JP4875774B2 - Endoscope - Google Patents

Description

  The present invention relates to an endoscope in which a work for exchanging a treatment tool is performed using a guide wire, particularly in endoscopic examination and endoscopic surgery of the pancreaticobiliary system.

  In recent years, endoscopic procedures have been increasingly used to treat diseases in the digestive and pancreaticobiliary systems. In the current treatment of pancreaticobiliary system using endoscopes, in addition to the diagnostic treatment of endoscopically imaging the bile duct and pancreatic duct, gallstones present in the common bile duct, etc. can be removed using a balloon or grasping instrument. There are also therapeutic treatments to be recovered.

In addition, when performing endoscopic procedures such as pancreatic ducts, bile ducts, and hepatic ducts, the distal end portion of the insertion portion of the endoscope is usually inserted to the vicinity of the duodenal papilla, from which a guide wire is guided under fluoroscopy. A treatment instrument such as a catheter is selectively inserted into the pancreatic duct or bile duct.
When performing endoscopic procedures such as pancreatic duct, bile duct, and hepatic duct using an endoscope, the distal end portion of the insertion portion of the endoscope is usually inserted to the vicinity of the duodenal papilla, and then X In general, a treatment tool such as a catheter is selectively inserted into a pancreatic duct or bile duct using a guide wire as a guide under fluoroscopy.

  Specifically, the following work is performed. First, after inserting the distal end portion 903 of the insertion portion 902 of the endoscope 901 shown in FIGS. 114 (A) and 114 (B) to the vicinity of the duodenal papilla, the catheter 904 is inserted into the treatment instrument insertion channel of the endoscope 901. And the distal end portion 904a of the catheter 904 is inserted endoscopically into the pancreatic duct or bile duct. Next, the guide wire 905 is inserted from the base 904 b on the proximal end side of the inserted catheter 904.

  Thereafter, under X-ray, it is confirmed that the guide wire 905 is correctly inserted into the pancreatic duct or bile duct, and the catheter 904 is grasped by hand while holding the proximal end side of the guide wire 905 as shown in FIG. 114 (A). Is extracted from the treatment instrument insertion channel of the endoscope 901. During this operation, when the distal end portion 904a of the catheter 904 comes out of the channel opening 907 on the operation portion 906 side of the endoscope 901 as shown in FIG. 114 (B), the vicinity of the channel opening 907 of the endoscope 901 is obtained. The guide wire 905 is grasped and the catheter 904 is completely pulled out from the endoscope 901.

Next, the proximal end side of the guide wire 905 is inserted into the insertion hole of another treatment instrument, and another treatment instrument is inserted into the treatment instrument insertion channel of the endoscope 901 while being guided by the guide wire 905. To do. Thereafter, the above-described operation is repeated as many times as the number of treatment instrument replacements.
A treatment instrument used for these treatments is generally set to a length of 190 cm or more in consideration of the length of the endoscope 901.

Further, the guide wire 905 is required to be at least about 400 cm because the length of the guide wire 905 is longer than the total length of the endoscope 901 and the length of the treatment instrument.
Further, for example, Patent Document 1 discloses a catheter for bile duct that can be quickly exchanged by extending a longitudinal opening between a distal end portion and a proximal end portion of a guide wire lumen in a catheter shaft. ing.

US Pat. No. 5,921,971

  By the way, when observing / treating the pancreaticobiliary system using the endoscope 901, when a treatment instrument such as the catheter 904 is inserted through the treatment instrument insertion channel of the endoscope 901, the guide wire 905 is used. Is inserted inside the treatment tool. Therefore, when the treatment tool is moved with respect to the endoscope 901, the guide wire 905 is also moved at the same time. For example, in the state where the distal end of the guide wire 905 is inserted into the nipple, the treatment tool is used with the guide wire 905 as a guide. When exchanging, it is necessary to always hold the guide wire 905 on the operation unit 906 side of the endoscope 901 in order to keep the tip of the guide wire 905 inserted in the nipple.

  Furthermore, while the conventional endoscope 901 is being used, the guide wire 905 is inserted by the same amount of movement while pulling out the treatment instrument from the treatment instrument insertion channel of the endoscope 901 during the operation of replacing the treatment instrument. Alternatively, since it is necessary to simultaneously perform two operations of pulling out the guide wire 905 by the same movement amount while inserting the treatment instrument into the treatment instrument insertion channel, the operation is complicated and troublesome.

In addition, since the guide wire 905 has a length of about 400 cm, it is difficult to route the guide wire 905 in a narrow endoscope room so that it does not contact an unclean area such as a floor.
Further, since the replacement cannot be performed unless the treatment tool is moved by the entire length of the guide wire 905, the time required for the replacement of the treatment tool itself may be increased. Therefore, there is a problem that it takes a lot of time when the treatment tool is replaced.

Furthermore, when performing an operation for exchanging the treatment tool, it is difficult for the operator to perform an exchanging operation alone, and at least two assistants are required in the operating room. For this reason, there is a problem that the human cost is high and the financial burden on the hospital and the patient is increased.
Further, in the case of a catheter in which a longitudinal opening is extended between the distal end portion and the proximal end portion of the guide wire lumen in the catheter shaft as in Patent Document 1, the longitudinal opening portion is added to the conventional contrast catheter. The work for providing is required. Therefore, there is a drawback that the manufacturing cost is higher than that of a conventional contrast catheter.

  Furthermore, in order to compensate for the decrease in rigidity of the catheter shaft due to the provision of the slit, it is necessary to take measures such as increasing the outer diameter of the shaft or making the material of the shaft harder. Therefore, since the diameter of the shaft is increased, insertability in the channel of the endoscope is deteriorated, so that the operator's workability may be deteriorated.

  In addition, the treatment of the pancreaticobiliary system requires skill, and a number of techniques have been established, so that the operator's preference for the treatment tool is particularly different. Further, depending on the patient's situation, it is frequently performed to use different treatment tools. However, this conventional technique has a drawback that treatment tools that can be used by itself are limited, and the range of selection by the operator is lost.

  The present invention has been made paying attention to the above circumstances, and its purpose is to easily replace the treatment tool in a shorter time without impairing the conventional operation method and operation feeling of the treatment tool, and to perform replacement treatment. An object of the present invention is to provide an endoscope apparatus that can be performed by a single operator.

In one aspect of the present invention, a treatment instrument insertion channel is disposed in an insertion portion that is inserted into a body cavity, and a distal end opening of the treatment instrument insertion channel is disposed in the vicinity of the distal end of the insertion portion. In the endoscope, the guide wire provided in the insertion portion and inserted through the treatment instrument insertion channel is guided from the distal opening of the treatment instrument insertion channel. A guide wire fixing means for releasably locking the guide wire in a state in which the movement of the guide wire in the axial direction is restricted when inserting or removing the treatment tool traveling on the treatment tool; There is a substantially V-shaped slit provided in the vicinity of the distal end opening of the common channel and sized to engage with only the guide wire on the top surface of the guide portion. A treatment instrument raising base that engages only the guide wire by pressing and inserting the guide wire into the slit, and within a predetermined operation range from the start of raising the treatment instrument raising base. An intermediate stopper for intermediately stopping the raising operation of the raising table and the intermediate stopping operation of the treatment tool raising table by the intermediate stopper are canceled to raise the treatment tool raising table to the full operation range of the treatment tool raising table. And an operating means that enables an upward movement.
Preferably, a plurality of the intermediate stoppers are provided.
Preferably, the operation means includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.

  According to the present invention, when the distal end portion of the guide wire inserted into the treatment instrument insertion channel is led out from the distal end opening portion of the treatment instrument insertion channel, the guide wire fixing means near the distal end portion of the insertion section is used. Since the guide wire is detachably locked, it is not necessary to grip the guide wire on the endoscope operation unit side when the treatment instrument is replaced. For this reason, the treatment tool can be easily replaced in a shorter time without impairing the conventional operation method of the treatment tool and the operation feeling, and the replacement procedure can be performed by a single operator.

The perspective view which shows schematic structure of the whole system of the endoscope apparatus incorporating the endoscope of 1st Embodiment of this invention and various external devices. The longitudinal cross-sectional view of the principal part which shows the internal structure of the front-end | tip part of the insertion part in the endoscope of 1st Embodiment. The top view of the principal part which shows the raising stand action | operation mechanism incorporated in the operation part in the endoscope of 1st Embodiment. The longitudinal cross-sectional view of the principal part which shows the raising stand action | operation mechanism incorporated in the operation part in the endoscope of 1st Embodiment. The longitudinal cross-sectional view of the principal part which shows the internal structure of the front-end | tip part of the insertion part in the endoscope of 1st Embodiment of this invention. (A) is a longitudinal cross-sectional view of the main part showing the locked state of the guide wire in the endoscope of the first embodiment, and (B) is a front view of the treatment instrument raising base. FIGS. 2A and 2B show a second embodiment of the present invention, in which FIG. 1A is a perspective view of a main part showing a schematic configuration of a distal end portion of an insertion portion in an endoscope, FIG. 2B is a plan view of a distal end portion of the insertion portion; C) is a longitudinal sectional view of the main part showing a state where the guide wire is moved to the locking position, and (D) is a longitudinal sectional view of the main part showing a modification of the first and second embodiments. FIGS. 3A and 3B show a third embodiment of the present invention, in which FIG. 3A is a cross-sectional view of a main part illustrating a schematic configuration of a distal end portion of an insertion portion in an endoscope, FIG. 3B is a plan view of a distal end portion of the insertion portion; C is a plan view of the distal end of the insertion portion showing a state where the guide wire is moved to the locking position, and (D) is a plan view of the distal end portion of the insertion portion showing a modification. The front view which shows the treatment tool raising base of 4th Embodiment of this invention. The 5th Embodiment of this invention is shown, (A) is a front view of a treatment tool raising base, (B) is a longitudinal cross-sectional view of a treatment tool raising base. The 6th Embodiment of this invention is shown, (A) is a rear view of a treatment tool raising base, (B) is the longitudinal cross-sectional view which expanded the part of the wire locking groove of a treatment tool raising base. (A) is a front view showing a first modification of the treatment instrument raising base of the sixth embodiment, (B) is a front view showing a second modification of the treatment instrument raising base of the sixth embodiment, (C) is The longitudinal cross-sectional view of the principal part which shows the 3rd modification of the treatment tool raising base of 6th Embodiment. The longitudinal cross-sectional view of the principal part which shows the inversion state of the treatment tool raising base in the state which penetrated the guide catheter in 7th Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the raising state of the treatment tool raising base of 7th Embodiment. (A) is a front view of a treatment instrument elevator according to the seventh embodiment, and (B) is a rear view of the treatment instrument elevator. The longitudinal cross-sectional view of the principal part which shows the structure of the treatment tool raising stand of the endoscope in 8th Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the ideal guide wire fixed state in the treatment tool raising stand of the endoscope of 8th Embodiment. The longitudinal cross-sectional view which shows the guide wire fixation state when the dispersion | variation by the process in the treatment tool raising stand of the endoscope of 8th Embodiment has occurred. The longitudinal cross-sectional view of the principal part which shows the state at the time of guide wire fixation in 9th Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the state at the time of the guide wire fixation in the conventional endoscope front-end | tip part. The top view of the principal part of the raising base action mechanism which shows 11th Embodiment of this invention. (A) is a longitudinal sectional view of the elevator operating mechanism of the eleventh embodiment, (B) is a perspective view of the main part showing the elevator operating knob, (C) is a perspective view showing a deterrence enhancing member of the brake mechanism, D) is a plan view of a deterrence enhancing member showing a buried state of the frictional resistance member. The top view which shows the suppression reinforcement member of the brake mechanism in the 1st modification of 11th Embodiment. The top view of the principal part of the raising base action mechanism which shows 10th Embodiment of this invention. (A) is a longitudinal cross-sectional view of the elevator operating mechanism showing the tenth embodiment, (B) is a vertical cross-sectional view of the main part showing a state in which the operation lever of the elevator operating mechanism is elastically deformed. The perspective view which shows the stopper member of the raising stand action | operation mechanism of 10th Embodiment. Explanatory drawing for demonstrating operation | movement of the raising base action mechanism of 10th Embodiment. The longitudinal cross-sectional view of the principal part which shows the modification of 10th Embodiment. FIG. 29 shows a twelfth embodiment of the present invention, (A) is a perspective view showing a distal end portion of an insertion portion of an endoscope, and (B) is a plan view showing an actual endoscope screen when a guide wire is fixed. The longitudinal cross-sectional view which shows the internal structure of the front-end | tip part in the insertion part of the endoscope of 12th Embodiment. (A) is a top view which shows the guide wire of 13th Embodiment of this invention, (B) is a top view which shows the 1st modification of the guide wire of 13th Embodiment, (C) is a guide of 13th Embodiment. The top view which shows the 2nd modification of a wire. (A) The longitudinal cross-sectional view of the principal part which shows the inversion state of the treatment tool raising base at the time of guide wire fixation in 14th Embodiment of this invention, (B) is the inversion of the treatment tool raising base at the time of the conventional guide wire fixation. The longitudinal cross-sectional view of the principal part which shows a state. FIG. 15 shows a fifteenth embodiment of the present invention, in which (A) is a perspective view of a main part showing a schematic configuration of a distal end portion of an insertion portion in an endoscope, and (B) shows an internal configuration of the distal end portion of the insertion portion. The longitudinal cross-sectional view of the principal part. The perspective view of the principal part which shows the modification of the front-end | tip cover of the insertion part in the endoscope of 15th Embodiment. The 16th Embodiment of this invention is shown, (A) is a cross-sectional view which shows the inversion state of the treatment tool raising stand seen from the endoscope front-end | tip part, (B) is at the time of raising of a treatment tool raising stand. The cross-sectional view which shows a state. FIG. 17 shows a seventeenth embodiment of the present invention, in which (A) is a transverse cross-sectional view showing an inverted state of the treatment instrument raising base viewed from the endoscope distal end, and (B) is when the treatment instrument raising base is raised. The cross-sectional view which shows a state. An 18th embodiment of the present invention is shown, (A) is a top view showing a tip part of an insertion part in an endoscope, and (B) is a longitudinal section of an important section showing an internal configuration of a tip part of an insertion part. (C) is a longitudinal cross-sectional view of the principal part which shows the state before fixation of a guide wire, (D) is a longitudinal cross-sectional view of the principal part which shows the fixation state of a guide wire. The longitudinal cross-sectional view of the principal part which shows the internal structure of the front-end | tip part of the insertion part in the endoscope of 19th Embodiment of this invention. The perspective view which shows the treatment tool raising base in the endoscope of 19th Embodiment. The longitudinal cross-sectional view of the principal part which shows the latching state of the guide wire in the endoscope of 20th Embodiment of this invention. In the twenty-first embodiment of the present invention, (A) is a perspective view showing a schematic configuration of a distal end portion of an insertion portion in an endoscope, and (B) is a perspective view showing a guide wire fixture. The longitudinal cross-sectional view which shows the inversion state of the treatment tool raising base in 22nd Embodiment of this invention. The longitudinal cross-sectional view which shows the raising state of the treatment tool raising base of 22nd Embodiment. The transverse cross section of the important section showing the internal configuration of the tip part in the insertion part of the endoscope of the 22nd embodiment. The schematic block diagram of the endoscope which shows 23rd Embodiment of this invention. The operation of the guide wire fixing tool in the endoscope of the twenty-fourth embodiment will be described. (A) is a perspective view of a main part showing a state where the guide wire fixing tool is held at the standby position, and (B). The perspective view of the principal part which shows the fixed state of a guide wire. FIG. 25 shows a twenty-fifth embodiment of the present invention, in which (A) is a perspective view of a main part showing a state in which a guide wire fixture in an endoscope is held at a standby position, and (B) is a guide wire fixed state. The perspective view of the principal part which shows. The top view of the front-end | tip part of the insertion part in the endoscope of 26th Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the state in which the guide wire fixing tool in the endoscope of 26th Embodiment is hold | maintained in the standby position. The longitudinal cross-sectional view of the principal part which shows the fixed state of the guide wire by the guide wire fixing tool in the endoscope of 26th Embodiment. The perspective view of the principal part which shows the 2nd modification of 11th Embodiment. The schematic block diagram of the principal part which shows 27th Embodiment of this invention. The longitudinal cross-sectional view which shows the internal structure of the front-end | tip part in the endoscope of 27th Embodiment. (A) is a perspective view which shows the guide wire latching member of 27th Embodiment, (B) is a perspective view which shows the rack gear of the front-end | tip of a pull wire. The perspective view which shows the modification of the guide wire latching member in 27th Embodiment. In the twenty-eighth embodiment of the present invention, (A) is a longitudinal sectional view of the main part showing the internal configuration of the distal end of the insertion part in the endoscope, and (B) is a perspective view showing the guide wire locking member. . (A) is a longitudinal cross-sectional view of the main part showing the internal configuration of the distal end portion of the insertion section in the endoscope of the twenty-ninth embodiment, and (B) is a guide wire fixing elevator base of the elevator operating mechanism held at the standby position. The longitudinal cross-sectional view of the principal part which shows the state currently performed, (C) is the longitudinal cross-sectional view of the principal part which shows the state by which the raising base for guide wire fixation of the raising base action | operation mechanism was moved to the latching position of a guide wire. In the thirtieth embodiment of the present invention, (A) is a perspective view showing a guide wire fixing elevator on the treatment instrument raising base, (B) is a perspective view showing a receiving part of the treatment instrument raising base, (C) is a perspective view which shows the raising base for guide wire fixation. (A) is a perspective view which shows the 1st modification of the raising base for guide wire fixation in the endoscope of 29th Embodiment, (B) is a perspective view which shows the 2nd modification of the raising base for guide wire fixation. . FIG. 31 shows a thirty-first embodiment of the present invention, in which (A) is a longitudinal sectional view of a main part showing a state where a guide wire fixing elevator of the elevator operating mechanism is held at a standby position, and (B) is an elevator. The longitudinal cross-sectional view of the principal part which shows the state by which the raising base for guide wire fixation of the upper base action mechanism was moved to the latching position of a guide wire. (A) is a perspective view showing a guide wire fixing elevator on the treatment instrument elevator in the endoscope of the thirty-first embodiment, and (B) shows an operation state of the guide wire fixing elevator on the elevator operating mechanism. FIG. The relational diagram showing the relationship between the raising angle of the treatment instrument raising base and the raising angle of the guide wire fixing raising base in the endoscope of the thirty-first embodiment. The perspective view which shows the modification of the raising base for guide wire fixation in the endoscope of 31st Embodiment. The perspective view of the front-end | tip part of the insertion part in the endoscope of 32nd Embodiment of this invention. The longitudinal cross-sectional view of the principal part which shows the state which the raising base for guide wire fixation of the raising base action mechanism of 32nd Embodiment was moved to the latching position of a guide wire. FIG. 33 shows a thirty-third embodiment of the present invention, in which (A) is a plan view showing an operation portion of the endoscope, (B) is a plan view showing an insertion portion of the endoscope, and (C) is a view of the endoscope. The longitudinal cross-sectional view of the principal part which shows the internal structure of an insertion part, (D) is a perspective view which shows a cam member. (A) is a top view which shows the 1st modification of the operation part of the endoscope in 33rd Embodiment, (B) is a top view which shows the 2nd modification of the operation part of an endoscope. FIG. 34 shows a thirty-fourth embodiment of the present invention, in which (A) is a longitudinal sectional view of an essential part showing an internal configuration of a distal end portion of an insertion portion in an endoscope, and (B) shows an operating state of a guide wire fixture. The longitudinal cross-sectional view of the principal part. FIG. 39 shows a thirty-fifth embodiment of the present invention, in which (A) is a longitudinal sectional view of the main part showing the internal configuration of the distal end portion of the insertion portion in the endoscope, and (B) shows the operating state of the guide wire fixture. The longitudinal cross-sectional view of the principal part, (C) is a perspective view which shows a torque transmission member. 36 shows a thirty-sixth embodiment of the present invention, in which (A) is a perspective view of a main part showing a schematic configuration of a distal end portion of an insertion portion in an endoscope, and (B) shows an internal configuration of the distal end portion of the insertion portion. The longitudinal cross-sectional view of the principal part, (C) is the longitudinal cross-sectional view of the principal part showing a state in which the guide wire fixing elevator is moved to the locking position of the guide wire. The top view of the principal part which shows the state in which the guide wire fixing | fixed part in the endoscope of 37th Embodiment of this invention is hold | maintained in the standby position. The top view of the principal part which shows the fixed state of the guide wire in the endoscope of 37th Embodiment. The top view which shows the modification of the fixed state of the edge part of the guide wire fixing | fixed part in the endoscope of 37th Embodiment. FIG. 38 shows a thirty-eighth embodiment of the present invention, in which (A) is a perspective view of a main part showing a schematic configuration of a distal end portion of an insertion portion in an endoscope, and (B) is a main part showing a configuration of a guide wire fixture. (C) is a longitudinal cross-sectional view of the principal part which shows the structure of a guide wire fixing tool. The longitudinal cross-sectional view of the principal part which shows the modification of the endoscope of 38th Embodiment. The perspective view which shows the hand side operation part of the endoscope in 39th Embodiment of this invention. (A) is a perspective view which shows the state before guide wire fixation of 39th Embodiment, (B) is a perspective view which shows the state after guide wire fixation. The longitudinal cross-sectional view which shows the internal structure of the front-end | tip part in the insertion part of the endoscope of 39th Embodiment. (A) is a perspective view which shows the state by which the snare of 39th Embodiment was closed, (B) is a perspective view which shows the state by which the snare was opened. The disassembled perspective view which shows the guide wire fixing member of 39th Embodiment. The perspective view which shows the state which attached the guide wire fixing member to the front-end | tip part of the insertion part of the endoscope in the endoscope apparatus of 40th Embodiment of this invention. The perspective view which showed the structure of the guide wire fixing member in the endoscope apparatus of 40th Embodiment. The operation | movement at the time of raising treatment tools other than a guide wire using the guide wire fixing member in the endoscope apparatus of 40th Embodiment is shown, (A) is the state before raising a treatment tool raising stand. FIG. 5B is a perspective view showing a state where the treatment instrument raising base is raised. The operation in the case of raising a guide wire using the guide wire fixing member in the endoscope apparatus of 40th Embodiment is shown, (A) is a perspective view which shows the state before raising a treatment tool raising stand. (B) is a perspective view which shows the state which raised the treatment tool raising base. The longitudinal cross-sectional view of the principal part which shows the state which locked the guide wire using the guide wire fixing member in the endoscope apparatus of 40th Embodiment. FIG. 48 shows a forty-first embodiment of the present invention, in which (A) is a perspective view of a main part showing the configuration of a guide wire fixing member, and (B) is a plan view showing an attachment part of the guide wire fixing member. The guide wire fixing member attachment mechanism in the endoscope apparatus of 41st Embodiment is shown, (A) is the principal part which shows the state before attaching a guide wire fixing member to the front-end | tip part of the insertion part of an endoscope. A longitudinal cross-sectional view, (B) is a longitudinal cross-sectional view of the main part showing a state where a guide wire fixing member is attached to the distal end portion of the insertion portion of the endoscope. The operation in the case of raising treatment tools other than a guide wire using the guide wire fixing member in the endoscope apparatus of 41st Embodiment is shown, (A) is the state before raising a treatment tool raising stand. FIG. 5B is a perspective view showing a state where the treatment instrument raising base is raised. The operation in the case of raising a guide wire using the guide wire fixing member in the endoscope apparatus of 41st Embodiment is shown, (A) is a perspective view which shows the state before raising a treatment tool raising stand. (B) is a perspective view which shows the state which raised the treatment tool raising base. The top view of the principal part which shows the state which attached the guide wire fixing member to the front-end | tip part of the insertion part of the endoscope in the endoscope apparatus of 42nd Embodiment of this invention. The top view of the principal part which shows the attachment mechanism of the guide wire fixing member in the endoscope apparatus of 42nd Embodiment. The guide wire fixing member attachment mechanism in the endoscope apparatus of 42nd Embodiment is shown, (A) is a top view of the principal part, (B) demonstrates the state which inserted the endoscope apparatus in the body cavity. Explanatory drawing for. The guide wire fixing mechanism main part which has the guide wire identification mechanism part and click mechanism in the endoscope apparatus of 42nd Embodiment is shown, (A) is a top view of the principal part of a guide wire fixing mechanism part, (B) is. The side view, (C) is a plan view showing the back of the guide wire fixing mechanism, (D) is a side view of the guide wire fixing mechanism. The base member of the guide wire fixing member main body in the endoscope apparatus of 42nd Embodiment is shown, (A) is a top view of the surface side of a base member, (B) is a top view of the back surface side of a base member, C) is a side view of the base member. The members in the endoscope apparatus according to the forty-second embodiment are shown, wherein (A) is a plan view of a guide wire fixing tool, (B) is a plan view of a guide wire identifying member, and (C) is a guide wire identifying member. A side view, (D) is a side view of a stopper, (E) is a top view of a stopper. The top view of the upper cover arrange | positioned at the front side of the base member of the guide wire fixing member main body in the endoscope apparatus of 42nd Embodiment. The attachment member of the guide wire fixing member in the endoscope apparatus of 42nd Embodiment is shown, (A) is a side view, (B) is a top view. It shows the click mechanism of the guide wire fixing member in the endoscope apparatus of the 42nd embodiment, (A) shows a click pin, and (B) shows a click groove. (A) is a top view which shows the initial state of the guide wire fixing member in the endoscope apparatus of 42nd Embodiment, (B) is the same side view, (C) is a stopper release part of a guide wire identification member, and a stopper member is used. The top view which shows the state expanded to right and left, (D) is a top view which shows the state by which the stopper was cancelled | released and the guide wire fixing tool was pushed in. (A) is a top view which shows the state hold | maintained in the state by which the guide wire fixing tool and guide wire identification member in the endoscope apparatus of 42nd Embodiment were pushed in, (B) is a click pin with a 2nd convex part. The top view which shows the state by which it reached | attained and the lock | rock was cancelled | released, (C) is a top view which shows the state in the middle of the guide wire fixing tool returning to an initial state. The operation in raising the treatment tool in the endoscope apparatus of the 42nd embodiment is shown, (A) is a plan view of the distal end portion of the insertion portion showing the state before raising the treatment tool raising base, (B) is the longitudinal sectional view, (C) is a plan view of the distal end portion of the insertion portion showing the state where the treatment instrument raising base is raised and the stopper is released, (D) is the longitudinal sectional view, (E ) Is a plan view of the distal end portion of the insertion portion showing a state where the guide wire fixture and the guide wire identification member are pushed in, and FIG. The operation at the time of raising the guide wire in the endoscope apparatus of the 42nd embodiment is shown, (A) is a plan view of the distal end portion of the insertion portion showing the state before raising the treatment instrument raising base, (B) is the longitudinal cross-sectional view, (C) is a plan view of the distal end portion of the insertion portion showing a state where the guide wire is pressed and fixed to the treatment instrument raising base and the guide wire fixing tool, and (D) is the same. FIG. FIG. 43 shows a forty-third embodiment of the present invention, in which (A) is a plan view of the front side of the base member in the guide wire fixing member body, (B) is a plan view of the back side of the base member in the guide wire fixing member body, ) Is a side view of the base member of the guide wire fixing member body, (D) is a plan view of the guide wire fixing tool, (E) is a plan view of the guide wire identifying member, (F) is the side view, and (G) is The top view of a stopper member, (H) is the same side view, (I) is a top view of the click pin of a click mechanism, (J) is a figure which shows the click groove | channel of a click mechanism. The operation | movement of the guide wire fixing member main body at the time of raising the treatment tool in the endoscope apparatus of 43rd Embodiment is shown, (A) is a top view which shows the initial state before raising a treatment tool raising stand. , (B) is the longitudinal sectional view, (C) is a plan view showing a state where the treatment instrument raising base is raised and the stopper is released, (D) is the longitudinal sectional view, and (E) is a guide wire fixed state. The top view which shows the state by which the tool and the guide wire identification member were pushed in, (F) is the longitudinal cross-sectional view. (A) is a top view which shows the click release state of the guide wire fixing tool and guide wire identification member in the endoscope apparatus of 43rd Embodiment, (B) is the longitudinal cross-sectional view, (C) is a guide wire fixing tool and The top view which shows the state which a guide wire identification member returns to an initial position, (D) is the longitudinal cross-sectional view. The operation | movement at the time of raising the treatment tool in the endoscope apparatus of 43rd Embodiment is shown, (A) is a top view of the front-end | tip part of the insertion part which shows the state before raising a treatment tool raising base, (B) is the longitudinal sectional view, (C) is a plan view of the distal end portion of the insertion portion showing the state where the treatment instrument raising base is raised and the stopper is released, (D) is the longitudinal sectional view, (E ) Is a plan view of the distal end portion of the insertion portion showing a state where the guide wire fixture and the guide wire identification member are pushed in, and FIG. The operation at the time of raising the guide wire in the endoscope apparatus of 43rd Embodiment is shown, (A) is a top view of the front-end | tip part of the insertion part which shows the state before raising a treatment tool raising base, (B) is the longitudinal cross-sectional view, (C) is a plan view of the distal end portion of the insertion portion showing a state where the guide wire is pressed and fixed to the treatment instrument raising base and the guide wire fixing tool, and (D) is the same. FIG. FIG. 44 shows a forty-fourth embodiment of the present invention, in which (A) is a perspective view of a main part showing a state in which a grasping treatment instrument is inserted into an external channel, and (B) is a snare inserted into the external channel. The perspective view of the principal part which shows the state which showed the state, (C) is the perspective view of the principal part which shows the state in which the guide wire pushing board was inserted in the external channel. The perspective view of the principal part which shows the attachment state of the guide wire fixing member in the endoscope apparatus of 45th Embodiment of this invention. FIG. 46 shows a forty-sixth embodiment of the present invention, in which (A) is a perspective view of a main part showing a state in which a grasping treatment instrument is attached to the distal end of an insertion part in an endoscope, and (B) is an endoscope of the endoscope. The perspective view of the principal part which shows the state which bent the bending part and loosened the operation wire, (C) is the perspective view of the principal part which shows the state raised to the position which a guide wire clamps with a holding | grip treatment tool. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1A is a conceptual diagram of the present invention, and FIG. (B) is a longitudinal sectional view of the main part showing a state where a guide wire is raised instead of the treatment instrument of (A), and (C) is a guide near the distal end of the insertion part of the endoscope. The longitudinal cross-sectional view of the principal part which shows the raising state of the treatment tool when the wire fixing member is embedded, FIG. The longitudinal cross-sectional view of a part. (A) is a plan view of a main part showing a distal end portion of an insertion portion in an existing endoscope, (B) is a side view of (A), and (C) is a guide wire at the distal end portion of the insertion portion of the endoscope. The top view of the principal part which shows the endoscope which has a fixing member installation space, (D) is a side view of (C), (E) shows the endoscope which has the attachment member of the guide wire fixing mechanism part. (F) is a side view of (E), (G) is an essential part showing an endoscope in which a guide wire fixing member having a guide wire fixing mechanism portion is detachably incorporated. The top view, (H) is a side view of (G). (A) is a top view of the principal part which shows the modification of a guide wire, (B) is a top view of the principal part which shows the other modification of a guide wire, (C) shows another modification of a guide wire. The top view of the principal part. FIG. 9 shows a use state of a guide wire when performing an endoscopic treatment using an endoscope in a conventional method. FIG. 5A shows an operation state in which a catheter is pulled out from a treatment instrument insertion channel of an endoscope. Explanatory drawing for demonstrating, (B) is explanatory drawing for demonstrating the operation state which pulls out a catheter completely from an endoscope.

  1 to 6 (A) and 6 (B) show a first embodiment of the present invention. FIG. 1 shows a schematic configuration of an entire system of an endoscope apparatus in which an endoscope 1 of this embodiment and various external devices are incorporated. Examples of the external device include a light source device 2, an image processing device 3, a monitor 4, an input keyboard 5, a suction pump device 6, and a water bottle 7. These devices are installed on a shelf 9 with a carrier 8. Yes.

  The endoscope 1 has an elongated insertion portion 12 to be inserted into a body cavity, a proximal side operation portion 13 connected to the proximal end portion of the insertion portion 12, and a proximal end portion connected to the operation portion 13. Universal cord 14 is provided. Further, the insertion portion 12 has an elongated flexible tube portion 15 having flexibility, a bending portion 16 connected to the distal end of the flexible tube portion 15, and a distal end disposed at the most distal position of the insertion portion 12. Each component part which consists of the part 17 is provided.

  A connector 18 is provided at the tip of the universal cord 14 connected to the operation unit 13. The connector 18 is provided with a light guide tube and an electrical contact portion. The connector 18 is connected to the light source device 2 and the image processing device 3 which are external devices.

  Further, as shown in FIG. 7, a concave cutout portion 17 a is formed on the outer peripheral surface of the distal end portion 17 of the endoscope 1 as shown in FIG. 7. And the channel opening part 26 is arrange | positioned at the one side part side of this notch part 17a. Further, an objective lens (not shown) of the observation optical system and an illumination lens (not shown) of the illumination optical system are arranged next to the channel opening 26.

Further, a nozzle (not shown) for air / water supply projects from the rear end wall surface 17b of the notch portion 17a of the front end portion 17. A fluid such as water or air is sprayed from the nozzle onto the outer surface of the objective lens to clean the lens surface.
Further, the operation section 13 of the endoscope 1 is provided with a bending operation section 56 for bending the bending section 16 of the insertion section 12 in the up / down / left / right directions, an air / water supply button 59, and a suction operation button 60, respectively. In addition, an insertion port 61 leading to the treatment instrument insertion channel 23 is provided. And it is comprised so that gas and a liquid may be selectively ejected to the nozzle of the front-end | tip part 17 by operation of the air supply / water supply button 59. FIG. Furthermore, a suction force is selectively applied to the channel opening 26 of the distal end portion 17 through the treatment instrument insertion channel 23 by operating the suction operation button 60 to collect mucus or the like in the body cavity.

  Further, as shown in FIG. 3 and FIG. 4, an elevator base operating mechanism 41 for operating the elevator wire 30 is built in the operation unit 13. A wire fixing member 42 made of a hard rod-like material such as metal is integrally fixed to the base end portion of the raising wire 30 with solder or the like. As shown in FIG. 4, a locking groove 43 made of a recess is formed in the proximal end portion of the wire fixing member 42.

  Further, a link member 44 made of a hard block body such as metal is fixed to the proximal end portion of the wire fixing member 42. The link member 44 is formed with an insertion hole 44 a for the wire fixing member 42. The proximal end portion of the wire fixing member 42 is fitted into the insertion hole 44 a of the link member 44. The base end portion of the wire fixing member 42 is entirely inserted into the insertion hole 44 a of the link member 44 in which the locking groove 43 is formed.

  The link member 44 is provided with a female screw portion 45 into which the fixing screw 46 of the wire fixing member 42 is screwed. The distal end portion of the fixing screw 46 screwed into the female screw portion 45 of the link member 44 is locked in a state of being inserted into the locking groove 43 of the wire fixing member 42. Thereby, the wire fixing member 42 is connected in a state of being fixed to the link member 44.

Further, a base 47 serving as a base of the operation unit 13 is disposed inside the operation unit 13. The link member 44 is disposed so as to freely advance and retract in the longitudinal direction of the base 47.
In addition, one end of an arm 49 is rotatably connected to the link member 44 by a link shaft 50 that is a rod-shaped shaft member. An engaging member 51 made of a C-type or E-type retaining ring or the like is engaged with the end of the link shaft 50 opposite to the end on the base 47 side.

  Further, the other end of the arm 49 is connected to a raising operation knob 48 provided adjacent to the bending operation unit 56. The raising wire 30 is pulled through the arm 49, the link member 44, and the wire fixing member 42 by the operation of the raising operation knob 48 in the operation unit 13, and the treatment instrument raising base 27 is turned up. 28 is configured to move up and down around the center. Thus, the guide catheter and the guide wire 68 inserted through the treatment instrument insertion channel 23 and led out from the channel opening 26 to the outside are configured to be raised by raising the treatment instrument raising base 27. Yes.

  Next, the structure of the front-end | tip part 17 of the insertion part 12 is demonstrated in detail using FIG. The distal end portion 17 is provided with a distal end rigid portion 21 as a distal end portion main body and a distal end cover 22 formed of a non-conductive material such as a resin so as to cover the periphery thereof. The tip cover 22 is fixed to the tip hard portion 21 by adhesion or the like.

  Furthermore, an introduction guide path 24 for guiding the introduction of the treatment tool or the like to the distal end side is formed in the distal end hard portion 21. The introduction guide path 24 is formed continuously with a treatment instrument insertion channel (insertion hole) 23 as a treatment instrument insertion guide path disposed in the insertion portion 12 of the endoscope 1.

  In addition, a storage chamber 25 that is a space formed by the distal end hard portion 21 and the distal end cover 22 is provided on the distal end side of the introduction guide path 24. A channel opening 26 constituting the distal end opening of the treatment instrument insertion channel 23 is formed by the opening of the storage chamber 25.

  Further, a treatment instrument raising base 27 for raising a treatment instrument such as a treatment instrument and a guide catheter introduced through the channel 23 to a desired position is disposed in the storage chamber 25. One end of the treatment instrument raising base 27 is pivotally attached by an raising base turning fulcrum 28 provided at the distal end hard portion 21.

  The elevator fulcrum 28 is disposed at a lower portion of the leading opening portion of the introduction guide path 24. Then, the treatment instrument elevator 27 is rotated around the elevator rotation support point 28 from the standby position indicated by the solid line in FIG. 2 to the treatment instrument activation position indicated by the phantom line in FIG. It is attached so that it can move up and down.

The treatment instrument raising base 27 is formed with a guide surface 29 for guiding a treatment instrument such as a treatment instrument or a guide catheter. The guide surface 29 is formed by a groove having a substantially V-shaped cross-section continuous from the introduction guide path 24.
Further, the distal end portion of the raising wire 30 is fixed to the treatment instrument raising base 27. The raising wire 30 is guided to the operation unit 13 side through a guide pipe 31 and a guide tube 32 that are inserted into the insertion unit 12, and is connected to an elevator operation mechanism 41 described later. Then, the treatment instrument raising base 27 is configured to move up and down around the raising base turning fulcrum 28 in accordance with the pulling operation of the raising wire 30.

  Further, as shown in FIG. 6B, a slit-like wire that removably engages a guide wire 68 as a guide wire fixing means at the bottom of the substantially V-shaped groove on the guide surface 29 of the treatment instrument raising base 27. A locking groove 321 is provided. The wire locking groove 321 has two opposing wall surfaces and has a width such that only the outer periphery of the guide wire 68 contacts.

  Note that the wire locking groove 321 is preferably a groove having a substantially V-shaped cross section whose width decreases in a tapered shape toward the bottom. The relationship between the opening slit width (groove width) T1 of the wire locking groove 321, the wire diameter D1 of the guide wire 68, and the outer diameter D2 of other treatment tools such as a treatment tool and a guide catheter is as follows. It is even better if D1 ≦ T1 <D2 ”is set.

  Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, a guide catheter is inserted into the treatment instrument insertion channel 23 from the insertion port 61 of the operation unit 13 of the endoscope 1. Then, this guide catheter is protruded to the outside from the channel opening 26 and is inserted into the pancreas / bile duct (not shown) transdermally. Thereafter, the currently used guide catheter is replaced with a treatment instrument to be used next. First, the guide wire 68 is inserted from the base on the proximal end side of the guide catheter. Then, it is confirmed from the observation image (endoscopic image) of the endoscope 1 that the distal end portion of the guide wire 68 has been inserted into the pancreas / bile duct, and the proximal end side of the guide wire 68 is grasped by hand. . Subsequently, an operation of pulling out the guide catheter is performed in this state, and after confirming that the guide catheter has been pulled out from the nipple in the observation image, the guide catheter is further pulled out toward the hand side. Then, the raising operation knob 48 of the treatment instrument raising base 27 is operated in a state where the distal end of the guide catheter is accommodated in the channel opening 26. In response to the operation of the raising operation knob 48, the raising wire 30 is pulled, and the treatment instrument raising base 27 is turned around the raising base turning fulcrum 28 to rise as shown by a virtual line in FIG. Is done.

  Further, when the treatment instrument raising base 27 is raised, the guide wire 68 is placed in the wire locking groove 321 along the substantially V-shaped groove on the guide surface 29 of the treatment instrument raising base 27 as shown in FIG. Then, as shown in FIG. 6B, the guide wire 68 is detachably locked in the wire locking groove 321. Then, the guide wire 68 is pressed against the upper surface 273 side of the introduction guide path 24 of the distal end hard portion 21 by the treatment instrument raising base 27 as indicated by an arrow P in FIG. At this time, a reaction force indicated by an arrow Fr in FIG. 6A that tries to keep a straight line acts from the hard guide wire 68, so that the guide wire 68 is pressed into the wire locking groove 321 by this reaction force. The guide wire 68 is mechanically fixed in this state.

Further, after confirming that the guide wire 68 is fixed, the guide catheter is completely pulled out from the operation portion 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment instrument passes through the treatment instrument elevator 27 by turning the treatment instrument elevator 27 upside down by operating the raising operation knob 48 when the distal end of the treatment instrument abuts against the treatment instrument elevator 27. The guide wire 68 is pushed out from the wire locking groove 321 by the pushing force of the treatment tool at that time, and the guide wire 68 is released from being fixed. Further, a treatment instrument is inserted into the pancreas / bile duct.

The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed only by the usual raising operation of the treatment instrument raising base 27, that is, the raising operation knob 48 of the hand operation unit 13 of the endoscope 1 is operated. Become.
Furthermore, in this embodiment, since the conventional treatment tool can be used as it is, the use of the treatment tool familiar to the surgeon can maintain a state in which operability remains good. Therefore, the treatment instrument can be easily replaced in a shorter time without impairing the conventional operation method of the treatment instrument and the operation feeling.

  Further, since the guide wire 68 can be fixed at the distal end portion 17 of the insertion portion 12 of the endoscope 1, the length of the guide wire 68 can be shortened. Therefore, it is easy to handle the guide wire 68, and there is an effect that a large work space is not required. In addition, the treatment tool can be easily replaced, the number of assistants can be reduced, and the working time can be shortened.

  Also, by forming the wire locking groove 321 in a substantially V shape, it is possible to stably lock the wire locking groove 321 firmly with respect to the guide wire 68 having slightly different outer diameters. In addition, by providing the wire locking groove 321, the guide wire 68 guided to the guide surface 29 is always located at the same wire locking groove 321, so that the fixed state is always stable, and the position of the guide wire 68 is It is possible to eliminate the variation in the fixing strength due to.

  Furthermore, in this embodiment, the relationship between the slit width (groove width) T1 of the wire locking groove 321, the wire diameter D1 of the guide wire 68, and the outer diameter D2 of other treatment tools such as a treatment tool and a guide catheter. Since “D1 ≦ T1 <D2” is set, a treatment tool that is normally used is, for example, a tube-like treatment tool that is extrapolated to the guide wire 68 without being caught in the wire locking groove 321 and can be used without any problem. Is possible.

FIGS. 7A to 7D show a second embodiment of the present invention. In the present embodiment, the configuration of the distal end portion 17 of the insertion portion 12 of the endoscope 1 in the first embodiment is changed as follows.
That is, in this embodiment, a slit-like wire locking groove 331 corresponding to the wire locking groove 321 of the treatment instrument raising base 27 for fixing the guide wire 68 of the first embodiment is provided as an introduction guide path for the distal end hard portion 21. 24 is provided on the upper surface 273 side. The relationship between the opening slit width (groove width) T1 of the wire locking groove 331, the wire diameter D1 of the guide wire 68, and the outer diameter D2 of other treatment tools such as a treatment tool and a guide catheter is as follows. As in the embodiment, “D1 ≦ T1 <D2” is set.

  Next, the operation of this embodiment will be described. When using the endoscope 1 of the present embodiment, the guide catheter and the guide wire 68 are inserted into the body through the channel 23 and then the guide catheter is drawn into the introduction guide path 24 or the channel 23 as in the first embodiment. In this state, the raising operation knob 48 of the treatment instrument raising base 27 is operated. In response to the operation of the raising operation knob 48, the raising wire 30 is pulled, and the treatment instrument raising base 27 is turned around the raising base turning fulcrum 28 to rise as shown by a virtual line in FIG. Is done.

  Further, when the treatment instrument raising base 27 is raised, the guide wire 68 is pressed against the upper surface 273 side of the introduction guide path 24 of the distal end hard portion 21 by the treatment instrument raising base 27 as shown in FIG. At this time, since a reaction force to keep a straight line acts from the hard guide wire 68, the guide wire 68 is strongly locked in the wire locking groove 331 of the distal end hard portion 21 by this reaction force, and FIG. As shown in A), the guide wire 68 is mechanically fixed in this state.

Further, after confirming that the guide wire 68 is fixed, the guide catheter is completely pulled out from the operation portion 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment instrument passes through the treatment instrument elevator 27 by turning the treatment instrument elevator 27 upside down by operating the raising operation knob 48 when the distal end of the treatment instrument abuts against the treatment instrument elevator 27. The guide wire 68 is pushed out from the wire locking groove 331 by the pushing force of the treatment tool at that time, and the guide wire 68 is released from being fixed.

  The present embodiment has the following effects. That is, in this embodiment, the guide wire 68 can be easily fixed only by the raising operation of the treatment instrument raising base 27 that is normally performed on the hand operation unit 13 side of the endoscope 1. Therefore, the same effect as that of the first embodiment can be obtained in this embodiment.

  Furthermore, in the present embodiment, the opening slit width (groove width) T1 of the wire locking groove 331, the wire diameter D1 of the guide wire 68, and the outer diameter D2 of other treatment tools such as a treatment tool and a guide catheter Since “D1 ≦ T1 <D2” is set, the treatment tool that is normally used is not caught in the wire locking groove 331 and can be used without any problem.

  As a modification of the first and second embodiments, as shown in FIG. 7D, a wire locking groove provided on the upper surface 273 side of the introduction guide path 24 of the distal end hard portion 21 shown in the second embodiment. You may provide in both 331 and the wire latching groove | channel 321 provided in the guide surface 29 of the treatment tool raising base 27 shown in 1st Embodiment.

As a result, as in the first and second embodiments, the guide wire 68 enters the wire locking grooves 321 and 331 and is locked at two points by raising the treatment instrument raising base 27. .
In addition to the same effects as those of the first and second embodiments described above, the effect of this is that the fixing strength is further increased by being locked at two points.

FIG. 8 shows a third embodiment of the present invention. In the present embodiment, the configuration of the distal end portion 17 of the insertion portion 12 in the endoscope 1 of the first embodiment is changed as follows.
That is, in this embodiment, as shown in FIGS. 8A, 8B, and 8C, the guide wire 68 can be engaged with and disengaged from the bottom of the substantially V-shaped groove on the guide surface 29 of the treatment instrument raising base 27. A slit-like wire locking groove 321 is provided to be locked. Assuming that the central axis of the wire locking groove 321 with respect to the insertion portion axial direction is M1, and the central axis of the guide surface 29 with respect to the insertion portion axial direction is M2, the angle of the wire locking groove 321 is inclined by θ, so that M1 and M2 Is tilted by θ.

Note that the inclination θ may be inclined to either the objective lens side or the opposite side of M1 of the objective lens with respect to M1.
Further, it is not always necessary to provide the wire locking groove 321 at the intersection of the central axis M1 of the wire locking groove 321 and the central axis M2 of the guide surface 29. For example, as shown in FIG. You may provide in the position shifted more.

  In the present embodiment, when the treatment instrument raising base 27 is raised, the treatment tool raising base 27 causes the guide wire 68 to be inserted into the wire locking groove 321 provided obliquely with respect to the insertion portion axial direction along the guide surface 29. As shown in FIG. 8 (B), it is guided and fitted into the wire locking groove 321 so as to be detachable. The subsequent operation is the same as that of the first embodiment described above.

FIG. 9 shows a fourth embodiment of the present invention. In this embodiment, the configuration of the treatment instrument elevator base 27 of the first embodiment is changed as follows.
That is, in this embodiment, a surface-treated surface 541 having a large frictional resistance is formed by applying a surface treatment that forms a rough surface on the inner surface of the wire locking groove 321 in the treatment instrument elevator base 27 of the first embodiment. Has been. The surface treatment surface 541 is, for example, a surface treatment for causing a chemical reaction such as corrosion on the inner surface of the wire locking groove 321, or a treatment such as embedding or pasting a member having a high frictional resistance, such as rubber, silicone, or other elastomer. Is formed by.

  The present embodiment has the following effects. That is, in this embodiment, the same effect as that of the first embodiment can be obtained, and in addition to this, the guide wire 68 and the wire locking can be secured by the surface treatment surface 541 of the inner surface of the wire locking groove 321 in the treatment instrument raising base 27. By increasing the frictional resistance with the groove 321, there is an effect that the amount of fixing force of the guide wire 68 can be increased.

FIGS. 10A and 10B show a fifth embodiment of the present invention. In this embodiment, the configuration of the treatment instrument raising base 27 of the endoscope 1 in the first embodiment is changed as follows.
That is, the treatment instrument elevator base 27 of the present embodiment is provided with a chamfered portion 551 that is chamfered over the entire circumference of the ridgeline between the wire locking groove 321 and the guide surface 521.

  The present embodiment has the following effects. That is, in this embodiment, the same effect as that of the first embodiment can be obtained, and in addition, when the treatment instrument raising base 27 is raised, the guide wire 68 is guided along the chamfered portion 551 and the wire is It becomes easy to enter the locking groove 321. Further, there is an effect that the guide wire 68 and other treatment tools are not damaged due to the guide wire 68 and other treatment tools being caught on the edge of the wire locking groove 321 when the guide wire 68 or other treatment tools are inserted.

FIGS. 11A and 11B show a sixth embodiment of the present invention. In this embodiment, the configuration of the treatment instrument raising base 27 of the endoscope 1 in the first embodiment is changed as follows.
That is, in this embodiment, the engagement protrusion 502 which narrows the width | variety of the opening edge part of the wire locking groove 321 is provided in the upper part of the wall surface 501 of both sides in the wire locking groove 321 of the treatment tool raising base 27. FIG. The interval between the engagement protrusions 502 on both sides at the opening end of the wire locking groove 321 is set to be a slightly narrower gap than the outer diameter dimension of the guide wire 68.

  Next, the operation of this embodiment will be described. In the present embodiment, similarly to the treatment instrument raising base 27 of the endoscope 1 of the first embodiment, the treatment instrument raising base 27 is raised in a state where the guide catheter is pulled into the treatment instrument insertion channel 23. The guide wire 68 is guided to the wire locking groove 321 by the guide surface 29 of the treatment instrument raising base 27.

At this time, the guide wire 68 is strongly pressed from the outside to the protrusion 502 as the turning angle of the treatment tool raising base 27 is increased with the turning operation of the treatment tool raising base 27, and the guide wire 68 starts to be elastically deformed. Then, the guide wire 68 gets over the protrusion 502 at an appropriate angle before the rotation angle of the treatment instrument raising base 27 reaches the maximum raising angle, and the guide wire 68 enters the wire locking groove 321 as shown in FIG. 68 fits in. As a result, the guide wire 68 is fixed in a state in which it is in contact at the four points of the wall surfaces 501 on both sides and the engagement protrusions 502 on both sides in the wire locking groove 321 of the treatment instrument raising base 27.
Thereafter, the guide catheter is pulled out at once, and another treatment instrument is inserted using the guide wire 68 as a guide. At this time, when the inserted treatment instrument passes through the wire locking groove 321, the guide wire 68 is pushed out of the wire locking groove 321 by the pressing force of the treatment tool, and the fixation of the guide wire 68 is released.

The present embodiment has the following effects. That is, in the present embodiment, only the raising operation of the treatment instrument raising base 27 that is normally performed to operate the raising operation knob 48 of the hand operation unit 13 of the endoscope 1 is performed, as in the endoscope 1 of the first embodiment. Thus, the guide wire 68 can be easily fixed.
Further, in this embodiment, in addition to the same effect as the endoscope 1 of the first embodiment, when the guide wire 68 is fixed, the engagement protrusions 502 on both sides of the opening end portion of the wire locking groove 321 are overcome from the outside. At this point, the guide wire 68 can be more firmly fixed by sandwiching the guide wire 68 between the wire locking groove 321 and the engaging protrusions 502 on both sides.

Furthermore, when the guide wire 68 is fixed, the force by which the guide wire 68 escapes in the upper surface direction of the treatment instrument raising base 27 can be suppressed by the engagement protrusions 502 on both sides.
In addition, as in the first modification of the treatment instrument elevator base 27 in the sixth embodiment shown in FIG. 12A, the engagement protrusions 502 on both sides of the opening end of the wire locking groove 321 of the treatment instrument elevator base 27. May be provided in the entire range of the wire locking groove 321 or in a part of the wire locking groove 321 along the insertion portion axial direction. Further, as in the second modified example of the treatment instrument raising base 27 in the sixth embodiment shown in FIG. 12B, a plurality of engagements are provided on both sides of the opening end of the wire locking groove 321 of the treatment instrument raising base 27. A mating protrusion 502 may be provided.

  Further, as in the third modified example of the treatment instrument elevator base 27 in the sixth embodiment shown in FIG. 12C, the wire engagement of the treatment instrument elevator base 27 within a range in which the fixing capability of the guide wire 68 is not extremely lowered. The engagement protrusion 502 may be provided only on one side of the opening end in the groove 321. As described above, when the engagement protrusion 502 is provided only on one surface of the opening end portion of the wire locking groove 321 of the treatment instrument raising base 27, the amount of operation force when the guide wire 68 is put in and out of the wire locking groove 321 is small. Since it becomes lighter, the guide wire 68 can be fixed relatively easily.

FIGS. 13 to 15 (A) and 15 (B) show a seventh embodiment of the present invention. In this embodiment, the configuration of the treatment instrument raising base 27 of the endoscope 1 in the first embodiment is changed as follows.
That is, in this embodiment, as shown in FIG. 13, the wire locking groove 321 of the treatment tool raising base 27 is placed in the inverted state of the treatment tool raising base 27, and the treatment tool is placed in the wire locking groove 321 when other treatment tools are advanced or retreated. It is provided in a position where it cannot be touched. FIG. 13 is a cross-sectional view of the treatment instrument elevator base 27 when the guide catheter 67 is inserted, and FIG. 14 is a cross-sectional view of the treatment instrument elevator base 27 when it is raised. The wire locking groove 321 of the treatment instrument elevator 27 includes a guide surface 521, a distal end surface 522, and a connecting surface 523 that connects these two surfaces.

  FIG. 15A is a front view of the treatment instrument elevator base 27, and FIG. 15B is a rear view of the treatment instrument elevator base 27. In this embodiment, the wire locking groove 321 of the treatment instrument raising base 27 is disposed at a position that cannot be seen from the hand side as shown in FIGS. The wire locking groove 321 of the treatment instrument raising base 27 is formed so as to gradually become deeper from the connecting surface 523 toward the distal end surface 522. Accordingly, the wire locking groove 321 is set to be exposed at the travel position of the guide wire 68 as the treatment instrument raising base 27 is raised.

  Next, the operation of this embodiment will be described. In the present embodiment, as in the first embodiment, the wire locking groove 321 appears by raising the treatment instrument raising base 27 in a state where the guide catheter 67 is pulled into the treatment instrument insertion channel 23, and the guide wire 68 is sandwiched and fixed. Others are the same as in the first embodiment.

The present embodiment has the following effects. That is, in the present embodiment, similarly to the first embodiment, the guide wire can be easily operated only by the raising operation of the treatment instrument raising base 27 which is normally performed to operate the raising operation knob 48 of the hand operation unit 13 of the endoscope 1. 68 can be fixed.
Further, in this embodiment, in addition to the same effect as the endoscope 1 of the first embodiment, the wire locking groove 321 does not appear on the guide surface 521 when the treatment instrument raising base 27 is inverted, so that the treatment instrument is There is no risk of injury and the effect of smoothing the advancement and retreat of the treatment tool is obtained.

FIGS. 16 to 18 show an eighth embodiment of the present invention. In this embodiment, the configuration of the treatment instrument raising base 27 of the endoscope 1 in the first embodiment is changed as follows.
That is, the wire locking groove 321 of the treatment instrument raising base 27 is desirably designed so that when the guide wire 68 is raised, the guide wire 68 is caught on the entire surface of the wire locking groove 321 as shown in FIG. In general, a slight deviation is caused on the contact surface between the wire locking groove 321 and the guide wire 68 as shown in FIG. When the guide wire 68 is raised by the treatment instrument elevator 27 and the angle between the insertion portion axis O and the wire locking groove 321 in the ideal state shown in FIG. As shown in the figure, if the angle between the insertion portion axis O and the wire locking groove 321 when the contact surface between the wire locking groove 321 and the guide wire 68 is displaced is θ2 due to processing accuracy, “θ < There may be a relationship of “θ2”. In this case, the distal end portion of the guide wire 68 is pressed by the distal end portion of the wire locking groove 321, so the guide wire contact point of the treatment instrument raising base 27 holding the guide wire 68 and the distal end hard portion 21. The distance L2 between the two points of the introduction guide path 24 and the guide wire contact point becomes relatively long. Therefore, in this state, there is a problem that the fixing strength of the guide wire 68 is lowered.

  In this embodiment, considering the tolerance due to the processing of the wire locking groove 321 of the treatment instrument elevator 27, when the guide wire 68 is raised by the treatment instrument elevator 27 as shown in FIG. With respect to the angle θ between the insertion portion axis O and the wire locking groove 321 in the ideal state shown in FIG. θ> θ1 ”. Thus, when the guide wire 68 is raised by the treatment instrument raising base 27, the proximal end of the wire locking groove 321 of the treatment instrument raising base 27 is shown on the proximal side end portion of the ideal wire locking groove 321 shown in FIG. It is set so that the contact point with the guide wire 68 is disposed on the proximal side of the wire locking groove 321. In this case, the distance L1 between two points of the guide wire contact point of the treatment instrument raising base 27 holding the guide wire 68 and the guide wire contact point of the introduction guide path 24 in the distal end hard portion 21 is as shown in FIG. Since it is smaller than L2 (L1 <L2), the fixing strength of the guide wire 68 can be made higher than in the case of FIG.

  Therefore, in this embodiment, when the guide wire 68 is raised by the treatment instrument raising base 27, the wire locking groove 321 of the treatment instrument raising base 27 and the guide wire contact point of the introduction guide path 24 in the distal end hard portion 21 are two. Since the distance between the points does not become longer due to variations in processing, the fixing strength of the guide wire 68 does not decrease due to processing variations of the wire locking groove 321 of the treatment instrument raising base 27, and the fixing strength of the guide wire 68 is reduced. Has the effect of keeping it stable.

19 and 20 show a ninth embodiment of the present invention. In this embodiment, the configuration of the treatment instrument elevator base 27 of the first embodiment is changed as follows.
That is, in the present embodiment, as shown in FIG. 19, the rising position of the guide wire 68 raised by the treatment instrument raising base 27 at the distal end portion of the treatment instrument raising base 27 when the treatment instrument raising base 27 is raised up to the maximum. Is provided with a wire locking groove 321 that strongly bends toward the proximal side with respect to the position of the elevator turn pivot 28. The wire locking groove 321 is disposed in the vicinity of the distal end of the guide surface 68 of the guide wire 68 of the treatment instrument raising base 27. When the treatment instrument raising base 27 is raised up to the maximum, the wire locking groove 321 is disposed at a position protruding from the position of the raising base turning fulcrum 28 toward the hand side by an appropriate distance L1.

It should be noted that the clearance between the wire locking groove 321 provided in the treatment instrument raising base 27 and the upper surface 273 of the introduction guide path 24 when the treatment instrument raising base 27 is raised is determined by inserting or removing the guide catheter or other treatment instrument. It is held in a state secured as before so as not to interfere.
Further, on the guide surface side wall surface 27a of the treatment instrument raising base 27, the treatment instrument can be inserted into and removed from a portion of the distal end of the distal end hard portion 21 that faces the raising angle stopper 462 when the treatment instrument raising base 27 is fully raised. A cutout portion 463 is formed in such a range that the contact with the rising angle stopper 462 is escaped within a range that does not hinder the contact.

Note that the configuration is not limited as long as the positional relationship between the wire locking groove 321 and the elevator turn pivot 28 is maintained.
On the other hand, FIG. 20 shows a sectional view of the distal end portion of the endoscope when the conventional guide wire 68 is fixed. As shown in FIG. 20, conventionally, the position where the guide wire 68 is fixed in the wire locking groove 321 when the treatment instrument raising base 27 is raised to the maximum raising position is more appropriate than the raising base rotating fulcrum 28. It is arranged on the tip side about a distance L2.

  Next, the operation of this embodiment will be described. In the present embodiment, the treatment instrument raising base 27 is raised in a state where the guide catheter is pulled into the treatment instrument insertion channel 23 as in the first embodiment. At this time, in the present embodiment, since the treatment instrument raising base 27 is raised more greatly than the conventional maximum raising angle position, the guide wire 68 is further bent. For this reason, the shearing force between the wire locking groove 321 and the upper surface 273 of the introduction guide path 24 and the reaction force of the guide wire 68 work more strongly, so that the guide wire 68 can be firmly fixed in this state.

  After confirming that the guide wire 68 is firmly fixed in this manner, the guide catheter is pulled out, and another treatment instrument is inserted through the guide wire 68, so that the treatment instrument inserted at this time is connected to the wire. When passing the stop groove 321, the treatment instrument raising base 27 is turned upside down, and the guide wire 68 is pushed out from the wire engagement groove 321 by the pushing force of the treatment instrument, and the guide wire 68 and the wire engagement groove 321 are fixed. Is released.

The present embodiment has the following effects. That is, in this embodiment, the same effect as that of the first embodiment can be obtained, and in addition to this, there is an effect that the guide wire 68 can be more firmly fixed.
Note that the above-described guide wire fixing means is not limited to the one having the wire locking groove 321, and only the treatment instrument raising base 27 may be substituted to increase the raising angle.

  FIG. 21 and FIGS. 22A to 22D show a tenth embodiment of the present invention. In this embodiment, the elevator operation configured as shown in FIGS. 21 and 22A instead of the elevator operation mechanism 41 disposed in the operation unit 13 of the endoscope 1 in the first embodiment. A mechanism 401 is provided.

  An elevator operation knob 402 is disposed at the edge of the operation unit 13 of the endoscope 1. The raising base operation knob 402 is provided with an operation lever 403 and a finger pad 405 fixed to the outer end of the operation lever 403 by a fixing screw 404 as shown in FIG.

Further, a fixed cylindrical body 406 for mounting the raising base operation knob 402 is projected from the operation portion 13 of the endoscope 1. The base end portion of the fixed cylinder 406 is fixed to a fixed frame (not shown) disposed in the operation unit casing 13a of the operation unit 13.
Further, a rotating ring 407 is rotatably fitted in the fixed cylinder 406.

The operation portion casing 13a is provided with a bearing portion 13b that rotatably supports the rotary ring 407.
Further, a ring-shaped connection ring 403a is provided at the inner end of the operation lever 403 as shown in FIG. The connecting ring 403 a is fixed to the outer surface of the rotating ring 407 with a plurality of fixing screws 408. The raising base operation knob 402 is pivotally supported so that the operation lever 403 can rotate along the central axis of the fixed cylindrical body 406.

  Further, the base end portion of the second link member 409 is fixed to the inner surface of the rotating ring 407. The second link member 409 is provided with a substantially L-shaped link arm 409a. The other end portion of the arm 49 in the elevator operating mechanism 41 of the first embodiment is rotatably connected to the distal end portion of the link arm 409a via a second link shaft 410 that is a rod-shaped shaft member. A locking member 411 made of a C-type or E-type retaining ring or the like is engaged with the end of the second link shaft 410 opposite to the end on the arm 49 side.

  When the raising base operation knob 402 in the operation unit 13 is rotated, the second link member 409 is rotated via the rotation ring 407 by rotating the operation lever 403 with the finger rest 405 as a fulcrum. As the second link member 409 rotates, the link member 44 is driven to advance and retract in the axial direction of the raising wire 30 via the arm 49, whereby the raising wire 30 is pulled and operated. The upper base 27 is configured so as to move up and down around the elevator turning fulcrum 28. Thus, the treatment instrument such as a guide catheter that is inserted into the treatment instrument insertion channel 23 and led out to the outside from the channel opening 26 is configured to be raised by raising the treatment instrument raising base 27. Yes.

  In addition, a brake mechanism 412 that brakes the turning operation force of the operation lever 403 of the elevator operation knob 402 is incorporated in the elevator operation mechanism 401 of this embodiment. As shown in FIG. 22B, the brake mechanism 412 has a deterring body 413 such as a pin protruding from the middle of the operation lever 403 of the elevator operation knob 402 and a position engaging with the deterring body 413. A deterrence enhancing member 414 shown in FIG. 22C is provided.

  Furthermore, a guide groove 414a having a substantially U-shaped cross section is formed in the suppression enhancing member 414 as shown in FIGS. 22C and 22D in which the suppression body 413 of the operation lever 403 is inserted. The guide groove 414 a is extended along the rotation path of the restraining body 413 when the operation lever 403 is rotated. The deterrence body 413 is configured to pass through the inside of the guide groove 414a of the deterrence enhancing member 414.

  Further, a friction resistance member 415 having a large frictional resistance is embedded in one end side of the guide groove 414a inside the guide groove 414a of the suppression enhancing member 414. The frictional resistance member 415 is arranged in a region L in which it is desired to suppress the rotation of the operation lever 403 when the operation lever 403 is rotated, in a region through which the suppression body 413 passes when rotating in the same range.

  Next, the operation of this embodiment will be described. In the present embodiment, during the operation of raising the treatment instrument raising base 27, the operation lever 403 of the raising base operation knob 402 of the operation unit 13 is rotated as in the endoscope 1 of the 29th embodiment. At this time, when the operation lever 403 is rotated to the suppression range L, the suppression body 413 comes into contact with the friction resistance member 415 in the guide groove 414 a of the suppression reinforcement member 414. Thereby, a load is applied to the turning operation of the operation lever 403, and the turning operation of the operation lever 403 is braked and fixed. Therefore, the treatment instrument elevator base 27 can be fixed in a state where the treatment instrument elevator base 27 is rotated to the raising position indicated by the phantom line in FIG. The guide wire 68 led out is inserted between the distal end surface of the introduction guide path 24 of the distal end rigid portion 21 and the treatment instrument raising base 27 and mechanically fixed.

In this way, after confirming that the guide wire 68 is fixed, the guide catheter is completely pulled out from the operation portion 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment instrument hits the treatment instrument elevator 27, the operation lever 403 of the elevator operation knob 402 is returned to its original position. At this time, the operation lever 403 exceeds the suppression range L, and the suppression body 413 is disengaged from the friction resistance member 415 in the guide groove 414a of the suppression reinforcement member 414, so that the operation lever 403 can be released from being fixed. Thereby, fixation of the guide wire 68 by the treatment instrument raising base 27 is released.

  The present embodiment has the following effects. That is, in this embodiment, since the brake mechanism 412 that brakes the turning operation force of the operation lever 403 of the elevator operation knob 402 is incorporated in the elevator operation mechanism 401, the treatment instrument elevator 27 is shown in FIG. The guide wire 68 can be maintained in a fixed state by fixing the treatment instrument raising base 27 in a state where the guide wire 68 is fixed to the raising position shown in FIG. There is no need to hold it, and the workability of the operator is improved.

  It should be noted that the brake mechanism 412 of this embodiment may be incorporated in the operation lever 72 of the guide wire fixing elevator base 267 described later. In this case, the guide wire 68 is fixed by fixing the guide wire fixing elevator 267 while the guide wire fixing elevator 267 is rotated to the raising position shown in FIG. Therefore, it is not necessary to hold the operation lever 72 of the guide wire fixing elevator base 267 while the guide wire 68 is fixed, and the operator's workability is improved.

  FIG. 23 shows a first modification of the tenth embodiment. In this modified example, two elastic members 416 such as two leaf springs 416 a and 416 b are disposed in the guide groove 414 a of the suppression enhancing member 414 of the brake mechanism 412 instead of the friction resistance member 415. The elastic member 416 is formed in a shape in which a restraining body 413 is inserted between the two leaf springs 416a and 416b, and the load increases as the restraining body 413 is inserted. Further, the elastic member 416 of the present modification can obtain the same effect as that of the brake mechanism 412 of the eleventh embodiment.

  FIG. 51 shows a second modification of the tenth embodiment. In this modification, instead of the brake mechanism 412 of the tenth embodiment, a notch 417 is provided in the pulling knob 264 that rotates in the direction of the axis along the circumferential direction of the operation unit 13 as in the thirty-third embodiment, and an elastic member (not shown) A brake mechanism of the type that fixes the rotation of the traction knob 264 by engaging the projection 418 protruding through the notch 417 detachably with the notch 417 is provided. In this modification, the same effect as that of the brake mechanism 412 of the eleventh embodiment can be obtained.

24 to 27 show an eleventh embodiment of the present invention. This embodiment is provided with a raising operation means 471 having a raising range selection type structure capable of selectively changing the raising range of the treatment instrument raising base 27 of the ninth embodiment to a plurality of stages as appropriate. .
That is, the raising operation means 471 of the present embodiment includes the raising stand operating mechanism 472 having the configuration shown in FIGS. 24 and 25A inside the operation unit 13 having substantially the same configuration as the endoscope 1 in the tenth embodiment. Is provided.

  The elevator operating mechanism 472 is provided with an arcuate stopper member (intermediate stopper) 473 centered on the central axis of the fixed cylinder 406. As shown in FIG. 26, a two-stage projecting portion 475 is formed on one end of the stopper member 473 so as to project in a stepwise manner in a vertically upward direction with respect to the planar base surface 474. The two-stage projecting portion 475 is provided with a low-stage first stopper 475a and a high-stage second stopper 475b. The high-stage second stopper 475b is disposed on the end side of the stopper member 473 behind the low-stage first stopper 475a. The stopper member 473 is fixed to the casing 13 a of the operation unit 13 with fixing screws 476.

  The height of the first stopper 475a is set within a range in which the operation lever 403 can be elastically deformed to such an extent that the operation lever (operation means) 403 of the elevator operation knob 402 can get over the first stopper 475a. . Further, the second stopper 475b is set to a height at which the operation lever 403 cannot get over the second stopper 475b by elastic deformation of the operation lever 403. Then, during the turning operation of the raising base operation knob 402, the first stage raising operation range is regulated at the position B in FIG. 24 where the operation lever 403 of the raising base operation knob 402 hits the first stopper 475a. It is configured. At this time, a normal treatment for guiding the treatment instrument or the like to a desired position as in the prior art by rotating the operation lever 403 in the first-stage raising operation range from the A position to the B position in FIG. The tool can be raised.

  Further, the operation lever 403 is elastically deformed by pulling up the finger rest 405 of the elevator operation knob 402 in the direction of the arrow in FIG. 403 can get over the first stopper 475a. Further, after the first stopper 475a has been overcome, the operation lever 403 is rotated to the position C in FIG. 24 where it abuts against the second stopper 475b, so that the second stage raising operation range is regulated. It is configured. Therefore, in the present embodiment, the raising range of the treatment instrument raising base 27 can be changed in two steps by the lower first stopper 475a and the higher second stopper 475b of the stopper member 473 of the raising operation means 471. it can. At this position C, the guide wire 68 led out from the channel opening 26 to the outside is sandwiched between the distal end surface of the introduction guide path 24 of the distal rigid portion 21 and the treatment instrument raising base 27 and mechanically. It is configured to be fixed.

  Next, the operation of this embodiment will be described. In this embodiment, when the raising base operation knob 402 is rotated, the operation lever 403 of the raising base operation knob 402 hits the first stopper 475a at the lower stage of the stopper member 473 of the raising operation means 471. Thus, the first stage raising operation range is regulated. At this time, a normal treatment for guiding the treatment instrument or the like to a desired position as in the prior art by rotating the operation lever 403 in the first-stage raising operation range from the A position to the B position in FIG. The tool can be raised.

Further, when the guide wire 68 is fixed, the treatment instrument raising base 27 is raised by rotating the operation lever 403 while the guide catheter is pulled into the treatment instrument insertion channel 23 as in the first embodiment.
At this time, when the operation lever 403 hits the first stopper 475a, as shown by an arrow in FIG. 25B, the finger resting portion 405 is pushed upward outward to hit the first stopper 475a. The operating lever 403 that has been bent is elastically deformed. As a result, the operation lever 403 can get over the first stopper 475a as shown by the phantom line in FIG.

  Furthermore, after overcoming the first stopper 475a, the operation lever 403 is further rotated to the position C in FIG. 24 where it abuts against the second stopper 475b. The two-stage raising operation range is regulated. At this position C, the guide wire 68 led out from the channel opening 26 to the outside is sandwiched between the distal end surface of the introduction guide path 24 of the distal rigid portion 21 and the treatment instrument raising base 27 and mechanically. It is firmly fixed.

  Accordingly, in this embodiment, the stopper member 473 of the raising operation means 471 is provided with the low-stage first stopper 475a and the high-stage second stopper 475b, and the operation lever 403 that is normally used is abutted against the first stopper 475a. The raising range of the treatment instrument raising base 27 is changed to two steps only by changing the operation of the operation lever 403 that is normally used so as to change the state to the state where it is in contact with the second stopper 475b. Can do. Therefore, since it is not necessary to provide a new complicated operation means to change the raising range of the treatment instrument raising base 27, the endoscope can be stably operated without causing confusion for the operator. effective.

  In addition, when the treatment instrument is raised and when the guide wire 68 is fixed, the rotation position of the operation lever 403 is not finely adjusted and the treatment instrument is easily raised, and the guide Since the wire 68 can be properly used for fixing, an effect of reducing the burden on the operator at the time of examination can be obtained.

  Further, after the operation lever 403 of the elevator control knob 402 is rotated to the position where the guide wire 68 is fixed, the operation of releasing the guide wire 68 from the C position through the B position to the A position is rotated. Since the operation lever 403 sometimes does not hit the stopper member 473 of the raising operation means 471, it is possible to easily perform the operation of returning the treatment instrument raising base 27 to the inverted position.

  In addition to the above, the clearance between the treatment instrument raising base 27 and the wire locking groove 321 in the ninth embodiment may be ensured as usual in the B position so as not to prevent insertion and removal of the treatment instrument. The clearance between the treatment instrument elevator 27 and the wire locking groove 321 when moving from the B position to the C position can be narrowed, and the fixing strength of the guide wire 68 is increased.

  The stopper member 473 and the operation portion casing 13a of the operation portion 13 may be integrally formed to reduce the number of parts. Furthermore, in the stopper member 473 of the present embodiment, a configuration in which two stoppers, a low-stage first stopper 475a and a high-stage second stopper 475b, are provided, but three or more stoppers are provided as necessary. May be.

  In the present embodiment, the stopper member 473 is provided on the casing 13a of the operation unit 13. However, the present invention is not limited to this, and the operation lever 403 and the operation lever 403 The fixed cylindrical body 406, the second link member 409, and the link member 44 may be provided in contact with each other.

  Further, the shape of the stopper member 473 is not limited to the plate-like member described above, and an elastic member 476 such as a leaf spring may be substituted as in the modification of the eleventh embodiment shown in FIG. The elastic member 476 is formed with a first stopper 475a for restricting the first-stage raising operation range by a pair of protrusions 477a and 477a protruding on the track of the operation lever 403, and further, the first stopper 475a. A second stopper 475b that restricts the second-stage raising operation range is formed by a pair of protrusions 477b and 477b that protrude from the position.

  FIGS. 29A, 29B, and 30 show a twelfth embodiment of the present invention. In the present embodiment, when the treatment instrument raising base 27 of the endoscope 1 of the first embodiment is raised, a part of the treatment instrument raising base 27 is placed on the objective optical system of the endoscope 1 as shown in FIG. The objective lens 481 is inserted into the observation field 482.

  Note that FIG. 29B shows an observation image 483 by the objective lens 481 of the endoscope 1. The objective optical system of the endoscope 1 is disposed at a position where a part of the guide wire 68 fixed by the wire locking groove 321 of the treatment instrument raising base 27 displayed in the observation image 483 is focused. .

  Next, the operation of this embodiment will be described. In the present embodiment, similarly to the endoscope 1 of the first embodiment, the treatment instrument raising base 27 is raised in a state where the guide catheter is pulled into the treatment instrument insertion channel 23, whereby the objective of the objective optical system is obtained. The treatment instrument elevator 27 and a guide wire 68 fixed thereto are inserted into the field of view 482 of the lens 481. When the treatment instrument raising base 27 is raised up to the maximum, as shown in FIG. 29 (B), the treatment instrument raising base 27 can be confirmed at the corner of the observation image 483 by the objective lens 481 of the endoscope 1. . At this time, the objective lens 481 is focused on the guide wire 68. In this state, the guide catheter is pulled out at once, and another treatment tool is inserted using the guide wire 68 as a guide. When the distal end of the treatment instrument abuts against the treatment instrument raising base 27, the treatment instrument raising base 27 is turned down, and when the treatment instrument passes through the wire locking groove 321, the guide wire 68 is engaged with the wire by the pressing force from the treatment instrument. The guide wire 68 is released from being pushed out of the stop groove 321.

The present embodiment has the following effects. That is, in the present embodiment, only the raising operation of the treatment instrument raising base 27 that is normally performed to operate the raising operation knob 48 of the hand operation unit 13 of the endoscope 1 is performed, as in the endoscope 1 of the first embodiment. Thus, the guide wire 68 can be easily fixed.
Furthermore, in this embodiment, in addition to the same effect as the endoscope 1 of the first embodiment, the guide wire 68 is securely fixed by viewing the observation image 483 by the objective lens 481 of the endoscope 1. It can be visually confirmed whether or not. Therefore, there is an effect that it is possible to prevent the occurrence of an erroneous operation, that is, pulling out the guide wire 68 that is not fixed by mistake.

The treatment instrument elevator 27 is inserted into the observation field 482 of the objective lens 481 of the objective optical system of the endoscope 1 so that the treatment instrument elevator 27 is moved to the fixed position of the guide wire 68. There is an effect that can be visually recognized.
The present embodiment is not necessarily limited to the endoscope 1 of the first embodiment, and can be applied to any apparatus having a mechanism for fixing the guide wire 68 using a guide wire fixing member.

  FIG. 31 (A) shows a thirteenth embodiment of the present invention. This embodiment is fixed by guide wire fixing means such as the treatment instrument raising base 27 of the endoscope 1 in the twelfth embodiment, and is inserted into the observation field 482 by the objective lens 481 of the objective optical system of the endoscope 1. The guide wire 68 is provided with an indicator 491 made of stripe marking.

The indicator 491 is shifted in the position of the guide wire 68 like the scale 492 of the first modification shown in FIG. 31B or the numeral 493 of the second modification shown in FIG. Any display that can be understood.
The present embodiment has the following effects. That is, in this embodiment, the same effect as that of the twelfth embodiment is obtained, and in addition to the same effect as that of the twelfth embodiment, the shift of the guide wire 68 can be more easily visually recognized.

  FIG. 32A shows a fourteenth embodiment of the present invention. In this embodiment, the treatment tool of the distal end cover 22 provided at the distal end portion 17 of the insertion portion 12 of the endoscope 1 with the position of the wire locking groove 321 in the treatment instrument raising base 27 of the endoscope 1 in the first embodiment. It is set so as to be lower than the guide surface 511.

  FIG. 32B shows a state in which the conventional treatment instrument raising base 27 is inverted when the guide wire 68 is fixed. As shown in FIG. 32B, in the conventional treatment instrument elevator 27, the position of the wire locking groove 321 of the treatment instrument elevator 27 is higher than the treatment instrument guide surface 511 of the distal end cover 22 of the insertion portion 12. Is arranged.

  Next, the operation of this embodiment will be described. In the treatment instrument elevator 27 of the present embodiment, like the treatment instrument elevator 27 of the endoscope 1 of the first embodiment, the guide wire 68 is fixed and the guide catheter is removed, and then the other treatment instruments are guided. The wire 68 is inserted as a guide. At this time, in the treatment instrument raising base 27 of the present embodiment, the treatment instrument raising base 27 is completely inverted, so that the guide wire 68 sandwiched and fixed by the wire locking groove 321 is guided to the treatment instrument of the distal end cover 22. The surface 511 is pushed upward. Therefore, the guide wire 68 is pushed out from the wire locking groove 321 by this pushing-up force, and the guide wire 68 is released from being fixed.

  The present embodiment has the following effects. That is, in this embodiment, the guide wire 68 is pushed out of the wire locking groove 321 only by operating the treatment tool raising base 27, and the guide wire 68 can be fixedly released. When passing, there is an effect that the workability is further improved as compared with the method of releasing the fixation of the guide wire 68 by the pressing force of the treatment instrument.

  FIGS. 33A and 33B show a fifteenth embodiment of the present invention. In this embodiment, instead of the wire locking groove 321 of the first embodiment, as shown in FIGS. 33 (A) and 33 (B), a material having a high frictional resistance, such as rubber, is used on the side wall surface 26a of the channel opening 26. A guide wire fixing mechanism 102 that fixes the guide wire 68 by embedding the elastic member 101, operating the treatment instrument raising base 27 to press the guide wire 68 against the elastic member 101 by the treatment instrument raising base 27. It is composed.

  Next, the operation of this embodiment will be described. In the present embodiment, as in the first embodiment, after the guide wire 68 and the guide catheter are inserted into the treatment instrument insertion channel 23, the guide catheter is drawn into the introduction guide path 24 or the channel 23 when the guide wire 68 is fixed. In this state, the raising operation knob 48 is operated to raise the treatment instrument raising base 27 with the raising wire 30 which is a pulling means. At this time, the treatment instrument raising base 27 is raised to a position where the guide wire 68 is pressed against the elastic member 101 by the treatment instrument raising base 27 as indicated by a virtual line in FIG. As described above, the guide wire 68 is sandwiched between the treatment instrument raising base 27 and the elastic member 101, so that the guide wire 68 is fixed without being slipped by the frictional resistance of the elastic member 101.

  In the present embodiment, the treatment instrument raising base 27 is raised by the operation of the raising operation knob 48 on the hand operation section 13 side of the endoscope 1, and the guide wire 68 is interposed between the treatment instrument raising base 27 and the elastic member 101. By pinching, the guide wire 68 can be fixed, and the same effect as in the first embodiment can be obtained.

Furthermore, in this embodiment, in particular, it is only necessary to embed the elastic member 101 in the proximal side wall surface 26a of the channel opening 26, and there is no need to provide additional parts such as a new urging mechanism. Therefore, the configuration of the distal end portion 17 of the endoscope 1 is not complicated and is equivalent to the conventional one.
Note that, in the endoscope 1 in which the tip cover 22 made of an elastic member is detachable, the channel opening 26 is provided at a portion corresponding to the channel opening 26 in the tip cover 22 as in the modification shown in FIG. A guide wire fixing portion 103 that extends to the proximal side wall surface 26 a may be provided integrally with the distal end cover 22. In this case, by replacing the conventional tip cover and the tip cover 22 of the present embodiment with the endoscope 1 of the type in which the tip cover 22 can be attached and detached, the guide wire fixing mechanism can be easily applied to the current scope. 102 can be provided.

  The elastic member 101 of the fifteenth embodiment may be replaced with a magnet. In this case, as in the first embodiment, after the guide catheter and the metal guide wire 68 are inserted into the treatment instrument insertion channel 23, when the guide catheter is pulled into the channel opening 26, the raising in the operation unit 13 is performed. By raising the treatment instrument raising base 27 with the upper operation knob 48, the raised guide wire 68 is attracted to the magnet on the proximal side wall surface 26a of the channel opening 26 by magnetic force.

  Thereafter, the guide catheter is completely pulled out, and the treatment instrument to be used next is inserted from the proximal end side of the guide wire 68. Then, the treatment instrument to be used next is inserted into the treatment instrument insertion channel 23 using the guide wire 68 as a guide. At this time, the treatment instrument passes through the position where the guide wire 68 is fixed by the magnet, so that the attractive force is weakened, the guide wire 68 is separated from the magnet, and further inserted into the pancreas / bile duct (not shown). Accordingly, in this case, the same effect as that of the fifteenth embodiment can be obtained.

Furthermore, in the endoscope 1 in which the distal end cover 22 is detachable, a magnet may be embedded in a portion corresponding to the front side wall surface 26a of the channel opening 26 in the distal end cover 22.
FIGS. 35A and 35B show a sixteenth embodiment of the present invention. In the present embodiment, a guide wire locking groove 441 is provided on the inner wall surface 25a of the storage chamber 25 of the treatment instrument raising base 27 in the distal end cover 22 disposed at the distal end portion 17 of the endoscope 1 of the first embodiment. It is. The relationship between the groove width M1 of the guide wire locking groove 441 and the wire diameter D1 of the guide wire 68 is set to “M1 ≦ D1”, for example. The groove width M1 of the guide wire locking groove 441 is such that when the guide wire 68 is pressed in the direction of the guide wire locking groove 441, the peripheral portion of the guide wire locking groove 441 in the tip cover 22 is elastically deformed. The size is set to fit in the guide wire locking groove 441.

  In addition, a guide surface 442 for guiding the guide wire 68 in the direction of the guide wire locking groove 441 is formed on the treatment instrument elevator base 27. As shown in FIG. 35A, the guide surface 442 is in a state (standby position) in which the treatment instrument raising base 27 is turned upside down and accommodated in the accommodating chamber 25 (standby position). It is formed by the inclined surface notched by the opposing side surface.

  During the operation of raising the treatment instrument raising base 27, the treatment instrument raising base 27 is guided along with the operation of turning from the standby position to the treatment instrument raising position within the storage chamber 25 around the raising base turning fulcrum 28. The wire 68 is guided in the direction of the guide wire locking groove 441 by the guide surface 442 of the treatment instrument raising base 27 and is configured to be partially fitted into the guide wire locking groove 441. In this state, when the treatment instrument raising base 27 is further raised, the side surface of the treatment instrument raising base 27 presses the guide wire 68 as shown in FIG. The guide wire 68 is pressed and fixed to the side surface of the tool raising base 27.

  Next, the operation of this embodiment will be described. In the present embodiment, as in the first embodiment, when the treatment instrument elevator 27 is raised with the guide catheter in the treatment instrument insertion channel 23, the guide wire 68 is guided by the guide surface 442 of the treatment instrument elevator 27. The guide wire 68 is guided into the guide wire locking groove 441, and a part of the guide wire 68 is fitted into the guide wire locking groove 441.

  In this state, when the treatment instrument raising base 27 is further raised, the side surface of the treatment instrument raising base 27 presses the guide wire 68, so that the guide wire locking groove 441 and the side surface of the treatment instrument raising base 27 are located. The guide wire 68 is pressed and fixed. At this time, by maintaining the treatment instrument raising base 27 in the raised state, the movement of the guide wire 68 to come out of the guide wire locking groove 441 can be restricted.

  Thereafter, the guide catheter is pulled out from the treatment instrument insertion channel 23 at once. Subsequently, another treatment tool is inserted using the guide wire 68 as a guide. At this time, when the distal end of the treatment instrument hits the treatment instrument raising base 27, the treatment instrument raising base 27 is turned down by operating the raising operation knob 48, and another treatment instrument passes through the guide wire locking groove 441. Furthermore, the guide wire 68 is pushed out from the guide wire locking groove 441 by the pressing force from the treatment instrument, and the guide wire 68 is released from being fixed.

  The present embodiment has the following effects. That is, this embodiment has the same effect as the endoscope 1 of the first embodiment, and in addition to this, the guide wire 68 inserted into the guide wire locking groove 441 is replaced with the treatment instrument raising base 27 and the guide wire. By being sandwiched and fixed between the locking grooves 441, there is an effect that stronger fixation is possible.

  FIGS. 36A and 36B show a seventeenth embodiment of the present invention. In the present embodiment, the guide wire locking groove 441 of the sixteenth embodiment is provided on the inner wall surface 25b on the distal end hard portion 21 side having the objective lens 445 of the objective optical system in the accommodation chamber 25 of the treatment instrument raising base 27. .

Note that the groove width of the guide wire locking groove 441 is set in the same manner as in the sixteenth embodiment.
Further, a guide wall 443 for restricting the protruding direction of the treatment instrument is provided at the distal end of the treatment instrument raising base 27 at the end opposite to the inner wall surface 25b on the distal end hard part 21 side. A guide surface 444 for guiding the guide wire 68 in the direction of the guide wire locking groove 441 is formed on the side of the guide wall 443.

  The present embodiment has the following effects. In other words, the present embodiment has the same effect as that of the sixteenth embodiment, and in addition to this, a treatment is applied to the distal end portion of the treatment instrument raising base 27 at the end portion opposite to the inner wall surface 25b on the distal end hard portion 21 side. Since the guide wall 443 for restricting the protruding direction of the instrument is provided, when the treatment instrument raising base 27 is raised, the guide wire 68 is guided by the guide wall 443 of the treatment instrument raising base 27 to the objective lens 445 of the distal end hard portion 21. The treatment tool can be protruded toward the side, and the operability of the treatment tool can be improved.

FIGS. 37A to 37D show an eighteenth embodiment of the present invention. In this embodiment, a guide wire fixing mechanism 381 having a different configuration is provided instead of the wire locking groove 321 of the first embodiment.
That is, the first urging member 382 and the second urging member 383 are fixed to the guide wire fixing mechanism 381 of the present embodiment so as to be detachably fixed with the guide wire 68 sandwiched therebetween. As shown in FIG. 37 (A), the first biasing member 382 is fixed to the proximal end of the channel opening 26 of the distal end rigid portion 21 provided at the distal end 17 of the insertion portion 12 in the endoscope 1. ing. Further, the second urging member 383 is disposed beside the first urging member 382 so as to be able to contact and separate from the first urging member 382.

Further, the treatment instrument guide surfaces 384 of the urging members 382 and 383 are formed by dropping meat according to the shape of the treatment instrument. Further, the second urging member 383 is provided with a guiding projection 385 at a position opposite to the treatment instrument guiding surface 384 as shown in FIG.
Further, a guide groove 386 of the second urging member 383 is provided on the wall surface on the hand side of the distal end hard portion 21. A guide projection 385 of the second urging member 383 is movably engaged with the guide groove 386. The second urging member 383 is supported so as to be movable substantially perpendicular to the introduction guide path 24 along the guide groove 386.

Further, a pulling wire 387 is disposed on the side of the second urging member 383 opposite to the first urging member 382. A rotatable roller 388 is connected to the distal end portion of the pulling wire 387.
Further, the proximal end portion of the pulling wire 387 is guided to the operation unit 13 through the pulling wire channel 389 and is connected to a link mechanism (not shown). As in the first embodiment, the pulling wire 387 can be pulled by operating the operation lever 72 on the hand side.

  Further, the first urging member 382 and the second urging member 383 are provided with a storage chamber 390 on the opposite side to the treatment instrument guiding surface 384. A coiled spring member 391 that urges the second urging member 383 in a direction to separate the first urging member 382 from the first urging member 382 is disposed in the storage chamber 390. The spring member 391 is disposed substantially perpendicular to the introduction guide path 24.

  In the present embodiment, as shown in FIG. 37C, the distance L1 between the first urging member 382 and the second urging member 383 in the normal state is the wire diameter D1 of the guide wire 68 and the treatment instrument. The relationship with the outer diameter D2 of other treatment tools such as a guide catheter and the like is set to “D1 <L1 <D2”.

Furthermore, when the operation lever 72 is pulled, the distance L2 between the first urging member 382 and the second urging member 383 when the second urging member 383 moves as shown in FIG. L2 ≦ D1 <D2 ”is set.
Further, a chamfered portion 392 having a corner portion cut obliquely is provided at a location where the second biasing member 383 first comes into contact with the roller 388 on the pulling wire 387 side.

  Next, the operation of this embodiment will be described. When the endoscope 1 of this embodiment is used, the guide catheter and the guide wire 68 are inserted into the body through the channel 23 and then the guide catheter is drawn into the introduction guide path 24 or the channel 23 as in the 29th embodiment. In this state, the raising operation knob 48 of the treatment instrument raising base 27 is operated. As the raising operation knob 48 is operated, the raising wire 30 is pulled, and the treatment instrument raising base 27 is turned around the raising base turning fulcrum 28 as shown by a virtual line in FIG. Is raised.

  At this time, the guide wire 68 is raised by raising the treatment instrument raising base 27, so that a guide is provided between the first urging member 382 and the second urging member 383 as shown in FIG. The wire 68 is guided and fitted. In this state, the roller 388 is pulled to the side of the second urging member 383 via the pulling wire 387 by the operation lever 72. As a result, as shown in FIG. 37D, the second urging member 383 is pushed out along the guide groove 386 and close to the first urging member 382, so that the first urging member 382 and the second urging member 382 are pushed. The width between the member 383 is narrowed, and the guide wire 68 is sandwiched and mechanically fixed.

Further, after confirming that the guide wire 68 is fixed, the guide catheter is completely pulled out from the operation portion 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment tool hits both biasing members 382 and 383, the operation lever 72 is operated to loosen the pulling wire 387, and the second biasing member 383 is pushed back by the force of the spring member 391. The wire 68 is released, and the treatment instrument is inserted into the pancreas / bile duct (not shown).

In the present embodiment, as in the first embodiment, the guide wire 68 can be easily fixed by the operation of the operation lever 72 of the hand operation section 13 of the endoscope 1, and the same effect as in the first embodiment can be obtained. It is done.
FIGS. 38 and 39 show a nineteenth embodiment of the present invention. In this embodiment, a substantially U-shaped guide wire fixture 121 is provided on the guide surface 29 of the treatment instrument raising base 27 as shown in FIGS. 38 and 39 in place of the wire locking groove 321 of the first embodiment. It is.

As shown in FIG. 39, the dimensions La and Lb of the guide wire fixing tool 121 are set to a relationship of “La, Lb> d” with respect to the outer diameter dimension d of the treatment instrument insertion channel 23.
Next, the operation of this embodiment will be described. In this embodiment, as in the first embodiment, after the guide wire 68 and the guide catheter are inserted into the treatment instrument insertion channel 23, the guide catheter 68 is pulled into the introduction guide path 24 or the channel 23 when the guide wire 68 is fixed. Manipulate. When the guide catheter enters the channel 23 when the guide catheter is removed, the treatment tool raising base 27 is raised to raise the treatment tool raising base 27 so that the guide wire fixing tool 121 and the distal end hard portion 21 are raised. The guide wire 68 is fixed by sandwiching the guide wire 68 between the guide guide lower surface 24a.

  In the present embodiment, the treatment instrument raising base 27 is raised by an operation by the raising operation knob 48 on the hand operation section 13 side of the endoscope 1, and the guide wire fixing tool 121 and the distal end hard part 21 of the treatment instrument raising base 27 are raised. By sandwiching the guide wire 68 between the lower surface of the introduction guide path 24a, the guide wire 68 can be fixed, and the same effect as in the first embodiment can be obtained.

  Furthermore, in this embodiment, in particular, the opening of the guide wire fixing tool 121 is made wider than the treatment tool insertion channel 23, so that the guide wire fixing tool 121 of the treatment tool raising base 27 allows the treatment tool in a normal case. The guide wire 68 can be fixed by raising the treatment instrument raising base 27 without being interrupted.

FIG. 40 shows a twentieth embodiment of the present invention. In the present embodiment, the configuration of the distal end portion 17 of the insertion portion 12 of the endoscope 1 in the first embodiment is changed as follows.
That is, in this embodiment, instead of the wire locking groove 331 of the second embodiment, a locking projection 341 for fixing the guide wire 68 is provided protruding from the peripheral portion of the channel opening 26 of the tip cover 22. It is. When the treatment instrument raising base 27 is raised, the latching convex part 341 presses against the guide surface 29 of the treatment instrument raising base 27 as indicated by a virtual line in FIG. The guide wire 68 is sandwiched between the upper base 27 and the guide wire 68 is detachably locked.

  Next, the operation of this embodiment will be described. When using the endoscope 1 of the present embodiment, the guide catheter and the guide wire 68 are inserted into the body through the channel 23 and then the guide catheter is drawn into the introduction guide path 24 or the channel 23 as in the first embodiment. In this state, the raising operation knob 48 of the treatment instrument raising base 27 is operated. As the raising operation knob 48 is operated, the raising wire 30 is pulled, and the treatment instrument raising base 27 is turned around the raising base turning fulcrum 28 to rise as shown by a virtual line in FIG. Is done.

  Further, when the treatment instrument raising base 27 is raised, the guide surface 29 of the treatment instrument raising base 27 is in pressure contact with a locking projection 341 provided at the peripheral portion of the channel opening 26 of the tip cover 22, and this locking projection The guide wire 68 is sandwiched between the 341 and the treatment instrument raising base 27 so that the guide wire 68 can be engaged and disengaged. In this state, the guide wire 68 is mechanically fixed.

  The present embodiment has the following effects. That is, in this embodiment, the guide wire 68 can be easily fixed only by the raising operation of the treatment instrument raising base 27 that is normally performed on the hand operation unit 13 side of the endoscope 1. Therefore, the same effect as that of the first embodiment can be obtained in this embodiment.

Furthermore, in this embodiment, in addition to the effects of the first embodiment, there is no need to newly provide a movable component at the distal end portion 17 of the insertion portion 12 of the endoscope 1, so the distal end portion of the insertion portion 12 The configuration of 17 can be simplified.
Further, in the present embodiment, even if the guide wire 68 cannot be sandwiched in the conventional elevator 27 due to the raising angle of the treatment instrument elevator 27, the distal end cover 22 is the detachable endoscope 1 even if the guide wire 68 cannot be sandwiched. The guide wire 68 can be fixed by replacing the tip cover 22 with a locking projection 341 for projecting the guide wire 68 at the peripheral portion of the channel opening 26 of the tip cover 22.

FIGS. 41A and 41B show a twenty-first embodiment of the present invention. In this embodiment, a guide wire fixing means 351 having a different configuration is provided instead of the wire locking groove 321 of the first embodiment.
That is, the guide wire fixing means 351 of the present embodiment is provided with a guide wire fixing member 352 for locking the guide wire 68 at the peripheral portion of the channel opening 26 of the distal end hard portion 21. As shown in FIG. 41B, the guide wire fixing member 352 is a guide wire made of two stainless steel wires protruding from both sides of the channel opening 26 of the distal end hard portion 21 to the inner side of the opening 26. Identification members 353a and 353b are provided. The base end portions of the guide wire identification members 353a and 353b are embedded in both side portions of the channel opening 26 of the distal end hard portion 21. Furthermore, at least two guide wire fixing member insertion holes 354 a and 354 b are provided on both sides of the side surface of the channel opening 26.

  The first guide wire identification member 353a, which is one of the two guide wire identification members 353a and 353b, extends from the upper edge side of the channel opening 26 to the inner side in FIG. And is curved to the left. Further, the other second guide wire identifying member 353b extends from the lower edge side of the channel opening 26 to the inner side and is curved rightward in FIG. 41B. The extended portions 353a1 and 353b1 of the two guide wire identification members 353a and 353b are spaced apart from each other and arranged substantially parallel to each other. An interval S with an appropriate width L is formed between the extended portions 353a1 and 353b1 of the guide wire identification members 353a and 353b. This interval S is set to be larger than the outer diameter dimension of the guide wire 68, for example.

  Further, the guide wire fixing means 351 is provided with a guide wire fixing tool 355 formed of a non-stretchable thread-like member, for example, a surgical suture. One end of the guide wire fixture 355 is fixed to the upper first guide wire identification member 353a in FIG. 41B. The guide wire fixing tool 355 passes through the guide wire fixing member insertion hole 354a on the upper side (first guide wire identification member 353a side) in FIG. In FIG. 41 (B), the other end side of the guide wire fixture 355 passes through the guide wire fixing member insertion hole 354b on the lower side (second guide wire identification member 353b side). 2 is fixed to the guide wire identifying member 353b. As a result, the guide wire fixture 355 is attached in a state of being laid between both side portions on the opening 26.

  Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, the guide catheter and the guide wire 68 are inserted into the body through the channel 23 and from the channel opening 26 of the distal end portion 17 of the endoscope 1 as in the first embodiment. Set in a protruding state. In this state, when the treatment instrument raising base 27 is raised by operating the raising operation knob 48 of the operation unit 13 of the endoscope 1, the guide catheter is extended to the extended portions 353a1, 353a1, 353a1, 353b of the guide wire identifying members 353a, 353b. Enter between 353b1.

  At this time, a guide catheter or the like having a diameter larger than that of the guide wire 68 pushes and spreads between the extended portions 353a1 and 353b1 of the guide wire identification members 353a and 353b, so that the tension of the guide wire fixture 355 is loosened. The guide catheter is raised without interfering with the guide wire fixture 355.

  When the guide wire 68 is raised, the guide wire 68 passes between the extended portions 353a1 and 353b1 of the two guide wire identification members 353a and 353b, so that the guide wire identification members 353a and 353b The tension | tensile_strength of the guide wire fixing tool 355 fixed to is not relaxed. Therefore, in this case, by raising the treatment instrument raising base 27, the guide wire 68 is sheared alternately by the treatment instrument raising base 27 and the guide wire fixing tool 355 in the opposite direction. It is bent and fixed in a letter shape.

  The present embodiment has the following effects. That is, in the present embodiment, the guide wire fixing member 352 for locking the guide wire 68 is provided at the peripheral portion of the channel opening 26 of the distal end hard portion 21, so that the proximal operation portion 13 of the endoscope 1 is raised. The guide wire 68 can be easily fixed only by the raising operation of the treatment instrument raising base 27 that is normally performed by operating the operation knob 48. Therefore, the same effect as that of the first embodiment can be obtained in this embodiment.

FIGS. 42 to 44 show a twenty-second embodiment of the present invention. In the present embodiment, the internal configuration of the distal end portion 17 of the insertion portion 12 in the endoscope 1 of the first embodiment is changed as follows.
In other words, in this embodiment, the guide wire fixing member storage chamber 531 is formed in the distal end hard portion 21 of the distal end portion 17 of the insertion portion 12 in the endoscope 1. A guide wire fixture 532 formed of an insulating member is accommodated in the storage chamber 531 so as to protrude and retract in the introduction guide path 24 communicating with the channel opening 26. The insulating member of this guide wire fixing tool 532 is used for preventing sparks when it accidentally contacts the endoscope distal end portion 17 when a high frequency is applied with a papillotomy knife or the like inserted through the treatment instrument insertion channel 23. It is what.

  Furthermore, as shown in FIG. 44, a substantially T-shaped guide projection 533 is provided on the upper portion of the guide wire fixture 532. A guiding groove 534 having a shape corresponding to the guiding protrusion 533 is formed in the distal end hard portion 21. The guide groove 534 is connected to the guide wire fixing member storage chamber 531. The guide protrusion 533 of the guide wire fixture 532 is engaged with the guide groove 534 of the distal end hard portion 21.

In addition, a coiled spring member 535 is disposed in the guide wire fixing member storage chamber 531 to urge the guide wire fixing tool 532 outwardly of the storage chamber 531 (toward the distal end of the endoscope 1). Yes.
Further, the distal end portion of the pulling wire 536 is fixed to the guide wire fixing tool 532. The puller wire 536 is guided to the operation unit 13 through the puller wire channel 537 and connected to a link mechanism (not shown). Thereby, similarly to the first embodiment, the guide wire fixing tool 532 can be pulled through the pulling wire 536 by operating the operation lever 72 on the hand side.

  Next, the operation of this embodiment will be described. In the present embodiment, the guide wire 68 is fixed to the distal end portion 17 of the insertion portion 12 in the endoscope 1 at the time of exchange work for exchanging the guide catheter inserted into the body via the guide wire 68 with another treatment tool. In some cases, as in the first embodiment, the pulling wire 536 is loosened by operating the operation lever 72 while the guide catheter is pulled into the treatment instrument insertion channel 23. At this time, the guide wire fixture 532 is pushed out toward the distal end of the insertion portion outside the storage chamber 531 by the spring force of the spring member 535, and protrudes into the introduction guide path 24 as shown in FIG. Thereby, the guide wire 68 raised by the treatment instrument raising base 27 is sandwiched between the guide wire fixing tool 532 and the treatment instrument raising base 27 and mechanically fixed.

  The present embodiment has the following effects. That is, in this embodiment, the same effect as that of the first embodiment can be obtained, and in addition to this, a guide wire 68 is fixed when the work for fixing the guide wire 68 to the distal end portion 17 of the insertion portion 12 in the endoscope 1 is performed. Since the guide wire 68 can be fixed in a surface contact state between the wire fixing tool 532 and the treatment instrument raising base 27, there is an effect that the guide wire 68 can be fixed more firmly than in the prior art.

  FIG. 45 shows a twenty-third embodiment of the present invention. In this embodiment, an indicator 451 indicating the insertion position of the guide catheter is provided at the proximal end portion of the guide catheter 67 of the seventh embodiment. In this embodiment, when the guide catheter 67 or the treatment tool is inserted into the treatment instrument insertion channel 23 of the endoscope 1, the indicator 451 of the guide catheter 67 is fixed to the guide catheter 68. When retracted to a possible position, it is arranged at a position corresponding to the insertion port 61 of the operation unit 13. Furthermore, the indicator 451 of the guide catheter 67 may be a visual display object with a color or the like, or a display object that can be recognized by a hand feeling with unevenness.

  Next, the operation of this embodiment will be described. In the present embodiment, as in the first embodiment, the guide catheter 67 is inserted into the treatment instrument insertion channel 23 from the insertion port 61 of the operation unit 13 of the endoscope 1, and then the guide catheter 67 is inserted into the channel opening. 26 to the outside and inserted into the pancreas / bile duct (not shown) transpapillarily.

  Thereafter, when exchanging the currently used guide catheter 67 with a treatment tool to be used next, first, the guide wire 68 is inserted from the base on the proximal end side of the guide catheter 67. Then, it is confirmed by an observation image (endoscopic image) of the endoscope 1 that the distal end portion of the guide wire 68 has entered the inside of the pancreas / bile duct (not shown), and the guide wire 68 is prevented from moving. The proximal end side of 68 is gripped by hand. Subsequently, an operation of pulling out the guide catheter 67 is performed in this state.

  At this time, after confirming that the guide catheter 67 has been pulled out from the nipple (not shown) by an endoscopic image, the guide catheter 67 is further pulled out. Then, the index 451 appears in the portion of the guide catheter 67 exposed from the insertion port 61 of the operation unit 13 in a state where the distal end of the guide catheter 67 is within the channel opening 26 at the distal end of the endoscope 1. Therefore, the operator or the operator can visually confirm the index 451 so that the position of the distal end of the guide catheter 67 can be confirmed with certainty.

Then, when it is confirmed that the distal end of the guide catheter 67 is within the channel opening 26 at the distal end of the endoscope 1, the guide wire 68 can be fixed by operating a guide wire fixing tool 69, which will be described later. It becomes.
The present embodiment has the following effects. That is, in this embodiment, an index 451 indicating the insertion position of the guide catheter 67 is provided at the proximal end portion of the guide catheter 67, and the index 451 is placed in the treatment instrument insertion channel 23 of the endoscope 1. When the instrument is inserted, when the guide catheter 67 or the treatment instrument is pulled to a position where the guide wire 68 can be fixed, the index catheter 451 is disposed at a position corresponding to the insertion port 61 of the operation section 13. By visually observing the operator, the position of the tip of the guide catheter 67 can be confirmed with certainty, and the operation timing of the guide wire fixture 69 can be easily understood.

  46A and 46B show a twenty-fourth embodiment of the present invention. A guide wire fixture 69 formed of a snare-shaped wire opened in a loop shape is disposed in the cutout portion 17a of the distal end portion 17 of the endoscope 1. A front end opening portion 71 a of a pulling wire channel 71 inserted into the insertion portion 12 is disposed on the rear end wall surface 17 b of the notch portion 17 a of the front end portion 17. A pulling wire 75 for pulling the guide wire fixing tool 69 is inserted into the pulling wire channel 71. The proximal end portion of the guide wire fixture 69 is connected to the distal end portion of the pulling wire 75.

  The pulling wire 75 is guided to the operation unit 13 through the pulling wire channel 71. Further, a base end portion of the pulling wire 75 is connected to an operation lever (operation transmission means) 72 (see FIG. 1) of the operation unit 13 through a link mechanism having the same structure as the above-described elevator operation mechanism 41. Yes.

  Since this link mechanism has the same structure as the above-described elevator operation mechanism 41, description thereof will be omitted. 46A, the guide wire fixing tool 69 is protruded from the tip opening 71a of the pulling wire channel 71 to the upper surface position of the channel opening 26 as shown in FIG. As shown to (B), it is comprised so that a movement to the accommodation position accommodated in the front-end | tip opening part 71a side of the pulling wire channel 71 is possible.

Further, the guide wire fixture 69 is configured so that the wire is opened in a loop shape when protruding from the tip opening 71a of the pulling wire channel 71 to the upper surface position of the channel opening 26.
In addition, the guide wire fixing tool 69 has a size that covers the entire channel opening 26 as shown in FIG. 46 (A) at the time of opening, and is substantially elliptical with respect to the axial direction of the insertion portion 12 of the endoscope 1. The length of the opening in the loop shape is set to be about 20 mm.

  In addition, a protrusion 70 that can temporarily fix the guide wire fixing tool 69 is provided on the distal end side of the channel opening 26 in the cutout portion 17 a of the distal end portion 17 of the endoscope 1. Then, the guide wire fixing tool 69 is held in the standby position by engaging the distal end portion of the guide wire fixing tool 69 in a state of being hooked on the projection 70.

  Further, when operating the operation lever 72 in the operation unit 13, the pulling wire 75 is pulled by the link mechanism having the same structure as the raising base actuating mechanism 41, and the guide wire fixing tool 69 is pulled as shown in FIG. 46 (B). The channel 71 is configured to be moved to the storage position stored on the tip opening 71a side. At this time, as the guide wire fixing tool 69 is pulled toward the tip opening 71a side of the pulling wire channel 71, the opening area of the loop-shaped opening by the wire of the guide wire fixing tool 69 is gradually reduced. Then, most of the guide wire fixing tool 69 is housed on the distal opening 71a side of the pulling wire channel 71, so that it is inserted into the treatment instrument insertion channel 23 as shown in FIG. The guide wire 68 led out to the outside is pressed against the edge portion on the rear end side of the channel opening 26 and fixed.

  Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, a protruding position in which the guide wire fixing tool 69 is protruded from the tip opening 71a of the pulling wire channel 71 to the upper surface position of the channel opening 26 as shown in FIG. Move to. At this time, the distal end portion of the guide wire fixing tool 69 is formed on the projection 70 of the distal end portion 17 of the endoscope 1 in a state where the loop-shaped opening portion of the guide wire fixing tool 69 is expanded around the channel opening portion 26. By hooking and locking, the guide wire fixture 69 is held at the standby position.

  In this state, the guide catheter 67 is inserted into the treatment instrument insertion channel 23 from the insertion port 61 of the operation unit 13 of the endoscope 1. Then, the guide catheter 67 is protruded to the outside from the channel opening 26 and inserted into the pancreas / bile duct (not shown) transpapillarily.

  Thereafter, when exchanging the currently used guide catheter 67 with a treatment tool to be used next, first, the guide wire 68 is inserted from the base on the proximal end side of the guide catheter 67. Then, it is confirmed by an observation image (endoscopic image) of the endoscope 1 that the distal end portion of the guide wire 68 has entered the inside of the pancreas / bile duct (not shown), and the guide wire 68 is prevented from moving. The proximal end side of 68 is gripped by hand. Subsequently, an operation of pulling out the guide catheter 67 is performed in this state.

  At this time, after confirming that the guide catheter 67 has been pulled out from the nipple (not shown) by an endoscopic image, the guide catheter 67 is further pulled out. Then, with the distal end of the guide catheter 67 within the channel opening 26 at the distal end of the endoscope 1, the guide wire fixing tool 73 is pulled by the operation lever 72 to pull the guide catheter 67 as shown in FIG. The front end opening 71a of the wire channel 71 is narrowed, and the guide wire 68 led out from the channel opening 26 to the outside is pressed against the edge portion on the rear end side of the channel opening 26 and mechanically fixed. .

Further, after confirming that the guide wire 68 is fixed, the guide catheter 67 is completely pulled out from the operation unit 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment tool hits the guide wire fixing tool 69, the guide wire 68 is released from being fixed by the guide wire fixing tool 69 by operating the operation lever 72, and is further inserted into the pancreas / bile duct (not shown). Insert the treatment tool until Thereafter, the treatment instrument can be exchanged by the same method as many times as necessary.

The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by the guide wire fixing tool 69 by the operation of the operation lever 72 on the hand operation unit 13 side of the endoscope 1.
Furthermore, since the guide wire fixing tool 69 of the present embodiment is formed by a snare-shaped wire that is opened in a loop shape, the snare-shaped wire of the guide wire fixing tool 69 can be firmly tightened when operated by the operation lever 72. Can be fixed.

In a normal case, the guide wire fixing tool 69 is inserted into the observation visual field of the endoscope 1 by storing the guide wire fixing tool 69 in the distal end opening 71 a of the pulling wire channel 71. Can be prevented. Therefore, cases can be performed without problems.
In the present embodiment, a projection 70 is provided on the distal end side of the channel opening 26 of the distal end portion 17 of the endoscope 1, and the guide wire fixing tool 69 can be temporarily fixed to the projection 70. As shown in A), the wire of the guide wire fixing tool 69 is opened in a loop at the protruding position where the guide wire fixing tool 69 protrudes from the tip opening 71a of the pulling wire channel 71 to the upper surface position of the channel opening 26. When opening to a state, it can open stably.

  In the present embodiment, as an example of the operation of the guide wire fixing tool 69, the configuration in which the pulling wire 75 is pulled through the link mechanism by the operation lever 72 of the operation unit 13 is shown, but the present invention is not limited to this. . For example, the operator pulls the guide wire fixing tool 69 of the insertion portion 12 of the endoscope 1 by pulling the pulling wire 75 of the guide wire fixing tool 69 from the operation unit 13 to the outside. Other means may be used as long as it can be guided in the axial direction.

  FIGS. 47A and 47B show a twenty-fifth embodiment of the present invention. In the present embodiment, instead of a snare-shaped wire opened like a loop like the guide wire fixing tool 69 of the twenty-fourth embodiment, a hook-shaped guide wire locking portion as shown in FIGS. The guide wire fixing tool 73 provided with 73a is changed to a configuration provided.

The distal end portion of the pulling wire 75 of the twenty-fourth embodiment is fixed to the proximal end portion of the guide wire fixing tool 73. A guide wire locking portion 73 a is formed at the distal end portion of the guide wire fixing tool 73.
Next, the operation of this embodiment will be described. In the normal case when the endoscope 1 of the present embodiment is used, the guide wire fixing tool 73 is pulled toward the hand side by the operation lever 72 and stored in the distal end opening 71 a of the pulling wire channel 71.

  Further, when the guide wire 68 is fixed, the guide wire fixing tool 73 is protruded from the tip opening 71a of the pulling wire channel 71 using the operation lever 72 as shown in FIG. Then, the guide wire locking portion 73 a of the guide wire fixture 73 is hooked on the guide wire 68. Subsequently, in this state, the guide wire fixture 73 is further pulled toward the hand side by the operation lever 72. As a result, as shown in FIG. 47 (B), the guide wire 68 led out from the channel opening 26 to the outside by the guide wire locking portion 73a of the guide wire fixture 73 is located on the rear end side of the channel opening 26. It is pressed against the edge part and mechanically fixed.

  The present embodiment has the following effects. That is, in this embodiment as well as the twenty-fourth embodiment, the guide wire 68 can be easily fixed by the guide wire fixing tool 73 by the operation by the operation lever 72 on the hand operating section 13 side of the endoscope 1. The same effect as the embodiment can be obtained.

  Further, in this embodiment, since the guide wire fixing tool 73 including the hook-shaped guide wire locking portion 73a is provided, the treatment instrument insertion channel 23 is inserted from the insertion opening 61 of the operation section 13 of the endoscope 1. When the guide catheter 67 is inserted into the guide wire 67, it is not necessary to set the loop-like opening of the guide wire fixing tool 69 in an open state as in the twenty-fourth embodiment. Therefore, only when the guide wire 68 is fixed, the guide wire 68 can be easily fixed by operating the operation lever 72 at hand, so that the operability of the endoscope 1 can be further improved.

48 to 50 show a twenty-sixth embodiment of the present invention. In this embodiment, the configuration of the distal end portion 17 of the endoscope 1 in the 25th embodiment is changed as follows.
That is, in the present embodiment, as shown in FIG. 48, the distal end opening 71a of the pulling wire channel 71 is disposed closer to the distal end side than the channel opening 26 in the notch 17a of the distal end portion 17 of the endoscope 1. The guide wire fixture 73 according to the twenty-fifth embodiment is configured to protrude from the distal end opening 71a on the distal end side with respect to the channel opening 26.

  49 and 50, a pulling wire channel 71 that bends in a substantially L shape along the lower surface side and the left end portion (tip portion) side of the storage chamber 25 of the treatment instrument raising base 27 in FIGS. Is formed. The tip opening 71 a of the pulling wire channel 71 is arranged on the cut surface of the notch 17 a of the tip 17.

  Further, the hook-shaped guide wire fixture 73 of the 25th embodiment is inserted into the pulling wire channel 71. The base end portion of the guide wire fixing tool 73 is guided to the operation portion 13 side as in the twenty-fourth embodiment, and is connected to the operation lever 72 via a link mechanism. Since this link mechanism has the same structure as the above-described elevator operation mechanism 41, description thereof will be omitted.

  Next, the operation of this embodiment will be described. In the endoscope 1 according to the present embodiment, when the operation lever 72 is operated, the hook-shaped guide wire fixing tool extends from the distal end opening portion 71 a closer to the distal end portion than the channel opening portion 26 in the cutout portion 17 a of the distal end portion 17 of the endoscope 1. 73 is projected.

  Then, in the state where the guide wire locking portion 73a of the guide wire fixing tool 73 is hooked on the guide wire 68, the guide wire fixing tool 73 is further pulled toward the hand side by the operation lever 72, as shown in FIG. The guide wire 68 led out from the channel opening 26 to the outside is moved closer to the edge of the distal end opening 71 a on the distal end side than the channel opening 26 by the guide wire locking portion 73 a of the guide wire fixture 73. It can be pressed and mechanically fixed.

  Further, in the present embodiment, as shown in FIG. 50, the guide wire 68 is hooked by the guide wire engaging portion 73a of the guide wire fixing tool 73, and the treatment tool raising base 27 is lifted so that the guide wire 68 is The pulling force from the guide wire fixing tool 73 and the pressing force from the treatment tool raising base 27 act in a shearing manner alternately in opposite directions. Therefore, the guide wire 68 is bent in a substantially L shape in response to the forces in the opposite directions, so that the guide wire 68 can be firmly fixed to the distal end portion 17 of the endoscope 1.

Also in this embodiment, the guide wire 68 can be easily fixed by the guide wire fixing tool 73 by the operation of the operation lever 72 on the hand operation unit 13 side of the endoscope 1 as in the first and 25th embodiments. The same effects as in the twenty-fourth embodiment are obtained.
In the present embodiment, in particular, since the distal end opening 71a of the pulling wire channel 71 is disposed closer to the distal end side than the channel opening 26 in the cutout portion 17a of the distal end portion 17 of the endoscope 1, the guide wire 68 is disposed. The treatment tool raising base 27 is raised in the state hooked by the guide wire locking portion 73a of the guide wire fixing tool 73, whereby the pulling force from the guide wire fixing tool 73 to the guide wire 68 and the treatment tool raising base 27 are increased. It is possible to apply a shearing force alternately in the opposite direction. Therefore, since the guide wire 68 can be firmly fixed in a state of being bent in a substantially L shape in response to these forces in the opposite directions, the hook shape is formed from the proximal side of the channel opening 26 as in the twenty-fifth embodiment. There is an effect that the guide wire 68 can be firmly fixed to the distal end portion 17 of the endoscope 1 more securely than the case where the guide wire fixing tool 73 is projected.

  FIGS. 52 to 54 (A) and (B) show a twenty-seventh embodiment of the present invention. In this embodiment, as in the twenty-fifth embodiment, instead of the hook-shaped guide wire locking portion 73a in the guide wire fixture 73 that is driven back and forth in the pulling direction of the pulling wire 75, it is rotated by a rotation operation mechanism 421 using a rack and pinion gear. A hook-shaped guide wire locking member 422 to be driven is provided.

As shown in FIG. 54A, the guide wire locking member 422 is provided with a hook-shaped guide wire locking portion 424 at the distal end portion of the elongated arm portion 423. Further, a pinion gear 425 is provided at the base end portion of the arm portion 423.
As shown in FIG. 54 (B), a rack gear 426 is fixed to the distal end portion of the pulling wire 75 of the 25th embodiment. The rack gear 426 of the puller wire 75 is meshed with the pinion gear 425 of the guide wire locking member 422 as shown in FIG. The pinion gear 425 and the rack gear 426 of the guide wire locking member 422 form a rotation operation mechanism 421 using a rack and pinion gear.

Further, as shown in FIG. 53, a locking member storage chamber 428 for storing the guide wire locking member 422 is formed in the distal end opening 71a of the pulling wire channel 71 in the distal end hard portion 21 of the endoscope 1. .
Note that the distal end portion of the pulling wire channel 71 is connected to a connecting pipe 71b fitted in a channel hole formed in the distal end hard portion 21.

  The locking member storage chamber 428 is provided with a bearing portion 427 that rotatably supports the pinion gear 425 of the guide wire locking member 422. The pinion gear 425 of the guide wire locking member 422 is rotatably supported by a support shaft 427a (shown in FIG. 52) of the bearing portion 427.

  The pinion gear 425 is fixed to the guide wire locking member 422 so that the guide wire 68 protruding from the channel opening 26 of the distal end portion 17 of the endoscope 1 can be gripped by the hook-shaped guide wire locking portion 424. It is arranged at the side end of the member storage chamber 428.

  Next, the operation of this embodiment will be described. In this embodiment, the guide wire locking member 422 is normally in a standby position where the hook-shaped guide wire locking portion 424 is moved to the rear end position of the channel opening 26 as shown by a solid line in FIG. Is held by. Then, by pulling the pulling wire 75 to the hand side by operating the operation lever 72 of the operation unit 13, the guide wire locking member 422 is rotationally driven by the rotation operation mechanism 421 by the rack and pinion. At this time, the hook-shaped guide wire locking portion 424 crosses the channel opening 26 so that the guide wire 68 is grasped by the hook-shaped guide wire locking portion 424, and the guide wire 68 is moved in the direction of the side wall of the distal end hard portion 21. Induce. In this state, the guide wire locking member 422 is further rotated to fix the guide wire 68 with the guide wire 68 interposed between the side wall of the distal end hard portion 21 and the hook-shaped guide wire locking portion 424.

  Further, when releasing the fixation of the guide wire 68, the guide wire locking member 422 is rotated reversely by returning the operation lever 72 of the operation portion 13 to the original position, and the hook as shown by the solid line in FIG. When the guide wire locking portion 424 having the shape is returned to the standby position moved to the rear end position of the channel opening portion 26, the guide wire 68 is detached from the guide wire locking portion 424 having the hook shape and the guide wire 68 is fixed. Is released.

  The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by the guide wire locking member 422 by the operation by the operation lever 72 on the hand operation portion 13 side of the endoscope 1 as in the 25th embodiment. Thus, it is possible to eliminate the need to grip the guide wire 68 on the operation unit 13 side of the endoscope 1. Therefore, since the replacement operation of the treatment instrument becomes easy, there is an effect that the work time required for the replacement operation of the treatment instrument can be shortened.

  In this embodiment, since the guide wire locking member 422 provided with the hook-shaped guide wire locking portion 424 is provided, the guide wire 68 can be easily operated by operating the operation lever 72 at hand only when the guide wire 68 is fixed. Can be fixed. Therefore, there is an effect that the operability of the endoscope 1 can be further enhanced.

  Further, in the present embodiment, in particular, since the elongated arm portion 423 of the guide wire locking member 422 is not pulled deep into the distal end hard portion 21, the depth of the locking member storage chamber 428 becomes shallow. Therefore, when the endoscope 1 is cleaned, the brush, the cleaning liquid, etc. easily spread inside the locking member storage chamber 428, and the workability during cleaning / disinfection is improved.

In addition, when the guide wire 68 is guided in the direction of the side wall of the distal end hard portion 21 by the hook-shaped guide wire locking portion 424, the guide wire 68 is fixed by the guide wire 68 entering the visual field. There is an effect that can be easily confirmed.
As in the modification of the twenty-seventh embodiment shown in FIG. 55, the arm portion 423 of the guide wire locking member 422 and the guide wire locking portion 424 having a hook shape at the tip of the arm portion 423 are separated from each other. The friction enhancing member 429 having a large frictional resistance may be used only for the hook-shaped guide wire locking portion 424.

FIGS. 56A and 56B show a twenty-eighth embodiment of the present invention. In this embodiment, the guide wire locking member 422 of the 27th embodiment is changed as follows.
That is, in the guide wire locking member 431 of this embodiment, as shown in FIG. 56 (B), a ring-shaped shaft fixing portion is provided at the base end portion of the arm portion 423 similar to the guide wire locking member 422 of the 27th embodiment. 432 is provided. One end of a support shaft 433 is fixed to the shaft fixing portion 432. A pinion gear 434 is fixed to the other end portion of the support shaft 433. Further, a sealing O-ring 435 is fitted on the outer peripheral surface of the support shaft 433 between the shaft fixing portion 432 of the guide wire locking member 431 and the pinion gear 434.

  As shown in FIG. 56A, the distal end hard portion 21 of the endoscope 1 is separately provided with a gear portion storage chamber 436 below the locking member storage chamber 428. The locking member storage chamber 428 of the distal end rigid portion 21 stores the shaft fixing portion 432 of the guide wire locking member 431, and the gear portion storage chamber 436 stores the pinion gear 434, respectively. Further, a sliding surface 637 that contacts the O-ring 435 is formed in the communication path between the locking member storage chamber 428 and the gear portion storage chamber 436. The O-ring 435 ensures water tightness between the locking member storage chamber 428 and the gear portion storage chamber 436.

Further, the tip of the channel hole of the pulling wire channel 71 formed in the distal end hard portion 21 is communicated with the gear portion storage chamber 436. The rack gear 426 at the tip of the pulling wire 75 is meshed with the pinion gear 434 in the gear portion storage chamber 436.
The guide wire locking member 431 of the present embodiment is rotationally driven by the same operation as that of the 27th embodiment via the meshing portion of the rack gear 426 at the tip of the pulling wire 75 and the pinion gear 434 in the gear portion storage chamber 436. Is done.

  The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by the guide wire locking member 431 by the operation by the operation lever 72 on the hand operation portion 13 side of the endoscope 1 as in the 27th embodiment. Thus, it is possible to eliminate the need to grip the guide wire 68 on the operation unit 13 side of the endoscope 1. Therefore, since the replacement operation of the treatment instrument becomes easy, there is an effect that the work time required for the replacement operation of the treatment instrument can be shortened.

  In the present embodiment, a separate gear portion storage chamber 436 is provided below the locking member storage chamber 428 in the distal end hard portion 21 of the endoscope 1, and between the locking member storage chamber 428 and the gear portion storage chamber 436. Since the O-ring 435 ensures the watertightness, no dirt or the like enters the gear portion storage chamber 436 and the pulling wire channel 71 that are configured in a complicated shape. Therefore, in addition to the effect of the twenty-seventh embodiment, there is an effect of further improving washing and disinfection.

FIGS. 57A, 57B, and 57C show a twenty-ninth embodiment of the present invention. In the present embodiment, the distal end portion 17 of the endoscope 1 in the first embodiment is changed as follows.
A configuration of the distal end portion 17 of the endoscope 1 will be described with reference to FIG. A guide wire fixing elevator base 267 is provided on the lower surface of the introduction guide path 24 in the distal end rigid portion 21 at the distal end portion 17 of the endoscope 1. One end of the guide wire fixing elevator base 267 is pivotally attached to the distal end hard portion 21 by an elevator rotary pivot 268. The elevator fulcrum 268 is disposed at a lower portion of the leading opening portion of the introduction guide path 24. Then, the guide wire fixing elevator base 267 is centered on the elevator pivot point 268 in the introduction guide path 24 from the standby position indicated by the solid line in FIG. 57A to the elevator position indicated by the virtual line in FIG. It is attached so that it can move up and down freely.

Further, as shown in FIG. 57 (B), the tip end portion of the pulling wire 269 is fixed to the other end portion of the guide wire fixing raising base 267. The puller wire 269 is guided to the operation unit 13 through the puller wire channel 274.
In addition, a link mechanism (not shown) for operating the pulling wire 269 of the guide wire fixing elevator 267 is built in the operation unit 13. Since this link mechanism has the same structure as the elevator operation mechanism 41, its description is omitted here. Then, by operating the operation lever 72 in the operation unit 13, the pulling wire 269 is sequentially passed through the arm 49 of the link mechanism similar to the elevator operating mechanism 41, the link member 44, and the wire fixing member 42 in the same manner as the treatment instrument elevator 27. The guide wire fixing elevator base 267 is configured to move up and down around the elevator pivot fulcrum 268. As a result, as shown in FIG. 57 (C), the guide wire 68 inserted through the treatment instrument insertion channel 23 and led out to the outside from the channel opening 26 is fixed by raising the guide wire fixing raising base 267. It is configured to be.

The operating means of the guide wire fixing elevator base 267 is not limited to this embodiment as long as the guide wire fixing elevator base 267 can be pulled.
Further, the guide surface 275 of the guide wire fixing elevator 267 has a step so as to smoothly connect the channel 23 and the guide surface 29 of the treatment instrument elevator 27 when the guide wire fixing elevator 267 is inverted. Is as small as possible.

The dimensional relationship of the guide wire fixing elevator base 267 is as follows when the length of the guide wire fixing elevator base 267 is L and the diameter of the introduction guide path 24 is D as shown in FIG. The relation “D ≦ L” is set.
Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, the guide wire fixing elevator base 267 is held in advance at the standby position shown in FIG.

  In this state, the guide catheter 67 is inserted into the treatment instrument insertion channel 23 from the insertion port 61 of the operation unit 13 of the endoscope 1. Then, the guide catheter 67 is protruded to the outside from the channel opening 26 and inserted into the pancreas / bile duct (not shown) transpapillarily. At this time, since the guide surface 275 of the guide wire fixing elevator 267, the channel 23, and the treatment instrument elevator 27 are smoothly connected, the guide catheter 67 can be inserted without being caught.

  Thereafter, when exchanging the currently used guide catheter 67 with a treatment tool to be used next, first, the guide wire 68 is inserted from the base on the proximal end side of the guide catheter 67. Then, it is confirmed by an observation image (endoscopic image) of the endoscope 1 that the distal end portion of the guide wire 68 has entered the inside of the pancreas / bile duct (not shown), and the guide wire 68 is prevented from moving. The proximal end side of 68 is gripped by hand. Subsequently, an operation of pulling out the guide catheter 67 is performed in this state.

  At this time, after confirming that the guide catheter 67 has been pulled out from the nipple (not shown) by an endoscopic image, the guide catheter 67 is further pulled out. Then, by pulling the pulling wire 269 with the operation lever 72 in a state where the distal end of the guide catheter 67 is housed in the treatment instrument insertion channel 23, the guide wire fixing elevator base 267 is virtually shown in FIG. It is rotated to the raising position indicated by the line. As a result, as shown in FIG. 57 (C), the guide wire 68 led out from the channel opening 26 to the outside is formed between the upper surface 273 of the introduction guide path 24 of the distal end hard portion 21 and the guide wire fixing elevator base 267. It is sandwiched between and fixed mechanically.

Further, after confirming that the guide wire 68 is fixed, the guide catheter 67 is completely pulled out from the operation unit 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment tool hits the guide wire fixing elevator 267, the operation lever 72 is operated to release the fixation by the guide wire fixing elevator 267 and further into the pancreas / bile duct (not shown). Insert the treatment tool until

  The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by operating the guide wire fixing elevator base 267 by the operation lever 72 on the hand operation unit 13 side of the endoscope 1. Further, when the guide wire 68 is fixed, the operation lever 72 is held at the operation position, so that the guide wire 68 can be firmly fixed.

Further, in the normal case, the guide guide fixing base 267 is placed at the standby position shown in FIG. 57 (B) so that the introduction guide path 24 of the distal end hard portion 21 is opened, so there is no problem. The treatment tool can be inserted.
Furthermore, in this embodiment, since the conventional treatment tool can be used as it is, the use of the treatment tool familiar to the surgeon can maintain a state in which operability remains good. Therefore, the treatment instrument can be easily replaced in a shorter time without impairing the conventional operation method of the treatment instrument and the operation feeling.

  Further, since the guide wire 68 can be fixed by the guide wire fixing elevator 267 at the distal end portion 17 of the insertion portion 12, the length of the guide wire 68 can be shortened. Therefore, it is easy to handle the guide wire 68, and there is an effect that a large work space is not required. In addition, the treatment tool can be easily replaced, the number of assistants can be reduced, and the working time can be shortened.

  In addition, the guide wire contact surface of the guide wire fixing elevator base 267 in the endoscope 1 of the twenty-ninth embodiment is within a range that does not hinder the insertion of the treatment instrument in order to increase the fixing strength due to frictional resistance. An elastic member 276 is provided on the guide wire fixing elevator 267 as in the first modification shown in A), or a guide wire fixing elevator 267 as in the second modification shown in FIG. 59 (B). A protrusion 277 may be provided on the guide wire contact surface.

FIGS. 58A to 58C show a thirtieth embodiment of the present invention. In the present embodiment, the configuration of the treatment instrument raising base 27 and the guide wire fixing raising base 267 of the endoscope 1 according to the 29th embodiment is changed as follows.
That is, in this embodiment, as shown in FIG. 58 (A), a plate-shaped guide wire fixing elevator base 282 is provided on the treatment instrument elevator base 281 so as to overlap. As shown in FIG. 58 (B), the treatment instrument elevator base 281 is provided with a mounting recess 284 for fixing the guide wire fixing elevator base 282 at the rotating portion in the vicinity of the elevator rotating pivot 283.

  As shown in FIG. 58C, a bearing portion 285 is formed on one end side of the guide wire fixing elevator base 282. The bearing portion 285 is rotatably inserted into the recess 284 of the treatment instrument elevator base 281. The rotation fulcrum 286 of the guide wire fixing elevator 282 is provided coaxially with the rotation fulcrum 283 of the treatment instrument elevator 281.

The rotation fulcrum 286 of the guide wire fixing elevator 282 and the rotation fulcrum 283 of the treatment instrument elevator 281 may have different axes.
Further, the tip end portion of the pulling wire 269 of the twenty-ninth embodiment is fixed to the side surface of the guide wire fixing elevator base 282. The pulling wire 269 is guided to the operation unit 13 through the pulling wire channel 274 and connected to a link mechanism (not shown). Similarly to the twenty-ninth embodiment, the guide wire fixing elevator base 282 can be pulled through the pulling wire 269 by operating the operation lever 72 on the hand side.

Similar to the twenty-ninth embodiment, an elastic member 276 shown in FIG. 59A or a protrusion 277 shown in FIG. 59B may be provided on the top surface of the guide wire fixing elevator base 282.
In this embodiment, by pulling the pulling wire 269 with the operation lever 72, the guide wire fixing elevator base 282 is rotated to the rising position. As a result, the guide wire 68 led out from the channel opening 26 to the outside as in the 29th embodiment is located between the upper surface 273 of the introduction guide path 24 of the distal end hard portion 21 and the guide wire fixing elevator 282. It is sandwiched and mechanically fixed.

  The present embodiment has the following effects. That is, also in this embodiment, by pulling the pulling wire 269 with the operation lever 72, the guide wire 68 is detachably fixed at the distal end portion 17 of the insertion portion 12 of the endoscope 1 by the guide wire fixing raising base 282. Therefore, the same effect as in the 29th embodiment can be obtained. Furthermore, in this embodiment, in particular, since the plate-shaped guide wire fixing elevator base 282 is provided on the treatment instrument elevator base 281, there is no need to provide an installation space for the guide wire fixing elevator base 282 alone. There is an effect that further space saving can be achieved.

FIGS. 60A, 60B to 62 show a thirty-first embodiment of the present invention. In the present embodiment, the guide wire fixing elevator base 267 according to the twenty-ninth embodiment is modified to be incorporated in the treatment instrument elevator base 27.
That is, as shown in FIGS. 61 (A) and 61 (B), the guide surface 291a of the treatment instrument elevator base 291 of the present embodiment is provided with an opening 293 that accommodates built-in components. In the opening 293, the guide wire fixing elevator base 292 and the elevator base moving member 295 of this embodiment are accommodated.

The raising base rotation fulcrum 294 of the guide wire fixing raising base 292 is pivotally coaxially mounted together with the rotation supporting point 294 of the treatment instrument raising base 291.
Note that the elevator turning fulcrum 294 of the guide wire fixing elevator 292 may be provided with a different axis from the rotation fulcrum 294 of the treatment instrument elevator 291.

  The elevator moving member 295 is disposed at a position closer to the distal end side of the endoscope 1 than the guide wire fixing elevator 292. The tip end portion of the pulling wire 269 of the twenty-ninth embodiment is fixed to the elevator moving member 295. The pulling wire 269 is guided to the operation unit 13 through the pulling wire channel 274 and connected to a link mechanism (not shown). As in the 29th embodiment, the pulling operation of the pulling wire 269 can be performed by operating the operation lever 72 on the hand side.

Note that the elevator moving member 295 is normally held at a standby position arranged in front of the guide wire fixing elevator 292 as shown in FIG. In this state, the guide wire fixing elevator base 292 is held at the standby position where the guide wire is fixed.
When the raising base moving member 295 is towed, the raising base moving member 295 moves to the hand side and presses the guide wire fixing raising base 292 as shown in FIG. Thereby, the guide wire fixing elevator base 292 is configured to rotate about the elevator base rotation fulcrum 294 and to the elevator position shown in FIG. 60 (B). At this time, the guide wire fixing elevator base 292 is set to a height corresponding to the upper surface 297 of the introduction guide path 24 of the distal end hard portion 21.

In addition, the guide surfaces 291a and 298 when the treatment instrument raising base 291 and the guide wire fixing raising base 292 are inverted are smoothly connected so as not to be uneven.
Further, the R curved surface portion 300 is formed by dropping the edge of the back surface of the guide wire fixing elevator 292 so that the elevator moving member 295 easily enters the back side of the guide wire fixing elevator 292. Furthermore, in order to reduce the frictional resistance of the guide surface 298 of the guide wire fixing elevator 292, the material of the elevator moving member 295 may be changed from metal to plastic.

In this embodiment, as shown in FIG. 62, the relationship between the rising angle θ1 of the treatment instrument raising base 291 and the rising angle θ2 of the guide wire fixing raising base 292 is set to “θ1 <θ2”. Yes.
Next, the operation of this embodiment will be described. When using the endoscope 1 of the present embodiment, as in the 29th embodiment, the operation of raising the guide wire fixing elevator 292 while the guide catheter 67 is retracted into the introduction guide path 24 or the channel 23. To do. In this case, in this embodiment, the elevator moving member 295 is pulled under the guide wire fixing elevator 292 by pulling the elevator moving member 295 with the operation lever 72, and the guide wire fixing elevator 292 is raised. Let And the guide wire 68 is pinched | interposed between the raising base 292 for guide wire fixation, and the upper surface 297 of the introduction guide path 24 of the front-end | tip hard part 21, and the guide wire 68 is fixed.

  In this embodiment, since the guide wire fixing elevator 292 and the elevator moving member 295 are housed in the opening 293 of the treatment instrument elevator 291, the same effects as those of the thirtieth embodiment are obtained. In addition to the effects of the thirtieth embodiment, in this embodiment, in particular, the relationship between the raising angle θ1 of the treatment instrument raising base 291 and the raising angle θ2 of the guide wire fixing raising base 292 is expressed as “θ1 < Since it is set to “θ2”, the guide wire 68 can be fixed by the guide wire fixing elevator 292 having a smaller size than the treatment instrument elevator 291.

  Further, like the modified example of the guide wire fixing elevator base 292 in the endoscope 1 of the thirty-first embodiment shown in FIG. 63, the back surface of the guide wire fixing elevator base 292 or the guide surface 298 of the elevator base moving member 295 is provided. A roller 299 may be provided to reduce the frictional resistance between the back surface of the guide wire fixing elevator 292 and the guide surface 298 of the elevator moving member 295.

FIGS. 64 and 65 show a thirty-second embodiment of the present invention. In this embodiment, instead of the guide wire fixing elevator base 267 of the endoscope 1 of the 29th embodiment, a guide wire fixing elevator base 301 having a different configuration is provided.
That is, as shown in FIG. 64, the guide wire fixing elevator 301 is disposed on the rear end wall surface 17b of the notch portion 17a at the distal end portion 17 of the insertion portion 12 in the endoscope 1 of the present embodiment. The guide wire fixing elevator 301 is disposed in a portion of the channel opening 26 facing the treatment instrument elevator 27.

  Further, one end portion of a guide wire fixing elevator base 301 is pivotally attached to the distal end hard portion 21 of the distal end portion 17 via a pivot fulcrum 302. Furthermore, the tip of the pulling wire 303 is fixed to the other end of the guide wire fixing elevator 301. The base end portion of the pulling wire 303 is guided to the operation unit 13 and connected to a link mechanism (not shown). As in the twenty-ninth embodiment, the guide wire fixing elevator base 301 can be pulled through the pulling wire 303 by operating the operation lever 72 on the hand side.

Similarly to the twenty-ninth embodiment, an elastic member 276 shown in FIG. 59A or a protrusion 277 shown in FIG. 59B may be provided on the top surface 301a of the guide wire fixing elevator base 301a.
Next, the operation of this embodiment will be described. In the normal case, the guide wire fixing elevator base 301 is pushed out by the operation lever 72, so that the guide wire fixing elevator base pivoting fulcrum 302 can be pivoted as shown by the dotted line in FIG. The treatment tool can be inserted without any problem.

  Further, in the present embodiment, by pulling the pulling wire 303 with the operation lever 72, the guide wire fixing elevator base 301 is rotated in the direction in which the guide wire fixing elevator base 301 abuts on the treatment instrument elevator base 27 side as shown by a solid line in FIG. Moved. As a result, the guide wire 68 led out from the channel opening 26 to the outside is sandwiched between the guide wire fixing elevator base 301 and the treatment instrument elevator base 27 and mechanically fixed. Similarly, the guide wire 68 can be fixed.

Even in this embodiment, the guide wire 68 can be fixed by the guide wire fixing elevator 301 in the same manner as in the 29th embodiment, and therefore, the same effects as in the 29th embodiment can be obtained in this embodiment.
66A to 66D show a thirty-third embodiment of the present invention. In this embodiment, instead of the operation lever 72 of the guide wire fixing elevator base 267 in the operation unit 13 of the endoscope 1 of the 29th embodiment, an operation mechanism of the guide wire fixing elevator base 267 having a different configuration is provided. is there.

  That is, the operation portion 13 of the endoscope 1 according to the present embodiment is provided between a grip 262 for holding the operation portion 13 and an oleome portion 263 below the insertion opening 61 as shown in FIG. Further, a pulling knob 264 formed in a substantially cylindrical shape for operating the guide wire fixing elevator 267 is disposed. As shown in FIG. 66C, the pulling knob 264 is rotatably mounted on a base 47 serving as a base of the operation unit 13. The rotation axis O1 of the pulling knob 264 is coaxial with the central axis O2 of the insertion portion 12.

In addition, since the rotation axis of the raising operation knob 48 of the treatment instrument raising base 27 is coaxial with the bending operation portion 56, it exists orthogonal to the central axis O <b> 2 of the insertion portion 12. The rotation axis O1 of the traction knob 264 exists at a position orthogonal to the rotation axis of the raising operation knob 48.
Furthermore, as shown in FIG. 66C, a cylindrical cam member 265 is embedded in the pulling knob 264. As shown in FIG. 66D, the cam member 265 is provided with a cam groove 265a obliquely. A moving pin 266 is engaged with the cam groove 265a of the cam member 265 so as to be movable along the cam groove 265a.

  Further, the proximal end portion of the pulling wire 269 inserted into the pulling wire channel 274 is fixed to the moving pin 266. The moving pin 266 moves along the cam groove 265a of the cam member 265 along with the rotation operation of the pulling knob 264, so that the pulling wire 269 moves in the direction of the central axis O2 of the insertion portion 12 via the moving pin 266. It is configured to be driven back and forth along.

  Next, the operation of this embodiment will be described. When pulling up the guide wire fixing elevator base 267 when using the endoscope 1 of the present embodiment, the pulling knob 264 is rotated. At this time, since the cam member 265 also rotates integrally with the pulling knob 264, the moving pin 266 moves in the cam groove 265a with the rotation of the cam member 265 and pulls the pulling wire 269, so that the guide wire is fixed. The elevator stand 267 is pulled.

  The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by the distal end portion 17 of the insertion portion 12 of the endoscope 1 as in the 29th embodiment, easily by the operation by the pulling knob 264 on the hand operation portion 13 side of the endoscope 1. And the same effects as those of the 29th embodiment can be obtained.

  In the present embodiment, in particular, the rotation axis O1 of the pulling knob 264 of the guide wire fixing elevator 267 exists at a position orthogonal to the rotation axis of the raising operation knob 48 of the treatment instrument elevator 27. The operation direction of the raising operation knob 48 of the tool raising base 27 is different from the operation direction of the pulling knob 264 of the raising base 267 for fixing the guide wire. Therefore, it is possible to prevent an erroneous operation that erroneously operates the raising operation knob 48 of the treatment instrument raising base 27 and the pulling knob 264 of the guide wire fixing raising base 267.

Furthermore, by providing the pulling knob 264 of the guide wire fixing elevator 267 near the insertion port 61, the insertion hole of the guide wire 68 and the pulling knob 264 of the guide wire fixing elevator 267 can be brought close to each other. As a result, workability is further improved.
Note that the position of the pulling knob 264 is not limited between the oleod portion 263 below the insertion opening 61 and the grip 262. For example, in the endoscope 1 in the thirty-third embodiment shown in FIG. 67 (A), the connector-side dome portion disposed at the connection portion with the universal cord 14 in the operation portion 13 as in the first modification of the operation portion 13. 14a or the connector 18 or the grip 262.

  Further, the operating means of the guide wire fixing elevator base 267 is not a knob type, but a lever type using an operating lever 278 as in the second modification of the operating unit 13 in the endoscope 1 shown in FIG. 67 (B). There may be. The operating force transmission mechanism of the operating lever 278 at that time is based on the link mechanism shown in the twenty-ninth embodiment, but is not limited to this as long as a towing operation is possible.

FIGS. 68A and 68B show a thirty-fourth embodiment of the present invention. In this embodiment, a guide wire fixing mechanism 361 having a different configuration is provided in place of the guide wire fixing elevator base 267 of the 29th embodiment.
That is, the guide wire fixing mechanism 361 of the present embodiment is provided with a substantially block-shaped guide wire fixing device 362. In the endoscope 1, the distal end hard portion 21 of the distal end portion 17 of the insertion portion 12 is provided with a storage chamber 363 for a guide wire fixture 362 on the upper surface of the introduction guide path 24 communicating with the channel opening 26. In the storage chamber 363, a coil-shaped spring member 364 is disposed to urge the guide wire fixture 362 in a direction to be pulled out substantially perpendicularly outside the storage chamber 363.

  Further, the distal end portion of the pull wire 365 is fixed to the guide wire fixture 362. The puller wire 365 is guided to the operation unit 13 through the puller wire channel 366 and is connected to a link mechanism (not shown). As a result, as in the twenty-ninth embodiment, the guide wire fixture 362 can be pulled through the pull wire 365 by operating the operation lever 72 on the hand side.

Similarly to the twenty-ninth embodiment, an elastic member 276 shown in FIG. 59A or a protrusion 277 shown in FIG. 59B may be provided on the contact surface of the guide wire fixture 362 with the guide wire 68.
Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, the pulling wire 365 is pulled by the operation lever 72 in the initial state in advance, and the guide wire fixture 362 is pulled into the storage chamber 363 as shown in FIG. deep.

  Similarly to the twenty-ninth embodiment, after the guide catheter 67 and the guide wire 68 are inserted into the body through the channel 23, the pulling wire 365 is moved by operating the operation lever 72 while the guide catheter 67 is pulled into the channel 23. Perform the loosening operation. At this time, the guide wire fixture 362 is pulled out substantially perpendicularly to the outside of the storage chamber 363 by the elastic force of the spring member 364 and protrudes into the introduction guide path 24 as shown in FIG. As a result, the guide wire 68 is sandwiched between the hard tip portion 21 and the guide wire fixture 362 and mechanically fixed.

Further, after confirming that the guide wire 68 is fixed, the guide catheter 67 is completely pulled out from the operation unit 13 side of the endoscope 1 to the outside of the treatment instrument insertion channel 23.
Thereafter, the treatment tool to be used next is inserted from the proximal end side of the guide wire 68. At this time, the treatment instrument is inserted into the treatment instrument insertion channel 23 with the guide wire 68 as a guide. When the treatment tool hits the guide wire fixing tool 362, the operation lever 72 is operated to release the fixation by the guide wire fixing tool 362, and the treatment tool is inserted into the pancreas / bile duct (not shown).

  The present embodiment has the following effects. That is, in this embodiment, the guide wire 68 can be easily fixed by the operation of the operation lever 72 of the hand operation unit 13 of the endoscope 1, and the guide wire fixing tool 362 is stored in the storage chamber 363 in a normal case. Since the introduction guide path 24 is opened, the treatment tool can be inserted without any problem.

  In addition, since the conventional treatment tool can be used in the present embodiment, the operability can be kept good by using the treatment tool familiar to the surgeon. Furthermore, since the guide wire 68 can be fixed at the distal end portion 17 of the insertion portion 12 of the endoscope 1, the length of the guide wire 68 can be shortened as compared with the conventional case, so that workability is improved.

  FIGS. 69A to 69C show a thirty-fifth embodiment of the present invention. In the present embodiment, the configuration is such that a torque transmission member 371 is provided between the guide wire fixture 362 and the pulling wire 365 of the 34th embodiment. The torque transmission member 371 is disposed in the upper portion of the storage chamber 363 of the hard distal end portion 21 provided at the distal end portion 17.

Furthermore, a rotating shaft 372 is provided near the center of the torque transmission member 371 as shown in FIG. The tip of the pulling wire 365 is fixed to one end of the torque transmission member 371.
A slit-like opening 374 through which the spring member 364 is inserted is provided on the torque transmission member 371 opposite to the fixed end 373 of the pulling wire 365.

Further, a concave portion 375 is formed in the distal end hard portion 21 to prevent the interference with the torque transmission member 371 when the torque transmission member 371 rotates by cutting the lower portion of the rotation shaft 372.
Next, the operation of this embodiment will be described. When the endoscope 1 of the present embodiment is used, the torque transmission member 371 is disposed substantially in parallel with the introduction guide path 24 as shown in FIG. Accordingly, since the spring member 364 has a natural length, the guide wire fixture 362 is stored in the storage chamber 363.

  Similarly to the twenty-ninth embodiment, after the guide catheter 67 and the guide wire 68 are inserted into the body through the channel 23, the pulling wire 365 is moved by operating the operation lever 72 while the guide catheter 67 is pulled into the channel 23. Perform towing operation. At this time, one end of the torque transmission member 371 is pulled by the pulling wire 365 and goes up, and at the same time, the other end goes down.

  As a result, the guide wire fixture 362 is pulled out substantially vertically out of the storage chamber 363 and protrudes into the introduction guide path 24 as shown in FIG. 69 (B). As a result, the guide wire 68 is sandwiched between the hard tip portion 21 and the guide wire fixture 362 and mechanically fixed.

Further, when the guide wire 68 is unfixed, the torque transmission member 371 is returned to its original position by returning the operation lever 72 to the original position, and the guide wire fixture 362 is also returned to the storage chamber 363 by the restoring force of the spring member 364. The guide wire 68 is unlocked.
The present embodiment has the following effects. That is, in the present embodiment, the guide wire 68 can be easily fixed by the operation of the operation lever 72 of the hand operation unit 13 of the endoscope 1 as in the 34th embodiment, and the guide wire fixing tool 362 is normally used in the case. Since the introduction guide path 24 is opened by storing it in the storage chamber 363, the treatment instrument can be inserted without any problem.

Further, in the present embodiment, in addition to the same effects as those in the 34th embodiment, the guide wire 68 can be kept pulled by the operation lever 72 when the guide wire 68 is fixed. It is possible to apply a strong force.
FIGS. 70A to 70C show a thirty-sixth embodiment of the present invention. In this embodiment, a guide wire fixing mechanism 311 having a different configuration is provided in place of the guide wire fixing elevator base 267 of the 29th embodiment.

  That is, the guide wire fixing mechanism 311 of this embodiment is provided with a plate-shaped guide wire fixing member 312 that can be elastically deformed as shown in FIG. In the endoscope 1, the distal end hard portion 21 of the distal end portion 17 of the insertion portion 12 is provided with a storage chamber 313 for the guide wire fixing member 312 on the upper surface of the introduction guide path 24 communicating with the channel opening 26. In the storage chamber 313, a coil-shaped spring member 314 is disposed to urge the guide wire fixing member 312 in the direction in which the guide wire fixing member 312 is pulled into the storage chamber 313.

Further, the distal end portion of the pulling wire 315 is fixed to the guide wire fixing member 312.
In addition, a rotatable guide roller 316 is disposed in the distal end hard portion 21 at a lower portion of the storage chamber 313 on the lower surface of the introduction guide path 24. The pulling wire 315 extending below the storage chamber 313 is led toward the operation unit 13 while being bent toward the operation unit 13 by the guide roller 316, and is connected to a link mechanism (not shown). . As a result, the guide wire fixing member 312 can be pulled through the pulling wire 315 by operating the operation lever 72 on the hand side as in the 29th embodiment.

Note that the pulling mechanism of the guide wire fixing member 312 is based on the above-described link mechanism, but is not limited to this as long as the guide wire fixing member 312 can be pulled.
Next, the operation of this embodiment will be described. When using the endoscope 1 of the present embodiment, the guide catheter 67 and the guide wire 68 are inserted into the body through the channel 23 as in the 29th embodiment, and then the guide catheter 67 is inserted into the introduction guide path 24 or the channel 23. In the retracted state, the operation of the operation lever 72 causes the guide wire fixing member 312 to be pulled through the pull wire 315. At this time, the guide wire fixing member 312 is pulled out from the storage chamber 313 and the lower end portion of the guide wire fixing member 312 contacts the lower surface of the introduction guide path 24 of the distal end hard portion 21 as shown in FIG. Touched. Accordingly, the guide wire 68 is fixed by sandwiching the guide wire 68 between the lower surface of the introduction guide path 24 of the distal end hard portion 21 and the guide wire fixing member 312.

  When the operation lever 72 is returned, the guide wire fixing member 312 is returned to the state where it is drawn into the storage chamber 313 by the restoring force of the spring member 314. As a result, the lower end portion of the guide wire fixing member 312 is separated from the guide wire 68, so that the guide wire 68 is released from being fixed.

  In the present embodiment, the guide wire fixing member 312 is pulled through the pulling wire 315 by operating the operation lever 72, and the guide wire fixing member 312 guides at the distal end portion 17 of the insertion portion 12 of the endoscope 1. Since the wire 68 can be detachably fixed, the same effect as that of the 29th embodiment can be obtained. In addition to the effect of the 29th embodiment, in this embodiment, particularly when the guidewire 68 is unlocked. By storing the guide wire fixing member 312 in the storage chamber 313 of the distal end portion 17, there is an effect that the guide wire fixing member 312 does not interfere with the case.

71 and 72 show a thirty-seventh embodiment of the present invention. In the present embodiment, the configuration of the distal end portion 17 of the endoscope 1 in the 24th embodiment is changed as follows.
That is, in this embodiment, a wire-shaped guide wire fixing tool 81 curved in a substantially U shape as shown in FIG. 71 is provided at the distal end portion of the pulling wire 75 of the twenty-fourth embodiment. The distal end is fixed to the side surface of the channel opening 26 in the notch 17 a of the distal end 17 of the endoscope 1. The guide wire fixing tool 81 is fixed to the distal end portion 17 by adhesion, solder, screw fixing, or the like.

Next, the operation of this embodiment will be described. When the endoscope 1 according to the present embodiment is used, the guide wire fixture 81 is set in a state of being expanded so as to surround the channel opening 26 as shown in FIG.
Similarly to the twenty-fourth embodiment, after the guide wire 68 and the guide catheter 67 are inserted into the treatment instrument insertion channel 23, when the guide wire 68 is fixed, the guide catheter 67 is pulled out into the channel 23, and only the guide wire 68 is extracted. The guide wire fixing tool 81 is pulled to the hand side by operating the operation lever 72 on the hand side in a state where the guide wire is protruded to the outside of the channel opening 26. 72, the guide wire 68 is sandwiched between the proximal side wall surface 26a of the channel opening 26 and the guide wire fixture 81, and the guide wire 68 is fixed.

In this embodiment as well as the twenty-fourth embodiment, the guide wire 68 can be easily fixed by the guide wire fixing tool 81 at the distal end portion of the pulling wire 75 by the operation by the operation lever 72 on the hand operation portion 13 side of the endoscope 1. Thus, the same effect as in the twenty-fourth embodiment can be obtained.
In the present embodiment, in particular, in addition to the effects of the twenty-fourth embodiment, the distal end portion of the pulling wire 75 as the operation means is fixed to the side surface of the channel opening portion 26 in the notch portion 17a of the distal end portion 17 of the endoscope 1. This is inexpensive because the guide wire fixture 81 is formed.

FIG. 73 shows a modified example of the fixed state of the distal end portion of the guide wire fixture 81 of the pulling wire 75 in the endoscope 1 of the 37th embodiment.
In this modification, as shown in FIG. 73, a plate material 82 is fixed to the distal end portion of the guide wire fixture 81 with solder or the like, and this plate material 82 is rotatably connected to the distal end portion 17 of the endoscope 1 with a pin 83 or the like. It is the structure which does.

Further, the notch 17a of the distal end portion 17 of the endoscope 1 is provided with a protrusion 70 that can be temporarily fixed in a state where the guide wire fixing member 81 is widened, as in the twenty-fourth embodiment, on the distal end side of the channel opening 26. Also good.
Therefore, in the present modification, the plate material 82 is fixed to the guide wire fixing tool 81, and the plate material 82 is rotatably connected to the distal end portion 17 of the endoscope 1 with a pin 83 or the like. The load acting on the guide wire fixture 81 is sometimes reduced.

74A to 74C show a thirty-eighth embodiment of the present invention. In the present embodiment, the configuration of the distal end portion 17 of the endoscope 1 in the 24th embodiment is changed as follows.
That is, in this embodiment, as shown in FIGS. 74A and 74B, a guide wire fixture 91 separate from the pull wire 75 is connected to the tip of the pull wire 75 of the 24th embodiment. is there.

  The shape of the guide wire fixing surface of the guide wire fixing tool 91 may be an arc shape, a flat shape, or an uneven shape matching the wire diameter of the guide wire 68. And the front-end | tip part of the pull wire 75 is being fixed to the one end part of this guide wire fixing tool 91. FIG. Further, a guide projection 92 is provided on the other end of the guide wire fixture 91.

  As shown in FIG. 74C, a guide groove 93 that guides the movement of the guide wire fixture 91 is provided in the axial direction of the insertion portion 12 of the endoscope 1 in the side surface portion of the storage chamber 25 of the distal end hard portion 21. It extends along. A guide protrusion 92 of the guide wire fixture 91 is engaged with the guide groove 93. Then, the guide wire fixture 91 is moved along the axial direction of the insertion portion 12 of the endoscope 1 in a state where the guide projection 92 slides along the guide groove 93 in accordance with the operation of the pulling wire 75. It is configured.

Further, the movement range of the guide wire fixing tool 91 by the operation of the pulling wire 75 is set from the proximal side wall surface 26 a of the channel opening 26 to the distal end side of the treatment instrument raising base 27.
Next, the operation of this embodiment will be described. In this embodiment, before the guide catheter 67 is inserted, the guide wire fixture 91 is set in a state of being pushed out to the distal end side of the distal end portion 17 of the endoscope 1 in advance.

  Similarly to the twenty-fourth embodiment, after the guide wire 68 and the guide catheter 67 are inserted into the treatment instrument insertion channel 23, when the guide wire 68 is fixed, the guide catheter 67 is pulled out into the channel 23, and only the guide wire 68 is extracted. In such a state that the guide wire fixture 91 is pulled out to the hand side through the pulling wire 75 by operating the operation lever 72 on the hand side. As a result, the guide wire 68 is sandwiched between the proximal side wall surface 26a of the channel opening 26 and the guide wire fixture 91, and the guide wire 68 is fixed.

In this embodiment as well as the twenty-fourth embodiment, the guide wire 68 can be easily fixed by the guide wire fixing tool 91 at the distal end portion of the pulling wire 75 by the operation by the operation lever 72 on the hand operation portion 13 side of the endoscope 1. Thus, the same effect as in the twenty-fourth embodiment can be obtained.
Further, in this embodiment, in particular, the guide groove 93 is provided in the side surface portion of the storage chamber 25 of the distal end hard portion 21, and the guide protrusion 92 of the guide wire fixture 91 is engaged with the guide groove 93. The fixture 91 does not go out of the channel opening 26, and the guide wire 68 can be stably fixed.

Further, the upper surface portion of the distal end hard portion 21 within a range in which the pulling wire 75 of the guide wire fixture 91 does not enter the observation field of view extending from the objective lens 57 as in the modification of the endoscope 1 in the thirty-eighth embodiment shown in FIG. You may make it the structure arrange | positioned.
FIGS. 76 to 80 show a thirty-ninth embodiment of the present invention. In the present embodiment, the internal configuration of the distal end portion 17 of the insertion portion 12 in the endoscope 1 according to the twenty-fourth embodiment is changed as follows.

  That is, in the present embodiment, as shown in FIG. 78, the second opening 561 is formed on the upper surface of the channel opening 26 in the distal end hard portion 21. The proximal end portion of the second opening 561 is connected to the distal end portion of the guide wire fixing tool insertion channel 563 via a connecting tube 562 fixed to the channel hole of the distal end hard portion 21. The base end portion of the guide wire fixing tool insertion channel 563 is connected to a second insertion base portion 564 provided in the operation portion 13 of the endoscope 1 as shown in FIG.

Note that the opening position on the proximal side of the guide wire fixing tool insertion channel 563 is not limited to the position of the second insertion base portion 564 of the operation unit 13 shown in FIG. Anywhere.
The guide wire fixing tool insertion channel 563 is configured such that a guide wire fixing tool 565 for fixing the guide wire 68 is removably inserted. As shown in FIG. 80, the guide wire fixture 565 is configured by assembling three parts, a snare unit 566, an elastic member 567 such as a coil spring, and an exterior unit 568.

The snare unit 566 is connected to the proximal end portion of the elongated puller wire 569 at the proximal end member 570. The terminal member 570 is formed by a two-stage columnar member in which a large-diameter columnar gripping portion 571 and a small-diameter second columnar portion 572 are connected.
Further, the second cylindrical portion 572 of the terminal member 570 is provided with an engaging protrusion 573, and an elastic member stopper 574 is provided at the step portion.

In addition, an indicator 575 that can confirm the rotational position is provided on one side of the grip portion 571 of the terminal member 570.
Further, a loop-shaped snare 576 is provided at the distal end portion of the pulling wire 569.
Note that the tip of the puller wire 569 is not limited to the snare 576, but may be of a hook shape that can be hooked and grasped by the guide wire 68.

  The exterior unit 568 is provided with a flexible tube 578 that guides the pulling wire 569 of the snare unit 566. A fixing member 579 that is detachably engaged with the terminal member 570 of the snare unit 566 is provided at the proximal end portion of the flexible tube 578.

  The fixing member 579 is provided with a base pressing member 580 that can be attached to the second insertion base 564 of the operation unit 13 of the endoscope 1 and a cylindrical member 581 that protrudes from the upper surface of the base pressing member 580. ing. An L-shaped engagement groove 582 is formed in the cylindrical member 581. An engagement protrusion 573 of the snare unit 566 can be engaged with the engagement groove 582.

A second stopper 583 is provided at the lower part of the cylindrical member 581.
The guide wire fixture 565 is integrally assembled by inserting the snare unit 566 into the cylindrical member 581 of the exterior unit 568 via an elastic member 567 such as a coil spring. At this time, the elastic member 567 is disposed between the elastic member stopper 574 of the snare unit 566 and the second stopper 583 of the exterior unit 568 and the engagement of the snare unit 566 in the engagement groove 582 of the cylindrical member 581. The protrusion 573 is set in the inserted state.

Note that the guide wire fixing tool 565 of the present embodiment may be replaced with a snare or a grasping treatment tool that is normally used as a treatment tool.
Next, the operation of this embodiment will be described. In the guide wire fixing device 565 of the present embodiment, the engagement protrusion 573 of the snare unit 566 is normally the end portion on the opening end side of the engagement groove 582 as shown in FIG. 79 (B) by the elastic force of the elastic member 567. A biasing force in a direction against the (starting end portion 582a) works, and the position of the snare unit 566 is regulated in this state. In this state, the grip portion 571 of the snare unit 566 is held in a state of protruding outside the cylindrical member 581 of the exterior unit 568, and the snare 576 is held in a closed state.

  When the snare 576 is opened, the grip portion 571 of the snare unit 566 is pushed into the inside of the cylindrical member 581 of the exterior unit 568 against the elastic force of the elastic member 567. With this operation, the engagement protrusion 573 of the snare unit 566 slides in the axial direction along the engagement groove 582 and moves to a position where it abuts against the end of the engagement groove 582 on the base presser member 580 side. In this state, as shown in FIG. 79A, the snare 576 protrudes from the flexible tube 578, and the snare 576 is opened.

  Subsequently, at this position, the grip portion 571 is rotated counterclockwise, and the engagement protrusion 573 of the snare unit 566 is moved to the engagement end portion 582b at the end of the engagement groove 582 as shown in FIG. , The engagement protrusion 573 can be engaged, and the snare 576 can be held open.

Further, when the snare 576 is closed, the gripping portion 571 is rotated in the clockwise direction, so that the engagement protrusion 573 is disengaged from the engagement end portion 582b at the end of the engagement groove 582, and the elastic force of the elastic member 567 is used. The snare unit 566 returns to the original position shown in FIG.
Next, a method for fixing the guide wire 68 to the distal end portion 17 of the insertion portion 12 using the guide wire fixing tool 565 of the present embodiment will be described. First, the endoscope 1 is inserted into the body, and when the nipple is caught by the distal end portion 17 of the insertion portion 12, the guide wire fixture 565 is inserted from the second insertion base portion 564 with the snare 576 closed. And when the front-end | tip of the guide wire fixing tool 565 protrudes from the 2nd opening part 561, the snare 576 is protruded as shown in FIG. 77 (B) by pushing-in operation of the holding part 571. Thereafter, the operation is the same as the operation of the guide wire fixture 69 of the twenty-fourth embodiment.

  The present embodiment has the following effects. That is, in this embodiment, the same effect as that in the 24th embodiment is obtained, and in addition to this, the guide wire fixing tool 565 can be easily detached from the endoscope 1, and therefore the distal end portion 17 of the endoscope 1. The guide wire fixture insertion channel 563 and the guide wire fixture 565 can be easily cleaned and disinfected.

Furthermore, there is an effect that the internal structure of the distal end portion 17 of the insertion portion 12 in the endoscope 1 is simplified.
In addition, an existing snare, a grasping treatment tool, or the like can be substituted for the guide wire fixing tool 565, and when the guide wire fixing tool 565 is not used, the guide wire fixing tool insertion channel 563 is used as the treatment channel. Alternatively, it can be used as a forward water supply pipeline.

  A 40th embodiment of the present invention will be described with reference to FIGS. FIG. 81 shows a schematic configuration of the distal end portion 603 of the insertion portion 602 of the endoscope 601 in the endoscope apparatus of the present embodiment. In the endoscope apparatus of the present embodiment, a side-view type endoscope 601 that observes a direction substantially orthogonal to the axial direction of the insertion portion 602 is used.

  The side-view type endoscope 601 is formed with a substantially planar side-view reference surface 612 formed by cutting out the outer peripheral surface of the distal end portion 603 of the insertion portion 602. An illumination window 613 of the illumination optical system and an observation window 614 of the observation optical system are juxtaposed in the front-rear direction on the side-view reference plane 612. Further, a channel opening 615 is disposed beside the side-by-side portion of the illumination window 613 and the observation window 614 on the side view reference plane 612. This channel opening 615 constitutes the distal end opening of the treatment instrument insertion channel 616 disposed in the insertion portion 602 of the endoscope 601.

Further, a treatment instrument raising base 617 is disposed in the channel opening 615. As shown in FIG. 85, one end portion of the treatment instrument elevator base 617 is rotatably connected to the main body 611a of the distal end portion 603 via a rotation shaft 618.
Furthermore, one end of a flexible operation wire (not shown) is fixed to the other end of the treatment instrument elevator base 617. The other end of the operation wire extends to the operation unit 606 side. Then, the operation wire is pulled by interlocking with the operation of the treatment tool raising base operation lever (not shown) disposed in the operation unit 606, and the treatment tool raising base 617 is moved around the rotation shaft 618 by the operation of the operation wire. It is configured to be rotationally driven. At this time, the treatment instrument raising base 617 is rotated from a standby position (inverted position) indicated by a virtual line in FIG. 85 to a maximum rotation position (rise position) indicated by a solid line in FIG. As shown in FIGS. 83 (A) and 83 (B) extending outward from the channel opening 615 by the rotational movement of 617, each operation of raising and lowering the treatment tool 619 such as a contrast tube is shown in the observation window 614. It is comprised so that it may carry out within the visual field.

Further, the treatment instrument 619 inserted into the treatment instrument insertion channel 616 of the endoscope 601 in this embodiment is a treatment such as an existing contrast tube provided with a guide wire lumen through which a guide wire 630 described later can be inserted. The tool can be used as it is.
Note that the treatment instrument 619 includes a configuration in which the guide wire lumen is coated to reduce the frictional force with the guide wire 630, and the inner surface of the guide wire lumen is smoothed in the present embodiment. Is preferred.

  Further, a substantially V-shaped receiving groove 20 is formed on the surface of the treatment instrument raising base 617 facing the treatment instrument 619. When the treatment tool 619 is raised, the treatment tool 619 is brought into contact with the treatment tool raising base 617 in a state where the treatment tool 619 is inserted and positioned in the receiving groove portion 20, and the treatment tool 619 is guided up and down in this state. Is configured to do.

  Furthermore, a guide wire fixing member 621 is mounted as a guide wire fixing means in the vicinity of the distal end portion 603 of the insertion portion 602 in the side-view type endoscope 601 of the present embodiment. The guide wire fixing member 621 has a substantially cylindrical shape and a flexible mounting portion 622 made of, for example, a material such as vinyl chloride, and a substantially cylindrical cap portion 623 connected to the distal end side of the mounting portion 622. Is provided.

  The material of the attachment portion 622 is not necessarily vinyl chloride, and may be made of polyethylene, polystyrene, polyurethane, or the like as long as it is a soft resin. Then, the attachment portion 622 is attached in the vicinity of the distal end portion 603 of the insertion portion 602 in the endoscope 601 in a state where the cap portion 623 is disposed around the distal end portion 603 of the insertion portion 602. Thereby, the guide wire fixing member 621 is detachably attached on the channel opening 615 or on the insertion portion 602 on the proximal end side of the channel opening 615 in the vicinity of the distal end portion 603 of the insertion portion 602 in the endoscope 601. It has been.

Further, the cap portion 623 is made of a polycarbonate resin having transparency. As for the color tone of the cap portion 623, one having high transparency is preferable, but it is not necessarily transparent.
In addition, regarding the composition of the material of the cap part 623, polycarbonate resin is most preferable, but acrylic resin, polyethylene resin, polypropylene resin, polystyrene resin, and the like can also be used.

  In addition, a treatment instrument insertion opening window 624 is formed at a position corresponding to the illumination window 613, the observation window 614, and the channel opening 615 in the side view reference plane 612 of the tip 603 on the distal end side of the cap 623. . The treatment instrument insertion opening window 624 of the cap portion 623 is open on the reference surface 612 side of the insertion portion 602 of the endoscope 601, and the width of the opening window 624 is about 1/4 of the circumference of the cap portion 623, It is formed in a substantially rectangular shape having a length of about 10 mm. Thereby, the visual field of the observation window 614 of the endoscope 601 and the advancement / retraction operation of the treatment instrument 619 such as a contrast tube extending from the channel opening 615 to the outside are not hindered, and guide wire identification members 627a and 627b described later. Is set so that a guide wire fixing tool insertion hole 628, which will be described later, can be disposed at an effective position.

  Further, the treatment instrument insertion opening window 624 of the cap portion 623 is provided with a guide wire identification mechanism portion 625 and a guide wire fixing mechanism portion 626. The guide wire identification mechanism 625 is provided with guide wire identification members 627 a and 627 b made of two stainless steel wires protruding from both sides of the opening window 624 to the inside of the opening window 624.

  One of the two guide wire identification members 627a and 627b is a first guide wire identification member 627a on the left side of the treatment instrument insertion opening window 624 along the upper edge of the cap portion 623 in FIG. It extends from the inside to the inside and is curved downward. Further, the other second guide wire identification member 627b is extended inward from the right side of the treatment instrument insertion opening window 624 along the upper edge of the cap portion 623 in FIG. 82, and is curved downward. Yes. The lower extension portions 627a1 and 627b1 of the two guidewire identification members 627a and 627b are spaced apart from and substantially parallel to each other along the center line direction of the guidewire fixing member 621. An interval S having an appropriate width dimension L is formed between the lower extension portions 627a1 and 627b1 of the guide wire identification members 627a and 627b. This interval S is set to be larger than the outer diameter of the guide wire 630, for example.

  Further, guide wire fixing tool insertion holes 628 are formed in the cap portion 623 on both sides of the treatment instrument insertion opening window 624. These guide wire fixing tool insertion holes 628 are arranged at substantially the center position of the treatment tool insertion opening window 624 along the center line direction of the guide wire fixing member 621.

  Further, the guide wire fixing mechanism 626 is provided with a non-stretchable thread-like member, for example, a guide wire fixing tool 629 formed of a surgical suture having an outer diameter of about 0.2 mm. One end of the guide wire fixture 629 is fixed to the left first guide wire identification member 627a in FIG. The guide wire fixing tool 629 passes through the guide wire fixing tool insertion hole 628 on the left side (first guide wire identifying member 627a side) in FIG. 82 of the treatment tool insertion opening window 624, and then the opening window 624. In FIG. 82, the other end side of the guide wire fixture 629 passes through the guide wire fixture insertion hole 628 on the right side (second guide wire identification member 627b side) in FIG. It is fixed to the identification member 627b. As a result, the guide wire fixture 629 is attached in a state of being laid between both side portions on the opening window 624.

In this embodiment, the guide wire fixture 629 uses a surgical suture having an outer diameter of about 0.2 mm. However, if the guide wire fixing tool 629 is a flexible thread member that is not stretchable and has high tensile strength, nylon is used. Other resin threads may be used.
The guide wire identification members 627a and 627b are not limited to stainless steel wires, but may be copper wires, other metals such as NiTi superelastic alloys, resins, or the like as long as they are elastic members.

  As a result, the guide wire fixing mechanism 626 does not interfere with the operation of the treatment instrument 619 in a state where the treatment instrument 619 protrudes from the channel opening 615 on the distal end 603 side of the insertion section 602 in the endoscope 601. In a state where only the guide wire 630 protrudes from the channel opening 615, the guide wire 630 is guided between the both sides on the opening window 624 of the guide wire fixing member 621 by the pressing force from the treatment instrument raising base 617. 629 is configured to be brought into pressure contact with and locked.

  The treatment instrument 619 is inserted into the treatment instrument insertion channel 616 and then pulled from the guide wire fixing mechanism section 626 to the operation section hand side, from the channel opening section 615 that is the operation section proximal opening of the treatment instrument insertion channel 616. Projection length necessary for work is secured.

Further, when the guide wire 630 is inserted into the guide wire lumen of the treatment instrument 619, the guide wire 630 has a necessary protrusion length from the distal end of the treatment instrument 619 to the target site, and from the rear end of the treatment instrument 619. Projection length necessary for work is secured.
The length of protrusion from the distal end of the treatment tool 619 is about 40 cm or less, and the amount of protrusion of about 10 cm from the base 604a on the base end side of the treatment tool 619 is the best and ideal.

  Next, the operation of this embodiment will be described. When the treatment instrument 619 such as a contrast tube is inserted into the treatment instrument insertion channel 616 on the operation unit 606 side of the endoscope 601 and used when the endoscope apparatus of the present embodiment is used, The distal end portion protrudes from the channel opening 615 of the distal end portion 603 of the insertion portion 602 in the endoscope 601. At this time, when the treatment instrument raising base 617 is held at the standby position (inverted position) indicated by the phantom line in FIG. 85, the distal end portion of the treatment instrument 619 is identified with a guide wire as shown in FIG. The mechanism unit 625 is held away from the guide wire identification members 627a and 627b and is freely movable.

  In this state, by operating a treatment instrument raising base operation lever (not shown) of the operation section 606 of the endoscope 601, the treatment instrument raising base 617 at the distal end portion 603 of the insertion section 602 is raised. In accordance with this operation, the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 in a direction in which the distal end portion is inserted into the treatment instrument insertion opening window 624 of the cap portion 623.

  At this time, the treatment instrument 619 is inserted between the lower extension portions 627a1 and 627b1 of the two guide wire identification members 627a and 627b projecting from both sides of the treatment instrument insertion opening window 624 of the cap portion 623. Therefore, the space between the lower extension portions 627a1 and 627b1 of the two guide wire identification members 627a and 627b is pushed and widened by the treatment instrument 619, and the interval between the lower extension portions 627a1 and 627b1 is widened. As a result, the guide wire identification members 627a and 627b approach the guide wire fixture insertion holes 628 on both sides of the treatment instrument insertion opening window 624, thereby being fixed to the guide wire identification members 627a and 627b, respectively. The tension of the wire fixture 629 is relaxed. Thus, when the tension of the guide wire fixing tool 629 is loosened, when the distal end portion of the treatment tool 619 is pushed out by the treatment tool raising base 617 in a direction to be inserted into the treatment tool insertion opening window 624 of the cap portion 623. In addition, the treatment tool 619 is not locked by the guide wire fixing tool 629, and the raising operation of the treatment tool 619 is performed as usual.

  Further, when the distal end portion of the guide wire 630 is led out from the channel opening 615 of the endoscope 601, the treatment instrument elevator base 617 is held at a standby position (inverted position) indicated by a virtual line in FIG. In this case, the guide wire 630 is configured to be separated from the guide wire fixture 629 and held at a freely disengaged position as shown in FIG.

  In this state, when the treatment instrument elevator base 617 is rotated to the maximum rotation position (elevation position) indicated by a solid line in FIG. 85, the treatment instrument elevator base 617 is used as shown in FIG. The guide wire 630 is pushed out in a direction to be inserted between the guide wire identification members 627a and 627b of the guide wire identification mechanism 625. At this time, since the spacing S between the lower extension portions 627a1 and 627b1 of the guide wire identification members 627a and 627b is larger than the outer diameter of the guide wire 630, for example, the lower extensions of the guide wire identification members 627a and 627b. The distance S between the two lower extending portions 627a1 and 627b1 is not widened by the guide wire 630 inserted between the protruding portions 627a1 and 627b1, and the guide wire fixing member 621 has a gap between both sides on the opening window 624. The tension of the installed guide wire fixture 629 is not relaxed.

  In this case, as the treatment instrument raising base 617 at the distal end 603 of the insertion portion 602 is raised by an operation of a treatment instrument raising base operation lever (not shown), the guide is guided by the pressing force from the treatment instrument raising base 617. The wire 630 is brought into pressure contact with the guide wire fixing member 629 between both side portions on the opening window 624 in the guide wire fixing member 621. At this time, the guide wire 630 is sheared between the treatment instrument raising base 617 and the guide wire fixing tool 629 and receives a force alternately in the opposite direction, so that the guide wire 630 is detachably locked.

  When the endoscope apparatus of the present embodiment is used, after the treatment instrument 619 such as a contrast tube is inserted into the pancreas / bile duct (not shown) transpapillarily, the replacement operation of the treatment instrument 619 is as follows. Done. First, the guide wire 630 is inserted from the base 4b on the proximal end side of the treatment instrument 619 and introduced into the pancreas / bile duct (not shown).

  After confirming that the guide wire 630 has entered the pancreas / bile duct (not shown), the treatment instrument 619 is pulled out while grasping the proximal end side of the guide wire 630 by hand so that the guide wire 630 does not move. At this time, after confirming that the distal end portion of the treatment tool 619 has been pulled out from the nipple (not shown) by an endoscopic image, the treatment tool 619 is further pulled out.

  Subsequently, when the distal end of the treatment instrument 619 is accommodated in the channel opening 615 on the distal end 603 side of the insertion portion 602, the guide wire 630 is moved along the treatment instrument raising base 617 by raising the treatment instrument raising base 617. The guide wire 630 is mechanically fixed in the vicinity of the distal end portion 603 of the insertion portion 602 of the endoscope 601 by the guide wire fixing mechanism portion 626.

  Further, after confirming that the guide wire 630 is fixed, the treatment instrument 619 is completely pulled out from the operation unit 606 side of the endoscope 601. Thereafter, the treatment instrument 619 to be used next is inserted from the proximal end side of the guide wire 630 and abuts against the treatment instrument elevator base 617. Thereafter, the treatment instrument raising base 617 is turned over, the proximal end portion of the guide wire 630 is grasped by hand, and only the treatment instrument 619 is inserted into the pancreas / bile duct (not shown) with the guide wire 630 as a guide.

Therefore, the operator need not always grasp the guide wire 630 when the treatment instrument 619 is replaced. Thereafter, the treatment instrument 619 can be replaced by the same method as many times as necessary.
The present embodiment has the following effects. In other words, in the present embodiment, the treatment instrument 619 other than the guide wire 630 can be raised, moved back and forth as usual by operating the treatment instrument raising base 617, and only the guide wire 630 has the treatment instrument raising base 617. By the above operation, the treatment instrument raising base 617 and the guide wire fixing tool 629 are sandwiched and locked in a locked state. Therefore, when replacing the treatment tool 619, the operation tool raising base 617 is operated to lock only the guide wire 630 between the treatment tool raising base 617 and the guide wire fixing tool 629, so that an endoscope is used as in the prior art. It is possible to eliminate the necessity of gripping the guide wire 630 on the operation unit 606 side of 601. Accordingly, there is an effect that the work for exchanging the treatment tool 619 is facilitated, and therefore the work time required for the work for exchanging the treatment tool 619 can be reduced.

  Further, when the guide wire 630 is inserted into the treatment instrument 619, conventionally, it has been necessary to insert, for example, 4 m, but in the present invention, it is only necessary to insert, for example, about 2.5 m. Therefore, conventionally, the total length of the guide wire 630 is about 4 m, and even when the guide wire 630 is inserted into the endoscope 601, more than half of the guide wire 630 goes out of the endoscope 601, so that the guide wire 630 is not handled during handling. Although there is a high possibility of touching an unclean area such as a floor and attention is required, in the present invention, the length of the portion of the guide wire 630 protruding from the endoscope 601 is short, and the guide wire 630 touches the unclean area. The possibility is reduced and handling becomes easier.

  Furthermore, when the guide wire 630 is left on the teat and only the treatment tool 619 is removed, it is conventionally necessary to simultaneously perform two operations of pulling the treatment tool 619 and pushing the guide wire 630 as much as the treatment tool 619 is pulled out. However, in the present invention, it is not necessary to grip the guide wire 630 on the operation unit 606 side, and only one operation of pulling out only the treatment tool 619 is sufficient. Therefore, the replacement time of the treatment tool 619 can be shortened, the number of assistants can be reduced, and the procedure can be simplified.

  86 (A), (B) to FIGS. 89 (A), (B) show a forty-first embodiment of the present invention. In this embodiment, a guide having a structure shown in FIGS. 86A and 86B, which is different from the guide wire fixing member 621 of the 40th embodiment, is provided at the distal end portion 603 of the insertion portion 602 of the endoscope 601 in the 40th embodiment. A wire fixing member 641 is attached.

That is, the guide wire fixing member 641 of the present embodiment is provided with a substantially funnel-shaped attachment portion 642 and a substantially cylindrical cap portion 643 connected to the distal end side of the attachment portion 642.
In addition, as shown in FIG. 87A, the attachment portion 642 gradually increases in thickness toward the proximal end side (lower side in FIG. 87A) of the insertion portion 602 of the endoscope 601. A tapered mounting portion main body 644 having a substantially cylindrical shape whose outer diameter dimension increases in a state is provided. A plurality of slits 645 are formed in the cylindrical wall portion of the mounting portion main body 644, as shown in FIG. 86 (B) in this embodiment. These slits 645 are open on the base end side of the attachment portion main body 644. Then, four tongue pieces 646 that can be elastically deformed are formed by portions between the slits 645.

  In addition, a fixing ring 647 that fixes the attachment portion 642 of the guide wire fixing member 641 to the distal end portion 603 of the insertion portion 602 in the endoscope 601 so as to be detachable is disposed outside the guide wire fixing member 641. . The inner diameter dimension of the fixing ring 647 is larger than the smallest outer diameter section 646a in which the outer diameter dimension of the tongue piece 646 of the mounting section main body 644 in the guide wire fixing member 641 is the smallest, and the mounting section main body 644 in the guide wire fixing member 641 is larger. The outer diameter of the tongue piece 646 is set to be smaller than the largest outer diameter portion 646b.

  In the state where the fixing ring 647 is held at the disengagement position where it is not engaged with the tongue piece 646 of the attachment portion main body 644 as shown in FIG. 87 (A), the insertion portion 602 of the endoscope 601 is not moved. Thus, the guide wire fixing member 641 is configured to be held in a movable state.

  In addition, when the fixing ring 647 is moved in the direction of the engagement position where it engages with the tongue piece 646 of the attachment portion main body 644 as shown in FIG. 87B, the tongue piece 646 of the attachment portion main body 644 is moved by the fixing ring 647. Is pressed inward and the inner end portions of the four tongue pieces 646 are elastically deformed inward.

  In the present embodiment, the inner diameter dimension of the mounting portion 642 of the guide wire fixing member 641 is 14 mm and the length is 10 mm in consideration of the size of the distal end portion 603 of the insertion portion 602 in the endoscope 601, and the mounting portion main body. The tapered surface of the 644 tongue piece 646 is set to a taper angle of 5 °. Further, the four slits 645 of the attachment portion main body 644 are arranged on the circumference of the attachment portion 642 at regular intervals at substantially 90 ° intervals.

  The length of each slit 645 is set to about 9 mm parallel to the axial direction of the endoscope 601 from the proximal end side to the distal end side of the attachment portion 642. Further, the number of slits 645 in the attachment main body 644 is preferably about 2 to 6 in view of ease of moldability and ease of mounting on the endoscope 601.

The fixing ring 647 movably mounted on the mounting portion 642 is set to have an inner diameter of 16 mm, an outer diameter of 18 mm, and a width of about 2 mm, for example.
The fixing ring 647 is not limited to this, and may have a function of tightening the slit 645 of the mounting portion 642. Therefore, the fixing ring 647 may be a belt-like member or a thread-like member.

  In addition, the material of the mounting portion 642 and the fixing ring 647 is desirably made of a polycarbonate that is the same quality as the cap portion 643 from the viewpoint of cost. However, other hard resins such as acrylic, natural rubber, synthetic rubber, soft resin such as silicon and urethane, or metal such as stainless steel may be used. Some elasticity and the insertion portion 602 of the endoscope 601 may be used. If it has a smooth inner surface to the extent that it does not damage the tip portion 603, it does not need to be transparent.

  Further, an opening window 648 is formed on the distal end side of the cap portion 643 of the guide wire fixing member 641 as in the case of the guide wire fixing member 621 of the 40th embodiment as shown in FIG. 86 (A). The opening window 648 is a state in which the distal end portion 603 side of the insertion portion 602 of the endoscope 601 is opened, and the illumination window 613, the observation window 614, and the channel opening in the side view reference plane 612 of the distal end portion 603 of the endoscope 601. It is formed at a site corresponding to the portion 615.

  Further, a guide wire identifying mechanism 649 and a guide wire fixing mechanism 650 are provided in the opening window 648 of the cap 643. The guide wire identification mechanism 649 has one stainless steel protruding from the one end of the opening window 648 (the opposite side of the observation window 614 in the endoscope 601) to the inner side of the opening window 648 with respect to the opening window 648. A guide wire identification member 651 made of a wire is provided. In FIG. 86, the guide wire identification member 651 extends from the right side of the opening window 648 to the inside along the upper edge of the cap portion 643, and is curved downward.

  Further, guide wire fixing member insertion holes 652 are formed in the cap portion 643 on both sides of the opening window 648, respectively. These guide wire fixing member insertion holes 652 are arranged at substantially the center position of the opening window 648 along the center line direction of the guide wire fixing member 641.

  Furthermore, the guide wire fixing mechanism 650 is provided with a guide wire fixing tool 653 formed of a non-stretchable thread-like member formed of, for example, a surgical suture. One end of the guide wire fixing tool 653 is fixed to a guide wire fixing member insertion hole 652 on the left side of the opening window 648 in FIG. 86A. The guide wire fixture 653 crosses over the opening window 648 and passes through the guide wire fixing member insertion hole 652 on the right side of the opening window 648 in FIG. 86A, and the other end of the guide wire fixture 653. The part side is fixed to the guide wire identification member 651. As a result, the guide wire fixture 653 is attached in a state of being laid between both side portions on the opening window 648.

  Next, the operation of this embodiment will be described. First, when the guide wire fixing member 641 is attached to the insertion portion 602 of the endoscope 601 of the endoscope apparatus according to the present embodiment, the following operation is performed. First, as shown in FIG. 87 (A), the insertion portion in the endoscope 601 from the slit 645 side of the guide wire fixing member 641 in the disengaged state in which the fixing ring 647 is moved to the distal end side of the guide wire fixing member 641. The distal end portion 603 of 602 is inserted into the attachment portion 642 of the guide wire fixing member 641.

  Further, after inserting the distal end portion 603 of the insertion portion 602 in the endoscope 601 into the attachment portion 642, the position of the opening window 648 on the cap portion 643 and the position of the channel opening portion 615 of the endoscope 601 are aligned, The fixing ring 647 is moved again to the base end side of the guide wire fixing member 641. At this time, along with the operation of moving the fixing ring 647 to the base end side, the portion of the tongue piece 646 between the slits 645 of the mounting portion 642 is pushed inward in the radial direction as shown in FIG. 87 (B). Therefore, at this time, the inner end side of the four tongue pieces 646 elastically deformed inward is engaged with the outer peripheral surface of the insertion portion 602 of the endoscope 601 being strongly pressed, and the guide wire fixing member 641 is engaged. The insertion unit 602 of the endoscope 601 is fixed so as not to move.

  Further, when the endoscope apparatus of the present embodiment is used, when a treatment instrument 619 such as a contrast tube is inserted into the treatment instrument insertion channel 616 on the operation unit 606 side of the endoscope 601, the treatment instrument is used. The distal end portion of 619 is projected from the channel opening portion 615 of the distal end portion 603 of the insertion portion 602 in the endoscope 601. At this time, if the treatment instrument raising base 617 is held at the standby position (inverted position) indicated by the phantom line in FIG. 85, the distal end portion of the treatment instrument 619 is identified with a guide wire as shown in FIG. The mechanism 649 is held away from the guide wire identifying member 651 and freely movable.

  In this state, by operating a treatment instrument raising base operation lever (not shown) of the operation section 606 of the endoscope 601, the treatment instrument raising base 617 at the distal end portion 603 of the insertion section 602 is raised. In accordance with this operation, the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 in a direction in which the distal end portion is inserted into the opening window 648 of the cap portion 643.

  By the movement operation of the treatment instrument 619 at this time, the lower extension portion 651a of the guide wire identification member 651 in the opening window 648 of the cap portion 643 is pushed out in the lateral direction. And the tension | tensile_strength of the guide wire fixing tool 653 fixed to the guide wire identification member 651 by the movement operation | movement of this guide wire identification member 651 is eased. In this way, when the tension of the guide wire fixing tool 653 is loosened, when the distal end portion of the treatment tool 619 is pushed out by the treatment tool raising base 617 in a direction to be inserted into the opening window 648 of the cap portion 643, the treatment tool. 619 does not interfere with the guide wire fixing device 653, and the raising operation of the treatment device 619 is performed as usual.

  In addition, in a state where the distal end portion of the guide wire 630 is led out from the channel opening 615 of the endoscope 601, a treatment tool elevator operating lever (not shown) of the operation portion 606 of the endoscope 601 is operated, and the insertion portion 602 is operated. When the treatment instrument raising base 617 at the distal end portion 603 is raised, the guide wire 630 is pushed out by the treatment instrument raising base 617 in a direction to be inserted into the opening window 648 as shown in FIG. . At this time, the lower extension portion 651a of the guide wire identification member 651 is not pushed laterally by the guide wire 630, and the guide wire is fixed between both side portions on the opening window 648 of the guide wire fixing member 641. The tension of the tool 653 is not relaxed. Therefore, in this case, the pressing force from the treatment instrument raising base 617 is accompanied by the operation of raising the treatment instrument raising base 617 at the distal end 603 of the insertion portion 602 by operating a treatment instrument raising base operation lever (not shown). As a result, the guide wire 630 is brought into pressure contact with the guide wire fixture 653 between both sides on the opening window 648 of the guide wire fixing member 641. At this time, the guide wire 630 is sheared between the treatment instrument raising base 617 and the guide wire fixing tool 653 so as to be sheared alternately in opposite directions, and is thus detachably locked.

  As a result, the guide wire fixing mechanism 650 does not interfere with the operation of the treatment instrument 619 in a state where the treatment instrument 619 protrudes from the channel opening 615 on the distal end 603 side of the insertion section 602, and the channel opening 615 In the state where only the guide wire 630 comes out of the guide wire 630, the guide wire 630 is pressed against the guide wire fixing tool 653 between both sides on the opening window 648 of the guide wire fixing member 641 by the pressing force from the treatment instrument raising base 617. And is configured to be locked.

  The present embodiment has the following effects. In other words, in the present embodiment, the treatment instrument 619 other than the guide wire 630 can be raised, moved back and forth as usual by operating the treatment instrument raising base 617, and only the guide wire 630 has the treatment instrument raising base 617. By this operation, the treatment tool raising base 617 and the guide wire fixing tool 653 are sandwiched and locked in a locked state. Therefore, when replacing the treatment tool 619, the operation tool raising base 617 is operated to lock only the guide wire 630 between the treatment tool raising base 617 and the guide wire fixing tool 653, so that an endoscope is used as in the prior art. It is possible to eliminate the necessity of gripping the guide wire 630 on the operation unit 606 side of 601. Therefore, the present embodiment also has an effect of facilitating the work of exchanging the treatment tool 619 as in the 40th embodiment, so that the work time required for the replacement work of the treatment tool 619 can be shortened.

  Further, in the present embodiment, in addition to the same effects as those of the 40th embodiment, in particular, the tension of the guide wire fixing member 653 can be adjusted by one guide wire identification member 651, so that it is used in the 40th embodiment. Of the two guide wire identification members 627a and 627b, the guide wire identification member 627a on the observation window 614 side of the endoscope 601 can be omitted. Therefore, there is an effect that the field of view of the observation window 614 of the endoscope 601 is ensured.

  Further, since the principle of the fixing portion for attaching the guide wire fixing member 641 to the distal end portion 603 of the insertion portion 602 in the endoscope 601 is based on the mechanical engagement / disengagement operation of the fixing ring 647 that does not use rubber elasticity, 1 There is an effect that it is possible to cope with a plurality of types of endoscopes 601 having different thicknesses at the attachment portion 642 in the guide wire fixing member 641 of various sizes.

Further, since the rubber part of the insertion portion 602 of the endoscope 601 is not rubbed when the guide wire fixing member 641 is attached, the insertion portion 602 of the endoscope 601 is hardly damaged, and the attaching operation of the guide wire fixing member 641 is performed. There is an effect that becomes easier.
FIGS. 90 to 102 (A) to (D) show a forty-second embodiment of the present invention. In this embodiment, the guide having the configuration shown in FIG. 91 is different from the guide wire fixing member 621 of the 40th embodiment at the distal end portion 603 of the insertion portion 602 of the side-view type endoscope 601 in the endoscope apparatus of the 40th embodiment. A wire fixing member 661 is attached.

That is, the guide wire fixing member 661 of this embodiment is provided with a guide wire fixing member main body 662 and an attachment member 663 for attaching the guide wire fixing member main body 662 to the endoscope 601 side.
First, the guide wire fixing member main body 662 will be described. The guide wire fixing member main body 662 includes a base member 664 shown in FIGS. 94 (A) to 94 (C), a guide wire fixing tool 665 shown in FIG. 95 (A), and FIGS. 95 (B) and 95 (C). A guide wire identification member 666 and an upper lid 667 shown in FIG. 96 are provided. The guide wire fixture 665 and the guide wire identification member 666 are supported so as to protrude and retract with respect to the base member 664.

  In addition, a guide groove 668 is provided on the surface side of the base member 664 to guide the protruding and retracting operations of the guide wire fixture 665 and the guide wire identification member 666. Furthermore, a guide wire fixing member 665 and a guide wire identification member 666 are provided on the base member 664 along the guide groove 668 on the distal end side of the guide groove 668 as shown in FIGS. 99 (A) and 99 (B). A movement restricting portion 669 for restricting the movement of the guide wire fixing member 665 and the guide wire identifying member 666 is provided at a protruding position protruding outward.

  A click groove 672 for guiding a click pin 671 of a click mechanism 670 (to be described later) for temporarily fixing the guide wire identification member 666 is provided on the base end side of the guide groove 668 of the base member 664. Furthermore, stopper insertion holes 673 penetrating from the back surface side to the front surface side are formed on both sides of the guide groove 668 in the vicinity of the movement restricting portion 669 of the guide groove 668 on the distal end side of the base member 664.

As shown in FIG. 94B, an engagement groove 674 for engagement with the mounting member 663 and a stopper fixing groove 76 for fixing a stopper member 675 described later are provided on the back surface side of the base member 664. It has been.
The guide wire fixture 665 is a substantially flat member having a size of about 10 mm in length, about 4 mm in width, and about 0.2 mm in thickness, and is made of stainless steel.

The guide wire fixture 665 is not limited to stainless steel, but may be other metal materials such as aluminum, or hard resin such as acrylic, polycarbonate, ABS resin, etc., as long as it has a sufficient thickness and can maintain rigidity.
As shown in FIG. 95A, the guide wire fixture 665 is formed with a recessed butting portion 677 that engages with the guide wire identifying member 666 at the center of the base end portion. Further, a guide wire fixing portion 678 for receiving the guide wire 630 is formed at the end portion on the distal end side of the guide wire fixing tool 665.

The guide wire fixing portion 678 is more preferably attached with an elastic member such as rubber in order to increase the friction with the guide wire 630 and to prevent the guide wire 630 from being damaged.
Further, in the middle portion of the guide wire fixing tool 665, a shoulder portion 679 that abuts against the movement restricting portion 669 of the base member 664 of the guide wire fixing member main body 662 on both sides, and a slit-like stopper abutting portion for receiving the stopper member 675. 680, respectively.

Further, as shown in FIGS. 95 (B) and 95 (C), the guide wire identification member 666 is a member formed in a substantially flat shape having a size of about 10 mm in length, about 4 mm in width, and about 0.4 mm in thickness. The material is stainless steel.
The guide wire identification member 666 is not limited to stainless steel but may be other metal materials such as aluminum, or may be a hard resin such as acrylic, polycarbonate, ABS resin, etc., as long as it has a sufficient thickness and can maintain rigidity.

  A treatment instrument receiving portion 681 is formed at the distal end portion of the guide wire identification member 666. A guide wire insertion groove 682 having a width of about 1 mm opened at the distal end is formed at the central portion of the treatment instrument receiving portion 681. The treatment instrument receiving portion 681 is configured to receive a treatment instrument 619 other than the guide wire 630.

The treatment instrument receiving portion 681 may be coated with fluorine to reduce friction with the treatment instrument 619, and the tip may be chamfered.
Further, as shown in FIG. 95C, an extrusion portion 683 bent in a substantially L shape is formed at the proximal end portion of the guide wire identification member 666. Furthermore, a large width portion 684 having a large lateral width is formed at a substantially central portion of the middle portion of the guide wire identification member 666. The wide width portion 684 has a shoulder portion 85 that abuts against the movement restricting portion 669 of the base member 664 in the guide wire fixing member main body 662 on both sides on the distal end side, and a smooth curved stopper on both sides on the proximal end side. Release parts 686 are respectively formed.

A concave portion 687 having a depth of about 0.2 mm is formed in the wide width portion 684 of the guide wire identification member 666. A slit 688 through which the click pin 671 is inserted is formed in the recess 687.
As shown in FIG. 93 (B), a guide wire identifying member 666 is disposed on the guide groove 668 on the surface side of the base member 664 of the guide wire fixing member main body 662, and A guide wire fixture 665 is disposed on the top. Therefore, the guide wire identification member 666 is disposed in a state of being sandwiched between the base member 664 of the guide wire fixing member main body 662 and the guide wire fixing tool 665.

  The distal end side of the guide wire fixing member 665 protrudes from the base member 664 of the guide wire fixing member main body 662 so as to be able to advance and retract. The distal end side of the guide wire fixture 665 reaches the channel opening 615 on the distal end portion 603 side of the insertion portion 602 in the endoscope 601.

Note that the distal end side of the guide wire identification member 666 is attached in a state of projecting further forward and backward to the distal end side than the guide wire fixture 665.
Further, when the guide wire identification member 666 moves in the direction protruding from the guide groove 668 of the base member 664 to the outside, the pushing portion 683 of the guide wire identification member 666 is formed on the abutting portion 677 of the guide wire fixture 665. It is configured to engage in a hooked state.

  Further, a stopper member 675 for interlocking the guide wire identification member 666 and the guide wire fixture 665 is fixed to the stopper fixing groove 76 provided on the back surface side of the base member 664 of the guide wire fixing member main body 662. As shown in FIGS. 95D and 95E, the stopper member 675 is two thin wires having a wire diameter of about 0.2 mm. The material is preferably a superelastic alloy made of NiTi, but has elasticity. As long as it is a wire, it may be a metal such as stainless steel or a hard resin such as acrylic or polycarbonate.

  In addition, a linear portion 675a having a substantially linear shape is formed in a portion of the thin wire member of the stopper member 675 disposed on the back surface side of the base member 664 of the guide wire fixing member main body 662. One end side of the stopper member 675 extends to the surface side of the base member 664 through a stopper insertion hole 673 opened on the distal end side of the base member 664 of the guide wire fixing member main body 662. Furthermore, a bent portion 675b that is bent in a substantially L shape is formed in a portion extending to the surface side of the base member 664. The distal end portion of the bent portion 675b of the stopper member 675 is bent in a direction away from the base member 664 of the guide wire fixing member main body 662 so as to reach the guide wire fixing tool 665 beyond the guide wire identification member 666.

  The bent portion 675b of the stopper member 675 abuts on the stopper releasing portion 686 of the guide wire identifying member 666, and the guide wire identifying member 666 is moved left and right between the bent portions 675b of the stopper member 675 by the stopper releasing portion 686. It is configured to spread.

  Further, as shown in FIGS. 93A and 93B, an upper lid 667 is disposed on the surface side of the guide wire fixing member main body 662. A spring fixing pin 89 projects from the distal end side of the upper lid 667, and a window 90 is formed on the proximal end side of the upper lid 667 from which the push-out portion 683 of the guide wire identification member 666 projects. Yes.

  The upper lid 667 is provided with a spring member 691 that is a torsion bar that urges the guide wire identifying member 666 in a direction in which the guide wire identifying member 666 is pressed toward the distal end side of the base member 664. One end portion of the spring member 691 is fixed to the spring fixing pin 89, and the other end portion is locked to the pushing portion 683 of the guide wire identification member 666.

The wire diameter of the spring member 691 is, for example, about 0.2 mm, and the material is preferably a superelastic alloy made of NiTi.
Further, the guide wire fixing member main body 662 of this embodiment is provided with a click mechanism 670 for temporarily fixing the guide wire identification member 666. The click mechanism 670 is provided with a click pin 671 shown in FIG. 98 (A) and a click groove 672 installed in the base member 664 of the guide wire fixing member main body 662.

The click pin 671 is made of stainless steel, but if it has a certain level of strength, no particular elasticity is required, and a hard resin may be used.
Note that the cross-sectional shape of the click pin 671 may be circular, but preferably a shape such as a rectangle that is not easily inclined with respect to the click groove 672.

  In addition, a U-shaped bent portion 671 a that is bent in a substantially U shape is formed at one end of the click pin 671. Further, an L-shaped bent portion 671b is formed at the other end of the click pin 671 so as to be bent in an L shape substantially at a right angle. The U-shaped bent portion 671a of the click pin 671 is rotatably attached to the slit 688 of the guide wire identification member 666. Further, the L-shaped bent portion 671 b of the click pin 671 is movably inserted into the click groove 672 of the base member 664.

An end edge portion 671c that is smoothly rounded so as to move smoothly in the click groove 672 that guides the pin is formed at the pin end portion on the L-shaped bent portion 671b side of the click pin 671.
The shape of the click groove 672 of the base member 664 is set as shown in FIG. 98 (B). That is, the front end side convex portion 672b provided with one linear portion 672a extending substantially in the axial direction disposed on the front end side of the base member 664, and the two arranged side by side on the rear end side of the base member 664. The rear end side convex portions 672c and 672d and a concave portion 672e disposed between these two rear end side convex portions 672c and 672d are formed in a distorted ring shape. When the guide wire fixing tool 665 protrudes from the guide groove 668 of the base member 664 of the guide wire fixing member main body 662, the click pin 671 is arranged on the tip side convex portion 672 b side, and the guide wire fixing tool 665 is the guide wire. The click pin 671 is configured to be disposed on the two rear end convex portions 672c and 672d when being buried in the guide groove 668 of the base member 664 of the fixing member main body 662.

Further, the click groove 672 has a smooth inner wall over its entire length, and considering the play of the click pin 671, the groove width of the click groove 672 is preferably about 0.25 mm, and the depth is 0.4 mm to 0.2 mm. It is set as follows in a state that changes between degrees. That is, the straight portion 672a on the tip side of the click groove 672 is set to a depth of about 0.4 mm. A left-hand groove 672f and a right-hand groove 672g that are bifurcated are connected to the end portion of the linear portion 672a. In this branch portion, the depth of the left groove 672f is not changed, and the depth is set to about 0.4 mm.
The right groove 672g has a discontinuous depth at a discontinuous point 672h and is set to about 0.2 mm.

Further, the left groove 672f continuously decreases in depth to 0.2 mm after branching, and reaches the left rear end convex portion 672c. The rear end convex portion 672c on the left side discontinuously increases in depth to about 0.4 mm at the discontinuous point 672i.
Further, the click groove 672 continuously reaches the recess 672e by decreasing the depth of the groove to 0.2 mm continuously from the left-side rear-end convex portion 672c. At the discontinuous point 672j of the recess 672e, the depth changes discontinuously to 0.4 mm. Subsequently, the click groove 672 continuously reduces the groove depth to 0.2 mm and reaches the right rear end convex portion 672d. The depth changes discontinuously at the discontinuous point 672k of the right-side rear end convex portion 672d, and becomes 0.4 mm.

Further, the click groove 672 extends from the right rear end convex portion 672d to the front end side to become a right groove 672g, and the depth is continuously reduced to 0.2 mm so as to form a branch portion at the end of the linear portion 672a. Join.
Further, the attachment member 663 has a substantially C-shaped belt-like attachment portion 693 having a discontinuous notch portion 692 in a part of the ring as shown in FIGS. 92 (A), 97 (A), and (B). Is provided. The belt shape of the belt-like attachment portion 693 is a belt-like member having a width of about 10 mm and a thickness of about 0.5 mm.

Furthermore, a mucous membrane protecting portion 694 is provided on the belt-like attachment portion 693 so as to prevent the guide wire fixing member 661 from being caught on the mucous membrane. The mucous membrane protective part 694 is disposed on the opposite side of the observation window 614 of the endoscope 601.
In addition, the attachment member 663 is provided with a projection 95 for alignment that fits into the channel opening 615 of the distal end 603 when attached to the endoscope 601. Further, as shown in FIG. 92A, engagement grooves 674 provided on the back surface side of the base member 664 of the guide wire fixing member main body 662 are provided at both ends of the discontinuous notch portion 692 of the belt-shaped attachment portion 693. A substantially L-shaped engagement convex portion 696 is provided so as to be fitted into the projection.

The attachment member 663 is preferably made of polycarbonate, but may be made of other resin such as rubber or metal such as stainless steel as long as it has strength and has a smooth surface so as not to damage the endoscope 601. good.
Next, the operation of this embodiment will be described. First, an operation of mounting the guide wire fixing member 661 of this embodiment on the distal end portion 603 of the insertion portion 602 of the endoscope 601 will be described. When the guide wire fixing member 661 is mounted, the positioning convex portion 95 of the mounting member 663 is fitted into the channel opening 615 of the endoscope 601. Subsequently, the engaging convex portion 696 of the mounting member 663 is fitted into the engaging groove 674 of the guide wire fixing member main body 662 in a state where the discontinuous notch portion 692 of the belt-shaped mounting portion 693 of the mounting member 663 is abutted. Let At this time, as shown in FIG. 91, the guide wire fixing member 661 is slid from the distal end side of the belt-shaped attachment portion 693, and the guide wire fixing member 661 is fixed to the distal end portion 603 of the insertion portion 602 in the endoscope 601. .

  When the distal end portion 603 of the endoscope 601 with the guide wire fixing member 661 attached is inserted into the body cavity, as shown in FIG. 92 (B), the mucosa protecting portion 694 of the guide wire fixing member 661 is attached to the body cavity. Since the inner mucous membrane 697 is pushed away, the guide wire fixing member main body 662 does not catch the mucous membrane 697.

  Further, with the distal end portion 603 of the endoscope 601 inserted into the body cavity, a treatment instrument 619 such as a contrast tube other than the guide wire 630 is inserted into the treatment instrument insertion channel 616 on the operation section 606 side of the endoscope 601. When used, the distal end portion of the treatment instrument 619 is protruded from the channel opening 615 of the distal end portion 603 of the insertion portion 602 in the endoscope 601. In the initial state, the treatment instrument elevator base 617 is held at the standby position (inverted position) shown in FIGS. 101 (A) and 101 (B), and the guide wire fixing member main body 662 is shown in FIGS. 99 (A) and 99 (B). Held in the state shown.

  At this time, the guide wire identifying member 666 of the guide wire fixing member 661 is biased in the direction of pressing toward the distal end portion side of the base member 664 by the spring force of the spring member 691, and the pushing portion 683 of the guide wire identifying member 666 is guided by the guide wire. It is held in a state of being abutted against the abutting portion 677 of the fixture 665. The click pin 671 is held in a state of being inserted into the linear portion 672a on the distal end side of the click groove 672.

  When the treatment instrument 619 is raised from the initial state, the following operation is performed. First, by operating a treatment instrument raising base operation lever (not shown) of the operation section 606 of the endoscope 601, the treatment instrument raising base 617 at the distal end portion 603 of the insertion section 602 is rotated in the raising operation direction. As the treatment instrument raising base 617 rotates, the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 toward the treatment instrument raising direction perpendicular to the axial direction of the insertion portion 602.

  At this time, the distal end portion of the treatment instrument 619 pushed out by the treatment instrument raising base 617 abuts on the treatment instrument receiving portion 681 of the guide wire identification member 666 during the rotation of the treatment instrument raising base 617. Therefore, the guide wire identification member 666 is pushed into the proximal end side of the endoscope 601 by the subsequent rotation operation of the treatment instrument raising base 617.

  Further, as the guide wire identification member 666 is pushed into the proximal end side of the endoscope 601, the stopper member 675 is expanded to the left and right along the stopper release portion 686 of the guide wire identification member 666. At this time, when the stopper member 675 moves to the end position along the stopper release portion 686 of the guide wire identification member 666, as shown in FIG. 99C, the stopper member 675 of the guide wire fixture 665 is stopped from the stopper member 675. Falls out. Therefore, in this state, since the stopper of the guide wire fixing tool 665 is released, the guide wire fixing tool 665 is also pushed into the proximal end side of the endoscope 601 together with the guide wire identifying member 666.

  Then, when the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 in the treatment instrument raising direction perpendicular to the axial direction of the insertion portion 602 as shown in FIGS. 101 (C) and 101 (D). 99D, the guide wire identification member 666 is pushed to the maximum pushing position in the guide groove 668 of the base member 664. As shown in FIG. At this time, the click pin 671 moves along the left groove 672f of the click groove 672 in conjunction with the guide wire identifying member 666 and reaches the left rear end convex portion 672c.

  Thereafter, when an operation for returning the treatment instrument elevator base 617 to the standby position (inverted position) shown in FIG. 101 (A) is performed, the spring force of the spring member 691 causes the spring force as shown in FIGS. 101 (E) and 101 (F). The guide wire identification member 666 is pushed back toward the distal end of the insertion portion 602. At the same time, the click pin 671 connected to the guide wire identification member 666 is recessed along the click groove 672e as shown in FIG. The guide wire fixing member 665 and the guide wire identification member 666 are held in the pushed state.

At this time, the click pin 671 does not rotate in the reverse direction because it passes through the discontinuous point 672i at the left rear end convex portion 672c.
It should be noted that the same reverse rotation preventing effect is obtained at all discontinuous points in the click groove 672 described below.
In this state, the guide wire fixing tool 665 and the guide wire identifying member 666 do not interfere with the treatment tool 619, and the guide wire fixing tool 665 and the guide wire identifying member 666 are obstructed even in the field of view of the observation window 614 of the endoscope 601. Don't be.

  When the treatment instrument 619 is raised again, as shown in FIGS. 101C and 101D, the guide wire fixing tool 665 and the guide wire identification member 666 are again pushed into the guide groove 668 of the base member 664 in the maximum amount. Pushed into position. At this time, as shown in FIG. 100 (B), the click pin 671 reaches the right rear end convex portion 672d along the click groove 672 and is unlocked.

  Thereafter, when the operation tool raising base 617 is returned to the standby position (inverted position) shown in FIG. 101A, the guide wire identification member 666 is moved in the distal direction of the insertion portion 602 by the spring force of the spring member 691. At the same time, the pushing portion 683 of the guide wire identifying member 666 is abutted against the abutting portion 677 of the guide wire fixing member 665 as shown in FIG. . As a result, the guide wire fixture 665 is also pushed out together with the guide wire identification member 666 to the distal end side of the endoscope 601 and returns to the initial state shown in FIGS. 99 (A) and 99 (B).

Further, as shown in FIGS. 102A and 102B, the treatment instrument raising base 617 is raised in a state (initial state) in which the distal end portion of the guide wire 630 is led out from the channel opening 615 of the endoscope 601. If so, the following operation is performed.
In other words, when the treatment instrument raising base 617 of the distal end 603 of the insertion portion 602 is rotated from the initial state, the treatment instrument raising base 617 causes the treatment instrument raising base 617 to rotate. The guide wire 630 is inserted into a guide wire insertion groove 682 provided in the treatment instrument receiving portion 681 at the distal end of the guide wire identification member 666. Therefore, in this case, the guide wire identification member 666 is not pushed by the guide wire 630.

Further, the guide wire 630 inserted into the guide wire insertion groove 682 of the treatment instrument receiving portion 681 by the rotation of the treatment instrument raising base 617 is the guide wire fixing tool 665 as shown in FIGS. It directly abuts against the guide wire fixing portion 678.
At this time, the guide wire fixing tool 665 is not pushed in because the guide member 665 is regulated by the stopper member 675 in the stopper abutting portion 680 as shown in FIG. It is pressed between the fixtures 665 and fixed in a locked state.

In order to release the locking of the guide wire 630, an operation of returning the treatment instrument elevator base 617 to the standby position (inverted position) shown in FIGS. 102 (A) and 102 (B) may be performed.
The present embodiment has the following effects. In other words, in the present embodiment, the treatment instrument 619 other than the guide wire 630 can be raised, moved back and forth as usual by operating the treatment instrument raising base 617, and only the guide wire 630 has the treatment instrument raising base 617. By this operation, the treatment instrument raising base 617 and the guide wire fixing tool 665 are sandwiched and locked in a locked state. Therefore, when replacing the treatment tool 619, the operation tool raising base 617 is operated to lock only the guide wire 630 between the treatment tool raising base 617 and the guide wire fixing tool 665, so that an endoscope is used as in the conventional case. It is possible to eliminate the necessity of gripping the guide wire 630 on the operation unit 606 side of 601. Therefore, the present embodiment also has an effect of facilitating the work of exchanging the treatment tool 619 as in the 40th embodiment, so that the work time required for the replacement work of the treatment tool 619 can be shortened.

Furthermore, in this embodiment, in addition to the same effects as those in the fortieth embodiment, the operation of the guide wire identification member 666 is reliable, and there is an effect that a wider field of view of the observation window 614 of the endoscope 601 can be secured.
FIGS. 103 (A) to (J) to FIGS. 107 (A) to (D) show a forty-third embodiment of the present invention. In this embodiment, the configuration of the guide wire fixing member main body 662 in the guide wire fixing member 661 of the forty-second embodiment is changed as follows.

The other parts are the same as those in the forty-second embodiment, and the same parts as those in the forty-second embodiment are denoted by the same reference numerals and the description thereof is omitted here.
That is, the guide wire fixing member main body 662 of the present embodiment has a different configuration from the guide wire fixing member 665 and the guide wire identification member 666 of the 42nd embodiment, and the guide wire fixing device 701 and FIG. 103 shown in FIG. A guide wire identification member 702 shown in (E) and (F) is provided.

  A substantially V-shaped guide wire locking groove 703 having a width smaller than the outer diameter of the guide wire 630 is formed at the distal end portion of the guide wire fixture 701 of the present embodiment. Further, a stopper abutting portion 704 that receives a stopper member, which will be described later, is provided at the central portion of the guide wire fixture 701 on the proximal end side.

  In addition, a thick portion 705 having a large lateral width is formed in the middle portion of the guide wire fixture 701. Then, shoulder portions 106 that abut against the movement restricting portion 669 of the base member 664 are formed on both sides of the wide width portion 705 on the distal end portion side, and guide wire identification members are formed on both sides of the wide width portion 705 on the proximal end portion side. An abutting portion 707 is formed.

  Further, the guide wire identification member 702 of this embodiment is configured as shown in FIGS. 103 (E) and 103 (F). A treatment instrument receiving portion 708 is formed at the distal end portion of the guide wire identification member 702. A guide wire insertion groove 709 having an opening at the distal end side is formed at the central portion of the treatment instrument receiving portion 708. The treatment instrument receiving portion 708 is configured to receive a treatment instrument 619 other than the guide wire 630.

  Further, a wide width portion 710 having a large lateral width is formed on the proximal end side of the guide wire identification member 702. Further, shoulder portions 711 that abut against the movement restricting portions 669 of the base member 664 in the guide wire fixing member main body 662 are formed on both sides on the distal end side of the wide width portion 710.

  Further, as shown in FIG. 103 (E), a bifurcated end edge portion 712 branched into a bifurcated shape is formed on the base end side of the wide width portion 710. As shown in FIG. 103 (F), the bifurcated end edge portion 712 is formed with a stopper release portion 713 whose thickness changes smoothly from the base end side toward the tip end side. Further, a pushing portion 714 of the guide wire fixing tool 701 is formed at the step portion at the tip of each stopper releasing portion 713. When the guide wire identification member 702 protrudes, the guide wire identification member abutting portion 707 of the guide wire fixture 701 is configured to receive the pushing portion 714 of the guide wire identification member 702.

The wide portion 710 of the guide wire identification member 702 is formed with a recess 715 and a slit 716 similar to the recess 687 and the slit 688 of the guide wire identification member 666 of the 42nd embodiment.
FIGS. 103A to 103C show the base member 664 of the guide wire fixing member main body 662 of this embodiment. As shown in FIG. 103 (G), the front end portion of the base member 664 has an upper lid function that covers the guide wire fixture 701, and the guide wire identification member 702 and the guide wire fixture 701 are interlocked. A substantially T-shaped stopper member 717 is attached.

The stopper member 717 is a plate-like member having a plate thickness of about 0.2 mm, and the material is preferably a NiTi superelastic alloy, but any member having elasticity such as stainless steel may be used.
On the distal end side of the stopper member 717, a fixing portion 717a that is fixed on the distal end portion on the surface side of the base member 664 of the guide wire fixing member main body 662 is provided. Further, a bent portion 717b bent at about 90 degrees is provided at the base end portion of the stopper member 717 as shown in FIG. The bent portion 717 b is in contact with the stopper abutting portion 704 of the guide wire fixture 701.

  Further, a click mechanism 718 having a configuration different from the click mechanism 670 of the forty-second embodiment is provided on the base end side of the guide groove 668 of the base member 664. The click mechanism 718 is disposed on the base end side of the guide groove 668 in the base member 664 of the base member 664 of the guide wire fixing member main body 662 and the click pin 719 shown in FIG. 103 (I) having the same configuration as the click pin 671 of the forty-second embodiment. The click groove 720 shown in FIG. 103 (J) is provided.

  A U-shaped bent portion 719 a that is bent into a substantially U shape is formed at one end of the click pin 719. Further, an L-shaped bent portion 719b that is bent in an L shape at a substantially right angle is formed at the other end of the click pin 719. The U-shaped bent portion 719 a of the click pin 719 is rotatably attached to the slit 716 of the guide wire identification member 702. Further, the L-shaped bent portion 719 b of the click pin 719 is movably inserted into the click groove 720 of the base member 664.

An end edge portion 719c that is smoothly rounded so as to move smoothly in the click groove 720 for guiding the pin is formed at the pin end portion of the click pin 719 on the L-shaped bent portion 719b side.
The shape of the click groove 720 of the base member 664 is set as shown in FIG. That is, a groove front end portion 720a disposed on the front end side of the base member 664, a groove rear end portion 720b disposed on the rear end side of the base member 664, and the groove front end portion 720a and the groove rear end portion 720b. A linear groove portion 720c that connects the holes, a hole portion 720d that is disposed on the side of the linear groove portion 720c, a linear groove portion 720e that connects the hole portion 720d and the groove tip portion 720a, and a hole portion 720d It is formed in a substantially triangular distorted ring shape having a linear groove portion 720f connecting the groove rear end portion 720b. When the guide wire fixing tool 701 protrudes from the guide groove 668 of the base member 664 of the guide wire fixing member main body 662, the click pin 719 is disposed on the groove tip portion 720a side, and the guide wire fixing tool 701 is fixed to the guide wire. The click pin 719 is configured to be disposed on the groove rear end portion 720b side when being embedded in the guide groove 668 of the base member 664 of the member main body 662.

  Further, a detailed structure of the shape of the click groove 720 of the base member 664 will be described. That is, the linear groove portion 720e connecting the groove tip portion 720a and the hole portion 720d of the click groove 720 is set to a depth of about 0.4 mm. The hole 720d is set to a depth of about 0.6 mm. Further, the gap between the hole 720d and the groove rear end 720b is set to about 0.5 mm. Further, the depth is continuously reduced between the hole 720d and the groove rear end 720b to 0.2 mm. The click groove 720 is discontinuously deep to 0.4 mm at a discontinuous point 720g of the groove rear end 720b. Thereafter, the groove extends from the groove rear end portion 720b along the straight groove portion 720c to the tip end side, continuously decreases in depth to 0.2 mm, and merges with the groove tip portion 720a on the tip end side through the discontinuous point 720h.

  Next, the operation of the guide wire fixing member main body 662 in this embodiment will be described. FIGS. 106A to 106F are views showing an operation state when the treatment instrument 619 other than the guide wire 630 is raised using the guide wire fixing member 661, and FIGS. 107A to 107D. FIG. 10 is a view showing an operation state when the guide wire 630 is raised using the guide wire fixing member 661.

  First, the case where the treatment tool 619 other than the guide wire 630 is raised will be described. With the distal end portion 603 of the endoscope 601 inserted into the body cavity, a treatment instrument 619 such as a contrast tube other than the guide wire 630 is inserted into the treatment instrument insertion channel 616 on the operation section 606 side of the endoscope 601. When used, the distal end portion of the treatment instrument 619 is projected from the channel opening 615 of the distal end portion 603 of the insertion portion 602 in the endoscope 601. In the initial state, the treatment instrument elevator base 617 is held at the standby position (inverted position) shown in FIGS. 106 (A) and 106 (B), and the guide wire fixing member 661 is shown in FIGS. 104 (A) and 104 (B). Held in a state.

  At this time, the guide wire identifying member 702 of the guide wire fixing member 661 is biased in the direction of pressing toward the distal end side of the base member 664 by the spring force of the spring member 691, and the pushing portion 714 of the guide wire identifying member 702 is moved to the guide wire. It is held in a state of being abutted against the guide wire identification member abutting portion 707 of the fixture 701. The click pin 719 is held in a state of being inserted into the groove tip portion 720a on the tip side of the click groove 720.

  When the treatment instrument 619 is raised from the initial state, the following operation is performed. First, by operating a treatment instrument raising base operation lever (not shown) of the operation section 606 of the endoscope 601, the treatment instrument raising base 617 at the distal end portion 603 of the insertion section 602 is rotated in the raising operation direction. As the treatment instrument raising base 617 rotates, the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 toward the treatment instrument raising direction perpendicular to the axial direction of the insertion portion 602.

  At this time, the distal end portion of the treatment instrument 619 pushed out by the treatment instrument raising base 617 abuts on the treatment instrument receiving portion 708 of the guide wire identification member 702 during the rotation of the treatment instrument raising base 617. Therefore, the guide wire identification member 702 is pushed into the proximal end side of the endoscope 601 by the subsequent rotation operation of the treatment instrument raising base 617.

  Further, as the guide wire identifying member 702 is pushed into the proximal end of the endoscope 601, the bent portion 717b of the stopper member 717 is pushed by the stopper of the guide wire fixing tool 701 by the stopper releasing portion 713 of the guide wire identifying member 702. It is pushed up in a direction away from the contact portion 704. At this time, when the stopper member 717 moves to the end position along the stopper release portion 713 of the guide wire identification member 702, the stopper member 717 from the stopper abutting portion 704 of the guide wire fixture 701 is shown in FIG. Falls out. Therefore, since the stopper of the guide wire fixing tool 701 is released in this state, the guide wire fixing tool 701 is also pushed into the proximal end side of the endoscope 601 together with the guide wire identifying member 702. At this time, the click pin 719 moves along the linear groove 720e on the left side in FIG. 103 (J) of the click groove 720 in conjunction with the guide wire identification member 702.

  When the distal end portion of the treatment instrument 619 is pushed out by the treatment instrument raising base 617 in the treatment instrument raising direction perpendicular to the axial direction of the insertion portion 602 as shown in FIGS. 106 (C) and (D). 104E and 104F, the guide wire identifying member 702 is pushed into the guide groove 668 of the base member 664 until the pushing position shown in FIGS. At this time, the click pin 719 reaches the hole 720d. The click pin 719 is caught in the hole 720d and fixed in a locked state. Therefore, the guide wire fixture 701 and the guide wire identification member 702 are held in a state where they are pushed in as shown in FIGS. 104 (E) and 104 (F).

  If the treatment instrument raising base 617 is slightly laid from this state, the guide wire fixing tool 701 and the guide wire identification member 702 do not interfere with the treatment tool 619, and the guide wire fixing tool 701 is also within the field of view of the observation window 614 of the endoscope 601. And the guide wire identification member 702 does not get in the way.

  When the treatment instrument 619 is raised again, as shown in FIGS. 105A and 105B, the guide wire fixing tool 701 and the guide wire identification member 702 are at the maximum pushing position in the guide groove 668 of the base member 664. Is pushed in. At this time, the click pin 719 escapes from the hole 720d of the click groove 720, reaches the groove rear end 720b along the linear groove 720f, and is unlocked.

  Thereafter, when the operation instrument raising base 617 is returned to the standby position (inverted position) shown in FIGS. 106A and 106B, the guide wire identifying member 702 is inserted into the insertion portion 602 by the spring force of the spring member 691. As shown in FIGS. 105C and 105D, the pushing portion 714 of the guide wire identifying member 702 is pushed by the guide wire fixing member 701 as the guide wire identifying member 702 moves at the same time. It is abutted against the abutting part 707. As a result, the guide wire fixture 701 is also pushed together with the guide wire identification member 702 to the distal end side of the endoscope 601 and returns to the initial state shown in FIGS. 104 (A) and 104 (B).

Further, as shown in FIGS. 107A and 107B, the treatment instrument raising base 617 is raised in a state (initial state) in which the distal end portion of the guide wire 630 is led out from the channel opening 615 of the endoscope 601. If so, the following operation is performed.
In other words, when the treatment instrument raising base 617 of the distal end 603 of the insertion portion 602 is rotated from the initial state, the treatment instrument raising base 617 causes the treatment instrument raising base 617 to rotate. The guide wire 630 is inserted into the guide wire insertion groove 709 of the treatment instrument receiving portion 708 provided at the distal end of the guide wire identification member 702. Therefore, in this case, the guide wire identification member 702 is not pushed by the guide wire 630.

  Further, the guide wire 630 in the guide wire insertion groove 709 of the treatment instrument receiving portion 708 reaches the position of the distal end portion 701 a of the guide wire fixing tool 701 by the rotation of the treatment instrument raising base 617. At this time, since the guide wire identifying member 702 is not pushed in, the guide wire fixing tool 701 is regulated and not pushed in with the stopper member 717 being locked to the stopper abutting portion 704.

  Further, when the treatment instrument raising base 617 is operated to rise, as shown in FIGS. 107C and 107D, the guide wire 630 is guided by the treatment instrument raising base 617 to the guide wire of the distal end portion 701a of the guide wire fixing tool 701. The groove is pressed against the locking groove 703 and is fixed in a state of being narrowed and locked in the guide wire locking groove 703.

  When releasing the locking of the guide wire 630, the treatment tool 619 is inserted into the guide wire 630 as a guide, and is protruded from the channel opening 615 of the distal end portion 603 of the insertion portion 602 in the endoscope 601. The treatment instrument 619 is released by pushing the guide wire 630 away from the guide wire locking groove 703.

  The present embodiment has the following effects. In other words, in the present embodiment, the treatment instrument 619 other than the guide wire 630 can be raised, moved back and forth as usual by operating the treatment instrument raising base 617, and only the guide wire 630 has the treatment instrument raising base 617. Thus, it is pressed against the guide wire locking groove 703 of the distal end portion 701a of the guide wire fixing tool 701, and is fixed while being narrowed and locked in this guide wire locking groove 703. Therefore, when the treatment tool 619 is replaced, the guide wire 630 alone is locked in the guide wire locking groove 703 of the distal end portion 701a of the guide wire fixing tool 701 by operating the treatment tool raising base 617. The need to grip the guide wire 630 on the operation unit 606 side of the endoscope 601 can be eliminated. Therefore, the present embodiment also has an effect of facilitating the work of exchanging the treatment tool 619 as in the 40th embodiment, so that the work time required for the replacement work of the treatment tool 619 can be shortened.

Furthermore, in this embodiment, in addition to the same effects as those in the fortieth embodiment, the number of components of the guide wire fixing member main body 662 is reduced, and the assembly work of the guide wire fixing member main body 662 is facilitated.
108 (A) to (E) show a forty-fourth embodiment of the present invention. In this embodiment, a guide wire fixing member 731 having a configuration different from that of the guide wire fixing member 621 of the 40th embodiment is provided at the distal end portion 603 of the insertion portion 602 of the side-view type endoscope 601 in the endoscope apparatus of the 40th embodiment. Is provided.

  That is, in this embodiment, the external channel 732 is disposed along the side surface of the insertion portion 602 of the endoscope 601 over almost the entire length of the insertion portion 602 of the endoscope 601. The distal end portion of the external channel 732 is disposed in the vicinity of the channel opening 615 provided at the distal end portion 603 of the insertion portion 602. Further, the base end portion of the external channel 732 is disposed in the vicinity of the operation portion 606 (see FIGS. 114A and 114B) of the endoscope 601.

  Further, the guide wire fixing member 731 of this embodiment is inserted into the external channel 732 so as to be movable forward and backward. FIG. 108A shows an example in which a grasping treatment instrument 733 is used as the guide wire fixing member 731. Further, FIG. 108B shows an example in which a snare 734 is used as the guide wire fixing member 731, and FIG. 108C shows an example in which a guide wire pushing tool 735 is used as the guide wire fixing member 731.

  The material of the external channel 732 is preferably porous PTFE, but is not limited to porous PTFE as long as the material has the same hardness and buckling resistance. If the material of the external channel 732 is hard, depending on the insertion shape of the endoscope 601, the external channel 732 may buckle or the waist strength of the insertion portion 602 is increased, so that the insertability is lowered.

  Conversely, if the material of the external channel 732 is soft, the amount of advancing / retreating force when the guidewire fixing member 731 is advanced / retreated is increased. Therefore, the hardness of the external channel 732 can be set to an appropriate state by forming the external channel 732 from porous PTFE.

  Further, regarding the size of the inner and outer diameters of the external channel 732, it is better that the outer diameter size is small in consideration of the insertability into the body cavity. On the other hand, the guide wire fixing member 731 to be inserted into the external channel 732 In consideration of the outer diameter, at least about 3 mm in diameter is necessary. For example, it is desirable to set the inner diameter to about 3 mm and the outer diameter to about 4 mm.

  Note that the grasping treatment instrument 733 of the guide wire fixing member 731 is provided with an openable and closable arm portion 737 as a grasping portion at the distal end portion of the operation wire 736a. The guide wire 630 is held between the arm portions 737. Further, as shown in FIG. 108D, a zigzag groove 737 a for preventing slip or an uneven groove 737 b that is substantially orthogonal to the axial direction of the guide wire 630 is cut in the contact surface of the arm portion 737 with the guide wire 630. . The grooves on the contact surface of the arm portion 737 with the guide wire 630 may be formed in steps so that the grooves facing each other fit each other.

In addition, as illustrated in FIG. 108E, the contact surface with which the guide wire 630 is in contact may be covered with a resin such as rubber 737c.
In the snare 734 in FIG. 108B, a loop-shaped snare wire 738 is disposed at the tip of the operation wire 736b. The guide wire 630 is held between the snare wires 738. Further, in the guide wire pushing tool 735 shown in FIG. 108 (C), a flat pushing plate 739 is disposed at the tip of the operation wire 736c. And it is comprised so that the guide wire 630 may be hold | gripped between this pushing board 739 and the treatment tool raising base 617. FIG.

Next, the operation of this embodiment will be described. First, when the treatment instrument 619 other than the guide wire 630 is raised, the grasping treatment instrument 733 which is the guide wire fixing member 731 is accommodated in the external channel 732 so that the operation of the treatment instrument 619 is not affected.
When raising the guide wire 630, the grasping treatment instrument 733 is protruded from the external channel 732, and the grasping treatment instrument 733 on the operation unit 606 side of the endoscope 601 is operated while confirming with an endoscopic image. The guide wire 630 is gripped by operating a portion (not shown).

  Further, an anti-slip groove substantially perpendicular to the guide wire 630 is cut on the contact surface of the arm 737 of the grasping treatment instrument 733 with the guide wire 630 so that the grooves facing each other are fitted to each other. When the guide wire 630 is in a step difference, the guide wire 630 is locked in a state where it receives shearing force along the groove of the arm portion 737.

  When the guide wire fixing member 731 is a snare 734, the snare wire 738 at the tip of the snare 734 is opened by projecting from the external channel 732, and the guide wire 630 is passed through the snare wire 738. In this state, the guide wire 630 is locked by operating a snare operation portion (not shown) on the operation portion 606 side of the endoscope 601 to reduce the loop of the snare wire 738.

  When the guide wire fixing member 731 is the guide wire pushing tool 735, the guide wire 630 is raised, the guide wire pushing tool 735 is pushed from the operation unit 606 side of the endoscope 601, and the treatment tool raising base 617 and The guide wire 630 is locked by sandwiching the guide wire 630 with the guide wire pushing tool 735.

  The present embodiment has the following effects. That is, in the guide wire fixing member 731 of the present embodiment, in addition to the same effects as those of the 40th embodiment, the guide wire 630 can be fixed and released by the operator's will, and an existing grasping instrument can be used. Therefore, it can be easily prepared.

  In addition, when there is a groove on the surface with which the guide wire 630 contacts, the fixing force of the guide wire 630 becomes larger. Furthermore, when the surface with which the guide wire 630 is in contact is covered with a resin such as rubber, the fixing force of the guide wire 630 is increased and the guide wire 630 is not damaged.

  When the guide wire fixing member 731 is the snare 734, if the guide wire 630 is passed through the loop of the snare wire 738 in the first operation, the guide wire 630 is fixed when the guide wire 630 is fixed in the second and subsequent operations. The operation of securing the wire 630 is facilitated.

  When the guide wire fixing member 731 is the guide wire pushing tool 735, only the operation wire 736c for operating the guide wire pushing tool 735 enters the external channel 732, so that the inner and outer diameters of the external channel 732 are reduced. Can be inserted into the body cavity.

FIG. 109 shows a 45th embodiment of the present invention. In this embodiment, the configuration of the guide wire fixing member 621 of the 40th embodiment is changed as follows.
The other parts are the same as those in the 40th embodiment, and the same parts as those in the 40th embodiment are denoted by the same reference numerals and the description thereof is omitted here.

  That is, in the guide wire fixing member 621 of the present embodiment, one end portion of the guide wire fixing tool 629 is fixed to the guide wire fixing tool insertion hole 628 disposed on one side of the treatment instrument insertion opening window 624 of the cap portion 623. . The guide wire fixing tool 629 crosses over the treatment tool insertion opening window 624, passes through the other guide wire fixing tool insertion hole 628 of the treatment tool insertion opening window 624, and then is inserted into the insertion portion 602 of the endoscope 601. It extends to the operation portion 606 side of the endoscope 601 through the treatment instrument insertion channel 616 disposed inside. Further, the extending end portion of the guide wire fixture 629 is configured to be connected to an operation portion (not shown) of the guide wire fixture 629 disposed on the operation portion 606 side of the endoscope 601. Yes.

Next, the operation of this embodiment will be described. In this embodiment, when the treatment tool 619 other than the guide wire 630 is raised, the guide wire fixing tool 629 is relaxed on the operation unit 606 side of the endoscope 601, and the raising of the treatment tool 619 is not hindered.
Further, when the guide wire 630 is raised, the guide wire fixing tool 629 is pulled from the operation unit 606 side of the endoscope 601, and the guide wire fixing tool crossing the treatment instrument insertion opening window 624 of the cap section 623. 629 generates a tension. In this state, the guide wire 630 is raised by the treatment instrument raising base 617, and this guide wire 630 is disposed between the treatment instrument raising base 617 and the guide wire fixing tool 629 crossing the treatment instrument insertion opening window 624. And pinch.

  The present embodiment has the following effects. That is, in this embodiment, in addition to the same effects as those in the 40th embodiment, the guide wire 630 can be fixed and released by the operator's intention and the external channel 732 in the 44th embodiment is not provided. There is a good effect on the insertion into.

FIGS. 110A to 110C show a 46th embodiment of the present invention. In this embodiment, the configuration of the guide wire fixing member 731 of the 44th embodiment is changed as follows.
That is, in the present embodiment, the grasping treatment instrument 733 is attached to the distal end portion 603 of the insertion portion 602 in the endoscope 601. Further, a bending portion 741 is connected to the rear end portion of the distal end portion 603 of the insertion portion 602. A wire fixing ring 742 is fixed to the proximal end side of the curved portion 741. The proximal end portion of the operation wire 736 a of the grasping treatment instrument 733 is fixed to the wire fixing ring 742.

  Next, the operation of this embodiment will be described. In this embodiment, as shown in FIG. 110B, when the guide wire 630 is raised, the bending portion 741 of the endoscope 601 is once bent and the operation wire 736a is relaxed. In this state, the endoscopic image is confirmed, and it is confirmed that the guide wire 630 is raised to a position where it can be pinched by the arm portion 737 of the grasping treatment instrument 733.

Thereafter, the bending of the bending portion 741 of the endoscope 601 is released. Thereby, as shown in FIG. 110C, the operation wire 736a is tensioned, the arm portion 737 of the grasping treatment instrument 733 is closed, and the guide wire 630 is held between the arm portions 737 in a state of being grasped.
The present embodiment has the following effects. That is, in this embodiment, in addition to the effects of the 44th embodiment, there is no need to attach the external channel 732, and there is no need to insert the operation wire into the treatment instrument insertion channel 616 as in the 45th embodiment. It does not take.

  The present invention is not limited to the above embodiments. For example, as shown in FIGS. 111 (A) and 111 (B), a guide comprising a guide wire fixing mechanism 751 and an attachment member 752 at the distal end 603 of the insertion portion 602 of the endoscope 601 having the treatment instrument raising base 617. The wire fixing member 753 may be attached, and only the guide wire fixing mechanism 751 built in the distal end portion 603 of the insertion portion 602 of the endoscope 601 as shown in FIGS. 111 (C) and (D). A guide wire fixing member 754 made of may be provided. A guide wire fixing mechanism 755 is incorporated in the guide wire fixing mechanism 751.

  111A and 111C show a state in which the treatment instrument raising base 617 is raised with the distal end portion of the treatment instrument 619 other than the guide wire 630 being led out from the channel opening 615 of the endoscope 601. 111 (B) and 111 (D) show a state where the treatment instrument raising base 617 is raised with the distal end portion of the guide wire 630 being led out from the channel opening 615 of the endoscope 601.

  Further, the endoscope 601 used in the present invention may be an existing endoscope 761 as shown in FIGS. 112 (A) and (B). Further, as shown in FIGS. 112 (C) and (D), a guide wire fixing member installation space 762 in which the guide wire fixing mechanism 751 is incorporated in the distal end portion 603 of the insertion portion 602 of the endoscope 601 in advance is provided. An endoscope 763 may be used.

  Further, as shown in FIGS. 112 (E) and 112 (F), an endoscope 765 having a mounting member 764 for the guide wire fixing mechanism 751 may be used, and as shown in FIGS. 112 (G) and (H). Alternatively, an endoscope 767 in which a guide wire fixing member 766 having a guide wire fixing mechanism portion 751 is detachably incorporated may be used.

  Conventionally, when inserting / removing a treatment tool traveling on a guide wire, the guide wire has to be twice as long as the treatment tool. Since the guide wire 630a can be fixed, the guide wire 630a in the present embodiment may be twice as long as the treatment instrument. More specifically, in the endoscope 601 used in the present invention, the guide wire 630a protrudes from the channel opening 615 of the endoscope 601 into the body to about 40 cm or less, and on the proximal end side of the treatment instrument 619. What is necessary is just to have the length which protrudes about 10 cm from a certain nozzle | cap | die 4a (refer FIG. 114 (A), (B)).

That is, an existing guide wire 5 having a length of about 400 cm (see FIGS. 114 (A) and (B)) can be used, but in this embodiment, as shown in FIG. 113 (A), the total length is about 250 cm or less. A guide wire 630A having a length of
In addition, the outer diameter of the guide wire 630A is preferably about 1 mm or less, but there is no need to specifically limit it.

  Furthermore, as shown in FIG. 113 (B), an extendable guide wire 630b provided with connecting portions 630b and 630c to which the extended guide wire 630a can be connected to the proximal end side of the guide wire 630B as necessary may be used. As shown in 113 (C), a guide wire 630C having an arc portion 630d curved in an arc shape at the tip may be used.

In addition, as the treatment instrument 619, an existing treatment instrument can be used as it is. In order to reduce the frictional force with the guide wire 630, it is more preferable in the present embodiment that the guide wire lumen of the treatment instrument is coated or that the inner surface is smoothed.
In addition, when the treatment instrument 619 comes out from the channel opening 615 on the distal end 603 side of the insertion portion 602, the guide wire fixing mechanism 751 does not disturb the operation of the treatment instrument 619, and only the guide wire 630 comes out. In this case, the guide wire 630 can be fixed.

  For example, as shown in the forty-fourth to forty-fifth embodiments, the operation of the guide wire fixing mechanism can freely advance and retreat in the external channel 732 on the side of the treatment instrument insertion channel 616 or the endoscope insertion portion 602. May be performed in the vicinity of the operation unit 606 of the endoscope 601 by operation wires 736b, 736c and the like which are movably disposed in the position, and as shown in the forty-fourth to forty-third embodiments, by a guide wire identification mechanism unit You may operate automatically.

Furthermore, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention.
Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional Item 1) In an endoscope in which a treatment instrument insertion channel is disposed in an insertion portion to be inserted into a body cavity, and a distal end opening of the treatment instrument insertion channel is disposed in the vicinity of the distal end of the insertion portion. ,
When inserting / removing a treatment instrument that travels on the guide wire in a state where the distal end portion of the guide wire inserted through the treatment instrument insertion channel is led out from the distal end opening of the treatment instrument insertion channel An endoscope, characterized in that guide wire fixing means for detachably locking the guide wire is provided in the insertion portion.
(Additional Item 2) The endoscope according to Additional Item 1, wherein the guide wire fixing means is provided in the vicinity of a distal end portion of the insertion portion.
(Additional Item 3) A guide wire fixing means by a treatment instrument raising base provided in the vicinity of the distal end opening of the treatment instrument insertion channel and a component provided at a position facing when the treatment instrument raising base is raised. The endoscope according to appendix 1, wherein the endoscope is configured.
(Additional Item 4) A slit that enables only the guide wire to be engaged by operating the treatment instrument raising base to raise the guide wire is provided at the top of the guide surface of the treatment instrument raising base. The endoscope according to additional item 3.
(Additional Item 5) The endoscope according to Additional Item 4, wherein the slit is provided on the upper surface of the treatment instrument insertion channel opening of the distal end hard portion.
(Additional Item 6) A wire contact surface provided at an upper portion of the opening of the treatment instrument insertion channel, wherein the raising base is turned up and the guide is interposed between the slit and the wire contact surface. The additional item 4 is characterized in that when the wire is clamped / fixed, the most distal contact portion between the wire contact surface and the guide wire is located on the proximal side with respect to the rotation shaft of the elevator. The endoscope described.
(Additional Item 7) An opening of the slit is provided with a protrusion through which the outer diameter of the guide wire is elastically deformed when the raising base is turned up, and the protrusion is provided inside the slit. The endoscope according to appendix 4, wherein a space in which the outer diameter of the guide wire is held is formed in cooperation with a portion.
(Additional Item 8) The endoscope according to Additional Item 7, wherein the protrusion is provided on both sides of the opening of the slit.
(Additional Item 9) The endoscope according to Additional Item 7, wherein the protrusion is provided over the entire length with respect to the insertion portion axial direction of the opening of the slit.
(Additional Item 10) A slit having two wall surfaces opposed to the top of the guide surface of the treatment instrument raising base is provided, and the wall surface fixes only the guide wire by contacting only the outer periphery of the guide wire. The endoscope according to appendix 4, wherein:
(Additional Item 11) The inner width according to Additional Item 4, wherein the width of the opening of the slit is wider than the outer diameter of the guide wire and smaller than the outer diameter of the treatment instrument sheathed on the guide wire. Endoscope.
(Additional Item 12) The endoscope according to Additional Item 4, wherein a central axis with respect to the insertion portion axial direction of the slit is inclined with respect to the central axis of the guide surface.
(Additional Item 13) An intermediate stopper for intermediately stopping the operation of the operation member at a position within a predetermined operation range from the start of raising the treatment instrument raising base is provided, and the intermediate stopper is released to operate the treatment instrument raising base. The endoscope according to appendix 4, wherein the endoscope has an operation means that allows further operation to the entire range.
(Additional Item 14) The endoscope according to Additional Item 13, wherein a plurality of the intermediate stoppers are provided.
(Additional Item 15) The endoscope according to Additional Item 13, wherein the operation means includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.
(Additional Item 16) The additional item 4 is characterized in that when the raising base is turned upside down, the height of the wall surface of the storage chamber of the treatment instrument raising base facing the slit is made higher than the bottom surface of the slit. The endoscope according to 1.
(Additional Item 17) A wire contact surface provided at an upper portion of the opening of the treatment instrument insertion channel, wherein the raising base is turned up and the raising base is interposed between the raising base and the wire contact surface. Item 3 is characterized in that when the guide wire is clamped and fixed, the most distal contact portion between the treatment instrument raising base and the guide wire is located on the proximal side with respect to the rotation axis of the raising base. The endoscope according to 1.
(Additional Item 18) An intermediate stopper is provided for intermediately stopping the operation of the operation member at a position within a predetermined operation range from the start of raising the treatment instrument raising base, and the intermediate stopper is released to operate the treatment instrument raising base. The endoscope according to Additional Item 3, further comprising an operation unit that allows further operation to the entire range.
(Additional Item 19) The endoscope according to Additional Item 18, wherein a plurality of the intermediate stoppers are provided.
(Additional Item 20) The endoscope according to Additional Item 18, wherein the operation means includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.
(Additional Item 21) The operation unit is connected to the proximal end portion of the insertion portion to be inserted into the body cavity, and the distal end opening portion of the treatment instrument insertion channel disposed in the insertion portion is the distal end portion of the insertion portion. An elevator that is pivoted about a pivot shaft provided at the lower end on the distal end side of the endoscope to raise and lower the treatment instrument, an operation lever that can operate the elevator, and one end The elevator is provided with a traction member that is fixed to a rotating body that rotates coaxially with the operation lever at the other end,
A rotation restraining body that is provided to face the rotating body and deters rotation of the rotating body, and a deterring force increasing mechanism that increases a deterring force by the restraining body when the rotating body rotates a predetermined amount. The endoscope according to additional item 3, wherein the endoscope is provided between the suppressor and the body.
(Additional Item 22) The endoscope according to Additional Item 3, wherein the constituent member is formed of a high frictional resistance portion.
(Additional Item 23) The endoscope according to Additional Item 22, wherein a high frictional resistance portion is formed by embedding rubber, elastic member, or the like having a high frictional resistance.
(Additional Item 24) The endoscope according to Additional Item 22, wherein the high frictional resistance portion is formed by embedding a magnet.
(Additional Item 25) The removable tip cover in the endoscope is formed of an elastic member, and the elastic member is extended to a position facing the treatment instrument raising base to form the high friction resistance portion. The endoscope according to item 22, wherein
(Additional Item 26) The endoscope according to Additional Item 3, wherein a guide wire locking groove into which the guide wire is fitted is provided on a side wall of the storage chamber of the treatment instrument raising base.
(Additional Item 27) The width of the guide wire locking groove is set such that the guide wire is pressed by elastic deformation of the guide wire by pressing the guide wire between the side surface of the treatment instrument raising base and the guide wire locking groove. The endoscope according to additional item 26, wherein the endoscope has a width that can be sandwiched between the endoscope and the endoscope.
(Additional Item 28) Additional Item 26, characterized in that a guide wall is provided on the guide surface of the treatment instrument elevator to guide the guide wire to the guide wire locking groove when the treatment instrument elevator is raised. The endoscope according to 1.
(Additional Item 29) The endoscope according to Additional Item 26, wherein the guide wire locking groove is provided at a position where the guide wire is fixed while being inclined in a direction in which the objective optical system is disposed. .
(Additional Item 30)
A first biasing member fixed to the proximal-side operation unit side of the treatment instrument channel opening at the distal end of the endoscope;
A second urging member disposed beside the first urging member and movable substantially perpendicularly to the endoscope insertion portion axis;
A roller for pushing out the second urging member toward the first urging member;
A guide wire fixing means composed of an elastic member disposed between the first urging member and the second urging member;
Operating means for pulling the roller;
The endoscope according to additional item 3, wherein the endoscope is characterized by having
(Additional Item 31) The endoscope according to Additional Item 1, wherein the guide wire fixing means is disposed in the vicinity of a treatment instrument raising base provided at a distal end of the insertion portion.
(Additional Item 32) Further, there is provided an operation transmission means including an operation lever provided in the operation section, and an operation wire having one end connected to the operation lever and the other end connected to the guide wire fixing means. The endoscope according to additional item 31.
(Additional Item 33) The endoscope according to Additional Item 32, wherein the rotation axis of the operation lever is provided at a position different from the rotation axis of the treatment instrument raising lever that operates the treatment instrument raising base.
(Additional Item 34) The endoscope according to Additional Item 33, wherein the rotation axis of the operation lever is provided at a position substantially orthogonal to the rotation axis of the treatment instrument raising lever.
(Additional Item 35) The rotation axis of the treatment instrument raising lever is provided on an axis substantially orthogonal to the central axis of the insertion portion, and the rotation axis of the operation lever is provided on an axis substantially parallel to the central axis of the insertion portion. 34. The endoscope according to additional item 33, wherein
(Additional Item 36) The additional item 33 is characterized in that a treatment instrument insertion port for guiding the treatment instrument to the treatment instrument insertion channel is provided in the grip, and an operation lever is provided at the insertion portion side end of the grip. The endoscope according to 1.
(Supplementary Item 37) The supplementary item 33, wherein the treatment instrument raising lever is provided closer to the hand than the grip for holding the operation portion, and the operation lever is provided closer to the insertion portion than the grip. Endoscope.
(Additional Item 38) The endoscope according to Additional Item 31, wherein the guide wire fixing means has a snare shape.
(Additional Item 39) The inner portion according to Additional Item 38, wherein a fixing member that temporarily fixes the guide wire fixing means is provided near the treatment instrument insertion channel opening of the endoscope. Endoscope.
(Additional Item 40) The endoscope according to Additional Item 31, wherein the guide wire fixing means has a hook shape.
(Appendix 41) Further,
A fixing part for fixing the guide wire;
An arm portion provided on the base end side of the fixing portion, and a guide wire fixing member including a support shaft that rotates and supports the arm portion orthogonal to the arm portion;
A rotation mechanism for rotating the support shaft of the guide wire fixing member;
A puller wire inserted through the insertion portion of the endoscope to remotely operate the rotating mechanism;
The fixing member is brought into contact with the outer diameter portion of the guide wire by rotating the arm portion, and is clamped and fixed with the main body portion at the distal end of the insertion portion. The endoscope according to appendix 40.
(Additional Item 42) The endoscope according to Additional Item 41, wherein at least the support shaft and the rotation mechanism are arranged in a watertight manner inside the distal end hard portion of the endoscope.
(Additional Item 43) A locking position for releasably locking a guide wire that is inserted into the treatment instrument insertion channel and guides the treatment instrument, and an unlocking position for releasing the locking of the guide wire 32. The endoscope according to appendix 31, wherein a guide wire fixing elevator that is movable to the distal end of the insertion portion is disposed as the guide wire fixing means.
(Additional Item 44) The endoscope according to Additional Item 43, wherein operation means for operating locking or releasing of the guide wire by the guide wire fixing elevator is provided in the operation unit of the endoscope. mirror.
(Supplementary Item 45) The supplementary item 43, wherein the guide wire is sandwiched and fixed between the wall surface portion of the treatment instrument insertion passage disposed at the distal end of the endoscope and a guide wire fixing elevator. Endoscope.
(Additional Item 46) The endoscope according to Additional Item 43, wherein the guide wire fixing elevator is provided on the treatment instrument elevator for raising the treatment instrument in the visual field direction.
(Additional Item 47) The additional item 43, wherein an opening is provided on a guide surface on which the treatment instrument of the treatment instrument raising base is arranged, and the guide wire fixing raising base is provided in the opening. Endoscope.
(Supplementary Item 48) The guide wire fixing elevator is arranged so that when the guide wire fixing elevator is turned upside down, the guide surface of the guide wire fixing elevator and the treatment instrument elevator are smoothly connected to each other. The endoscope according to additional item 43, which is characterized in that it is made.
(Additional Item 49) The endoscope according to Additional Item 43, wherein the raising angle of the guide wire fixing elevator exceeds that of the treatment instrument elevator.
(Additional Item 50) The endoscope according to Additional Item 43, wherein an elastic member is provided at a guide wire contact position when the guide wire is fixed by the guide wire fixing elevator.
(Additional Item 51) The endoscope according to Additional Item 43, wherein a protrusion is provided at a guide wire contact position of the elevator when the guide wire is fixed by the guide wire fixing elevator.
(Additional Item 52)
An urging member that is movable in a direction substantially perpendicular to the treatment instrument insertion path at the endoscope distal end;
A guide wire fixing means composed of a spring material for assisting the movement of the urging member;
32. The endoscope according to appendix 31, wherein an operation transmission means is provided to enable the guide wire to be fixed and released by the guide wire fixing means.
(Additional Item 53) The endoscope according to Additional Item 52, wherein a guide wire fixing unit is configured by providing a torque transmission member between the biasing member and the operation transmission unit.
(Additional Item 54) The guide wire fixing means is configured by fixing the end portion of the fixing operation wire protruding from the guide conduit provided in the endoscope near the distal end side opening portion of the treatment instrument insertion channel. The endoscope according to item 31, which is characterized.
(Additional Item 55) The endoscope according to Additional Item 54, wherein an end portion of the guide wire fixing means is rotatably fixed.
(Additional Item 56) The endoscope according to Additional Item 1, wherein the guide wire fixing means is built in the vicinity of the distal end of the insertion portion.
(Additional Item 57) The endoscope according to Additional Item 1, wherein the guide wire fixing means is disposed in the vicinity of the opening.
(Additional Item 58) The guide wire fixing means is disposed at a position in contact with or near the surface of the insertion portion and at a position away from an observation window disposed at the distal end of the insertion portion. 58. The endoscope according to additional item 57, which is characterized.
(Additional Item 59) The endoscope according to Additional Item 1, wherein the guide wire fixing means is configured to be detachable from the insertion portion.
(Additional Item 60) The endoscope according to Additional Item 59, wherein the guide wire fixing means is configured to be detachable from a distal end of the insertion portion.
(Additional Item 61) The endoscope according to Additional Item 59, further including an attachment mechanism for attaching the guide wire fixing means to the insertion portion.
(Additional Item 62) The endoscope according to Additional Item 61, wherein the attachment mechanism is made of a soft resin such as vinyl chloride or rubber.
(Additional Item 63) The endoscope according to Additional Item 61, wherein the attachment mechanism includes a positioning member including a convex portion fitted into the opening of the treatment instrument insertion channel.
(Additional Item 64) The attachment mechanism has at least a length from the distal end of the insertion portion to the guide wire fixing means for covering the protrusion provided on the guide wire fixing means, and excludes the corners as a whole. 62. The endoscope according to additional item 61, further comprising a mucous membrane protecting part.
(Additional Item 65) The attachment mechanism includes a mounting portion formed in a substantially cylindrical shape, a thickness changing portion formed so as to gradually increase in thickness toward one end in the axial direction of the mounting portion, At least one slit provided in the wall thickness changing portion and having an opening on the one end side, and a ring member that is movable in the axial direction at least the outer peripheral portion of the wall thickness changing portion in the mounting portion. 62. The endoscope according to additional item 61, wherein the thickness changing portion is fitted to a distal end of an insertion portion in the endoscope.
(Additional Item 66) Further, a guide wire fixing member insertion channel having a first opening opened at the distal end of the treatment instrument insertion channel and a second opening opened near the first opening at the distal end. And a guide wire fixing means for holding and fixing the guide wire extending from the first opening for guiding the treatment instrument to the treatment target site is extended from the second opening. Item 56. The endoscope according to item 59, which is characterized.
(Additional Item 67) The endoscope according to Additional Item 66, wherein the guide wire fixing means has a snare tip.
(Additional Item 68) The endoscope according to Additional Item 66, wherein the guide wire fixing means has a hook shape having a distal end portion made of a soft member.
(Additional Item 69) The guide wire fixing means includes at least two movable members arranged substantially in parallel, and has a guide wire fixing portion that is movable in a direction toward and away from each other. The endoscope according to appendix 1, wherein
(Additional Item 70) The endoscope according to Additional Item 69, wherein the two guide wire fixing portions sandwich and fix the guide wire when approaching each other.
(Additional Item 71) The guide wire fixing means is disposed in the vicinity of the opening of the treatment instrument insertion channel so as to cross the opening, and is provided at the distal end portion of the endoscope in the longitudinal direction of the insertion portion. Additional Item 1 characterized by having a guide wire fixing portion that is attached so as to be movable in a direction approaching and separating from the treatment instrument raising base and has a portion in contact with the guide wire on a surface facing the treatment instrument raising base. The endoscope according to 1.
(Additional Item 72) The endoscope according to Additional Item 1, wherein the guide wire fixing means includes at least one loop-shaped member, and a loop diameter of the loop-shaped member is freely expandable and contractible.
(Additional Item 73) The above-mentioned guidewire fixing means has a groove having a width slightly smaller than the outer diameter of the guidewire on the surface facing the treatment instrument raising base disposed at the distal end of the insertion portion. 1. The endoscope according to 1.
(Additional Item 74) The endoscope according to Additional Item 1, wherein the guide wire fixing means includes a guide wire fixing portion having irregularities on a surface in contact with the guide wire.
(Additional Item 75) The endoscope according to Additional Item 74, wherein the guide wire fixing portion includes a pair of guide wire fixing members that sandwich the guide wire.
(Additional Item 76) The endoscope according to Additional Item 75, wherein the concave and convex portions of the other guide wire fixing member are fitted into the concave portions of the one guide wire fixing member.
(Additional Item 77) The endoscope according to Additional Item 74, wherein the unevenness includes a step substantially orthogonal to the guide wire.
(Additional Item 78) The endoscope according to Additional Item 1, wherein a material having a large frictional resistance made of an elastic member such as rubber is disposed on a surface of the guidewire fixing unit that contacts the guidewire. .
(Additional Item 79) The guide wire fixing means is installed on a transparent substantially cylindrical member having a treatment instrument insertion opening through which a treatment instrument protruding from the opening of the treatment instrument insertion channel can pass. The endoscope according to appendix 1, wherein the endoscope is characterized in that
(Additional Item 80) The endoscope according to Additional Item 1, wherein the guide wire fixing means includes a guide wire identification mechanism that identifies the guide wire and a treatment instrument other than the guide wire.
(Additional Item 81) The endoscope according to Additional Item 80, wherein the guide wire identifying mechanism has a protruding portion that protrudes at least partially over the opening of the treatment instrument insertion channel so as to be movable forward and backward.
(Additional Item 82) The guide wire identification mechanism includes a protrusion that protrudes forward and backward from the proximal end side in the longitudinal direction of the insertion portion onto the opening of the treatment instrument insertion channel. 82. The endoscope according to additional item 81, wherein a gap having a width larger than the diameter of the guide wire is provided on the opposite side.
(Additional Item 83) Further, the elastic member is movable to the guide wire fixing means and is biased to a first position where the guide wire is fixed or a second position where a treatment instrument other than the guide wire can be inserted. The endoscope according to additional item 80, further comprising a guide wire fixing member or a guide wire identification member.
(Additional Item 84) The additional item, wherein the guide wire fixing means has a click mechanism that can lock at least one of the guide wire fixing member and the guide wire identification member at the first position or the second position. 83. The endoscope according to 83.
(Additional Item 85) The endoscope according to Additional Item 84, wherein the click mechanism includes a click pin and a click groove that guides the click pin.
(Additional Item 86) The endoscope according to Additional Item 85, wherein the click groove has a step that prevents reverse rotation of the click pin.
(Additional Item 87) The click pin is rotatably attached to a moving member including at least one of the guide wire fixing member and the guide wire identifying member, and is further opposite to the side on which the moving member is urged. The click pin so that the forward and return paths of the click pin are different when the moving member reciprocates between the first position and the second position. 87. The endoscope according to additional item 86, wherein a step for preventing reverse rotation is provided at a turning point in the groove.
(Additional Item 88) The click pin is rotatably attached to a moving member composed of at least one of the guide wire fixing member and the guide wire identification member, and further on the side where the guide wire fixing portion is urged. One provided convex portion, a first convex portion and a second convex portion provided on the opposite side of the biased side, and a concave portion provided between the two convex portions. When the guide wire fixing portion reciprocates between the first position and the second position, all the turn-back points are prevented from rotating backward so that the forward path and the return path of the click pin are different. The endoscope according to additional item 85, wherein a step is provided.
(Additional Item 89) The endoscope according to Additional Item 80, wherein the guide wire fixing means is interlocked with the guide wire identification mechanism.
(Additional Item 90) The endoscope according to Additional Item 89, wherein the guide wire fixing means includes a portion that is caught by the guide wire identification mechanism unit.
(Additional Item 91) The endoscope according to Additional Item 1, further comprising operation means for operating the guide wire fixing means.
(Additional Item 92) The endoscope according to Additional Item 91, wherein the operation means is provided in an operation unit of the endoscope.
(Additional Item 93) The endoscope according to Additional Item 91, wherein a transmission mechanism that transmits an operation of the operation unit is provided between the operation unit and the guide wire fixing unit.
(Additional Item 94) The endoscope according to Additional Item 93, wherein the transmission mechanism is an operation wire disposed in a treatment instrument insertion channel.
(Additional Item 95) The above transmission mechanism is disposed in an external channel provided between the vicinity of the distal end of the insertion portion and the proximal side along the side surface of the endoscope. The endoscope according to 1.
(Additional Item 96) The endoscope according to Additional Item 95, wherein the transmission mechanism is an operation wire disposed in an external channel.
(Additional Item 97) The endoscope according to Additional Item 91, wherein a member for fixing the operation wire is provided in the vicinity of the proximal end of the bending portion in the endoscope.
(Additional Item 98) The endoscope according to Additional Item 91, wherein the operation unit and the endoscope operation unit are spaced apart from each other.
(Additional Item 99) An insertion portion to be inserted into a body cavity;
An operation unit connected to the proximal end of the insertion unit;
A treatment instrument elevator that is disposed at the distal end of the insertion section and can be operated by the operation section;
In an endoscope having
An endoscope characterized in that a slit that allows only the guide wire to be engaged by operating the treatment instrument raising base to raise the guide wire is provided at the top of the guide surface of the treatment instrument raising base. .
(Additional Item 100) A slit having two wall surfaces facing the top of the guide surface of the treatment instrument raising base is provided, and the wall surface is fixed only to the guide wire by contacting only the outer periphery of the guide wire. The endoscope according to additional item 99.
(Additional Item 101) The inner width according to Additional Item 99, wherein the width of the opening of the slit is wider than the outer diameter of the guide wire and smaller than the outer diameter of the treatment instrument sheathed on the guide wire. Endoscope.
(Additional Item 102) The endoscope according to Additional Item 99, wherein the slit is provided on the upper surface of the treatment instrument insertion channel opening of the distal end hard portion of the endoscope.
(Additional Item 103) A wire contact surface is provided above the opening of the treatment instrument insertion channel provided at the distal end of the endoscope, and the raising base is turned up so that the slit and the wire contact surface When the guide wire is sandwiched and fixed between the slit and the guide wire, the most distal contact portion between the slit and the guide wire is located on the proximal side with respect to the pivot shaft of the elevator. Item 99. The endoscope according to Item 99.
(Additional Item 104) A guide wire having an objective optical system at the distal end portion of the endoscope, and a part of the treatment instrument raising base is in the observation field when the guide wire is fixed, and is fixed and enters the observation field The endoscope according to appendix 99, wherein the objective optical system is set so as to focus on a part of the endoscope.
(Additional Item 105) The opening of the slit is provided with a protrusion through which the outer diameter of the guide wire is elastically deformed and passed when the raising base is turned up. 99. The endoscope according to additional item 99, wherein the endoscope forms a space in which the outer diameter of the guide wire is maintained in cooperation with a portion.
(Additional Item 106) The endoscope according to Additional Item 105, wherein the protrusion is provided on both sides of the opening of the slit.
(Additional Item 107) The endoscope according to Additional Item 105, wherein the protruding portion is provided over the entire length with respect to the insertion portion axial direction of the opening of the slit.
(Additional Item 108) An intermediate stopper is provided for intermediately stopping the operation of the operation tool raising base at a position within a predetermined operation range from the start of raising the treatment instrument raising base, and the intermediate stopper is released to perform the above operation. The endoscope according to additional item 99, further comprising operation means that allows further operation to a full operation range of the member.
(Additional Item 109) The endoscope according to Additional Item 108, wherein a plurality of the intermediate stoppers are provided.
(Additional Item 110) The endoscope according to Additional Item 108, wherein the operation means includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.
(Additional Item 111) In the Additional Item 99, the height of the wall surface of the treatment instrument elevator base housing chamber facing the slit is made higher than the slit bottom surface when the elevator base is turned upside down. The endoscope described.
(Additional Item 112) The treatment instrument elevator includes a guide surface for guiding the treatment tool facing the opening of the treatment instrument insertion channel, another surface facing the distal end of the endoscope, and the guide surface 100. The endoscope according to additional item 99, wherein the slit is provided from the connection surface or the connection surface to the other surface.
(Additional Item 113) The endoscope according to Additional Item 99, wherein a central axis of the slit with respect to the axial direction of the insertion portion is inclined with respect to a central axis of the guide surface.
(Additional Item 114) A treatment instrument insertion channel is disposed in an insertion portion to be inserted into a body cavity, the distal end opening of the treatment instrument insertion channel is located near the distal end of the insertion portion, and the operation portion is near the operation portion. An endoscope provided with a treatment instrument insertion port which is an opening of a treatment instrument insertion channel;
A guide wire capable of passing through the treatment instrument insertion channel;
A treatment instrument having a conduit through which the guide wire can be inserted, and capable of being inserted into the treatment instrument insertion channel;
In an endoscope system having
The treatment instrument has a projection length from the distal end opening necessary for treatment in a state of being inserted into the treatment instrument insertion channel and a projection length from the treatment instrument insertion port necessary for work on the hand side. When the treatment tool that travels on the guide wire is inserted and removed while the distal end portion of the guide wire inserted through the treatment instrument insertion channel is led out from the distal end opening, Guide wire fixing means for detachably locking the guide wire is provided in the vicinity of the distal end portion of the insertion portion, and the guide wire pulls the distal end portion of the treatment instrument from the locking position toward the operation portion hand side to fix the guide wire. An endoscope system characterized by having a length protruding from the proximal end of the treatment instrument in a state of being locked by the means.
(Additional Item 115) Further, a slit that allows only the guide wire to be engaged by operating the treatment instrument raising base provided near the distal end opening of the treatment instrument insertion channel to raise the guide wire, 115. The endoscope system according to additional item 114, wherein the endoscope system is provided at the top of the guide surface of the treatment instrument raising base.
(Additional Item 116) A projection provided at the upper part of the opening of the treatment instrument insertion channel, wherein the raising base is rotated up and the guide wire is sandwiched between the slit and the projection. 116. The endoscope system according to additional item 115, wherein when being fixed, the most distal contact portion between the protrusion and the guide wire is located on the proximal side with respect to the rotation shaft of the elevator. .
(Additional Item 117) An intermediate stopper is provided for intermediately stopping the operation of the operation member at a position within a predetermined operation range from the start of raising the treatment instrument raising base, and the intermediate stopper is released to fully operate the operation member. 116. The endoscope system according to additional item 115, further comprising operation means that enables further operation.
(Additional Item 118) The endoscope system according to Additional Item 117, wherein the operation means includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.
(Additional Item 119) The internal view according to Additional Item 115, wherein the slit has two opposing wall surfaces, and the wall surfaces are set so as to lock only the outer peripheral surface of the guide wire. Mirror system.
(Additional Item 120) The endoscope system according to Additional Item 115, wherein a width of the slit is set to be wider than an outer diameter of the guide wire and smaller than an outer diameter of a treatment instrument to be sheathed on the guide wire.
(Additional Item 121) The endoscope system according to Additional Item 115, wherein a central axis with respect to a central axis direction of the insertion portion of the slit is inclined with respect to a central axis of the guide surface.
(Additional Item 122) The endoscope system according to Additional Item 114, wherein the total length of the guide wire is set to be equal to or less than twice the total length of the treatment instrument.
(Additional Item 123) The total length of the guide wire is such that the distal end portion of the treatment instrument is retracted from the locking position toward the proximal side operation portion and the guide wire is fixed to the guide wire fixing means. 115. The endoscope system according to additional item 114, wherein the endoscope system is set so as to protrude from the opening of the channel and to protrude from the proximal end of the treatment instrument.
(Additional Item 124) The distal end portion of the treatment instrument is retracted from the locking position to the hand side operation unit side, and the guide wire is locked by the guide wire fixing means from the treatment instrument insertion port of the treatment instrument. 115. The endoscope system according to additional item 114, wherein the protruding length is set to 30 to 60 cm, and the length of the guide wire protruding from the proximal side of the treatment instrument in the same state is set to 20 cm or less.
(Additional Item 125) An endoscope having an endoscope auxiliary tool mounting mechanism including a belt-like member wound around the insertion portion.
(Additional Item 126) Having an endoscope auxiliary tool mounting mechanism composed of at least two substantially cylindrical members in which a second substantially cylindrical member is disposed inside the first substantially cylindrical member so as to be movable. Endoscope characterized by.
(Additional Item 127) The endoscope according to Additional Item 126, wherein at least one of the inner diameter, the outer diameter, and the thickness of each of the two substantially cylindrical members is formed non-uniformly.
(Additional Item 128) The inner diameter of one end of the first substantially cylindrical member extends in a tapered shape that gradually increases toward the opening, and the outer diameter of one end of the second substantially cylindrical member is an opening. 131. The endoscope according to additional item 126, wherein the endoscope is narrowly formed in a tapered shape that gradually decreases toward the portion.
(Additional Item 129) The endoscope according to Additional Item 126, wherein the second substantially cylindrical member is provided with at least one slit.
(Additional Item 130) A locking mechanism such as a click, a screw, or a fitting groove is provided so that the first substantially cylindrical member can be temporarily fixed in a state where the second substantially cylindrical member is pushed into the first substantially cylindrical member. 131. The endoscope according to additional item 126, wherein
(Additional Item 131) A mounting portion formed in a substantially cylindrical shape, and a thickness changing portion formed so as to gradually increase in thickness toward one end in the axial direction of the mounting portion,
At least one slit provided in the thickness changing portion and having an opening on the one end side;
A ring member capable of moving in the axial direction at least the outer peripheral portion of the thickness changing portion in the mounting portion;
An endoscope auxiliary tool mounting member, wherein the thickness changing portion is fitted to the distal end of the insertion portion of the endoscope.
(Additional Item 132) In a method of performing endoscopic diagnosis or treatment using a guide wire,
Inserting a guide wire into the guide wire insertion lumen of the treatment instrument inserted through the endoscope; and
After confirming that the guide wire has secured the lumen, gripping and fixing the guide wire on the endoscope operation unit side, and pulling back the treatment instrument;
After the distal end of the treatment instrument is pulled back to the inside of the endoscope insertion portion, a step of fixing the guide wire at the distal end of the endoscope insertion portion using a guide wire fixing member;
After confirming that the guide wire is fixed, withdrawing the treatment tool completely from the endoscope;
A method for diagnosis or treatment comprising the steps of:
(Additional Item 133) The method of performing diagnosis or treatment according to Additional Item 132, wherein the operation of fixing or releasing the guide wire is performed by an operation unit disposed in an operation unit of an endoscope.
(Additional Item 134) In a method of diagnosing or treating endoscopically using a guide wire,
Confirming that the guide wire is fixed by the guide wire fixing member at the distal end of the endoscope insertion portion;
Inserting the proximal end side of the guide wire into the guide wire insertion lumen of the treatment instrument;
Inserting the treatment instrument through an endoscope;
After confirming that the distal end of the treatment instrument has been inserted to the vicinity of the distal end of the insertion portion of the endoscope, releasing the fixation by the guide wire fixing member;
Gripping and fixing the endoscope operation unit side of the guide wire;
Further inserting the treatment tool along the guide wire;
A method for diagnosis or treatment comprising the steps of:
(Additional Item 135) The method of performing diagnosis or treatment according to Additional Item 134, wherein the operation of fixing or releasing the guide wire is performed by an operation unit disposed in an operation unit of an endoscope. .

    DESCRIPTION OF SYMBOLS 12 ... Insertion part, 17 ... Tip part, 23 ... Channel for treatment instrument insertion, 26 ... Channel opening part, 27 ... Treatment instrument raising base (guide wire fixing means), 68 ... Guide wire, 403 ... Operation lever (operation means) 473 ... Stopper member (intermediate stopper), 475a ... First stopper, 475b ... Second stopper.

Claims (3)

In an endoscope in which a treatment instrument insertion channel is disposed in an insertion portion to be inserted into a body cavity, and a distal end opening of the treatment instrument insertion channel is disposed in the vicinity of the distal end of the insertion portion.
A treatment that runs on the guide wire in a state where the distal end portion of the guide wire provided in the insertion portion and inserted through the treatment instrument insertion channel is led out from the distal end opening of the treatment instrument insertion channel. A guide wire fixing means for releasably locking the guide wire in a state of restricting movement of the guide wire in the axial direction when inserting and removing the tool;
The insertion portion is provided in the vicinity of the distal end opening of the treatment instrument insertion channel, and has a substantially V-shaped slit formed on the top surface of the guiding portion so as to be engageable only with the guide wire. The treatment tool raising base that engages only the guide wire by pressing and inserting the guide wire into the slit by raising the guide wire by the above, and a predetermined from the start of raising the treatment tool raising base An intermediate stopper for intermediately stopping the raising operation of the raising base within the operation range;
An operation means for enabling the treatment tool raising base to be lifted up to the entire operation range of the treatment tool raising base by releasing the intermediate stop operation of the treatment tool raising base by the intermediate stopper,
An endoscope comprising:   The endoscope according to claim 1, wherein a plurality of the intermediate stoppers are provided.   The endoscope according to claim 1, wherein the operation unit includes a protrusion provided on the operation member and an elastic member engaged with the protrusion.

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