JP4772362B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscope apparatus having a treatment tool raising base that raises a protruding direction of a treatment tool protruded from an endoscope under observation by an endoscope.

  In recent years, various therapeutic treatments have been performed using a treatment instrument inserted into a treatment instrument insertion conduit provided in the insertion section by observing an organ in the body cavity by inserting an elongated insertion section into the body cavity. Endoscopic devices are widely used.

  An endoscope apparatus having a treatment instrument insertion conduit has an illumination window and an observation window for optically observing an organ in a body cavity at the distal end portion of the insertion portion, and is provided with an ultrasonic transmission / reception unit. A therapeutic treatment with a treatment tool is performed by observation and ultrasonic tomographic images.

  The treatment instrument inserted into the treatment instrument insertion conduit of the endoscope apparatus needs to protrude from the distal end of the insertion part to the affected part in the organ where the therapeutic treatment is accurately performed based on the optical observation and the ultrasonic tomographic image. is there. In order to project the treatment tool to the affected part in the organ, a treatment tool raising base for adjusting the protruding direction of the treatment tool is provided at the distal end portion of the insertion portion.

  For example, Patent Document 1 proposes an ultrasonic endoscope diagnostic apparatus having a treatment instrument raising base at a distal end portion of an insertion portion. An outline of the electronic scanning ultrasonic endoscope diagnosis apparatus proposed in Patent Document 1 will be described with reference to FIGS.

  As shown in FIG. 8, an electronic scanning ultrasonic endoscope diagnostic apparatus 1 includes an electronic scanning ultrasonic endoscope (hereinafter simply referred to as ultrasonic endoscope) having an electronic scanning ultrasonic transmission / reception unit at the distal end of an insertion unit. (Referred to as a mirror) 2, a light source device 3 for supplying illumination light for illuminating the observation site to the illumination optical system of the ultrasonic endoscope 2, a drive signal for generating an ultrasonic wave, and a received reflected ultrasonic signal An ultrasonic observation apparatus 4 that performs predetermined signal processing, and a monitor (not shown) that is connected to the ultrasonic observation apparatus 4 and displays an ultrasonic tomographic image are mainly configured.

  The ultrasonic endoscope 2 includes an elongated insertion portion 2a that is inserted into a body cavity, an operation portion 2b that is positioned at the rear end of the insertion portion 2a, and an eyepiece portion 2c that is provided at the proximal end of the operation portion 2b. The universal cord 5 extends from the side of the operation unit 2b.

  An endoscope connector 6 connected to the light source device 3 is provided at the distal end of the universal cord 5, and an ultrasonic connector 8 for connecting to the ultrasonic observation device 4 is provided from the side of the endoscope connector 6. An ultrasonic cable 7 is extended.

  The insertion portion 2a of the ultrasonic endoscope 2 includes a distal end hard portion 9 formed of a hard resin member in order from the distal end side, a bendable bending portion 10 located at the rear end of the distal end hard portion 9, and a bending portion 10. A flexible portion 11 having a small and long diameter and being located at the rear end and reaching the tip of the operation portion 2b is continuously provided. An ultrasonic transducer portion 20 is connected and fixed to the distal end of the distal end hard portion 9 of the insertion portion 2a.

  A bending knob 12 for bending the bending portion 10 in the vertical and horizontal directions, an air / water supply button 13 for performing air supply and water supply operations, a suction button 14 for performing suction operations, and a treatment tool are inserted into the operation unit 2b. A treatment instrument raising lever 16 for operating a treatment instrument raising base (described later) provided in the treatment instrument insertion port 15 and the distal end hard portion 9 is provided.

  The bending knob 12 is connected to a proximal end of a bending wire which is built in the flexible portion 11 of the insertion portion 2 a from the operation portion 2 b and has a distal end connected to the bending portion 10. The air supply / water supply button 13 operates an air supply / water supply pump for supplying air / water to the air supply / water supply tube provided in the endoscope connector 6, the universal cord 5, the operation portion 2b, and the insertion portion 2a. To do. The proximal end of the air / water supply tube is connected to an air / water pump provided in the light source device 3 by the endoscope connector 6. The suction button 14 operates a suction pump that performs a suction operation in the body cavity via a treatment instrument insertion conduit provided in the insertion portion 2a. The treatment instrument insertion conduit is connected to the suction pump provided in the light source device 3 through the universal cord 5 and the suction tube provided in the endoscope connector 6 from the operation unit 2b. The treatment instrument raising lever 16 is connected to a proximal end of a raising wire having a distal end connected to a treatment instrument raising base built in the insertion portion 2a and provided in the distal end hard portion 9 from the operation portion 2b.

  Next, the configuration of the distal end hard portion 9 and the ultrasonic transducer portion 20 of the insertion portion 2a will be described with reference to FIG. A treatment instrument 42 indicated by a one-dot chain line in the figure is connected to the treatment instrument insertion port 15 on the distal end surface 9a of the distal rigid portion 9 and is inserted through the treatment instrument insertion conduit provided in the operation section 2b and the insertion section 2a. A treatment instrument raising base 25 for raising the treatment instrument projecting opening 9b, the illumination window 23, the observation window 24, the air / water supply nozzle 26, and the treatment instrument 42 protruding from the treatment instrument protruding opening 9b. Etc. Further, the distal end rigid portion 9 is provided with an ultrasonic transducer unit 20, and the ultrasonic transducer unit 20 is provided with an ultrasonic transducer 20 a composed of a plurality of transducer arrays that are electronically scanned.

  The relationship between the treatment instrument protrusion opening 9b provided in the distal end rigid portion 9 and the treatment instrument raising base 25 will be described with reference to FIGS. 10 is a longitudinal sectional view showing the relationship between the treatment instrument protruding opening 9b provided in the distal end hard portion 9 and the treatment instrument raising base 28, and FIG. 11 shows the treatment instrument raising base 25 provided in the distal end hard portion 9. It is a longitudinal cross-sectional view which shows the relationship of the raising wire 27. FIG.

  As shown in FIG. 10, the treatment instrument protrusion opening 9b communicates with the treatment instrument insertion port 15 of the operation section 2b, and the distal end of the treatment instrument insertion conduit 41 formed from the operation section 2b to the inside of the insertion section 2a is positioned. To do. The treatment instrument protruding opening 9 b is inserted from the treatment instrument insertion port 15, and a treatment instrument 42 indicated by a dotted line in the drawing, which is inserted through the treatment instrument insertion conduit 41, projects in the distal direction of the distal end hard portion 9. A treatment tool raising base 25 (indicated by hatching in the drawing) for raising the protruding treatment tool 42 is provided at the tip of the treatment tool protruding opening 9b. The treatment instrument raising base 25 is rotatably attached and fixed to the distal end hard portion 9 formed of a resin member by an raising base fixing tool 28 formed of a metal member that holds a rotation shaft 34 that is a center of raising rotation. Has been. Wire fixing with which the end of the raising wire 27 connected to the treatment instrument raising lever 16 of the operation unit 2b for raising and rotating the rotating shaft 34 about the raising rotation axis is fixed to the treatment instrument raising base 25. Part 36.

  As shown in FIG. 11, the raising wire 27 is led out from the raising wire base 46 provided in the distal end hard portion 9 through the raising wire insertion conduit 45 provided in the insertion portion 2a from the operation portion 2b. Then, it is fixed to the wire fixing part 36 of the treatment instrument raising base 25. The treatment instrument elevator 25 is formed with a protrusion 26 that comes into contact with an elevator fixture 28 for stopping at the maximum elevator position when the treatment instrument elevator 25 is rotated about the rotation shaft 34.

  That is, as shown in FIG. 10, the treatment instrument fixing base 25 operates the treatment instrument raising lever 16 from the state where the treatment instrument 42 protruding from the treatment instrument protruding opening 9 b is placed, so that the raising wire 27 is When pulled, as shown in FIG. 11, the treatment tool 42 that is rotated from the rotation shaft 34 as the center of rotation and protrudes from the treatment tool protrusion opening 9 b is raised. In addition, when the raising wire 27 by the treatment instrument raising lever 16 is returned from the pulled state, the treatment instrument raising base 25 rotates around the rotation shaft 34 as the rotation center, and the treatment instrument 42 protruding from the treatment instrument protruding opening 9b is restored. Return to the position.

The ultrasound endoscope 2 is subjected to predetermined signal processing based on the reflected ultrasound signal of the ultrasound signal transmitted from the ultrasound transducer unit 20 to the organ in the body cavity under the control of the ultrasound observation apparatus 4. The projection direction of the treatment instrument 42 is monitored by the ultrasonic tomographic image displayed on the monitor, and the treatment instrument raising base 25 is operated by the treatment instrument raising lever 16 to project the treatment instrument 42 to the affected area of the organ. Let
JP 2000-245734 A

  The distal end rigid portion 9 of the conventional ultrasonic endoscope 2 described with reference to FIGS. 9 to 11 uses a treatment instrument that treats the affected area with high frequency as the treatment instrument 42 that projects from the treatment instrument projecting opening 9b. In consideration of the above, it is formed of a resin member that is not easily affected by high frequencies. When the treatment instrument raising base 25 is directly attached and fixed to the distal end hard portion 9 formed of the resin member, the attachment fixing strength of the treatment instrument raising base 25 cannot be sufficiently obtained. The treatment instrument raising base 25 is attached and fixed using the fixture 28.

  The raising base fixture 28 is formed in a substantially L shape when viewed from the side, and has a female screw hole 35 into which a male screw inserted into a screw hole provided in the distal end hard portion 9 is screwed, and a treatment instrument raising base. And a shaft hole in which a rotation shaft 34 which is a rotation center of 25 is held.

  As shown in FIG. 10, the treatment instrument raising base 25 protrudes toward the affected part in a state where the treatment instrument 42 projected from the treatment instrument protruding opening 9 b is placed on the treatment instrument raising base 25. When the upper wire 27 is pulled, the treatment instrument raising base 25 is raised and rotated about the rotation shaft 34, and the treatment instrument 42 is moved at the treatment instrument contact portion 37 where the treatment instrument raising base 25 and the treatment instrument 42 come into contact with each other. Get up in the direction of the affected area. That is, the treatment instrument 42 is formed of a relatively soft member that is raised by the treatment instrument raising base 25.

  In this way, in the ultrasonic endoscope 2 having the treatment instrument raising base 25 at the distal end hard portion 9, the distal end rigid portion 9 is repeatedly operated while the treatment instrument 42 protruded from the distal end rigid portion 9 is raised and repeated. In some cases, the riser fixture 28 to which the treatment tool elevator 25 is attached and fixed is loosened. When loosening of the fixing of the raising base fixture 28 to the distal end rigid portion 9 occurs, the raising operation of the treatment instrument raising base 25 becomes difficult, and the range of the raising operation is reduced to raise the treatment tool. Decreases the efficiency.

  As a first cause of loosening of the raising base fixture 28 for attaching and fixing the treatment tool raising base 25 to the distal end hard portion 9, a treatment formed of a hard member that is difficult to perform the raising operation on the treatment tool raising base 25. When the instrument 42 is used, the treatment instrument raising base 25 does not raise the rigid treatment instrument 42 even if the treatment instrument raising lever 16 is raised and the raising wire 27 is pulled. However, since the raising wire 27 is slightly stretched, the treatment tool raising lever 16 pulls the raising wire 27 until the operator notices that the treatment tool 42 is a hard member that is difficult to raise. It is conceivable that the elevator fixture 28 is loosened due to the operation.

  Further, as a second cause of the loosening of the raising base fixture 28, the treatment tool raising lever 16 is operated to pull the raising wire 27 and the projection 26 provided on the treatment equipment raising base 25 is raised to the raising base fixture 28. It is conceivable that the raising base fixture 28 is loosened by pulling the raising wire 27 despite being in contact with the raising base 27.

  As shown in FIG. 10, the first cause of the loosening of the raising base fixing tool 28 is from the treatment tool raising base 25 and the treatment tool protruding opening 9b which are rotated up around the rotation shaft 34 by pulling up the raising wire 27. The position of the treatment tool contact portion 37 with the protruding hard member treatment tool 42 is the center of the wire fixing portion 36 where the end of the raising wire 27 is fixed from the rotation axis 34 of the treatment tool raising base 25. This is probably because the distance is longer than the distance L0. That is, when the raising wire 27 is pulled, the treatment instrument raising base 25 is connected to the rotary shaft 34 of the treatment instrument raising base 25 with the treatment instrument contact portion 37 between the treatment instrument raising base 25 and the treatment instrument 42 as a fulcrum in the drawing. The generated force indicated by the arrow x is generated, and the generated force x generates the component force indicated by the arrow y in the drawing that lifts the portion of the rotating shaft 34 upward in the drawing on the treatment instrument protruding opening 9b side of the distal end hard portion 9. . If this component force y is generated frequently, it is conceivable that the male screw screwed into the female screw hole 35 of the elevator base fixture 28 is loosened. That is, the right screw is used as the male screw that is screwed into the female screw hole 35, and the component force y generated in the elevator base fixture 28 becomes the component force y in the direction of loosening the male screw, and the force that loosens the elevator fixture 28. It becomes.

  Further, as shown in FIG. 11, the second cause of the loosening of the raising base fixture 28 is that the position where the raising wire 27 of the distal end rigid portion 9 is led out reaches the maximum raising position of the treatment instrument raising base 25. The treatment instrument raising base 25 is set so as to be pulled upward even at the maximum raising position.

  For this reason, if the raising wire 27 continues to be pulled from the state in which the protrusion 26 which is the maximum raising position of the treatment instrument raising base 25 is in contact with the raising base fixing tool 28, the wire fixing of the treatment instrument raising base 25 is performed. In the portion 36, a generated force indicated by an arrow x in the drawing, which is the pulling direction of the raising wire 27, is generated, and the generated force x causes the treatment instrument raising base 25 to be on the treatment instrument protruding opening 9b side of the distal end hard portion 9. A component force indicated by an arrow y in the drawing that lifts upward in the drawing is generated. If this component force y is generated frequently, it is conceivable that the male screw screwed into the female screw hole 35 of the elevator base fixture 28 is loosened.

  As described above, the treatment tool raising base 25 is loosely attached to the distal end rigid portion 9 while the treatment tool raising base 25 is repeatedly operated by the treatment tool raising base 25 of the endoscope apparatus. Has occurred, and there has been a problem that the raising operation of the treatment instrument 42 becomes slow.

  The present invention has been made in view of such circumstances, and a hard treatment instrument that is difficult to be raised by the treatment instrument raising base is used, or a further raising operation is performed from the maximum raising state of the treatment instrument raising stand. It is an object of the present invention to provide an endoscope apparatus that does not cause loosening of an elevator base fixing tool that fixes and fixes a treatment tool elevator base to a distal end hard portion.

The endoscope apparatus of the present invention includes an insertion portion to be inserted into a body cavity, a distal end rigid portion provided at a distal end of the insertion portion, an operation portion provided at the proximal end of the insertion portion, the distal end rigid A recess recessed in a direction perpendicular to the insertion axis of the insertion portion, a treatment instrument insertion conduit inserted through the insertion portion from the operation portion to the hard distal end portion, and the hard distal end A treatment instrument protrusion opening provided in a portion and projecting the treatment instrument inserted through the treatment instrument insertion conduit in the forward direction in the recess, and an elevator base fixture fixed in contact with the bottom surface of the recess The proximal end portion is supported by the raising base fixture so as to be rotatable about a rotation axis that is provided in front of the treatment instrument protruding opening, is orthogonal to a plane including the insertion axis, and is parallel to the bottom surface portion. Raising stand and inserted through the insertion part from the operation part to the recess A rising wire whose tip is fixed to the wire fixing portion of the tip portion of the raising base, and the protrusion protruding from the treatment instrument protruding opening by the rotation of the raising stand accompanying the pulling of the raising wire. An endoscopic device capable of raising a treatment tool in a direction away from the bottom surface along a plane orthogonal to the rotation axis, when viewed from a direction along the rotation axis, The treatment instrument contact portion where the treatment instrument projecting linearly from the treatment instrument projecting opening contacts the raising base is set at a position closer to the rotation axis than the distance between the rotation axis and the wire fixing portion. It is characterized by being.

  The endoscope apparatus according to the present invention uses a treatment tool that is a hard member that is difficult to perform a raising operation using the treatment instrument raising base, or the treatment instrument raising base is used for further raising operation from the maximum raising state. Even if a lifting force is applied, there is no loosening of the lifting fixture for attaching the treatment tool raising base to the hard tip, and there is an effect that the raising operation of the treatment tool by the treatment tool raising base can be continued. is doing.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The endoscope apparatus according to the embodiment of the present invention corresponds to the ultrasonic endoscope 2 used in the electronic scanning ultrasonic endoscope diagnostic apparatus 1 described above with reference to FIGS. 8 to 11, and is an endoscope apparatus. The overall configuration is the same as that of the ultrasonic endoscope 2. The difference between the endoscope apparatus of the present invention and the ultrasonic endoscope 2 is that a treatment instrument is applied even when an unnecessary raising force is applied to the treatment instrument raising base 25 attached and fixed to the distal end hard portion 9 of the insertion portion 2a. This is designed to prevent loose mounting of the elevator. Hereinafter, description will be made with reference to FIGS.

  FIG. 1 is a plan view showing a configuration of a distal end hard portion of an endoscope apparatus according to an embodiment of the present invention, and FIG. 2 is a treatment instrument raising base provided at the distal end hard portion of the endoscope apparatus according to an embodiment of the present invention. FIG. 3 is a longitudinal sectional view cut along a cutting line AA in FIG. 1, and FIG. 3 shows a treatment instrument raising base and a raising wire provided at the distal end hard portion of the endoscope apparatus according to the embodiment of the present invention. FIG. 4 is a longitudinal cross-sectional view of the raising wire cut along the cutting line BB in FIG. 1, and FIG. 4 is a treatment instrument raising base provided at the distal end hard portion of the endoscope apparatus according to the embodiment of the present invention. FIG. 5 is a longitudinal sectional view of a pulling state of the raising wire cut along the cutting line BB in FIG. 1 showing the raising wire, and FIG. 5 is a raising fixture for the endoscope apparatus according to the embodiment of the present invention. 5 (a) is a top view, FIG. 5 (b) is a side view, FIG. 5 (c) is a front view, and FIG. 5 (d) is a- FIG. 6 is a cross-sectional view taken along the cutting line -c-d, and FIG. 6 is a diagram of FIG. 2 showing the treatment instrument raising base and the raising base fixing tool attached to the distal end hard portion of the endoscope apparatus according to the embodiment of the present invention. FIG. 7 is a cross-sectional view taken along the cutting line CC, and FIG. 7 is a cross-sectional view of FIG. 2 showing the treatment instrument raising base and the raising base fixture attached to the distal end hard portion of the endoscope apparatus according to the embodiment of the present invention. It is sectional drawing cut | disconnected by the line DD.

  As described above, the endoscope apparatus according to the embodiment of the present invention has the same overall configuration as the ultrasonic endoscope apparatus 2 described with reference to FIGS. The treatment instrument raising base provided at the distal end hard portion 9 of the insertion portion 2a of the endoscope apparatus will be described mainly. The same parts as those in FIGS. 8 to 11 are denoted by the same reference numerals.

  A configuration of the distal end hard portion 9 provided at the distal end of the insertion portion 2a of the endoscope apparatus according to the embodiment of the present invention will be described with reference to FIG. The distal end surface 9a of the distal end hard portion 9 of the insertion portion 2a of the endoscope apparatus has a treatment instrument protruding opening 9b through which the treatment instrument projects in communication with the treatment instrument insertion conduit, an illumination window 23, an observation window 24, and an air supply A water supply nozzle 26 is provided. A treatment instrument raising base 25 is attached and fixed to the treatment instrument protruding opening 9b by a raising base fixture 28. On one side surface of the treatment instrument raising base 25, an end portion of the raising wire 27 is attached, and a protruding portion 26 that comes into contact with the raising base fixing tool 28 is provided.

  The distal end of the distal end hard portion 9 is provided with an ultrasonic transducer unit 20 including an ultrasonic transducer including a plurality of transducer arrays that transmit and receive ultrasonic signals.

  A configuration of the treatment instrument raising base 25 provided in the treatment instrument protrusion opening 9b of the distal end rigid portion 9 will be described with reference to FIG. The treatment instrument projecting opening 9b of the distal end rigid portion 9 is located at the end of the treatment instrument insertion conduit 41 provided in the insertion portion 2a, and the treatment instrument indicated by a dotted line in the figure through which the treatment instrument insertion conduit 41 is inserted. 42 protrudes in the forward direction of the front end surface 9a.

  Between the distal end surface 9a of the distal end rigid portion 9 and the treatment instrument protruding opening 9b, a recess 9c for attaching and fixing the treatment instrument raising base 25 (shown by an inclined surface in the figure) is formed. In this recess 9c, the treatment instrument raising base 25 is attached and fixed by an raising base fixing tool 28 that holds the rotation shaft 34 inserted into the raising rotation shaft hole 25a serving as the raising rotation center. The treatment instrument raising base 25 has a recess 25b in which a treatment instrument 42, which will be described later, is placed on the upper surface, and the projection 26 and the center of the raising fulcrum hole 25a into which the rotation shaft 34 is inserted on one side surface. A wire fixing portion 36 to which the end portion of the raising wire 27 is attached is provided at a position at a distance L.

  The elevator fixture 28 is formed of a metal member, and has a substantially prismatic connecting rod 29 and a first prism-shaped first raised from one end of the connecting rod 29 as shown in FIGS. 5 and 6. The column portion 30 and the second column portion 31 having a substantially prismatic shape raised from the other end of the connecting rod 29 are substantially U-shaped when viewed from above, and the cross-sectional shape is substantially L-shaped. Is formed. In the upper part of the first support column 30, a female screw hole 32 is provided in which a female screw into which a male screw 35 inserted through the screw hole of the distal end hard portion 9 is engaged with the elevator base fixture 28 is formed. . A shaft hole 33 a into which the rotation shaft 34 inserted through the raising rotation shaft hole 25 a that becomes the center of the raising rotation of the treatment instrument raising base 25 is provided at the lower portion of the first support column 30. The second support column 31 is provided with a shaft hole 33b into which the end of the rotary shaft 34 is inserted at a position facing the shaft hole 33a provided in the first support column 30.

  As shown in FIGS. 6 and 7, the raising base fixture 25 having such a shape is provided between the first column 30 and the shaft holes 33 a and 33 b of the second column 31. The rotating shaft 34 is inserted into the shaft holes 33 a and 33 b of the first and second support columns 30 and 31 with the raising rotary shaft hole 25 a interposed, and the treatment instrument raising base 25 is attached to the raising base fixture 28. Attaches so that it can rotate freely. The raising base fixture 28 to which the treatment instrument raising base 25 is rotatably attached is attached to the concave portion 9 c of the distal end hard portion 9 and has a male screw 35 inserted through a screw hole provided in the distal end hard portion 9. It is screwed into a female screw hole 32 provided in the first support column 30. Since the raising base fixture 28 is formed of a metal member, it can be securely attached and fixed to the distal end hard portion 9 with the male screw 35.

  As shown in FIG. 2, the treatment instrument raising base 25 attached and fixed to the distal end rigid portion 9 by the raising base fixing tool 28 is raised and rotated around the rotation shaft 34 to raise the treatment instrument 42. The treatment instrument contact portion 37 with the treatment instrument 42 is set at a position in the vertical direction from a straight line 34 a connecting the center of the rotation shaft 34 and the center of the wire fixing portion 36. That is, the treatment instrument contact portion 37 of the treatment instrument raising base 25 with which the treatment instrument 42 contacts is at a position in the vertical direction from the straight line 34a connecting the rotation shaft 34 and the wire fixing section 36, and the rotation shaft 34 and the wire fixing section. The position 2 is set to be shorter than the distance L between 36.

  Next, the raising operation of the treatment tool 42 by the treatment tool raising base 25 having such a configuration will be described.

  As shown in FIG. 2, the treatment instrument 42 is projected from the treatment instrument protruding opening 9 b toward the distal direction of the distal rigid part 9 with the position of the treatment instrument raising base 25 provided in the distal rigid part 9 as an initial position. Then, the surgeon pulls up the raising wire 27 to raise and rotate the treatment instrument raising base 25 with the rotation shaft 34 as a fulcrum, and raises the treatment instrument 42 in contact with the treatment instrument contact portion 37. In this raising operation, if the treatment instrument 42 is soft, the treatment instrument 42 can be easily raised by the treatment instrument raising base 25.

  However, if the treatment tool 42 is rigid, it is difficult to get up the treatment tool 42 against the raising operation of the treatment tool raising base 25, and the surgeon continues the raising wire 27 to raise the treatment tool 42. Tow. The pulling force applied to the wire fixing portion 36 of the treatment instrument raising base 25 by the pulling of the raising wire 27 holds the rotating shaft 34 with the treatment instrument contact portion 37 where the treatment instrument raising base 25 and the treatment instrument 42 are in contact as a fulcrum. A force in the direction indicated by the arrow x in the figure is generated in the raising base fixture 28. Due to the generated force x, a component force acting in the direction of pressing the elevator fixture 28 indicated by the arrow y in the drawing against the distal end hard portion 9 acts. Thereby, the surgeon protrudes the hard treatment tool 42 from the treatment tool protrusion opening 9b of the distal end hard portion 9 and pulls the raising wire 27 to repeat the raising operation on the treatment tool raising base 25 a plurality of times. In this case, the raising force generated in the wire fixing portion 36 of the treatment instrument raising base 25 uses the treatment base raising section 28 and the distal end hard part 9 as a fulcrum using the treatment instrument contact portion 37 where the treatment instrument raising base 25 and the treatment instrument 42 are in contact with each other. The component force y in the direction of pressing down, that is, the force in the direction in which the elevator fixture 28 does not loosen. Therefore, the raising base fixture 28 is not loosened by the raising operation of the hard treatment instrument 42.

  In general, a right screw is used as the male screw 35 for attaching the elevator base fixture 28 to the distal end hard portion 9. In the endoscope apparatus according to the embodiment of the present invention, a left screw is used as the male screw 35 used when the elevator base fixture 28 is attached to the recess 9c of the distal end hard portion 9. As described above, when the raising base fixture 28 moves slightly in the recess 9c of the distal end hard portion 9 by the component force y generated by raising the hard treatment tool 47, the male screw 35 is turned to the left screw. By doing so, since the force is in the direction of tightening the elevator base fixture 28, the elevator fixture 28 is less likely to loosen.

  Next, the treatment instrument raising base 25 and the raising wire 27 will be described with reference to FIGS. 3 and 4. In the distal end rigid portion 9 of the endoscope apparatus according to the embodiment of the present invention, a raising wire 27 connected to the treatment instrument raising lever 16 of the operation portion 2b is provided from the operation portion 2b to the insertion portion 2a. The wire is inserted into the wire insertion conduit 45 and is led out from the raising wire base 46 and the raising wire lead-out port 9 d provided in the distal end hard portion 9 and fixed to the wire fixing portion 36 of the treatment instrument raising base 25. The treatment instrument raising base 25 is formed with a protrusion 26 that comes into contact with the raising base fixing tool 28 for stopping at the maximum raising position when the treatment tool raising base 25 is rotated about the rotation shaft 34.

  The treatment instrument elevator 25 is located at the maximum raising position where the treatment instrument elevator 25 is raised and the protrusion 26 abuts the elevator fixture 28 with the center of the rotation axis 34 of the treatment instrument elevator 25 as a reference. Whether the height 2 to the center of the raising wire 27 protruding from the wire lead-out opening 9d formed in the distal end hard portion 9 is the same as the height 1 with respect to the height 1 to the center of the wire fixing portion 36, Alternatively, it is set to a low state (height 1 ≧ height 2).

  By making the height 2 from the wire lead-out opening 9d to the center of the raising wire 27 the same as or lower than the height 1 to the center of the wire fixing portion 36 of the treatment instrument raising base 25, it is shown in FIG. As described above, when the treatment tool raising base 25 is pulled to the maximum raising position, when the raising wire 27 is pulled, the rotation shaft 34 portion of the treatment instrument raising base 25 and the raising base fixing tool 28 are pressed in the direction in which the distal end rigid portion 9 is pressed. Works. As a result, even if the raising operation is further performed at the maximum raising position of the treatment tool raising base 25, the raising base fixing tool 28 does not loosen.

  In addition, since the male screw 35 for attaching the elevator base fixture 28 to the distal end hard portion 9 is a left-hand thread, the elevator wire 27 is temporarily pulled at the maximum raising position of the treatment instrument elevator 25, and the treatment instrument Even if the elevator fixture 28 that fixes the elevator 25 moves slightly in the concave portion 9c of the distal end hard portion 9, the male screw 35 that fixes the elevator fixture 28 to the distal rigid portion 9 is fixed. The movement in the tightening direction results in no loosening of the elevator fixture 28.

  As described above, the endoscope apparatus according to the embodiment of the present invention uses a treatment tool formed on a hard member as a treatment tool that is operated to be raised by a treatment tool raising base, or uses a treatment tool raising base. Even if the raising operation is further performed from the maximum raising state, the raising device fixing device for fixing the treatment device raising table to the distal end hard portion is not loosened, and the raising operation of the treatment device can be executed for a long period of time.

[Appendix]
According to the embodiment of the present invention described in detail above, the following configuration can be obtained.

(Supplementary note 1) When an insertion portion to be inserted into a body cavity, an operation portion provided at the proximal end of the insertion portion, and a raising wire provided at the insertion portion from the operation portion are pulled, the distal end of the insertion portion An endoscopic apparatus having a treatment instrument raising base provided at a distal end portion of the insertion portion for raising a treatment instrument derived from a section,
While holding the raising rotary shaft of the treatment instrument raising base, the raising base fixing means for attaching and fixing the treatment instrument raising base to the distal end portion;
When the treatment tool raising base is operated by pulling the raising wire whose end is fixed to the treatment instrument raising base, the treatment instrument raising base is moved with respect to the raising base fixing means. A lifting prevention means for biasing the raising base fixing means in a direction that prevents the raising base fixing means from being raised,
An endoscope apparatus comprising:

(Additional remark 2) The insertion part inserted in a body cavity, the operation part provided in the base end of the said insertion part, the at least light guide provided in the insertion part from the said operation part, an image guide, and a treatment tool penetration tube A path, an illumination window provided at the distal end of the insertion portion, at least where the distal end of the light guide is positioned, an observation window where the distal end of the image guide is positioned, and a treatment instrument inserted through the treatment instrument insertion conduit project An endoscope apparatus having a distal end portion having a treatment tool protruding opening and a treatment tool raising base for raising the treatment tool protruding from the treatment tool protruding opening of the distal end portion,
An elevating base fixture for holding the elevating rotation shaft of the treatment instrument elevating base and attaching and fixing the treatment instrument elevating base in the vicinity of the treatment instrument protruding opening of the distal end portion;
Wire fixing provided on the treatment instrument raising base and attached and fixed to the end portion of the raising wire provided in the insertion section from the operation section for pulling and raising operation around the raising rotation axis of the treatment instrument raising base And
A treatment instrument contact portion provided on the treatment instrument raising base and in contact with a treatment instrument provided at a position perpendicular to a straight line connecting the raising rotation shaft of the treatment instrument raising base and the wire fixing portion; ,
An endoscope apparatus comprising:

(Additional remark 3) The insertion part inserted in a body cavity, the operation part provided in the base end of the said insertion part, the light guide provided from the said operation part to the insertion part, the image guide, and the treatment instrument penetration tube A path, an illumination window provided at the distal end of the insertion portion, at least where the distal end of the light guide is positioned, an observation window where the distal end of the image guide is positioned, and a treatment instrument inserted through the treatment instrument insertion conduit project An endoscope apparatus having a distal end portion having a treatment tool protruding opening and a treatment tool raising base for raising the treatment tool protruding from the treatment tool protruding opening of the distal end portion,
An elevating base fixture for holding the elevating rotation shaft of the treatment instrument elevating base and attaching and fixing the treatment instrument elevating base in the vicinity of the treatment instrument protruding opening of the distal end portion;
Wire fixing provided on the treatment instrument raising base and attached and fixed to the end portion of the raising wire provided in the insertion section from the operation section for pulling and raising operation around the raising rotation axis of the treatment instrument raising base And
A height position from the rotating shaft of the treatment instrument raising base to the wire fixing portion when the raising wire is pulled up to bring the treatment instrument raising base to the maximum raising state. Raising wire protrusion opening provided at the same height position or a position lower than the wire fixing part,
An endoscope apparatus comprising:

  (Additional remark 4) The said raising stand fixing means or the said raising stand fixing tool is the said front-end | tip part with the fixing tool of the fastening direction different from the raising direction of the said treatment tool raising means or the said treatment tool raising fixing stand. The endoscope apparatus according to any one of appendices 1 to 3, wherein the endoscope apparatus is fixedly attached to the endoscope.

  (Supplementary Note 5) The treatment instrument contact portion provided on the treatment instrument raising base is provided at a position within a radius to the raising wire fixing portion of the treatment instrument raising base around the rotation axis of the treatment instrument raising base. The endoscope apparatus according to appendix 2, characterized by:

The top view which shows the structure of the front-end | tip hard part of the endoscope apparatus which is embodiment of this invention. The longitudinal cross-sectional view cut | disconnected by the cutting line AA in the figure of FIG. 1 which shows the treatment tool raising base provided in the front-end | tip hard part of the endoscope apparatus which is embodiment of this invention. The longitudinal section of the raising wire cut | disconnected by cutting line BB in the figure of FIG. 1 which shows the treatment tool raising stand provided in the front-end | tip hard part of the endoscope apparatus of embodiment of this invention, and a raising wire of FIG. Plan view. The longitudinal section of the pulling state of the raising wire cut | disconnected by cutting line BB in the figure of FIG. 1 which shows the treatment tool raising stand provided in the front-end | tip hard part of the endoscope apparatus of embodiment of this invention, and a raising wire. Figure. FIG. 5A is a top view, FIG. 5B is a side view, FIG. 5C is a front view, and FIG. 5D is a diagram illustrating an elevator base fixture used in the endoscope apparatus according to the embodiment of the present invention. ) Is a cross-sectional view taken along the line ab-c-d shown in FIG. Sectional drawing cut | disconnected by the cutting line CC in the figure of FIG. 2 which shows the treatment tool raising base provided in the front-end | tip hard part of the endoscope apparatus of embodiment of this invention, and a raising base fixing tool. Sectional drawing cut | disconnected by the cutting line DD in the figure of FIG. 2 which shows the treatment tool raising base provided in the front-end | tip hard part of the endoscope apparatus of embodiment of this invention, and a raising base fixing tool. 1 is a schematic diagram showing a schematic configuration of an electronic scanning ultrasonic endoscope diagnosis apparatus using an endoscope apparatus according to an embodiment of the present invention and a conventional ultrasonic endoscope. FIG. The perspective view which shows the structure of the front-end | tip hard part of the conventional ultrasonic endoscope. Sectional drawing of the front-end | tip hard part explaining the subject of the treatment tool raising base provided in the front-end | tip hard part of the conventional ultrasonic endoscope. Sectional drawing of the front-end | tip hard part explaining the subject of the treatment tool raising base provided in the front-end | tip hard part of the conventional ultrasonic endoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 2 Insertion part 9 Tip hard part 10 Bending part 25 Treatment tool raising base 26 Protrusion 27 Raising wire 28 Raising base fixing tool 34 Rotating shaft 35 Female screw hole 36 Wire fixing part 37 Contact 41 Treatment tool insertion pipe line 42 Treatment tool

Claims (3)

An insertion part to be inserted into the body cavity;
A hard tip portion provided at the tip of the insertion portion;
An operation portion provided at a proximal end of the insertion portion;
A recess formed in the distal end hard portion in a direction perpendicular to the insertion axis of the insertion portion; and
A treatment instrument insertion conduit inserted through the insertion portion from the operation portion to the distal end hard portion;
A treatment instrument projecting opening provided in the distal end hard part and projecting the treatment instrument inserted into the treatment instrument insertion conduit in the forward direction in the recess; and
An elevator base fixture fixed in contact with the bottom surface of the recess,
Raising stand provided at the front end of the treatment instrument protruding opening, and having a base end portion supported by the raising stand fixing tool so as to be rotatable around a rotation axis perpendicular to a plane including the insertion shaft and parallel to the bottom face portion. When,
A raising wire that is inserted through the insertion portion from the operation portion into the recess, and whose tip is fixed to the wire fixing portion of the tip portion of the raising base,
The treatment tool protruding from the treatment tool protrusion opening is rotated away from the bottom surface along a plane orthogonal to the rotation axis by rotation of the raising base accompanying pulling of the raising wire. An endoscopic device that can be raised
When viewed from the direction along the rotational axis, the treatment instrument contact portion where the treatment instrument projecting linearly from the treatment instrument projecting opening and the raising base come into contact is between the rotational axis and the wire fixing portion. An endoscope apparatus, characterized in that the endoscope apparatus is set at a position closer to the rotation axis than the distance . When viewed from the direction along the rotation axis, the height from the bottom surface portion to the rising wire protruding opening from which the rising wire protrudes in the state where the rising base is in the maximum rising state is the bottom surface portion. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is set to a state that is the same as or lower than a height from the wire fixing portion to the wire fixing portion . When the hard tip portion is viewed from the front side so that the bottom surface portion is downward, the elevator fixture is rotated from the left outer side of the hard tip portion to the left wall surface of the concave portion. It is fixed by a male screw inserted parallel to the shaft,
The male screw is a left-hand screw, and when viewed from a direction along the rotation axis, the male screw is disposed farther from the bottom surface than the rotation axis and on the front side of the rotation axis. The endoscope apparatus according to claim 1 or 2 .

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