JP5717991B2 - Endoscope device - Google Patents

Description

  The present invention relates to an endoscopic device used for endoscopic treatment.

  In recent years, EMR (endoscopic mucosal resection) and ESD (endoscopic submucosal dissection) that remove tumors while observing with an endoscope have been in the limelight. In such a treatment method using an endoscope, various endoscopic devices are used. During the treatment, the operator inserts an endoscopic device that matches the purpose from the forceps opening of the endoscope, protrudes the treatment section from the distal end of the endoscope, and monitors the situation with the endoscope. To perform the desired treatment.

  When operating such an endoscopic device, if the operator is unable to grasp the sense of distance within the endoscope visual field, the treatment section is excessively projected from the distal end of the endoscope. There is a risk that smooth treatment cannot be performed.

  Therefore, as a device for an endoscope, conventionally, the maximum protrusion amount of the treatment portion from the distal end of the endoscope can be regulated to an appropriate range, and according to the difference in the dimensions of the endoscope to be used, There is also known one capable of easily adjusting the maximum protrusion amount (see, for example, Patent Document 1).

  In this device, when the device is inserted into the endoscope, the detection member provided near the operation portion of the device hits a stopper provided in the insertion port of the endoscope, so that the device from the distal end of the endoscope The amount of protrusion is regulated within an allowable range. Further, by visually observing the positional relationship between the detection member and the insertion port, it is possible to confirm whether or not the tip of the device has reached the tip of the endoscope.

Japanese Patent No. 3796805

  However, according to this conventional endoscope device, the operator recognizes that the treatment portion at the tip of the device has reached the tip of the endoscope or the vicinity thereof when the device is inserted into the endoscope. Therefore, it is necessary to insert the device while visually grasping the positional relationship between the detection member and the insertion port. Therefore, during that time, the operator must remove his / her line of sight from the monitor screen of the endoscope.

  An object of the present invention is to recognize, without relying on sight, that the treatment portion at the tip of the device has reached the vicinity of the tip of the endoscope in the endoscope device in view of the problems of the conventional technology. There is to be able to do it.

In order to achieve this object, an endoscope device according to the present invention includes a treatment section for performing treatment under an endoscope, an operation section for operating the treatment section, the treatment section, and an operation. comprising a sheath accommodating a member for connecting the parts, and a regulating member provided et the on the sheath, the regulating member is provided in an endoscope to insert the treatment portion and the sheath to the endoscope A large-diameter portion having a diameter larger than the inner diameter of the insertion port, and a small-diameter portion disposed at a predetermined position on the treatment unit side with respect to the large-diameter portion and having a diameter smaller than the inner diameter of the insertion port The small diameter portion increases the force that contacts the insertion port and resists feeding into the insertion port when the sheath moves into the insertion port by being fed into the insertion port. the large-diameter portion, movement to the insertion mouth of the large-diameter portion is due to the insertion inlet In the blocked point, characterized in that to limit the amount of projection of the treatment portion of the endoscope tip.

  According to this, when the treatment section approaches the predetermined position before the position where the projection amount of the treatment section is limited by the large diameter section, for example, a position near the distal end of the endoscope, the small diameter section is Since the force against the insertion opening and resisting feeding into the insertion opening is increased, this repulsive force is transmitted to the operator who is sending the sheath through the sheath. Thus, the operator can recognize that the treatment unit has approached the predetermined position without relying on vision.

  Further, in the present invention, the large diameter portion is a spherical member having a diameter larger than the inner diameter of the insertion port, and the small diameter portion is a spherical member having a diameter smaller than the inner diameter of the insertion port, The small-diameter portion is attached so that the predetermined distance can be changed at a position away from the large-diameter portion by a predetermined distance along the sheath.

  According to this, by changing the distance between the large-diameter portion and the small-diameter portion, the distance between the large-diameter portion and the small-diameter portion suitable for various types of endoscope devices can be set.

1 is a diagram illustrating an endoscope device and an endoscope according to an embodiment of the present invention. It is a figure which shows the function of the large diameter part and small diameter part in the device for endoscopes of FIG. It is a figure which shows another example of the control member in the device for endoscopes of FIG.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows an endoscope device 10 and an endoscope 20 according to an embodiment of the present invention. In the figure, a state in which the distal end side of the device 10 is inserted from the forceps port 23 into the endoscope 20 is shown. Examples of the device 10 include devices such as various forceps, snares, and electric scalpels.

  As shown in the figure, the device 10 includes a treatment section 11 for performing a surgical treatment within the field of view of an endoscope 20, an operation section 12 for operating the treatment section 11, a treatment section 11 and an operation. The flexible sheath 13 which accommodated the operation wire etc. which connect between the parts 12 and the regulation member 14 provided on the sheath 13 are provided.

  The regulating member 14 is disposed at a predetermined position on the treatment section 11 side with respect to the large diameter portion 14a and a spherical large diameter portion 14a having a larger diameter than the inner diameter of the forceps port 23, and a diameter smaller than the inner diameter of the forceps port 23. A small-diameter portion 14b having

  The insertion of the device 10 into the endoscope 20 is performed by the sheath 13 being sequentially sent from the treatment section 11 side into the forceps port 23 by the operator's right hand 40. When the device 10 is inserted, the treatment unit 11 protrudes from the distal end of the endoscope 20, so that the operator operates the treatment unit 11 with the operation unit 12, thereby performing a function corresponding to the type of the device 10. be able to.

  With respect to the insertion amount of the device 10 into the endoscope 20, that is, the protrusion amount of the treatment portion 11 from the distal end of the endoscope 20, a certain upper limit value can be set according to the type of device and the state of the affected part. . The small-diameter portion 14b has a function of giving a sense of discomfort to the operator's hand and prompting attention when the insertion amount of the device 10 reaches the vicinity of the upper limit value.

  That is, when the treatment portion 11 protrudes from the distal end of the endoscope 20, the small diameter portion 14 b moves into the forceps port 23 integrally with the sheath 13 that is fed into the forceps port 23. At this time, the small diameter portion 14 b comes into contact with the forceps opening 23 and applies a force against the feeding operation of the sheath 13 to the sheath 13. This resistance force is transmitted to the operator's right hand 40 through the sheath 13.

  When the sheath 13 is further fed and the insertion amount of the device 10 reaches the above-described upper limit value, the large-diameter portion 14a comes into contact with the forceps port 23, and further feeding of the sheath 13 is prevented. That is, the large-diameter portion 14a has a function of limiting the protruding amount of the treatment portion 11 from the distal end of the endoscope 20 so as not to exceed the above-described upper limit value.

  The position of the large-diameter portion 14a on the sheath 13 is determined so that this function can be realized. As the position of the small diameter portion 14b, for example, when the small diameter portion 14b is located at the entrance of the forceps port 23, the position where the distal end of the treatment portion 11 is located just at the distal end of the endoscope 23, or the treatment portion 11 is Such a position corresponds to a position slightly protruding from the distal end of the endoscope 23.

  The large-diameter portion 14a and the small-diameter portion 14b are attached on the sheath 13 so that the respective centers are located on the central axis of the sheath 13. The large-diameter portion 14a and the small-diameter portion 14b are configured such that this attachment is detachable and the attachment positions can be changed according to the dimensions of the device 10 and the endoscope 20 to be used. That is, the large diameter portion 14 a and the small diameter portion 14 b can be arbitrarily attached to various devices 10 at desired positions on the sheath 13.

  For example, the large-diameter portion 14a and the small-diameter portion 14b are each composed of two hemispherical members, and the two members are sandwiched between the two members to join the two members. This can be realized by mounting on the sheath 13.

  The endoscope 20 includes an operation unit 21 for operating the endoscope 20, an insertion unit 22 to be inserted into the body, a forceps port 23 for inserting the device 10, and a lid provided on the forceps port 23. 24 and a connection cable 25 that connects the operation unit 21 to an external light source device, a supply source of air or water, a monitor, and the like. The lid 24 is closed to prevent inflow of dust and the like when the device 10 is not used.

  At the distal end of the insertion portion 22, an objective lens for observing a target site for surgical treatment, a nozzle for ejecting water or air, a forceps port for projecting the treatment portion 11 at the distal end of the device 10, A light guide or the like for illuminating the observation target is provided. The insertion portion 22 accommodates various channels such as an optical fiber and a supply path that communicate with each element at the tip. Various channels include device channels for inserting the device 10.

  The operation section 21 is provided with an angle knob 211 for controlling the direction of the distal end portion of the insertion section 22, an air / water supply button 212, a suction button 213, and the like. The air / water supply button 212 is used to wash out dirt by ejecting water or air supplied via the connection cable 25 from the nozzle at the tip of the insertion portion 22 when the objective lens at the tip of the insertion portion 22 becomes dirty. . The suction button 213 is for sucking mucus or the like.

  FIG. 2 shows the functions of the large diameter portion 14a and the small diameter portion 14b. In the figure, a portion in the vicinity of the forceps opening 23 in the endoscope 20 is indicated by a two-dot chain line. 26 in the figure is a device channel provided in the endoscope 20 for inserting the device 10. The device channel 26 is provided from the forceps opening 23 to the distal end of the insertion portion 22. An end of the forceps port 23 is an entrance of the forceps port 23.

  When the device 10 is inserted into the endoscope 20 until the distal end of the treatment portion 11 reaches the distal end of the insertion portion 22 or in the vicinity thereof, as shown in FIG. The resistance force generated by contacting the part is transmitted to the operator via the sheath 13. Thus, the operator can recognize that the distal end of the measure portion 11 is present at or near the distal end of the insertion portion 22.

  In this state, since the small diameter portion 14b has a diameter smaller than the inner diameter of the forceps port 23, the operator can further insert the device 10 against the resistance force by the small diameter portion 14b. However, when the large diameter portion 14a reaches the forceps opening 23 as shown in FIG. 2 (b), further insertion is prevented.

  In this configuration, when the device 10 is inserted into the endoscope 20 in a state where the insertion portion 22 is inserted into the body, the operator uses the left hand 30 as shown in FIG. The operation unit 21 is held. Then, the device 10 is inserted by sequentially sending the sheath 13 from the treatment section 11 side through the forceps port 23 into the device channel 26 with the right hand 40.

  During this time, the operator does not need to shift the line of sight from the monitor image by the endoscope 20, and sends the sheath 13 while confirming whether the distal end of the insertion portion 22 is abnormally close to the inner wall of the body cavity by the monitor image. Can do. When the distal end of the treatment portion 11 reaches the distal end of the insertion portion 22 or in the vicinity thereof, as shown in FIG. 2A, the small diameter portion 14b comes into contact with the end portion of the forceps port 23, and a repulsive force against feeding the sheath 13 is obtained. Then, it is transmitted to the operator's right hand 40 through the sheath 13.

  Thereby, the operator recognizes that the treatment section 11 has reached the distal end of the insertion section 22 or the vicinity thereof. In response to this recognition, the operator carefully adjusts the feed of the sheath 13 while observing the monitor image by the endoscope 20 more carefully, and causes the treatment portion 11 to protrude from the distal end of the insertion portion 22 to obtain a preferable protrusion amount. Can be obtained. At that time, if the sheath 13 is mistakenly fed excessively, excessive protrusion of the treatment portion 11 is prevented by the large diameter portion 14a.

  Thus, when the device 10 is inserted, the operator inserts the device 10 while observing the monitor image without having to move the line of sight before the treatment unit 11 is projected, and the right hand 40 increases the resistance. When it feels, the protrusion of the treatment part 11 can be recognized thereby, and then the treatment part 11 can be safely protruded.

  As described above, according to the present embodiment, since the regulating member 14 including the large diameter portion 14a and the small diameter portion 14b is provided, the operator can set the distal end of the treatment portion 11 at or near the distal end of the insertion portion 22. Can be recognized without requiring visual confirmation. Therefore, the treatment section 11 can be safely projected without having to shift the line of sight from the monitor video by the endoscope 20. At that time, excessive protrusion of the treatment portion 11 can be prevented by the large diameter portion 14a.

  FIGS. 3A and 3B show other regulating members 15 and 16 that can be used instead of the regulating member 14. 3A is a conical member having an apex on the treatment section 11 side, and is fixed to the sheath 13 on the central axis thereof. Whereas the restriction member 14 is composed of the large diameter portion 14a and the small diameter portion 14b separated from each other, the restriction member 15 has a structure in which the large diameter portion and the small diameter portion are integrated.

  That is, when the restriction member 15 is used, when the distal end of the treatment portion 11 reaches the distal end of the insertion portion 22 or in the vicinity thereof, first, a portion having a small diameter near the apex of the restriction member 15 is the end of the inner surface of the forceps port 23. The resistance against the feeding of the sheath 13 is increased. This resistance force is transmitted to the operator via the sheath 13. That is, this portion of the restricting member 15 has the same effect as that of the small diameter portion 14b of the restricting member 14.

  This resistance increases as the amount of insertion of the device 10 increases. When the diameter of the regulating member 15 that contacts the end of the inner surface of the forceps port 23 becomes equal to the inner diameter of the forceps port 23, further insertion of the device 10 is prevented. That is, this portion of the regulating member 15 has the same effect as that of the large-diameter portion 14 a of the regulating member 14.

  Since the conical member 15 has such a characteristic that the resistance is gradually increased as described above, it is desirable to apply it to the device 10 suitable for such a characteristic. The attachment position and dimensions of the regulating member 15 in the sheath 13 are determined according to required characteristics.

  The regulating member 16 shown in FIG. 3B includes a spherical large-diameter member 16a having a large diameter and a spherical small-diameter member 16b having a smaller diameter. Neither the large-diameter member 16a nor the small-diameter member 16b is a perfect sphere, and has a shape in which both poles are cut off by a plane. A sheath 13 penetrates between both poles.

  The large-diameter member 16 a has a function of preventing excessive protrusion of the treatment portion 11 as in the case of the large-diameter portion 14 a of the regulating member 14. The diameter of the small diameter member 16b is smaller than the inner diameter of the forceps port 23, but larger than the diameter of the small diameter portion 14b. The small diameter portion 14b is separated from the large diameter portion 14a, while the small diameter member 16b is adjacent to the large diameter member 16a. Therefore, the small-diameter member 16b has a considerably greater resistance to feeding the sheath 13 than the small-diameter portion 14b.

  The position and size of the regulating member 16 in the sheath 13 are determined in consideration of such characteristics. The restricting member 16 is applied to the device 10 suitable for such characteristics. As in the case of the regulating member 14, both the regulating members 15 and 16 can be configured to be detachably attached to any position on the sheath 13.

  DESCRIPTION OF SYMBOLS 10 ... Endoscope device, 11 ... Treatment part, 12 ... Operation part, 13 ... Sheath, 14, 15, 16 ... Restriction member, 14a ... Large diameter part, 14b ... Small diameter part, 16a ... Large diameter member, 16b ... Small diameter member, 20 ... endoscope, 23 ... forceps opening.

Claims (2)

A treatment section for performing an endoscopic treatment;
An operation unit for operating the treatment unit;
A sheath containing a member connecting between the treatment section and the operation section;
And a provided et the regulating member on the sheath,
The restriction member includes a large-diameter portion having a diameter larger than an inner diameter of an insertion port provided in the endoscope for inserting the treatment portion and the sheath into the endoscope, and the treatment portion than the large-diameter portion. A small-diameter portion disposed at a predetermined position on the side and having a diameter smaller than the inner diameter of the insertion port,
When the sheath moves into the insertion port by being sent into the insertion port, the small diameter portion increases the force that contacts the insertion port and resists feeding into the insertion port,
The large-diameter portion restricts the amount of protrusion of the treatment portion from the distal end of the endoscope when movement of the large-diameter portion into the insertion port is blocked by the insertion port. Endoscopy device. The large diameter portion is a spherical member having a diameter larger than the inner diameter of the insertion port,
The small diameter portion is a spherical member having a diameter smaller than the inner diameter of the insertion port,
The endoscopic device according to claim 1, wherein the small-diameter portion is attached so that the predetermined distance can be changed at a position separated from the large-diameter portion by a predetermined distance along the sheath.

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