JPH063301U - Introduction aid for endoscopes - Google Patents

Abstract

(57) [Abstract] [Purpose] To provide an endoscope introduction assisting tool that can be reliably locked in a living body lumen that has been inserted, and that the locking member is not likely to be damaged when performing a guiding operation. It is an object. [Structure] A tubular guide tube (2) through which an endoscope can be inserted is provided, and an endoscope is passed through an inner hole of the guide tube (2) in a state where a distal end portion of the guide tube (2) is inserted into a lumen of a living body. In the endoscope introduction assisting tool 1 for introducing the above into the lumen, the flexible inner tube 4 and the outer circumference of the inner tube 4 are movably fitted in the longitudinal direction of the inner tube 4. The guide tube 2 is composed of the outer tube 6 and a radial direction of the guide tube 2 due to a relative displacement between the outer tube 6 and the inner tube 4 caused by the movement of the outer tube 6 at a tip side portion of the guide tube 2. An elastic member 8 that elastically projects and locks in the lumen of the living body is provided.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to an endoscope introduction assisting tool used as a guide when inserting an endoscope into a lumen.

[0002]

[Prior art]

 In recent years, laparoscopic cholecystectomy has been performed to remove a diseased gallbladder without laparotomy using an endoscope. In this surgical procedure, a tubular tracar is inserted into several points on the abdomen of a patient, and a laparoscope, a treatment tool, etc. are introduced into the abdominal cavity through the trocar to remove the sick gallbladder under laparoscopic observation. It is to be excised with a treatment tool. Since this operation method is a minimally invasive procedure that does not require laparotomy, it has the advantages of less burden on the patient and a shorter hospital stay.

In recent years, attempts have been made to insert a flexible endoscope into the common bile duct during the laparoscopic cholecystectomy and remove the common bile duct stone endoscopically. This will be described below with reference to FIG.

When removing the common bile duct stone 58 through the endoscope, first, as described above, a tubular trocar is inserted into several places on the abdomen of the patient, and a laparoscope or a treatment tool is inserted through the trocar. Etc. are introduced into the abdominal cavity, and an incision is made with a treatment tool such as scissors forceps in the gallbladder duct 52 that connects the gallbladder 50 and the common bile duct 54 under laparoscopic observation.

Next, the incision 55 of the gallbladder canal 52 is expanded with a dilator, and the distal end portion of the endoscopic introduction assisting device 56 introduced through the trocar is guided while grasping with a grasping forceps. From the inside into the gallbladder tube 52. After the distal end portion of the endoscopic introduction assisting device 56 is introduced into the gallbladder duct 52, the flexible endoscope 60 is introduced from the gallbladder duct 52 into the common bile duct 54 through the endoscopic introducing aid 56. . Then, with the tip of the flexible endoscope 60 facing the calculus 58, a basket-shaped grasping forceps 62 is projected from the channel of the flexible endoscope 60, and the calculus 58 is crushed and grasped by the grasping forceps 62. It is to collect and so on.

[0006]

[Problems to be solved by the device]

 However, as shown in FIG. 5 (a), the flexible endoscope 60 is inserted through the introductory aid 56 for an endoscope, the distal end portion of which is inserted into the gallbladder duct 52 through the incision 55 of the gallbladder duct 52. When moving, the distal end of the flexible endoscope 60 pushes the inner wall of the endoscopic introduction assisting tool 56, so that the endoscopic introducing assisting tool 56 moves to the gallbladder duct 52 as shown in FIG. 5B. Sometimes it easily slipped out of the incision 55.

If the endoscopic introduction assisting tool 56 falls off from the incision 55 of the gallbladder tube 52 in this way, the endoscopic introducing aid 56 must be inserted into the incision 55 again by a grasping forceps or the like. Not only that, the operation time becomes long, which puts a heavy burden on the operator and the patient. Further, it is necessary to increase the locking force by inserting the endoscope introduction assisting tool 56 quite deeply.

In view of this, the endoscope introduction assisting device disclosed in Japanese Patent Laid-Open No. 62-22623 is provided with a balloon at the distal end side thereof, and the balloon inflated by inflating the balloon is pressed against the inner wall of the gallbladder duct. , This is trying to lock the distal part of the endoscopic introduction aid to the gallbladder duct.

However, if the grasping forceps that guides the endoscope introduction assisting tool to the incision 55 of the gallbladder duct 52 grasps the balloon on the distal end side of the endoscope introduction assisting tool, the balloon may be damaged. There is.

The present invention has been made in view of the above circumstances, and an object thereof is to securely lock an inserted living body lumen and to perform a guiding operation by the locking member. An object of the present invention is to provide an endoscopic introduction assisting tool that is not likely to be damaged when dented.

[0011]

[Means for Solving the Problems]

 In order to solve the above problems, the present invention has a tubular guide tube through which an endoscope can be inserted, and the distal end portion of the guide tube is inserted into the lumen of a living body. In an endoscope introduction assisting tool for introducing an endoscope into the lumen through an inner hole, a flexible inner tube and an outer circumference of the inner tube are movably fitted in the longitudinal direction of the inner tube. The guide tube is composed of the outer tube and the outer tube, and the guide tube is elastically projected in the radial direction of the guide tube due to the relative displacement of the outer tube and the inner tube due to the movement of the outer tube at the tip side portion of the guide tube. An elastic member that locks in the lumen of the living body is provided.

[0012]

[Action]

 With the above configuration, the distal end portion of the endoscope introduction assisting tool can be locked to the lumen by protruding the elastic member in the radial direction.

[0013]

【Example】

 Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment of the present invention. The endoscope introduction assisting tool 1 of the present embodiment has a tubular guide tube 2 which is inserted into the lumen and through which the endoscope can be inserted. The guide tube 2 is composed of an inner tube 4 and an outer tube 6 which are formed of a flexible resin material. The outer pipe 6 is fitted on the outer periphery of the inner pipe 4 so as to be movable in the longitudinal direction of the inner pipe 4.

The inner tube 4 has an inner diameter that allows the endoscope to be freely inserted therethrough, and the tip edge portion thereof is a protruding portion 4 a protruding in the radial direction thereof. The tip of the outer tube 6 is arranged at a position separated from the protruding portion 4a by a certain distance. The outer peripheral surface of the protruding portion 4a is substantially flush with the outer peripheral surface of the outer tube 6 fitted to the inner tube 4, and the tip end edge of the protruding portion 4a is formed into a smooth curved surface. Improves insertability when inserted inside.

A tubular elastic member 8 made of an elastic material is fitted into the outer circumference of the inner pipe 4 in a space portion between the front end face of the outer pipe 6 and the rear proximal end face of the protruding portion 4a with almost no gap. It is installed in a closed state. The outer peripheral surface of the elastic member 8 is substantially flush with the outer peripheral surface of the outer tube 6, whereby the outer peripheral surface of the guide tube 2 is formed into a substantially smooth surface over the entire length. The elastic member 8 may be fixed to both or either of the distal end surface of the outer tube 6 and the proximal end surface of the protruding portion 4a, but it is not fixed to the outer peripheral surface of the inner tube 4 and will be described later. As described above, when the outer tube 6 is pushed to the tip side, the elastic member 8 is elastically deformed and is provided so as to project in the radially outward direction. Further, the elastic member 8 is formed of a material that has flexibility so that it can be elastically deformed by a reasonable force and that has a hardness that does not break even if a slight force is applied.

The base 10 of the inner tube 4 is provided with a base 10 as an opening for introducing the endoscope into the inner tube 4. A slide member 12 that slides the outer pipe 6 along the inner pipe 4 is provided at the base end of the outer pipe 6. The slide member 12 has a substantially cylindrical shape with a hollow portion 12a formed therein, and is fitted onto the outer circumference of the inner pipe 4 with the opening of the hollow portion 12a facing the outer surface of the inner pipe 4. .

A compression spring 14 and a ball member 16 are provided in the hollow portion 12 a of the slide member 12. The compression spring 14 is interposed between the inner wall of the slide member 12 and the ball member 16 in a radially compressed state. In this state, the ball member 16 is urged against the outer surface of the inner tube 4. There is. The ball member 16 can be engaged with the first engagement groove 17 and the second engagement groove 19 formed on the outer surface of the inner tube 4 on the base end side. The outer pipe 6 can be positioned with respect to the inner pipe 4 by engaging with the grooves 17 and 19. Further, the first locking groove 17 is a position where the ball member 16 is locked in a state where the elastic member 8 is not elastically deformed and is kept in a flat natural length (see (a) of FIG. 1). The second locking groove 19 is located closer to the tip side than the first locking groove 17 and the elastic member 8 is elastically deformed and protrudes in the radial direction (see FIG. 1). It is provided at a position where the ball member 16 is locked in (see (b)).

Next, the endoscope is introduced into the common bile duct by using the endoscope introduction assisting tool 1 having the above-described configuration, and the case where the stone in the common bile duct is removed endoscopically is the endoscope. A description will be given together with the operation of the manual introduction aid 1.

As shown in FIG. 2, the tubular trocar 22 is inserted into the abdominal wall 24 of the patient at several points. One of these trocars 22 is for guiding the laparoscope into the abdominal cavity, and the other is for guiding treatment tools such as scissors forceps and grasping forceps into the abdominal cavity, and a soft material for removing common bile duct stones. It is for guiding the endoscope introduction assisting tool 1 for guiding the endoscope 20.

When a laparoscope, a treatment tool and the like are introduced into the common bile duct site in the abdominal cavity through the trocar 22 inserted into the abdominal wall 24, scissors forceps are attached to the gallbladder duct 31 connecting the gallbladder 30 and the common bile duct 32 under laparoscopic observation. Make an incision with a treatment tool such as.

Next, the incision 33 of the gallbladder canal 31 is expanded with a dilator, and the endoscopic introduction assisting tool 1 introduced through the trocar 22 is guided while being grasped by the grasping forceps, and is guided through the incision 33. Insert into tube 31. At this time, in the endoscope introduction assisting tool, the ball member 16 is locked in the first locking groove 17 as shown in FIG. 1 (a), and the elastic member 8 is flat without being elastically deformed. It is inserted into the gallbladder duct 31 while maintaining its natural length.

After the distal side portion of the endoscope introduction assisting tool 1 is introduced into the gallbladder canal 31, the slide member 12 is pushed forward to move the outer tube 6 along the inner tube 4 in the distal direction. When the outer tube 6 moves in the distal direction, the distance between the proximal end surface of the protruding portion 4a at the distal end of the inner tube 4 and the distal end surface of the outer tube 6 gradually decreases, so that the elastic member 8 receives a compressive force. It is crushed in the longitudinal direction. The elastic member 8 is elastically deformed by being crushed in the longitudinal direction and protrudes in the radial direction. In this state, the elastic member 8 forms a large-diameter enlarged portion protruding in the radial direction of the proposed tube 2, as shown in FIG. The elastic member 8 protruding in the radial direction of the guide tube 2 is pressed against the inner wall of the gallbladder tube 31 and locks the distal end side portion of the endoscope introduction assisting tool 1 with respect to the gallbladder tube 31. In addition, since the ball member 16 is locked in the second locking groove 19 in a state where the distal end side portion of the endoscope introduction assisting tool 1 is locked in the gallbladder tube 31, the outer tube 6 is fixed to the inner tube 4. Positioning is performed without sliding with respect to each other, and the locked state of the endoscopic introduction assisting tool 1 and the gallbladder duct 31 is maintained.

While maintaining such a locked state, this time, the flexible endoscope 20 is introduced from the gallbladder duct 31 into the common bile duct 32 through the endoscope introduction assisting tool 1. Then, with the tip of the flexible endoscope 20 facing a calculus (not shown) located in the common bile duct 32, a basket-like grasping forceps is projected from the channel of the flexible endoscope 20, and the calculus is grasped by the grasping forceps. It is to be grasped and collected.

As described above, in the endoscopic introduction assisting tool 1 of the present embodiment, the distal end portion of the endoscope assisting tool 1 can be locked to the gallbladder duct 31 by protruding the elastic member 8 in the radial direction. Therefore, when the flexible endoscope 20 is inserted into the endoscope introduction assisting tool 1, the distal end of the flexible endoscope 20 pushes the inner wall of the endoscope introducing aid 1 so that the endoscope The guide aid 1 for a mirror does not fall out from the incision 33 of the gallbladder duct 31. Further, since the operator can freely control the expansion / contraction operation of the elastic member 8 in the radial direction by the slide member 12, it is easy to insert and remove the endoscopic introduction assisting tool 1 into the gallbladder duct incision 33. I can do it. Therefore, the operation time can be shortened and the burden on the operator and the patient can be reduced. Further, since the elastic member 8 is not made of a material that is weak like a conventional balloon, the elastic member 8 is not damaged even when gripped by gripping forceps, and has good strength.

FIG. 3 shows a second embodiment of the present invention. The endoscope introduction assisting tool 40 of the present embodiment is an elastic tube 42 formed by integrally molding the elastic member 8 and the outer tube 6 of the first embodiment, and other configurations are the same as those of the first embodiment. The same as the embodiment.

The elastic tube body 42 as an outer tube is configured such that the tip end side portion thereof elastically protrudes in the radial direction by the compressive force in the longitudinal direction, and the protruding shape is shown in FIG. 3B. It is pre-molded to have a bellows shape. The bellows-shaped distal end portion 42a is locked to the inner wall of the lumen so that the endoscope introduction assisting tool 40 can be fixed in the lumen.

Therefore, similarly to the first embodiment, if the elastic tube body 42 as the outer tube is pushed forward through the slide member 12, as shown in FIG. The tip side part of is subjected to compressive force and protrudes in the radial direction. Conversely, if the elastic tube body 42 is extended in the direction of the arrow in FIG. 3A via the slide member 12, the elastic tube body 42 will have a uniform outer diameter over the entire length. In this state, the endoscopic introduction assisting tool 40 is inserted into and removed from the gallbladder duct incision.

[0028]

[Effect of device]

 As described above, the endoscope insertion assisting tool of the present invention can lock the distal end portion of the elastic member in the lumen by protruding the elastic member in the radial direction. When the endoscope is inserted through the insertion aid, the distal end of the endoscope pushes the inner wall of the insertion aid so that the insertion aid for the endoscope comes out of the incision in the lumen. It does not fall out. Therefore, the operation time can be shortened and the burden on the operator and the patient can be reduced. Further, since the elastic member is not weak in material unlike conventional balloons, it is not damaged even when grasped by grasping forceps and has good strength.

[Brief description of drawings]

1A and 1B show a first embodiment of the present invention, FIG. 1A is a cross-sectional view of an endoscope introduction aid in a state where an elastic member does not protrude in a radial direction, and FIG. 1B shows an elastic member in a radial direction. FIG. 4 is a cross-sectional view of the endoscope introduction assisting tool in a state of protruding to the front.

FIG. 2 is an explanatory view showing an embodiment of the endoscope introduction assisting tool of FIG.

FIG. 3 shows a second embodiment of the present invention, (a) is a cross-sectional view of the introduction aid for an endoscope in a state where the elastic member does not project in the radial direction, and (b) shows the elastic member in the radial direction. FIG. 4 is a cross-sectional view of the endoscope introduction assisting tool in a state of protruding to the front.

FIG. 4 is an explanatory view showing an embodiment of a conventional endoscope introduction assisting tool.

FIG. 5 (a) is a cross-sectional view showing a state in which a distal end side portion of a conventional endoscope introduction assisting tool is introduced into the gallbladder duct, and FIG. 5 (b) is a distal end portion of a conventional endoscope introducing aid tool. FIG. 6 is a cross-sectional view showing a state in which the blood vessel falls out of the gallbladder duct.

[Explanation of symbols]

1, 40 ... Introduction aid for endoscope, 2 ... Guide tube, 4 ... Inner tube, 6 ... Outer tube, 8 ... Elastic member, 42 ... Elastic tube body (outer tube), 42a ... Tip part (elastic member) ).

Claims (1)

[Scope of utility model registration request] 1. A tubular guide tube into which an endoscope can be inserted is provided, and the endoscope is inserted through an inner hole of the guide tube in a state where a distal end portion of the guide tube is inserted into a lumen of a living body. In the endoscope introduction assisting tool to be introduced into the lumen, a flexible inner tube and an outer tube fitted to an outer periphery of the inner tube so as to be movable in a longitudinal direction of the inner tube are provided. A guide tube is formed, and a distal end portion of the guide tube is elastically protruded in a radial direction of the guide tube due to a relative displacement between the outer tube and the inner tube due to the movement of the outer tube and engages with a lumen of a living body. An endoscope insertion assisting tool, which is provided with an elastic member for stopping.