 4U is connected and fixed to the upward UP position of the bending portion 3, and the upward operation wire 4U is bent by being pulled from the operation portion 1 side. Part 3 bends upward in the upward direction.
[0023]
On the other hand, the observation optical axis X perpendicular to the observation window 12 is inclined clockwise by an angle θ when viewed from the hand side with respect to the upward direction UP. (The flat portion 11a of the distal end portion main body 11 on which the observation window 12 is disposed is formed in such an orientation).
In addition, (theta) exists in the range of about 10 degrees-45 degrees.
[0024]
FIG. 1 shows a state in which the bending portion 3 of the duodenoscope configured as described above is bent in the upward direction UP, and the observation optical axis X is clockwise when viewed from the hand side with respect to the upward direction UP. Tilt in the direction. The alternate long and short dash line indicates the upward direction from the insertion portion flexible tube 2 to the bending portion 3.
[0025]
When the duodenoscope thus configured is inserted from the patient's mouth through the stomach and into the duodenum, as shown in FIG. 2, the curved portion 3 located in the duodenum 100 due to their anatomical shape. Upward UP is deviated to the left of Mr. Pharter's nipple 101, but since the observation optical axis X is directed toward Mr. Pharter's nipple 101, the Mr. Pharter's nipple 101 can be observed near the central position of the observation range A. .
[0026]
【The invention's effect】
According to the present invention, as viewed from the hand side, the observation optical axis directed outward from the observation window is inclined clockwise with respect to the upward direction in the bending direction of the bending portion. When inserted into the duodenum via the stomach, the observation optical axis is directed toward the Mr. Pharter's nipple, so that the diagnosis and treatment can be performed smoothly and easily by looking directly at the Mr. Pharter's nipple.
[Brief description of the drawings]
FIG. 1 is a perspective view of a state in which a curved portion of a duodenoscope according to an embodiment of the present invention is bent upward.
FIG. 2 is a schematic view of a state in which a section perpendicular to the axis is viewed from the hand side in a state where the duodenoscope according to the embodiment of the present invention is inserted into the duodenum.
FIG. 3 is an external view showing an overall configuration of a duodenoscope according to an embodiment of the present invention.
FIG. 4 is a side composite sectional view of a distal end portion of a duodenoscope according to an embodiment of the present invention.
FIG. 5 is an external view of a state in which a planar portion on which an observation window and an illumination window are arranged at the distal end of a duodenoscope according to an embodiment of the present invention is viewed from the front.
FIG. 6 is a perspective view of the vicinity of the connection portion between the bending portion and the distal end portion main body of the duodenoscope according to the embodiment of the present invention when viewed from the hand side.
FIG. 7 is a schematic view of a state where a cross section perpendicular to the axis is viewed from the hand side in a state where a conventional duodenoscope is inserted into the duodenum.
[Explanation of symbols]
3 bending portion 4U upward operation wire 5UD up / down bending operation knob 11 tip body 12 observation window A observation range X observation optical axis UP upward

Claims (2)

A bending portion that is bent by a remote operation from an operation portion provided on the proximal side is provided at the distal end portion of the insertion portion flexible tube, and the distal end portion body in which an observation window and a treatment instrument protruding port are disposed on the side surface is the bending portion. In the duodenoscope connected to the tip of
When viewed from the proximal side, the observation optical axis toward the side of the tip body from the observation window, tilt memorial clockwise relative to the upper direction in the bending direction of the curved portion, leading-edge of the curved portion A duodenal endoscope characterized in that the portion and the tip body are connected in a state where the upward direction and the direction of the observation optical axis are relatively twisted . The duodenal endoscope according to claim 1, wherein the observation optical axis is inclined by 10 ° to 45 ° with respect to an upward direction in a bending direction of the bending portion.

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