JP6095864B2 - Advancement / retraction aid, endoscope, and endoscope system - Google Patents

Description

  The present invention relates to an advance / retreat assist tool, an insertion device, and an endoscope system for a treatment tool for insertion device.

  For example, Patent Literature 1 discloses an advance / retreat assist tool (hereinafter referred to as an assist tool) for a treatment tool that assists a treatment tool for an insertion device to move forward and backward. The insertion device is, for example, an endoscope. The insertion device has a treatment instrument insertion portion disposed in the operation portion of the insertion device, and the auxiliary tool is inserted into the treatment tool insertion portion around the forceps plug portion disposed in the treatment instrument insertion port portion. It is attached to the part.

  When the insertion device is inserted into the lumen, for example, and the treatment instrument is inserted into the insertion device through the auxiliary tool, the forceps plug portion, and the treatment tool insertion port, the insertion device is liquid from the lumen. When sucking, the liquid may leak from between the treatment tool and the forceps plug portion. For this reason, the forceps plug portion is in close contact with the treatment tool, and liquid tightness is ensured by the close contact between the treatment tool and the forceps plug portion.

JP-A-9-276211

  In order to ensure liquid tightness, the forceps plug portion needs to be firmly attached to the treatment instrument. However, the higher the adhesive force, the greater the resistance of the forceps plug portion with respect to the treatment tool, and the auxiliary property of the auxiliary device, in other words, there is a possibility that the insertion / extraction assistance property of the treatment device is lowered. In other words, the insertion / extraction assistance is also advancing / retreating assistance.

  Thus, in the state in which the auxiliary tool is attached to the insertion device, ensuring the liquid-tightness and ensuring the insertion / extraction assistiveness are in a trade-off relationship with each other, and it is not easy to achieve both.

  The present invention has been made in view of these circumstances, and an object thereof is to provide an advancing / retreating tool, an insertion device, and an endoscope system that ensure both liquid-tightness and insertion / extraction assistance. To do.

One aspect of the advance / retreat assist tool of the present invention has a fixed-side tube portion, and is in a liquid-tight state at the treatment tool insertion port portion so that the fixed-side tube portion communicates with the treatment tool insertion port portion of the endoscope. A fixed member to be attached; and a movable side cylindrical portion into which the treatment instrument is inserted and fixed, and the movable side cylindrical portion is inserted into the fixed side cylindrical portion, or the fixed side cylindrical portion is connected to the movable side cylindrical portion. A moving member to be inserted, wherein the moving-side tube portion moves forward and backward with respect to the fixed-side tube portion along a central axis direction of the fixed-side tube portion; and the fixed-side tube portion and the movement Arranged between the fixed-side tube portion and the movable-side tube portion so as to ensure liquid tightness with the side tube portion, and is substantially the same as the fixed-side tube portion on the peripheral surface of the fixed-side tube portion. comprising an elastic member fixed coaxially, said elastic member is partly adhered to the peripheral surface of the movable-side cylinder portion, the thickness of the elastic member Diameter are different annular shape in direction.

  ADVANTAGE OF THE INVENTION According to this invention, the advance / retreat auxiliary tool, insertion apparatus, and endoscope system which can ensure liquid-tightness and ensuring insertion / extraction assistance can be provided.

FIG. 1A is a schematic perspective view of a state in which the advance / retreat assist tool according to the first embodiment of the present invention is attached to an endoscope and the treatment tool moves forward / backward. FIG. 1B is a diagram illustrating the angle θ1 and a rotating unit that rotates around the axis of the rotation center axis. FIG. 1C is a perspective view of a base member including a fixed-side tube portion on which the moving-side tube portion slides and a concave portion. FIG. 1D is an exploded perspective view of the attachment portion, and is a view for explaining attachment of the main body portion and the support portion, attachment of the main body portion to the base portion, and attachment of the support portion to the base member. FIG. 1E is a diagram illustrating a distal end portion of the spiral groove portion and an external communication groove portion at the distal end portion of the rotating main body member. FIG. 1F is a perspective view of the advance / retreat assist tool when the treatment tool advances. FIG. 1G is a perspective view of the advance / retreat assist tool when the treatment instrument is retracted. FIG. 1H is a longitudinal cross-sectional view of the advance / retreat unit when the treatment tool moves forward / backward. FIG. 1I is an enlarged vertical sectional view around the first elastic member and the second elastic member shown in FIG. 1H. FIG. 1J shows a state in which a rotating part is disposed inside the clearance and the gripping part is gripped by the left hand of the surgeon in the endoscope to which the advance / retreat assist tool is attached. FIG. 6 is a schematic view showing a state where the endoscope is operated by the finger of the left hand and the grasping of the endoscope and the forward / backward movement operation of the treatment instrument are simultaneously performed with one hand. FIG. 1K is a schematic view of a state in which a rotation part is disposed outside the clearance in the endoscope to which the advance / retreat assist tool is attached and the advance / retreat assist tool is prevented from obstructing gripping. FIG. 2 is an enlarged longitudinal sectional view around the first elastic member and the second elastic member in the advance / retreat assisting tool of the first modification of the first embodiment. FIG. 3A is an enlarged vertical cross-sectional view showing the configuration of the positioning portion in the advance / retreat assist tool of the second modification of the first embodiment. FIG. 3B is an enlarged vertical cross-sectional view showing the configuration of the positioning portion in the advance / retreat assist tool of the second modified example of the first embodiment. FIG. 4 is an enlarged vertical cross-sectional view showing the configuration of the first elastic member in the advance / retreat assisting tool of the third modified example of the first embodiment. FIG. 5 is an enlarged vertical cross-sectional view showing the configuration of the liquid-tightness securing member in the advance / retreat assisting tool of the fourth modified example of the first embodiment. FIG. 6 is an enlarged vertical cross-sectional view showing the configuration of the liquid-tightness securing member in the advance / retreat assisting tool of the fifth modified example of the first embodiment. FIG. 7 is an enlarged vertical cross-sectional view showing the configuration of the liquid-tightness securing member in the advance / retreat assisting tool of the sixth modified example of the first embodiment. FIG. 8A is a view showing a modification of the longitudinal cross-sectional shape of the first elastic member and the second elastic member in the advance / retreat assisting tool of the seventh modification of the first embodiment. FIG. 8B is a diagram illustrating a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 8C is a view showing a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 8D is a diagram showing a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 8E is a diagram showing a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 8F is a diagram illustrating a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 8G is a diagram showing a modification of the shape of the longitudinal cross section of the first elastic member and the second elastic member, substantially similar to FIG. 8A. FIG. 9A is a schematic perspective view of a state in which the advance / retreat assist tool according to the second embodiment of the present invention is attached to an endoscope and the treatment tool moves forward / backward. FIG. 9B is a schematic view of a state in which the treatment tool is advanced and retracted by the advance / retreat assist tool. FIG. 9C is a perspective view of a state in which the advance / retreat unit moves forward / backward because the treatment tool moves forward / backward. FIG. 9D is a longitudinal sectional view showing a state in which the advance / retreat unit moves forward and backward. FIG. 9E shows an endoscope in which an advance / retreat assisting tool is attached, in which a grasping portion is grasped by the operator's left hand, and the long portion and the flexible tube portion are grasped by the operator's right hand. It is the schematic of the state currently hold | gripped with the right hand.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[First Embodiment]
[Constitution]
The first embodiment will be described with reference to FIGS. 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I, 1J, and 1K. In FIG. 1C, the illustration of the treatment instrument 51 is omitted, and in some drawings, the illustration of a part of the members is omitted for clarity of illustration.

As shown in FIG. 1A, when the moving side cylinder 215 of the moving member 210 moves forward, the moving side cylinder 215 moves so that the moving side cylinder 215 is inserted into the fixed side cylinder 205 of the fixing member 200. It means moving along the direction of the central axis 215a of the side tube portion 215.
As shown in FIG. 1A, when the moving side cylinder part 215 is retracted, the moving side cylinder part 215 is removed from the fixed side cylinder part 205, so that the moving side cylinder part 215 is the central axis 215a of the moving side cylinder part 215. It means moving along the direction.
As shown in FIG. 1A, for example, the movement of the moving-side cylinder part 215 includes advancing and moving the moving-side cylinder part 215 and a backward movement of the moving-side cylinder part 215.
As shown in FIG. 1A, for example, when the treatment instrument 51 moves forward, the treatment tool 51 moves from the operation section 30 side to the distal end hard section 21 side by the advance of the moving side cylinder section 215 as shown in FIG. This means that the treatment instrument 51 moves so that the distal end portion 51a of the treatment instrument 51 protrudes from the inside of the insertion portion 20 to the outside through the distal end opening 35b.
As shown in FIG. 1A, for example, when the treatment instrument 51 is retracted, the treatment instrument 51 is moved from the distal end hard portion 21 side to the operation portion 30 side by the retraction of the moving side cylindrical portion 215 as shown in FIG. This means that the treatment instrument 51 moves so that the distal end portion 51a of the treatment instrument 51 is accommodated in the insertion portion 20 from the outside via the distal end opening 35b.
As illustrated in FIG. 1A, for example, the advancement / retraction of the treatment instrument 51 includes the advancement of the treatment instrument 51 and the retreat of the treatment instrument 51.

[Endoscope system 5]
As shown in FIG. 1A, an endoscope system 5 includes an insertion device such as an endoscope 10, an insertion device treatment tool (hereinafter, referred to as a treatment tool 51), and an advance / retreat assist tool for the treatment tool 51. (Hereinafter referred to as the auxiliary tool 100).

[Endoscope 10]
As shown in FIG. 1A, the endoscope 10 includes, for example, a hollow elongated insertion portion 20 that is inserted into a body cavity, and an operation portion 30 that is connected to the proximal end portion of the insertion portion 20 and operates the endoscope 10. Have.

[Insertion section 20]
As shown in FIG. 1A, the insertion portion 20 has a distal end hard portion 21, a bending portion 23, a flexible tube portion 25, and a flexible tube portion 25 in order from the distal end side of the insertion portion 20 toward the proximal end portion side of the insertion portion 20. Have The proximal end portion of the distal end hard portion 21 is connected to the distal end portion of the bending portion 23, and the proximal end portion of the bending portion 23 is connected to the distal end portion of the flexible tube portion 25.

The distal end hard portion 21 is the distal end portion of the insertion portion 20 and is hard and does not bend. The distal end hard portion 21 includes a distal end opening 35b and an observation window (not shown) included in an observation optical system (not shown). The distal end hard portion 21 is disposed in a state of sandwiching the observation window, and includes a pair of illumination windows (not shown) included in an illumination optical system (not shown), and a nozzle (not shown) that supplies air and water toward the observation window. Have The tip opening 35b, the observation window, the illumination window, and the nozzle are disposed on the tip surface of the tip hard portion 21.
The bending portion 23 is bent in a desired direction, for example, up, down, left, and right, by an operation of a bending operation unit 37 described later. When the bending portion 23 is bent, the position and orientation of the distal end hard portion 21 are changed. Then, illumination light (not shown) is illuminated on the observation object, and the observation object is captured in the observation field. The observation object is, for example, an affected part or a lesion part in a subject (for example, a body cavity).
The flexible tube portion 25 has desired flexibility. Therefore, the flexible tube portion 25 is bent by an external force. The flexible tube portion 25 is a tubular member extending from a bend preventing portion 31 described later in the operation portion 30.

[Operation unit 30]
As shown in FIG. 1A, the operation unit 30 is connected to a bend preventing part 31 from which the flexible tube part 25 extends and a proximal end part of the bend preventing part 31 and is grasped by an operator who operates the endoscope 10. And a universal cord 41 connected to the grip portion 33.

[Grip part 33]
As shown in FIG. 1A, the grasping unit 33 includes a treatment instrument insertion unit 35, a bending operation unit 37 that performs a bending operation on the bending unit 23, and a switch unit 39. The treatment instrument insertion portion 35 is disposed on the distal end side of the grip portion 33, and the bending operation portion 37 and the switch portion 39 are disposed on the proximal end portion side of the grip portion 33.

[Treatment instrument insertion part 35]
The treatment instrument insertion portion 35 is branched with respect to the grasping portion 33. For this reason, as shown in FIG. 1A, the central axis direction of the treatment instrument insertion portion 35 is inclined with respect to the central axis 33 a direction of the grasping portion 33.
As shown in FIG. 1A, the treatment instrument insertion portion 35 is disposed at an end of the treatment instrument insertion portion 35 and has a treatment instrument insertion port portion 35 a for the treatment instrument 51 to be inserted into the endoscope 10.

The treatment instrument insertion port 35a is connected to a proximal end portion of a treatment instrument insertion channel (not shown). The treatment instrument insertion channel is disposed inside the insertion portion 20, and is disposed from the treatment instrument insertion portion 35 to the distal end hard portion 21 via the bend preventing portion 31, the flexible tube portion 25, and the bending portion 23. . The distal end portion of the treatment instrument insertion channel communicates with the distal end opening 35 b disposed in the distal end rigid portion 21. The treatment instrument insertion port portion 35a is an insertion slot for inserting the treatment instrument 51 into the treatment instrument insertion channel.
As shown in FIG. 1A, the central axis 35c of the treatment instrument insertion port portion 35a is disposed coaxially with the central axis of the treatment instrument insertion portion 35, and is therefore inclined with respect to the central axis 33a of the grasping portion 33. ing. Further, the direction of the central axis 35 c is inclined with respect to the direction of the central axis 33 a of the grip portion 33.

  As shown in FIGS. 1A, 1D, and 1H, the treatment instrument insertion portion 35 has a cylindrical base portion 36 that is detachably disposed in the treatment instrument insertion port portion 35a. The central axis of the base part 36 is arranged coaxially with the central axis 35c of the treatment instrument insertion port part 35a. For this reason, the central axis of the cap part 36 is inclined with respect to the central axis 33 a of the grip part 33. When the base part 36 is inserted into the treatment instrument insertion port part 35a, the base part 36 communicates with the treatment instrument insertion channel. The base part 36 has, for example, a cylindrical shape. The base part 36 is made of metal, for example. A treatment tool 51 can be inserted into and removed from the base part 36.

  As shown in FIGS. 1A, 1D, and 1H, an auxiliary tool 100 is attached to the base portion 36. In this case, the base part 36 communicates with a first hole 311 of the base member 310 described later. The base portion 36 has a distal end portion that is inserted into the treatment instrument insertion port portion 35a, and a proximal end portion that protrudes outside from the treatment instrument insertion port portion 35a and is exposed to the outside. The proximal end portion has an edge portion 36c. The edge portion 36 c is formed as an outer flange, and is bent outward in the radial direction of the base portion 36.

[Bending operation unit 37]
As shown in FIG. 1A, the bending operation section 37 includes a left / right bending operation knob 37a for bending the bending section 23 to the left and right and an up / down bending operation knob 37b for bending the bending section 23 up and down. The bending operation section 37 includes a left / right fixing knob 37c that fixes the position of the bending section 23 that is bent left and right, and an up / down fixing knob 37d that fixes the position of the bending section 23 that is bent up and down.

[Switch section 39]
As shown in FIG. 1A, the switch unit 39 is operated by a finger of the left hand when the grasping unit 33 is grasped by the left hand of the surgeon. The switch unit 39 is operated when various functions of the endoscope such as air supply / water supply / suction / photographing are operated.

[Universal code 41]
The universal cord 41 has a connection connector (not shown) that is detachable from a control device (not shown).

[Treatment tool 51]
The treatment instrument 51 has, for example, an elongated linear member. The treatment tool 51 is inserted into the endoscope 10 (treatment tool insertion channel) from the base portion 36 via the treatment tool insertion port portion 35a. The distal end portion 51a of the treatment instrument 51 can protrude from the distal end opening 35b.

[Auxiliary tool 100]
The auxiliary tool 100 is detachably attached to the treatment instrument insertion portion 35 of the endoscope 10. Specifically, as shown in FIG. 1A, FIG. 1B, FIG. 1J, and FIG. 1K, the assisting tool 100 has the assisting tool 100 around the axis of the base portion 36 (the central axis 35c of the treatment instrument insertion port portion 35a). It is detachably attached to the base part 36 inserted into the treatment instrument insertion port part 35a of the treatment instrument insertion part 35 so as to be freely rotatable. As shown in FIG. 1A, the auxiliary tool 100 assists the treatment tool 51 inserted into the endoscope 10 from the treatment tool insertion port 35 a to move forward and backward along the central axis direction of the treatment tool 51. .

  As shown in FIGS. 1A, 1J, and 1K, the auxiliary instrument 100 includes a base unit 300, and the base unit 300 is rotatable about the axis of the central axis 35c of the treatment instrument insertion port 35a (the base 36). As shown, the base unit 300 has an attachment portion 400 that is detachably attached to the treatment instrument insertion portion 35 (cap portion 36). The auxiliary tool 100 includes a moving member 210 having a moving tube portion 215 through which the treatment tool 51 is inserted and guides the treatment tool 51 to the endoscope 10 through the base unit 300, and the moving tool tube portion 215. And an engaging member 600 that engages with. As shown in FIGS. 1A, 1E, 1F, 1G, 1H, 1J, and 1K, the auxiliary tool 100 is detachably disposed on the base unit 300 so as to be adjacent to the moving-side cylinder portion 215. A rotating part 700, an advancing / retracting mechanism 800 for moving the moving side cylinder part 215 forward and backward based on the rotational force of the rotating part 700, and a regulating mechanism 900 for restricting the advancing / retreating movement of the moving side cylinder part 215. In the present embodiment, although details will be described later, the moving-side tube portion 215 can be inserted into and removed from the fixed-side tube portion 205 of the fixing member 200 provided in the base unit 300. As shown in FIGS. 1H and 1I, the auxiliary tool 100 includes a first elastic member 220 and a second elastic member 230.

[Base unit 300]
As shown in FIGS. 1A, 1B, 1F, 1G, 1H, 1J, and 1K, the base unit 300 is detachably attached to the base portion 36 by an attachment portion 400. The base unit 300 is attached to the base part 36 by the attachment part 400 so as to be rotatable about the central axis of the base part 36. As shown in FIGS. 1A and 1C, the base unit 300 includes a base member 310.

  As shown in FIG. 1A, the base member 310 faces the treatment instrument insertion port 35a in the direction of the central axis 35c of the treatment instrument insertion port 35a when the auxiliary tool 100 is attached to the endoscope 10.

[Base member 310]
As shown in FIG. 1H, the base member 310 has a first hole 311 having a central axis 311a.

  The first hole 311 faces the inside of the base part 36 and the treatment instrument insertion channel when the auxiliary tool 100 is attached to the endoscope 10. At this time, as shown in FIGS. 1A and 1B, the central axis 311a of the first hole 311 is arranged coaxially with the central axis 35c of the treatment instrument insertion port portion 35a, and the center of the grasping portion 33 It is inclined with respect to the shaft 33a.

  The first hole 311 communicates with the outside at one end surface of the base member 310. The first hole 311 is recessed with respect to one end surface of the base member 310.

  As shown in FIG. 1H, the first hole 311 is a guide hole portion that guides the treatment instrument 51 that is inserted through the movable cylinder portion 215 to the treatment instrument insertion port portion 35 a via the attachment portion 400 and the base portion 36. Function as. The first hole 311 has substantially the same diameter as the treatment instrument 51.

  As shown in FIGS. 1D and 1H, the base member 310 has a second hole 315 that communicates with the first hole 311 and has a diameter larger than the diameter of the first hole 311. The central axis of the second hole 315 is disposed coaxially with the central axis 311 a of the first hole 311. The second hole 315 communicates with the outside at the other end surface of the base member 310 and is recessed with respect to the other end surface of the base member 310. The second hole 315 is disposed on the base part 36 side. The support portion 430 of the attachment portion 400 is screwed into the second hole 315.

  As shown in FIGS. 1C and 1H, the base member 310 is recessed with respect to one end surface of the base member 310, and is disposed on the side of the first hole 311 adjacent to the first hole 311. A recess 319 is provided. For this reason, the central axis of the recessed part 319 is arrange | positioned in parallel with respect to the central axis 311a in the direction orthogonal to the central axis 311a. The concave portion 319 is arranged away from the first hole 311 and the fixed-side cylinder portion 205 in a direction orthogonal to the direction of the central axis 311a so that a rotating main body member 730, which will be described later, can rotate about the axis of the central axis 700a. Established.

[Fixing member 200 and stationary cylinder portion 205]
As shown in FIGS. 1A, 1C, 1F, 1G, 1H, 1J, and 1K, the base member 310 has a central axis that is disposed coaxially with the central axis 311a of the first hole 311. It has the fixing member 200 which has. The fixing member 200 is erected with respect to the base member 310 such that the fixing member 200 is integrated with the base member 310. When the auxiliary tool 100 is attached to the endoscope 10, the fixing member 200 is fixed in position without moving in the central axis direction of the fixing member 200 together with the base member 310. When the auxiliary tool 100 is attached to the endoscope 10, the fixing member 200 is rotatable together with the base member 310 around the central axis of the base part 36 with respect to the base part 36.

[Fixed side cylinder portion 205]
The fixed member 200 has a fixed-side tube portion 205 into which the treatment instrument 51 can be inserted and removed, and a moving-side tube portion 215 of the moving member 210 can be inserted and removed. The fixed side cylinder part 205 has a cylindrical shape, for example, a cylindrical shape. The fixed side cylinder part 205 is formed in a straight line shape. The fixed-side cylinder portion 205 communicates with the first hole 311 and is disposed so as to surround the first hole 311. The central axis 205 a of the fixed-side cylinder portion 205 is disposed coaxially with the central axis 311 a of the first hole 311. The inner diameter of the fixed side cylinder portion 205 is larger than the diameter of the first hole 311.

  When the assisting tool 100 is attached to the endoscope 10, the fixed-side tube portion 205 stands up with respect to the plane on which the treatment tool insertion port portion 35a is disposed, and the central axis 205a of the fixed-side tube portion 205 is treated. The fixed tube portion 205 is disposed coaxially with the central axis of the instrument insertion port portion 35 a and communicates with the treatment instrument insertion port portion 35 a via the first hole 311 and the base portion 36. In this case, the central axis 205a of the fixed-side cylinder portion 205 is orthogonal to the plane direction of the plane on which the treatment instrument insertion port portion 35a is disposed.

  As long as liquid-tightness is ensured between the fixed side cylinder part 205 and the base member 310, the fixed side cylinder part 205 may be integrated with the base member 310 or may be a separate body. In this case, the method of attaching the fixed side cylinder part 205 to the base member 310 is not particularly limited, for example, the distal end part 205b of the fixed side cylinder part 205 is detachably fitted into the first hole 311.

  The moving side cylinder part 215 inserts and removes the fixed side cylinder part 205. For this reason, in this embodiment, the fixed side cylinder part 205 functions as an outer cylinder part. The central axis 205a of the fixed side cylindrical portion 205 is disposed coaxially with the central axis 215a of the movable side cylindrical portion 215, and the movable side cylindrical portion 215 moves forward and backward along the direction of the central axis 215a. Is prevented from moving in a direction perpendicular to the direction of the central axis 215a, and the movable side cylinder part 205 is prevented from rattling by the fixed side cylinder part 205. 215 is held. Therefore, the outer diameter of the moving side cylinder part 215 is substantially the same as the inner diameter of the fixed side cylinder part 205. The length of the fixed-side cylinder portion 205 is defined as desired according to the amount of movement of the treatment instrument 51.

  As described above, the fixing member 200 includes the fixed-side cylinder portion 205 into which the treatment instrument 51 can be inserted. The fixing member 200 is attached in a liquid-tight state to the treatment instrument insertion port portion 35a by the base 36 so that the fixed-side cylinder portion 205 communicates with the treatment instrument insertion port portion 35a.

  As shown in FIG. 1A, FIG. 1C, FIG. 1F, FIG. 1G and FIG. 1H, the moving side cylinder 215 moves in the direction of the central axis 311a of the first hole 311 in order to move forward and backward with respect to the fixed side cylinder 205. The fixed-side cylinder part 205 is moved along. The fixed side cylinder part 205 is shorter than the movement side cylinder part 215.

  As shown in FIG. 1C, the fixed-side tube portion 205 has a long groove portion 317a disposed on the outer peripheral surface of the fixed-side tube portion 205 along the direction of the central axis 205a. The base end portion 317b of the long groove portion 317a is open upward. The long groove portion 317a is recessed from the outer peripheral surface of the fixed side cylindrical portion 205 toward the inner peripheral surface. The long groove portion 317 a does not penetrate through the fixed side cylindrical portion 205 toward the inside of the fixed side cylindrical portion 205 in the thick portion of the fixed side cylindrical portion 205.

[Mounting part 400]
As shown in FIG. 1A, FIG. 1H, FIG. 1J, and FIG. 1K, the attachment portion 400 has a central axis 311a disposed coaxially with a central axis 35c of the treatment instrument insertion port portion 35a. The base unit 300 is inserted into the treatment tool so that the base member 310 can rotate around the axis of the central axis 35c of the treatment tool insertion port 35a (the central axis of the mouthpiece 36), facing the treatment tool insertion port 35a. Removably attached to the part 35 (base part 36).

  As shown in FIGS. 1D, 1H, 1J, and 1K, the attachment portion 400 includes a cylindrical main body portion 410 and a cylindrical support portion 430. The main body 410 is detachably attached to the base 36 so that the main body 410 is rotatable about the central axis 35c of the treatment instrument insertion port 35a. The support part 430 is detachably attached to the main body part 410 and supports the base member 310. The main body part 410 is a separate body from the support part 430. The main body portion 410 and the support portion 430 are formed of, for example, resin, rubber, metal, or the like.

[Attachment of Main Body 410 and Support 430]
As shown in FIG. 1H, the main body portion 410 has a main body screw groove portion 411 formed on the inner peripheral surface of the main body portion 410. The main body screw groove portion 411 is disposed at the base end portion of the main body portion 410.
As shown in FIGS. 1D and 1H, the support portion 430 is formed on the outer peripheral surface of the support portion 430 and has a tip support screw groove portion 431 that meshes with the main body screw groove portion 411. The tip support screw groove 431 is disposed at the tip of the support portion 430.
When the main body 410 is attached to the base 36, as shown in FIG. 1D, when the support 430 is screwed into the main body 410 in the central axis direction of the attachment 400, the main body screw groove 411 and the tip The support screw groove 431 meshes with each other. As a result, the support portion 430 is attached to the main body portion 410. As described above, the main body 410 and the support 430 are fastened to each other. At this time, the main body portion 410 and the support portion 430 communicate with the base portion 36.

  As shown in FIG. 1H, when the support portion 430 is attached to the main body portion 410, the edge portion 36c of the base portion 36 formed as an outer flange in the direction of the central axis 35c of the treatment instrument insertion port portion 35a It is arrange | positioned between 430 and the front-end | tip part of the main-body part 410 formed as an inner side flange. By attaching the support portion 430 to the main body portion 410, the support portion 430 pushes the edge portion 36 c into the distal end portion of the main body portion 410. Thereby, the attachment part 400 is fixed to the base part 36.

  As shown in FIGS. 1D and 1H, the auxiliary tool 100 is interposed between the support part 430 and the edge part 36c in the direction of the central axis 35c of the treatment tool insertion port part 35a, and the support part 430 and the edge part 36c. The interference prevention member 450 which prevents interference with is included. The interference preventing member 450 is made of, for example, PTFE. The interference preventing member 450 is in close contact with the support portion 430 and the edge portion 36c. The interference preventing member 450 is also in close contact with the base part 36, the main body part 410, and the support part 430, and also functions as a liquid tightness securing member for ensuring liquid tightness in these parts. The interference preventing member 450 is formed of, for example, rubber or resin for close contact. The interference preventing member 450 includes, for example, a ring-shaped packing.

[Main Body 410]
As shown in FIG. 1D, the main body 410 has a notch 413 formed by recessing a part of the edge of the main body 410 in the central axis direction of the main body 410. The notch 413 is disposed at the tip of the main body 410. The notch 413 is not disposed on the same plane as the main body screw groove 411, and is disposed closer to the treatment instrument insertion port 35 a than the main body screw groove 411. The notch 413 is not formed over the entire circumference of the main body 410 in the circumferential direction of the main body 410, but is formed with a size smaller than, for example, a semicircle. The notch 413 communicates with the inside of the main body 410 in the radial direction of the main body 410.

  As described above, the distal end portion of the main body 410 is bent inward as an inner flange.

[Attaching the Main Body 410 to the Base 36]
The main body 410 is not attached to the base 36 by being fitted into the base end of the base 36 in the central axis direction of the base 36. As shown in FIG. 1D, the notch 413 functions as the head, and the body 410 is pushed from the notch 413 into the base end of the base 36 in the radial direction of the body 410. That is, the main body portion 410 is pushed into the proximal end portion of the base portion 36 from the side surface side of the treatment instrument insertion portion 35 via the notch portion 413 in the radial direction of the main body portion 410. As a result, the main body 410 is fitted into the base end portion of the base portion 36 and attached to the base end portion of the base portion 36. In other words, the base end portion of the base portion 36 is fitted into the main body portion 410 in the radial direction of the main body portion 410 via the notch portion 413. The main body portion 410 is attached to the base end portion of the base portion 36, and the base end portion of the base portion 36 is disposed inside the main body portion 410. At this time, as shown in FIG. 1H, the front end portion of the main body portion 410 formed as the inner flange is caught by the edge portion 36c of the base portion 36 formed as the outer flange. In this state, as shown in FIGS. 1J and 1K, the main body 410 is rotatable with respect to the base 36 around the central axis 35c of the treatment instrument insertion port 35a.

  When the main body 410 is removed from the base part 36, contrary to the above, the main body part 410 is pulled with respect to the base end part of the base part 36 in the radial direction of the main body part 410 via the notch part 413. The base 36 is removed from the base end.

[Supporting part 430]
As shown in FIGS. 1D and 1H, in the support portion 430 that supports the base member 310, the support portion 430 is coaxial with the center axis 311a of the first hole 311 and the center axis 35c of the treatment instrument insertion port portion 35a. The first hole 311 is attached to the main body 410 so as to face the treatment instrument insertion port 35a.

  As shown in FIGS. 1D and 1H, the support portion 430 includes a distal end portion that is screwed into the main body portion 410 and a proximal end portion that supports the base member 310 by being screwed into the second hole 315. Have The proximal end portion is screwed into the second hole 315 so that the support portion 430 communicates with the first hole 311.

  As shown in FIG. 1D and FIG. 1H, the support portion 430 is disposed inside the base end portion of the support portion 430 to ensure liquid tightness between the base member 310 and the support portion 430, and the forceps plug portion A liquid-tightness securing member 433 that functions as: The liquid-tightness securing member 433 includes, for example, a ring-shaped packing.

  As illustrated in FIG. 1D, the liquid-tightness securing member 433 includes a protrusion 433 a disposed on the outer peripheral surface of the liquid-tightness securing member 433. When the liquid-tightness securing member 433 is inserted into and removed from the base end portion of the support portion 430, the protrusion portion 433 a slides in the sliding groove portion 435 formed at the base end portion of the support portion 430. The protrusion 433 a is gripped when the liquid-tightness securing member 433 is inserted into and extracted from the base end of the support portion 430, and is disposed to position the liquid-tightness securing member 433 in the circumferential direction of the support portion 430.

[Attaching the Supporting Section 430 to the Base Member 310]
As shown in FIGS. 1D and 1H, the base member 310 has a base screw groove 315a formed on the inner peripheral surface of the second hole 315.

  As shown in FIGS. 1D and 1H, the support portion 430 is formed on the outer peripheral surface of the support portion 430 and has a base end support screw groove portion 437 that meshes with the base screw groove portion 315a. The proximal end support screw groove portion 437 is disposed at the proximal end portion of the support portion 430.

  As shown in FIGS. 1D and 1H, when the support portion 430 is screwed into the second hole 315 in the central axis direction of the attachment portion 400, the base screw groove portion 315a and the base end support screw groove portion 437 are engaged with each other. . As a result, the support portion 430 is attached to the base member 310. Thus, the base member 310 and the support part 430 are fastened to each other. At this time, the support portion 430 communicates with the first hole 311.

[The base unit 300 rotates around the axis of the central axis 35c of the treatment instrument insertion port 35a]
As described above, the base member 310 is attached to the support part 430, the support part 430 is attached to the main body part 410, and the main body part 410 is attached to the base part 36.

  In this state, as shown in FIG. 1B, the central axis direction of the treatment instrument insertion portion 35 is inclined with respect to the central axis 33 a direction of the grasping portion 33.

  As shown in FIG. 1B, an angle formed between the direction of the central axis 35c of the treatment instrument insertion port portion 35a (the direction of the central axis 311a of the first hole 311) and the direction of the central axis 33a of the grasping portion 33 is an angle θ1. And The angle θ1 does not change even when the auxiliary tool 100 including the attachment part 400 rotates around the central axis of the base part 36.

As shown in FIGS. 1B, 1J, and 1K, when the auxiliary tool 100 is attached, a clearance 60 is formed between the fixed-side cylinder portion 205 including the moving-side cylinder portion 215 and the grip portion 33. Is done.
As shown in FIGS. 1B, 1J, and 1K, when the base member 310 rotates around the axis of the central axis 35c of the treatment instrument insertion port portion 35a, the central axis 311a and the central axis 215a of the moving side cylinder portion 215 The central axis 35c of the treatment instrument insertion port portion 35a functions as a rotation central axis of the base member 310. Then, when the base member 310 rotates around the central axis 35c of the treatment instrument insertion port portion 35a, the rotating portion 700 including the central shaft 700a has the rotating portion 700 disposed inside the clearance 60 and the gripping portion. It rotates about the rotation center axis so that the rotation part 700 is disposed outside the clearance 60 and away from the gripping part 33.

As shown in FIG. 1B, FIG. 1J, and FIG. 1K, the state where the rotating part 700 is disposed inside the clearance 60 is the internal state, and the state where the rotating part 700 is disposed outside the clearance 60 is the external state. And
As shown in FIG. 1A, FIG. 1B, and FIG. 1J, the rotating part 700 approaches the grip part 33 and is adjacent to the grip part 33 in the internal state. The internal state indicates a state in which, for example, the rotating unit 700 is operated to move the treatment tool 51 forward and backward, and the grasping of the endoscope 10 and the forward / backward movement operation of the treatment tool 51 can be performed simultaneously with one hand. The internal state indicates a state in which the treatment instrument 51 moves forward and backward by operating the rotating unit 700.
As shown in FIGS. 1B and 1K, the rotating unit 700 is separated from the gripping unit 33 in the external state. The external state is formed, for example, when there is no need to move the treatment tool 51 forward and backward, and the rotating unit 700 is not operated, and indicates a state in which the treatment tool 51 is inserted into and removed from the endoscope 10 by an operator's operation. The state which eliminates that the auxiliary tool 100 prevents a holding | grip is shown.

  As shown in FIGS. 1A, 1B, 1J, and 1K, the rotating unit 700 is disposed inside the clearance 60 when the rotating unit 700 is operated, and the rotating unit 700 is operated when the rotating unit 700 is not operated. The attachment portion 400 attached to the base portion 36 rotates around the central axis 35c of the treatment instrument insertion port portion 35a so that 700 is disposed outside the clearance 60. As a result, the base member 310 and the rotating part 700 attached to the attaching part 400 are similarly rotated.

[Moving member 210 and moving cylinder 215]
As shown in FIGS. 1A, 1C, 1F, 1G, 1H, and 1I, the moving member 210 has a moving side cylinder portion 215 through which the treatment instrument 51 is inserted. The movement side cylinder part 215 has the center axis | shaft 215a. As described above, the moving-side cylinder part 215 is inserted into and removed from the fixed-side cylinder part 205 and is held by the fixed-side cylinder part 205. For this reason, the moving side cylinder part 215 of the moving member 210 is arranged so that the moving side cylinder part 215 is coaxial with the fixed side cylinder part 205 and the moving side cylinder part 215 communicates with the fixed side cylinder part 205. It is inserted into the fixed side cylinder part 205. The moving-side cylinder 215 can move forward and backward with respect to the fixed-side cylinder 205 along the direction of the central axis 205a of the fixed-side cylinder 205. Note that the moving-side cylinder portion 215 can be removed from the fixed-side cylinder portion 205. Thus, in this embodiment, the movement side cylinder part 215 functions as an inner cylinder part. The movement side cylinder part 215 has a cylindrical shape, for example, a cylindrical shape. The moving side cylinder part 215 is formed in a straight line shape. As described above, the moving-side cylinder portion 215 is prevented from rattling by the fixed-side cylinder portion 205.

  The treatment instrument 51 is inserted from the proximal end portion 215c of the moving side cylindrical portion 215 into the moving side cylindrical portion 215 and protrudes from the distal end portion 215b of the moving side cylindrical portion 215.

  When the moving side cylinder portion 215 moves forward, the treatment instrument 51 is directly inserted into the first hole 311. When the moving side cylinder part 215 moves backward, the treatment instrument 51 is removed from the first hole 311 via the fixed side cylinder part 205. That is, the moving side cylinder portion 215 functions as a guide member that guides the treatment instrument 51 to the first hole 311.

  The movable side cylinder part 215 includes the central axis 215a described above, a distal end part 215b that moves the fixed side cylinder part 205 when the movable side cylinder part 215 moves forward and backward, and a proximal end part of the treatment instrument 51 by the engaging member 600. And a base end portion 215c to be engaged.

  The distal end portion 215b extends along the central axis 205a (central axis 215a) so that the movable cylinder portion 215 communicates with the first hole 311 when the movable cylinder portion 215 moves forward. The fixed side cylinder part 205 is advanced toward the tip part 205b. The distal end portion 215b extends along the center axis 205a (center axis 215a) so that the movement side cylinder portion 215 faces the first hole 311 when the movement side cylinder portion 215 moves backward. The fixed side cylinder part 205 is retracted toward the base end part 205c. The length of the moving side cylinder 215 is defined as desired according to the amount of movement of the treatment instrument 51. The base end portion 215c is always removed from the fixed side cylindrical portion 205 along the direction of the central axis 205a (central axis 215a), exposed from the fixed side cylindrical portion 205, and outside the fixed side cylindrical portion 205. Protruding.

  The moving-side cylinder 215 is arranged on the fixed-side cylinder 205 so that the direction of the central axis 215a is arranged along the direction of the central axis 311a and the central axis 215a is arranged coaxially with the central axis 311a. The The moving side cylinder portion 215 is formed as a cylinder member into which the treatment instrument 51 is inserted. The moving side cylinder part 215 is inserted into the fixed side cylinder part 205 and moves along the fixed side cylinder part 205.

[Engaging member 600]
As shown in FIGS. 1A and 1H, the engagement member 600 has a cylindrical shape, for example, a cylindrical shape. The engaging member 600 is disposed at the base end portion 215 c of the moving side cylinder portion 215 so that the engaging member 600 communicates with the moving side cylinder portion 215. The engaging member 600 is configured such that the treatment instrument 51 inserted through the movement-side cylinder portion 215 can move together with the movement-side cylinder portion 215, and the movement assists the movement of the treatment instrument 51 in the central axis direction of the treatment instrument 51. The base end portion of the treatment instrument 51 is engaged with the base end portion 215c of the moving side cylinder portion 215. The engaging member 600 functions as a cap member that caps the base end portion 215c. The engaging member 600 functions as a forceps plug portion.

  As shown in FIG. 1H, the engaging member 600 is disposed at the base end portion 215c, and includes a fixing member 605 through which the treatment instrument 51 is inserted, and a base end portion 215c through which the treatment instrument 51 is inserted and includes the fixing member 605. And a fastening portion 603 that functions as a covering cap. The tightening unit 603 tightens the fixing member 605 in order to fix the fixing member 605 to the treatment instrument 51.

  The fastening part 603 compresses the fixing member 605 by rotating around the axis of the fastening part 603. The fixing member 605 is in close contact with the proximal end portion 51b of the treatment instrument 51 by compression. As a result, the treatment instrument 51 is integrated with the moving-side cylinder portion 215 via the engaging member 600. The fixing member 605 is formed of elastic material such as rubber.

  When the engaging member 600 is disposed at the base end portion 215c and the treatment instrument 51 is not inserted into the moving side tubular portion 215 via the engaging member 600, the fixed member 605 is closed and the moving side tubular portion 215 is fixed to the fixed member 605. Closed by. When the treatment instrument 51 is inserted into the moving-side cylinder 215 via the engaging member 600, the fixing member 605 is closed, the fixing member 605 is in close contact with the proximal end portion of the treatment instrument 51, and the fixing member 605 is the treatment instrument. The base end portion of 51 is engaged with the base end portion 215 c of the moving side cylinder portion 215. As a result, the treatment instrument 51 is integrated with the moving-side cylinder portion 215 via the engaging member 600.

  Such an engagement member 600 is formed between the proximal end portion of the treatment instrument 51 and the engagement member 600 by the closing operation of the fixation member 605 and the close contact operation of the fixation member 605 to the proximal end portion of the treatment instrument 51. And a liquid-tightness securing member that secures liquid-tightness between the engaging member 600 and the base end portion 215c of the moving-side cylinder 215.

[Rotating unit 700]
As shown in FIGS. 1A, 1B, 1F, 1G, and 1H, the rotating portion 700 has a central axis 700a that is different from the central axis 205a of the fixed-side cylinder portion 205. Rotate around the axis. In the direction orthogonal to the direction of the central axis 215a, the rotating part 700 is attached to the base unit 300 so that the central axis 700a is disposed in parallel to the central axis 215a and the rotating part 700 is adjacent to the moving side cylindrical part 215. It is detachably arranged.

  The rotating part 700 is provided around a rotating shaft member 710 having a center shaft 700a, and a rotating body member 730 that rotates around the rotating shaft member 710 around the center axis 700a. Have

[Rotating shaft member 710]
As shown in FIG. 1H, in the rotation shaft member 710, the center axis 700a is disposed in parallel to the center axis 215a in the direction orthogonal to the direction of the center axis 215a, and the rotation shaft member 710 is moved to the moving side cylinder portion 215. Are fixed to the base unit 300 so as to be adjacent to each other. The rotating shaft member 710 has a cylindrical shape, for example. The rotating shaft member 710 may be fixed to the base unit 300 integrally or detachably.

  The rotating shaft member 710 is fitted into the recess 319 of the base member 310 and has a tip portion formed as a fixed end fixed to the base member 310 by, for example, a screw portion 263e. The screw portion 263e is inserted through the side surface of the base member 310 and comes into contact with the peripheral surface of the distal end portion of the rotating shaft member 710. The rotating shaft member 710 is fixed to the base unit 300 by the screw portion 263e and is prevented from rotating around the center axis 700a. The concave portion 319 and the rotating shaft member 710 are disposed away from the fixed-side cylinder portion 205 in a direction orthogonal to the direction of the central axis 215a so that the rotating main body member 730 can rotate around the axis of the central axis 700a.

  In a state where the rotary shaft member 710 is inserted into the rotary body member 730 and the distal end portion of the rotary shaft member 710 is fitted into the recess 319, the base end portion of the rotary shaft member 710 extends along the direction of the central axis 700a. The rotation shaft member 710 has such a length that it protrudes outward from the base end portion.

  The rotating unit 700 further includes a drop-off preventing member 750 that is disposed at a proximal end portion of the rotating shaft member 710 protruding from the rotating body member 730 and prevents the rotating body member 730 from coming off the rotating shaft member 710. The drop-off preventing member 750 is, for example, a cap that covers the base end portion of the rotating shaft member 710 and is thicker than the base end portion. The drop-off prevention member 750 covers the base end portion of the rotating shaft member 710 and abuts against the upper surface portion of the rotary body member 730 to prevent the drop-off member. The drop-off prevention member 750 is formed of, for example, rubber or metal.

[Rotating body member 730]
As shown in FIG. 1H, the rotating body member 730 has a cylindrical shape into which the rotating shaft member 710 is inserted, and functions as a rotating cylindrical portion. As shown in FIGS. 1F and 1G, the rotary body member 730 is disposed away from the fixed-side cylinder portion 205 in a direction orthogonal to the direction of the central axis 215a. For this reason, a gap is formed between the rotating main body member 730 and the fixed-side cylinder 205 in a direction orthogonal to the direction of the central axis 215a. As a result, the rotating main body member 730 can rotate around the axis of the central axis 700 a in a state adjacent to the moving-side cylinder portion 215.

  As shown in FIG. 1A, FIG. 1E, FIG. 1F, and FIG. 1G, the rotating body member 730 is disposed on the outer peripheral surface of the rotating body member 730 so as to wind the central shaft 700a. 801 has a helical spiral groove portion 731 to be engaged. Such a rotation main body member 730 functions as a cam ring.

As shown in FIG. 1A, when the auxiliary tool 100 is attached to the endoscope 10, the rotating main body member 730 is disposed adjacent to the grip portion 33. Thus, the rotary body member 730 functions as an operation knob.
As shown in FIGS. 1A, 1E, 1F, and 1G, the rotating body member 730 is disposed on the outer peripheral surface of the rotating body member 730 so as to avoid the spiral groove portion 731, and holds the grip portion 33. A recess 733 on which the finger of the hand to be hung is hung. The recess 733 is disposed along the direction of the central axis 700a. The recess 733 is connected to the adjacent recess 733 in the direction around the center axis 700a. The inner peripheral surface of the recess 733 has a smooth semicircular shape, for example. As shown in FIG. 1J, the recess 733 is formed as a placement surface on which a finger of the left hand that grips the grip portion 33 is placed.

[Configuration of Advance / Retreat Mechanism 800]
As shown in FIG. 1A, FIG. 1F, FIG. 1G, and FIG. 1H, the advance / retreat mechanism 800 is disposed in the rotating part 700, the moving side cylinder part 215, and the fixed side cylinder part 205. When the rotation unit 700 rotates, the advance / retreat mechanism 800 converts the rotational force of the rotation unit 700 into the advance / retreat force of the movement-side cylinder part 215 and transmits the advance / retreat force to the movement-side cylinder part 215, thereby moving the movement-side cylinder. The part 215 is moved back and forth along the direction of the central axis 215a.
As shown in FIGS. 1C, 1F, 1G, and 1H, the advance / retreat mechanism 800 includes a protrusion 801, a spiral groove 731, and an anti-rotation portion 805.

[Protrusion 801]
As shown in FIG. 1C, FIG. 1F, FIG. 1G, and FIG. 1H, in the central axis 215a and the central axis 700a that are arranged in parallel to each other, the protrusion 801 is the protrusion 801 is the moving side cylinder 215. Are arranged linearly along the radial direction of the moving-side cylinder 215 so as to be arranged between the central axis 215a and the central axis 700a along the radial direction. As described above, the projecting portion 801 is interposed between the moving side tubular portion 215 (fixed side tubular portion 205) and the rotating portion 700.

  As shown in FIG. 1C, the protruding portion 801 is disposed on the moving-side cylinder portion 215 and is disposed on the support member 217 that is disposed outside the fixed-side cylinder portion 205. The support member 217 is disposed along the moving side cylinder portion 215. The support member 217 moves together with the moving side cylinder portion 215. The support member 217 is disposed inside the long groove portion 317a and contacts the inner peripheral surface of the long groove portion 317a. The support member 217 slides in the long groove portion 317 a along the central axis 215 a of the moving side cylindrical portion 215 as the moving side cylindrical portion 215 moves. The support member 217 may be detachable with respect to the moving side cylinder portion 215.

  The support member 217 has a base end part integral with the base end part 215c of the moving side cylinder part 215, and a front end part on which the projection part 801 is disposed. The support member 217 has, for example, an L shape. The protruding portion 801 protrudes from the long groove portion 317 a toward the spiral groove portion 731. Note that the protrusion 801 may be detachably fixed to the support member 217.

  The protruding portion 801 engages with the spiral groove portion 731. The protrusion 801 has a diameter such that it contacts the edge of the spiral groove 731.

[Spiral groove portion 731]
As shown in FIGS. 1F and 1G, as described above, the spiral groove portion 731 is disposed on the outer peripheral surface of the rotating body member 730 so as to wind the central shaft 700a, and engages with the protrusion 801. To do.

  The spiral groove portion 731 is not disposed over the entire circumference of the rotary body member 730, but is disposed, for example, in a ¼ arc shape or a ½ arc shape. The proximal end portion 731 a of the spiral groove portion 731 is disposed below the proximal end portion of the rotating body member 730, and the distal end portion 731 b of the spiral groove portion 731 is disposed at the distal end portion of the rotating body member 730. The spiral groove portion 731 does not penetrate the rotating body member 730 in the direction of the central axis 700a. The spiral groove portion 731 does not penetrate the rotating body member 730 in the thickness direction of the rotating body member 730.

  The length of the spiral groove portion 731 or the length from the base end portion 731a of the spiral groove portion 731 to the distal end portion 317c of the long groove portion 317a corresponds to the amount of movement of the protrusion 801 and corresponds to the amount of movement of the moving side tubular portion 215. This corresponds to the amount of movement of the treatment instrument 51. These are approximately the same size. The maximum value of the length corresponds to the maximum value of the movement amount and the maximum value of the advance / retreat movement amount. These maximum values correspond to the size of the site to be treated by the treatment tool 51 and have desired values. The maximum value is 30 mm, for example.

[Rotation prevention unit 805]
The rotation preventing unit 805 is disposed on the base member 310 of the base unit 300, and prevents the moving side cylinder unit 215 from rotating around the central axis 215a.

  As illustrated in FIG. 1C, the rotation prevention unit 805 includes a long groove portion 317 a and a support member 217.

[Operation of Advance / Retreat Mechanism 800]
As shown in FIG. 1A, FIG. 1F, FIG. 1G, and FIG. 1H, when the rotating body member 730 rotates around the axis of the central axis 700a, the spiral groove portion 731 disposed on the rotating body member 730 simultaneously Rotate around the axis.

  As shown in FIGS. 1F and 1G, the protrusion 801 is in contact with the edge of the spiral groove 731. Therefore, when the spiral groove portion 731 rotates, the protrusion 801 is pushed to rotate by the spiral groove portion 731. As shown in FIG. 1C, in the rotation preventing portion 805, the support member 217 is also in contact with the long groove portion 317a. Therefore, the protrusion 801 is pushed by the spiral groove 731 so that the support member 217 including the protrusion 801 moves in the long groove 317a along the direction of the central axis 215a.

Thus, the spiral groove portion 731 rotates as the rotating main body member 730 rotates. When the spiral groove portion 731 rotates, the support member 217 including the protrusion 801 moves the long groove portion 317a along the central axis 215a direction by the spiral groove portion 731.
As shown in FIG. 1C, the support member 217 abuts against the edge of the long groove portion 317a, thereby preventing the moving side cylinder portion 215 having the support member 217 from rotating about the central axis 215a.
1F, FIG. 1G, and FIG. 1H, the spiral groove portion 731 rotates, and the support member 217 having the protrusion 801 moves along the central axis 215a direction to move the long groove portion 317a. The cylindrical portion 215 moves forward and backward along the direction of the central axis 215a while being prevented from rotating about the central axis 215a. As a result, the treatment instrument 51 fixed to the moving-side cylinder portion 215 moves forward and backward.

  That is, when the spiral groove portion 731 rotates, the spiral groove portion 731 is prevented from rotating around the axis of the central axis 215a by the support member 217 and the long groove portion 317a of the rotation prevention portion 805. Then, the movable side cylinder 215 is moved forward and backward along the direction of the central axis 215a via the protrusion 801.

  As shown in FIG. 1H, the rotating shaft member 710 is fixed to the base member 310 by a screw portion 263e. Therefore, the rotating shaft member 710 is not affected by the rotation of the rotating main body member 730 and remains fixed.

  As shown in FIG. 1C, the support member 217 only moves along the long groove portion 317a along the direction of the central axis 215a. Therefore, the movement side cylinder part 215 only moves forward and backward along the direction of the central axis 215a, and is prevented from rotating around the axis of the central axis 215a. Similarly, the treatment instrument 51 is prevented from rotating around the central axis 215a only by moving forward and backward.

  As described above, when the rotating unit 700 rotates around the center axis 700a, the advancing / retracting mechanism 800 causes the treatment instrument 51 to rotate around the axis of the center axis 215a when the rotating unit 700 rotates around the axis of the center axis 700a. The treatment instrument 51 is moved back and forth while being prevented from rotating.

[Regulatory mechanism 900]
When the movement side cylinder part 215 moves forward and backward along the direction of the central axis 215a, the restriction mechanism 900 is configured such that the distal end part 215b of the movement side cylinder part 215 moves along the direction of the central axis 215a. A portion where the first hole 311 disposed on the portion side communicates with the movable side tubular portion 215, and a movable side tubular portion 215 disposed on the proximal end side of the fixed side tubular portion 205 includes the fixed side tubular portion 205. The movement-side cylinder portion 215 is restricted from moving forward and backward so that the movement-side cylinder portion 215 moves between the positions of the movement-side cylinder portion 215 and the position where the movement-side cylinder portion 215 falls off.
As shown in FIG. 1C, the restriction mechanism 900 is formed by a protrusion 801, an edge portion of the base end portion 731a of the spiral groove portion 731 and an edge portion of the distal end portion 317c of the long groove portion 317a.

[Locking mechanism 950]
The auxiliary tool 100 includes a lock mechanism 950 that is disposed in the rotation unit 700 and locks the rotation body member 730 inadvertently rotating.
As shown in FIG. 1E, the lock mechanism 950 is disposed on the outer peripheral surface of the distal end portion of the rotating body member 730 so as to communicate with the distal end portion 731b of the spiral groove portion 731, and extends along the direction around the axis of the central axis 700a. The external communication groove portion 951 is disposed. A part of the external communication groove portion 951 communicates with the outside in the direction of the central axis 700a so that the protrusion 801 is inserted into and extracted from the external communication groove portion 951 from the outside. The external communication groove 951 is also provided for the protrusion 801 to engage with the spiral groove 731.

  The moving side cylinder part 215 is inserted into the fixed side cylinder part 205 so that the support member 217 slides in the long groove part 317a. In this state, the rotating main body member 730 is inserted into the rotating shaft member 710 such that the protruding portion 801 is inserted into the external communication groove portion 951. When the protrusion 801 is engaged with the external communication groove 951, the lock mechanism 950 locks inadvertent rotation of the rotary body member 730.

  After the rotation, the rotating body member 730 rotates around the axis of the central shaft 700a, whereby the protrusion 801 moves from the external communication groove 951 to the tip 731b of the spiral groove 731 and engages with the spiral groove 731. It will be.

  In the present embodiment, the auxiliary tool 100 includes a rotation restricting portion that restricts the movement-side tube portion 215 from rotating around the central axis 205 a of the fixed-side tube portion 205 with respect to the fixed-side tube portion 205. Good. The rotation restricting unit includes the rotation preventing unit 805 described above.

[First elastic member 220]
As shown in FIG. 1I, the first elastic member 220 is disposed on the inner peripheral surface of the fixed-side cylinder portion 205.
The first elastic member 220 has a hollow shape. The first elastic member 220 has, for example, an annular shape (ring shape). The first elastic member 220 is made of, for example, elastic rubber or resin.

  As shown in FIG. 1I, the first elastic member 220 ensures that the first elastic member 220 is liquid-tight between the fixed-side tube portion 205 and the movable-side tube portion 215 in the radial direction of the fixed-side tube portion 205. As described above, the fixed-side tube portion 205 is disposed between the fixed-side tube portion 205 and the movable-side tube portion 215 in the radial direction of the fixed-side tube portion 205. As described above, the first elastic member 220 functions as a liquid-tightness securing member that secures liquid-tightness between the fixed-side tubular portion 205 and the moving-side tubular portion 215.

  As shown in FIG. 1I, the central axis of the first elastic member 220 is disposed substantially coaxially with the central axis 205 a of the fixed-side cylinder portion 205, and between the first elastic member 220 and the fixed-side cylinder portion 205. The first elastic member 220 is closely attached and fixed to the peripheral surface of the fixed-side cylinder portion 205 so that the liquid tightness is ensured. Specifically, the first elastic member 220 is press-fitted into a fixed-side inner peripheral groove portion 205d disposed around the entire inner peripheral surface of the fixed-side cylindrical portion 205, and is in close contact with and fixed to the fixed-side inner peripheral groove portion 205d. Is done. For this reason, the first elastic member 220 is closely attached and fixed to the fixed-side cylinder portion 205 on the outer peripheral surface, the upper surface, and the lower surface of the first elastic member 220. Due to this close contact, liquid tightness between the first elastic member 220 and the fixed-side cylinder 205 is ensured.

  As shown in FIG. 1I, the diameter of the first elastic member 220 is different in the thickness direction of the first elastic member 220. For this reason, the first elastic member 220 is partially in close contact with the peripheral surface of the moving-side cylinder portion 215. Specifically, the first elastic member 220 is disposed on the peripheral surface of the first elastic member 220 facing the peripheral surface of the moving-side cylinder portion 215, and is in close contact with the peripheral surface of the moving-side cylinder portion 215. A close contact portion 221. The first elastic member 220 is disposed on the peripheral surface of the first elastic member 220, and is separated from the peripheral surface of the moving side cylindrical portion 215 in the radial direction of the first elastic member 220. And a first non-contact portion 223 that does not closely contact. In the thickness direction of the first elastic member 220, the first contact portion 221 is disposed at a position different from the first non-contact portion 223.

  Specifically, the first contact portion 221 is disposed closer to the treatment instrument insertion port portion 35a than the first non-contact portion 223 in the thickness direction of the first elastic member 220. The first contact portion 221 and the first non-contact portion 223 are the same body, and are continuous with each other in the thickness direction of the first elastic member 220.

  In the present embodiment, the first contact portion 221 and the first non-contact portion 223 are disposed on the entire inner peripheral surface of the first elastic member 220 facing the outer peripheral surface of the moving-side cylinder portion 215. . In the present embodiment, the first close contact portion 221 is in close contact with the outer peripheral surface of the moving side tubular portion 215. The first non-contact portion 223 is opposed to the outer peripheral surface of the moving-side cylinder portion 215 but is not in close contact therewith. For this reason, a gap portion is formed between the first non-contact portion 223 and the outer peripheral surface of the moving-side tube portion 215 in the radial direction of the fixed-side tube portion 205. The first contact portion 221 and the first non-contact portion 223 have a hollow shape, for example, a ring shape. In the present embodiment in which the moving-side cylinder portion 215 is inserted into and removed from the fixed-side cylinder portion 205, the inner diameter of the first close contact portion 221 is the close contact of the first close contact portion 221 and the close contact of the first close contact portion 223. Therefore, the inner diameter of the first non-contact portion 223 is smaller. For this reason, the first elastic member 220 is in close contact with the moving side cylindrical portion 215 at the first close contact portion 221 that is a part of the inner peripheral surface of the first elastic member 220 and moves with the fixed side cylindrical portion 205. Liquid tightness with the side tube portion 215 is ensured. And the outer peripheral surface of the movement side cylinder part 215 will slide the 1st contact | adherence part 221 of the 1st elastic member 220. FIG.

  In such a longitudinal section of the first elastic member 220, as described above, the inner diameter of the first elastic member 220 is different in the thickness direction of the first elastic member 220. Specifically, the inner diameter dimension of the first contact portion 221 disposed on the treatment instrument insertion port portion 35a side is opposite to the treatment instrument insertion port portion 35a in the central axis direction of the first elastic member 220. This is different from the inner diameter dimension of the first non-contact portion 223 disposed. For example, the inner diameter dimension of the first contact portion 221 is smaller than the inner diameter dimension of the first non-contact portion 223 so that the cross section of the first elastic member 220 has a trapezoidal shape, for example. The inner diameter of the part 205 and the outer diameter of the moving side cylinder part 215 are substantially the same.

[Second elastic member 230]
As shown in FIG. 1I, the second elastic member 230 is disposed on the outer peripheral surface of the moving-side cylinder portion 215.

  The second elastic member 230 has a hollow shape. The second elastic member 230 has, for example, an annular shape (ring shape). The second elastic member 230 is made of, for example, elastic rubber or resin.

  As shown in FIG. 1I, the second elastic member 230 and the first elastic member 220 are different only in the arrangement position and the arrangement direction. For this reason, the configuration of the second elastic member 230 is substantially the same as the configuration of the first elastic member 220. Below, the detail of the 2nd elastic member 230 is demonstrated.

  As shown in FIG. 1I, the second elastic member 230 ensures that the second elastic member 230 is liquid-tight between the fixed-side tube portion 205 and the movable-side tube portion 215 in the radial direction of the fixed-side tube portion 205. As described above, the fixed-side tube portion 205 is disposed between the fixed-side tube portion 205 and the movable-side tube portion 215 in the radial direction of the fixed-side tube portion 205. The second elastic member 230 is disposed closer to the treatment instrument insertion port portion 35a than the first elastic member 220 is. As described above, the second elastic member 230 functions as a liquid-tightness securing member that secures liquid-tightness between the fixed-side tubular portion 205 and the moving-side tubular portion 215.

  As shown in FIG. 1I, the central axis of the second elastic member 230 is disposed substantially coaxially with the central axis 215 a of the moving side cylinder 215, and between the second elastic member 230 and the moving side cylinder 215. The second elastic member 230 is closely attached to and fixed to the peripheral surface of the moving-side cylinder portion 215 so as to ensure liquid tightness. Specifically, the second elastic member 230 is press-fitted into the movement-side outer circumferential groove portion 215e disposed around the entire outer circumferential surface of the movement-side cylindrical portion 215, and is in close contact with and fixed to the movement-side outer circumferential groove portion 215e. The movement-side outer peripheral groove 215e is disposed closer to the treatment instrument insertion port 35a than the fixed-side inner peripheral groove 205d in a state where the movement-side cylinder 215 is inserted into the fixed-side cylinder 205. The second elastic member 230 is closely attached to and fixed to the moving-side cylinder portion 215 on the inner peripheral surface, the upper surface, and the lower surface of the second elastic member 230. For this reason, the second elastic member 230 is movable together with the movable side cylinder portion 215. Due to the close contact, liquid tightness between the second elastic member 230 and the moving side cylinder 215 is ensured.

  As shown in FIG. 1I, the diameter of the second elastic member 230 is different in the thickness direction of the second elastic member 230. For this reason, the second elastic member 230 is partially in close contact with the peripheral surface of the fixed-side cylinder portion 205. Specifically, the second elastic member 230 is disposed on the peripheral surface of the second elastic member 230 facing the peripheral surface of the fixed-side cylinder portion 205, and is in close contact with the peripheral surface of the fixed-side cylinder portion 205. The contact portion 231 is provided. The second elastic member 230 is disposed on the peripheral surface of the second elastic member 230, and is separated from the peripheral surface of the fixed-side cylindrical portion 205 in the radial direction of the second elastic member 230. And a second non-contact portion 233 that does not closely contact. In the thickness direction of the second elastic member 230, the second contact portion 231 is disposed at a position different from the second non-contact portion 233.

  Specifically, the second non-contact portion 233 is disposed closer to the treatment instrument insertion port portion 35a than the second contact portion 231 in the thickness direction of the second elastic member 230. For this reason, the 2nd contact part 231 is arrange | positioned facing the 1st contact part 221 in the central axis 205a direction. The second contact portion 231 and the second non-contact portion 233 are the same body, and are continuous with each other in the thickness direction of the second elastic member 230.

  In the present embodiment, the second contact portion 231 and the second non-contact portion 233 are disposed on the entire outer peripheral surface of the second elastic member 230 facing the inner peripheral surface of the fixed-side cylinder portion 205. . In the present embodiment, the second contact portion 231 is in close contact with the inner peripheral surface of the fixed-side cylinder portion 205. The second non-contact portion 233 faces the inner peripheral surface of the fixed-side cylinder portion 205 but does not closely contact. For this reason, a gap is formed between the second non-contact portion 233 and the inner peripheral surface of the fixed-side tube portion 205 in the radial direction of the fixed-side tube portion 205. The second contact portion 231 and the second non-contact portion 233 have a hollow shape, for example, a ring shape. In the present embodiment in which the moving-side cylinder portion 215 is inserted into and removed from the fixed-side cylinder portion 205, the outer diameter of the second contact portion 231 is the close contact of the second close contact portion 231 and the non-adhesion of the second non-contact portion 233. Therefore, the outer diameter of the second non-contact portion 233 is larger. For this reason, the second elastic member 230 is in close contact with the fixed-side cylinder portion 205 at the second contact portion 231 that is a part of the outer peripheral surface of the second elastic member 230, and the fixed-side cylinder portion 205 and the moving side Liquid tightness with the cylinder part 215 is ensured. And the 2nd contact part 231 of the 2nd elastic member 230 will slide on the internal peripheral surface of the stationary side cylinder part 205. FIG.

  In such a longitudinal section of the second elastic member 230, as described above, the outer diameter of the second elastic member 230 is different in the thickness direction of the second elastic member 230. Specifically, the outer diameter of the second non-contact portion 233 disposed on the treatment instrument insertion port portion 35a side is opposite to the treatment instrument insertion port portion 35a in the central axis direction of the second elastic member 230. This is different from the outer diameter of the second contact portion 231 disposed on the side. For example, the outer diameter of the second contact portion 231 is larger than the outer diameter of the second non-contact portion 233 so that the cross section of the second elastic member 230 has a trapezoidal shape, for example. The inner diameter of the side cylinder part 205 and the outer diameter of the moving side cylinder part 215 are substantially the same.

  Such a second elastic member 230 is disposed in a direction opposite to that of the first elastic member 220.

  As described above, the fixed-side cylinder portion 205 prevents the movement-side cylinder portion 215 from moving in a direction orthogonal to the direction of the central axis 215a, so that the movement-side cylinder portion 215 moves relative to the fixed-side cylinder portion 205. The moving side cylinder portion 215 is held so as to prevent rattling. The first elastic member 220 and the second elastic member 230 that are in close contact with the fixed-side cylinder portion 205 and the moving-side cylinder portion 215 assist in this point. In other words, the first elastic member 220 and the second elastic member 230 also function as support members that support the fixed-side tube portion 205 and the moving-side tube portion 215 so that this point is achieved.

  The close contact force of the first close contact portion 221 with respect to the moving side tubular portion 215 is larger than the close contact force of the liquid tightness securing member 433 with respect to the treatment instrument 51. For this reason, for example, the contact area of the first close contact portion 221 with respect to the moving side tubular portion 215 is larger than the contact area of the liquid tightness securing member 433 with respect to the treatment instrument 51.

  The adhesion force of the second adhesion part 231 with respect to the fixed-side cylinder part 205 is greater than the adhesion force of the liquid-tightness securing member 433 with respect to the treatment instrument 51. For this reason, for example, the contact area of the second contact portion 231 with respect to the fixed-side cylinder portion 205 is larger than the contact area with the liquid-tightness securing member 433 with respect to the treatment instrument 51.

  The sum of the adhesion force of the first adhesion part 221 to the moving side cylinder part 215 and the adhesion force of the second adhesion part 231 to the fixed side cylinder part 205 is greater than the adhesion force of the liquid tightness securing member 433 to the treatment instrument 51. large. For this reason, for example, the sum of the contact area of the first contact part 221 with respect to the moving side cylinder part 215 and the contact area of the second contact part 231 with respect to the fixed side cylinder part 205 is equal to the liquid tightness securing member 433 with respect to the treatment instrument 51. Greater than contact area.

[Action]
[Liquid tightness]
The auxiliary tool 100 is attached to the endoscope 10, and the treatment tool 51 is connected to the distal end opening 35 b via the engagement member 600, the moving side cylinder part 215, the fixed side cylinder part 205, the base part 36, and the treatment tool insertion channel. Protruding.

In this state, liquid tightness between the treatment instrument insertion port 35a and the base 36 is ensured.
Liquid tightness between the base part 36 and the base unit 300 is secured by the mounting part 400 including the liquid tightness securing member 433 and the interference preventing member 450.
The liquid tightness between the fixed side cylinder part 205 and the moving side cylinder part 215 is ensured by the first elastic member 220. Liquid tightness between the fixed side cylinder part 205 and the moving side cylinder part 215 is further ensured by the second elastic member 230.
The engagement member 600 ensures liquid tightness between the proximal end portion of the treatment instrument 51 and the engagement member 600 and liquid tightness between the engagement member 600 and the proximal end portion 215c of the moving side tubular portion 215. Is done.
For this reason, when the endoscope 10 sucks liquid from, for example, a lumen, the liquid is prevented from leaking to the outside from between the treatment instrument insertion port 35a and the base 36, and the base 36 and the base Leakage from between the unit 300 and the outside is prevented. Further, the liquid is prevented from leaking to the outside from between the fixed side cylinder part 205 and the moving side cylinder part 215, and leaks to the outside from between the base end part of the treatment instrument 51 and the engaging member 600. Is prevented.

If liquid leaks from the treatment instrument insertion port 35a or the base 36, the liquid enters the inside of the moving side cylinder 215 from the base 36 via the first hole 311 and the fixed side cylinder 205. To do.
Even in this case, the first elastic member 220 prevents the liquid from leaking from between the fixed side cylinder part 205 and the movement side cylinder part 215 to the outside. The second elastic member 230 further prevents the liquid from leaking to the outside from between the fixed side cylinder part 205 and the movement side cylinder part 215. The engagement member 600 prevents the liquid from leaking from between the proximal end portion of the treatment instrument 51 and the engagement member 600.

  Thus, in this embodiment, liquid tightness is ensured as desired.

[Grip between endoscope 10 and treatment tool 51]
Since the rotating part 700 is disposed inside the clearance 60, the rotating part 700 is disposed adjacent to the grip part 33. The grasping portion 33 is grasped by the left hand of the surgeon, the rotating portion 700 adjacent to the grasping portion 33 is operated by the left hand, for example, the little finger or the ring finger, and the bending operation portion 37 is operated by the left hand thumb. As described above, the grasping of the endoscope 10 and the forward / backward movement operation of the treatment instrument 51 are simultaneously performed with one hand.

[Advance / backward movement operation of treatment tool 51 and insertion / extraction assistance]
When the rotating part 700 is operated by, for example, the little finger or the ring finger of the left hand, the rotating part 700 rotates around the axis of the central axis 700a. As a result, the treatment instrument 51 fixed to the moving-side tube portion 215 moves forward and backward together with the moving-side tube portion 215.

In the present embodiment, as described above, the liquid tightness is ensured as desired, and therefore the base portion 36 and the attachment portion 400 do not need to be firmly attached to the treatment instrument 51 in order to secure the liquid tightness. In other words, liquid tightness is ensured by the first elastic member 220, and liquid tightness is further ensured by the second elastic member 230 and the engaging member 600. For this reason, the contact | adherence force of the nozzle | cap | die part 36 with respect to the treatment tool 51 for liquid-tightness in the nozzle | cap | die part 36 and the attachment part 400 and the adhesion | attachment force of the attachment part 400 can be suppressed. Therefore, when the treatment tool 51 moves back and forth, the resistance of the base part 36 and the resistance of the attachment part 400 with respect to the treatment tool 51 are prevented from increasing, and the auxiliary property of the auxiliary tool 100, in other words, the insertion / extraction assistance of the treatment tool 51 It is prevented that the property is lowered.
For this reason, in this embodiment, insertion / extraction assistance will be ensured as desired.

In the present embodiment, when the moving-side cylinder portion 215 moves forward and backward with respect to the fixed-side cylinder portion 205, the outer peripheral surface of the moving-side cylinder portion 215 slides on the first contact portion 221 and the second contact portion. The part 231 slides on the inner peripheral surface of the fixed-side cylinder part 205. For this reason, in the resistance of the auxiliary tool 100 with respect to the treatment tool 51 when the treatment tool 51 moves forward and backward, this resistance is generated in the first close contact portion 221 and the second close contact portion 231.
In this embodiment, the sum of the adhesion force of the first adhesion part 221 with respect to the moving-side cylinder part 215 and the adhesion force of the second adhesion part 231 with respect to the fixed-side cylinder part 205 is a liquid-tightness securing member for the treatment instrument 51. It is larger than the adhesion force of 433. For this reason, for example, the sum of the contact area of the first contact portion 221 with respect to the moving-side cylinder portion 215 and the contact area of the second contact portion 231 with respect to the fixed-side cylinder portion 205 is the treatment instrument 51 and the liquid-tightness securing member 433. Is larger than the contact area.

Unlike the present embodiment, the treatment instrument 51 in the case where the first adhesion part 221 and the second adhesion part 231 are not provided and the liquid-tightness securing member 433 is firmly adhered to the treatment instrument 51. The resistance of the liquid-tightness securing member 433 with respect to is referred to as resistance A. In the present embodiment, the first close contact portion 221 and the second close contact portion 231 are provided, and the liquid tightness securing member 433 may be in close contact with the treatment instrument 51. The resistance of the securing member 433 is referred to as resistance B. The resistance B in the present embodiment can be reduced more than the resistance A by the first close contact portion 221 and the second close contact portion 231. In other words, the insertion / extraction force amount of the present embodiment is smaller than the insertion / extraction force amount with respect to the treatment instrument 51 when the liquid tightness securing member 433 is firmly attached to the treatment instrument 51 in order to ensure liquid tightness. That is, the insertion / extraction assistance is improved.
Therefore, in this embodiment, insertion / extraction assistability is ensured as desired.

Similar to the liquid-tightness securing member 433, the engaging member 600 that is in close contact with the treatment instrument 51 moves together with the treatment instrument 51 as the movement-side cylinder portion 215 moves. For this reason, the resistance of the engaging member 600 with respect to the treatment tool 51 is eliminated.
Therefore, in this embodiment, insertion / extraction assistability is ensured as desired.

  Thus, in this embodiment, ensuring liquid-tightness and ensuring insertion / extraction assistance are compatible.

[effect]
In the present embodiment, the first elastic member 220 ensures liquid tightness in the fixed side cylinder part 205 and the moving side cylinder part 215. For this reason, the adhesion force of the liquid-tightness securing member 433 that functions as a forceps plug portion for the treatment instrument 51 for liquid-tightness can be suppressed. Therefore, when the treatment instrument 51 moves back and forth, the resistance of the liquid-tightness securing member 433 with respect to the treatment instrument 51 is prevented from increasing, and the auxiliary property of the auxiliary tool 100, in other words, the insertion / extraction assistance property of the treatment tool 51 is reduced. Is prevented.
Thereby, in this embodiment, ensuring of liquid-tightness and ensuring of insertion / extraction assistance are compatible.

  In the present embodiment, the first elastic member 220 is partially in close contact with the peripheral surface of the moving member 210 by the first close contact portion 221. For this reason, in this embodiment, the contact force of the first contact portion 221 with respect to the movable tube portion 215 can be made smaller than the contact force of the liquid-tightness securing member 433 with respect to the treatment instrument 51. Therefore, in the present embodiment, compared to the resistance A of the liquid-tightness securing member 433 with respect to the treatment instrument 51 when the liquid-tightness securing member 433 is firmly adhered to the treatment instrument 51 in order to ensure liquid tightness, The resistance B of the liquid-tightness securing member 433 with respect to the treatment instrument 51 in the embodiment can be reduced. As a result, in the present embodiment, it is possible to ensure insertion / extraction assistance as desired.

  In the present embodiment, the second elastic member 230 and the engagement member 600 can further ensure both the liquid-tightness and the insertion / extraction assistance as described above.

In the present embodiment, the first contact portion 221 is disposed closer to the treatment instrument insertion port portion 35a than the first non-contact portion 223. For this reason, in this embodiment, the movement side cylinder part 215 can be advanced easily.
In the present embodiment, the second contact portion 231 is disposed farther from the treatment instrument insertion port portion 35a side than the second non-contact portion 233. For this reason, in this embodiment, the movement side cylinder part 215 can be easily retracted.
In the present embodiment, the first contact portion 221 is disposed to face the second contact portion 231. For this reason, in this embodiment, liquid-tightness is securable between the 1st contact part 221 and the 2nd contact part 231. FIG.

  In the present embodiment, the first elastic member 220 and the second elastic member 230 prevent the movement-side cylinder portion 215 from moving in a direction orthogonal to the direction of the central axis 215a, and the movement-side cylinder portion 215. Is prevented from rattling with respect to the fixed cylindrical portion 205. In the present embodiment, the fixed side cylinder part 205 and the movable side cylinder part 215 can be supported by the first elastic member 220 and the second elastic member 230.

  In the present embodiment, the first elastic member 220 is press-fitted into the fixed-side inner peripheral groove portion 205d, and is in close contact with and fixed to the fixed-side inner peripheral groove portion 205d. The second elastic member 230 is press-fitted into the moving-side outer peripheral groove 215e, and is closely attached and fixed to the moving-side outer peripheral groove 215e. For this reason, in this embodiment, even if sliding occurs with respect to the 1st elastic member 220 and the 2nd elastic member 230 when the movement side cylinder part 215 advances / retreats, the 1st elastic member The position 220 and the second elastic member 230 are prevented from being displaced or removed. Therefore, in this embodiment, liquid tightness can always be ensured.

[First Modification]
Hereinafter, a first modification of the present embodiment will be described with reference to FIG. In this modification, only points different from the first embodiment will be described.
[Constitution]
[Fixed-side tube portion 205 and moving-side tube portion 215]
In the first embodiment, the moving side cylinder part 215 inserted into the fixed side cylinder part 205 moves forward and backward so as to be inserted into and extracted from the fixed side cylinder part 205. However, in this modified example, as shown in FIG. 2, the fixed-side tube portion 205 is inserted into the moving-side tube portion 215, and the moving-side tube portion 215 (the inner surface of the moving-side tube portion 215) is fixed. It moves forward and backward with respect to (the outer surface of the fixed side cylindrical portion 205). The fixed-side cylinder portion 205 can be removed from the moving-side cylinder portion 215. For this reason, the fixed side cylinder part 205 functions as an inner cylinder part, and the movement side cylinder part 215 functions as an outer cylinder part.

[First elastic member 220]
As shown in FIG. 2, the first elastic member 220 of this modification is press-fitted into a fixed outer peripheral groove 205e disposed around the entire outer peripheral surface of the fixed cylinder 205, and the fixed outer peripheral groove 205e. It is closely attached and fixed to. Therefore, the first elastic member 220 is closely attached and fixed to the fixed-side cylinder portion 205 on the inner peripheral surface, the upper surface, and the lower surface of the first elastic member 220. Due to this close contact, liquid tightness between the first elastic member 220 and the fixed-side cylinder 205 is ensured.

  As shown in FIG. 2, the first contact portion 221 and the first non-contact portion 223 of the present modified example are the entire outer peripheral surface of the first elastic member 220 facing the inner peripheral surface of the moving-side cylinder portion 215. Arranged around the circumference. In the present modification, the first contact portion 221 is in close contact with the inner peripheral surface of the moving-side cylinder portion 215. The first non-contact portion 223 is opposed to the inner peripheral surface of the moving-side cylinder portion 215 but is not in close contact. For this reason, a gap portion is formed between the first non-contact portion 223 and the inner peripheral surface of the moving-side tube portion 215 in the radial direction of the fixed-side tube portion 205. The first contact portion 221 and the first non-contact portion 223 have a hollow shape, for example, a ring shape. In this modified example in which the fixed-side tube portion 205 is inserted into and removed from the moving-side tube portion 215, the outer diameter of the first contact portion 221 is the close contact of the first close contact portion 221 and the close contact of the first non-contact portion 223. Therefore, the outer diameter of the first non-contact portion 223 is larger. For this reason, the first elastic member 220 is in close contact with the moving side cylindrical portion 215 at the first close contact portion 221 that is a part of the outer peripheral surface of the first elastic member 220, and the fixed side cylindrical portion 205 and the moving side Liquid tightness with the cylinder part 215 is ensured. Then, the inner peripheral surface of the moving-side cylinder portion 215 slides on the first contact portion 221 of the first elastic member 220.

  As shown in FIG. 2, in the longitudinal section of the first elastic member 220, the outer diameter of the first elastic member 220 is different in the thickness direction of the first elastic member 220 as described above. . Specifically, the outer diameter dimension of the first contact portion 221 disposed on the treatment instrument insertion port portion 35a side is opposite to the treatment instrument insertion port portion 35a in the central axis direction of the first elastic member 220. It differs from the outer diameter size of the first non-contact portion 223 disposed in the. For example, the outer diameter of the first contact portion 221 is larger than the outer diameter of the first non-contact portion 223 so that the cross section of the first elastic member 220 has a trapezoidal shape. The outer diameter of the cylindrical portion 205 and the inner diameter of the moving side cylindrical portion 215 are substantially the same.

[Second elastic member 230]
As shown in FIG. 2, the second elastic member 230 of the present modification is press-fitted into the moving-side inner circumferential groove portion 215 d disposed on the entire inner peripheral surface of the moving-side cylinder portion 215, It is adhered and fixed to the circumferential groove portion 215d. The movement-side inner circumferential groove portion 215d is disposed closer to the treatment instrument insertion port portion 35a than the fixed-side outer circumferential groove portion 205e in a state where the fixed-side cylinder portion 205 is inserted into the movement-side cylinder portion 215. For this reason, the second elastic member 230 is in close contact with and fixed to the moving-side cylinder portion 215 on the outer peripheral surface, the upper surface, and the lower surface of the second elastic member 230. For this reason, the second elastic member 230 is movable together with the movable side cylinder portion 215. Due to this close contact, liquid tightness is secured between the second elastic member 230 and the moving-side cylinder 215.

  As shown in FIG. 2, the second contact portion 231 and the second non-contact portion 233 of the present modification are the entire inner peripheral surface of the second elastic member 230 facing the outer peripheral surface of the fixed-side cylinder portion 205. Arranged around the circumference. The second contact portion 231 and the second non-contact portion 233 have a hollow shape, for example, a ring shape. In the present modification, the second contact portion 231 is in close contact with the outer peripheral surface of the fixed-side cylinder portion 205. The second non-contact portion 233 faces the outer peripheral surface of the fixed-side cylinder portion 205 but does not closely contact. For this reason, a gap portion is formed between the second non-contact portion 233 and the outer peripheral surface of the fixed-side tube portion 205 in the radial direction of the fixed-side tube portion 205. In the present modification in which the fixed-side tube portion 205 is inserted into and removed from the moving-side tube portion 215, the inner diameter of the second contact portion 231 is the close contact between the second contact portion 231 and the second contact portion 233. Therefore, the inner diameter of the second non-contact portion 233 is smaller. For this reason, the second elastic member 230 is in close contact with the fixed side cylindrical portion 205 at the second close contact portion 231 that is a part of the inner peripheral surface of the second elastic member 230, and moves with the fixed side cylindrical portion 205. Liquid tightness with the side tube portion 215 is ensured. And the 2nd contact part 231 of the 2nd elastic member 230 will slide on the outer peripheral surface of the stationary side cylinder part 205. FIG.

  As shown in FIG. 2, in the longitudinal section of the second elastic member 230, as described above, the inner diameter of the second elastic member 230 is different in the thickness direction of the second elastic member 230. Specifically, the inner diameter dimension of the second non-contact portion 233 disposed on the treatment instrument insertion port portion 35a side is opposite to the treatment instrument insertion port portion 35a in the central axis direction of the second elastic member 230. This is different from the inner diameter of the second contact portion 231 disposed on the surface. For example, the inner diameter dimension of the second contact portion 231 is smaller than the inner diameter dimension of the second non-contact portion 233 so that the cross section of the second elastic member 230 has a trapezoidal shape. The outer diameter of 205 and the inner diameter of the moving cylinder 215 are substantially the same.

  Such a second elastic member 230 is disposed in a direction opposite to that of the first elastic member 220.

[effect]
Even when the fixed-side cylinder portion 205 is inserted into the movable-side cylinder portion 215 and the movable-side cylinder portion 215 moves forward and backward with respect to the fixed-side cylinder portion 205 as in the present modification example, The substantially same effect as that of the first embodiment can be obtained.

[Second Modification]
Hereinafter, a second modification of the present embodiment will be described with reference to FIGS. 3A and 3B. In this modification, only points different from the first embodiment will be described. For convenience of explanation, the first modification will be used.
[Constitution]
[Positioning part 240]
As shown in FIGS. 3A and 3B, the auxiliary tool 100 includes a positioning portion 240 that positions the moving-side cylinder portion 215 with respect to the fixed-side cylinder portion 205.

[Configuration 1 of Positioning Unit 240]
As illustrated in FIG. 3A, the positioning unit 240 includes, for example, a positioning member 241 and a positioning engagement unit 243 with which the positioning member 241 is detachably engaged.

  The positioning member 241 has a hollow shape. The positioning member 241 has a ring shape, for example. The positioning member 241 is formed of, for example, elastic rubber or resin. The positioning member 241 is press-fitted into the fixed-side positioning outer peripheral groove portion 205g disposed on the entire outer peripheral surface of the fixed-side cylindrical portion 205, and the fixed-side positioning outer peripheral groove portion 205g on the outer peripheral surface, the upper surface, and the lower surface of the positioning member 241. It is closely attached and fixed to. The positioning member 241 is configured such that the outer peripheral portion of the positioning member 241 protrudes outward from the outer peripheral surface of the fixed-side cylinder portion 205 in the radial direction of the positioning member 241, and the outer peripheral portion of the positioning member 241 is engaged with the positioning engagement portion 243. Are disposed.

  The positioning engaging portion 243 has a moving side positioning inner peripheral groove portion 215f disposed on the entire inner peripheral surface of the moving side cylindrical portion 215.

  The positioning member 241 and the positioning engagement portion 243 are disposed outside the portion between the portions where the first elastic member 220 and the second elastic member 230 ensure liquid tightness in the axial direction of the moving side cylinder portion 215. Established. The positioning member 241 and the positioning engagement portion 243 are positioned as desired according to the fixed position of the treatment instrument 51. Such a positioning part 240 functions as a lock mechanism, for example.

[Action]
When the positioning member 241 engages with the positioning engagement portion 243 as the movement-side cylinder portion 215 moves forward and backward, the movement-side cylinder portion 215 is positioned with respect to the fixed-side cylinder portion 205. Thereby, the treatment instrument 51 is reliably positioned and fixed.

[effect]
In this way, the positioning member 241 engages with the positioning engagement portion 243, whereby the moving-side tube portion 215 can be positioned with respect to the fixed-side tube portion 205, and the treatment instrument 51 can be reliably positioned and fixed.

  Note that a plurality of positioning engagement portions 243 may be disposed in the axial direction of the moving side cylinder portion 215. Thereby, the several fixed position of the treatment tool 51 can be arrange | positioned reliably.

  The arrangement positions of the positioning member 241 and the positioning engagement portion 243 may be opposite to the above. For this reason, the positioning member 241 is disposed on one of the fixed-side tube portion 205 and the moving-side tube portion 215, and the positioning engagement portion 243 is disposed on the other of the fixed-side tube portion 205 and the moving-side tube portion 215. It only has to be.

  The positioning member 241 may be disposed, for example, at the proximal end portion 205c of the fixed-side cylinder portion 205, and the positioning engagement portion 243 may be disposed, for example, at the proximal end portion 215c of the moving-side cylinder portion 215.

[Configuration 2 of positioning unit 240]
As illustrated in FIG. 3B, the positioning unit 240 includes a fastening portion 245 that fastens the moving-side tube portion 215 to the fixed-side tube portion 205 from the outside. The fastening portion 245 has a hollow shape. The fastening portion 245 has, for example, a ring shape. The fastening portion 245 is fitted into the distal end portion 215 b of the moving side cylinder portion 215 and is disposed coaxially with the moving side cylinder portion 215. The fastening portion 245 functions as a diameter variable portion that can be reduced in diameter by fastening. Such a fastening portion 245 has a variable ring.

  In the present modification, the distal end portion 215b is thinner than the proximal end portion 215c of the moving side cylindrical portion 215 so that the distal end portion 215b is fixed to the fixed side cylindrical portion 205 by being tightened by the fastening portion 245. Yes.

[Action]
The fastening portion 245 fixes the distal end portion 215b to the fixed side cylindrical portion 205 by fastening, whereby the moving side cylindrical portion 215 is positioned with respect to the fixed side cylindrical portion 205. Thereby, the treatment instrument 51 is reliably positioned and fixed.

[effect]
In this way, the fastening portion 245 fastens the distal end portion 215b to the fixed-side tube portion 205 by fastening, whereby the moving-side tube portion 215 can be positioned with respect to the fixed-side tube portion 205, and the treatment instrument 51 can be reliably positioned and fixed. . By the fastening part 245, the fixed position of the moving side cylinder part 215, in other words, the fixed position of the treatment instrument 51 can be freely adjusted.

  In consideration of the first embodiment and the first modification, the fastening portion 245 is arranged outside in a state where one of the fixed side cylinder portion 205 and the moving side cylinder portion 215 is arranged outside the other. It is fitted into one provided, and one is fastened to the other from the outside.

[Third Modification]
Hereinafter, a third modification of the present embodiment will be described with reference to FIG. In this modification, only points different from the first embodiment will be described. For convenience of explanation, the first modification will be used.
[Constitution]
As shown in FIG. 4, the first elastic member 220 covers the base end portion 205 c of the fixed side cylindrical portion 205 including the base end surface and the outer peripheral surface of the fixed side cylindrical portion 205. The first elastic member 220 functions as a cap member that caps the base end portion 205c.

  The distal end portion 215 b of the moving side cylindrical portion 215 is bent toward the fixed side cylindrical portion 205 so as to be caught by the first elastic member 220. The first elastic member 220 has elasticity, and the outer peripheral surface of the first elastic member 220 has a tapered shape and widens from the top to the bottom on the paper surface of FIG. The outer diameter of the first contact portion 221 and the outer diameter of the first non-contact portion 223 are larger than the outer diameter of the fixed-side tube portion 205, and the outer diameter size of the first contact portion 221 is the moving-side tube. The outer diameter of the first non-contact part 223 is smaller than the inner diameter of the moving side cylinder part 215. The distal end portion 215b of the moving side cylindrical portion 215 is movable in the radial direction of the moving side cylindrical portion 215 due to, for example, a thin wall, and is expanded in the radial direction of the moving side cylindrical portion 215. For this reason, the front-end | tip part 215b can penetrate the 1st elastic member 220 so that the movement side cylinder part 215 accommodates the 1st elastic member 220. FIG. In a state in which the moving side cylindrical portion 215 houses the first elastic member 220, the distal end portion 215b of the moving side cylindrical portion 215 moves upward and is caught by the first elastic member 220, so that the movement with respect to the fixed side cylindrical portion 205 is performed. The side cylinder portion 215 is prevented from coming off.

[effect]
In this modification, the first elastic member 220 can be easily attached to and detached from the fixed-side cylinder portion 205. In the present modification, the first elastic member 220 can prevent the moving-side cylinder part 215 from coming off the fixed-side cylinder part 205.
This modification can be applied to the second elastic member 230 in the first embodiment.

[Fourth Modification]
Hereinafter, a fourth modification of the present embodiment will be described with reference to FIG. In this modification, only points different from the first embodiment will be described. For convenience of explanation, the first modification will be used.
[Constitution]
[Liquid-tightness securing member 251]
The auxiliary tool 100 includes a liquid-tightness securing member 251 that secures liquid-tightness between the fixed-side tubular portion 205 and the moving-side tubular portion 215. The liquid-tightness securing member 251 has elasticity that expands and contracts along the axial direction of the moving-side cylinder 215 as the moving-side cylinder 215 moves. The liquid-tightness securing member 251 is, for example, rubber. Such a liquid-tightness securing member 251 has, for example, a bellows shape. The liquid-tightness securing member 251 is disposed along the axial direction of the fixed-side tube portion 205 so as to surround the entire circumference of the fixed-side tube portion 205. The liquid-tightness securing member 251 has a cylindrical shape, for example, a cylindrical shape. For this reason, the fixed-side cylinder portion 205 is inserted into the liquid-tightness securing member 251. One end portion of the liquid-tightness securing member 251 is liquid-tightly fixed to the distal end portion 215b of the moving-side tubular portion 215, and the other end portion of the liquid-tightness securing member 251 is the base member 310 at the proximal end portion 205c of the stationary-side tubular portion 205. It is liquid-tightly fixed to the end face.

[effect]
In this modification, the liquid-tightness securing member 251 can secure the liquid-tightness between the fixed-side tubular part 205 and the moving-side tubular part 215. The amount of expansion and contraction of the liquid-tightness securing member may define the amount of movement of the moving side cylinder portion 215, in other words, the amount of movement of the treatment instrument 51. Accordingly, in this modification, the treatment instrument 51 can be positioned and fixed by the liquid-tightness securing member 251 when the liquid-tightness securing member 251 is extended to the maximum and contracted to the minimum.

  In the first embodiment, the liquid-tightness securing member 251 is disposed along the axial direction of the moving-side cylinder 215 so as to surround the entire circumference of the moving-side cylinder 215. For this reason, the moving side cylinder portion 215 is inserted into the liquid-tightness securing member 251. For example, one end of the liquid-tightness securing member 251 is liquid-tightly fixed to the engaging member 600 disposed on the base end 215c of the moving-side cylinder 215, and the other end of the liquid-tightness securing member 251 is fixed. It is liquid-tightly fixed to the front end part 205b or the base end part 205c of the cylindrical part 205.

[Fifth Modification]
Hereinafter, a fifth modification of the present embodiment will be described with reference to FIG. In this modification, only points different from the fourth modification of the first embodiment will be described. For convenience of explanation, the first modification will be used.
[Constitution]
[Liquid-tightness securing member 251]
As shown in FIG. 6, the liquid-tightness securing member 251 is placed on the base end surface of the fixed-side cylinder portion 205 so as to be covered by the moving-side cylinder portion 215. The liquid-tightness securing member 251 has stretchability that expands and contracts along the direction of the central axis 215a of the moving side cylindrical portion 215 as the moving side cylindrical portion 215 moves, and water absorption. Such a liquid-tightness securing member 251 is formed by a member such as a sponge, for example. The liquid-tightness securing member 251 has a cylindrical shape, for example, a cylindrical shape so that the treatment instrument 51 can be inserted through the liquid-tightness securing member 251.

[effect]
In this modification, the liquid-tightness securing member 251 can secure the liquid-tightness between the fixed-side tubular part 205 and the moving-side tubular part 215.

  In the first embodiment, the liquid-tightness securing member 251 is accommodated in the fixed-side cylinder portion 205 so as to communicate with the first hole 311 and the moving-side cylinder portion 215.

[Sixth Modification]
Hereinafter, a sixth modification of the present embodiment will be described with reference to FIG. In this modification, only points different from the first embodiment will be described.

[Constitution]
[Treatment instrument insertion port side liquid-tightness securing member (hereinafter referred to as liquid-tightness securing member 253)]
As shown in FIG. 7, in the present modification, the base part 36 is attached to the second hole 315. In this case, the auxiliary tool 100 ensures liquid-tightness provided between the base part 36 and the second hole 315 so that liquid-tightness between the second hole 315 and the base part 36 is ensured. A member 253 is included. The liquid-tightness securing member 253 is in close contact with the planar end surface of the base portion 36, the bottom surface portion of the second hole 315 facing the end surface, and the inner peripheral surface of the second hole 315.

  The liquid-tightness securing member 253 has, for example, a hollow shape. The liquid-tightness securing member 253 has, for example, a ring shape. The liquid-tightness securing member 253 is disposed so as to communicate with the base portion 36 and the second hole 315. The liquid-tightness securing member 253 is formed of, for example, elastic rubber or resin.

[Action]
When the base part 36 is fitted into the second hole 315, the liquid-tightness securing member 253 is compressed by the base part 36 and the second hole 315. As a result, the liquid-tightness securing member 253 is in close contact with the planar end surface of the base portion 36, the bottom surface portion of the second hole 315 facing the end surface, and the inner peripheral surface of the second hole 315. By this close contact, liquid tightness between the second hole 315 and the base 36 is ensured.

[effect]
In this modification, the liquid-tightness securing member 253 can ensure the liquid-tightness between the second hole 315 and the base part 36. Thereby, in this modification, it can prevent reliably that a liquid leaks from between the base unit 300 and the nozzle | cap | die part 36. FIG.

[Seventh Modification]
Below, the 7th modification of this embodiment is demonstrated. In this modification, only points different from the first embodiment will be described. For convenience of explanation, the first modification will be used. In the first modification, the cross section of the first elastic member 220 has a trapezoidal shape, for example, but it is not necessary to limit to this. In this modification, a modification of the cross-sectional shape of the first elastic member 220 will be described. The contents described in this modification are also effective for the shape of the second elastic member 230.

  If the outer peripheral surface of the first elastic member 220 has a tapered surface, the cross section of the first elastic member 220 is, for example, a triangular shape as shown in FIG. 8A or an L shape as shown in FIG. 8B. Also good. The first contact portion 221 and the first non-contact portion 223 may be separate from each other as shown in FIG. 8C. As shown in FIG. 8D, the first non-contact portion 223 may have an outer peripheral groove portion 225 a formed on the outer peripheral surface of the first non-contact portion 223.

  When the cross section of the first elastic member 220 has a trapezoidal shape, for example, the first non-contact portion 223 is formed on the outer peripheral surface of the first non-contact portion 223 as shown in FIG. You may have the convex part 225b protruded outside from the outer peripheral surface in the radial direction of the elastic member 220. FIG. The convex portion 225b is the same body as the first non-contact portion 223. The convex part 225b may have a curved surface shape, for example.

  When the cross section of the first elastic member 220 has a substantially trapezoidal shape, for example, the outer peripheral surface of the first elastic member 220 may be formed as a convex curved surface portion 225c as shown in FIG. As shown in FIG. 8G, it may be formed as a concave curved surface portion 225c.

[Second Embodiment]
The second embodiment will be described below with reference to the drawings. In the present embodiment, only points different from the first embodiment will be described. For clarity of illustration, in some drawings, the base part 36 and the forceps plug part 36a are not shown in FIG. 9A, and the base part 36 is not shown in FIG. 9D. For the sake of simplicity, the illustration of a part of the members is omitted.

[Auxiliary tool 100]
As shown in FIGS. 9A and 9D, the auxiliary tool 100 includes a base unit 110, a fixing unit 130, an advance / retreat unit 150, an extension part 170, and a long part 180.

[Base unit 110]
As shown in FIGS. 9A and 9D, the base unit 110 is detachably attached to the treatment instrument insertion portion 35, the gripping portion 33, and the folding stop portion 31 with the treatment instrument insertion port 35a as the center. As shown in FIGS. 9A and 9D, the base unit 110 includes a flat plate-like base member 111 and a U-shaped base member 112. The base unit 110 includes a support member 113 that supports the base member 111 via the base member 112, and an extending member 115 that extends from the support member 113 toward the insertion portion 20.

As shown in FIGS. 9A and 9D, the base member 111 and the base member 112 are disposed on the treatment instrument insertion port portion 35a side when the auxiliary instrument 100 is attached to the endoscope 10.
As shown in FIG. 9A, the support member 113 is disposed on the side of the grip portion 33 when the auxiliary tool 100 is attached to the endoscope 10.
As shown in FIG. 9A, the extending member 115 is disposed on the side of the folding preventing portion 31 when the auxiliary tool 100 is attached to the endoscope 10.

[Base member 111]
As shown in FIGS. 9A and 9D, the base member 111 is disposed in parallel to the plane of the treatment instrument insertion port portion 35a. The base member 111 is fixed to the support member 113 via the base member 112 with a screw (not shown), for example.

  As shown in FIG. 9D, the base member 111 has one end 111 a that is the back side of the base member 111 and another end 111 b that is the front side of the base member 111. The base member 111 has an insertion hole 111c that passes through the base member 111 from the one end 111a toward the other end 111b and into which the treatment instrument 51 is inserted in a state in which one end 155a of a guide connecting member 155 described later is fitted. . The base member 111 has a fitting hole 111h that passes through the base member 111 from the one end 111a toward the other end 111b and into which a fixed cylinder member 190c described later is fitted.

  As illustrated in FIG. 9D, the insertion hole 111 c faces the treatment instrument insertion port portion 35 a when the auxiliary tool 100 is attached to the endoscope 10. At this time, the central axis 111d of the insertion hole 111c is disposed coaxially with the central axis 35c of the treatment instrument insertion port portion 35a.

  As illustrated in FIG. 9D, the insertion hole 111 c is provided on the other end 111 b side of the base member 111 and has a fitting portion 111 e that fits with the one end 155 a of the guide connecting member 155. The insertion hole 111c is disposed on the one end 111a side of the base member 111, communicates with the fitting portion 111e, and is inserted so that the treatment instrument 51 protruding from the guide coupling member 155 is inserted into the treatment instrument insertion port 35a. It has the insertion part 111f to do.

  The diameter of the insertion part 111f is smaller than the diameter of the fitting part 111e. The central axis of the insertion part 111f is arranged coaxially with the central axis of the fitting part 111e. The one end portion 111a is in close contact with the forceps plug portion 36a, and liquid tightness is ensured with the forceps plug portion 36a.

  As shown in FIG. 9D, the fitting hole 111 h is disposed on the side of the insertion hole 111 c and is displaced from the insertion hole 111 c in the planar direction of the base unit 110. The central axis of the fitting hole 111h is disposed in parallel with the central axis 111d of the insertion hole 111c in the planar direction of the base member 111. In the fixed cylinder member 190c fitted in the fitting hole 111h, the extending portion 170 is inserted through the fixed cylinder member 190c along the central axis of the fixed cylinder member 190c. In this case, the extension hole 170 is inserted into the fitting hole 111h, and the extension part 170 advances and retracts along the direction of the central axis 111d of the insertion hole 111c when the elongated part 180 moves forward and backward along the longitudinal axis direction. It functions as a guide hole portion that guides the extending portion 170 so as to move.

[Base member 112]
As shown in FIG. 9D, the base member 112 is interposed between the support member 113 and the base member 111 in the direction of the central axis 111d of the insertion hole 111c. The base member 112 is fixed to the base member 111 and the support member 113 by, for example, a screw (not shown).

  The inner peripheral surface of the base member 112 is disposed in a U shape along the axis of the central axis 35 e of the treatment instrument insertion portion 35.

[Support member 113]
As illustrated in FIG. 9A, the support member 113 prevents the base unit 110 including the support member 113 from being displaced by, for example, sandwiching the treatment instrument insertion portion 35 when the auxiliary tool 100 is attached to the endoscope 10. A misalignment prevention unit 113c is provided. As shown in FIG. 9A, when the assisting tool 100 is attached to the endoscope 10, the misalignment preventing portion 113c is configured such that the support member 113 is disposed on the side of the grip portion 33, and the extension member 115 is a bend preventing portion. 31, the insertion hole 111c faces the treatment instrument insertion port 35a, and the central axis 111d of the insertion hole 111c is arranged coaxially with the central axis 35c of the treatment instrument insertion port 35a. In addition, the position shift of the base unit 110 is prevented. The misalignment prevention unit 113 c is disposed on the side surface of the support member 113. The inner peripheral surface of the misalignment preventing portion 113c is formed along the shape of the outer peripheral surface of the treatment instrument insertion portion 35, and has, for example, a U shape, and abuts on the outer peripheral surface of the treatment instrument insertion portion 35. .

[Extending member 115]
As shown in FIG. 9A, the extending member 115 is, for example, a rod-shaped member. The extension member 115 is integral with the support member 113. The central axis of the extending member 115 is arranged in parallel to the central axis 31 a of the folding stop portion 31 when the auxiliary tool 100 is attached to the endoscope 10.

[Fixed unit 130]
As shown in FIG. 9A, in the fixing unit 130, the insertion hole 111c faces the treatment instrument insertion port portion 35a, and the central axis 111d of the insertion hole 111c is disposed coaxially with the central axis 35c of the treatment instrument insertion port portion 35a. As described above, the base unit 110 is fixed to the endoscope 10. The fixed unit 130 is disposed on the base unit 110.

  As shown in FIGS. 9A and 9D, the fixing unit 130 includes a fixing unit that fixes the support member 113 to the holding unit 33 by, for example, wrapping around the holding unit 33 when the auxiliary tool 100 is attached to the endoscope 10. 133. The fixed unit 130 includes a misalignment prevention unit 135 that prevents misalignment of the base unit 110 including the extending member 115 by sandwiching the bend preventing unit 31, for example. Note that the fixing unit 130 may include the base member 112 described above.

[Fixed portion 133]
As shown in FIG. 9A, the fixing portion 133 is wound around the grip portion 33 after the displacement prevention portion 113 c abuts on the grip portion 33. The fixing part 133 is a U-shaped belt-like member, for example. One end portion of the fixing portion 133 is detachably fixed to one side surface of the support member 113 by, for example, a screw portion 261c. The other end portion (not shown) of the fixing portion 133 is detachably fixed to the other side surface of the support member 113 by, for example, a screw portion (not shown).

[Position displacement prevention unit 135]
As illustrated in FIG. 9A, the misalignment prevention unit 135 is disposed along a direction orthogonal to the direction of the central axis 31 a of the anti-bending unit 31. The misalignment prevention unit 135 is fixed to the extending member 115 by, for example, a screw portion 261b. The misalignment prevention unit 135 has, for example, a substantially Y shape. The inner peripheral surface of the misalignment prevention unit 135 is formed so as to follow the shape of the outer peripheral surface of the bend preventing portion 31, and is disposed around the central axis 31 a of the bend preventing portion 31. The inner peripheral surface has, for example, a U shape, and abuts on the outer peripheral surface of the bend preventing portion 31. The misregistration prevention unit 135 abuts against the bend preventing unit 31 at the same time as the misregistration prevention unit 113 c abuts on the gripping portion 33.

[Advance / Retreat Unit 150]
As shown in FIGS. 9A, 9B, 9C, and 9D, the advancing / retreating unit 150 includes the elongate portion 180 so that the treatment instrument 51 moves forward and backward in conjunction with the elongate portion 180 moving forward and backward. The treatment tool 51 is connected to each other. For this reason, the advancing / retreating unit 150 is disposed to face the base unit 110 and holds the proximal end portion 51b of the treatment instrument 51 so that the treatment instrument 51 is inserted into the insertion hole 111c. The advance / retreat unit 150 moves the treatment instrument 51 forward and backward in the direction of the central axis of the treatment instrument 51 by moving the advance / retreat unit 150 forward and backward along the central axis 111 d direction of the insertion hole 111 c with respect to the base unit 110.

As shown in FIGS. 9A, 9B, 9C, and 9D, the advancing / retreating unit 150 is juxtaposed with the base member 111, connected to the extending portion 170, and the central axis of the insertion hole 111c with respect to the base unit 110. It has a flat base member 151 that moves forward and backward along the 111d direction. The advancing / retreating unit 150 is connected to the base member 151 so as to be coaxially disposed with respect to the insertion hole 111c, and has a cylindrical guide member 153 that guides the treatment instrument 51 when the treatment instrument 51 is inserted.
As shown in FIGS. 9A, 9B, 9C, and 9D, the advance / retreat unit 150 is coaxially disposed with respect to the insertion hole 111c, communicates with the guide member 153, and accompanies the advance / retreat movement of the base member 151. A cylindrical guide coupling member 155 coupled to the insertion hole 111c so as to be inserted into the guide member 153 is provided. The guide connecting member 155 guides the treatment tool 51 inserted through the guide connecting member 155 in the direction of the central axis 111d of the insertion hole 111c between the base unit 110 and the base member 151.
As shown in FIGS. 9A, 9B, 9C, and 9D, the advance / retreat unit 150 is disposed on the guide member 153, and the proximal end portion 51b of the treatment instrument 51 is coupled to the treatment instrument 51 so as to be connected to the guide member 153. And a restricting member 159 for restricting the forward / backward movement of the base member 151.

[Base member 151]
As shown in FIGS. 9C and 9D, the base member 151 is disposed such that the base member 111 is interposed between the base member 151 and the treatment instrument insertion portion 35 in the direction of the central axis 111d of the insertion hole 111c. The That is, the base member 151 is disposed farther from the treatment instrument insertion port 35 a than the base member 111.

As shown in FIG. 9D, the base member 151 is connected to an extending part 170 that is connected to the long part 180.
Accordingly, as shown in FIGS. 9A, 9B, 9C, and 9D, the base member 151 moves the extending portion 170 along the longitudinal axis of the long portion 180 as the long portion 180 moves forward. It is pulled by the long part 180. The base member 151 advances along the direction of the central axis 111d of the insertion hole 111c and approaches the base member 111. Thereby, the treatment tool 51 moves forward. The position where the treatment instrument 51 has advanced corresponds to the position where the base member 151 approaches the base member 111 and the position where the long portion 180 has advanced.
As shown in FIGS. 9A, 9B, 9C, and 9D, when the long portion 180 is retracted along the longitudinal axis direction of the long portion 180, the base member 151 is elongated through the extending portion 170. It is pushed back by the scale portion 180. The base member 151 is retracted along the direction of the central axis 111d of the insertion hole 111c and is separated from the base member 111. Thereby, the treatment tool 51 moves backward. The position where the treatment instrument 51 is retracted corresponds to a position where the base member 151 is separated from the base member 111 and a position where the long portion 180 is retracted.

  The forward / backward movement amount of the base member 151 corresponds to the forward / backward movement amount of the long portion 180 and corresponds to the forward / backward movement amount of the treatment instrument 51. These forward and backward movement amounts are the same in size. The maximum value of these forward / backward movement amounts corresponds to the length of a long opening 159c described later in the direction of the central axis 111d of the insertion hole 111c. The maximum value corresponds to the size of the site to be treated by the treatment tool 51 and has a desired value. The maximum value is 30 mm, for example.

  As illustrated in FIG. 9D, the base member 151 includes a first end 151 a that is on the back surface side of the base member 151 and faces the other end 111 b, and a second end 151 b that is the front side of the base member 151. The base member 151 passes through the base member 151 from the one end portion 151a toward the other end portion 151b, is disposed to face the insertion hole 111c, and has a fitting hole 151c into which the one end portion 153a of the guide member 153 is fitted. Have. The base member 151 passes through the base member 151 from the one end portion 151a toward the other end portion 151b, is disposed to face the fitting hole 111h, and is fitted to the other end portion 170b of the extending portion 170. It has a hole 151h.

[Guide member 153]
The guide member 153 functions as the moving side cylinder portion 215 in the first embodiment.
As shown in FIGS. 9C and 9D, the guide member 153 is disposed perpendicular to the planar direction of the base member 151. The guide member 153 is erected on the base member 151 so as to be separated from the treatment instrument insertion port portion 35a. The guide member 153 is disposed along the direction of the central axis 35c of the treatment instrument insertion port portion 35a. The guide member 153 is disposed coaxially with the treatment instrument insertion port portion 35a.

9C and 9D, the guide member 153 moves forward and backward along the direction of the central axis 111d of the insertion hole 111c together with the base member 151 because the guide member 153 is coupled to the base member 151. The inner diameter of the guide member 153 is substantially the same as the outer diameter of the guide connecting member 155.
For this reason, as shown in FIGS. 9C and 9D, when the base member 151 moves forward along the direction of the central axis 111d of the insertion hole 111c so as to approach the base member 111 as described above, the guide member 153 The connecting member 155 is inserted into the guide member 153, and the guide member 153 moves forward so as to cover the guide connecting member 155.
As shown in FIGS. 9C and 9D, when the base member 151 retreats along the direction of the central axis 111d of the insertion hole 111c so as to be separated from the base member 111 as described above, the guide member 153 is guided by the guide connecting member 155. Is retracted so that is removed from the guide member 153.

  As shown in FIG. 9D, the guide member 153 has one end 153a that fits into the fitting hole 151c and the other end 153b in which the holding portion 157 is disposed. The one end 153a is fixed to the base member 151 by, for example, a screw portion 261i.

[Guide connecting member 155]
The guide connecting member 155 functions as the fixed-side cylinder portion 205 in the first embodiment.
As shown in FIGS. 9C and 9D, the guide connecting member 155 is formed as a cylindrical member through which the treatment instrument 51 protruding from the guide member 153 is inserted. The guide connecting member 155 is disposed perpendicular to the planar direction of the base member 111 and the planar direction of the base member 151. The guide connecting member 155 is erected on the base member 111. The guide connecting member 155 is disposed along the direction of the central axis 35c of the treatment instrument insertion port portion 35a. The guide connecting member 155 is disposed coaxially with the treatment instrument insertion port portion 35a.

  As shown in FIGS. 9C and 9D, the guide connecting member 155 is inserted into one end portion 155a that is in close contact with the fitting portion 111e in a state where liquid tightness is ensured, and one end portion 153a of the guide member 153. The other end 155b. The one end portion 155a is fixed to the base member 111 by, for example, a screw portion 261e.

  When the guide member 153 moves forward and backward along the direction of the central axis 111 d of the insertion hole 111 c together with the base member 151, the guide connecting member 155 moves through the guide member 153 and is inserted into or removed from the guide member 153. At this time, the guide connecting member 155 guides the guide member 153 so that the guide member 153 moves forward and backward along the direction of the central axis 111d of the insertion hole 111c.

[Holding unit 157]
The holding part 157 functions as the engaging member 600 in the first embodiment.
As shown in FIG. 9C and FIG. 9D, the holding portion 157 is placed on the end portion of the tube portion 157a and the tube portion 157a inserted into the other end portion 153b of the guide member 153 through which the treatment instrument 51 is inserted. And a fixing member 157c through which the treatment instrument 51 is inserted. The holding portion 157 functions as a cap that covers the cylindrical portion 157a and the fixing member 157c, and has a tightening portion 157b that engages with the cylindrical portion 157a and tightens the fixing member 157c.

  The tightening portion 157b engages with the cylindrical portion 157a by rotating around the axis of the tightening portion 157b, and the tightening portion 157b tightens the fixing member 157c and compresses the fixing member 157c by tightening. The fixing member 157c comes into close contact with the proximal end portion 51b of the treatment instrument 51 by compression. Thereby, the treatment instrument 51 is integrated with the holding portion 157, the guide member 153, the base member 151, the extending portion 170, and the long portion 180. The fixing member 157c is formed of elastic material such as rubber.

  Therefore, as shown in FIGS. 9C and 9D, as described above, the treatment tool 51 held by the holding portion 157 moves forward when the base member 151 approaches the base member 111.

  As shown in FIGS. 9C and 9D, as described above, the treatment tool 51 held by the holding portion 157 moves backward when the base member 151 is separated from the base member 111.

[Regulating member 159]
As shown in FIG. 9C, the regulating member 159 has, for example, a T shape. The T-shaped piece 159a is fixed to the side surface of the base member 111 by, for example, a screw portion 261f. The other piece 159b of the T shape has a long opening 159c. The long opening 159c is disposed along the longitudinal axis of the other piece 159b, and is disposed along the direction of the central axis 111d of the insertion hole 111c. The long opening 159c penetrates the other piece 159b in the thickness direction of the other piece 159b. A threaded portion 261i that is fixed to the side surface of the base member 151 passes through the long opening 159c. One edge 159d of the long opening 159c is disposed at a position where the base member 151 contacts the base member 111 when the base member 151 moves forward.

  As the screw portion 261i moves along the long opening 159c, the base member 151 moves forward and backward along the direction of the central axis 111d of the insertion hole 111c. When the base member 151 moves back and forth, the screw portion 261i comes into contact with the edges 159d and 159e of the long opening 159c, so that the base member 151 is prevented from moving back and forth.

[Extension part 170]
As shown in FIGS. 9C and 9D, the extension 170 is disposed along the direction of the central axis 111d of the insertion hole 111c, and is shifted from the treatment instrument 51 in the plane direction of the base unit 110. Established. The extending portion 170 is connected to the advance / retreat unit 150 and extends from the advance / retreat unit 150 toward the base unit 110 so as to penetrate the base unit 110. Such an extension part 170 is, for example, a bar member. The extending part 170 is arranged in parallel with the guide connecting member 155 in the planar direction of the base member 111. The extending portion 170 is inserted into the fixed cylinder member 190c, and has one end 170a through which the fixed cylinder member 190c is inserted as the base member 151 moves forward and backward, and the other end 170b that fits into the fitting hole 151h. The other end 170b is fixed to the base member 151 by, for example, a pin-shaped member 261j.

[Long part 180]
As shown in FIGS. 9A and 9D, the long portion 180 has a length from the treatment instrument insertion portion 35 to the distal end portion side of the insertion portion 20 and has a length from the treatment instrument insertion portion 35 to the distal end of the insertion portion 20. It is arranged to the part side. The long portion 180 has a longitudinal axis. The long portion 180 is connected to the extending portion 170. The long portion 180 moves the advance / retreat unit 150 forward / backward via the extension portion 170 as the long portion 180 moves forward / backward along the longitudinal axis direction.

  The long portion 180 is, for example, an elongated rigid body having flexibility. Such a long portion 180 is formed of a strand that is rigid in the axial direction and soft in the radial direction. As shown in FIG. 9D, the long portion 180 is disposed coaxially with the extending portion 170. The long portion 180 is disposed from the treatment instrument insertion portion 35 to the flexible tube portion 25 as shown in FIG. 9A.

  As shown in FIG. 9A, the long portion 180 advances along the longitudinal axis direction of the long portion 180 when the long portion 180 is pulled from the operation portion 30 side to the distal end hard portion 21 side. As a result, the long portion 180 brings the base member 151 close to the base member 111 via the extending portion 170 and advances the treatment instrument 51.

  As shown in FIG. 9A, the long portion 180 retreats along the longitudinal axis direction of the long portion 180 when the long portion 180 is pushed back from the distal end hard portion 21 side to the operation portion 30 side. As a result, the long portion 180 separates the base member 151 from the base member 111 via the extending portion 170 and retracts the treatment instrument 51.

  As shown in FIGS. 9A and 9D, the long portion 180 includes a proximal end portion 180a connected to one end portion 170a of the extending portion 170 and a distal end protruding from a distal end portion 190b of a long guide member 190 described later. And a long operation portion 180c that is disposed at the distal end portion and operates to move the long portion 180 forward and backward. The long operation unit 180c functions as a knob held by an operator, for example.

[Long guide member 190]
As shown in FIGS. 9A and 9B, the auxiliary tool 100 includes a long guide member 190 that guides the long portion 180 when the long portion 180 is inserted. The long guide member 190 is formed as an elongated cylindrical member through which the long portion 180 is inserted. The long guide member 190 is shorter than the long portion 180. The long portion 180 guide is disposed from the treatment instrument insertion portion 35 to the flexible tube portion 25. The long guide member 190 has flexibility.

  The long guide member 190 has a proximal end portion 190a and a distal end portion 190b from which the distal end portion of the long portion 180 including the long operation portion 180c protrudes.

  As shown in FIG. 9D, the long guide member 190 has a fixed cylinder member 190 c disposed at the base end portion 190 a of the long guide member 190. The fixed cylinder member 190c is fixed to the base unit 110 such that the extending portion 170 is inserted into the fixed cylinder member 190c. The fixed cylinder member 190 c fixes the long guide member 190 to the base unit 110. The fixed cylinder member 190c is inserted into the base end portion 190a and fixed to the base end portion 190a, and is inserted into the fitting hole 111h to be fitted into the fitting hole 111h. The extending portion 170 is inserted into the fixed cylinder member 190c, and is inserted through the fixed cylinder member 190c as the base member 151 moves forward and backward.

  As shown in FIGS. 9A and 9B, the long guide member 190 has a finger insertion portion 190d disposed at the distal end portion 190b. In a state where the surgeon grasps the long portion 180 including the long guide member 190 and pinches the long operation portion 180c, the finger of the operator's hand pinching the long operation portion 180c passes through the finger insertion portion 190d. The finger insertion part 190d is a ring-shaped strip member.

[First elastic member 220 and second elastic member 230]
In the present embodiment, as shown in FIG. 9D, the first elastic member 220 is disposed on the guide connecting member 155 that functions as the fixed-side cylinder portion 205. The first elastic member 220 has a hollow shape. The first elastic member 220 has, for example, a ring shape.

  As shown in FIG. 9D, the second elastic member 230 is disposed on the guide member 153 that functions as the moving-side cylinder portion 215. The second elastic member 230 has a hollow shape. The second elastic member 230 has, for example, a ring shape.

  In the present embodiment, even if the auxiliary tool 100 is of a type different from the first embodiment as described above, when the auxiliary tool 100 is used as shown in FIG. 9E, it is substantially the same as the first embodiment. An effect can be obtained.

  The present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements 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.

Claims (11)

A fixing member that has a fixed-side tube portion and is attached to the treatment instrument insertion port portion in a liquid-tight state so that the fixed-side tube portion communicates with the treatment instrument insertion port portion of the endoscope ;
A moving member in which a treatment instrument is inserted and fixed, and the moving cylinder is inserted into the fixed cylinder or the fixed cylinder is inserted into the moving cylinder A moving member in which the moving side cylinder part moves forward and backward with respect to the fixed side cylinder part along the central axis direction of the fixed side cylinder part;
It is arranged between the fixed side cylinder part and the moving side cylinder part so as to ensure liquid-tightness between the fixed side cylinder part and the moving side cylinder part, and on the peripheral surface of the fixed side cylinder part. And an elastic member fixed substantially coaxially with the fixed-side tube portion ;
Equipped with,
The elastic member is an advancing / retreating assisting tool having an annular shape having a diameter different in the thickness direction of the elastic member, which is in close contact with the peripheral surface of the moving-side cylinder portion .   The advance / retreat assist tool according to claim 1, wherein the moving-side tube portion is disposed coaxially with the fixed-side tube portion. The elastic member is
A close contact portion that is disposed on a peripheral surface of the elastic member facing the peripheral surface of the moving side cylindrical portion, and is in close contact with the peripheral surface of the moving side cylindrical portion;
A non-contact portion disposed on the peripheral surface of the elastic member and not in close contact with the peripheral surface of the moving side tubular portion in the radial direction of the elastic member;
Have
The contact portion is disposed closer to the treatment instrument insertion port than the non-contact portion,
When the moving side cylinder part is inserted into the fixed side cylinder part, the inner diameter of the contact part is smaller than the inner diameter of the non-contact part,
The advance / retreat assist tool according to claim 1, wherein when the fixed-side cylinder portion is inserted into the movable-side cylinder portion, an outer diameter of the close contact portion is larger than an outer diameter of the non-contact portion. Another elastic member that is disposed at a position different from the elastic member between the fixed-side tube portion and the movable-side tube portion and ensures liquid tightness between the fixed-side tube portion and the movable-side tube portion. Comprising
Said another elastic member, wherein the circumferential surface or the fixed-side cylinder portion is fixed to the peripheral surface of the movable tubular portion, radial in the thickness direction are different, forward and backward according to claim 1 which is ring shaped Auxiliary tool. 5. The other elastic member is fixed substantially coaxially with the moving-side tube portion on the peripheral surface of the moving-side tube portion, and partially adheres to the peripheral surface of the fixed-side tube portion. Advancement / retraction aid described in 1. The other elastic member is:
Is disposed on the peripheral surface of the other elastic member that faces the peripheral surface of the stationary cylindrical portion, and a close contact portion in close contact with the circumferential surface of the stationary cylindrical portion,
Said disposed in the circumferential surface of the other elastic member, not in close contact with the peripheral surface of the fixed-side cylinder portion in a radial direction of said other elastic member non-adhesion portion,
Have
The non-contact part is disposed closer to the treatment instrument insertion port than the contact part,
When the moving side cylinder part is inserted into the fixed side cylinder part, the outer diameter of the contact part is larger than the outer diameter of the non-contact part,
The advance / retreat assist tool according to claim 5 , wherein an inner diameter of the contact portion is smaller than an inner diameter of the non-contact portion when the fixed-side tube portion is inserted into the moving-side tube portion.   The advance / retreat assist tool according to claim 1, further comprising an engaging member that engages the treatment instrument with the movement-side cylinder portion so that the treatment instrument inserted through the movement-side cylinder portion moves together with the movement-side cylinder portion. . A rotating part having an axis different from the central axis of the fixed-side cylinder part and rotating around the axis;
An advancing / retracting mechanism for converting the rotational force of the rotating part into the advancing / retreating force of the moving side cylinder part and transmitting the advancing / retracting force to the moving member to move the moving member forward / backward;
The advance / retreat assist tool according to claim 1, comprising:   The advance / retreat assist tool according to claim 1, further comprising a rotation restricting portion that restricts the movement-side tube portion from rotating around the central axis of the fixed-side tube portion with respect to the fixed-side tube portion.   An endoscope to which the advance / retreat assist tool according to claim 1 is attached. The advance / retreat assist tool according to claim 1,
An endoscope to which the advance / retreat assist tool is attached;
A treatment instrument that is inserted into the endoscope and is advanced and retracted by the advance / retreat assist tool;
An endoscope system comprising:

Images