JP6756780B2 - Endoscope system - Google Patents

Description

The present invention relates to an endoscope system in which an endoscope and an insertion assisting tool are used in combination, and particularly to bending rigidity of an insertion portion of the endoscope.

An endoscope may be used for diagnosis and surgery of the stomach, duodenum, small intestine, etc. Then, in order to improve the insertability of the endoscope at the time of diagnosis or surgery, it is known that the hardness of the insertion portion of the endoscope is changed according to the operation of the operator (for example, Patent Document 1). , 2).

However, when a conventional endoscope as in Patent Documents 1 and 2 is used alone in diagnosis and surgery, the insertion portion does not become straight due to adhesion by surgery or fixation of the intestinal tract by the Tritz ligament, and the stomach and the like In many cases, the insertion portion bends inside and the insertion force cannot be transmitted to the tip portion, so that the tip portion cannot move forward, which is a so-called “difficult to insert example”. Therefore, an endoscope system in which an endoscope with a balloon and an overtube (insertion aid) with a balloon are used in combination has been proposed (see, for example, Patent Document 3). Further, also in such an endoscope system, a technique for varying the hardness of the insertion portion of the endoscope is known (see, for example, Patent Document 4).

Japanese Unexamined Patent Publication No. 2013-027466 Japanese Patent No. 3850377 Japanese Unexamined Patent Publication No. 2013-090875 Japanese Patent No. 4499479

In a conventional endoscope system as described in Patent Documents 3 and 4, when the insertion portion of the endoscope is inserted through the overtube, the insertion portion is made a predetermined stroke with respect to the overtube (of the insertion portion of the endoscope). It is slid by (determined by the relationship between the effective length and the length of the overtube). In such a sliding state, the tip end side of the insertion portion is exposed from the overtube, and the insertion portion is not covered by the overtube, so that the bending rigidity is only that of the insertion portion, and the insertion portion is easily bent. On the other hand, if the total length of the overtube is made relatively long with respect to the insertion portion in order to secure flexural rigidity, the slidable length becomes short and the insertion itself becomes difficult, so the overtube should be made too long. Can't.

In addition, in postoperative patients such as the Roux-en-Y Method, the magnitude and bending of the flexural rigidity required for the insertion part depends on the conditions such as the gastric removal range (total removal / semi-removal) and the observation position. Although the position and range in which rigidity is required are different, it is difficult to meet such requirements for flexural rigidity for each patient with the conventional techniques as described in Patent Documents 1 to 4.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide an endoscopic system capable of ensuring an appropriate flexural rigidity of the insertion portion while maintaining the slide length of the insertion portion.

In order to achieve the above object, the endoscopic system according to the first aspect of the present invention has an insertion portion inserted into the body and an operation portion connected to the proximal end side of the insertion portion, and is inserted. The portion includes an endoscope having a hard tip portion, a curved portion connected to the base end side of the hard tip portion, and a soft portion connected to the proximal end side of the curved portion, and a tip opening and a proximal end opening. The tube body is provided with an insertion passage through which the insertion portion is inserted through the base end opening, the insertion portion is movable in the longitudinal axis direction of the tube body, and the insertion portion of the tube body advances and retreats with respect to the tube body. An endoscopic system comprising an insertion aid in which at least a portion of the soft portion is formed with a length protruding from the tip opening when located at the tip position within the possible range, the soft portion having the insertion portion tube. When it is located at the tip position of the advancing / retreating range with respect to the main body, it has a protruding region protruding from the tip opening, and the protruding region is a bend in which bending rigidity increases from the first position on the tip side to the second position on the proximal end side. It has a rigidity changing part.

According to the first aspect of the present invention, in the protruding region where the flexible portion of the endoscope protrudes from the tip opening of the insertion assisting tool, a flexural rigidity changing portion in which the bending rigidity increases from the tip side toward the proximal end side is provided. Therefore, it is possible to secure the required flexural rigidity even in the protruding region where the flexible portion protrudes from the tip of the insertion assisting tool. Therefore, it is not necessary to lengthen the insertion assisting tool, and the slide length of the insertion portion can be maintained. Further, since the flexible portion has such a flexural rigidity changing portion, the required bending rigidity can be secured by appropriately setting the rigidity of the bending rigidity changing portion, and the flexible portion is prevented from bending unnecessarily in the protruding region. be able to. Further, by appropriately setting the range in which the flexural rigidity changing portion is provided and the rigidity of the bending rigidity changing portion, the slide length of the insertion portion is maintained, and the insertion portion is appropriate in response to the different bending rigidity requirements for each patient. Flexural rigidity can be ensured.

The change in the bending rigidity at the bending rigidity changing portion may be such that the bending rigidity increases uniformly from the first position to the second position (the rate of increase in the bending rigidity is constant), or the first position. The rate of increase in flexural rigidity may change between the position and the second position.

In order to achieve the above object, the endoscope system according to the second aspect of the present invention has an insertion portion to be inserted into the body and an operation portion connected to the proximal end side of the insertion portion, and is inserted. The portions include an endoscope having a hard tip portion, a curved portion connected to the base end side of the hard tip portion, and a soft portion connected to the base end side of the curved portion, and a tip opening and a base end opening. An endoscope having an insertion aid having a tube body having an insertion passage through which an insertion portion is inserted from a base end opening and having an insertion portion capable of advancing and retreating in the longitudinal axis direction of the tube body. In the system, the insertion aid has an abutting portion on the proximal end side of the tube body that abuts the endoscope, and the tube body is at least a soft portion when the endoscope abuts the abutting portion. A part is formed with a length protruding from the tip opening, and the flexible portion has a protruding region protruding from the tip opening when the endoscope abuts on the contact portion, and the protruding region is the first on the tip side. It has a bending rigidity changing portion in which the bending rigidity increases from the position toward the second position on the proximal end side.

According to the second aspect of the present invention, as in the first aspect, it is possible to secure an appropriate flexural rigidity of the insertion portion while maintaining the slide length of the insertion portion. Also in the second aspect, the change in the bending rigidity at the bending rigidity changing portion is such that the bending rigidity increases uniformly from the first position to the second position (the rate of increase in the bending rigidity is constant). Alternatively, the rate of increase in flexural rigidity may change between the first position and the second position.

In the first or second aspect of the endoscopic system according to the third aspect, the first position is the tip position of the protruding region and the second position is the proximal position of the protruding region. The third aspect defines the tip position and the base end position of the flexural rigidity changing portion.

In the first or second aspect of the endoscope system according to the fourth aspect, the protruding region has a flexural rigidity uniform portion on the tip side of the first position, and the flexural rigidity uniform portion is the longitudinal axis of the flexible portion. The flexural rigidity is constant along the direction. According to the fourth aspect, by providing the bending rigidity uniform portion having uniform bending rigidity on the tip side of the protruding region from the first position, the curved portion curved at the time of insertion is in contact with the wall surface in the body. Even if the endoscope is pushed in, the uniform bending rigidity portion bends to absorb the pushing force, and the load on the body can be reduced.

In any one of the first to fourth aspects of the endoscope system according to the fifth aspect, the second position is the proximal position of the protruding region, and the flexural rigidity changing portion is from the first position to the second. As a position, it is formed up to the base end position of the protruding region, and further formed up to a third position on the base end side of the protruding region in the soft portion. That is, in the fifth aspect, the flexural rigidity changing portion is also provided in a portion (non-projecting region) that does not protrude from the tip opening when the insertion portion is located at the tip position of the advancing / retreating range with respect to the tube body. According to the fifth aspect, it is possible to absorb the change in the radius of curvature at the time of the bending operation in the portion where the bending rigidity changes in the insertion assisting tool (non-protruding region).

In the first or second aspect of the endoscope system according to the sixth aspect, the second position is on the distal end side of the proximal end position of the protruding region. That is, in the sixth aspect, the flexural rigidity changing portion is provided not in the entire protruding region but in a part thereof. As a result, it is possible to prevent the insertion portion from bending in the body and make it easier for the hard tip portion to move forward.

In any one of the first to sixth aspects of the endoscope system according to the seventh aspect, the maximum bending rigidity of the bending rigidity changing portion is twice or more the minimum bending rigidity. When the endoscope is inserted, depending on the insertion site, the tip hard part becomes difficult to move forward due to a small bending part, and the soft part tends to bend in front of the tip hard part. According to the seventh aspect, Even in a situation where the flexible portion is likely to bend, it is possible to prevent the flexible portion from bending and make it easier to insert the endoscope.

In the endoscopic system according to the eighth aspect, in any one of the first to seventh aspects, the difference between the maximum bending rigidity and the minimum bending rigidity of the bending rigidity changing portion is the maximum bending rigidity portion of the tube body. Greater than half the flexural rigidity. The eighth aspect is to increase the effect of providing the flexural rigidity changing portion by making the difference between the maximum bending rigidity and the minimum bending rigidity of the bending rigidity changing portion larger than half of the bending rigidity of the tube body.

As described above, according to the endoscope system of the present invention, it is possible to secure an appropriate flexural rigidity of the insertion portion while maintaining the slide length of the insertion portion.

FIG. 1 is a diagram showing a configuration of an endoscope system according to an embodiment of the present invention. FIG. 2 is a cross-sectional view showing the structure of the flexible portion 36 (near the flexural rigidity changing portion). FIG. 3 is a diagram showing a slide range of the insertion portion 12 with respect to the overtube 50. FIG. 4 is a diagram showing an example in which the bending rigidity is changed depending on the material composition of the outer skin 37E of the insertion portion 12. FIG. 5 is a graph showing the flexural rigidity in the first embodiment. FIG. 6 is a graph showing the flexural rigidity in the second embodiment. FIG. 7 is a diagram showing a state of insertion into the body in the second embodiment. FIG. 8 is a graph showing the flexural rigidity in the third embodiment. FIG. 9 is a graph showing the bending rigidity when the bending rigidity uniform portion 82 is provided at the tip end portion of the protruding region 70 in the third embodiment. FIG. 10 is a graph showing the flexural rigidity in the fourth embodiment. FIG. 11 is a diagram showing a state of insertion into the body in the fourth embodiment. FIG. 12 is a graph showing the rigidity of the flexible portion 36 and the overtube 50. FIG. 13 is a graph showing flexural rigidity in another invention (another invention). FIG. 14 is a diagram showing a state in which the insertion portion of the endoscope system in another invention (another invention) is inserted into the body of the subject.

Hereinafter, the endoscope system according to the present invention will be described with reference to the accompanying drawings. FIG. 1 is a diagram showing an overall configuration of the endoscope system 100 according to the present embodiment.

<Overall configuration of the endoscope system>
As shown in FIG. 1, the endoscope system 100 includes an endoscope 10 and an overtube 50. The endoscope 10 includes an insertion portion 12 to be inserted into the body of the subject, and a hand operation portion 14 is connected to the base end portion of the insertion portion 12. A universal cord 16 is connected to the hand operation unit 14, and a light source connector 18 is provided at the tip of the universal cord 16. Further, the cable 20 is branched from the light source connector 18, and the processor connector 22 is provided at the tip of the cable 20. The light source connector 18 and the processor connector 22 are detachably connected to the light source device 24 and the processor device 26, respectively. The overtube 50 is one aspect of the insertion assisting tool.

<Structure of overtube>
The overtube 50 includes a grip portion 52 gripped by an operator and a tube body 54. The grip portion 52 is a tubular body made of a hard material such as resin. The tube body 54 is formed of a flexible material such as polyurethane into a tubular shape having a tip opening 56 and a base end opening 58, and the inside of the tubular portion serves as an insertion passage 59 through which the insertion portion 12 is inserted. , The insertion portion 12 can move forward and backward in the longitudinal axis direction (X direction in FIG. 3) of the overtube 50. As will be described later, when the insertion portion 12 is located at the tip position of the advancing / retreating range with respect to the overtube 50, the inner edge of the base end opening 58 comes into contact with the break prevention member 15 of the insertion portion 12. That is, in this embodiment, the inner edge of the base end opening 58 constitutes the contact portion.

A balloon 57 is attached to the outer peripheral surface of the tip of the tube body 54. The balloon 57 is formed in a tubular shape by an elastic material such as rubber, and has a bulging portion in the center. The balloon 57 is attached and fixed to the outer peripheral surface of the tip of the tube body 54, and is expanded or contracted by a fluid (air, water, etc.) supplied / sucked through a fluid pipeline (not shown). The balloon control device 60 controls the expansion and contraction of the balloon 57. The balloon control device 60 is a device that supplies / sucks fluid or controls pressure in order to inflate / contract the balloon 57 or maintain the state of the balloon 57, and is a device main body 62 provided with a pump, a sequencer, or the like, and a hand. A switch 63 and a balloon monitor 64 are provided.

<Overall configuration of insertion part>
The insertion portion 12 is configured by sequentially connecting the soft portion 36, the curved portion 38, and the tip hard portion 40 from the base end side (hand operation portion 14 side) toward the tip end side. A break-preventing member 15 of the insertion portion 12 is provided on the most basic end side of the flexible portion 36. The break prevention member 15 is processed (tapered) so that the diameter gradually decreases from the base end side to the tip end side.

<Structure of hand operation unit>
The hand operation unit 14 has an angle knob 28 for bending operation and an air supply / water supply button 30 for ejecting air, water, or the like from the tip of the insertion portion 12 (an opening provided in the tip rigid portion 40 described later). , And a suction button 32 and the like are provided. Further, a forceps opening 34 through which various treatment tools are inserted is provided on the insertion portion 12 side of the hand operation portion 14.

Further, in response to the operation of the air supply / water supply button 30, air or water is supplied from the air supply / water supply device built in the light source device 24, and is ejected from the air supply / water supply nozzle toward the observation window. The forceps outlet is connected to a forceps channel (not shown) provided in the insertion portion 12 and communicates with the forceps opening 34. The tip of the treatment tool inserted through the forceps opening 34 is exposed from the forceps outlet.

<Structure of soft part>
As shown in FIG. 2, the flexible portion 36 is a spiral tube 37 formed by spirally winding a thin strip plate 37A having elasticity on the innermost side, and is a net in which a metal wire is woven on the outside of the spiral tube 37. The body 37B is covered, and the bases 37C are fitted to both ends thereof to form a tubular body 37D, and an outer skin 37E made of resin is laminated on the outer peripheral surface of the tubular body 37D. As will be described in detail later, a part of the flexible portion 36 is provided with a flexural rigidity changing portion 80 (see FIG. 1) in which the bending rigidity changes along the longitudinal axis direction (X direction in FIG. 3).

<Structure of curved part>
In the curved portion 38, angle rings (not shown) are rotatably connected to each other to form a structure, and the outer circumference of the structure is covered with a mesh body woven with a metal wire and further covered with a rubber outer skin. It has a broken structure. A plurality of operation wires (not shown) are extended from the hand operation portion 14 to the curved portion 38, and the tip portions of these operation wires are fixed to the angle ring of the tip portion constituting the curved portion 38. As a result, the curved portion 38 is curved up, down, left and right in response to the operation of the angle knob 28 provided on the hand operation portion 14. A balloon 39 is attached to the outer periphery of the curved portion 38, and like the balloon 57 described above, fluid (air, water) supplied / discharged through a fluid pipeline (not shown) provided in the insertion portion 12. Etc.) to expand or contract.

<Structure of hard tip>
An optical system (lens, image sensor, etc., not shown) for in-subject imaging is built in the hard tip 40, and an observation window and illumination (not shown) are on the front surface of the hard tip 40. A window, an air supply / water supply nozzle, a forceps outlet, etc. are provided. Behind the illumination window, an exit end of a light guide that guides the illumination light from the light source device 24 is provided, and the illumination light guided by the light guide irradiates the observation site in the subject through the illumination window. Will be done.

<Protruding area>
Next, the protruding region 70 (protruding region) of the flexible portion 36 will be described. FIG. 3 is a diagram showing the positional relationship between the insertion portion 12 and the overtube 50. In the present embodiment, the case where the effective length of the insertion portion 12 is 1520 mm and the total length of the overtube 50 is 1050 mm will be described, but in the present invention, the lengths of the insertion portion 12 and the overtube 50 are limited to such cases. It is not something that is done. Further, FIG. 3 is for clarifying the relationship between each element, and does not accurately reflect the actual dimensions and shape.

In the portion (a) of FIG. 3, the insertion portion 12 is inserted into the overtube 50, and the anti-folding member 15 provided on the base end side of the insertion portion 12 comes into contact with the overtube 50 (that is, the insertion portion 12). Is a diagram showing the positional relationship between the insertion portion 12 and the overtube 50 in a state of being slid (moved) to a position located at the tip position of the advancing / retreating range with respect to the overtube 50 (Note that FIG. 3 shows the positional relationship). Although the insertion portion 12 and the overtube 50 are shown separately for the sake of clarity, the insertion portion 12 is actually inserted into the overtube 50). In this positional relationship, the outer diameter of the breakage prevention member 15 is equal to the inner diameter of the base end opening 58 of the overtube 50, and the overtube 50 comes into contact with the breakage prevention member 15, so that the overtube 50 of the insertion portion 12 Further sliding to the tip side is restricted.

In the state shown in the portion (a) of FIG. 3, a part of the tip hard portion 40, the curved portion 38, and the soft portion 36 of the insertion portion 12 protrudes from the tip opening 56 of the overtube 50. In the present embodiment, the length of the protruding portion is 500 mm, and the region in which a part of the soft portion 36 protrudes is hereinafter referred to as “protruding region 70 (protruding region)”. As described above, the balloon 39 is attached to the curved portion 38, and the curved portion 38 cannot slide in the overtube 50 (this state is shown by a dotted line in the portion (b) of FIG. 3). The overtube 50 can be slid within the range of the protruding region 70 (that is, between the state shown in the portion (a) and the state shown in the portion (b) of FIG. 3).

In this embodiment, it is assumed that the total length of the hard tip portion 40 and the curved portion 38 is 100 mm. Therefore, the length of the protruding region 70 is 400 mm.

<Flexural rigidity change part>
In the present embodiment, the bending rigidity changing portion 80 in which the bending rigidity changes is provided in the protruding region 70. As shown in FIG. 2, in the flexural rigidity changing portion 80, the outer skin 37E of the soft portion 36 is composed of resin layers RH and RS having different hardnesses, and the thickness of the resin layers is changed from the tip end side to the base end side. It can be realized by making it. Specifically, as shown in the portion (a) of FIG. 4, the outer portion of the outer skin 37E is a hard (high flexural rigidity) resin layer RH, and the inner portion is a flexible (less flexural rigidity than the resin layer RH). ) It is composed of the resin layer RS, and the resin layer RS is thickened at the first position P1 (first position) on the tip side in the range of the flexural rigidity changing portion 80, and the resin layer RS is thickened from the first position P1 to the second position P2 (second position). ), The resin layer RS is thinned and the resin layer RH is thickened (the total thickness of the resin layers RH and RS is assumed to be constant). In this way, as shown in the portion (c) of FIG. 4, the bending rigidity of the bending rigidity changing portion 80 increases uniformly from the tip end side to the base end side (the rate of increase in the bending rigidity is constant). There is) can be done.

The change in flexural rigidity as shown in the portion (c) of FIG. 4 can be realized by changing the mixing ratio of the hard resin and the flexible resin instead of changing the thickness of the resin layer. Specifically, as shown in the portion (b) of FIG. 4, the ratio of the flexible resin (low flexural rigidity) is increased on the tip side, and the resin is hard (high flexural rigidity) from the tip side to the base end side. ) The ratio of resin may be increased. Further, instead of using a plurality of resins, a single resin is used to increase the thickness of the resin layer from the tip end side to the base end side (increase the thickness of the outer skin 37E) to increase the flexural rigidity. It may be.

In the present embodiment, the case where the flexural rigidity of the flexural rigidity changing portion 80 increases uniformly from the tip end side to the base end side (the rate of increase in flexural rigidity is constant) is described. In the present invention, the mode of changing the bending rigidity in the bending rigidity changing portion is not limited to such a case, and the bending rigidity increase rate may be changed from the tip end side to the base end side.

<Insert into the subject>
In the endoscope system 100 having the above configuration, the insertion portion 12 and the overtube 50 can be inserted into the subject as follows, for example. Specifically, the operator first grips the grip portion 52, inserts the overtube 50 into the body through the mouth of the subject, inserts a predetermined length, and then controls the balloon control device 60 to inflate the balloon 57. The overtube 50 is fixed to the subject. Then, in this state, the insertion portion 12 is inserted into the insertion passage 59 of the overtube 50, and the insertion portion 12 is inserted into the back of the subject until the break prevention member 15 comes into contact with the inner circumference of the base end opening 58. In this state, the insertion portion 12 is located at the tip position of the advancing / retreating range with respect to the overtube 50, and a part of the tip side of the flexible portion 36 and the curved portion 38 are exposed from the tip opening 56. The balloon 39 is inflated by controlling 60, and the insertion portion 12 is fixed to the subject. Then, this time, the balloon 57 is contracted to release the fixation of the overtube 50 to the subject, and the overtube 50 is inserted further inward (until the tip opening 56 is located at the base end portion of the curved portion 38). Then, the overtube 50 is fixed to the subject by the expansion of the balloon 57, the fixed state of the insertion portion 12 is released by the contraction of the balloon 39, and the insertion portion 12 is further inserted deeper. By repeating such a procedure, the insertion portion 12 and the overtube 50 can be inserted to a desired site of the subject.

<Example>
Next, the position and range in which the bending rigidity changing portion 80 is provided and the value of the bending rigidity in the bending rigidity changing portion 80 will be described in detail with reference to each embodiment. In each of the following examples, the case where the insertion portion 12 and the overtube 50 are inserted near the stomach to the small intestine of the subject will be described, but the situation where the endoscope system of the present invention can be applied is such a case. It is not limited.

<Example 1>
FIG. 5 is a graph showing a state of change in flexural rigidity in Example 1. In the first embodiment, the bending rigidity changing portion 80 is in a state where the protruding region 70 (the insertion portion 12 is located at the tip position of the advancing / retreating range with respect to the overtube 50, that is, the insertion portion 12 is provided with the folding prevention member 15 at the base end opening 58. It is provided over the entire range of the soft portion 36 protruding from the tip opening 56 of the overtube 50 in a state of being moved until it comes into contact with the inner edge. Specifically, as shown in FIG. 5, the first position P1 at which the bending rigidity starts to increase is 100 mm from the tip of the insertion portion 12 (the tip surface of the tip rigid portion 40), and the second position P2 at which the increase in the bending rigidity ends. Is located at a position of 500 mm from the tip, and the length of the flexural rigidity changing portion 80 is 400 m.

As described above, in the first embodiment, the length of the bending rigidity changing portion 80 and the length of the protruding region 70 are equal, and the base end side of the flexible portion 36 with respect to the bending rigidity changing portion 80 is entirely covered with the overtube 50.

Further, in the first embodiment, the bending rigidity of the bending rigidity changing portion 80 is uniformly increased from the first position P1 to the second position P2 (the rate of increase of the bending rigidity is constant). Assuming that the flexural rigidity at the first position P1 is 1, the flexural rigidity (relative ratio) at the second position P2 and its proximal end side is 2 or more. When the insertion portion 12 and the overtube 50 are inserted beyond the stomach of the subject (small intestine side), the tip portion of the insertion portion 12 is difficult to move forward due to a small flexure portion or the like beyond the stomach, and thus the front portion of the tip portion. The flexible portion 36 tends to bend at (base end side), but in Example 1, the bending rigidity of the portion covered by the overtube 50 is twice or more than the bending rigidity of the minimum bending rigidity portion (first position P1). By doing so, it is possible to prevent bending on the front side and facilitate insertion.

The change in flexural rigidity shown in FIG. 5 can be realized by changing the thickness of the resin layer having different bending rigidity and the mixing ratio of the resin in the outer skin 37E of the flexible portion 36 as described above.

<Example 2>
FIG. 6 is a graph showing a state of change in flexural rigidity in Example 2. In the second embodiment, the bending rigidity uniform portion 82 is provided in a range of up to 100 mm from the connecting portion between the curved portion 38 and the soft portion 36. In the flexural rigidity uniform portion 82, the flexural rigidity is constant (the flexural rigidity is the lowest when placed in the flexible portion 36) along the longitudinal axis direction (X direction in FIG. 3) of the flexible portion 36. The position on the most proximal end side of the flexural rigidity uniform portion 82 is the first position P1 in the second embodiment, and the flexural rigidity changing portion is within a range of 300 mm from this first position P1 to the second position P2 on the proximal end side. 80 is provided, and the bending rigidity is gradually increased. The base end side of the second position P2 is covered with the overtube 50. As in the first embodiment, the magnitude (relative ratio) of the flexural rigidity at the second position P2 is 2 or more when the magnitude of the flexural rigidity at the first position P1 is 1.

By providing the flexural rigidity uniform portion 82 on the curved portion 38 side as in the second embodiment and lengthening the portion having the minimum flexural rigidity, as shown in FIG. 7, the curved portion 38 curved at the time of insertion into the subject is formed. Even if the insertion portion 12 is pushed in while in contact with the intestinal wall (the state shown in the portion (a) of FIG. 7), the bending rigidity uniform portion 82 having the lowest bending rigidity bends due to this pushing force to absorb the pushing force ( The state shown in the part (b) of FIG. 7), the burden on the intestinal wall can be reduced.

<Example 3>
FIG. 8 is a graph showing a state of change in flexural rigidity in Example 3. In the third embodiment, the flexural rigidity changing portion 80 is provided in addition to the entire range of the protruding region 70, further to the proximal end side of the protruding region 70. Specifically, as shown in FIG. 8, the first position P1 at which the bending rigidity starts to increase is 100 mm from the tip of the insertion portion 12, and the second position P2 at a position 500 mm from the tip (here, the protruding region 70 is The increase in flexural rigidity ends at the third position P3 (third position) (600 mm from the tip), which is 100 mm from the second position P2 on the base end side. As in the first and second embodiments, assuming that the magnitude of the flexural rigidity at the first position P1 is 1, the magnitude (relative ratio) of the flexural rigidity at the third position P3 is 2 or more.

As described above, in the third embodiment, the length of the flexural rigidity changing portion 80 is 500 m. That is, the bending rigidity changing portion 80 is provided from the second position P2 to the third position P3 also in the region of the soft portion 36 covered by the overtube 50. In Example 3, the distance from the second position P2 to the third position P3 is 100 mm, but the distance from the second position P2 to the third position P3 may be any other value (for example, a range of 100 mm or more and 200 mm or less). Good.

By forming the flexural rigidity changing portion 80 up to the third position P3 as in the third embodiment, the change in the curvature range of the insertion portion 12 at the position where the change in bending rigidity ends is absorbed within the range covered by the overtube 50. can do.

In the third embodiment as well, the uniform bending rigidity portion 82 (the portion having the lowest bending rigidity) may be provided at the tip portion of the flexible portion 36 as in the second embodiment. An example of the change in flexural rigidity in this case is shown in FIG.

<Example 4>
FIG. 10 is a graph showing a state of change in flexural rigidity in Example 4. As shown in FIG. 10, in the fourth embodiment, the flexural rigidity changing portion 80 ends on the tip side of the protruding region 70. Specifically, the first position P1 at which the bending rigidity starts to increase is 100 mm from the tip of the insertion portion 12, and the increase in the bending rigidity ends at the second position P2 at a position 400 mm from the tip. As in Examples 1 to 3, assuming that the magnitude of the flexural rigidity at the first position P1 is 1, the magnitude of the flexural rigidity at the second position P2 is 2 or more. As described above, in the fourth embodiment, the length of the flexural rigidity changing portion 80 is 300 mm. Further, the protruding region 70 is a range from the second position P2 to 100 mm further toward the proximal end side. The flexural rigidity is constant on the proximal end side of the second position P2.

FIG. 11 is a diagram showing a state in which the insertion portion 12 having the flexural rigidity changing portion 80 and the overtube 50 of Example 4 are inserted into the stomach portion of the subject in which the stomach remains completely. As shown in FIG. 11, when the tip portion of the insertion portion 12 (shown by the solid line in FIG. 11) is located at the anastomotic portion PA, the insertion portion 12 is located near the position PB in the stomach (about 400 mm to 600 mm from the anastomotic portion PA). ), The tip portion may not move forward (toward the small intestine), but by configuring the flexural rigidity changing portion 80 as in Example 4 and increasing the bending rigidity of the insertion portion 12 inside the stomach. , The bending of the insertion portion 12 inside the stomach can be prevented, and the tip portion can be easily moved forward.

In the same manner as in Examples 1 to 3, the magnitude of the flexural rigidity at the second position P2 is 2 or more when the magnitude of the flexural rigidity at the first position P1 is 1.

<Relationship between the amount of change in flexural rigidity at the flexural rigidity change part and the maximum flexural rigidity of the overtube>
FIG. 12 is a graph showing an example of the relationship between the amount of change in flexural rigidity at the bending rigidity changing portion and the maximum bending rigidity of the overtube in the present invention. In the present invention, as shown in FIG. 12, it is effective to make the difference between the maximum bending rigidity and the minimum bending rigidity of the flexural rigidity changing portion 80 larger than half of the maximum bending rigidity of the overtube 50.

Specifically, as shown in the portion (a) of FIG. 12, the value of the bending rigidity of the overtube 50 alone is set to C, and the value of the bending rigidity in the bending rigidity changing portion 80 is set to A (value at the first position P1). ), B (value at the second position P2) (where A, B, C> 0 and B> A), (BA)> {(1/2) × C }. In this case, the total bending rigidity of the insertion portion 12 and the overtube 50 is as shown in the portion (b) of FIG.

It should be noted that such a relationship of flexural rigidity can be adopted in any of the above-described Examples 1 to 4.

As described above, according to the endoscope system 100 according to the present invention, it is possible to secure an appropriate flexural rigidity of the insertion portion while maintaining the slide length of the insertion portion.

<Another invention>
Next, an endoscope system as another invention other than the present invention will be described. In Examples 1 to 4 of the present invention, a region in which the bending rigidity changes (flexural rigidity changing portion 80) is provided in at least a part of the protruding region 70, but in another invention, the bending rigidity is constant in the protruding region 70 (in another invention). The insertion portion 12 is set to the lowest bending rigidity), and the insertion portion 12 is slid (moved) until the break prevention member 15 abuts on the overtube 50 (that is, until the insertion portion 12 is located at the tip position of the advancing / retreating range with respect to the overtube 50). A flexural rigidity changing portion 83 is provided in a portion (covered region) where the flexible portion 36 is covered with the overtube 50 in the state of being made to stand.

<Configuration of endoscopy system>
Since the configuration of the endoscope system according to another invention is the same as the configuration shown in FIGS. 1 and 2 except for the flexural rigidity changing portion 83 shown below, the same elements are designated by the same reference numerals and details thereof. Explanation is omitted.

FIG. 13 is a diagram showing the flexural rigidity of the flexible portion 36 in another invention. As shown in FIG. 13, in another invention, the tip position of the protruding region 70 is 100 mm from the tip of the insertion portion 12, and the length of the protruding region 70 is 400 mm (from the tip of the insertion portion 12 to 500 mm). Then, in the region where the flexible portion 36 is covered with the overtube 50 after the most proximal end portion of the protruding region 70, the first position P1 of 200 mm (from the tip end of the insertion portion 12 to 700 mm) is further toward the proximal end side. The flexural rigidity is constant (the lowest part of the flexural rigidity). From this first position P1 to the second position P2 on the base end side (900 mm from the tip of the insertion portion 12) is the flexural rigidity changing portion 83 in which the bending rigidity increases.

In the example of FIG. 13, the length of the covering region 72 (the range in which the soft portion 36 is covered by the overtube 50) is 200 mm, but the length of the covering region 72 may be changed in the range of 200 mm to 300 mm. .. Further, the length of the flexural rigidity changing portion 83 may also be changed in the range of 200 to 300 mm.

Further, in another invention, the change in the bending rigidity in the bending rigidity changing portion 83 changes the thickness of the resin layers having different hardness, or changes the thickness of the resin, as described in FIGS. 2 and 4 and in connection with these figures. This can be achieved by changing the mixing ratio.

Also in another invention, assuming that the bending rigidity of the minimum bending rigidity portion is 1, it is preferable that the bending rigidity (relative ratio) on the proximal end side of the second position P2 is 2 or more. Further, it is preferable that the relationship between the bending rigidity of the flexible portion 36 and the bending rigidity of the overtube 50 is the same as in FIG.

FIG. 14 is a diagram showing a state in which the insertion portion 12 and the overtube 50 of the endoscope system 100 according to another invention are inserted into a subject whose stomach has been completely removed. For such a subject, in the endoscope system 100 according to another invention, a portion (up to about 600 mm) inserted after the Y leg (anastomosis between the small intestine and the duodenum) indicated by the symbol PY in FIG. 14 is provided. The load due to insertion from the Y leg to the duodenum side can be reduced by setting all of them to have the lowest bending rigidity (700 mm in length in the above example).

Also in the endoscope system according to another invention, it is possible to secure an appropriate flexural rigidity of the insertion portion while maintaining the slide length of the insertion portion, as described above for the present invention.

The present invention and another invention are not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of each invention.

10 ... Endoscope, 12 ... Insertion part, 14 ... Hand operation part, 36 ... Soft part, 37 ... Exodermis, 38 ... Curved part, 39 ... Balloon, 40 ... Hard tip part, 50 ... Overtube, 56 ... Tip opening , 58 ... Base end opening, 59 ... Insertion passage, 70 ... Projection area, 72 ... Covering area, 80, 83 ... Flexural rigidity changing part, 82 ... Bending rigidity uniform part, P1 ... 1st position, P2 ... 2nd position, P3 ... 3rd position

Claims (2)

It has an insertion part to be inserted into the body and an operation part connected to the base end side of the insertion part, and the insertion part is a curved tip connected to a hard tip portion and a base end side of the hard tip end portion. An endoscope having a portion and a flexible portion connected to the proximal end side of the curved portion,
A tube body having a tip opening and a proximal opening and having an insertion passage through which the insertion portion is inserted from the proximal opening is provided, and the insertion portion is movable in the longitudinal axis direction of the tube body. The tube body includes an insertion assisting tool in which at least a part of the soft portion protrudes from the tip opening when the insertion portion is located at the tip position of the advancing / retreating range with respect to the tube body.
It is an endoscopic system equipped with
The insertion assisting tool has a balloon provided on the tip end side of the tube body, and has a balloon.
The flexible portion has a protruding region that protrudes from the tip opening when the insertion portion is located at the tip position of the advancing / retreating range with respect to the tube body.
The projecting region, have a flexural rigidity changing portion bending rigidity is increased toward the second position on the base end side from a first position on the front end side,
The first position is the tip position of the protruding region, and the second position is the base end position of the protruding region.
Endoscopic system. It has an insertion part to be inserted into the body and an operation part connected to the base end side of the insertion part, and the insertion part is a curved tip connected to a hard tip portion and a base end side of the hard tip end portion. An endoscope having a portion and a flexible portion connected to the proximal end side of the curved portion,
A tube body having a tip opening and a proximal opening and having an insertion passage through which the insertion portion is inserted through the proximal opening, wherein the insertion portion can move forward and backward in the longitudinal axis direction of the tube body. With insertion aids
It is an endoscopic system equipped with
The insertion assisting tool has a balloon provided on the tip end side of the tube body, and has a balloon.
The insertion assisting tool has a contact portion that comes into contact with the endoscope on the proximal end side of the tube body, and the tube body has at least the softness when the endoscope abuts on the contact portion. A part of the portion is formed with a length protruding from the tip opening.
The flexible portion has a protruding region that protrudes from the tip opening when the endoscope abuts on the abutting portion.
The projecting region, have a flexural rigidity changing portion bending rigidity is increased toward the second position on the base end side from a first position on the front end side,
The first position is the tip position of the protruding region, and the second position is the base end position of the protruding region.
Endoscopic system.