JP6744831B2 - Treatment instrument channel and endoscope - Google Patents

Description

The present invention relates to a treatment tool channel and an endoscope, and more particularly to a treatment tool channel for inserting a treatment tool and an endoscope including the treatment tool channel.

Conventionally, in the medical field, medical diagnosis using an endoscope has been performed. In medical diagnosis using an endoscope, an imaging element is built into a rigid end of an endoscope insertion portion (hereinafter referred to as an insertion portion) that is inserted into the body to capture an image of the inside of the body, and this image is displayed on a monitor. After displaying, for example, a procedure of collecting a tissue with a treatment tool such as a puncture needle or a procedure of placing a stent is performed.

In such an endoscope, a treatment tool having high bending rigidity has recently been used. The treatment instrument is inserted into the insertion portion through the treatment instrument insertion port and led out to the outside through the treatment instrument lead-out port. The treatment instrument insertion port is provided in the operation portion of the endoscope, and the treatment instrument lead-out port is provided in the tip end main body of the hard tip portion.

Patent Document 1 discloses a convex type ultrasonic endoscope using a puncture needle. The operation portion of this ultrasonic endoscope is provided with a puncture needle insertion port, and the puncture needle insertion port has a proximal end of a flexible puncture needle insertion tube (corresponding to a treatment instrument insertion tube). The sides are connected. The puncture needle insertion tube is inserted and arranged from the flexible portion of the insertion portion to the curved portion. A connecting portion is formed on the distal end side of the treatment instrument insertion tube, and the connecting portion is connected to the proximal end side of a connecting pipe (corresponding to a pipe member). The tip side of the connecting pipe is communicated with an outlet (corresponding to a treatment instrument outlet), and this outlet is provided in a tip block (corresponding to the tip body) of the tip (corresponding to the hard tip). ing.

In general, a puncture needle is inserted into a treatment instrument insertion port together with a sheath in a state where it is inserted into a flexible sheath, and is drawn out from a treatment instrument extraction port via a treatment instrument insertion tube and a pipe member. The bending rigidity of the sheath is lower than the bending rigidity of the puncture needle, but the rigidity of the puncture needle is governed by the insertion of the puncture needle. In the case of a puncture needle, the sheath and the like are called a treatment tool.

Japanese Unexamined Patent Publication No. 2-21852

By the way, in the ultrasonic endoscope disclosed in Patent Document 1, when the puncture needle is inserted in a shape in which the insertion portion is curved toward the up side (upper side), that is, an up-angle shape, the following problems occur. It may occur especially. The up-angle configuration is a configuration in which the insertion section is curved to the up side when the direction in which the treatment tool is drawn by the ultrasonic transducer is orthogonal to the central axis of the insertion section.

FIG. 20 is an enlarged cross-sectional view of a main part of the treatment instrument channel 206 in which the distal end side connection portion 202 of the treatment instrument insertion tube 200 is connected to the proximal end side of the forceps pipe 204 which is a pipe member. Further, FIG. 20 shows a state in which the puncture needle 208 having an up-angled shape and high bending rigidity is inserted into the treatment instrument insertion tube 200 together with the sheath 210.

Here, the connection portion 202 of the treatment instrument insertion tube 200 is a length from the distal end 200A of the treatment instrument insertion tube 200 to the base end 204A of the forceps pipe 204 in the central axis A direction of the treatment instrument insertion tube 200. Refers to the cylindrical portion of B.

In the up-angle configuration, the central axis A of the treatment instrument insertion tube 200 in the vicinity of the connection portion 202 is largely inclined with respect to the insertion direction C of the sheath 210, so that the distal end 210A of the sheath 210 is positioned at the treatment instrument insertion tube 200. Abuts on the inner peripheral portion 200B. When the sheath 210 is advanced in the insertion direction C toward the forceps pipe 204 in this state, the distal end 210A advances to the outside of the treatment instrument insertion tube 200 while elastically deforming the inner peripheral portion 200B. Then, when the tip 210A reaches the base end 204A of the forceps pipe 204, the tip 210A is caught on the base end 204A of the forceps pipe 204 as shown in FIG. Due to such a phenomenon, in the treatment tool channel of Patent Document 1, there is a problem that the sheath 210 cannot be smoothly advanced toward the forceps pipe 204.

It should be noted that such a problem is not limited to the sheath 210, and it is considered that the same problem may occur when other treatment tools such as forceps having high bending rigidity are inserted.

The present invention has been made in view of such circumstances, and an object thereof is to provide a treatment instrument channel and an endoscope capable of smoothly advancing the treatment instrument from the treatment instrument insertion tube toward the pipe member. To do.

In order to achieve the object of the present invention, a treatment instrument channel according to the present invention is attached to a distal end body of an endoscope insertion portion, and a pipe member that communicates with a treatment instrument outlet provided in the distal end body. And a treatment instrument insertion tube connected to the pipe member, wherein the treatment instrument insertion tube has a first region formed on a distal end side of the treatment instrument insertion tube and a proximal end side of the first region. The second region is formed, the first region is a region having a higher crush resistance than the second region, and a connection portion connected to the pipe member is formed in the first region.

According to the treatment instrument channel of the present invention, when the tip of the treatment instrument inserted in the treatment instrument insertion tube comes into contact with the inner peripheral portion of the second region, the tip of the treatment instrument is the inner periphery of the second region. The part is elastically deformed to the outside while advancing toward the first region. When the distal end of the treatment tool passes through the second region and comes into contact with the inner peripheral portion of the first region, the first region has a higher crush resistance than the second region, so that the distal end of the treatment tool is It advances along the inner peripheral portion of the first region in which the elastic deformation to the outside is suppressed. As a result, the distal end of the treatment tool is guided to the pipe member without being caught by the proximal end of the pipe member.

Further, according to the treatment instrument channel of the present invention, the distal end of the treatment instrument inserted into the treatment instrument insertion tube directly contacts the inner peripheral portion of the first region without contacting the inner peripheral portion of the second region. When in contact, the distal end of the treatment tool advances along the inner peripheral portion of the first region in which the outward elastic deformation is suppressed. As a result, the distal end of the treatment tool is guided to the pipe member without being caught by the proximal end of the pipe member.

Therefore, according to the treatment instrument channel of the present invention, the treatment instrument can be smoothly advanced from the treatment instrument insertion tube toward the pipe member.

According to one aspect of the present invention, in a state before the treatment instrument insertion tube is connected to the pipe member, the inner diameter of the connecting portion is smaller than the outer diameter of the pipe member, and the inner diameter of the connecting portion is the connecting portion of the first region. When the pipe member is formed larger than the inner diameter on the proximal end side and the pipe member and the treatment instrument insertion tube are connected, the inner diameter on the proximal end side with respect to the connecting portion of the first region is the same as the inner diameter of the pipe member or It is preferable that the inner diameter of the pipe member is smaller than that of the pipe member.

According to one aspect of the present invention, the connection portion is expanded outward by fitting the pipe member, and is closely fixed to the pipe member when the pipe member is completely fitted. At this time, since the inner diameter of the first region on the proximal side of the connecting portion is the same as the inner diameter of the pipe member or smaller than the inner diameter of the pipe member, it is ensured that the distal end of the treatment tool is caught on the proximal end of the pipe member. Can be prevented.

According to one aspect of the present invention, it is preferable that the outer diameter of the connecting portion is larger than the outer diameter of the connecting portion in the first region on the base end side before the connecting portion is connected to the pipe member. ..

According to one aspect of the present invention, it is possible to increase the strength of the connection portion of the treatment instrument insertion tube.

According to one aspect of the present invention, the treatment instrument insertion tube is provided with an outer pipe on the outer periphery of the connection portion, and the outer pipe extends from the connection portion to the proximal end side of the treatment instrument insertion tube. It is preferable that a part is formed.

According to the aspect of the present invention, at least the connection portion of the first region can be prevented from being deformed by the outer pipe.

In one aspect of the present invention, it is preferable that the second region is formed closer to the proximal end side of the treatment instrument insertion tube than the outer pipe.

According to the aspect of the present invention, in the angled form, the second region smoothly curves without being restricted by the outer pipe.

According to one aspect of the present invention, in a state before the treatment instrument insertion tube is connected to the pipe member, the inner diameter of the connecting portion is smaller than the outer diameter of the pipe member, and the inner diameter of the connecting portion is the connecting portion of the first region. When the pipe member is formed larger than the inner diameter on the proximal end side and the pipe member and the treatment instrument insertion tube are connected, the inner diameter on the proximal end side with respect to the connecting portion of the first region is the same as the inner diameter of the pipe member or The inner diameter of the pipe member is smaller than the outer diameter of the connecting portion in the state before the connecting portion is connected to the pipe member, and the outer diameter of the connecting portion is larger than the outer diameter on the base end side of the connecting portion. The treatment instrument insertion tube is provided with an outer pipe on the outer peripheral portion of the connection portion, and the outer pipe is formed with an extension portion extending from the connection portion to the proximal end side of the treatment instrument insertion tube. An adhesive is preferably applied to a gap between the portion and the treatment instrument insertion tube.

According to one aspect of the present invention, it is possible to reliably prevent the distal end of the treatment tool from being caught on the proximal end of the pipe member, and it is possible to increase the strength of the connection portion of the treatment tool insertion tube. The deformation of at least the connection portion in the first region can be suppressed by the outer pipe, and further, the application region of the first region to which the adhesive is applied can be reinforced.

In one aspect of the present invention, the adhesive preferably extends from the gap to the proximal end side of the treatment instrument insertion tube.

According to one aspect of the present invention, the treatment instrument insertion tube located on the proximal side from the gap can be reinforced with an adhesive.

In one aspect of the present invention, it is preferable that the second region is formed closer to the proximal end side of the treatment instrument insertion tube than the outer pipe.

According to the aspect of the present invention, in the angled form, the second region smoothly curves without being restricted by the outer pipe.

According to one aspect of the present invention, in a state before the treatment instrument insertion tube is connected to the pipe member, the inner diameter of the connecting portion is smaller than the outer diameter of the pipe member, and the inner diameter of the connecting portion is the connecting portion of the first region. When the pipe member is formed larger than the inner diameter on the proximal end side and the pipe member and the treatment instrument insertion tube are connected, the inner diameter on the proximal end side with respect to the connecting portion of the first region is the same as the inner diameter of the pipe member or The inner diameter of the pipe member is smaller than the outer diameter of the connecting portion in the state before the connecting portion is connected to the pipe member, and the outer diameter of the connecting portion is larger than the outer diameter on the base end side of the connecting portion. The treatment instrument insertion tube is provided with an outer pipe on the outer peripheral portion of the connection portion, and the outer pipe is formed with an extension portion extending from the connection portion to the proximal end side of the treatment instrument insertion tube. It is preferable that a close contact spring is provided outside the outer circumference of the treatment instrument insertion tube in a gap between the portion and the treatment instrument insertion tube.

According to one aspect of the present invention, it is possible to reliably prevent the distal end of the treatment tool from being caught on the proximal end of the pipe member, and it is possible to increase the strength of the connection portion of the treatment tool insertion tube. The deformation of at least the connection portion in the first region can be suppressed by the outer pipe, and further, the exterior region of the first region in which the contact spring is exterior can be reinforced.

In one aspect of the present invention, it is preferable that the contact spring extends from the gap to the proximal end side of the treatment instrument insertion tube.

According to one aspect of the present invention, the treatment instrument insertion tube located on the proximal side from the gap can be reinforced by the contact spring.

In one aspect of the present invention, it is preferable that the second region is formed closer to the proximal end side of the treatment instrument insertion tube than the outer pipe.

According to the aspect of the present invention, in the angled form, the second region smoothly curves without being restricted by the outer pipe.

In one aspect of the present invention, it is preferable that a boundary portion formed between the first region and the second region of the treatment instrument insertion tube is provided within a range in which the close contact spring is covered.

According to one aspect of the present invention, the boundary portion between the first region and the second region can be reinforced by the contact spring.

In one aspect of the present invention, it is preferable that an annular protrusion that protrudes toward the outer peripheral portion of the treatment instrument insertion tube is provided on the inner peripheral portion of the extending portion of the outer pipe.

According to one aspect of the present invention, since the treatment instrument insertion tube is brought into contact with and supported by the protrusion in the angled form, excessive deformation of the treatment instrument insertion tube can be suppressed.

According to one aspect of the present invention, the endoscope insertion portion includes a flexible portion, a bending portion, and a distal end portion main body from the proximal end side toward the distal end side, and includes a first region and a second region of the treatment instrument insertion tube. It is preferable that the boundary portion formed between the two is formed at a position on the distal end side of the bending portion in the direction from the distal end to the proximal end of the treatment instrument insertion tube.

According to one aspect of the present invention, the boundary portion between the first region and the second region is formed at the position on the tip side of the bending portion, so that the bending portion can be smoothly curved.

The endoscope of the present invention includes the treatment instrument channel of the endoscope of the present invention in order to achieve the object of the present invention.

According to the endoscope of the present invention, the treatment instrument can be smoothly advanced from the treatment instrument insertion tube toward the pipe member.

According to the present invention, the treatment instrument can be smoothly advanced from the treatment instrument insertion tube toward the pipe member.

Overall perspective view of an ultrasonic examination system having an ultrasonic endoscope provided with a treatment tool channel of the present embodiment Schematic diagram showing the overall configuration of the ultrasonic inspection system of FIG. Enlarged cross-sectional view of the main part showing the non-angled form of the insertion part shown in FIG. Perspective view of the rigid tip of the ultrasonic endoscope Plan view of the rigid tip of the ultrasonic endoscope Side view of the rigid tip of the ultrasonic endoscope Front view of the rigid tip of the ultrasonic endoscope Enlarged sectional view of the main part of the treatment tool channel according to the first embodiment. Explanatory drawing showing a state in which the sheath is inserted into the treatment instrument insertion tube in an up-angle form The perspective view which expanded and showed the front end side of the treatment tool insertion tube and the base end side of the forceps pipe. Explanatory drawing in which the boundary part is arranged within the range of the axial length of the connecting pipe Explanatory drawing which shows the structure of the treatment tool channel which formed the boundary part in the position of the front end side of a bending part. The principal part expanded sectional view which shows the 1st modification of the treatment tool channel of 1st Embodiment. The principal part expanded sectional view which shows the 2nd modification of the treatment tool channel of 1st Embodiment. Enlarged sectional view of the main part of the treatment tool channel of the second embodiment Enlarged sectional view of the main part of the treatment tool channel of the third embodiment Enlarged sectional view of the main part of the treatment tool channel of the fourth embodiment Enlarged sectional view of the main part of the treatment tool channel of the fifth embodiment Enlarged sectional view of the main part of the treatment tool channel of the sixth embodiment Enlarged cross-sectional view of the main part in which the puncture needle is inserted into the treatment instrument insertion tube together with the sheath in the up-angle form

Hereinafter, preferred embodiments of a treatment instrument channel and an endoscope according to the present invention will be described in detail with reference to the accompanying drawings.

FIG. 1 is an overall perspective view showing an example of an ultrasonic inspection system 1, and shows an ultrasonic endoscope 10 including a treatment tool channel of the present embodiment. FIG. 2 is a schematic diagram showing the overall configuration of the ultrasonic inspection system 1 shown in FIG.

As shown in FIGS. 1 and 2, an ultrasonic examination system 1 includes an ultrasonic endoscope 10 that captures an endoscopic image and an ultrasonic image inside a body, and an ultrasonic processor unit 12 that generates an ultrasonic image. An endoscope processor unit 14 that generates an endoscopic image, a light source device 16 that supplies illumination light that illuminates the inside of the body to the ultrasonic endoscope 10, and a monitor 18 that displays the endoscopic image and the ultrasonic image. And

The ultrasonic endoscope 10 is a convex type ultrasonic endoscope, and includes an insertion portion 22 to be inserted into the body, an operation portion 24 that is continuously provided at the proximal end of the insertion portion 22, and an operation portion 24. And a universal cord 26 having ends connected to each other. A connector 28 connected to the ultrasonic processor unit 12, a connector 30 connected to the endoscope processor unit 14, and a connector 32 connected to the light source device 16 are provided at the tip of the universal cord 26. Has been. The ultrasonic endoscope 10 is detachably connected to the ultrasonic processor unit 12, the endoscope processor unit 14, and the light source device 16 via these connectors 28, 30, 32.

The processor unit 12 for ultrasonic waves, the processor unit 14 for endoscopes, and the light source device 16 are loaded on a cart 20 with casters as shown in FIG. A monitor 18 is attached to a pole 34 of the cart 20. The monitor 18 has its screen direction and height adjusted by a rotation mechanism and a height adjustment mechanism (not shown) provided on the pole 34. To be done.

As shown in FIG. 2, the insertion portion 22 is configured by connecting the flexible portion 36, the bending portion 38, and the distal end hard portion 40 from the proximal end side toward the distal end side. The distal end rigid portion 40 has a distal end portion main body 42 made of a hard member, and the treatment instrument outlet port 44 (see FIG. 3) is provided in the distal end portion main body 42.

FIG. 3 is an enlarged sectional view of an essential part showing a non-angled form of the insertion part 22 shown in FIG. The non-angled state means the state of the insertion portion 22 in which the bending portion 38 is not bent.

The distal end portion of the bending portion 38 is connected to the proximal end portion of the distal end portion body 42. The bending portion 38 is composed of a plurality of node rings 46. The plurality of node rings 46 are arranged along the central axis D of the insertion portion 22. Each node ring 46 is swingably connected to an adjacent node ring 46 via a pin 48. In addition, a node ring (hereinafter, referred to as a tip node ring) 46A located on the tip side among the plurality of node rings 46 is connected to a base end portion of the tip portion main body 42 via a pin 48A. All the node rings 46 including the tip node ring 46A are covered with a flexible jacket tube (not shown). Thereby, the bending portion 38 is configured to be bendable.

The treatment instrument insertion tube 50 shown in FIG. 3 is inserted and arranged inside the insertion portion 22 shown in FIG. The puncture needle 208 inserted in the sheath 210 (see FIG. 20) is guided to the treatment instrument lead-out port 44 by the treatment instrument insertion tube 50. The treatment instrument insertion tube 50 is configured by a flexible tube made of, for example, polytetrafluoroethylene. The treatment instrument insertion tube 50 has a first region 52 formed on the distal end side of the treatment instrument insertion tube 50 and a second region 54 formed on the proximal end side of the first region 52. The first area 52 and the second area 54 will be described later.

The proximal end of the treatment instrument insertion tube 50 is connected to the treatment instrument insertion port 24a provided on the distal end side of the operation unit 24 in FIG. Further, as shown in FIG. 3, the distal end side connection portion 56 of the treatment instrument insertion tube 50 is connected to the proximal end side of the forceps pipe 58 which is a pipe member. The forceps pipe 58 has the tip end side of the forceps pipe 58 attached to the tip end main body 42 and communicates with the treatment instrument lead-out port 44.

Returning to FIG. 2, the operation section 24 includes an angle knob 24b for bending the bending section 38, an upright lever 24c for uprighting the upright stand 64 (see FIG. 3), a suction button 24d for performing a suction operation, an air feeding and An air/water supply button 24e for performing a water supply operation and a switching button 24f for switching an image displayed on the monitor 18 are provided.

Next, the configuration of the distal end hard portion 40 of the ultrasonic endoscope 10 will be described with reference to FIGS. 4 to 7.

4 is a perspective view of the tip rigid portion 40, FIG. 5 is a plan view of the tip rigid portion 40, FIG. 6 is a side view of the tip rigid portion 40, and FIG. 7 is a front view of the tip rigid portion 40.

An ultrasonic observation unit 60 and an endoscope observation unit 62 are provided on the distal end body 42 of the distal end hard portion 40. The endoscope observation section 62 is provided on the proximal end side of the ultrasonic observation section 60, and the treatment instrument outlet 44 is provided in the endoscope observation section 62.

The ultrasonic observation section 60 has an ultrasonic transducer 70 including an electroacoustic conversion section 66 and a backing material 68, as shown in FIG.

The electroacoustic conversion unit 66 includes a plurality of piezoelectric elements (not shown) arranged along the main body central axis Z direction of the distal end main body 42. An observation surface 66a for transmitting and receiving ultrasonic waves is formed on the surface of each of the plurality of piezoelectric elements. An acoustic lens 72 for converging ultrasonic waves is provided on the observation surface 66a. The backing material 68 is fixed to the surface opposite to the observation surface 66a.

Each piezoelectric element of the electroacoustic conversion unit 66 is provided with an electrode (not shown), and the electrode is connected to the wiring connection unit 74 via a flexible printed board (not shown). The wiring connecting portion 74 is provided on the bottom surface of the backing material 68. A plurality of wires 76 are connected to the wire connecting portion 74, and the wires 76 are wired to the wire insertion hole 78 of the tip end main body 42 and a flexible pipe (not shown), so that the ultrasonic processor unit 12 of FIG. Connected to. According to the ultrasonic observation unit 60 configured as described above, the piezoelectric elements of the electroacoustic conversion unit 66 are sequentially driven by the ultrasonic processor unit 12 to perform ultrasonic electronic scanning.

As shown in FIGS. 4 and 5, the endoscope observation section 62 includes an observation optical system 80, illumination optical systems 82 and 84, and an image sensor (not shown).

On the left and right sides of the treatment instrument lead-out port 44 of the distal end portion main body 42, inclined surfaces 86a and 86b are provided which are inclined toward the base end side by a predetermined angle with respect to a plane orthogonal to the main body central axis Z. An observation window 80a of the observation optical system 80 and an illumination window 82a of one illumination optical system 82 are provided on the inclined surface 86a on the left side from the base end side of the tip end portion main body 42 toward the tip end side. Further, an illumination window 84a of the other illumination optical system 84 is provided on the inclined surface 86b on the right side from the proximal end side of the distal end portion main body 42 toward the distal end side.

The observation optical system 80 includes an optical system member (not shown) that takes in light from a subject in the observation visual field range through the observation window 80a and forms a subject image inside the distal end rigid portion 40. An image pickup element (not shown) that picks up a subject image formed by the observation optical system 80 and generates an image pickup signal is arranged inside the hard tip portion 40. This image sensor is driven and controlled by the endoscope processor unit 14 shown in FIG. The endoscope processor unit 14 acquires an image pickup signal transmitted from the image pickup element and performs various signal processing to generate a video signal for an endoscopic image.

The illumination optical systems 82 and 84 are optical system members that emit the illumination light transmitted from the light source device 16 (see FIG. 2) via a light guide (not shown) to the observation visual field range via the illumination windows 82a and 84a. Equipped with. A cleaning nozzle 88 for ejecting a liquid or gas toward the observation window 80a is provided near the observation window 80a on the inclined surface 86a.

The treatment instrument outlet 44 is provided on the proximal side of the ultrasonic observation unit 60. In addition, the treatment tool outlet 44 is communicated with a recessed upright stand accommodating portion 90. The upright stand accommodating portion 90 is rotatably provided with a upright stand 64 that changes the direction in which the sheath 210 (see FIG. 20) is led out. The upright base 64 is reciprocated between the fallen position and the upright position by operating the upright lever 24c shown in FIG. In addition, in the present embodiment, as the treatment tool, the one including the puncture needle 208 and the sheath 210 is illustrated, but the treatment tool is not limited to this, and other treatment tools such as forceps may be used.

Next, an embodiment of the treatment tool channel according to the present invention will be described.

FIG. 8 is an enlarged cross-sectional view showing the distal end side of the treatment instrument insertion tube 50 shown in FIG. 3, and is an enlarged cross-sectional view of a main part of the treatment instrument channel 100 according to the first embodiment.

As shown in FIG. 8, the treatment instrument channel 100 includes a forceps pipe 58 and a treatment instrument insertion tube 50 connected to the forceps pipe 58. The treatment instrument insertion tube 50 has a first region 52 formed on the distal end side of the treatment instrument insertion tube 50 and a second region 54 formed on the proximal end side of the first region 52. The first region 52 is a region having higher crush resistance than the second region 54, and the connection portion 56 connected to the forceps pipe 58 is formed in the first region 52. The connecting portion 56 of the treatment instrument insertion tube 50 is a length B from the distal end 50A of the treatment instrument insertion tube 50 to the base end 58A of the forceps pipe 58 in the central axis A direction of the treatment instrument insertion tube 50. Refers to the cylindrical part of.

The first region 52 of the embodiment is configured to have a solid structure by making the firing temperature higher or the firing time longer than the second region 54 when the treatment instrument insertion tube 50 is manufactured. As a result, the first region 52 becomes a region having higher crush resistance than the second region 54.

Regarding the second region 54, the entire region of the treatment instrument insertion tube 50 except the first region 52 may be set as the second region. In addition, the area that is inserted and arranged in the insertion section 22 excluding the area that is inserted in the operation section 24 may be set as the second area. Furthermore, the area inserted and arranged in the insertion section 22 excluding the area on the proximal end side of the insertion section 22 may be set as the second area. Since the second region 54 has a lower crush resistance than the first region 52, in other words, is softer than the first region 52, it does not affect the flexibility of the insertion portion 22.

FIG. 9 is an explanatory diagram showing a state in which the puncture needle 208 having an up-angled shape and high bending rigidity is inserted into the treatment instrument insertion tube 50 together with the sheath 210. According to FIG. 9, the sheath 210 is inserted into the treatment instrument insertion tube 50 along the insertion direction C.

According to the treatment instrument channel 100 of the first embodiment, when the distal end 210A of the sheath 210 abuts on the inner peripheral portion 54A of the second region 54, the distal end 210A of the sheath 210 becomes the inner peripheral portion 54A of the second region 54. Is elastically deformed to the outside while advancing toward the first region 52. When the distal end 210A of the sheath 210 passes through the second region 54 and comes into contact with the inner peripheral portion 52A of the first region 52, the first region 52 has a higher crush resistance than the second region 54. The distal end 210A of the sheath 210 advances along the inner peripheral portion 52A of the first region 52 in which the outward elastic deformation is suppressed. As a result, the distal end 210A of the sheath 210 is smoothly guided to the forceps pipe 58 without being caught by the proximal end 58A of the forceps pipe 58, as shown by the solid line in FIG.

Further, according to the treatment instrument channel 100 of the first embodiment, the distal end 210A of the sheath 210 directly contacts the inner peripheral portion 52A of the first region 52 without contacting the inner peripheral portion 54A of the second region 54. In this case, the distal end 210A of the sheath 210 advances along the inner peripheral portion 52A of the first region 52 in which the outward elastic deformation is suppressed. As a result, the distal end 210A of the sheath 210 is smoothly guided to the forceps pipe 58 without being caught by the proximal end 58A of the forceps pipe 58, as shown by the solid line in FIG.

Therefore, according to the treatment instrument channel 100 of the first embodiment, the distal end 210A of the sheath 210 has the inner peripheral portion of the treatment instrument insertion tube 50 (the inner peripheral portion 54A of the second region 54 and the inner peripheral portion of the first region 52). 52A), the sheath 210 can be smoothly advanced from the treatment instrument insertion tube 50 toward the forceps pipe 58.

FIG. 10 is an enlarged perspective view of the distal end side of the treatment instrument insertion tube 50 and the proximal end side of the forceps pipe 58.

As shown in FIG. 10, the inner diameter 56Di (diameter inside) of the connecting portion 56 is smaller than the outer diameter 58Do (diameter outside) of the forceps pipe 58 in a state before the treatment instrument insertion tube 50 is connected to the forceps pipe 58. It is formed. The inner diameter 56Di of the connecting portion 56 is formed to be larger than the inner diameter 52Di of the first region 52 on the proximal side of the connecting portion 56.

Further, as shown in FIG. 8, when the forceps pipe 58 and the treatment instrument insertion tube 50 are connected, the inner diameter 56Di of the first region 52 on the proximal side of the connection portion 56 is the same as the inner diameter 58Di of the forceps pipe 58. The diameter is smaller than the inner diameter 58Di of the forceps pipe 58.

According to the treatment instrument channel 100 of the first embodiment having the above-described configuration, the inner diameter 56Di of the connecting portion 56 and the outer diameter 58Do of the forceps pipe 58 have a relationship of 56Di<58Do, as shown in FIG. The forceps pipe 58 is expanded by fitting the forceps pipe 58, and is firmly fixed to the forceps pipe 58 when the forceps pipe 58 is completely fitted. At this time, the inner diameter 52Di (see FIG. 8) on the proximal end side of the connection portion 56 of the first region 52 is the same as the inner diameter 58Di of the forceps pipe 58 or smaller than the inner diameter 58Di. As a result, it is possible to reliably prevent the distal end 210A of the sheath 210 (see FIG. 9) from being caught by the proximal end 58A of the forceps pipe 58.

Further, in the treatment instrument channel 100 of the first embodiment, as shown in FIG. 10, in the state before the connecting portion 56 is connected to the forceps pipe 58, the outer diameter 56Do of the connecting portion 56 is the connecting portion of the first region 52. It is formed larger than the outer diameter 52Do on the base end side of 56.

With the above configuration, according to the treatment instrument channel 100 of the first embodiment, the wall thickness of the connection portion 56 ((56Do-56Di)/2) can be increased, so that the strength of the connection portion 56 can be increased. it can.

The treatment instrument channel 100 of the first embodiment includes an outer pipe 102 as shown in FIG. The outer pipe 102 is mounted on the outer peripheral portion of the connecting portion 56. Further, the outer pipe 102 is formed with an extending portion 104 extending from the connecting portion 56 to the proximal end side of the treatment instrument insertion tube 50. That is, the outer pipe 102 has a length E that reliably covers the connecting portion 56 having a length B.

With the above configuration, according to the treatment instrument channel 100 of the first embodiment, at least the connection portion 56 in the first region 52 can be protected and reinforced by the outer pipe 102. The connecting portion 56 is a portion that is deformed when the angle form shown in FIG. 9 is formed, but the outer pipe 102 can suppress the deformation of the connecting portion 56. As a result, the stress generated in the connection portion 56 due to the deformation of the connection portion 56 can be reduced, so that the service life of the treatment instrument insertion tube 50 is extended. Further, in the mode in which the connecting portion 56 and the outer pipe 102 are fixed by an adhesive (not shown), it is possible to prevent the connecting portion 56 from being deformed due to peeling of the adhesive.

Further, in the treatment instrument channel 100 of the first embodiment, as shown in FIG. 8, a second region 54 is formed on the proximal end side of the treatment instrument insertion tube 50 with respect to the outer pipe 102.

With the above configuration, according to the treatment instrument channel 100 of the first embodiment, the second region 54 is smoothly curved without being restricted by the outer pipe 102 in the angled form shown in FIG. 9.

Further, in the treatment instrument channel 100 of the first embodiment, as shown in FIG. 8, a close contact spring 108 is provided in a gap 106 between the extending portion 104 of the outer pipe 102 and the treatment instrument insertion tube 50. The close contact spring 108 is provided in the gap 106 by being mounted on the outer peripheral portion of the treatment instrument insertion tube 50.

With the above configuration, according to the treatment instrument channel 100 of the first embodiment, the gap region 110 located in the gap 106 of the first region 52 can be protected and reinforced by the contact spring 108. The gap region 110 is a region corresponding to the length of the gap 106 in the central axis A direction of the treatment instrument insertion tube 50. The gap region 110 is a portion that deforms when the angle form shown in FIG. 9 is formed, but the deformation of the gap region 110 can be suppressed by the contact spring 108. Thereby, the stress generated in the gap region 110 due to the deformation of the gap region 110 can be reduced, so that the service life of the treatment instrument insertion tube 50 is extended.

Further, in the treatment instrument channel 100 of the first embodiment, the contact spring 108 extends from the gap 106 to the proximal end side of the treatment instrument insertion tube 50.

With the above configuration, according to the treatment instrument channel 100 of the first embodiment, the treatment instrument insertion tube 50 located on the proximal side from the gap 106 can be reinforced by the contact spring 108. In this case, the base end side of the contact spring 108 is inserted into the curved portion 38 as shown in FIG. 3, but since the contact spring 108 has flexibility, the curved spring is not restricted by the contact spring 108. 38 flexes flexibly.

Further, the treatment instrument insertion tube 50 has a boundary portion 112 formed between the first region 52 and the second region 54, as shown in FIG. 8. The boundary portion 112 is provided within a range of the treatment instrument insertion tube 50 in the direction of the central axis A in which the contact spring 108 is covered.

According to the treatment instrument channel 100 of the first embodiment having the above-described configuration, the boundary 112 can be reinforced by the contact spring 108, so that the contact spring 108 suppresses the deformation of the boundary 112 in the angle mode. You can Thereby, the stress generated in the boundary portion 112 due to the deformation of the boundary portion 112 can be reduced, so that the service life of the treatment instrument insertion tube 50 is extended.

Further, an annular protrusion 114 that protrudes toward the outer peripheral portion of the treatment instrument insertion tube 50 is provided on the inner peripheral portion of the extending portion 104 of the outer pipe 102.

With the configuration described above, according to the treatment instrument channel 100 of the first embodiment, the outer peripheral portion of the treatment instrument insertion tube 50 abuts and is supported by the protrusion 114 in the angle configuration shown in FIG. 9. As a result, excessive deformation of the treatment instrument insertion tube 50 can be suppressed, so that the service life of the treatment instrument insertion tube 50 is extended.

Next, a preferable formation position of the boundary portion 112 formed between the first region 52 and the second region 54 will be described with reference to FIGS. 11 and 12.

In FIG. 11, the connecting pipe 116 is arranged between the distal end main body 42 and the distal node ring 46A, and the boundary 112 of the treatment instrument insertion tube 50 is formed within the range F of the axial length of the connecting pipe 116. It is explanatory drawing which shows a structure. Further, FIG. 11 also shows a graph showing the change in hardness of the treatment instrument insertion tube 50 in the direction from the distal end 50A of the treatment instrument insertion tube 50 to the base end. Here, the hardness of the treatment instrument insertion tube 50 is equivalent to that the treatment instrument insertion tube 50 has high crush resistance.

The hardness change of the treatment instrument insertion tube 50 includes the following two forms. That is, as shown by the line A in the graph of FIG. 11, the first form is a form in which the hardness gradually decreases along the direction from the distal end 50A of the treatment instrument insertion tube 50 toward the proximal end. The second form is a form in which the hardness sharply decreases at one point in the direction from the distal end 50A of the treatment instrument insertion tube 50 toward the proximal end, as indicated by the line B in the graph. In the case of the first mode, the range of the wide region G in which the hardness gradually changes is the boundary 112, and in the case of the second mode, the range of the very narrow region H in which the hardness sharply decreases is the boundary 112. Becomes

Further, the boundary portion 112 is preferably formed closer to the distal end side of the treatment instrument insertion tube 50 than the position of the distal node ring 46A in order not to hinder the bending operation of the bending portion 38. Therefore, in the structure of the treatment instrument channel of FIG. 11, the connecting pipe 116 is connected to the proximal end side of the distal end portion main body 42, and the boundary portion 112 is formed within the range F of the axial length of the connecting pipe 116.

However, in the structure of the treatment instrument channel of FIG. 11, the distal end main body 42 and the connecting pipe 116 form the distal end hard portion. Therefore, the length of the hard tip portion (the length of the insertion portion 22 in the central axis D direction) is increased by the axial length of the connecting pipe 116, and the hard tip portion is increased in size, which is not preferable. Further, when the connecting pipe 116 is removed to reduce the size of the distal end hard portion, the boundary portion 112 is formed from the distal end portion main body 42 to the proximal end side, which hinders the bending operation of the bending portion 38.

In other words, when the treatment instrument insertion tube 50 having the boundary 112 is used for an endoscope, a treatment is performed with a structure capable of smoothly performing the bending operation of the bending portion while reducing the size of the distal end hard portion. It is necessary to prepare for the ingredient channel.

Therefore, the treatment instrument channel 100 of the first embodiment has a structure capable of smoothly performing the bending operation of the bending portion 38 while reducing the size of the distal end hard portion 40. An example of the specific structure is shown in FIG.

The treatment instrument channel 100 of FIG. 12 does not have the connecting pipe 116 of FIG. 11. Further, in the treatment instrument channel 100 of FIG. 12, a boundary portion 112 is formed at a position on the tip end side of the bending portion 38 in the direction from the tip end 50A of the treatment instrument insertion tube 50 toward the base end.

FIG. 12 also shows graphs of the third form and the fourth form showing changes in hardness of the treatment instrument insertion tube 50 in the direction from the distal end 50A of the treatment instrument insertion tube 50 toward the base end. The third form is a form in which the hardness gradually decreases along the direction from the distal end 50A of the treatment instrument insertion tube 50 toward the proximal end, as indicated by the line C in the graph of FIG. The fourth form is a form in which the hardness sharply decreases at a point in the direction from the distal end 50A of the treatment instrument insertion tube 50 toward the proximal end, as indicated by the line D in the graph. In the case of the third form, the range of the wide region I in which the hardness gradually changes is the boundary part 112, and in the case of the fourth form, the range of the very narrow region J in which the hardness sharply decreases is the boundary part 112. Becomes

In the third embodiment, it is preferable to arrange the region I of the boundary 112 as close to the tip side of the curved portion 38 as possible. Similarly, in the fourth embodiment, it is preferable that the region J of the boundary portion 112 is arranged as close to the tip side of the bending portion 38 as possible.

With the above structure, according to the treatment instrument channel 100 of the first embodiment, the boundary portion 112 is formed at the position on the distal end side of the bending portion 38 without the connecting pipe 116 of FIG. It is possible to smoothly bend the bending portion 38 while achieving downsizing.

Although the treatment instrument channel 100 of the first embodiment has been described above, the treatment instrument channel 100 of the first embodiment includes modified examples shown in FIGS. 13 and 14 below. FIG. 13 is an enlarged cross-sectional view of a main part of a treatment tool channel 118 that is a first modification of the treatment tool channel 100, and FIG. 14 is a treatment tool channel 120 that is a second modification of the treatment tool channel 100. FIG.

The difference between the treatment instrument channel 118 (see FIG. 8) of the treatment instrument channel 118 of FIG. 13 will be described. The outer pipe 102 is not provided with the protrusion 114, and the extension portion 104 and the treatment instrument insertion tube are provided. The point is that the contact spring 108A having a short length is provided only in the gap 106 between the contact spring 50 and 50. According to the treatment instrument channel 118 of FIG. 13, only the gap region 110 of the treatment instrument insertion tube 50 can be protected and reinforced by the contact spring 108A.

14 is different from the treatment instrument channel 100 (see FIG. 8) in that the outer pipe 102 is not provided with the protrusion 114. According to the treatment instrument channel 120 of FIG. 14, the gap region 110 can be protected and reinforced by only the contact spring 108.

Hereinafter, another embodiment of the treatment tool channel according to the present invention will be described with reference to FIGS. 15 to 19.

FIG. 15 is an enlarged cross-sectional view of a main part of the treatment tool channel 122 of the second embodiment. In describing the treatment instrument channel 122, the same or similar members as those of the treatment instrument channel 100 of the first embodiment shown in FIG. 8 are designated by the same reference numerals, and the description thereof will be omitted.

The treatment instrument insertion tube 124 of the treatment instrument channel 122 includes a first region 126 formed on the distal end side of the treatment instrument insertion tube 124 and a second region 128 formed on the proximal end side of the first region 126. have. The first region 126 is a region having a higher crush resistance than the second region 128, and the first region 126 is provided with the connection portion 130 connected to the forceps pipe 58.

The treatment instrument insertion tube 124 is a tube in which the inside diameter 124Di and the outside diameter 124Do are uniform over the entire length of the treatment instrument insertion tube 124 before being connected to the forceps pipe 58. The inner diameter 124Di of the treatment instrument insertion tube 124 is formed smaller than the outer diameter 58Do of the forceps pipe 58. As a result, the connecting portion 130 is pushed outward by the fitting of the forceps pipe 58, and is firmly fixed to the forceps pipe 58 when the forceps pipe 58 is completely fitted.

Also in the treatment instrument channel 122 of the second embodiment, since the first region 126 is formed on the distal end side of the treatment instrument insertion tube 124, the same effect as the treatment instrument channel 100 of the first embodiment, that is, the treatment is performed. The treatment instrument can be smoothly advanced from the instrument insertion tube 124 toward the forceps pipe 58.

FIG. 16 is an enlarged cross-sectional view of a main part of the treatment tool channel 132 of the third embodiment. In describing the treatment instrument channel 132, the same or similar members as those of the treatment instrument channel 100 of the first embodiment shown in FIG. 8 are designated by the same reference numerals, and the description thereof will be omitted.

The treatment instrument insertion tube 134 of the treatment instrument channel 132 includes a first region 136 formed on the distal end side of the treatment instrument insertion tube 134 and a second region 138 formed on the proximal end side of the first region 136. have. The first region 136 is a region having higher crush resistance than the second region 138, and the connection portion 140 connected to the forceps pipe 58 is formed in the first region 136.

In the treatment instrument insertion tube 134, the inner diameter 140Di of the connecting portion 140 is formed smaller than the outer diameter 58Do of the forceps pipe 58 before the forceps pipe 58 is connected. Further, the inner diameter 140Di of the connecting portion 140 is formed to be larger than the inner diameter 136Di of the first region 136 on the proximal end side of the connecting portion 140. Furthermore, when the forceps pipe 58 and the treatment instrument insertion tube 134 are connected, the inner diameter 136Di is formed to be the same as the inner diameter 58Di of the forceps pipe 58 or smaller than the inner diameter 58Di of the forceps pipe 58.

With the above configuration, according to the treatment tool channel 132 of the third embodiment, the connecting portion 140 is spread outward by the fitting of the forceps pipe 58, and is closely attached to the forceps pipe 58 when the forceps pipe 58 is completely fitted. Fixed. At this time, since the inner diameter 136Di is the same as or smaller than the inner diameter 58Di of the forceps pipe 58, it is possible to reliably prevent the distal end of the treatment tool from being caught by the proximal end 58A of the forceps pipe 58.

Therefore, also in the treatment tool channel 132 of the third embodiment, the treatment tool can be smoothly advanced from the treatment tool insertion tube 134 toward the forceps pipe 58.

FIG. 17 is an enlarged cross-sectional view of a main part of the treatment tool channel 142 of the fourth embodiment.

The treatment instrument channel 142 of the fourth embodiment is such that the outer pipe 144 is externally mounted on the outer peripheral portion of the connection portion 140 of the treatment instrument insertion tube 134 shown in FIG. According to the treatment instrument channel 142, the deformation of the connecting portion 140 can be suppressed by the outer pipe 144.

FIG. 18 is a sectional view of a main part of the treatment tool channel 150 according to the fifth embodiment. In describing the treatment instrument channel 150, the same or similar members as those of the treatment instrument channel 100 of the first embodiment shown in FIG. 8 are designated by the same reference numerals, and the description thereof will be omitted.

Explaining the difference between the treatment instrument channel 100 (see FIG. 8) and the treatment instrument channel 150 in FIG. 18, the outer pipe 102 is not provided with the protrusion 114 and is not provided with the contact spring 108. That is, the adhesive 152 is applied only to the gap 106 between the extending portion 104 and the treatment instrument insertion tube 50. According to the treatment instrument channel 150 of FIG. 18, the gap region 110 of the treatment instrument insertion tube 50 can be protected and reinforced by the adhesive agent 152.

FIG. 19 is a cross-sectional view of a main part of the treatment tool channel 154 of the sixth embodiment. In describing the treatment instrument channel 154, the same or similar members as those of the treatment instrument channel 150 shown in FIG. 18 are designated by the same reference numerals, and the description thereof will be omitted.

The difference between the treatment instrument channel 154 of FIG. 19 and the treatment instrument channel 150 (see FIG. 18) will be described. From the gap 106 between the extending portion 104 of the outer pipe 102 and the treatment instrument insertion tube 50, the treatment instrument channel 154 is shown. The point is that the adhesive 156 is extended to the proximal end side of the insertion tube 50. According to the treatment instrument channel 154 of FIG. 19, the treatment instrument insertion tube 50 located on the proximal side from the gap 106 can be reinforced by the adhesive 156.

Although the ultrasonic endoscope 10 is illustrated as the endoscope in the present embodiment, the endoscope is not limited to this. The ultrasonic endoscope 10 is a typical endoscope in which the main body central axis K of the forceps pipe 58 is inclined with respect to the central axis A (see FIG. 3) of the treatment instrument insertion tube 50. The treatment instrument channel can be preferably applied. In other words, the treatment instrument channel of the present invention is an endoscope in which the main body central axis K of the forceps pipe 58 is inclined with respect to the central axis A of the treatment instrument insertion tube 50, for example, a direct-view type such as a colonoscope. It can also be applied to an endoscope.

1 Ultrasonic Examination System 10 Ultrasound Endoscope 12 Ultrasound Processor Unit 14 Endoscope Processor Unit 16 Light Source Device 18 Monitor 20 Cart 22 Insertion Part 24 Operation Part 24a Treatment Tool Insertion Port 24b Angle Knob 24c Standing Lever 24d Suction Button 24e Air supply/water supply button 24f Switching button 26 Universal cord 28 Connector 30 Connector 32 Connector 34 Pole 36 Flexible part 38 Bending part 40 Tip hard part 42 Tip part main body 44 Treatment tool outlet 46 Node ring 46A Tip node ring 48 Pin 48A pin 50 Treatment tool insertion tube 50A Tip 52 First region 52A Inner peripheral portion 54 Second region 54A Inner peripheral portion 56 Connection portion 58 Forceps pipe 58A Base end 60 Ultrasonic observation portion 62 Endoscope observation portion 64 Stand 66 Electroacoustic Converter 66a Observation surface 68 Backing material 70 Ultrasonic transducer 72 Acoustic lens 74 Wiring connection portion 76 Wiring 78 Wiring insertion hole 80 Observation optical system 80a Observation window 82 Illumination optical system 82a Illumination window 84 Illumination optical system 84a Illumination window 86a Sloped surface 86b Inclined surface 88 Washing nozzle 90 Stand base accommodation part 100 Treatment tool channel 102 Outer pipe 104 Extension part 106 Gap 108 Adhesion spring 108A Adhesion spring 110 Gap region 112 Boundary 114 Protrusion 116 Connecting pipe 118 Treatment tool channel 120 Treatment tool Channel 122 Treatment tool channel 124 Treatment tool insertion tube 126 First area 128 Second area 130 Connection portion 132 Treatment tool channel 134 Treatment tool insertion tube 136 First area 138 Second area 140 Connection portion 142 Treatment tool channel 144 Outer pipe 150 Treatment Tool Channel 152 Adhesive 154 Treatment Tool Channel 156 Adhesive 200 Treatment Tool Insertion Tube 200A Tip 202 Connection Portion 204 Forceps Pipe 204A Base End 206 Treatment Tool Channel 208 Puncture Needle 210 Sheath 210A Tip

Claims (14)

A pipe member that is attached to the distal end body of the endoscope insertion portion and communicates with a treatment instrument outlet provided in the distal end body,
A treatment instrument insertion tube connected to the pipe member,
Equipped with
The treatment instrument insertion tube has a first region formed on a distal end side of the treatment instrument insertion tube and a second region formed on a proximal end side with respect to the first region,
The first region is a region having higher crush resistance than the second region,
A connection part connected to the pipe member is formed in the first region ,
In a state before the treatment instrument insertion tube is connected to the pipe member, the inner diameter of the connection portion is smaller than the outer diameter of the pipe member, and the inner diameter of the connection portion is the connection portion of the first region. It is formed larger than the inner diameter of the base end side,
In a state where the pipe member and the treatment instrument insertion tube are connected, the inner diameter of the first region on the proximal end side of the connecting portion is the same as the inner diameter of the pipe member or the inner diameter of the pipe member. Formed smaller,
A treatment instrument channel for an endoscope. In a state before the connecting portion is connected to the pipe member, an outer diameter of the connecting portion is formed to be larger than an outer diameter of a proximal end side of the connecting portion in the first region,
The treatment instrument channel for an endoscope according to claim 1 . The treatment tool insertion tube is provided with an outer pipe on the outer peripheral portion of the connection portion,
In the outer pipe, an extension portion extending from the connection portion to the proximal end side of the treatment instrument insertion tube is formed,
Treatment instrument channel of an endoscope according to claim 1 or 2. The second region is formed on the proximal end side of the treatment instrument insertion tube with respect to the outer pipe,
The treatment instrument channel of the endoscope according to claim 3 . Adhesive is applied to the gap between the treatment instrument insertion tube and the front Kinobezai portion,
The treatment instrument channel of the endoscope according to claim 3 . The adhesive is extended from the gap to the proximal end side of the treatment instrument insertion tube,
The treatment instrument channel of the endoscope according to claim 5 . The second region is formed on the proximal end side of the treatment instrument insertion tube with respect to the outer pipe,
The treatment instrument channel of the endoscope according to claim 5 . Contact springs into the gap between the treatment instrument insertion tube and the front Kinobezai portion is provided is fitted on an outer peripheral portion of the treatment instrument insertion tube,
The treatment instrument channel of the endoscope according to claim 3 . The contact spring extends from the gap to the proximal end side of the treatment instrument insertion tube,
The treatment instrument channel for an endoscope according to claim 8 . The second region is formed on the proximal end side of the treatment instrument insertion tube with respect to the outer pipe,
Treatment instrument channel of an endoscope according to claim 8 or 9. A boundary portion formed between the first region and the second region of the treatment instrument insertion tube is provided within a range where the contact spring is exteriorly mounted.
Treatment instrument channel of an endoscope according to claim 8 or 9. An inner peripheral portion of the extending portion of the outer pipe is provided with an annular protrusion that protrudes toward the outer peripheral portion of the treatment instrument insertion tube,
The treatment instrument channel for an endoscope according to any one of claims 8 to 11 . The endoscope insertion portion is composed of a flexible portion, a bending portion and the tip portion main body from the base end side toward the tip end side,
The boundary portion formed between the first region and the second region of the treatment instrument insertion tube is on the distal end side of the bending portion in the direction from the distal end of the treatment instrument insertion tube toward the base end. Formed in position,
The treatment instrument channel for an endoscope according to any one of claims 1 to 12 . A treatment instrument channel of the endoscope according to any one of claims 1 to 13 ,
Endoscope.

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