JP5663712B2 - Endoscope aids - Google Patents

Description

  The present invention relates to an endoscope apparatus for use in colonoscopy and the like, and an auxiliary tool for an endoscope apparatus for use with a collective treatment tool such as a polyp, and more particularly, in the large intestine in colonoscopy and the like. Multiple tissues such as multiple polyps can be easily and safely excised without removing or reinserting the endoscopic device, and these polyps can be collected in a lump. The present invention relates to an endoscope apparatus auxiliary tool for use together with a collective treatment tool such as an endoscope apparatus and a polyp.

  Conventionally, colonoscopy is performed using an endoscope apparatus having an insertion portion, and when a lesion such as a polyp is found during this colonoscopy, It is common practice to remove a lesion such as a polyp with a treatment tool used in combination. The excised polyp or the like needs to be taken out for histological diagnosis or the like.

  Conventionally, when there is a polyp exceeding 5mm in the deep colon such as the ascending colon, polypectomy is performed, and the polyp taken is taken out from the treatment tool insertion port of the so-called tripod and captured. Then, the colonoscopy apparatus is pulled out and collected as it is to perform tissue diagnosis. However, polyps in the large intestine often occur not only in one place but also in multiple places at the same time. If a large polyp is found when the colonoscope is pulled out, the colonoscope is reinserted to remove the polyp. And had to be recovered. At this time, there was a problem that air increased in the large intestine, it took time to reinsert the endoscope, and the burden on the patient was heavy.

  When this polyp is very small, it can be collected by suction with a suction trap from various treatment tool insertion ports of the endoscope. At that time, the polyp may be destroyed, A large polyp exceeding 1800 was not able to be recovered because it did not enter into the processing tool insertion port.

  On the other hand, a rotary collection net device is already on the market as a treatment tool that collects such polyps and the like collectively after being cut out. Here, a specific configuration of the collection net device will be described with reference to FIG. FIG. 7 is a plan view showing a collection net device such as a commercially available polyp. A collection net device 80 such as a polyp is provided with a net portion 81 made of a soft fiber, and a net wire 82 made of a snare-like hard elastic wire is passed near the opening of the net portion 81, The shape of the opening of the portion 81 is held so as to be substantially oval so that a polyp can be easily received.

  A slide wire 84 is further connected to the end 83 of the snare-shaped net wire 82, and the slide wire 84 is connected to the net through an elongated flexible sheath 85 and a main body 86 attached integrally to the sheath 85. It extends to the ring 87. The sheath 85 and the finger ring 88 are integrally formed on the main body 86, and a slider 89 is slidably attached between the main body 86 and the finger ring 88. The slider 89 is provided with two rings 90a and 90b for inserting fingers at both ends, and a net ring attaching portion 91 for attaching and fixing the net ring 87 at the center.

  The method of using the collection net device 80 is as follows. First, one or a plurality of polyps are removed by a treatment tool separately inserted into a large intestine endoscope of a subject. Next, the tip of the net wire 82 is closed after the tip of the snare-shaped net wire 82 is opened and attached so as to support the open end of the net portion 81 in an open state. If it does so, the net part 81 will be in the state which does not remove | deviate from the snare-shaped net wire 82. FIG. Thereafter, the net ring 87 of the slide wire 84 is attached to the net ring attachment portion 91, and then the index finger and middle finger are respectively attached to the two rings 90a and 90b, the thumb is attached to the finger ring 88, and the slider 89 is placed on the finger ring 88 side. Move to. Then, since the end of the snare-shaped net wire 82 is drawn into the sheath 85, the central portion of the sheath-shaped net wire 82 is closed and becomes an elongated shape, and can be inserted into various treatment tool insertion ports of the colonoscope. .

  In this state, the collection net device 80 is inserted from various treatment tool insertion ports (not shown) such as forceps of the large intestine endoscope device inserted from the anus of the subject from the net portion 81 side. When the predetermined position is reached, the slider 89 is returned to the initial position. Then, the snare-shaped net wire 82 returns to its original state by its own elasticity, so that the opening of the net portion 81 is opened. Next, by rotating the main body 86, one or a plurality of polyps are collected into the net portion 81, and then the opening end of the net portion 81 is closed when the slider 89 is moved again to the finger ring 88 side. One or a plurality of polyps are collected.

  When the colonoscopy device is pulled out from the subject's anus at this stage, the net portion 81 is also pulled out together with it, so that one or a plurality of polyps can be taken out by one operation. By using this recovery net device 80, it is possible to safely and reliably recover the lesioned tissue that tends to fall apart, and to prevent the recovered tissue from being destroyed.

  However, when using the above-described commercially available collection net device 80, it is necessary to cut out polyps and the like in advance and collect a large number of the removed polyps in one place before collection. Even when a new polyp or the like is discovered when the colon device is withdrawn in the net device 80 and pulled out, the sheath 85 of the recovery net device 80 is inserted into various processing tool insertion ports of the colon endoscope device. Therefore, there has been a problem that it is impossible to insert a treatment tool for excising the newly discovered polyp or the like again. Of course, if a plurality of various treatment tool insertion ports can be provided in the colonoscope apparatus, a predetermined treatment is performed from various treatment tool insertion ports different from the various treatment tool insertion ports into which the sheath 85 of the collection net device 80 is inserted. Although a tool can be inserted, such a configuration is not practical because the outer diameter of the large intestine endoscope apparatus becomes too large and the pain given to the subject increases.

  Therefore, the present inventors have developed a novel polyp and other collective treatment tool that solves the problems of the conventional polyp and other such collective treatment tools (see Patent Document 1 below, hereinafter). The invention described herein is referred to as “prior invention”). A collective collecting tool such as a polyp of the prior invention will be described with reference to FIGS.

  8A is a partial cross-sectional view of the collection net and thread of the collective collection treatment tool such as a polyp of the prior invention, and a first flexible tube, and FIG. 8B is a second flexible tube and a snare. 8C is a perspective view of a state in which the members shown in FIGS. 8A and 8B are combined. FIG. 9A is a diagram showing a state where polyps and the like are collected at one place, and FIG. 9B is a diagram showing a state where polyps and the like are collected at two places.

  As shown in FIG. 8A, a collective treatment tool 10 such as a polyp of the prior invention has a collection net 12a having a flexible one end opened, and the opening end 14 of the collection net 12a is extremely fine. An annular ring 16 made of an annular thread, for example, an extra fine teg, is provided. One end of a thread 18a made of, for example, ultra-fine tegs is tied to an arbitrary position of the annular ring, and this thread 18a passes through the flexible first sheath 22 via the net stoppers 20a and 20b. And extends further outward from an opening 24 provided in the middle of the first sheath.

  The net stoppers 20a and 20b are slidably provided on the thread 18a. When the thread 18a is pulled, the opening end 14 of the recovery net 12a is squeezed and closed to maintain the state. It has resistance, and its size is larger than the outer diameter of the first sheath 22. Therefore, when the thread 18a is pulled in the state shown in FIG. 5A, the net stoppers 20a and 20b are caught by the opening end of the first sheath 22, and then the annular ring 16 is drawn into the net stoppers 20a and 20b. The opening end 14 of the collection net 12a is squeezed and closed.

  Furthermore, in the prior invention, as shown in FIG. 8B, the flexible second sheath 26 is larger in diameter than the flexible first sheath 22 and larger in diameter than the net stoppers 20a and 20b. A snare 28 made of a known elastic member is inserted into the flexible second sheath 26, the tip of the snare 28 is separated, and the end is the end of the second sheath 26. It is derived more externally. The flexible first sheath 22 shown in FIG. 8A is inserted into the flexible second sheath 26 shown in FIG. 8B, and the snare 28 is placed at the open end of the recovery net 12a. When passed, a collective treatment tool 10 such as a polyp as shown in FIG. 8C is obtained. In this state, the opening end 14 of the collection net 12a is held open by the elastic force of the snare 28. And it is normally assembled and stored in this state before use.

  When the collective treatment tool 10 such as a polyp is used, if the end portion 36 of the snare 28 is pulled and the yarn 18a is pulled simultaneously to such an extent that it does not sag, the snare 28 enters the second sheath 26. At the same time, the first sheath 22 and the net stoppers 20a and 20b also enter the second sheath. However, when the distal end 32 of the snare 28 enters the second sheath 26, the width of the snare 28 narrows and the recovery net The shape of the opening end 14 of 12a becomes long and thin. In this state, the collective treatment tool 10 is inserted through the various treatment tool insertion ports 44 of the endoscope apparatus 40 similar to that of the conventional example as shown in FIG. 9A and sent to a predetermined position of the large intestine. The endoscope device 40 includes an operation unit 42, various treatment instrument insertion ports 44 such as forceps, a flexible tube 46, a treatment instrument insertion conduit 47, various treatment instrument outlet openings 48, an observation window, an illumination window, and the like. Various tip openings 49 are provided, but since these configurations are all well-known, detailed description thereof is omitted.

  Next, the snare 28 comes out of the opening of the second sheath 26 by pushing the end portion 36 of the snare 28 with the distal end of the second sheath 26 protruding from the various treatment instrument outlet openings 48 of the endoscope device 40. Then, the snare 28 returns to its original shape due to its elastic force, so that the opening end 14 of the collection net 12a is opened, and preparations for collecting polyps and the like are made.

  After collecting the polyp or the like in the collection net 12a by a predetermined operation, when the yarn 18a and the end portion 36 of the snare 28 are pulled simultaneously, the net stoppers 20a and 20b are caught at the entrance end of the first sheath, Since the tip 30 of the snare is open, the snare 28 comes out of the opening end of the recovery net 12a, and the annular ring is subsequently drawn into the first sheath 22 via the net stoppers 20a and 20b. The opening end 14 of 12a is squeezed, and the recovered polyp or the like is held in the recovery net 12a.

  In this state, when the first sheath 22, the second sheath 26, and the snare 28 are pulled out from the various processing tool insertion ports 44 of the large intestine endoscope, as shown in FIG. 9A, a collection net holding a polyp or the like is obtained. 12a remains in the large intestine while being connected to the thread 18a. In this state, only the thread 18a remains in the treatment instrument insertion conduit 47 of the endoscope apparatus 40. Therefore, when a new polyp or the like is discovered when the endoscope apparatus 40 is taken out, various treatments are performed. A forceps or the like can be newly inserted from the tool insertion port 44, and a polyp or the like can be excised again. Thereafter, after removing the forceps and the like and inserting the collective treatment tool 10 such as a polyp as shown in FIG. 9C again, the polyp and the like can be collected in the reinserted collection net 12b.

  In this state, when the first sheath 22, the second sheath 26, and the snare 28 are pulled out from the various treatment instrument insertion ports 44 of the endoscope apparatus 40, the previous polyp and the like are held as shown in FIG. 9B. With the collected nets 12a and 12b remaining, the collected nets 12a and 12b holding the polyp are connected to the yarns a8a and 18b, respectively, and remain in the large intestine. After such a treatment is repeated as many times as necessary, when the endoscope device 40 and the threads 18a, 18b,... Are pulled out at the same time, a collection net holding a polyp or the like behind the distal end opening of the endoscope device 40. 12a, 12b... Can be taken out in a state of being connected in a daisy chain.

Japanese Patent No. 4130766

  According to the collective collection device 10 such as polyps of the prior invention disclosed in the above-mentioned Patent Document 1, one or a plurality of polyps can be distinguished and taken out for each place where they are collected in one operation. Not only can the tissue of the easily affected lesion be safely and reliably collected and the collected tissue can be prevented from being destroyed, but also the excellent effect of having very little influence on the patient can be achieved.

  However, if the following operation is performed with the collection net 12a once holding the polyp, etc., using the collective treatment tool 10 such as the polyp of the above-described prior invention, the endoscopic photograph shown in FIG. As described above, the recovery net 12a holding the recovered polyp or the like (in FIG. 10, the recovery net 12a is not shown because the recovery net 12a is located further back) and the yarn connected thereto. 18 is present in front of the objective lens of the endoscope apparatus, which may obstruct the field of view. Also, when the next polyp is cut, it becomes difficult to cut the thread. There is a problem that there is a risk of cutting.

  In this case, if the recovery net 12a holding the recovered polyp and the thread 18 connected thereto are present on the front side (anus side) of the endoscope device 40, the above-described problem However, in the conventional endoscope apparatus 40, since the thread is led out from the opening formed at the distal end of the endoscope apparatus 40, the collection net 12a holding the collected polyp or the like is used. In addition, it is difficult to dispose the thread 18 connected thereto in front of the endoscope tip.

  The present invention has been made to solve the problems of the conventional example as described above, and a plurality of polyps such as multiple polyps can be obtained without removing or reinserting the colonoscope in the colonoscopy, for example. Endoscope apparatus that can easily and safely excise tissue and collects these polyps all together, and an endoscope apparatus for use with a collective treatment tool such as polyps The purpose is to provide aids.

In order to achieve the above-described object, the endoscope apparatus auxiliary tool of the present invention has a distal end portion and a root portion, and an annular shape for attaching and using the root portion so as to cover the distal end portion side of the endoscope apparatus. A cap,
The pipe has a diameter smaller than the diameter of the base portion of the annular cap attached along the outer peripheral side of the annular cap, the outlet end is located at the tip of the annular cap, and the inlet end is the annular cap. A treatment instrument insertion conduit formed at an end extending long beyond the root,
An auxiliary device for an endoscopic device comprising:
The treatment instrument insertion conduit is formed with a slit that continuously communicates between the inside and the outside of the treatment instrument insertion conduit from the outlet end to the inlet end side.

  The auxiliary device for an endoscope apparatus of the present invention can be easily attached to an already-made endoscope apparatus for use. Moreover, according to the auxiliary device for an endoscopic device of the present invention, when collecting a polyp or the like using a collective treatment tool such as a known polyp in which a thread is connected to a collection net such as a polyp, The net holding the polyp or the like and the thread connected thereto are prevented from interfering with the field of view of the endoscope apparatus, and the thread that cuts the next polyp is obstructed and difficult to cut. As a result, multiple tissues such as multiple polyps can be easily and safely excised without removing or reinserting the endoscopic device. And can be collected.

  In addition, if the slit is continuously formed from the outlet end to the inlet end side of the treatment instrument insertion conduit of the endoscope apparatus auxiliary tool, the endoscope apparatus to which the endoscope apparatus auxiliary tool is attached is provided. Even when inserted into the body cavity, the net holding the collected polyp etc. is pulled along the slit formed in the treatment instrument insertion line by pulling the thread connected to the net holding the collected polyp etc. Can be taken out of the body cavity. In addition, since the thread is located in the treatment instrument insertion conduit when the thread is pulled, the thread does not come into contact with the body tissue, so that the thread does not rub against the body tissue and damage the body tissue. .

It is a figure showing the state which collect | recovered polyps etc. in one place using the endoscope apparatus of the reference example 1. FIG. It is a figure which shows the state which collect | recovered polyps etc. in two places using the endoscope apparatus of the reference example 1. FIG. It is a figure showing the state which collect | recovered polyps etc. using the endoscope apparatus of the reference example 2, and the movement state of a collection | recovery net | network. It is a figure showing the state which collect | recovered polyps etc. using the endoscope apparatus of the reference example 3. FIG. It is a figure showing the state which collect | recovered polyps etc. using the endoscope apparatus of the reference example 4. FIG. It is a figure showing the state which attached the auxiliary tool for endoscope apparatuses of an Example, and this to the endoscope apparatus. It is a top view which shows collection | recovery net apparatuses, such as the conventional polyp. FIG. 8A is a partial cross-sectional view in which the collection net and thread of the collective collection treatment tool such as a polyp of the prior invention are combined with the first flexible tube, and FIG. 8B is the second flexible tube and the snare. FIG. 8C is a perspective view of a collection net such as a polyp of the prior invention. FIG. 9A is a diagram showing a state in which polyps and the like are collected at one place using a collective treatment tool such as polyps of the prior invention, and FIG. 9B is a diagram showing a state in which the polyps and the like are collected at two places. It is an endoscopic photograph at the time of collect | recovering the next polyp etc. using a prior invention.

  Hereinafter, an endoscope apparatus and an endoscope set according to the present invention will be described with reference to the drawings. However, the endoscope apparatus and the endoscope set shown below are intended to limit the present invention to these. However, the present invention can be equally applied to various modifications without departing from the technical idea shown in the claims. Further, the collective collection tool such as a polyp used in the endoscope apparatus and endoscope set of the present invention is not substantially different from that shown in FIG. 8, and accordingly, FIG. The same components as those shown in FIG. 9 are given the same reference numerals for explanation. In addition, in each drawing used for the description in this specification, in order to make each member a size that can be recognized on the drawing, the scale is appropriately changed for each member. It is not displayed in proportion to the actual dimensions.

[Reference Example 1]
A case of a large intestine endoscope apparatus as an example of the endoscope apparatus 40A according to the reference example 1 will be described with reference to FIGS. FIG. 1 is a diagram showing a state in which polyps and the like are collected at one place using the endoscope apparatus of Reference Example 1. FIG. 2 is a diagram illustrating a state in which polyps and the like are collected at two locations using the endoscope apparatus of Reference Example 1. The endoscope apparatus 40A of the reference example 1 includes an operation unit 42 on one end side, various treatment instrument insertion ports 44 such as forceps, a flexible tube 46, and a treatment instrument insertion tube formed in the flexible tube 46. A path 47, various treatment instrument outlet openings 48 and various distal end openings 49 such as an observation window and an illumination window are provided, and these basic configurations are not different from those of the conventional example described above. The detailed description of is omitted.

  The configuration of the endoscope apparatus 40A of Reference Example 1 is different from that of the conventional endoscope apparatus 40 shown in FIG. 9A in that various treatment tools are provided from the various treatment tool outlet openings 48 to the treatment tool insertion conduit 47. A slit 50a having a fixed length, for example, a length of 5 cm, is formed to communicate between the inside and the outside of the treatment instrument insertion conduit 47 toward the insertion port 44 side. The length of the slit 50a may be any length that can move the collection net 12a once holding the polyp or the like out of the observation field of the endoscope apparatus 40A, and may be at least 2 cm. Further, the width of the slit 50a may be any width that allows the fine thread 18a connected to the recovery net 12a to move without resistance, but is preferably slightly wider than the thickness of the thread 18a to be used. .

  The process of collecting the first polyp and the like using the endoscope apparatus 40A of the reference example 1 is not different from the above-described prior invention. That is, by using the collective treatment tool 10 such as a polyp shown in FIG. 8C, the end portion 36 of the snare 28 is pulled at the time of use, and the thread 18a is simultaneously pulled to such an extent that the snare 28 is not loosened. 26, the shape of the opening end 14 of the collection net 12a is elongated, and the collective treatment tool 10 is in this state the various treatment tools of the endoscope apparatus 40 of Reference Example 1 as shown in FIG. It is inserted from the insertion port 44 and sent from the various treatment instrument outlet openings 48 to a predetermined position of the large intestine via the treatment instrument insertion conduit 47. A combination of the endoscope apparatus 40A and the collective treatment tool 10 such as a polyp corresponds to the endoscope set of the present invention.

  Next, the snare 28 is pushed out of the opening of the second sheath 26 by pushing the end portion 36 of the snare 28 in a state where the distal end of the second sheath 26 protrudes from the various treatment instrument outlet openings 48 at the distal end of the endoscope apparatus 40A. When it comes out, the snare 28 returns to its original shape due to its elastic force, so that the opening end 14 of the collection net 12a is opened, and preparations for collecting polyps and the like are made.

  After collecting the polyp or the like in the collection net 12a by a predetermined operation, when the yarn 18a and the end portion 36 of the snare 28 are pulled simultaneously, the net stoppers 20a and 20b are caught at the entrance end of the first sheath, Since the tip 30 of the snare is open, the snare 28 comes out of the opening end of the recovery net 12a, and the annular ring is subsequently drawn into the first sheath 22 via the net stoppers 20a and 20b. The opening end 14 of 12a is squeezed, and the recovered polyp or the like is held in the recovery net 12a. In this state, when the first sheath 22, the second sheath 26, and the snare 28 are pulled out from the various processing tool insertion ports 44 of the endoscope apparatus 40A, the recovery net 12a holding the polyp and the like is connected to the thread 18a. It remains in the large intestine.

  When a new polyp or the like is discovered when the endoscope device 40A is taken out, first, the endoscope device 40A is rotated so that the thread 18a is positioned at the tip of the slit 50a, and in this state, the thread 18a When the endoscope device 40A is pulled or pushed in, the thread 18a is inserted into the slit 50a, and the recovery net 12a holding the polyp or the like has various tip openings of the endoscope device 40A as shown in FIG. It comes to be located in front of the part 49. In this state, when the various distal end openings 49 of the endoscope apparatus 40A are brought close to the vicinity of a new polyp or the like to be excised, the collection net 12a holding the polyp or the like is more reliably out of the field of view of the endoscope apparatus 40A. Can be moved to.

  In this state, since only the thread 18a exists in the treatment instrument insertion conduit 47, a forceps or the like can be newly inserted from the various treatment instrument insertion ports 44, and the polyp or the like can be excised again. Thereafter, after removing the forceps and the like, when the collective treatment tool 10 such as a polyp as shown in FIG. 8C is inserted again, as shown in FIG. 2, the collective treatment tool such as a polyp inserted again is used. Polyps and the like can be collected in the 10 collection nets 12b.

  In this state, when the first sheath 22, the second sheath 26, and the snare 28 are pulled out from the various treatment instrument insertion ports 44 of the endoscope apparatus 40A, the recovery nets 12a and 12b holding the polyps and the like are removed. The collection nets 12a and 12b holding the polyp and the like are connected to the yarns a8a and 18b, respectively, and remain in the large intestine. After such treatment is repeated as many times as necessary, when the endoscope device 40A and the threads 18a, 18b,... Are pulled out at the same time, a collection net holding a polyp or the like behind the distal end opening of the endoscope device 40A. 12a, 12b... Can be taken out in a state of being connected in a daisy chain.

  As described above, according to the endoscope apparatus 40A and the endoscope set of Reference Example 1, the net holding the collected polyp and the thread connected thereto do not interfere with the visual field of the endoscope apparatus. As a result, there is no risk that the thread that cuts the next polyp will be in the way, making it difficult to cut or cutting the thread, and without having to remove or reinsert the endoscope device 40A. A plurality of tissues can be easily and safely excised, and these polyps and the like can be easily collected together.

[Reference Example 2]
In the endoscope apparatus 40A of Reference Example 1, the treatment instrument insertion conduit 47 is provided between the inside and outside of the treatment instrument insertion conduit 47 from the various treatment instrument outlet openings 48 toward the various treatment instrument insertion ports 44. An example in which a slit 50a having a certain length communicating with each other is formed is shown. However, the length of the slit 50a is not critical and arbitrary as long as the recovery net 12a once holding the polyp or the like can be moved out of the observation field of the endoscope apparatus 40A. .

  Therefore, in the endoscope apparatus 40B of Reference Example 2, slits 50b communicating between the inside and outside of the treatment instrument insertion conduit 47 are continuously formed from the various treatment instrument outlet openings 48 to the various treatment instrument insertion ports 44. did. An endoscope apparatus 40B of Reference Example 2 will be described with reference to FIG. FIG. 3 is a diagram illustrating a state in which polyps and the like are collected using the endoscope apparatus 40B of Reference Example 2 and a moving state of the collection net 12a. Since the endoscope apparatus 40B of the reference example 2 is different from the endoscope apparatus 40A of the reference example 1 only in the slit 50b, the internal structure of the reference example 1 shown in FIGS. The same reference numerals are given to the same components as those of the endoscope apparatus 40A, and detailed description thereof will be omitted.

  According to the endoscope apparatus 40B of the reference example 2, in addition to the same effects as the endoscope apparatus 40A of the reference example 1, as shown in FIG. 3, by pulling the thread 18a further forward, The collection net 12a once holding the polyp or the like can be moved to an arbitrary position. Therefore, the recovery net 12a once holding the polyp or the like is moved to a place where the surrounding space in the body cavity is wide, or if the held polyp or the like is small, various treatments are performed without pulling out the endoscope device 40B as necessary. It can also be moved directly to the position of the instrument insertion port 44 and taken out of the body cavity. Further, after the endoscope device 40B is pulled out, the recovery net 12a holding the yarn 18a and the polyp can be removed from the treatment instrument insertion conduit 47 of the endoscope device 40B simply by pulling the yarn 18a. become able to.

[Reference Example 3]
In the endoscope apparatuses 40A to 40B of Reference Example 1 and Reference Example 2, an example is shown in which the slits 50a to 50b are formed directly between the inside and the outside of the treatment instrument insertion conduit 47 of the endoscope apparatuses 40A to 40B. It was. With such a configuration, the obtained endoscope apparatuses 40A to 40B are not versatile, and are economically expensive. Therefore, as the endoscope apparatus 40C of Reference Example 3, an external treatment instrument insertion conduit in which a slit is formed from the outlet end toward the inlet end along the outer periphery of the conventional endoscope apparatus is formed. An endoscope apparatus 40C of the reference example 3 will be described with reference to FIG. FIG. 4 is a diagram illustrating a state in which polyps and the like are collected using the endoscope apparatus 40C of Reference Example 3. Also in the endoscope apparatus 40C of Reference Example 3, the operation unit 42 on one end side, various treatment instrument insertion ports 44 such as forceps, a flexible tube 46, and a treatment instrument formed in the flexible tube 46 An insertion pipe 47, various treatment instrument outlet openings 48, and various distal end openings 49 such as an observation window and an illumination window are provided, and these basic configurations are not different from those of the conventional example described above. A detailed description of the configuration will be omitted.

  The endoscope device 40C of Reference Example 3 has a certain length along the outer surface of the endoscope device of the conventional example from the various distal opening portions 49 side to the various treatment instrument insertion ports 44 to the various distal opening portions 49 side. The external treatment instrument insertion conduit 52a having a slit 50c formed therein and having a smaller diameter than the outer shape of the endoscope apparatus 40C is formed. Since this external treatment instrument insertion conduit 52a does not require insertion of forceps or the like, it is preferably smaller in diameter than the treatment instrument insertion conduit 47 so as not to give pain to the patient. It is preferable that the diameter of the second sheath of the collective treatment instrument 10 is slightly larger than the second sheath 26 (see FIG. 8C). The external treatment instrument insertion conduit 52a is preferably made of a flexible resin having a self-shaping property, and is bonded to the outside of the endoscope device 40C or appropriately using a mounting band or the like. It only has to be attached.

  According to the endoscope device 40C of the reference example 3 having such a configuration, the same effects as the endoscope device 40A of the reference example 1 are obtained, and in particular, the conventional endoscope device itself is not processed. Therefore, it can be manufactured at a low cost.

[Reference Example 4]
In the endoscope apparatus 40C of the reference example 3, along the outer surface of the endoscope apparatus of the conventional example, the various lengths from the various distal end opening portions 49 to the various treatment instrument insertion ports 44 are fixed to the various distal end opening portions 49 side. The slit 50c is formed and the external treatment instrument insertion conduit 52a having a smaller diameter than the outer shape of the endoscope apparatus 40C is formed. However, as in the case of the endoscope apparatus 40B of Reference Example 2, the slit 50c may be continuously formed from the outlet end side of the external treatment instrument insertion conduit 52a to the end of various treatment instrument insertion ports 44. it can.

  An endoscope apparatus 40D of Reference Example 4 in which such slits 50d are continuously formed from the outlet end side of the external treatment instrument insertion conduit 52b to the various treatment instrument insertion ports 44 will be described with reference to FIG. FIG. 5 is a diagram illustrating a state in which polyps and the like are collected using the endoscope apparatus 40D of Reference Example 4. Further, since the endoscope apparatus 40D of the reference example 4 is different from the endoscope apparatus 40C of the reference example 3 only in the slit 50d, the endoscope apparatus of the reference example 3 shown in FIG. The same components as those of the mirror device 40C are denoted by the same reference numerals, and detailed description thereof is omitted.

  According to the endoscope apparatus 40D of the reference example 4, in addition to the same operational effects as the endoscope apparatus 40C of the reference example 3, there are also the same operational effects as the endoscope apparatus 40B of the reference example 2. Will be able to.

[Example]
2. Description of the Related Art Conventionally, for the purpose of securing the visual field of an endoscope apparatus, the distal end portion of the endoscope apparatus is used with a distal end cap made of a transparent annular resin material. An example in which the endoscope apparatus auxiliary tool 60 according to the embodiment is applied to an endoscope apparatus using such a tip cap will be described with reference to FIG. FIG. 6 is a diagram illustrating a state where the endoscope apparatus auxiliary tool according to the embodiment is attached to the endoscope apparatus. In FIG. 6, the same components as those in the endoscope apparatus described in FIGS. 4 and 5 are denoted by the same reference numerals, and detailed description thereof is omitted.

  In the endoscope apparatus auxiliary tool 60 of the embodiment, an external treatment instrument insertion conduit 52c is integrally attached to the distal end cap 54 in advance, and an insertion port is inserted from the distal cap 54 side of the external treatment instrument insertion conduit 52c. In the same manner as in the case of the endoscope apparatus 40B of Reference Example 2, slits are formed and attached to the various treatment instrument outlet openings 48 at the distal end of the conventional endoscope apparatus. That is, the tip cap 54 and the treatment instrument insertion conduit 52c integrated in advance correspond to the endoscope apparatus auxiliary tool 60 of the present invention. It should be noted that the treatment instrument insertion conduit 52c is naturally smaller in diameter than the diameter of the distal end portion of the endoscope apparatus 40C, that is, smaller in diameter than the diameter of the root portion of the distal end cap 54. A commercially available tip cap 54 can be used as it is, and the endoscope device auxiliary tool 60 may be attached to a conventional endoscope device.

  According to the endoscope apparatus auxiliary tool 60 of the embodiment having such a configuration, the same function and effect as the endoscope apparatus 40B of the reference example 2 can be obtained, and the use of the distal end cap 54 is known. You can also expect the effects of.

  DESCRIPTION OF SYMBOLS 10 ... Collective collection treatment tool 12a, 12b ... Collection net 14 ... Open end 16 ... Annular ring 18, 18a, 18b ... Thread 20a, 20b ... Net stopper 22 ... First sheath 24 ... Opening 26 ... Second Sheath 28 ... Snare 40, 40A-40G ... Endoscope device 42 ... Operation unit 44 ... Various treatment tool insertion port 46 ... Flexible tube 47 ... Treatment tool insertion passage 48 ... Various treatment device outlet opening 49 ... Various tip opening portions 50a-50e ... slit 52a-52e ... external treatment instrument insertion conduit 54 ... tip cap 56 ... notch 60 ... auxiliary device for endoscope apparatus

Claims (1)

An annular cap having a distal end portion and a root portion, and attaching and using the root portion so as to cover the distal end portion side of the endoscope apparatus;
The pipe has a diameter smaller than the diameter of the base portion of the annular cap attached along the outer peripheral side of the annular cap, the outlet end is located at the tip of the annular cap, and the inlet end is the annular cap. A treatment instrument insertion conduit formed at an end extending long beyond the root,
An auxiliary device for an endoscopic device comprising:
An endoscope characterized in that the treatment instrument insertion conduit is formed with a slit that communicates between the inside and the outside of the treatment instrument insertion conduit continuously from the outlet end to the inlet end side. Equipment aids.