JPH065601U - Introduction aid for endoscopes - Google Patents

Abstract

(57) [Abstract] [Purpose] An object of the present invention is to provide an endoscope introduction assisting tool that is safe and easy to guide the endoscope and can be reliably locked in the inserted body lumen. [Structure] A tubular guide tube (2) through which an endoscope can be inserted is provided, and an endoscope is inserted through an inner hole of the guide tube (2) with a distal end portion of the guide tube (2) inserted into a lumen of a living body. In the endoscope introduction assisting tool 1 to be introduced into the lumen, an inner tube 4 having flexibility, and an outer member fitted to the outer circumference of the inner tube 4 so as to be movable in the longitudinal direction of the inner tube 4. A guide tube 2 is formed from the tube 6 and is projectingly provided on the outer peripheral surface of the inner tube 4 and taken in and pressed below the inner surface of the outer tube 6 as the outer tube 6 moves along the inner tube 4.
Then, the inner pipe 4 is cut in the longitudinal direction from the tip edge of the inner pipe 4 and closed by the pressing force of the outer pipe 6 that presses the protruding portion 10.
At least one slit 12 for tapering and deforming the distal end side portion of the inner tube 4 and a locking portion 8 projecting from the outer peripheral surface of the distal end portion of the inner tube 4 for locking the lumen of the living body.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to an endoscope introduction aid 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 the flexible endoscope 60 is introduced from the gallbladder duct 52 into the common bile duct 54 in order to remove the stones generated in the common bile duct 54 transendoscopically, first, as described above. A tubular trocar 51 is inserted into the abdomen 53 of the patient and a laparoscope, a treatment tool, etc. are introduced into the abdominal cavity through the trocar 51, and the gallbladder 50 and the common bile duct 54 are observed under the laparoscopic observation. An incision is made in the gallbladder canal 52 that connects to and with a treatment tool such as scissors.

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 51 is guided while being grasped by the grasping forceps 57. And insert it into the gallbladder duct 52 through the incision 55. After the distal end portion of the endoscopic introduction assisting device 56 is introduced into the gallbladder duct 52, the insertion portion of the flexible endoscope 60 is introduced from the gallbladder duct 52 into the common bile duct 54 through the endoscopic introducing aid 56. It will be done. Then, a basket-like grasping forceps (not shown) is introduced into the common bile duct 54 through the flexible endoscope 60, and the grasping forceps performs crushing, grasping, recovery, etc. of calculi in the common bile duct 54.

On the other hand, after expanding the gallbladder canal with a dilator, the insertion part of the flexible endoscope 60 is directly inserted into the incision 55 of the gallbladder canal 52 by the grasping forceps 57 without using the endoscope introduction assisting device 56. There is also a way to insert it. In this case, if the grasping forceps 57 directly grasps the insertion portion of the flexible endoscope 60, it may damage the insertion portion or cause a failure. Therefore, the endoscope grasping member 65 as shown in FIG. To use. The endoscope holding member 65 includes a tubular portion 65a having an insertion opening 69 through which the insertion portion of the flexible endoscope 60 can be inserted, and a treatment instrument holding portion 65b provided on the outer surface of the tubular portion 65a. In the state where the insertion portion of the flexible endoscope 60 is passed through the insertion port 69, the treatment tool grip portion 65b is grasped by the grasping forceps 57, and the insertion portion of the flexible endoscope 60 is fixed to the gallbladder duct 52. It is guided to the incision 55.

[0007]

[Problems to be solved by the device]

 However, when the flexible endoscope 60 is inserted through the endoscope introduction aid 56 in which the distal end portion is inserted into the gallbladder duct 52 through the incision 55 of the gallbladder duct 52, When the tip pushes the inner wall of the endoscopic introduction assisting tool 56, the endoscopic introducing aid 56 may easily fall out of the incision 55 of the gallbladder duct 52.

When the endoscopic introduction assisting tool 56 falls off from the incision 55 of the gallbladder tube 52 in this manner, the endoscopic introducing aid 56 must be inserted into the incision 55 again by the grasping forceps 57. Therefore, the operation time becomes long, which puts a heavy burden on the operator and the patient.

In addition, when the insertion portion of the flexible endoscope 60 is directly inserted into the incision 55 of the gallbladder duct 52 without using the endoscopic introduction assisting tool 56, the grasping forceps 57 is used to grasp the endoscope. Since only the site of the treatment instrument gripping portion 65b of the member 65 can be gripped, there is a problem that the operability when guiding the insertion portion of the flexible endoscope 60 to the incision 55 of the gallbladder duct 52 is poor. .

The present invention has been made in view of the above circumstances, and an object thereof is to guide and operate the endoscope safely and easily, and to securely lock the endoscope in the inserted living body lumen. It is to provide an introduction aid for an endoscope.

[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. A guide portion that is formed of the outer pipe and a protruding portion that is projectingly provided on the outer peripheral surface of the inner pipe and that is taken in and pressed below the inner surface of the outer pipe when the outer pipe moves along the inner pipe. , At least one slit that is cut in the longitudinal direction from the tip edge of the inner tube, and is closed by the pressing force of the outer tube that presses the protruding portion, and the tip side portion of the inner tube is tapered and deformed; And a locking portion that projects from the outer peripheral surface and locks in the lumen of the living body.

[0012]

[Action]

 When the projection is taken under the inner surface of the outer tube, the outer tube presses the projection by the inner surface. The pressing force with which the inner surface of the outer pipe presses the protruding portion crushes the slit of the inner pipe so as to close it, and the tip side portion of the inner pipe is tapered and deformed. On the contrary, when the outer tube is moved to the proximal side, the pressing force of the outer tube acting on the protruding part is released, so the tip side part of the inner tube elastically expands radially outward and returns to the original state. . At this time, the locking portion projecting from the outer peripheral surface of the distal end portion of the inner tube bites into the inner wall of the lumen, and the inner tube is locked in the lumen.

[0013]

【Example】

 An embodiment of the present invention will be described below with reference to the drawings. As shown in (a) of FIG. 1, the endoscope introduction assisting tool 1 of this embodiment has a tubular guide tube 2 that is inserted into a lumen and can be inserted through an insertion portion of an endoscope (not shown). is doing. The guide tube 2 includes an inner tube 4 and an outer tube 6 formed of a flexible resin material. The outer tube 6 is fitted on the outer circumference of the inner tube 4 so as to be movable in the longitudinal direction of the inner tube 4.

The inner tube 4 has an inner diameter that allows the insertion portion of the endoscope to be freely inserted therethrough. Further, a locking portion 8 that locks in the lumen of the living body is provided on the outer peripheral surface of the distal end portion of the inner tube 4. The locking portion 8 has a tapered taper surface 8a, and the proximal side portion of the taper surface 8a which is the base edge is a sharp pointed portion 8b which bites into the inner wall of the lumen.

Further, four slits 12 ... Are cut from the tip edge of the inner tube 4 in the longitudinal direction. As shown in FIG. 1C, the slits 12 ... Are provided at an angular interval of 90 ° in the circumferential direction of the inner tube. Further, a projecting portion 10 projecting in the radial direction is provided over substantially the entire circumference at the outer peripheral surface portion of the inner pipe 4 where the end portion of the slit 12 is located. The protruding portion 10 has tapered surfaces 10a and 10b having gentle slopes on both sides thereof along the longitudinal direction of the guide tube 2. When the outer pipe 6 located on the base end side of the protruding portion 10 is moved forward along the inner pipe 4 by the taper surfaces 10a and 10b, the protruding portion 10 smoothly moves below the inner surface of the outer pipe 6. It is designed to be incorporated into.

A base member 16 is provided at the base end portion of the inner tube 4 as an opening for introducing the insertion portion of the endoscope into the inner tube 4. An annular seal member 18 is fitted on the inner peripheral surface of the mouthpiece member 16 so as to maintain an airtight state between the insertion portion of the endoscope introduced into the inner tube 4 and the inner tube 4. A slide member 14 for moving the outer pipe 6 along the inner pipe 4 is provided at the base end of the outer pipe 6.

Next, the operation of the endoscope introduction assisting tool 1 having the above-described configuration will be described. First, when the slide member 14 is moved forward from the state shown in FIG. 1A in which the front end of the outer tube 6 is located closer to the base end side than the protruding portion 10, the outer tube 6 has an inner surface on the distal end side. Is moved along the base end side taper surface 10b of the protrusion 10, whereby the protrusion 10 is taken under the inner surface of the outer tube 6, and the outer tube 6 is tapered by the inner surface of the outer tube 6. Press the surface 10b. In this case, since the protruding portion 10 is provided on the outer peripheral surface portion of the inner tube 4 where the end portion of the slit 12 is located, the inner surface of the outer tube 6 presses the base end side taper surface 10b of the protruding portion 10. The pressing force crushes the slit 12 of the inner tube 4 so as to close it, and the tip side portion of the inner tube 4 is tapered and deformed as shown in FIGS. 1B and 1C. That is, the tip side portion of the outer tube 6 moves so as to ride on the protruding portion 10, and the tip side portion of the inner tube 4 is directed radially inward with the terminal end portion of the slit 12 as a hinge.

In this state, the endoscopic introduction assisting tool 1 was introduced into the abdominal cavity from the abdomen through the trocar, and the endoscopic introducing aid 1 was expanded by a dilator by guiding a gripping member (not shown). It is introduced into the gallbladder duct 30 through the incision 33 of the gallbladder duct 30. The cutting opening 33 may be expanded by the dilator until the inner diameter of the inner tube 4 is about the same. With the distal end portion of the inner tube 4 of the endoscope introduction aid 1 introduced into the gallbladder tube 30 to some extent, the outer tube 6 is moved to the proximal side through the slide member 14 this time. As a result, the pressing force of the outer pipe 6 that acts on the base end side tapered surface 10b of the protrusion 10 is released, so that the tip end side portion of the inner pipe 4 is elastically radially outward with the end portion of the slit 12 as a hinge. , And returns to the original state shown in FIG. At this time, the pointed portion 8b of the engaging portion 8 protruding from the outer peripheral surface of the distal end of the inner duct 4 bites into the inner wall of the gallbladder duct 30 as shown in FIG. 2, and the inner duct 4 is locked to the gallbladder duct 30. It After that, the endoscope is inserted into the inner tube 4 from the mouthpiece member 16 provided at the proximal end of the inner tube 4, and the endoscope is inserted into the gallbladder tube 30.

As described above, in the endoscopic introduction assisting tool 1 of the present embodiment, the distal end portion of the inner tube 4 is fixed to the gallbladder tube 30 by the locking portion 8 projecting outward in the radial direction of the inner tube 4. Since it can be securely locked with respect to the endoscope, when the endoscope is inserted into the endoscope introduction assisting tool 1, the tip of the endoscope is fixed to the inner wall of the endoscope introducing assist tool 1. By pushing, the endoscopic introduction assisting tool 1 does not fall out from the incision 33 of the gallbladder duct 30. Further, the radial protrusion of the locking portion 8 can be freely controlled by the operator by the expansion / contraction operation of the distal end side portion of the inner tube 4 by sliding the outer tube 6, so that the endoscope can be introduced. The assisting tool 1 can be easily inserted into and removed from the gallbladder canal opening 33. Therefore, the operation time can be shortened, the burden on the operator and the patient can be reduced, and the guide operation of the endoscope becomes safe and easy.

In the present embodiment, the outer tube 6 is an integral flexible tube over the entire length, but the tip side portion of the outer tube 6 may be formed of a hard metal such as metal. In this case, it is possible to prevent the tip side portion of the outer tube 6 from extending and contracting by pressing the protrusion 10 by the tip side portion of the outer tube 6. Will be good.

[0021]

[Effect of device]

 As described above, the introduction aid for an endoscope of the present invention ensures that the distal end portion of the inner tube is securely locked to the lumen by the locking portion that projects radially outward of the inner tube. Therefore, when the endoscope is inserted into the endoscope introduction assisting tool, the tip of the endoscope pushes the inner wall of the endoscope introducing aid to introduce the endoscope. The assistive device does not fall out of the lumen. Further, the radial projection of the locking portion allows the operator to freely control by the expansion / contraction operation of the distal end side portion of the inner tube by sliding the outer tube, so that the insertion aid for the endoscope can be controlled. It can be easily inserted into and removed from the lumen. Therefore, the operation time can be shortened, the burden on the operator and the patient can be reduced, and the guide operation of the endoscope becomes safe and easy.

[Brief description of drawings]

FIG. 1 (a) is a partial cross-sectional view of an endoscope introduction assisting tool showing a first embodiment of the present invention, and FIG. 1 (b) is a distal side portion of the endoscope introduction assisting tool of (a). An enlarged cross-sectional view, (c) is a perspective view of the endoscope introduction assisting tool with the distal end deformed in a tapered shape.

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

FIG. 3 is an explanatory view showing an embodiment of a conventional endoscope introduction assisting tool.

FIG. 4 is an explanatory diagram showing a method of using a conventional endoscope holding member.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Introduction aid for endoscopes, 2 ... Guide tube, 4 ... Inner tube, 6 ...
Outer tube, 8 ... Locking portion, 10 ... Projection portion, 12 ... Slit.

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, which is provided on the outer peripheral surface of the inner tube and is protruded and pressed below the inner surface of the outer tube along with the movement of the outer tube along the inner tube; At least one slit that is cut in a direction and is closed by the pressing force of the outer tube that presses the protruding portion to taper-deform the tip side portion of the inner tube, and a living body that is provided on the outer peripheral surface of the tip portion of the inner tube. An endoscopic introduction assisting tool, comprising: a locking portion that locks in a lumen.