JP5301933B2 - Medical Advancement and Retraction Control Mechanism - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical mechanism for controlling forward/backward movement which can control the forward/backward movement of an endoscope tool within a tool channel to regulate easily the projection, and facilitates the determination of an early position; and a medical method for controlling forward/backward movement. <P>SOLUTION: The medical mechanism for controlling forward/backward movement 50 includes a controller 60 mounted detachably to an insertion hole 40, and an abutment 80 mounted to a bendable tube 210. The end surfaces 65a, 66a of the controller 60 makes the abutment 80 abut against the end surfaces 65a, 66a when the endoscope tool 200 (the bendable tube 210) moves forward/backward within the tool channel 39, thereby regulating the forward/backward shift of the endoscope tool 200. The abutment 80 abuts against the end surface 65a to regulate the projection of a curve 211 projecting from the tool channel 39, while the abutment 80 abuts against the end surface 66a to regulate the backward movement of a tip 212, and determines the early position of the tip 212 within the tool channel 39. <P>COPYRIGHT: (C)2010,JPO&amp;INPIT

Description

  The present invention relates to a medical advance / retreat amount regulating mechanism that regulates the advance / retreat amount of the distal end of an endoscopic treatment instrument such as a treatment instrument with respect to the distal end of an in-vivo guide member such as a treatment instrument channel.

  Generally, a treatment instrument channel through which a treatment instrument that is an in-vivo insertion section to be inserted into the body is inserted is disposed in an insertion section of an endoscope. An endoscope having a treatment instrument channel is a guide member for guiding the treatment instrument into the body.

  The treatment tool is, for example, a forceps or a high-frequency resection tool, has a multi-joint, passes through the treatment tool channel, and protrudes toward the body. The insertion part has a multi-joint, and when operated by the operation part, the insertion part curves toward the affected part arranged in the body. In this state, the treatment tool treats the affected area.

  For example, Patent Literature 1 discloses an endoscope treatment tool that can reliably recognize a position where the insertion / removal operation of the treatment tool should be interrupted.

  Further, for example, Patent Document 2 discloses an endoscope cleaning instrument that can easily clean the inside of a conduit and a mouthpiece.

Further, for example, in Patent Document 3, it is possible to keep the distal treatment piece securely stored in the flexible sheath when inserted into the treatment instrument channel of the endoscope. An endoscopic treatment tool for endoscope that can reliably hold the protruding length of the distal treatment piece from the distal end of the sheath at a predetermined length is disclosed.
JP-A-10-248800 Japanese Patent Laid-Open No. 7-194533 JP-A-2005-279126

  It is difficult for the surgeon to grasp the protruding amount of the treatment tool protruding from the treatment tool channel, for example, with a monitor or the like during use. Further, when the treatment instrument is stored in the treatment instrument channel, the treatment instrument is not displayed on the monitor. Therefore, the surgeon may not be able to easily grasp the positional relationship between the insertion portion distal end and the treatment instrument distal end. In other words, if the advancement / retraction amount of the treatment tool with respect to the treatment tool channel is not restricted, the protrusion amount of the treatment tool is not restricted, and the treatment in the treatment tool channel is performed before the treatment tool inserted into the treatment tool channel is used, for example. The initial position of the tool will not be set. Therefore, there is a possibility that the operation of the surgeon may be hindered.

  If the initial position of the treatment instrument in the treatment instrument channel is not set, for example, when the insertion section is bent, the treatment instrument protrudes from the insertion section against the operator's intention, and the treatment instrument has a body protruding from the insertion section. There is a risk of injury. Further, if the protruding amount is not regulated and the initial position is not set, there is a possibility that the treatment instrument is arranged in a state protruding from the insertion portion. Thereby, there exists a possibility that the inside of a body may be damaged by the treatment tool which protrudes from the insertion part.

  Therefore, it is preferable to restrict the advancement / retraction amount of the treatment tool with respect to the treatment tool channel. That is, it is preferable that the protruding amount of the treatment tool protruding from the treatment tool channel is regulated.

  Further, when the initial position is not set and the treatment tool is accommodated in the treatment tool channel and the insertion portion is bent, for example, the treatment tool may come into contact with the treatment tool channel against the operator's intention. This may cause the treatment instrument to be damaged.

  In addition, in order to prevent the treatment instrument from protruding from the insertion portion against the operator's intention and contact with the treatment instrument channel, before the treatment instrument inserted into the treatment instrument channel is used, It is preferable to set the initial position of the treatment tool at a desired position such as the distal end of the insertion portion.

  Therefore, in view of the above problems, the present invention regulates the advancement / retraction amount of the endoscope treatment tool with respect to the treatment tool channel, can easily regulate the protrusion amount, and can easily set the initial position. An object is to provide a quantity regulation mechanism.

To achieve the object, the present invention is detachable from an insertion port communicating with a treatment instrument channel disposed in the in-vivo guide member through which an endoscopic treatment instrument guided into the body by an in-vivo guide member can be inserted. Is a medical advance / retreat amount restriction mechanism that restricts the advance / retreat movement of the endoscope treatment tool relative to the in-vivo guide member, and has a first opening through which the endoscope treatment tool can be inserted. A restriction member including a distal end side end surface connected to the insertion port and a proximal end side end surface having a second opening through which the endoscope treatment tool can be inserted; and the endoscope treatment. The endoscope treatment tool advances and retreats with respect to the in-vivo guide member by being inserted into the second opening and moving between the distal end surface and the proximal end surface. comprising the abutting-in portion for restricting the movement, the said abutting with portions By contacting the proximal end surface, the distal end of the endoscopic treatment instrument is proximal by a desired distance from the distal end of the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state. A medical advance / retreat amount regulating mechanism is provided , characterized in that an initial position, which is a position disposed on the side and accommodated in the treatment instrument channel, is set .

In order to achieve the object of the present invention , the endoscope treatment tool guided into the body by the in- vivo guide member can be attached to and detached from the insertion port communicating with the treatment instrument channel disposed in the in-vivo guide member. A medical advance / retreat amount regulating mechanism that is freely attached and regulates the advance / retreat movement of the endoscopic treatment tool relative to the in-vivo guide member, wherein the first opening through which the endoscopic treatment tool can be inserted is provided. A restricting member including a distal end side end surface connected to the insertion port and a proximal end end surface having a second opening through which the endoscope treatment instrument can be inserted; and for the endoscope The endoscope treatment tool is disposed on a treatment tool, and is inserted through the second opening and moves forward and backward between the distal end surface and the proximal end surface. A contact portion that regulates forward / backward movement, and the contact The length from the distal end surface to the proximal end surface that can move forward and backward is the length of the endoscope treatment tool from the proximal end of the bending portion that is disposed on the endoscope treatment tool and can be bent. Provided is a medical advance / retreat amount regulating mechanism characterized by being longer than the length to the tip .

  According to the present invention, there is provided a medical advance / retreat amount regulation mechanism that regulates the advance / retreat amount of the endoscope treatment tool relative to the treatment tool channel, can easily regulate the protrusion amount, and can easily set the initial position. can do.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
An embodiment will be described with reference to FIGS. FIG. 1 is a diagram illustrating a schematic configuration of an endoscope operation system 1 according to the present embodiment.
As shown in FIG. 1, the endoscope 2 is provided with an elongated insertion portion 10 that is inserted into a patient's body and the like, and an operation portion 30 that is connected to the proximal end of the insertion portion 10 and operates the insertion portion 10. ing.

  In the present embodiment, the body includes body cavities such as the digestive tract and blood vessels, the abdominal cavity, and the thoracic cavity. In the present embodiment, the endoscope 2 is an in-vivo guide member that guides an endoscopic treatment tool inserted into the body into the body. The endoscope treatment tool is, for example, an endoscope treatment tool 200 described later.

  The operation unit 30 is provided with a gripping unit 31 that the surgeon grips and a bending operation knob 32 that bends the bending unit 12 described later of the insertion unit 10.

  A base end portion of the universal cord 33 is connected to the grip portion 31. A connector portion 34 connected to a light source device (not shown), a video processor, or the like is disposed at the distal end portion of the universal cord 33.

  The bending operation knob 32 is provided with a left / right bending operation knob 32a for bending a bending portion 12 (to be described later) of the insertion portion 10 to the left and right, and an up / down bending operation knob 32b for bending the bending portion 12 up and down. A left / right bending operation mechanism driven by the left / right bending operation knob 32a is connected to the left / right bending operation knob 32a. Further, an up / down bending operation mechanism driven by the up / down bending operation knob 32b is connected to the up / down bending operation knob 32b. The bending operation mechanism in the vertical direction and the bending operation mechanism in the horizontal direction are connected to the proximal end of an operation wire (not shown) that performs the bending operation on the entire bending portion 12.

  The operation unit 30 includes a suction button 35, an air / water supply button 36, various buttons 37 for endoscopic photography, and a treatment instrument insertion unit 38. The treatment instrument insertion portion 38 is provided with an insertion port 40 for a treatment instrument channel 39 (described later), which is an insertion section through which an endoscope treatment instrument 200 (described later) is inserted.

  The insertion part 10 shown in FIG. 1 has a flexible tube part (serpentine part) 11, a bending part 12, and a hard end part 13 in order from the operation part 30 side. Specifically, the operation unit 30 is connected to the proximal end of the elongated flexible tube unit 11. The distal end of the flexible tube portion 11 is connected to the proximal end of the bending portion 12. The distal end of the bending portion 12 is connected to the proximal end of the distal end rigid portion 13.

  The flexible tube portion 11 has elasticity and flexibility, and is bent by an external force.

The bending portion 12 has a plurality of node rings like the bending portion 211 described later, and has substantially the same configuration as the bending portion 211. Therefore, the bending part 12 has an articulated bending mechanism.
When the left and right bending operation knob 32a is operated, the bending portion 12 is bent in the left and right direction by pushing an operation wire (not shown) through the bending operation mechanism. Further, when the up / down bending operation knob 32b is operated, the bending portion 12 is bent in the vertical direction by pushing and pulling an operation wire (not shown) through the bending operation mechanism. When the bending portion 12 is bent, the position and orientation of the distal rigid portion 13 are changed, and a desired observation target (an affected area, a lesion area, or the like in the body) is captured in the observation visual field (or imaging visual field).

Specifically, an operation wire (not shown) performs bending operations on the entire bending portion 12 in four directions, up, down, left, and right. The distal end of the operation wire is inserted into the bending portion 12 and connected to the proximal end of the distal end rigid portion 13. The proximal end of the operation wire is connected to the above-described vertical bending operation mechanism and the horizontal bending operation mechanism of the operation unit 30.
For example, with the turning operation of the left / right bending operation knob 32a, the bending operation mechanism in the left / right direction moves, and each operation wire is pulled and driven. Thereby, for example, the bending portion 12 is indicated by a solid line or a two-dot chain line in the drawing from a normal straight line state (non-curved state) in which the bending angle extends straight at 0 ° as shown by a one-dot chain line in FIG. Thus, it is bent in a bending state that is bent at an arbitrary bending angle in the left-right direction.

  As shown in FIG. 1, the distal end surface 13a of the distal end rigid portion 13 is provided with an observation window 14, an illumination window 15, and a distal end opening 39a.

  Inside the observation window 14, an imaging unit including an optical system such as an objective lens (not shown) and an imaging element such as a CCD is provided. The imaging unit images an affected area in the body. The imaging signal obtained by the imaging unit is sent to an image processing device (not shown).

  The distal end opening 39 a communicates with the distal end side of the treatment instrument channel 39 formed in the insertion portion 10. Further, the proximal end side of the treatment instrument channel 39 communicates with the insertion port 40. That is, the distal end opening 39 a is the distal end of the treatment instrument channel 39 and communicates with the insertion port 40 through the treatment instrument channel 39. The treatment instrument channel 39 is used as a passage through which the endoscope treatment instrument 200 having an articulated bending mechanism is inserted, for example. The endoscope treatment tool 200 is inserted through the insertion port 40, the treatment tool channel 39, and the distal end opening 39a. The endoscope treatment tool 200 is inserted from the insertion port 40, passes through the treatment tool channel 39, and protrudes from the distal end opening 39a.

  In the present embodiment, it is assumed that one endoscope treatment tool 200 is inserted into one treatment tool channel 39, but the number is not necessarily limited. For example, a plurality of endoscope treatment tools is provided. 200 may be inserted into the treatment instrument channel 39. Also, a plurality of treatment instrument channels 39 are provided, and the endoscope treatment instrument 200 can be inserted into each insertion channel.

  The flexible tube portion 11 and the bending portion 12 are covered with an unshown outer tube. The outer tube is made of an elastic material such as rubber and has substantially the same shape (for example, a hollow shape or a cylindrical shape) as the flexible tube portion 11 and the curved portion 12. The outer tube may be injection-molded with an elastic material made of a thermoplastic elastomer (such as styrene, olefin, or urethane). The molding of the thermoplastic elastomer is not limited to injection molding, and various molding methods such as casting, extrusion, and blow may be applied.

  The distal end rigid portion 13 may be covered with an outer tube similar to the flexible tube portion 11 and the bending portion 12.

  Moreover, the insertion part 10 in the endoscope 2 should just be a bendable tube.

Next, the endoscope treatment tool 200 in the present embodiment will be described.
As shown in FIG. 1, an endoscope treatment tool 200 for treating an affected part has a multi-joint bending mechanism. The endoscope treatment tool 200 in this embodiment is an endoscope treatment tool inserted into the body as described above.
The endoscope treatment tool 200 has an insertion portion 202 that is inserted into the body. The proximal end of the insertion unit 202 is connected to a drive control unit 203 that controls the driving of the endoscope treatment tool 200. The drive control unit 203 is a bending drive unit that drives the bending unit 211 in the insertion unit 202 to be bent. The drive control unit 203 is provided with a treatment instrument operation unit 201 that operates a grasping forceps 213 described later.

  As shown in FIG. 3, the insertion portion 202 includes a flexible tube portion (soft portion) 210, a bending portion 211 connected to the tip of the flexible tube portion 210, and a tip connected to the tip of the bending portion 211. Part 212. As shown in FIGS. 1 and 3, the insertion portion 202 protrudes (inserts) into the body from the distal end opening 39 a through the insertion port 40 and the treatment instrument channel 39. Note that the bending portion 211 and the distal end portion 212 are the distal end of the endoscope treatment tool 200.

  The flexible tube portion 210 has elasticity and flexibility, and is bent by an external force.

  The bending portion 211 has an articulated bending mechanism and bends up and down and left and right as desired. Specifically, as shown in FIG. 3, the bending portion 211 includes a node ring 221, a node ring 222, a node ring 223, and a node ring 224, and the node ring 221, the node ring 222, the node ring 223, and the node ring 224. Are connected to each other. Note that the number of node rings to be connected is not limited to four, and may be at least two. The node ring 221, the node ring 222, the node ring 223, and the node ring 224 are formed of an annular member, and are coaxially arranged in a line in the long axis direction of the insertion portion 202. The node ring 221, the node ring 222, the node ring 223, and the node ring 224 are rotatably connected between adjacent node rings, thereby forming an articulated bending mechanism. The node ring 224 is a node ring that is connected to the distal end of the flexible tube portion 210 and is disposed on the most proximal side of the bending portion 211.

The node ring 221 and the node ring 222 are connected so as to be rotatable about the first rotation shaft portion 225, and are connected rotatably by the first rotation shaft portion 225. The node ring 221 and the node ring 222 are relatively rotatable in the left-right direction when viewed from the base end side.
The node ring 222 and the node ring 223 are connected so as to be rotatable about the second rotation shaft portion 226, and are connected rotatably by the second rotation shaft portion 226. The node ring 222 and the node ring 223 are relatively vertically rotatable when viewed from the base end side.
The node ring 223 and the node ring 224 are connected so as to be rotatable about the third rotation shaft portion 227, and are connected rotatably by the third rotation shaft portion 227. The node ring 223 and the node ring 224 are relatively rotatable in the left-right direction as viewed from the base end side.

  The articulated bending mechanism configured as described above is covered with a flexible outer skin (not shown). Thereby, the bending part 211 is comprised.

  The distal end portion 212 is provided with a grasping forceps 213 that is a treatment instrument main body for treating an affected area. The grasping forceps 213 includes grasping members 213a and 213b that open and close as shown in FIGS. 1 and 3 by an operation wire 234 inserted through the insertion portion 202. The distal end portion 212 is not limited to the grasping forceps 213 but may be provided with a treatment instrument such as a high-frequency knife or a high-frequency coagulator.

  Note that the endoscopic treatment tool 200 for treating an affected part may have only a treatment tool such as a grasping forceps 213, a high-frequency knife, or a high-frequency coagulator at the tip without having a multi-joint mechanism.

  Note that a pair of operation wires 231, 232, and 233 that individually correspond to the node rings 221, 222, and 223 described above are connected. In the bending portion 211, when the pair of operation wires 231, 232, 233 is appropriately selected and pushed and pulled, the node rings 221, 222, 223 rotate independently.

  Thus, a multi-joint mechanism is formed, and the bending portion 211 is configured to be able to bend in four directions, up, down, left, and right.

  Various means can be adopted as means for connecting the distal ends of the operation wires 231, 232, 233 to the node rings 221, 222, 223, for example, brazing and fixing.

  As shown in FIG. 3, the drive control unit 203 is provided with a bending portion operating mechanism and a treatment portion operating mechanism.

  The bending portion operating mechanism includes drive motors 251, 252, and 253 that push and pull the operation wires 231, 232, and 233, respectively.

  The treatment section operation mechanism includes a drive motor 254 for pushing and pulling the operation wire 234.

  The operation wires 231, 232, and 233 correspond to the node rings 221, 222, and 223 to be rotated and are rotated. The operation wire 234 operates the grasping forceps 213.

  Pulleys 255 are attached to the drive shafts of the drive motors 251, 252, 253, and 254, respectively. Each drive shaft may be connected to each pulley 255 via a speed reducer (not shown). Operation wires 231, 232, 233, and 234 are hung on each pulley 255. When the drive motors 251, 252, 253, and 254 are individually driven and the pulley 255 rotates, the operation wires 231, 232, 233, and 234 hung on the pulley 255 are pushed and pulled.

  As the bending portion operating mechanism and the treatment portion operating mechanism, a transmission mechanism using a pulley 255 is used. However, for example, a pinion gear or a gear mechanism using a rack may be used. The bending portion operating mechanism and the treatment portion operating mechanism may use other types of drive actuators instead of the drive motors 251, 252, 253, and 254.

  As shown in FIGS. 1 and 3, the drive control unit 203 is connected to the treatment instrument control unit 258 via a cable 257. A bending operation unit 204 as an operation input device is connected to the treatment instrument control unit 258 via a cable 259. The treatment instrument control unit 258 is provided with a power supply power cord 290 as shown in FIG.

  The bending operation unit 204 includes, for example, a joystick (operation input device) 205 that instructs the position and posture of the endoscope treatment tool 200 when operated by, for example, an operator. The joystick 205 has three joystick switches 205a, 205b, and 205c that are connected in three layers. The joystick switches 205a, 205b, and 205c are attached to the operation box 206.

  FIG. 3 illustrates the drive control unit 203, the treatment tool control unit 258, and the bending operation unit 204 for one endoscope treatment tool 200. Further, as described above, when a plurality of endoscope treatment tools 200 are inserted into one treatment tool channel 39, the drive control unit 203 and the treatment tool control unit for each of the endoscope treatment tools 200 are provided. 258 and the bending operation unit 204 are arranged.

  As shown in FIG. 1, the treatment instrument control unit 258 has a function control input unit 258 a for inputting an instruction output from the joystick 205, a condition for controlling the function of the joystick 205, and the like, and drive motors 251, 252, A motor driver (treatment instrument drive control unit) 258b that controls the drive of H.253, and a motor unit communication unit 258c that is connected to the drive control unit 203 via the cable 257 and communicates with the drive control unit 203 are provided. .

When the joystick switches 205a, 205b, and 205c are selectively operated, the treatment instrument control unit 258 sends a control signal for driving the drive motors 251, 252, and 253 to the motor driver 258b in accordance with the operation of the joystick 205 by the operator. Then, the drive motors 251, 252, and 253 are rotated. That is, the drive motors 251, 252, and 253 are individually driven in response to the operation of the joystick 205. As a result, the operation wires 231, 232, and 233 are respectively pushed and pulled by the rotating pulley 255, the node rings 221, 222, and 223 are individually independently rotated in the vertical and horizontal directions, and the joint portions are bent. . That is, the bending portion 211 is bent.
As described above, the bending operation unit 204 is an operation input device that operates the drive control unit 203 and performs a bending operation on the bending unit 211. The electric endoscope treatment tool 200 constitutes a manipulator (master slave) type electric endoscope treatment tool. In addition, when the joystick 205 is operated by an operator or the like after the control for moving the endoscope treatment tool 200 is set, the operation instruction for the joystick 205 is given priority.

  The drive motors 251, 252, and 253 are provided with encoders (not shown) that measure the number of rotations. The encoder generates a signal corresponding to the number of rotations and transmits it to the motor driver 258b to perform feedback control on the drive motors 251, 252, and 253.

Next, the treatment instrument channel 39, the distal end opening 39a, the insertion port 40, the medical advance / retreat amount regulating mechanism 50, and the endoscope treatment instrument 200 will be described.
The medical advance / retreat amount regulating mechanism 50 moves forward and backward with respect to the distal end opening 39a, which is the distal end of the treatment instrument channel 39, when the bending portion 211 and the distal end portion 212, which are the distal ends of the endoscope treatment instrument 200, move forward and backward. The advance / retreat amount of the bending portion 211 and the tip portion 212 with respect to the tip opening 39a is restricted. As shown in FIGS. 1 and 4A, the medical advance / retreat amount restriction mechanism 50 includes a restriction member 60 that is detachably attached to the insertion port 40, and a contact portion 80 that is disposed in the flexible tube portion 210. Have.

  The restricting member 60 shown in FIGS. 4A and 4B has, for example, a cylindrical shape and is made of an elastic material. Examples of the elastic material include elastomers, silicon, rubbers such as butyl rubber, isopropylene rubber, and silicon rubber. The restricting member 60 protrudes from the tip 61 a of the restricting member 60, has three leg portions 62 that are arranged at equal intervals in the circumferential direction of the restricting member 60, and a claw portion 63 that is provided at the tip of the leg portion 62. And an O-ring 64 provided on the inner peripheral surface of the leg portion 62. The claw part 63 and the O-ring 64 are attachment parts for the restriction member 60 to be detachably attached to the insertion port 40. When the restricting member 60 is attached to the insertion port 40, the leg portion 62 comes into contact with the side surface of the insertion port 40, the claw portion 63 is fitted into the distal end side surface of the insertion port 40, and the O-ring 64 is the base end of the insertion port 40. Adhere to the side.

  At the distal end 61a, the restricting member 60 extends from the side surface 60a of the restricting member 60 with respect to the longitudinal axis direction of the restricting member 60 (the direction in which the endoscope treatment tool 200 advances or retreats (forwards or retreats) the treatment instrument channel 39). It has an end face 65a which is a plane protruding substantially vertically. In other words, the end surface 65 a is a surface that protrudes from the side surface 60 a toward the inner peripheral side of the regulating member 60, and is a plane that is perpendicular to the longitudinal axis direction of the regulating member 60. The restricting member 60 has an end surface 66a similar to the end surface 65a at the base end 61b. The end surface 65 a is a distal end side end surface of the regulating member 60, and the end surface 66 a is a proximal end side end surface of the regulating member 60. The above-described O-ring 64 is disposed on the distal end side of the end face 65a. The end surface 66a is formed of an elastic material as described above, for example.

  The restricting member 60 has an opening 65b formed in the end surface 65a and an opening 66b formed in the end surface 66a in the same straight line as the opening 65b in the longitudinal axis direction of the restricting member 60. . The opening 65b is formed in the central portion in the radial direction of the end surface 65a, and the opening 66b is formed in the central portion in the radial direction of the end surface 66a. The diameter D1 of the opening 65b and the diameter D2 of the opening 66b are larger than the diameter D3 of the insertion portion 202 such as the flexible tube portion 210. Therefore, the endoscope treatment tool 200 (flexible tube portion 210) is freely inserted into the openings 65b and 66b. That is, the endoscope treatment tool 200 (flexible tube portion 210) is inserted into the restriction member 60 toward the treatment tool channel 39.

  At this time, the end faces 65a and 66a are caused by the abutting portion 80 coming into contact with the end faces 65a and 66a when the endoscope treatment instrument 200 (flexible tube section 210) moves forward and backward in the treatment instrument channel 39. The advance / retreat movement of the endoscope treatment tool 200 (flexible tube section 210) is restricted.

  Between the end surface 65a and the end surface 66a, a space portion 68 is formed in which the abutting portion 80 can move forward and backward along the longitudinal axis direction of the regulating member 60. The length L1 of the space 68 in the direction substantially orthogonal to the longitudinal axis direction of the regulating member 60 is larger than the diameter D1 of the opening 65b, the diameter D2 of the opening 66b, and the diameter D3 of the insertion portion 202. The length L1 is the length (diameter) of the space portion 68 and the inner diameter of the regulating member 60.

  The abutting portion 80 abuts against either the end surface 65a or the end surface 66a that contacts the space portion 68 when the flexible tube 210 is inserted through the regulating member 60 and moves forward and backward relative to the regulating member 60. The amount of protrusion of the bending portion 211 that is the tip of the endoscope treatment tool 200 protruding from the treatment tool channel 39 is regulated by being applied to 65a, and the tip of the endoscope treatment tool 200 is applied to the end surface 66a. The retraction amount of the distal end portion 212 is regulated to set the initial position of the distal end portion 212 in the treatment instrument channel 39.

  As shown in FIG. 4C, the abutting portion 80 is fitted in a groove 81 formed over the entire circumference of the outer peripheral surface of the flexible tube portion 210. The abutting portion 80 has a thickness that is greater than the depth of the groove 81.

  When the restriction member 60 is attached to the insertion port 40 by the claw portion 63 and the O-ring 64 and the endoscope treatment tool 200 is inserted into the treatment tool channel 39 via the restriction member 60 and the insertion port 40, FIG. As shown, the abutting portion 80 abuts against the end surface 66a. Since the end surface 66a is formed of an elastic material, the end surface 66a is elastically deformed toward the space portion 68 by the abutting portion 80 and is spread by the abutting portion 80 as shown in FIG. 5B. Thereby, the contact part 80 passes the opening part 66b, and will be arrange | positioned in the space part 68, as shown to FIG. 4A and FIG. 5C.

  When the abutting portion 80 is arranged in the space portion 68 in this manner, the abutting portion 80 faces the end surfaces 65a and 66a and the openings 65b and 66b. Further, the abutting portion 80 is disposed in the space portion 68, and the endoscopic treatment instrument 200 moves back and forth along the longitudinal axis direction of the regulating member 60, so that the abutting portion 80 also moves the space portion 68 of the regulating member 60. It moves forward and backward along the longitudinal direction. As a result, the abutting portion 80 abuts against the end surface 65a as shown in FIG. 5D or abuts against the end surface 66a as shown in FIG. 5E (surface contact).

  The outer diameter D4 of the abutting portion 80 is larger than the diameter D5 of the treatment instrument channel 39. The outer diameter D4 of the contact portion 80 is larger than the diameter D1 of the opening 65b and the diameter D2 of the opening 66b.

  As described above, the abutting portion 80 is obtained when the endoscope treatment instrument 200 (flexible tube portion 210) is inserted through the opening 66b and the abutting portion 80 is abutted against the end surface 66a as shown in FIG. 5A. In addition, as shown in FIG. 5B, the end surface 66a is elastically deformed and expanded so that it can pass through the opening 66b. In other words, the end surface 66a can be expanded by being elastically deformed toward the space 68 around the opening 66b when the abutting portion 80 abuts against the end surface 66a. The end surface 66a has an opening 66b through which the abutting portion 80 can pass when the end surface 66a is expanded when the diameter D2 is smaller than the outer diameter D4 of the abutting portion 80.

  The diameter D1 of the opening 65b is smaller than the diameter D2 of the opening 66b and the diameter D4 of the abutting portion 80. Therefore, unlike the end surface 66a, the end surface 65a is not spread about the opening 66b even when the abutting portion 80 contacts the end surface 65a. The diameter D1 of the opening 65b is preferably substantially the same as the diameter D5 of the treatment instrument channel 39.

  The opening 65b and the end surface 65a also serve as a prevention unit that prevents the contact portion 80 from moving forward from the end surface 65a to the distal end side (the treatment instrument channel 39). In other words, the opening 65b and the end surface 65a prevent the abutting portion 80 from moving forward in the longitudinal direction of the regulating member 60 relative to the end surface 65a, and the distal end opening 39a that is the distal end of the treatment instrument channel 39. It is also a regulation part which regulates the amount of projection of curved part 211 which is the tip of endoscope treatment tool 200 which projects from.

  The size of the diameter D1 of the opening 65b is not limited as long as the contact portion 80 can pass through the opening 66b and can be prevented from freely moving back and forth between the treatment instrument channel 39 and the space 68.

  The abutting portion 80 is preferably formed of a material harder than the regulating member 60. The abutting portion 80 may be formed of a plastic material such as polyolefin.

  The protrusion amount of the distal end of the endoscope treatment tool 200 protruding from the treatment tool channel 39 will be described. This protrusion amount means that when the endoscopic treatment instrument 200 is inserted into the treatment instrument channel 39, the abutting portion 80 abuts against the end surface 65a as shown in FIG. Even in the non-curved state, as shown in FIG. 6A, the node ring 224 disposed on the most proximal side is the distal end of the treatment instrument channel 39 in the bending portion 211 that is the distal end of the endoscope treatment instrument 200. This is an amount protruding from the tip opening 39a, which is a desired amount. That is, the abutting portion 80 abuts against the end surface 65a, thereby restricting the protruding amount of the bending portion 211 (node ring 224) protruding from the tip opening portion 39a and from the tip opening portion 39a to the bending portion 211 (node ring 224). Is projected by a desired amount.

  A length L2 from the end surface 65a to the end surface 66a to which the abutting portion 80 can move forward and backward is longer than a length L3 from the node ring 224 to the tip end portion 212 as shown in FIG. 4A. The length L2 is equal to the advance / retreat amount by which the contact portion 80 moves forward / backward. The amount of advancement / retraction is determined even if the distal end 212 is accommodated in the treatment instrument channel 39 from the position where the bending portion 211 (node ring 224) protrudes from the treatment instrument channel 39 and the endoscope 2 is bent in this state. This is the distance to the position where the mirror treatment instrument 200 (for example, the distal end portion 212) does not break due to contact with the inner peripheral surface of the treatment instrument channel 39, for example.

  Next, the initial position of the distal end of the above-described endoscope treatment tool 200 will be described. The initial position of the distal end of the endoscope treatment tool 200 means that when the endoscope treatment tool 200 is inserted into the treatment tool channel 39, the contact portion 80 contacts the end surface 66a as shown in FIG. 5E. Thus, even if the bending portion 12 is in a curved state or a non-curved state, the distal end portion 212 that is the distal end of the endoscope treatment instrument 200 is the distal end opening that is the distal end of the treatment instrument channel 39 as shown in FIG. 6B. It is disposed at the base end side by a desired distance from 39a and is accommodated in the treatment instrument channel 39. In this state, even if the endoscope 2 is bent, the endoscope treatment instrument 200 is not damaged as described above. . In this position, the distal end portion 212 may coincide with the distal end opening portion 39a, or the distal end portion 212 may be disposed on the proximal end side by a desired length from the distal end opening portion 39a.

Next, the operation method of this embodiment will be described in detail.
When the regulating member 60 is pushed toward the insertion port 40, the leg portion 62 comes into contact with the side surface of the insertion port 40, the claw portion 63 fits into the distal end side surface of the insertion port 40, and the O-ring 64 is connected to the insertion port 40. Close contact with the proximal side. As a result, the regulating member 60 is attached to the insertion port 40 as shown in FIG. 5A. At this time, the treatment instrument channel 39 communicates with the opening 65b through the insertion port 40.

  The insertion portion 202 is inserted into the treatment instrument channel 39 via the restriction member 60 and the insertion port 40. At this time, in order for the insertion part 202 to easily pass through the treatment instrument channel 39, it is preferable that the flexible tube part 11 and the bending part 12 are in an uncurved state. However, it is not always necessary to be in a non-curved state, as long as the insertion portion 202 can be easily inserted through the treatment instrument channel 39.

  When the flexible tube portion 210 in the insertion portion 202 is inserted into the treatment instrument channel 39, the contact portion 80 contacts the end surface 66a as shown in FIG. 5A. Therefore, the insertion of the flexible tube portion 210 into the treatment instrument channel 39 is temporarily stopped. At this time, the flexible tube portion 210 is caused to move to the treatment instrument channel 39 by the first force amount used when the flexible tube portion 210 is inserted into the treatment instrument channel 39 or a second force amount larger than the first force amount. As shown in FIG. 5B, the end surface 66a is elastically deformed toward the space 68. Therefore, the abutting portion 80 passes through the opening 66b and moves from the outside of the regulating member 60 to the space portion 68 as shown in FIG. 5C.

  When the abutting portion 80 moves to the space portion 68, the end surface 66a is elastically deformed toward the outside of the regulating member 60 by the elastic force of the end surface 66a formed of an elastic material, and as shown in FIG. 80 returns to the state before passing through the opening 66b.

  Further, when the flexible tube portion 210 is pushed in, the flexible tube portion 210 moves forward, and as shown in FIG. 5D, the contact portion 80 comes into surface contact (contacts) with the end surface 65a. At this time, the bending portion 211 (node ring 224) which is the distal end of the endoscope treatment tool 200 is desired from the distal end opening 39a as shown in FIG. 6A even when the bending portion 12 is in a curved state or a non-curved state. Protrusively. In other words, the contact portion 80 is in surface contact with the end surface 65a as shown in FIG. 5D, so that, for example, when the endoscope treatment tool 200 is used, the curved portion 211 (node ring) protruding from the distal end opening 39a. 224) is defined. At this time, even if the flexible tube portion 210 is pushed in by the first force amount or the second force amount, the end surface 65a and the opening portion 65b prevent the contact portion 80 from moving forward. Therefore, the protruding amount of the curved portion 211 (node ring 224) protruding from the tip opening 39a is always the same as the contact portion 80 comes into surface contact with the end surface 65a. Further, the bending portion 211 (node ring 224) is regulated by the end face 65a and the opening 65b with respect to the protruding amount protruding from the tip opening 39a.

  Further, when the flexible tube portion 210 is pulled, the flexible tube portion 210 moves backward, and as shown in FIG. 5E, the contact portion 80 comes into surface contact (contacts) with the end surface 66a. At this time, the distal end portion 212 which is the distal end of the endoscope treatment instrument 200 is disposed at the initial position in the treatment instrument channel 39 as shown in FIG. 6B even if the bending portion 12 is in a curved state or a non-curved state. The As described above, the initial position is such that the distal end portion 212 is disposed on the proximal end side by a desired distance from the distal end opening 39a and is accommodated in the treatment instrument channel 39, and the endoscope 2 is curved in this state. This is a position where the endoscope treatment tool 200 is not damaged. That is, the contact portion 80 is in surface contact with the end surface 66a as shown in FIG. 5E, so that the initial position of the distal end portion 212 in the treatment instrument channel 39 is determined before the treatment instrument 200 for endoscope is used, for example. It will be set.

  Further, since the abutting portion 80 is in surface contact with the end surface 66a, the abutting portion 80 and the end surface 66a can be used even if the endoscopic treatment tool 200 is pulled by the first force. Is prevented from further retreating than the position where the contact portion 80 and the end surface 66a are in contact with each other. That is, the abutting portion 80 and the end surface 66a are in surface contact with each other, so that the flexible tube portion 210 is prevented from moving backward, the amount of retraction of the distal end portion 212 is restricted, and the endoscope treatment tool 200 is inserted into the insertion port. 40 is prevented from being pulled out.

  5D, when the bending portion 211 (node ring 224) protrudes from the distal end opening 39a, the endoscope treatment tool 200 is operated by the joystick 205, and the endoscope 2 is operated by the operation unit 30. The affected area in the body is treated.

  When the treatment is completed, the endoscope treatment tool 200 is pulled out of the treatment tool channel 39, the insertion port 40, and the regulating member 60. When the endoscope treatment tool 200 is pulled out from the restricting member 60, the contact portion 80 contacts the end surface 66a as shown in FIG. 5E. At that time, as described above, the treatment tool 200 for endoscope 200 is moved by the first force amount or the second force amount, contrary to the movement of the contact portion 80 from the outside of the regulating member 60 to the space portion 68. By being pulled out, the end surface 66a is elastically deformed toward the outside of the regulating member 60 as shown in FIG. 5B. Therefore, the abutting portion 80 passes through the opening 66 b and moves from the space portion 68 to the outside of the regulating member 60. As a result, the endoscope treatment tool 200 is pulled out of the regulating member 60.

  Thereafter, the claw portion 63 is disengaged from the insertion port 40, the leg portion 62 is separated from the side surface of the insertion port 40, and the O-ring 64 is detached from the insertion port 40. As a result, the restricting member 60 is removed from the insertion port 40. Thereby, the operation of the present embodiment is completed.

  At the same time as the restriction member 60 is removed from the insertion port 40, the endoscope treatment tool 200 may be pulled out of the treatment tool channel 39 and the insertion port 40.

  As described above, in the present embodiment, the restricting member 60 is attached to the insertion port 40, and the advancing / retreating amount of the insertion portion 10 with respect to the treatment instrument channel 39 is restricted by merely attaching the contact portion 80 to the end surfaces 65a and 66a. The protruding amount of the curved portion 211 (node ring 224) protruding from the opening 39a can be easily regulated, and the initial position of the distal end portion 212 in the treatment instrument channel 39 can be easily set.

  Further, in the present embodiment, the abutting portion 80 is abutted against the end surface 65a, so that the distal end portion 212 is disengaged from the treatment instrument channel 39 against the operator's intention even when the bending portion 12 is in a curved state or a non-curved state. Protruding more than necessary can be prevented.

Further, in the present embodiment, the abutting portion 80 is abutted against the end surface 66a, so that the distal end portion 212 is at the proximal end side by a desired distance from the distal end opening 39a even when the bending portion 12 is in a curved state or a non-curved state. The distal end 212 is accommodated in the treatment instrument channel 39, and the initial position is set so that the endoscope treatment instrument 200 is not damaged even if the endoscope 2 is bent.
Accordingly, in the present embodiment, the abutting portion 80 is applied to the end surface 66a, so that the distal end portion 212 can be reliably stored in the treatment instrument channel 39 even when the bending portion 12 is in a curved state or a non-curved state. It is possible to prevent the distal end 212 thus formed from being damaged by the bending of the endoscope 2.

  Further, in the present embodiment, as shown in FIG. 4A, the length L2 from the end surface 65a to the end surface 66a is made longer than the length L3 from the node ring 224 to the tip portion 212, thereby making the curved portion 211 the tip opening 39a. Thus, the distal end portion 212 can be reliably stored in the treatment instrument channel 39.

  Further, in this embodiment, by fitting the abutting portion 80 into the groove 81, even if the abutting portion 80 abuts against the end surfaces 65a and 66a, it can be prevented from coming out of the groove 81, and the deviation between the protruding amount and the initial position Can be prevented.

  Further, in the present embodiment, even when the restriction member 60 is attached to the insertion port 40, the endoscope treatment tool 200 can be pulled out from the treatment tool channel 39, the insertion port 40, and the restriction member 60. Therefore, the present embodiment can ensure cleanability and disinfection for the endoscope treatment tool 200.

  In the present embodiment, the restriction member 60 is removed from the insertion port 40, and at the same time, the endoscope treatment tool 200 can be pulled out from the treatment tool channel 39 and the insertion port 40. Therefore, since this embodiment can implement the operation | movement which removes the control member 60, and the operation | movement which pulls out the treatment tool 200 for endoscopes at once, the effort after a treatment can be saved.

  In the present embodiment, it is preferable that the restricting member 60 is formed of an elastic material, and the abutting portion 80 is formed of a material harder than the restricting member 60. However, the present invention is not limited to this. The contact portion 80 may be formed of, for example, an elastic material, and the restriction member 60 may be formed of a material harder than the contact portion 80.

  In the present embodiment, in order to prevent a deviation between the protruding amount and the initial position, the contact portion 80 is fitted in the groove 81, but it is not necessary to limit to this. For example, the contact portion 80 may be directly fixed to the outer peripheral surface of the flexible tube portion 210. In addition, a protrusion similar to the abutting portion 80 may be provided on the outer periphery of the flexible tube portion 210.

  In the present embodiment, the end surface 66a may have a notch 66c formed along the periphery of the opening 66b as shown in FIG. In FIG. 7, the illustration of the flexible tube portion 210 on the claw portion 63 side is omitted for the sake of simplicity.

  As a result, when the end surface 66a is elastically deformed by the abutting portion 80, the end surface 66a is easily pushed out by the notch portion 66c. Therefore, in the present embodiment, the abutting portion 80 can be easily passed through the opening 66b, and the endoscope treatment instrument 200 including the abutting portion 80 is easily inserted into or removed from the regulating member 60. can do.

Next, a first modification of the present embodiment will be described with reference to FIGS. 8A to 8F, FIGS. 9A to 9C, and FIGS. 10A to 10C.
In this modified example, as shown in FIG. 8A, the contact portion 80 and the opening 66b have a tapered shape that is tapered toward the insertion direction of the endoscope treatment tool 200 and whose diameter is reduced. Yes. The abutting portion 80 having a tapered shape can be inserted through the opening 66b having a tapered shape.

  As shown in FIG. 8B, the restricting member 60 in the present modification has, for example, a hollow prismatic shape. Therefore, as shown in FIGS. 8A to 8C, the regulating member 60 does not have the leg portion 62 and the claw portion 63 and can be detachably attached to the distal end surface 69 by a fastening member such as a screw 42. An attachment member 70 is provided.

  As shown in FIG. 8C, the tip mounting member 70 has a substantially U-shape when seen in a plan view from a direction orthogonal to the longitudinal axis direction of the regulating member 60. The tip attachment member 70 is relatively opposite to the first leg portion (leg portion 71a) which is one of the U-shaped sides opposed to each other when the tip attachment member 70 is viewed in plan view. A second leg portion (leg portion 71b) which is the other side of the U-shaped side, and a groove portion 71c formed between the leg portion 71a and the leg portion 71b. When the tip attachment member 70 is attached to the tip surface 69, the leg portion 71 a and the leg portion 71 b abut against the tip surface 69.

  The tip mounting member 70 has four engagement ports 72 for engaging the screws 42 and a through port 73 through which the endoscope treatment tool 200 (flexible tube portion 210) can pass. The engagement port 72 and the through-hole 73 penetrate the tip mounting member 70 in the longitudinal axis direction of the regulating member 60. The through-hole 73 is disposed in the approximate center of the tip mounting member 70, and the engagement port 72 is disposed around the through-hole 73.

  As shown in FIGS. 8A and 8B, the end surface 65 a in this modification is disposed at the middle end 61 c of the regulating member 60. An O-ring 64 is disposed on the distal end side of the end surface 65a.

  As shown in FIG. 8B, the space portion 68 is communicated with the space portion 68 on the inner side of the distal end 61 a of the restricting member 60, and the endoscope treatment tool 200 (flexible tube portion 210) can be inserted in the same manner as the space portion 68. 68a is formed. The distal end surface 69 to which the distal end mounting member 70 is attached is disposed at substantially the center of the distal end surface 69, communicates with the space 68a, and allows the endoscope treatment tool 200 (flexible tube portion 210) to pass therethrough. 69a and four engagement ports 69b that are disposed around the through-hole 69a and for engaging the screw 42 that attaches the distal end mounting member 70 to the distal end surface 69 are disposed. The diameter D6 of the through hole 69a is substantially the same as the outer diameter D7 of the insertion port 40, and is the length of the space portion 68a in a direction substantially orthogonal to the longitudinal axis direction of the regulating member 60.

  The through-hole 69 a faces the through-hole 73 and has the same size as the through-hole 73. The engagement port 69 b faces the engagement port 72.

  Next, a stopper 90 for detachably attaching the regulating member 60 of this modification to the insertion port 40 will be described with reference to FIGS. 8D to 8F. The stopper 90 is detachably attached to the insertion port 40 by sliding the groove 71 c in a direction orthogonal to the longitudinal axis direction of the restriction member 60. The width L4 of the stopper 90 is shorter than the length L5 of the groove 71c shown in FIG. 8C. The length L4 is preferably substantially the same as the length L5.

  The stopper 90 is inserted by sliding the through hole 90a that can penetrate the outer diameter of the insertion hole 40 and the stopper 90 that penetrates the through hole 90a in a direction perpendicular to the longitudinal axis direction of the regulating member 60. It has an engagement port 90 b that engages with the cylindrical portion 41 in the port 40.

  The diameter D8 of the through-hole 90a is larger than the outer diameter D7 of the insertion port 40. The diameter D9 of the engagement port 90b is smaller than the outer diameter D7 of the insertion port 40 and is substantially the same as the outer diameter D10 of the cylindrical portion 41.

  The through-hole 90a is used when the regulating member 60 is detachably attached from the insertion port 40. The engagement port 90 b communicates with the through-hole 90 a and is used when the restricting member 60 is attached to the insertion port 40. That is, the stopper 90 and the O-ring 64 are attachment portions for attaching the regulating member 60 to the insertion port 40 in a detachable manner. As shown in FIGS. 8A and 8F, the fastener 90 has a tapered shape that tapers from the engagement port 90b toward the through port 90a in the peripheral portion 90c of the through port 90a.

Next, a method for attaching the regulating member 60 in this modification will be described with reference to FIGS. 9A and 9B.
In a state where the stopper 90 is disposed in the groove portion 71c, the leg portion 71a and the leg portion 71b are brought into contact with the distal end surface 69. Next, when the screw 42 is engaged with the engagement port 72 and the engagement port 69b, the tip attachment member 70 is attached to the tip surface 69 as shown in FIG. 9A. At this time, the through hole 90a faces the through hole 73 and the through hole 69a.

  When the through port 73 moves toward the insertion port 40, the insertion port 40 is disposed in the space portion 68 a and abuts on the O-ring 64, and the cylindrical portion 41 is disposed in the through port 73. Since the diameter D6 of the through hole 69a (the length of the space 68a) and the outer diameter D7 of the insertion port 40 are substantially the same, the restricting member 60 is relative to the insertion port 40 in the longitudinal axis direction of the restricting member 60. It is possible to prevent a shift in a substantially orthogonal direction.

  As shown in FIG. 9B, when the stopper 90 slides in the groove 71c in a direction perpendicular to the longitudinal axis direction of the regulating member 60, the cylindrical portion 41 engages with the engagement port 90b. In addition, since the peripheral part 90c is a taper shape, the fastener 90 slides smoothly. At that time, the peripheral portion 90 c presses the insertion port 40 toward the O-ring 64.

  Thereby, the restricting member 60 is attached to the insertion port 40 by the stopper 90 without rattling.

  In this modification, the stopper 90 has a claw portion 91 that prevents the stopper 90 from sliding due to the elastic force of the O-ring 64 and the engagement port 90b from coming off the cylindrical portion 41 as shown in FIG. 9C. Also good.

  FIG. 10A to FIG. 10C show a state in which the abutting portion 80 moves from the outside of the regulating member 60 to the space portion 68 in this modified example, but the operation method at this time is substantially the same as that of FIG. 5A to FIG. 5C described above. Therefore, detailed description is omitted. Further, the state in which the abutting portion 80 abuts against the end faces 65a and 66a is substantially the same as that in FIGS. 5D to 5E described above, and thus detailed description thereof is omitted.

Accordingly, in the present modification, the contact portion 80 can be easily inserted into the space portion 68 from the outside of the restriction member 60 due to the tapered shape, and the insertion portion 202 can be easily inserted into the treatment instrument channel 39 via the restriction member 60. Can be inserted. In this modification, only one of the contact part 80 and the opening 66b may have a tapered shape.
Further, in this modification, the regulating member 60 can be easily attached to the insertion port 40 in a detachable manner by sliding the stopper 90 in a direction orthogonal to the longitudinal axis direction of the regulating member 60. Further, since the peripheral portion 90c presses the insertion port 40 toward the O-ring 64, in this modification, the restricting member 60 can be attached to the insertion port 40 by the stopper 90 without rattling.

Next, a second modification of the present embodiment will be described with reference to FIG.
In the present modification, as shown in FIG. 11, a thread groove 80a that is a male screw is formed on the peripheral edge of the abutting portion 80, and a screw groove 66d that is a female thread is formed on the peripheral edge of the opening 66b.
The restricting member 60 is detachably attached to the insertion port 40 by the attachment mechanism 94 instead of the claw portion 63 and the O-ring 64. The attachment mechanism 94 includes, for example, a screw groove 62 a that is a female screw formed on the inner peripheral surface of the leg portion 62, and a screw groove 40 a that is a male screw formed on the peripheral edge portion of the insertion port 40. .

  Thus, in this modification, the abutting portion 80 can be easily passed through the opening 66b by screwing the abutting portion 80 into the opening 66b, and the flexible tube portion 210 can be passed through the restricting member 60. Can be easily inserted or removed. Further, in the present modified example, since the abutting portion 80 can be easily passed through the opening 66b by screwing, the regulating member 60 can be achieved only by the first force amount without using the second force amount described above. On the other hand, the endoscope treatment tool 200 can be easily inserted or removed.

  Further, in this modification, the regulating member 60 can be detachably attached to the insertion port 40 by screwing the regulating member 60 into the insertion port 40 via the leg portion 62.

  The contact portion 80 and the regulating member 60 may be formed of a hard metal or the like for the screw grooves 62a, 66d, and 80a.

Next, a third modification of the present embodiment will be described with reference to FIGS. 12A to 12D.
In this modification, the contact part 80 can be divided into, for example, two in the circumferential direction as shown in FIG. 12A. The abutting portion 80 has an engaging portion 82 for re-engaging after the division, and a protrusion 83 for fitting into the groove 81. The number to be divided is not limited.

The flexible tube portion 210 has a plurality of grooves 81 as shown in FIG. 12B. The abutting portion 80 of the present modification is movable along the longitudinal axis direction of the flexible tube portion 210 as shown in FIGS. 12B to 12D, and is changed in arrangement from one groove 81 to the other groove 81. Is possible.
Accordingly, in the present modification, the initial position of the distal end portion 212 in the treatment instrument channel 39 can be adjusted in multiple stages by the groove 81.

Next, a fourth modification of the present embodiment will be described with reference to FIGS. 13A to 13D.
In this modification, the abutting portion 80 may be an elastic ring that is a substantially C-shaped elastic body having a notch 85. The abutting portion 80 is detachably fitted into the flexible tube portion 210 via the notch portion 85. Thus, in the present modification, the abutting portion 80 can be reused by making the abutting portion 80 detachable with respect to the flexible tube portion 210.

  In the above-described embodiment and each modified example, the restriction member 60 attached to the insertion port 40 includes a drive control unit that is provided with an endoscope treatment tool 200 outside the endoscope 2 as illustrated in FIG. 14A. A guide tube (guide pipe) 100 for guiding from 203 to the treatment instrument channel 39 via the insertion port 40 may be detachably attached. At this time, the guide tube 100 may be detachably attached to the end surface 66a.

Next, a fifth modification of the present embodiment will be described with reference to FIG.
In the above-described embodiment and modifications, the overtube 101 serving as an in-vivo guide member that guides the endoscope treatment tool 200 (insertion unit 202) into the body may be used.
The overtube 101 includes a treatment instrument channel 103 through which the endoscope treatment instrument 200 can be inserted, and an endoscope channel 104 through which the endoscope 2 can be inserted.

  In the treatment instrument channel 103, a distal end opening portion 103 a that is a distal end and a projecting opening from which the endoscope treatment instrument 200 projects and an endoscope treatment instrument 200 that is a proximal end are inserted into the treatment instrument channel 103. An insertion port 103b is provided. The distal end opening 103 a communicates with the insertion port 103 b through the treatment instrument channel 103. The endoscope treatment tool 200 is inserted through the insertion port 103b, the treatment tool channel 103, and the distal end opening 103a.

The insertion port 103b is the same as the insertion port 40. Therefore, the restricting member 60 is detachably attached to the insertion port 103b in the same manner as in the above-described embodiment and modifications. The treatment instrument channel 103 is the same as the treatment instrument channel 39, and the distal end opening 103a is similar to the distal opening 39a.
That is, the structure and operation of the overtube 101 are substantially the same as the structure and operation of the endoscope 2 provided with the treatment instrument channel 39 except that the endoscope channel 104 through which the endoscope 2 can be inserted is provided. Are identical.

  The endoscope channel 104 has a distal end opening 104 a that is a distal end and a projecting opening from which the endoscope 2 projects, and an endoscope 2 that is a proximal end for insertion into the endoscope channel 104. An insertion port 104b is provided. The distal end opening 104 a communicates with the insertion port 104 b through the endoscope channel 104. The endoscope 2 is inserted through the insertion port 104b, the endoscope channel 104, and the distal end opening 104a.

  FIG. 16 is a perspective view of the external channel 105 having the same configuration as that of the fifth modification. As in the fifth example, the external channel 105 is an in-vivo guide member that guides the endoscope treatment tool 200 (insertion unit 202) into the body in the above-described embodiment and modifications. The external channel 105 has a treatment instrument channel (not shown) into which the endoscope treatment instrument 200 (insertion section 202) can be inserted, and is used by being attached to the endoscope 2. The point that the restricting member 60 is detachably attached to the insertion port (not shown) of the treatment instrument channel is the same as in the fifth modification.

(Appendix)
The invention having the following configuration can be extracted from the specific embodiment.

(1) An endoscope treatment tool inserted into a body has an insertion port disposed in an in-vivo guide member that guides the endoscope treatment tool into the body, and a treatment tool channel communicating with the insertion port. When the distal end of the guided endoscopic treatment instrument advances and retreats with respect to the distal end of the treatment instrument channel, the guide of the treatment instrument channel is guided. A medical advance / retreat amount regulating mechanism for regulating the advance / retreat amount of the distal end of the endoscope treatment tool with respect to the distal end,
The endoscope treatment tool is detachably attached to the insertion port, the endoscope treatment tool can be inserted toward the treatment tool channel, and the endoscope treatment tool moves forward and backward in the treatment tool channel. A restricting member having a distal end side end surface and a proximal end side end surface for restricting advance / retreat movement of the treatment instrument for endoscope;
Any one of the distal end side end surface and the proximal end side end surface is disposed in the endoscope treatment tool and the endoscope treatment tool is inserted into the restriction member and moves forward and backward with respect to the restriction member. The amount of protrusion of the endoscope treatment instrument protruding from the distal end of the treatment instrument channel is regulated by being applied to either one of them and the end face on the distal end side, and applied to the proximal end face. A contact portion for regulating a retreat amount of the distal end of the endoscope treatment instrument and setting an initial position of the distal end of the endoscope treatment instrument in the treatment instrument channel;
A medical advance / retreat amount regulating mechanism comprising:

(Correspondence with embodiment)
The embodiment relating to the medical advance / retreat amount regulating mechanism described in (1) corresponds to, for example, one embodiment and first to fifth modifications. For example, in one embodiment and each modification, the endoscope treatment tool 200 corresponds to the endoscope treatment tool, and the endoscope 2 and the overtube 101 correspond to the in-vivo guide member.

(Function and effect)
According to the medical advance / retreat amount regulating mechanism described in (1), for example, an endoscopic treatment tool that regulates the advance / retreat amount of the endoscope treatment tool with respect to the treatment tool channel and projects from the distal end of the treatment tool channel. The projection amount of the distal end of the endoscope can be easily regulated, and the initial position of the distal end of the endoscope treatment instrument in the treatment instrument channel can be easily set.

  (2) The abutting part is abutted against the end surface on the distal end side, so that even if the in-vivo guide member is in a curved state or a non-curved state, The medical advance / retreat amount regulating mechanism according to (1), wherein the projection amount of the distal end is regulated, and the distal end of the treatment instrument channel is projected by a desired amount from the distal end of the endoscope treatment instrument.

(Function and effect)
According to the medical advance / retreat amount regulating mechanism described in (2), even if the in-vivo guide member is in a curved state or a non-curved state, for example, by applying the abutting portion to the distal end side surface, It can prevent that the front-end | tip of a treatment tool protrudes from a treatment tool channel more than necessary contrary to an operator's intention.

  (3) The tip of the endoscopic treatment instrument is positioned in the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state by abutting the abutting portion on the proximal end surface. The medical advance / retreat amount regulating mechanism according to (1), wherein the initial position, which is a position that is disposed on the proximal end side by a desired distance from the distal end of the needle and is stored in the treatment instrument channel, is set.

(Function and effect)
According to the medical advance / retreat amount regulating mechanism described in (3), even when the in-vivo guide member is in a curved state or a non-curved state, for example, by applying the contact portion to the proximal end surface, the endoscope The distal end of the treatment instrument can be securely stored in the treatment instrument channel, and the distal end of the stored endoscope treatment instrument contacts the inner peripheral surface of the treatment instrument channel against the operator's intention and is damaged. Can be prevented.

  (4) The length from the distal end surface to the proximal end surface where the abutting portion is movable back and forth is from the curved portion that is disposed on the endoscope treatment tool and can be bent. The medical advance / retreat amount regulating mechanism according to (1), characterized in that it is longer than the length to the distal end of the treatment instrument.

(Correspondence with embodiment)
For example, in one embodiment, the length L2 from the end surface 65a to the end surface 66a is the length from the distal end side end surface to the base end side end surface, and the bending portion 211 (node ring 224) and the bending portion 12 are the bending portion. Further, the length L3 from the node ring 224 to the distal end portion 212 corresponds to the length from the curved portion to the distal end of the endoscope treatment tool.

(Function and effect)
According to the medical advance / retreat amount regulating mechanism described in (4), for example, the bending portion can be reliably protruded from the distal end of the treatment instrument channel, and the distal end of the endoscope treatment instrument can be reliably inserted into the treatment instrument channel. Can be stored.

(5) An endoscope treatment tool inserted into the body has an insertion port disposed in an in-vivo guide member for guiding the endoscope treatment tool into the body, and a treatment tool channel communicating with the insertion port. Is inserted into the body by the in-vivo guide member, and the guided distal end of the endoscope treatment tool moves forward and backward relative to the distal end of the channel. A medical advance / retreat amount regulating method for regulating the advance / retreat amount of the distal end of the endoscope treatment tool,
The endoscope treatment tool can be inserted toward the treatment tool channel, and the endoscope treatment tool is restricted from moving forward and backward when the endoscope treatment tool moves back and forth in the treatment tool channel. A first step of detachably attaching a regulating member having a distal end side end surface and a proximal end side end surface to the insertion port;
A second step of inserting the endoscope treatment instrument into the treatment instrument channel via the restriction member and the insertion port;
Any one of the distal end side end surface and the proximal end side end surface is disposed in the endoscope treatment tool and the endoscope treatment tool is inserted into the restriction member and moves forward and backward with respect to the restriction member. A third step of restricting the protruding amount of the distal end of the treatment instrument for an endoscope projecting from the distal end of the treatment instrument channel by applying an abutting portion to be applied to either one of the distal end side surfaces;
The abutting portion is applied to the proximal end surface to regulate the retreat amount of the distal end of the endoscope treatment instrument, and the initial position of the distal end of the endoscope treatment instrument in the treatment instrument channel is set. A fourth step;
A medical advance / retreat amount regulating method characterized by comprising:

(Correspondence with embodiment)
In the embodiment relating to the medical advance / retreat amount regulating method described in (5), for example, one embodiment corresponds to the first to fifth modifications. Each component in the medical advance / retreat amount regulating method described in (5) is substantially the same as the component of the medical advance / retreat amount regulating mechanism described in (1).
For example, in one embodiment and each modification, the state shown in FIG. 5A is the first step, the states shown in FIGS. 5A, 5B, and 5C are the second step, and the state shown in FIG. The state shown in FIG. 5E corresponds to the third step and corresponds to the fourth step.

  As described above, the present invention is not limited to the above-described embodiments and modifications as they are, and can be embodied by modifying the components without departing from the scope of the invention in the implementation stage. Further, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment.

FIG. 1 is a diagram schematically showing an endoscope system according to an embodiment of the present invention. FIG. 2 is a diagram illustrating a bending state of the bending portion. FIG. 3 is a perspective view schematically showing the endoscope treatment tool. FIG. 4A is a cross-sectional view showing a state in which the restriction member is attached to the insertion port, the endoscope treatment tool is inserted through the restriction member, the insertion port, and the treatment tool channel, and the contact portion is disposed in the space. is there. FIG. 4B is a perspective view of the regulating member. FIG. 4C is a side view of the flexible tube portion. FIG. 5A is a diagram illustrating a state in which the contact portion moves from the outside of the regulating member to the space. FIG. 5B is a diagram illustrating a state in which the contact portion moves from the outside of the regulating member to the space. FIG. 5C is a diagram illustrating a state in which the contact portion is disposed in the space portion. FIG. 5D is a diagram illustrating a state in which the abutting portion is in surface contact with the end surface on the front end side. FIG. 5E is a diagram illustrating a state in which the abutting portion is in surface contact with the proximal end surface. FIG. 6A is a diagram for explaining the protruding amount of the distal end of the endoscope treatment tool protruding from the treatment tool channel. FIG. 6B is a diagram illustrating an initial position of the distal end of the endoscope treatment tool. FIG. 7 is a perspective view of a regulating member having a notch formed along the periphery of the opening. In FIG. 8A, the restriction member in the first modification is attached to the insertion port, the endoscope treatment tool is inserted through the restriction member, the insertion port, and the treatment tool channel, and the contact portion is disposed in the space. It is sectional drawing which shows a state. FIG. 8B is a cross-sectional view of the regulating member in the first modification. FIG. 8C is a perspective view of a regulating member in the first modified example. FIG. 8D is a perspective view of a fastener. FIG. 8E is a front view of the fastener. FIG. 8F is a cross-sectional view of the fastener. FIG. 9A is a diagram illustrating a state in which the restriction member is attached to the insertion port in the first modification. FIG. 9B is a diagram illustrating a state in which the restriction member is attached to the insertion port in the first modification. FIG. 9C is a diagram illustrating a regulating member having a claw portion in the first modification. FIG. 10A is a diagram illustrating a state in which the contact portion moves from the outside of the regulating member to the space in the first modification. FIG. 10B is a diagram illustrating a state in which the contact portion moves from the outside of the regulating member to the space in the first modification. FIG. 10C is a diagram illustrating a state in which the contact portion is disposed in the space portion in the first modification. In FIG. 11, the restriction member in the second modification is attached to the insertion port, the endoscope treatment tool passes through the restriction member, the insertion port, and the treatment tool channel, and the contact portion is disposed in the space. It is sectional drawing which shows a state. FIG. 12A is a cross-sectional view of a contact portion in a third modification. FIG. 12B is a diagram illustrating a state of the flexible tube portion having a plurality of grooves and the abutting portion fitted in one groove in the third modification. FIG. 12C is a diagram illustrating a state of the abutting portion moving from one groove to the other groove and the flexible tube portion in the third modification. FIG. 12D is a diagram showing a state of the flexible tube portion and the abutting portion fitted in the other groove in the third modified example. FIG. 13A is a cross-sectional view of an abutting portion and a flexible tube portion into which the abutting portion is fitted in a fourth modification. FIG. 13B is a perspective view of the abutting portion and the flexible tube portion into which the abutting portion is fitted in the fourth modified example. FIG. 13C is a diagram illustrating a state in which the contact portion is removed from the flexible tube portion. FIG. 13D is a diagram illustrating a contact portion and a flexible tube portion from which the contact portion has been removed in a fourth modified example. FIG. 14 is a cross-sectional view showing a state in which the guide tube is attached to the restriction member in the second modified example attached to the insertion port. FIG. 15 is a perspective view of an overtube in a fifth modification. FIG. 16 is a perspective view of an external channel having the same configuration as that of the fifth modification.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 2 ... Endoscope, 10 ... Insertion part, 11 ... Flexible tube part, 12 ... Bending part, 13 ... Hard tip part, 13a ... Tip surface, 39 ... Treatment instrument channel, 39a ... Tip opening part, 40 ... Insertion opening , 50 ... Medical advance / retreat amount regulating mechanism, 60 ... regulating member, 62 ... leg, 63 ... claw, 64 ... O-ring, 65a ... end face, 65b ... opening, 66a ... end face, 66b ... opening, 68 ... Space part, 80 ... Abutting part, 100 ... Guide tube, 101 ... Over tube, 103 ... Treatment instrument channel, 103a ... Tip opening, 103b ... Insertion port, 104 ... Endoscope channel, 105 ... External channel, 200 DESCRIPTION OF SYMBOLS Endoscopic treatment tool, 202 ... Insertion part, 210 ... Flexible tube part, 211 ... Bending part, 212 ... Tip part, 213 ... Grasping forceps, 221, 222, 223, 224 ... Node ring.

Claims (6)

An endoscope treatment instrument guided into the body by an in-vivo guide member is detachably attached to an insertion port communicating with a treatment instrument channel disposed in the in-vivo guide member through which the endoscope treatment instrument can be inserted. A medical advance / retreat amount regulation mechanism for regulating the advance / retreat movement of the endoscope treatment tool,
The endoscope treatment instrument has a first opening through which the endoscope treatment instrument can be inserted, and has a distal end side end face connected to the insertion port , and a second opening through which the endoscope treatment instrument can be inserted. A restricting member including a proximal end surface;
The endoscope is disposed on the endoscope treatment tool, passes through the second opening, and moves forward and backward between the distal end side end surface and the proximal end side end surface, whereby the endoscopic guide member with respect to the in-vivo guide member is moved. The abutting part that regulates the forward and backward movement of the mirror treatment tool,
Equipped with,
The abutting portion is abutted against the proximal end surface, so that the distal end of the endoscopic treatment instrument is separated from the distal end of the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state. A medical advance / retreat amount regulating mechanism , wherein an initial position, which is a position that is disposed on a proximal end side by a desired distance and is stored in the treatment instrument channel, is set .   The abutting portion is abutted against the distal end side end surface, so that the distal end of the endoscope treatment instrument with respect to the distal end of the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state. 2. The medical advance / retreat amount regulating mechanism according to claim 1, wherein a projection amount is regulated, and a distal end of the endoscope treatment instrument is projected from a distal end of the treatment instrument channel by a desired amount.   The length from the distal end side end surface to which the abutting portion is movable back and forth to the proximal end side surface is set on the endoscope from the proximal end side of the bending portion that is disposed on the endoscope treatment tool and can be bent. The medical advance / retreat amount regulating mechanism according to claim 1, wherein the medical advancement / retraction amount regulating mechanism is longer than a length of the treatment instrument.   An endoscope treatment instrument guided into the body by an in-vivo guide member is detachably attached to an insertion port communicating with a treatment instrument channel disposed in the in-vivo guide member through which the endoscope treatment instrument can be inserted. A medical advance / retreat amount regulation mechanism for regulating the advance / retreat movement of the endoscope treatment tool,
  The endoscope treatment instrument has a first opening through which the endoscope treatment instrument can be inserted, and has a distal end side end face connected to the insertion port, and a second opening through which the endoscope treatment instrument can be inserted. A restricting member including a proximal end surface;
  The endoscope is disposed on the endoscope treatment tool, passes through the second opening, and moves forward and backward between the distal end side end surface and the proximal end side end surface, whereby the endoscopic guide member with respect to the in-vivo guide member is moved. The abutting part that regulates the forward and backward movement of the mirror treatment tool,
  Comprising
  The length from the distal end side end surface to which the abutting portion is movable back and forth to the proximal end side surface is set on the endoscope from the proximal end side of the bending portion that is disposed on the endoscope treatment tool and can be bent. A medical advance / retreat amount regulating mechanism characterized by being longer than the length to the distal end of the medical treatment instrument.   The abutting portion is abutted against the distal end side end surface, so that the distal end of the endoscope treatment instrument with respect to the distal end of the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state. 5. The medical advance / retreat amount regulating mechanism according to claim 4, wherein a projection amount is regulated, and a distal end of the endoscope treatment instrument is projected by a desired amount from a distal end of the treatment instrument channel.   The abutting portion is abutted against the proximal end surface, so that the distal end of the endoscopic treatment instrument is separated from the distal end of the treatment instrument channel even when the in-vivo guide member is in a curved state or a non-curved state. The medical advance / retreat amount regulating mechanism according to claim 4, wherein an initial position, which is a position that is disposed at a proximal end side by a desired distance and is stored in the treatment instrument channel, is set.

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