JP4847175B2 - Endoscope system and endoscope insertion aid - Google Patents

Description

  The present invention relates to a medical endoscope system that is used by being inserted into a lumen of a subject, particularly into a urethra, and an endoscope insertion aid.

  Endoscopes are used to perform inspections or treatments in body cavities. When performing inspection and treatment with an endoscope, an insertion portion of the endoscope is introduced in the vicinity of a target site in a body cavity via a trocar or a lumen. For example, when the insertion portion is introduced into the stomach, the insertion portion is guided into the stomach via an open lumen such as the oral cavity or the esophagus. On the other hand, when the insertion portion is introduced into the bladder, the insertion portion is guided into the bladder through the urethra, which is a closed lumen.

  Conventionally, the insertion part of a urological endoscope has been rigid. When a rigid insertion part is inserted into the bladder, there arises a problem that it causes great pain to the patient. This is because a bent portion called a membrane-like portion exists in the path from the urethra to the bladder, and the membrane-like portion is linearized by passing through the rigid insertion portion.

  In recent years, a urinary endoscope having a flexible insertion portion has been used. In an endoscope having a flexible insertion portion, the insertion portion can smoothly pass through the membrane-like portion, and pain is greatly reduced.

  However, the technique of inserting the soft insertion portion into the closed lumen requires skill, and the edge provided on the distal end plane of the distal end portion constituting the insertion portion rubs the lumen wall. May cause pain to the patient. For this reason, in the endoscope where the insertion portion is flexible, it is desired to further improve the insertion property that enables introduction into the bladder without causing pain to the patient like a urinary catheter.

  For example, Japanese Utility Model Laid-Open No. 6-75404 discloses a guide device in which a distal end portion can be easily inserted into a biological duct and an endoscope or the like can be easily inserted from the sheath duct into the biological duct. . In this guide device, a tip member that can be contracted into a conical shape with a thin front is provided at the tip, and a link-shaped balloon is provided on the outer periphery of the tip member, and fluid can be fed into the balloon through a fluid conduit. It is like that.

Further, Patent Document 2 is shown as an endoscope that meets the above-described demand. The endoscope of Patent Document 2 includes a spatula-like projecting portion projecting forward at the distal end portion of the insertion portion inserted into the lumen, and the above-mentioned between the distal end of the spatula-like projecting portion and the base portion of the distal end portion. And a sloped portion that presses against the inner wall of the lumen. According to this endoscope, it is possible to smoothly push the lumen closed while the distal end portion configured in the shape of a tapered spatula is expanded, and the pain given to the patient is further reduced.
Japanese Utility Model Publication No. 6-75404 JP 2004-351138 A

  However, in a hospital or the like having an endoscope in which the insertion portion is flexible and the distal end portion of the insertion portion is configured by a distal end plane, the cost burden increases by purchasing the endoscope shown in Patent Document 1. Problems occur. Therefore, an improvement in the insertion property of the endoscope has been desired from hospitals and the like having an endoscope in which the distal end portion of the soft insertion portion is configured by a distal end plane.

  The present invention has been made in view of the above circumstances, and in an endoscope having a flexible insertion portion and having a distal end plane at the distal end portion of the insertion portion, the insertion portion is closed in the lumen. An object of the present invention is to provide an endoscope system that can be smoothly inserted into a patient to reduce patient's pain.

The endoscope system of the present invention has a treatment instrument insertion channel in a flexible insertion portion, and the treatment instrument is inserted into a distal end plane which is an orthogonal plane orthogonal to the insertion portion longitudinal axis of the distal end portion constituting the insertion portion. An endoscope in which the distal end opening of the common channel, the observation window of the observation optical system, and the illumination window of the illumination optical system are disposed, and an auxiliary instrument insertion portion that is inserted into the treatment instrument insertion channel of the endoscope; A tapered shape is formed in a state in which it is expanded by the fluid supplied through the fluid path to the distal end side of the auxiliary tool insertion portion, and is in close contact with the orthogonal plane disposed on the distal side of the distal end plane that is the orthogonal plane. An endoscope system comprising an endoscope insertion assisting tool having an introduction balloon provided with a proximal end surface serving as a contact surface and an outer peripheral surface serving as the tapered guide surface,
The endoscope insertion assisting device includes a distal end tip having a through-hole constituting a liquid feeding path on the distal end side of the assisting instrument insertion portion, and the distal end tip is tapered from the proximal end side toward the distal end direction. A first tube body in which the introduction balloon is arranged by forming an exterior of the auxiliary instrument insertion portion on the base end side thereof, and a distal end portion of the introduction balloon is fixed. 1 connection convex part, and the 2nd connection convex part with which a tube body whose diameter is smaller than the said 1st tube body which comprises the said liquid feeding path is comprised .

  According to this configuration, the balloon provided in the auxiliary instrument insertion portion is exposed from the distal end opening via the treatment instrument insertion channel of the endoscope, and fluid is supplied into the balloon. Then, when the balloon is inflated, a tapered balloon is disposed on the distal side of the distal end portion. As a result, the shape of the distal end portion of the endoscope becomes a tapered shape.

  According to the present invention, even in an endoscope having a distal end plane at the distal end portion of the insertion portion, the insertion portion is configured to be soft, and the insertion portion is smoothly inserted into a closed lumen, An endoscope system that reduces patient pain can be realized.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
1 to 9 relate to an embodiment of the present invention, FIG. 1 is a diagram for explaining an endoscope system including a balloon catheter and an endoscope, and FIG. 2 is a distal end side of an insertion portion of the endoscope. FIG. 3 is a diagram illustrating the configuration of the balloon catheter, and FIG. 4 is a diagram illustrating a state in which the introduction balloon disposed on the front side of the distal end portion of the endoscope is inflated. FIG. 5 is a view showing a state where a step is generated between the introduction balloon and the distal end portion, FIG. 6 is a view showing a state where the balloon catheter is disposed in a channel provided in the insertion portion, and FIG. FIG. 8 is a view showing a state in which a balloon provided on a balloon catheter arranged on the balloon is inflated. FIG. 8 introduces an insertion portion in which an introduction balloon is arranged on the front side of the distal end surface of the endoscope into the urethra. 9 is a diagram for explaining the state of It is a view for explaining another configuration of.

  As shown in FIG. 1, the endoscope system 1 is composed of, for example, an endoscope 2 for urology and a balloon catheter 3 which is an endoscope insertion aid.

The endoscope 2 includes a flexible insertion portion 11, an operation portion 12, and a universal cord 13. The insertion portion 11 is configured by connecting a rigid distal end portion 14, for example, a bending portion 15 that can be bent in the vertical direction, and a flexible flexible tube portion 16 in order from the distal end side. Incidentally, the distal end surface of the tip portion 14 is formed in a plane as shown in FIG. 2 to be described later.

  An eyepiece 17 is provided at the base end of the operation unit 12. A bending operation knob 18 is provided on a side portion on the proximal end side of the operation unit 12. Further, the universal cord 13 extends from the side portion on the proximal end side of the operation portion. Further, a channel base 19 and the like communicating with a channel tube (reference numeral 37 in FIG. 2) provided in the insertion portion 11 are provided on the side portion on the distal end side of the operation portion 12.

  The flexible tube portion 16 is flexibly followed by applying an external force of a certain level or more, and has a restoring property. The bending portion 15 is configured to bend in the vertical direction by rotating the bending operation knob 18.

  Reference numeral 20 denotes an endoscope connector, which is provided at the base end portion of the universal cord 13. The endoscope connector 20 is connected to a light source device (not shown) that supplies illumination light to the endoscope 2.

  On the other hand, the balloon catheter 3 includes a fixing portion 4, a catheter body (see reference numeral 5 in FIG. 3), an introduction balloon 61, and the like. The fixed portion 4 has an air supply connection portion (hereinafter referred to as a first connection portion) 41a having an air supply base 41b made of a luer base, and a liquid supply base 42b made of, for example, a luer base. A liquid connecting portion (described as a second connecting portion) 42a is provided.

  One end of a stopcock 71 having a knob 71a is communicated with the air feeding base 41b of the first connecting portion 41a. One end of the air supply tube 72 is communicated with the other end of the stopcock 71. The other end of the air supply tube 72 is disposed in communication with the air supply device 73. On the other hand, one end portion of the liquid feeding tube 74 is arranged in communication with the liquid feeding base 42b of the second connecting portion 42a. The other end of the liquid feeding tube 74 is arranged in communication with the liquid feeding device 75.

  When the air supply device 73 and the liquid supply device 75 are syringes, these syringes are directly attached to the other end portion of the stopcock 71 and the liquid supply cap 42b of the second connection portion 42a, respectively.

    As shown in FIG. 2, the bending portion 15 of the endoscope has a configuration in which a plurality of bending pieces 21 are rotatably connected to bend in the vertical direction. In the present embodiment, the bending portion 15 is configured to bend in two directions, upper and lower. The bending portion 15 is not limited to the bending operation in the vertical direction, but may be configured to bend in the left-right direction in addition to the vertical direction.

  A guide ring 23 through which the operation wire 22 is inserted is attached to a predetermined upper and lower position of the plurality of bending pieces 21 constituting the bending portion 15. The distal end portion of the operation wire 22 is joined to the bending piece 21a located at the forefront by soldering or brazing. A proximal end portion of the operation wire 22 is connected to a bending operation drive mechanism (not shown) including the bending operation knob 18.

  A so-called blade 24 is put on the outer periphery of the plurality of bending pieces 21 constituting the bending portion 15, and an outer skin 25 is covered on the outer side of the blade 24. The distal end side of the outer skin 25 extends to the base portion of the distal end portion 14, and is provided with, for example, a bobbin bonding portion 26 on the outer periphery of the distal end portion 14.

  The distal end portion 14 is configured by a distal end hard portion 27 made of, for example, resin. The distal end surface 27a of the distal end hard portion 27 is formed as a distal end plane which is an orthogonal plane orthogonal to the insertion portion longitudinal axis. The distal end side edge portion 27b of the distal end rigid portion 27 is formed in a curved surface shape.

  The distal end hard portion 27 includes a channel hole 28 that is a treatment instrument hole constituting the distal end opening 28a, an observation hole 29 in which a member such as the first lens frame 30 constituting the observation optical system is installed, and illumination optics. It has a pair of illumination holes (not shown) in which members such as the illumination window 7 constituting the system are installed.

  The illumination hole is provided with the observation hole 29 in between. Further, the central axes of the channel hole 28, the observation hole 29, and the illumination hole are parallel to the insertion portion longitudinal axis of the insertion portion 11.

  The observation optical system includes a first optical lens 31 and an image guide fiber 33 arranged in the first lens frame 30, an observation window 8 as a tip lens arranged in the second lens frame 34, and a second optical lens 32. And so on.

  The first lens frame 30 is inserted and arranged in the observation hole 29. A second lens frame 34 in which the observation window 8 and the second optical lens 32 are assembled in advance is fixed to the front end opening side of the first lens frame 30. The second lens frame 34 has an outer diameter that can be inserted into the first lens frame 30, and is inserted into the first lens frame 30 from the rear end opening side.

  The distal end portion of the image guide fiber 33 is covered with a base 35 that is a tube member. The first optical lens 31 is bonded and fixed to the tip surface of the base 35. The first optical lens 31 is inserted into the first lens frame 30 from the rear end opening side of the first lens frame 30 together with the cap 35 of the image guide fiber 33.

  A protrusion 31a as a stopper protruding in the direction of the central axis is formed on the end opening side of the first lens frame 30 over the entire circumference or partly. When the second lens frame 34 is inserted from the proximal opening of the first lens frame 30, the tip of the second lens frame 34 abuts on the protrusion 31 a of the first lens frame 30 and is positioned.

  The image guide fiber 33 disposed behind the base 35 is covered with a protective soft tube 36. The image guide fiber 33 is guided to the operation unit 12 through the bending portion 15 and the flexible tube portion 16, and a base end surface thereof is disposed at the eyepiece portion 17.

  A distal end portion of a channel tube 37 constituting a treatment instrument insertion channel is communicated with the channel hole 28 via a connection base 38. The channel tube 37 is guided into the operation portion 12 through the bending portion 15 and the flexible tube portion 16, and the base end portion thereof is communicated with the channel base 19. Accordingly, the treatment instrument insertion channel (hereinafter abbreviated as “channel”) 39 is constituted by the channel base 19, the channel tube 37, the connection base 38, and the channel hole 28.

  In this embodiment, the channel 39 is used not only for insertion of the treatment instrument but also for air / water supply or for installing the balloon catheter 3 for improving the insertion property of the insertion portion 11 as will be described later. When air / water is supplied using the channel 39, an adapter of an air / water supply device (not shown) is attached to the channel base 19 for air / water supply.

  Note that an air / water supply operation instruction button may be provided in the operation unit 12, and the air / water supply operation may be performed by operating the instruction button. In addition, an air / water supply channel (not shown) separate from the channel 39 may be provided exclusively for air supply / water supply.

As shown in FIG. 3, the balloon catheter 3 includes a fixing portion 4, a catheter body 5, an introduction balloon 61, a positioning balloon 62, and the like.
The catheter body 5 is an auxiliary tool insertion portion, and is configured by a distal tip 51 provided at the distal end and a double tube portion 52. The double tube portion 52 includes a first tube body 53 that constitutes the exterior of the auxiliary tool insertion portion, and a second tube body 54 that has a smaller diameter than the first tube body 53. The 2nd tube body 54 is arrange | positioned in the hole of the 1st tube body 53, and comprises a liquid feeding path.

  A gap 55 is formed between the first tube body 53 and the second tube body 54, which is a fluid path and forms an air supply path. On the outer peripheral surface of the first tube body 53 at a predetermined position, an introduction balloon 61 and a positioning balloon 62 are disposed in order from the distal end side, for example, by bonding.

  The first tube body 53 is provided with supply holes 63 and 64 for supplying air, which is a fluid, to the balloons 61 and 62, respectively. The first supply hole 63 communicates with the introduction balloon 61 and has a predetermined diameter, and the second supply hole 64 communicates with the positioning balloon 62 and has a predetermined diameter.

  One supply hole 63, 64 provided in the first tube body 53 is provided for the balloons 61, 62, or a plurality of supply holes are provided at predetermined intervals in the circumferential direction, for example.

  The tip 51 is elongated and has a chip through hole 51a that constitutes a liquid feeding path in the longitudinal axis direction. The distal end side portion of the distal tip 51 is formed as, for example, a tapered inclined surface 51b that tapers from the proximal end toward the distal end. A first connecting convex portion (abbreviated as a first convex portion) 51c and a second connecting convex portion (abbreviated as a second convex portion) 51d are provided concentrically on the proximal end side of the distal tip 51. .

  The distal end portion of the second tube body 54 is integrally fixed to the second convex portion 51d, for example, by bonding. The distal end portion of the first tube body 53 is integrally fixed to the first convex portion 51c, for example, by adhesion. The distal end portion of the introduction balloon 61 is fixed to the outer peripheral surface of the distal end side of the first tube body 53 fixed to the first convex portion 51c by, for example, thread winding adhesion. The proximal end portion of the introduction balloon 61, the distal end portion of the positioning balloon 62, and the proximal end portion of the positioning balloon 62 are integrally fixed to a predetermined position of the first tube body 53 by, for example, adhesion.

  The fixing portion 4 includes a substantially tubular air supply port member 41 and a substantially tubular liquid supply port member 42. The liquid supply port member 42 is integrally fixed in the through hole 41c provided in the air supply port member 41 by, for example, adhesion. The liquid supply port member 42 is a tubular member having convex portions 42c and 42d on both end sides. The base end portion of the second tube body 54 is integrally fixed to the convex portion 42c by, for example, adhesion, and the distal end portion of the tube body 42e constituting the second connecting portion 42a is integrally fixed to the convex portion 42d by, for example, adhesion.

  Accordingly, the fluid path is constituted by the tube body 42e, the through hole 42f provided in the liquid supply port member 42, the second tube body 54, and the chip through hole 51a. Then, for example, physiological saline is supplied from the liquid feeding device 75 in a state where the liquid feeding tube 74 extended from the liquid feeding device 75 is connected to the liquid feeding base 42b. As a result, physiological saline flows out from the tip of the tip 51 as shown in FIG.

  As shown in FIG. 3, a first convex portion 41 d and a second convex portion 41 e are provided concentrically on the distal end side of the air supply port member 41. For example, a communication hole 41f in which a connection base 43 is disposed is formed in a side portion of the air supply port member 41. The central axis of the communication hole 41f and the central axis of the through hole 41g are set to intersect each other. A distal end portion of a tube body 43a constituting 41a is integrally fixed to the connection base 43 by, for example, adhesion.

  The base end portion of the first tube body 53 is fixed to the second convex portion 41e by, for example, thread winding adhesion. The first convex portion 41 d is inserted and arranged in the channel base 19.

  The inner diameter dimension of the second protrusion 41e and the first protrusion 41d is larger than the outer diameter of the second tube body 54 by a predetermined dimension. Therefore, a space portion 41 h communicating with the gap 55 is formed between the inner peripheral surface of the through hole 41 g and the outer peripheral surface of 54.

  Therefore, the air supply path is constituted by the pipe body 43 a, the through hole provided in the connection base 43, the space 41 h, and the gap 55. Then, with one end of the stopcock 71 provided at the tip of the air supply tube 72 extended from the air supply device 73 being connected to the air supply base 41b, the knob 71a is opened to provide the air supply device. For example, a predetermined amount of air is supplied from 73.

  Then, a predetermined amount of air is supplied into the introduction balloon 61 through the supply hole 63, and a predetermined amount of air is supplied into the positioning balloon 62 through the supply hole 64. As a result, the introduction balloon 61 is inflated into a tapered substantially bullet shape as shown by a two-dot chain line, and the positioning balloon 62 is inflated into a substantially spherical shape as shown by a two-dot chain line. Note that the fluid for inflating the balloon is not limited to air, and may be another gas, physiological saline, or the like.

  The inflating balloon 61 inflated as shown in FIGS. 3 and 4 has a tapered substantially bullet shape, in other words, a flat, generally conical shape. Specifically, the introduction balloon 61 has an outer peripheral surface as a guide surface 61a formed so as to be reduced in diameter from the proximal end side toward the distal end, and a contact formed so as to be in close contact with the distal end surface 27a. And a base end surface as the surface 61b. The introduction balloon 61 includes a first surface portion 61c that is slightly inflated with respect to the central axis of the catheter body 5, and a second surface portion 61d that is greatly inflated as compared with the first surface portion 61c. . Note that a transition surface portion that transitions from the expanded state of the first surface portion 61c to the expanded state of the second surface portion 61d may be provided between the first surface portion 61c and the second surface portion 61d.

  On the other hand, the positioning balloon 62 is shaped to expand in a substantially spherical shape. The positioning balloon 62 is inflated in the distal end hard portion 27 and its outer surface is in close contact with the inner peripheral surface of the channel hole 28. As a result, the positional relationship between the flat introduction balloon 61 and the distal end surface 27a is positioned and held in a predetermined state.

  As shown in FIG. 4, the introduction balloon 61 inflated is configured such that at least a portion facing the illumination window 7 and the observation window 8 is transparent or translucent. Accordingly, an endoscope image on the front side in the introduction direction can be obtained through the introduction balloon 61 when the introduction balloon 61 is in an inflated state.

  Note that the positioning balloon 62 need not be transparent or translucent. Further, in the case of a configuration in which only the introduction balloon 61 is provided without providing the positioning balloon 62, the positional relationship between the flat introduction balloon 61 and the distal end surface 27a is shifted as shown in FIG. There is a possibility that a problem that a step is generated between the distal end hard portion 27 and the introduction balloon 61 may occur.

The operation of the endoscope system 1 configured as described above will be described.
In inserting the insertion portion 11 of the endoscope 2 into the bladder via the urethra, first, a medical staff (abbreviated as staff) prepares the endoscope 2 and the balloon catheter 3.

  Next, the staff inserts the catheter body 5 of the balloon catheter 3 into the channel 39 through the channel cap 19. At this time, the balloons 61 and 62 provided in the catheter body 5 are in a contracted state.

  The staff then inserts the catheter body 5 into the channel 39 until the distal tip 51 constituting the catheter body 5 protrudes from the distal opening 28a.

  If the tip 51 protrudes from the tip opening 28 a, the staff inserts and arranges the first convex portion 41 d constituting the fixing portion 4 in the channel base 19. Then, the balloon catheter 3 is arranged with respect to the channel 39 of the endoscope 2 as shown in FIG. That is, the introduction balloon 61 in the contracted state protrudes from the distal end surface 27 a of the distal end hard portion 27 and the positioning balloon 62 in the contracted state is disposed in the channel hole 28.

  Next, the staff connects one end of the stopcock 71 connected to the air supply tube 72 to the air supply base 41b, and connects one end of the liquid supply tube 74 to the liquid supply base 42b. And the knob 71a of the stopcock 71 is opened, and a predetermined amount of air is supplied from the air supply device 73. Then, the balloons 61 and 62 are in a predetermined inflated state.

  The staff closes the knob 71a and checks whether or not there is a step between the distal end hard portion 27 and the introduction balloon 61 as shown in FIG. When the step is confirmed by the staff, the knob 71a is opened, the air in the balloons 61 and 62 is sucked, and the position of the introduction balloon 61 with respect to the distal end surface 27a is adjusted. Thereafter, air is supplied again into the balloons 61 and 62, the knob 71a is closed, the expanded state is maintained, and the above-described confirmation operation is performed.

Here, as shown in FIG. 4 and FIG. 7, the contact surface 61b of the inflated introduction balloon 61 is in close contact with the distal end surface 27a, and the tapered bullet-shaped guide surface is formed on the distal side of the distal end surface 27a. When 61a is in the placed state, the preparation for insertion is completed. As a result, the shape of the distal end portion 14 of the endoscope 2 becomes a tapered shape. Further, as shown in FIG. 7, the positioning balloon 62 is positioned so that the balloon outer surface is in close contact with the inner peripheral surface of the channel hole 28 so that the position of the introduction balloon 61 does not move.
The staff prepares a light source device, a video processor, and a monitor (not shown) as well as an operation for attaching the balloon catheter 3 to the channel 39.

  Next, a procedure for introducing the insertion portion 11 in which the introduction balloon 61 in the inflated state is disposed ahead of the distal end surface 27a into the bladder via the urethra will be described.

  First, the operator instructs the supply of physiological saline by the liquid delivery device 75. Then, as shown by the arrow in FIG. 4, physiological saline flows out from the tip opening of the tip through-hole 51a constituting the tip of the fluid path. The surgeon inserts the insertion portion 11 through the urethra while the physiological saline is flowing out. That is, the operator inserts the distal tip 51 into the urethra in a closed state in a reflux state in which physiological saline is flowing out from the distal end of the distal tip 51.

  The urethra is anatomically loose and straight until just before the urethral sphincter. For this reason, by inserting the insertion portion 11 linearly in the reflux state, the insertion portion 11 can easily extend in the back direction by expanding the urethra with the distal tip 51 and the introduction balloon 61 as shown in FIG. Will be introduced.

  That is, the closed urethra is pushed and widened by the distal tip 51 and the introduction balloon 61, and the distal end portion 14 is easily introduced toward the back. Then, the introduction balloon 61 is introduced into the bladder. Then, an endoscopic image of the bladder is displayed on the monitor screen.

The surgeon confirms that the distal end portion 14 has been introduced into the bladder by an endoscopic image displayed on the screen of the monitor. Here, the surgeon reopens the knob 71a and sucks the air in the balloons 61 and 62. Then, the balloons 61 and 62 in an inflated state change to a deflated state. Here, the surgeon removes the catheter body 5 of the balloon catheter 3 from the channel 39.
Thereafter, the surgeon observes the inside of the bladder or inserts a treatment tool into the bladder via the channel 39 to collect tissue.

  In this way, the distal end portion is tapered by disposing the introduction balloon that expands into a tapered substantially bullet shape on the distal side of the distal end surface constituting the distal end portion of the endoscope insertion portion. As a result, the contact resistance between the distal end portion of the endoscope insertion portion and the body tissue is greatly reduced. Therefore, it is possible to improve the insertability of the insertion portion whose distal end portion is a distal end plane into a closed lumen. As a result, the permeability of the membrane-like part is greatly improved, and examinations and treatments with less pain for the patient are realized.

  Further, the distal end portion of the introduction balloon is disposed on the distal tip having the tip through hole. For this reason, when introducing the insertion portion into the closed lumen with the introduction balloon inflated, a liquid such as physiological saline is allowed to flow out from the tip through-hole toward the distal side in the insertion direction. It can be carried out. This can further improve the insertability of the insertion portion.

  Furthermore, by providing the positioning balloon, it is possible to reliably prevent the positional relationship between the flat conical introduction balloon and the distal end face from being displaced. This reliably prevents a step between the hard tip portion and the introduction balloon.

  In addition, since the portion facing the observation window and the illumination window of the introduction balloon is configured to be transparent or translucent, an endoscopic image is displayed on the monitor screen when the insertion portion is introduced toward the bladder. Is displayed. Thereby, it can be confirmed by the endoscopic image that the distal end portion has been introduced into the bladder through the urethra.

  In the above-described embodiment, the portion of the introduction balloon 61 facing the observation window and the illumination window is configured to be transparent or translucent. However, even if the introduction balloon 61 is not transparent or translucent, the introduction performance can be improved if the inflated shape of the introduction balloon 61 is tapered.

  In the present embodiment, the balloons 61 and 62 are separately provided on the first tube body 53, respectively. However, as shown in FIG. 9, the first tube body 53 is provided with a balloon 65 having a first balloon portion 61A inflated into a flat conical shape and a second balloon portion 62A inflated into a spherical shape. good. In the balloon 65, in addition to the distal end portion and the proximal end portion, an intermediate portion between the first balloon portion 61A and the second balloon portion 62A is integrally fixed by, for example, bonding.

  The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

The figure explaining the endoscope system comprised with a balloon catheter and an endoscope Sectional drawing explaining the structure of the front end side of the insertion part of an endoscope The figure explaining the structure of a balloon catheter The figure which shows the state which the balloon for introduction arrange | positioned ahead from the front end surface of the front-end | tip part of an endoscope is inflating The figure which shows the state which the level | step difference has arisen between the balloon for introduction and the front-end | tip part The figure which shows the state which has arrange | positioned the balloon catheter in the channel provided in the insertion part. The figure which shows the state which the balloon provided in the balloon catheter arrange | positioned at the channel was expanded. The figure explaining the state which has introduced into the urethra the insertion part by which the balloon for introduction was arrange | positioned ahead of the front end surface of the front-end | tip part of an endoscope The figure explaining another composition of a balloon

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscopy system 2 ... Endoscope 3 ... Balloon catheter
27a ... tip surface 28 ... channel hole 28a ... tip opening
39 ... Channel 41h ... Space 51 ... Tip
51a ... chip through hole 52 ... double tube portion 53 ... first tube body 54 ... second tube body 55 ... gap 61 ... introducing balloon 61a ... guide surface 61b ... contact surface 62 ... positioning balloon
63 ... 1st supply hole 64 ... 2nd supply hole

Claims (7)

A treatment instrument insertion channel in a flexible insertion portion, and the distal end opening of the treatment instrument insertion channel on the distal end plane, which is an orthogonal plane orthogonal to the insertion portion longitudinal axis of the distal end portion constituting the insertion portion, observation optical system An endoscope in which an observation window and an illumination window of an illumination optical system are arranged,
An auxiliary instrument insertion portion inserted into the treatment instrument insertion channel of the endoscope is formed, and a tapered shape is formed in a state where the distal end portion of the auxiliary instrument insertion portion is expanded by a fluid supplied through a fluid path. And a balloon for introduction provided on the front side of the distal plane that is the orthogonal plane, each having a proximal end surface serving as a contact surface in close contact with the orthogonal plane and an outer peripheral surface serving as the tapered guide surface. In an endoscope system comprising an endoscope insertion aid,
The endoscope insertion assisting tool includes a tip on the distal end side of the assisting instrument insertion portion and having a through-hole that constitutes a liquid feeding path.
The distal tip has an inclined surface that tapers from the proximal side toward the distal direction,
A first tube body in which the introduction balloon is arranged by forming an exterior of the auxiliary tool insertion portion on the base end side, and a first connection convex portion to which a distal end portion of the introduction balloon is fixed And a second connecting convex portion to which a tube body having a diameter smaller than that of the first tube body constituting the liquid feeding path is connected,
An endoscope system comprising:   The endoscope system according to claim 1, wherein the endoscope insertion assisting tool includes positioning means for positioning the assisting instrument insertion portion in the treatment instrument insertion channel.   The endoscope system according to claim 2, wherein the positioning means is a positioning balloon that is arranged at a different position in the first tube body from the introduction balloon and expands in a spherical shape. A tip having a through hole;
An auxiliary instrument insertion portion that is connected to the distal tip and is inserted into a treatment instrument insertion channel provided in an endoscope, which is configured by a first tube body and a second tube body;
A base part that supplies fluid to a gap formed between the first tube body and the second tube body that is connected to the auxiliary instrument insertion part, and a base part that supplies fluid to the second tube body A fixing portion fixed to a base communicating with the treatment instrument insertion channel,
An introduction balloon having a distal end fixed to the distal end of the first tube body and in the vicinity of the distal tip and inflated into a tapered shape by a fluid supplied through the gap. In endoscope insertion aids,
The distal tip has an inclined surface that tapers from the proximal side toward the distal direction,
A first tube body, a first connecting convex portion to which a distal end portion of the introduction balloon is fixed, and a tube body having a diameter smaller than that of the first tube body are connected to the base end side. Two connecting projections;
An endoscope insertion aid characterized by comprising: The introduction balloon is disposed on the front side of the distal end surface of the distal end portion constituting the insertion portion of the endoscope,
The endoscope insertion aid according to claim 4, further comprising: a base end surface serving as a contact surface in close contact with the distal end surface in an expanded state; and an outer peripheral surface serving as the tapered guide surface.   The endoscope insertion assisting tool according to claim 4, further comprising positioning means for positioning the assisting instrument insertion portion in the treatment instrument insertion channel.   The positioning means is a positioning balloon provided at a position different from the introduction balloon and inflated in a spherical shape by the fluid supplied through the gap. Endoscope insertion aid.

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