JPH01254135A - Endoscope device for bile and pancreatic ducts - Google Patents
Endoscope device for bile and pancreatic ductsInfo
- Publication number
- JPH01254135A JPH01254135A JP63083588A JP8358888A JPH01254135A JP H01254135 A JPH01254135 A JP H01254135A JP 63083588 A JP63083588 A JP 63083588A JP 8358888 A JP8358888 A JP 8358888A JP H01254135 A JPH01254135 A JP H01254135A
- Authority
- JP
- Japan
- Prior art keywords
- guide tube
- endoscope
- tube
- insertion section
- bile
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 210000000277 pancreatic duct Anatomy 0.000 title claims abstract description 46
- 210000000013 bile duct Anatomy 0.000 title claims abstract description 22
- 238000003780 insertion Methods 0.000 claims abstract description 67
- 230000037431 insertion Effects 0.000 claims abstract description 66
- 210000001198 duodenum Anatomy 0.000 claims abstract description 12
- 210000002445 nipple Anatomy 0.000 description 18
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 10
- 239000011780 sodium chloride Substances 0.000 description 10
- 238000010586 diagram Methods 0.000 description 5
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 5
- 239000002184 metal Substances 0.000 description 3
- 230000000694 effects Effects 0.000 description 2
- 210000003445 biliary tract Anatomy 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 210000000232 gallbladder Anatomy 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 230000002262 irrigation Effects 0.000 description 1
- 238000003973 irrigation Methods 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 210000000496 pancreas Anatomy 0.000 description 1
- 230000010412 perfusion Effects 0.000 description 1
- 239000000843 powder Substances 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 230000008719 thickening Effects 0.000 description 1
Landscapes
- Endoscopes (AREA)
Abstract
Description
【発明の詳細な説明】
〔産業上の利用分野〕
この発明は、非観血的な胆・膵管の内視鏡的観察を行う
ための胆・膵管用内視鏡装置に関するものである。DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an endoscopic device for biliary and pancreatic ducts for performing non-invasive endoscopic observation of biliary and pancreatic ducts.
十二指腸まで挿入可能な挿入部を有する親内視鏡と、挿
入部の鉗子孔を通して経乳頭的に挿入する挿入部を有す
る子内視鏡とを使用する親子スコープ方式が知られてい
る。この方式では、子内視鏡の挿入部を親内視鏡の鉗子
孔を通して直接乳頭へ挿入して胆・膵管内を観察するも
のである。しかし、胆・膵管を観察するためには、観察
部内を洗浄するための潅流をする必要がある。そのため
に子内視鏡の挿入部には潅流用の生食水等を送るための
通路が必要となり、子内視鏡の挿入部の径は太くならざ
るを得なかった。このような子内視鏡の挿入部先端は、
方向を定めるために彎曲しないと乳頭へうまく挿入でき
ず、そのため上下２方向に先端部が彎曲する機能を有す
るようになっていた。A parent-child scope system is known that uses a parent endoscope that has an insertion section that can be inserted up to the duodenum, and a child endoscope that has an insertion section that is inserted transpapillary through a forceps hole in the insertion section. In this method, the insertion section of the child endoscope is directly inserted into the nipple through the forceps hole of the parent endoscope to observe the inside of the biliary and pancreatic ducts. However, in order to observe the bile and pancreatic ducts, it is necessary to perform perfusion to clean the inside of the observation area. Therefore, the insertion section of the child endoscope requires a passage for sending saline for irrigation, and the diameter of the insertion section of the child endoscope has to be increased. The tip of the insertion section of such a child endoscope is
If it is not curved to determine the direction, it cannot be inserted into the nipple properly, so the tip has the function of being curved in two directions, up and down.
生食水送水用の通路及び先端部が彎曲する機能を持たせ
るため手内視鏡の挿入部外径は３−．５ｍ程度となり、
乳頭挿入時の操作を誤ると乳頭や胆・膵管を傷つける虞
れがあるのみならず、乳頭挿入操作も難しいものであっ
た。The outer diameter of the insertion part of the hand endoscope is 3-mm in order to provide a passage for saline water supply and a function of curving the tip. It will be about 5m,
Not only is there a risk of damaging the nipple or the bile/pancreatic duct if the operation is incorrect when inserting the nipple, but the operation of inserting the nipple is also difficult.
そこで、この発明は、直接子内視鏡の挿入部を乳頭へ挿
入せず、いくつかの径の異なるガイドチューブを準備し
、最初に最も細径のガイドチューブを選択し、選択され
たガイドチューブを乳頭を介して胆・膵管内へ挿入させ
、このガイドチューブに手内視鏡の挿入部を挿入するこ
とにより挿入操作が容易かつ安全に行えるようにすると
ともに、このガイドチューブと手内視鏡の挿入部との間
隙を利用して生食水を送水でき、さらに細径のガイドチ
ューブを利用して太い径のガイドチューブを胆・膵管へ
挿入した後に細径のガイドチューブを抜き出して手内視
鏡の挿入部を太い径のガイドチューブへ挿入し、この間
隙に各種処置具を挿入できるようにした胆・膵管用内視
鏡装置を提供することを目的とする。Therefore, in this invention, instead of directly inserting the insertion part of the child endoscope into the nipple, several guide tubes with different diameters are prepared, the narrowest guide tube is selected first, and the selected guide tube is is inserted into the bile/pancreatic duct via the papilla, and the insertion section of the hand endoscope is inserted into this guide tube, making the insertion operation easy and safe. Saline can be delivered using the gap between the insertion part of the tube and the larger diameter guide tube, which can be inserted into the biliary and pancreatic ducts using the smaller diameter guide tube, and then the smaller diameter guide tube can be pulled out for manual endoscopic observation. It is an object of the present invention to provide an endoscope device for biliary and pancreatic ducts in which the insertion portion of a mirror is inserted into a guide tube with a large diameter, and various treatment tools can be inserted into this gap.
上述の目的を達成するため、この発明は、鉗子孔を有す
る挿入部が十二指腸まで挿入可能な親内視鏡とこの親内
視鏡の鉗子孔から柔軟性を存するガイドチューブに導か
れて胆・膵管内へ挿入される挿入部を有する手内視鏡と
を備え、手内視鏡の挿入部基端側に挿入部を被覆するよ
うに２以上の径の異なる固定用チェープを同心的に設け
、親内視鏡の鉗子孔から胆・膵管へ挿入された２以上の
径の異なるガイドチューブ中選択されたものの径に応じ
てアダプタを介して選択されたガイドチューブに対応す
る固定用チューブとガイドチューブとを連通可能に連結
できるように構成したものである。In order to achieve the above-mentioned object, the present invention includes a master endoscope whose insertion section having a forceps hole can be inserted up to the duodenum, and a guide tube having flexibility guided from the forceps hole of the master endoscope to insert the biliary tract into the gallbladder. A hand endoscope having an insertion section to be inserted into the pancreatic duct, and two or more fixing chains with different diameters are concentrically provided on the proximal side of the insertion section of the hand endoscope so as to cover the insertion section. , a fixing tube and a guide corresponding to the selected guide tube via an adapter according to the diameter of the selected guide tube among two or more guide tubes with different diameters inserted into the bile/pancreatic duct from the forceps hole of the parent endoscope. It is configured so that it can be connected to the tube in a communicable manner.
この発明の装置で胆・膵管を観察しようとする場合、親
内視鏡の挿入部先端を経口的に十二指腸まで挿入して乳
頭の位置を確認した後、鉗子孔へ乳頭へ挿入し易い径の
ガイドチューブを挿入し、親内視鏡の挿入部先端に設け
られた鉗子起立台等を利用してガイドチューブ先端部を
乳頭に向けて更に挿入すれば、ｐ°イドチューブは柔軟
性に富んでいるため乳頭を傷つけることなく経乳頭的に
胆管又は膵管へ挿入される。また、ガイドチューブは、
手内視鏡の単に観察機能だけをもった挿入部（通路や鉗
子孔は不要）が挿入される太さで良いために十分に細（
形成でき、無理なく乳頭へ挿入可能となる。ガイドチュ
ーブが乳頭から胆管或いは膵管へ挿入されたならば、手
内視鏡の挿入部をガイドチューブへ挿入する。手内視鏡
の挿入部とガイドチューブとの間隙を利用してて生食水
を送水できる。このとき、２以上の固定用チューブから
細径のガイドチューブを対応するものを選び、これらチ
ェーブをアダプタを介して連通可能に連結し、アダプタ
を利用して生食水を送水する。さらに、太い径のガイド
チューブを利用するときには、細径のガイドチューブを
利用して太い径のガイドチューブを胆・膵管へ挿入し、
細径のガイドチューブを抜き取る。太い径のガイドチュ
ーブに対応する固定用チューブを選び、アダプタを介し
てこれらチューブを連通可能に連結し、アダプタを利用
して各種処置具を挿入する。When attempting to observe the biliary and pancreatic ducts with the device of this invention, after orally inserting the insertion end of the master endoscope into the duodenum and confirming the position of the papilla, select a diameter that is easy to insert into the papilla through the forceps hole. Insert the guide tube and use the forceps stand provided at the tip of the parent endoscope to insert the tip of the guide tube toward the nipple.The tube is highly flexible. Because of this, it can be inserted transpapillary into the bile duct or pancreatic duct without damaging the papilla. In addition, the guide tube
The insertion section of the hand endoscope, which has only the observation function (no passageway or forceps hole required), is thin enough to allow insertion.
It can be easily inserted into the nipple. Once the guide tube has been inserted from the nipple into the bile duct or pancreatic duct, insert the insertion section of the hand endoscope into the guide tube. Saline can be delivered using the gap between the insertion part of the hand endoscope and the guide tube. At this time, a corresponding small-diameter guide tube is selected from two or more fixing tubes, these tubes are communicatively connected via an adapter, and saline is fed using the adapter. Furthermore, when using a larger diameter guide tube, use a smaller diameter guide tube to insert the larger diameter guide tube into the bile/pancreatic duct.
Remove the small diameter guide tube. A fixation tube corresponding to the large diameter guide tube is selected, these tubes are connected via an adapter so that they can communicate, and various treatment instruments are inserted using the adapter.
以下に、この発明の好適な実施例を図面を参照して説明
する。Preferred embodiments of the present invention will be described below with reference to the drawings.
第１図はこの装装置全体を示す概略図であり、十二指腸
まで挿入可能な挿入部２を有する親内視鏡１と、鉗子孔
３の挿入口４から胆・膵管内へ挿入される挿入部５を有
する手内視鏡６と、細径のガイドチューブ７とから成る
。十二指腸まで挿入される挿入部２の先端は、第２図に
示すように、イメージガイド窓８とライトガイド窓９並
びに送気及び送水口１０、更には鉗子孔３の個所に設け
た鉗子起立台１１を備えている。Ｉｌ内視鏡１、ガイド
チューブ７、手内視鏡６を使用して胆・膵管を観察する
場合は、親内視鏡１の挿入口４からガイドチューブ７を
鉗子孔３へ挿入する。このガイドチューブ７の基端部側
にはルアーロック１２を取付け、このルアーロック１２
に可撓性を持った芯金１３を取付けである。芯金１３の
先端はガイドチューブ７の先端から突出しないようにな
っている、親内視鏡１の挿入部２の先端で十二指腸１０
０にある乳頭１０１，１０２を観察し、鉗子孔３からガ
イドチューブ７を乳頭ｌＯ１へ挿入する。FIG. 1 is a schematic diagram showing the entire device, including a master endoscope 1 having an insertion section 2 that can be inserted into the duodenum, and an insertion section that is inserted into the biliary and pancreatic ducts from the insertion port 4 of the forceps hole 3. It consists of a hand endoscope 6 having a diameter of 5, and a small diameter guide tube 7. As shown in FIG. 2, the tip of the insertion section 2 inserted into the duodenum includes an image guide window 8, a light guide window 9, an air and water supply port 10, and a forceps stand provided at the forceps hole 3. It is equipped with 11. When observing the biliary and pancreatic ducts using the Il endoscope 1, guide tube 7, and hand endoscope 6, the guide tube 7 is inserted into the forceps hole 3 from the insertion port 4 of the parent endoscope 1. A luer lock 12 is attached to the proximal end of the guide tube 7.
A flexible core bar 13 is attached to the core bar 13. The tip of the core bar 13 is designed not to protrude from the tip of the guide tube 7, and is inserted into the duodenum 10 at the tip of the insertion section 2 of the parent endoscope 1.
Observe the nipples 101 and 102 at position 0, and insert the guide tube 7 from the forceps hole 3 into the nipple lO1.
第４図上、上にある膵管１０３は副膵管であり、下側の
太い方が主膵管である。また、符号１０４は胆管を示し
、符号１０５は膵臓である。乳頭１０１ヘガイドチユー
ブ７を挿入する際、親内視鏡２で観察しながら鉗子起立
台１１を操作し、ガイドチューブ７の先端を乳頭１０１
に挿入する。芯金１３がガイドチューブ７に挿入しであ
るので、柔軟性を備えたガイドチューブ７を乳頭１０１
から膵管１０３内へ挿入し易くなる。膵管１０３や胆管
１０４を撮影したとき、芯金１３の存在によりガイドチ
ューブ７が膵管１０３や胆管１０４のどの部位まで挿入
されたかが分かる。また、ガイドチューブ７を介して膵
管１０３或いは胆管１０４内へ像影剤を注入することが
できる。胆管１０４や膵管１０３へ挿入されるガイドチ
ューブ７の直径は１．７鶴のものを使用した。このよう
なガイドチューブ７に芯金１３を挿入しておくのは、鉗
子孔３内での蛇行を防止するとともにガイドチューブ７
を乳頭１０１，１０２へ挿入し易くするためと共に、透
視時に芯金１３の像が映し出され、先端位置の確認がで
きるようにするためであるが、ガイドチューブ７を乳頭
１０１或いは１０２へ挿入し易い程度の柔軟さに形成し
ておき、膵管１０３や胆管１０４に挿入されるカイトチ
ューブ７の先端側を透視時に像が映るように金属粉末等
をコーティングしておけば、芯金１３を挿入しなくても
差し支えない、このようにして親内視鏡１の挿入口４か
ら鉗子孔３内へガイドチューブ７を挿入し、ガイドチュ
ーブ７の先端部を例えば膵管ｌＯ３へ挿入したならば、
ルアーロック１２を取外しかつ芯金１３をガイドチュー
ブ７から抜き出す。The pancreatic duct 103 at the top in FIG. 4 is an accessory pancreatic duct, and the thicker one at the bottom is the main pancreatic duct. Further, reference numeral 104 indicates a bile duct, and reference numeral 105 indicates a pancreas. When inserting the guide tube 7 into the nipple 101, operate the forceps stand 11 while observing with the parent endoscope 2, and insert the tip of the guide tube 7 into the nipple 101.
Insert into. Since the core bar 13 is inserted into the guide tube 7, the flexible guide tube 7 is inserted into the nipple 101.
It becomes easier to insert the pancreatic duct 103 into the pancreatic duct 103. When photographing the pancreatic duct 103 or the bile duct 104, it can be seen to which part of the pancreatic duct 103 or the bile duct 104 the guide tube 7 has been inserted due to the presence of the core bar 13. Further, an imaging medium can be injected into the pancreatic duct 103 or the bile duct 104 via the guide tube 7. The diameter of the guide tube 7 inserted into the bile duct 104 and the pancreatic duct 103 was 1.7 mm. Inserting the core metal 13 into such a guide tube 7 prevents meandering within the forceps hole 3 and also prevents the guide tube 7 from meandering.
This is to make it easier to insert the guide tube 7 into the nipple 101 or 102, and to make it easier to insert the guide tube 7 into the nipple 101 or 102, as well as to make it easier to insert the guide tube 7 into the nipple 101 or 102. If the tip of the kite tube 7 inserted into the pancreatic duct 103 or the bile duct 104 is coated with metal powder or the like so that the image is visible when viewed through the pancreatic duct 103 or the bile duct 104, the core bar 13 does not have to be inserted. If the guide tube 7 is inserted into the forceps hole 3 from the insertion port 4 of the parent endoscope 1 in this way, and the distal end of the guide tube 7 is inserted into the pancreatic duct IO3, for example,
Remove the Luer lock 12 and pull out the core metal 13 from the guide tube 7.
次いで、予肉視鏡６の生食水送水用通路や鉗子孔のない
挿入部５をガイドチューブ７へ挿入していく、予肉視鏡
６の挿入部５の先端部とガイドチューブ７の先端部とが
略揃う位置でかつ挿入部５がガイドチューブ７の先端部
よりも突出しないように挿入部５をガイドチューブ７へ
挿入してゆくときに、挿入部５の過挿入を防止するため
予肉視鏡６にアダプタ１４を設けである。アダプタ１４
は、直管部１４Ａと直管部１４Ａに直交し連通ずる交叉
管１４Ｂとから成る。直管部１４Ａの一端は予肉視鏡６
に設けた固定用チューブ１５．１６の中細径の固定用チ
ューブ１５に連結され、他端はガイドチューブ７の基端
部に連結される（第１．５図参照）、アダプタ１４の交
叉管１４Ｂはチューブ１７に連結してあり、このチュー
ブ１７を介して生食水を供給する管路となっている。生
食水の供給は、チューブ１７の他端に設けたルアーロッ
ク１８によって接続される注射器等から供給されチュー
ブ１７、交叉管１４日１直管部１４Ａを介し挿入部５と
ガイドチューブ７との間隙を通って胆・膵管１０３．１
０４内へ送水される。予肉視鏡６の挿入部５の基端側に
同心的に設けた固定用チューブ１５．１６のうち太い径
の固定用チューブ１６は、他のガイドチューブ１９と
アダプタ２０を使用するときのものであり、これについ
ては後述する。細径の固定用チューブ１５と、予肉視鏡
６の挿入部５との間の間隙は挿入部５の基端側で密閉す
るため、密閉用リング２１を設け、最外周には固定用リ
ング２２を設けである（第５図参照）。Next, the insertion section 5 of the pre-nacroscopic scope 6, which does not have a saline water supply passage or a forceps hole, is inserted into the guide tube 7. When inserting the insertion section 5 into the guide tube 7 so that the insertion section 5 is approximately aligned and the insertion section 5 does not protrude beyond the distal end of the guide tube 7, pre-thickening is applied to prevent over-insertion of the insertion section 5. The endoscope 6 is provided with an adapter 14. adapter 14
consists of a straight pipe section 14A and a crossed pipe 14B that is perpendicular to and communicates with the straight pipe section 14A. One end of the straight tube portion 14A is a pre-nacroscope 6.
The cross tube of the adapter 14 is connected to the fixing tube 15 with a medium and small diameter of the fixing tube 15. 14B is connected to a tube 17, and serves as a conduit through which saline is supplied. Saline water is supplied from a syringe or the like connected by a luer lock 18 provided at the other end of the tube 17, and is supplied to the gap between the insertion section 5 and the guide tube 7 via the tube 17 and the straight tube section 14A of the crossed tube 14. Through the biliary and pancreatic ducts 103.1
Water is sent into 04. Among the fixing tubes 15 and 16 provided concentrically on the proximal end side of the insertion section 5 of the preliminary macroscope 6, the fixing tube 16 with a larger diameter is used when using the other guide tube 19 and adapter 20. This will be discussed later. A sealing ring 21 is provided to seal the gap between the small-diameter fixing tube 15 and the insertion section 5 of the pre-nacroscope 6 on the proximal end side of the insertion section 5, and a fixation ring is provided on the outermost periphery. 22 (see Figure 5).
次に内視鏡を３つ使用する場合について説明すると、上
述したように親内視鏡１とガイドチューブ７を使用して
ガイドチューブ７を胆・膵管１０３．１０４内へ挿入し
たならば、第７図に示すようなジテント２３でガイドチ
ューブ７と同径の継ぎチューブ２４とを連結する（第６
図参照）０両チューブ７．２４をそのままに（ガイドチ
ューブ７の先端を胆・膵管１０３，１０４へ挿入したま
ま）親内視鏡１を抜き取る０次いで第８図に示すように
鉗子孔３よりも大きい鉗子３゛を備えた内視鏡１′を経
口的に十二指腸１００まで挿入する。Next, to explain the case where three endoscopes are used, once the guide tube 7 is inserted into the biliary and pancreatic ducts 103 and 104 using the master endoscope 1 and the guide tube 7 as described above, Connect the guide tube 7 and a joint tube 24 of the same diameter with a ditent 23 as shown in Fig. 7 (6th
(See figure) 0 Remove the parent endoscope 1 while leaving both tubes 7 and 24 as they are (with the tip of the guide tube 7 inserted into the biliary and pancreatic ducts 103 and 104) 0 Then, as shown in Figure 8, remove the parent endoscope 1 from the forceps hole 3. An endoscope 1' equipped with large forceps 3' is orally inserted into the duodenum 100.
このとき両チューブ７．２４を鉗子孔３′に挿入し、チ
ューブ２４から順次挿入口４′を経て外部へ出す０次い
で、太い径のガイドチューブ１９を両チューブ７．２４
に案内させて胆・膵管１０３゜１０４へ挿入してゆく
（第９図参照）。ガイドチエーゾ１９の先端は、既に胆
・膵管１０３．１０４内意へ挿入されているガイドチュ
ーブ７に案内されたならば、チューブ７．２４を抜き取
る。内視鏡１′の挿入部２′の先端が十二指腸１００へ
挿入され、ガイドチューブ１９の先端が胆・膵管１０３
．１０４のいずれかに挿入された状態から、第１０図に
示すようにアダプタ２０を介して手内視鏡６の挿入部５
をガイドチューブ１９へ挿入する。アダプタ２０の直営
部２０Ａの一端は固定用チューブ１６に、他端はガイド
チューブ１９に連結される。この状態の詳細は、第１１
図に示す通りであり、交叉管２０Ｂの連通個所は固定用
チューブ１５の先端よりガイドチューブ１９寄りになっ
ている。このアダプタ２０を手内視鏡６に取付けるとと
もにガイドチューブ１９に取付けたとき、挿入部５の先
端はガイドチューブ１９の先端にほぼ揃い、突出しない
ように設計しであることは勿論である。太い径のガイド
チューブ１９と挿入部５との管の間隙を利用し、アダプ
タ２０の交叉管２０Ｂから生食水を送水できるのみなら
ず、第１２図に示すように鉗子２５等の各種処置具を挿
入できる。なお、親内視鏡１の親とも言うべき内視鏡１
′を使用したが、初めから内視鏡１′を親として細径の
ガイドチューブ７を挿入した後に太い径のガイドチュー
ブ１９を挿入してゆくことも可能である。At this time, both tubes 7.24 are inserted into the forceps hole 3', and the tubes 24 and 24 are sequentially passed through the insertion port 4' to the outside.
guide it and insert it into the biliary and pancreatic ducts 103° and 104.
(See Figure 9). Once the distal end of the guide thief 19 has been guided into the guide tube 7 that has already been inserted into the bile/pancreatic duct 103, 104, the tube 7, 24 is removed. The tip of the insertion section 2' of the endoscope 1' is inserted into the duodenum 100, and the tip of the guide tube 19 is inserted into the bile/pancreatic duct 103.
．． 104, insert the insertion section 5 of the hand endoscope 6 via the adapter 20 as shown in FIG.
into the guide tube 19. One end of the direct portion 20A of the adapter 20 is connected to the fixing tube 16, and the other end is connected to the guide tube 19. Details of this condition can be found in Chapter 11.
As shown in the figure, the communicating portion of the intersecting tube 20B is closer to the guide tube 19 than the distal end of the fixing tube 15. Of course, when this adapter 20 is attached to the hand endoscope 6 and the guide tube 19, the distal end of the insertion portion 5 is substantially aligned with the distal end of the guide tube 19 and is designed so as not to protrude. Utilizing the gap between the large-diameter guide tube 19 and the insertion section 5, it is possible not only to feed saline through the crossover tube 20B of the adapter 20, but also to use various treatment tools such as forceps 25 as shown in FIG. Can be inserted. In addition, endoscope 1, which can also be called the parent of parent endoscope 1,
. However, it is also possible to use the endoscope 1' as a parent from the beginning and insert the narrow guide tube 7 and then insert the large diameter guide tube 19.
以上説明したように、この発明によれば２以上のガイド
チューブを利用し、最初に細径のガイドチューブを胆・
膵管へ挿入した後にこのガイドチューブ内へ手内視鏡の
挿入部を挿入してゆ（のでた、安全かつ容易に挿入部を
胆・膵管へ挿入することができる。また、太い径のガイ
ドチューブの挿入も細径のガイドチューブに案内される
ためにスムースに胆・膵管へ挿入可能となる。しかもい
ずれのガイドチューブ挿入時でもアダプタを介して手内
視鏡の挿入部基端に設けた固定用チューブとガイドチュ
ーブとを連結でき、このときに予め設計しておけば挿入
部先端がガイドチューブ先端から突出することもな（、
アダプタからガイドチューブ内へ生食水や各種処置具を
挿入することが゛できる。As explained above, according to the present invention, two or more guide tubes are used, and the small diameter guide tube is first
After inserting the endoscope into the pancreatic duct, the insertion section of the hand endoscope can be inserted into the guide tube, allowing the insertion section to be safely and easily inserted into the biliary and pancreatic ducts. The insertion of the guide tube into the biliary and pancreatic ducts is smooth because it is guided by a small-diameter guide tube.Furthermore, when inserting either guide tube, it is fixed at the proximal end of the insertion section of the hand endoscope via an adapter. The insertion tube and guide tube can be connected, and if you design this in advance, the tip of the insertion tube will not protrude from the tip of the guide tube (
Saline and various treatment instruments can be inserted into the guide tube from the adapter.
第１図はこの装置の概略を示す全体図、第２図は親内視
鏡挿入部先端の拡大図、第３図は親内視鏡の鉗子孔へガ
イドチューブを挿入したとの斜視図、第４図は親内視鏡
を十二指腸まで挿入し乳頭へ向けてガイドチューブを挿
入しようとする状態の説明図、第５図はアダプタの詳細
を示す断面図、第６図は継ぎチューブをつないだ正面図
、第７図はジヨイントを示す断面図、第８図は親内視鏡
を抜き取った後に内視鏡を挿入する説明図、第９図は太
い径のガイドチューブ挿入時の説明図、第１０図は手内
視鏡の挿入部を挿入する説明図、第１１図はアダプタの
詳細を示す断面図、第１２図は鉗子を挿入した状態の図
である。
１ ・・・親内視鏡、
１′・・・内視鏡、
２．２′・・・挿入部、
３．３′・・・鉗子孔、
４．４′・・・挿入口、
５ ・・・挿入部、
６ ・・・手内視鏡、
７．１９・・・ガイドチューブ、
１１．１１’・・・鉗子起立台、
１４．２０・・・アダプタ、
１５．１６・・・固定用チューブ。Fig. 1 is an overall view showing the outline of this device, Fig. 2 is an enlarged view of the tip of the main endoscope insertion section, and Fig. 3 is a perspective view of the guide tube inserted into the forceps hole of the main endoscope. Figure 4 is an explanatory diagram of the state in which the parent endoscope is inserted into the duodenum and the guide tube is inserted toward the nipple, Figure 5 is a cross-sectional view showing details of the adapter, and Figure 6 is a diagram showing how the connecting tube is connected. Front view, Figure 7 is a sectional view showing the joint, Figure 8 is an explanatory diagram of inserting the endoscope after removing the parent endoscope, Figure 9 is an explanatory diagram of inserting a large diameter guide tube, FIG. 10 is an explanatory view of inserting the insertion section of the hand endoscope, FIG. 11 is a sectional view showing details of the adapter, and FIG. 12 is a view with forceps inserted. 1... Parent endoscope, 1'... Endoscope, 2.2'... Insertion section, 3.3'... Forceps hole, 4.4'... Insertion port, 5. ... Insertion section, 6 ... Hand endoscope, 7.19 ... Guide tube, 11.11' ... Forceps stand, 14.20 ... Adapter, 15.16 ... For fixation tube.
Claims (1)
内視鏡とこの親内視鏡の鉗子孔から柔軟せ有するガイド
チューブに導かれて胆・膵管内へ挿入される挿入部を有
する子内視鏡とを備え、子内視鏡の挿入部基端側に挿入
部を被覆するように２以上の径の異なる固定用チューブ
を同心的に設け、 親内視鏡の鉗子孔から胆・膵管へ挿入された２以上の径
の異なるガイドチューブ中選択されたものの径に応じて
アダプタを介して選択されたガイドチューブに対応する
固定用チューブとガイドチューブとを連通可能に連結で
きるように構成したことを特徴とする胆・膵管用内視鏡
装置。[Scope of Claims] 1. A master endoscope whose insertion part having a forceps hole can be inserted up to the duodenum and a flexible guide tube guided through the forceps hole of this master endoscope and inserted into the biliary and pancreatic ducts. The main endoscope is equipped with a secondary endoscope having an insertion section, and two or more fixing tubes with different diameters are concentrically provided on the proximal side of the insertion section of the secondary endoscope so as to cover the insertion section. The fixation tube corresponding to the selected guide tube can be communicated with the guide tube via an adapter according to the diameter of the selected guide tube among two or more guide tubes with different diameters inserted into the bile/pancreatic duct through the forceps hole of the An endoscope device for biliary and pancreatic ducts, characterized in that it is configured so that it can be connected to a biliary and pancreatic duct.
Priority Applications (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP63083588A JPH01254135A (en) | 1988-04-05 | 1988-04-05 | Endoscope device for bile and pancreatic ducts |
| US07/332,859 US4979496A (en) | 1988-04-05 | 1989-04-03 | Endoscope for bile duct and pancreatic duct |
| DE1989624663 DE68924663T2 (en) | 1988-04-05 | 1989-04-05 | Endoscope for examining the bile and pancreatic ducts. |
| EP89105987A EP0336399B1 (en) | 1988-04-05 | 1989-04-05 | Endoscope for bile duct and pancreatic duct |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP63083588A JPH01254135A (en) | 1988-04-05 | 1988-04-05 | Endoscope device for bile and pancreatic ducts |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH01254135A true JPH01254135A (en) | 1989-10-11 |
| JPH0438413B2 JPH0438413B2 (en) | 1992-06-24 |
Family
ID=13806650
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP63083588A Granted JPH01254135A (en) | 1988-04-05 | 1988-04-05 | Endoscope device for bile and pancreatic ducts |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JPH01254135A (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH04354929A (en) * | 1991-05-31 | 1992-12-09 | Olympus Optical Co Ltd | Endscope |
| CN116076990A (en) * | 2023-03-22 | 2023-05-09 | 精微致远医疗科技(武汉)有限公司 | Confocal microscopic choledochoscope system |
-
1988
- 1988-04-05 JP JP63083588A patent/JPH01254135A/en active Granted
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH04354929A (en) * | 1991-05-31 | 1992-12-09 | Olympus Optical Co Ltd | Endscope |
| CN116076990A (en) * | 2023-03-22 | 2023-05-09 | 精微致远医疗科技(武汉)有限公司 | Confocal microscopic choledochoscope system |
Also Published As
| Publication number | Publication date |
|---|---|
| JPH0438413B2 (en) | 1992-06-24 |
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| Date | Code | Title | Description |
|---|---|---|---|
| LAPS | Cancellation because of no payment of annual fees |