JPH0956667A - Treatment implement drawing device for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enhance the operability of a treatment tool by releasing the linkage between a treatment implement inserting and drawing device and the treatment implement in the state where the treatment implement is inserted into the channel of an endoscope, and removing the body of the treatment implement inserting and drawing device from the endoscope side. SOLUTION: The lower end part 57 of the front end wall of a front cover part 53 is bent inward in L-shape, the lower end part 57 is fitted the lower end of a flange part 58 protruded from the front upper end of a grip cover 26, touched and engaged thereby. The lower end part 57 is further touched by the front surface 59 of the grip cover 26, and the side surface of the lower end part 57 is also touched by the side surface of the flange part 58. Elastic connecting arms 85 are integrally formed on the front ends of left and right part upper covers 51 so as to be protruded forward, and hook parts 85a are provided on the tips of the connecting arms 85. The connecting arms 85 nip the peripheral surface of the extended part of the treatment tool insert port part of the operating part of an endoscope, and the hook parts 85a are fitted to corresponding grooves to install a treatment tool inserting and drawing device 25 to the endoscope.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic treatment tool insertion / extraction device for inserting a treatment tool such as forceps or a tube into a channel of an endoscope.

[0002]

2. Description of the Related Art Conventionally, when a treatment tool such as forceps or a tube is inserted into a channel of an endoscope, an operator holds the sheath portion of the treatment tool in his hand and pushes it in little by little. . However, when a treatment tool is inserted into a channel of an endoscope having a total length of 2 m like an endoscope for deep colon, it takes a lot of time and labor for biopsy and the like is very troublesome. . If the surgical instrument is inserted too quickly and an unnecessary bending force is applied to the portion of the sheath of the surgical instrument that is exposed from the channel of the endoscope, it may cause buckling or the like in the sheath. Was tedious to work with great care so as not to apply unnecessary bending force.

As a means for solving the problems of such a general treatment instrument insertion procedure, for example, an "endoscopic treatment instrument insertion / removal device" proposed in Japanese Patent Laid-Open No. 56-8028 is known. This is to automatically insert and remove the treatment instrument by sandwiching the sheath of the treatment instrument between a pair of rollers and rotating the rollers.

In Japanese Patent Laid-Open No. 57-117823, there is also known an "endoscope with a treatment instrument insertion / removal device". This shows a treatment instrument insertion / extraction device that has a drive mechanism for inserting a treatment instrument and a means for detecting the insertion amount, and controls the drive mechanism according to information on the insertion amount.

Further, in Japanese Patent Laid-Open No. 57-190541, in addition to a device for automatically inserting a treatment tool, a part of a gear train connecting a drive roller and a motor is automatically engaged after completion of insertion of the treatment tool. It is shown that the release device is incorporated therein to reduce the amount of rotational force of the drive roller.

[0006]

[Problems to be Solved by the Invention]

(Problems of the prior art) Both the treatment instrument insertion / extraction devices proposed in Japanese Patent Laid-Open No. 56-8028 and Japanese Patent Laid-Open No. 57-117823 described above use a treatment instrument to perform delicate operations such as biopsy. Even when performing a treatment operation, the sheath portion of the treatment instrument is still set on the roller of the automatic treatment instrument insertion / extraction device, which causes a problem that the operation feeling of the treatment instrument deteriorates.

Further, in Japanese Patent Application Laid-Open No. 57-190541, it is relatively easy to finely adjust the insertion amount by hand after inserting the treatment tool, but the roller presses the sheath portion of the treatment tool. As a result of the continued operation, the feeling of operation of the treatment tool tends to deteriorate due to that. further,
Since the state in which the roller presses the sheath portion of the treatment tool is continued, for example, there is a problem in that the wire built into the treatment tool becomes slippery and the operation force of the operation handle becomes heavy.

(Object of the Invention) The present invention has been made in view of the above circumstances, and at least the main body portion of the device can be removed from the endoscope and the treatment tool after the treatment tool is inserted, so that the operability of the treatment tool is improved. An object is to provide a treatment instrument insertion / extraction device for an endoscope.

[0009]

SUMMARY OF THE INVENTION The present invention provides a treatment instrument insertion / removal device for an endoscope including a mechanism for inserting / removing a treatment instrument into / from a channel of an endoscope from an insertion opening formed in an operation portion of the endoscope. In a state where the treatment tool is inserted into the channel of the endoscope, the connection between the treatment tool insertion / removal device and the treatment tool is released, and the main body of the treatment tool insertion / removal device is removable from the endoscope side. The endoscope treatment tool insertion / removal device. According to this, after inserting the treatment tool into the channel of the endoscope, the automatic insertion / removal device can be removed from the treatment tool. Since at least the main body of the endoscopic treatment tool insertion / extraction device can be detached from the endoscope side, the operability of the treatment tool inserted into the channel of the endoscope is not impaired.

[0010]

BEST MODE FOR CARRYING OUT THE INVENTION

<First Embodiment> A first embodiment of the present invention will be described with reference to FIGS.

(Structure) FIG. 2 is an explanatory view showing a schematic structure of the entire endoscope apparatus. The endoscope 1 includes an operation unit 2,
The operation portion 2 is provided with a grip portion 2a for holding it by hand. The insertion portion 3 and the universal cord 4 are connected to the operation portion 2. A connector 5 is provided at the extension end of the universal cord 4,
The connector 5 is a light source device 6 for an endoscope that supplies illumination light.
It is designed to be detachably connected to.

The insertion portion 3 is provided with a tip forming portion 9 via a curved portion 8. The bending portion 8 is bent by the angle knob 7 provided on the operation portion 2. The distal end forming portion 9 is provided with a distal end opening 9d of the treatment instrument insertion channel inserted in the insertion portion 3. Further, the tip forming section 9 is provided with an observation window 9b, a nozzle 9a capable of supplying air and water toward the observation window 9b, and an illumination window 9c for illuminating an observation object. . The base end of the insertion portion 3 is provided with a folding cover 3a for preventing abrupt bending and damage.

The operation portion 2 is provided with a treatment instrument insertion opening 10 which forms an opening at the other end of the channel. The treatment instrument insertion opening 10 is formed by forming an insertion opening 10b communicating with the channel at a protruding tip portion of an extending portion 10a which is integrally formed with the main body of the operation portion 2 and projects obliquely upward. is there.

A forceps plug 11 is attached to the insertion opening 10b as required. The forceps plug 11 is provided with a hole 11a that allows a treatment tool 100, which will be described later, to penetrate in an airtight manner and is normally in a closed state. Treatment tool insertion opening 1
The insertion opening 10 is formed on the outer peripheral side surface of the extending portion 10a at 0.
The connecting groove 12 which is a rectangular hole is provided at two positions symmetrical with respect to the central axis of b. This connection groove 12
A treatment instrument insertion / removal device 25 for an endoscope, which will be described later, is detachably attached to the treatment instrument insertion opening 10 by utilizing the.

The connector 5 of the universal cord 4 is connected to the air supply device 13, the water supply device 14 and the gas supply device 15, and is also connected to the video processor 16 for processing video signals via the connection adapter 16a. ing.

The video processor 16 includes a monitor 17 for displaying a subject image based on the signal-processed video signal, a VTR deck 18 for recording / reproducing the video signal, a video printer 19 for printing the subject according to the video signal, and a video signal. Video disk 20 which is a large-capacity storage device for recording
Etc. are connected. The video processor 16 is operated by a switch 21 provided on the operation unit 2.

Further, in the operating portion 2, an air / water switching device 22 for connecting to a nozzle 9a opening to the tip forming portion 9 of the insertion portion 3 for supplying air and water, and a suction operating device 23 for sucking. And a gas feed operation device 24 for pressure-feeding a gas such as an inert gas such as CO ₂ .

Next, the treatment instrument 100 which is used by being inserted into the channel of the endoscope 1 will be described. The treatment tool 100 is shown in FIG.
As shown in FIG. 5, a sheath 101, which is an elongated member having an outer diameter smaller than the inner diameter of the channel of the endoscope and having flexibility, is provided, and the distal end of the sheath 101 is a treatment for performing treatment inside the patient's body. A section 102 is provided. A grip portion 103 is connected to the proximal end of the sheath 101. The grip 103 includes a handle 104 for operating the treatment section 102.
Is provided. There are various treatment tools 100 adapted to various treatments depending on the type of the treatment section 102, and various treatment tools such as biopsy forceps, high-frequency snares, and grasping forceps are known.

Next, the endoscopic treatment tool insertion / extraction device 25 will be described. As shown in FIG. 1, a treatment instrument insertion / extraction device 2 for an endoscope.
5 has a box-shaped grip cover 26. The grip cover 26 accommodates a battery box, a motor, an encoder, a rotation transmitting gear train, a control circuit, wiring, and the like, which will be described below.

First, inside the lower portion of the grip cover 26, a battery case 28 for mounting the battery 27 is arranged. The battery 27 supplies electric power to the motor 29 by a wiring (not shown) and a control circuit (not shown).

Although the battery 27 is used as the power source in this embodiment, the type of the battery 27 is not particularly limited. Further, instead of the battery 27, a mechanism using an AC power source may be used, and furthermore, the endoscopic treatment tool insertion / extraction device 25.
It is not necessary to have a built-in power source, and electric power may be taken in from outside.

Although a DC motor is used as the motor 28 in this embodiment, the type of the motor 29 is not particularly limited, and for example, an AC motor, a DC servo motor, a stepping motor, an ultrasonic motor or the like may be used. Is also good.

The motor 29 is arranged vertically along the axial direction of the grip cover 26, and its drive shaft 28
a projects upward. Drive shaft 28 of motor 28
The treatment tool insertion / removal drive roller 31 and the encoder 32 are connected to a through a gear train mechanism as described below. That is, the pinion gear 33 is integrally connected to the drive shaft 28a. The pinion gear 33 has a gear 3
4 meshes with each other, and an intermediary gear 36 is provided on a rotary shaft 35 of the gear 34. The gear 34 and the gear 36 are integrally fixed to the same rotary shaft 35, and the gear 34, the rotary shaft 35, and the gear 36 are integrally rotated around the axis center of the rotary shaft 35. There is.

The gear 36 meshes with a gear 37 attached to the input shaft 32a of the encoder 32. The gear 37 is integrally attached to the input shaft 32a of the encoder 32, and the gear 37 is attached to the input shaft 3a.
It rotates integrally with 2a and operates the encoder 32. When the input shaft 32a of the encoder 32 rotates, the encoder 32 transmits a pulse signal, and the pulse signal is transmitted to the control circuit (not shown) by wiring (not shown).

In this embodiment, the encoder 32 is used to detect the amount of insertion and transfer of the treatment tool, but it is also possible to detect the insertion amount by marking the treatment tool with some marking and reading it. good. Examples of marking include a method in which a projection is provided on the sheath of the treatment instrument to read with a piezoelectric element, a method in which the reflectance of the sheath is partially changed and then read with an optical element, and a magnetic substance is attached to the sheath. Various methods are conceivable, such as a method of reading it with a magnetic head, and any method may be used. Also, a tacho generator may be combined with the encoder 32, or a plurality of the above-mentioned systems may be combined and used.

On the other hand, the gear 36 is the gear 4 of another gear train.
1 is engaged. The gear 41 is fixedly attached to the rotary shaft 42. The other end of the rotary shaft 42 penetrates the upper wall of the grip cover 26 and projects to the outside of the grip cover 26, and the drive gear 43 of the external drive gear train is integrally fixed to the projecting end. The gear 41, the rotary shaft 42, and the gear 43 rotate integrally with the rotary shaft 42 as an axis center. An O-ring 44 is provided at the boundary between the rotary shaft 42 that penetrates the upper wall of the grip cover 26 and the grip cover 26, and the watertightness of the penetrating portion is maintained. The O-ring 44 is assembled and held by being sandwiched between the grip cover 26 and an O-ring stop member 45 that is adhesively fixed to the grip cover 26.

A passive gear 46 is engaged with the external drive gear 43. The passive gear 46 is connected to a rotary shaft 47, which is rotatably supported by the upper right cover, which will be described later, in a fixed state. A drive roller 31 for inserting / removing the treatment instrument, which is made of a cylindrical elastic member, is provided at an outer end of the rotating shaft 47.
Are connected together in a fixed state. And
The passive gear 46, the rotary shaft 47, and the drive roller 31 are designed to rotate integrally with the center of the rotary shaft 47.

The structure of the above-mentioned gear train is not particularly limited to the above-mentioned one, but may be changed in any way as required, and a chain, belt, pulley or the like may be used. good.

The upper surface of the grip cover 26 is shown in FIG.
An upper right cover 51 as schematically shown in FIG. The upper right portion cover 51 is formed by integrally connecting a front cover portion 53 and a tongue portion 54 formed of a plate-like member continuing to the rear end of the front cover portion 53, and the upper surface portion of the grip cover 26 is entirely covered by both of them. There is. The tongue portion 54 is provided with a mounting hole 54a. Then, the mounting screw 55 is screwed into the screw hole 56 formed in the upper wall of the grip cover 26 through the mounting hole 54a, whereby the upper right portion cover 5 is formed.
1 is fixedly attached to the grip cover 26.

As shown in FIG. 1, the front cover portion 53 has a lower surface portion for driving the drive gear 43 in the external drive gear train.
And a space 52 for accommodating the passive gear 46 is formed, and when the gear cover 4 is mounted on the grip cover 26,
It is shaped so as to cover up 3,46. The lower end portion 57 of the front end wall of the front cover portion 53 is bent inwardly in an L shape. The lower end 57 is the grip cover 2
The lower end of the flange portion 58 protruding to the upper end of the front portion of 6 is fitted into and abuts on. The end face shape of the lower end portion 57 is a rectangular flat surface, and this portion is in contact with the front surface 59 of the grip cover 26 which is also flat. Further, the side surface of the lower end portion 57 and the side surface of the flange portion 58 are in flat contact with each other.

As shown in FIG. 5, in the front cover portion 53, a cover portion 61 for covering both the driving gear 43 and the passive gear 46 in the external drive gear train is formed so as to project higher than the other portions, and the cover thereof is formed. A low flat portion 62 is formed on the left side portion of the portion 61. Cover part 61
An opening 63 is formed in the left side wall of the driving roller 31 so as to open toward the flat portion 62 and expose one circumferential portion of the driving roller 31.

An upper left cover 64 is installed on the flat portion 62 of the front cover portion 53. The left upper cover 64 has the same height as the cover portion 61. The left upper cover 64 is integrally provided with a rod-shaped cover rod connecting arm 65 projecting downward and a rectangular parallelepiped projecting portion 66 projecting downward similarly. Corresponding to the cover rod connecting arm 65 and the protrusion 66, the flat portion 62 of the front cover portion 53 is formed with passage holes 67 and 68 into which they are inserted. An elastic claw 66a is formed at the tip of the protrusion 66. The elastic claw 66
A left cover retaining ring 69, which is a donut-shaped elastic body having an outer shape larger than the hole diameter of the passage hole 68, is fitted in a so as to prevent the protruding portion 66 from coming out of the passage hole 68. There is.

Due to the left cover retaining ring 69, the upper left cover 64 does not fall out of the front cover portion 53 and is movable in the direction toward the front cover portion 53 of the upper right cover 51. Left upper cover 6
The cover portion 61 of the upper right cover 51 is provided on the left side surface of
An opening 71 is formed to open toward. The opening 71 faces the opening 63 of the upper right portion cover 51.
Therefore, when the upper left cover 64 is moved until it abuts against the front cover part 53, as shown in FIG.
1 and the adjusting roller 72 are completely covered and closed so that they are not exposed to the outside.

An adjusting roller 72, which is a cylindrical elastic member, is provided inside the upper left cover 64, and the adjusting roller 72 is arranged to face the drive roller 31 through the opening 71. The adjusting roller 72 is rotatably supported by a shaft 74 that is integrally fixed to a rod 73 that is an elongated plate member.

The rod 73 is a holding force adjusting portion 7 which will be described later.
5 are provided in association with each other. That is, the rod 73
Is pierced through the receiving ring 76 and is supported by the receiving ring 76 so as to be smoothly movable in the longitudinal direction. The receiving ring 76 has a threaded portion 77 formed on the outer periphery thereof and is screwed to the upper left cover 64. A disk-shaped flange portion 73a is integrally formed at the protruding end of the rod 73 penetrating the receiving ring 76. The flange portion 73a is configured to slide coaxially in a cylindrical adjustment dial mounting portion 78 formed integrally with the upper left cover 64 so as to project therefrom. A rod-shaped convex portion 73b is integrally fixed to the flange portion 73a so as to be substantially the same as the central axis thereof.

A coil spring 79 for pressing the rod 73 is mounted in the adjusting dial mounting portion 78. One end of the coil spring 79 has a flange portion 7 of the rod 73.
The rod 73 is elastically pressed against the end face of 3a.

A cup-shaped adjustment dial 81 is rotatably mounted on the adjustment dial mounting portion 78. A cam groove 82 is provided in a spiral shape on the outer peripheral surface of the adjustment dial mounting portion 78. The adjustment dial 81 is provided with a cam pin 83 protruding from the cam groove 82 so as to be engaged with the cam groove 82. The adjustment dial 81 is provided with an adjustment dial shaft 84 that can enter the inside of the adjustment dial mounting portion 78 and is concentric with the adjustment dial 81 and integrally formed. The tip end surface of the adjusting dial shaft 84 contacts the other end of the coil spring 79 and is pushed in.

Then, the cam groove 82 and the cam pin 83 are formed.
When the adjustment dial 81 is rotated clockwise, the adjustment dial shaft 84 moves to the right in FIG. 4, and when the adjustment dial 81 is rotated counterclockwise, the cam structure shown in FIG. It is designed to move to the left. Thereby, the drive roller 31 and the adjusting roller 72
The gripping force of the treatment instrument sandwiched between the two can be adjusted.

In this embodiment, the adjusting dial 81 has a cam structure, but screws capable of being screwed are provided on both the adjusting dial 81 and the adjusting dial mounting portion 78, and the longitudinal axis thereof is rotated by the screwing of the both. A structure that moves back and forth in the direction may be used. Further, a structure may be provided in which the sliding portion and the joint portion of each component are kept watertight by an O-ring or an adhesive.

A connecting arm 85, which is a plate-like member having elasticity, is integrally formed by projecting forward at the front end of the right upper cover 51, and a plate-like member having elasticity is also formed at the front end of the left upper cover 64. The connecting arm 86, which is a member of the above, is integrally formed by projecting forward. The connecting arms 85 and 86 are arranged in parallel, and the hooks 85a, which are hook-shaped projections, are provided at their tips.
86a are provided so as to face them. Then, as shown in FIG. 8, the connecting arms 85 and 86 sandwich the outer peripheral surface of the extending portion 10a of the treatment instrument insertion port portion 10 provided in the operating portion 2 of the endoscope 1 and hook portions 85a and 86a thereof.
The means for mounting the treatment instrument insertion / removal device 25 on the endoscope 1 is configured by fitting and hooking the respective instruments into the corresponding connection grooves 12.

In the present embodiment, the connecting arms 85 and 86 are provided with hook-shaped projections which cannot be easily released from the connection with the endoscope 1 in a normal use state, but it is particularly necessary to be hook-shaped. However, the protrusion may have any shape as long as the connection cannot be easily disconnected. For example, it may have a semi-disc shape or a hemispherical shape.

A modified example as shown in FIG. 9 is also conceivable as a means for mounting the endoscopic treatment tool insertion device 25 on the endoscope 1. That is, at least one hole or hole 87 is provided in a part of the side surface of the extending portion 10a of the treatment instrument insertion opening 10, and the connecting arm 88 having an outer shape that fits therein is provided. Alternatively, a modification as shown in FIG. 10 may be used. This is a tubular member 89 having an internal shape that is substantially the same as the outer shape of the extending portion 10a of the treatment instrument insertion port portion 10 instead of the connecting arm.
The structure is such that it covers a.

In this embodiment, the treatment tool 100 and the endoscope 1 are simultaneously disconnected.
Of course, the connection may be released separately.

Further, in the present embodiment, the entire endoscope treatment tool insertion / extraction device 25 has a structure that can be detached from the treatment instrument 100 and the endoscope 1. However, it is not necessary to remove the entire device, for example, in FIG. As shown, a structure in which only the portion corresponding to the portion 90 where the treatment instrument 100 is mounted can be removed and the internal structure of the grip cover 26 is built in the endoscope 1 is also conceivable.

Incidentally, the treatment instrument mounting portion 90 composed of a group of components integrally or movably attached to the upper right portion cover 51 can be detached from the grip cover 26 by removing the attaching screw 55. Is.

In this embodiment, the automatic treatment instrument insertion / removal device 25 is limited to insertion only. However, the automatic treatment instrument insertion / removal device 25 is reattached after the removal treatment from the treatment instrument 100 is completed, and the treatment is performed. The tool 100 may be removed.

By the way, as shown in FIG. 12, in a state where the upper left cover 64 is abutted against the upper right cover 51, a cover is provided at a contact portion between the upper left cover 64 and the upper right cover 51. Treatment tool 1 on the front side
An insertion port 91 for guiding the sheath 101 of No. 00 into the inside of the upper left cover 64 and the upper right cover 51 is provided, and the treatment tool 100 is further provided on the rear surface of the cover from the inside of the upper right cover 51 and the upper left cover 64. A delivery port 92 that leads to the outside is provided.

That is, as shown in FIG. 12, when the upper left cover 64 is abutted against the upper right cover 51, the insertion port 91 and the delivery port 92 are in contact with each other.
The notches 93 and 94 respectively formed at the joint end portion of 1 and the upper left cover 64 are formed together.

With the upper left cover 64 closed, the hook portions 85a, 86a of the connecting arms 85, 86 are mounted in the connecting groove 12 of the endoscope 1 and held in this state by the locking means described later. To be done. Endoscopic treatment instrument insertion / extraction device 2
When 5 is attached to the endoscope 1, the end face of the forceps plug 11 abuts the end face of the cover, and the hole 11 of the forceps plug 11 is present.
The position of a and the delivery port 92 are aligned.

The method of connecting to the endoscope 1 is not limited to the above-mentioned configuration, and it is conceivable that, for example, three or more members corresponding to the connecting arms 85 and 86 are provided to increase stability at the time of connection. .

As shown in FIG. 11, on the side surface of the grip cover 26, an insertion length setting switch 9 for selecting a length for inserting the treatment instrument 100 into the channel of the endoscope 1.
5 is provided, which is connected to the control device (not shown) via wiring (not shown).

Further, on the front surface of the grip cover 26, there is provided a drive switch 96 for starting the driving of the motor 29 by pushing it, which is also connected to the control device (not shown) through wiring (not shown). Has been done. Although the number of the drive switch 96 is one in the present embodiment, a plurality of drive switches 96 may be provided. Further, for example, a switch for inserting the treatment tool and a switch for removing the treatment tool may be provided, or a plurality of switches having different insertion or removal speeds may be prepared. Further, a drive switch and a dial (or switch) for setting the insertion speed may be provided. Alternatively, one switch may have a plurality of functions.

For example, when the switch is pressed the first time, it functions as a drive switch, but if the switch is pressed during operation, it may function as a switch for emergency stop.
The switch may be used alternately as a switch having different functions, such that insertion can be performed by pressing once and removal can be performed by pressing the second time. Alternatively, the first operation may be insertion, the second operation may be removal of the treatment tool, and the third operation may be removal.

The insertion length setting switch 95 and the drive switch 96 are adhesively fixed to the grip cover 26 over the entire circumference so as to keep watertightness. However, there is no particular need for adhesive fixing, and it may be configured to maintain watertightness by interposing an elastic member or the like.

Of course, if one switch has a plurality of functions, it is not necessary to limit the combination to the above. Further, a plurality of switches having the plurality of functions may be provided, or the switch may be used in combination with a switch having only one function. Further, although the push-type switch is used in the above description, it suffices that the switch has a function as a switch, and the switch system is not particularly limited.
Further, a display screen for clearly indicating the current operation status, an operation confirmation lamp, or the like may be provided. Further, an index for indicating the use position of the switches may be provided on the external components such as the grip cover 26 and the upper right cover 51.

The shape of the grip cover 26 does not need to be box-shaped as shown in FIG. 11, and may be any shape as long as it can be easily gripped.

On the other hand, the treatment instrument 100 used may have a stopper 97 attached in advance to the sheath 101 thereof as shown in FIG. This stopper 97 is shown in FIG.
As shown by (3), it has a tightening screw 98, and this tightening screw 98 is configured by integrating the abutting portion 98a and the male screw portion 98b. Further, the tightening screw 98 is provided with a hole portion 98c whose inner diameter is substantially the same as the outer diameter of the sheath 101.

A cylindrical elastic member 99 abuts against the end surface 98d of the screw portion of the tightening screw 98. The inner diameter of the cylindrical elastic member 99 is the sheath 10 of the treatment instrument 100.
The outer diameter is approximately equal to 1. Further, the outer shape of the cylindrical elastic member 99 is tapered.

With the cylindrical elastic member 99 abutting against the tightening screw 98, a tightening ring 99a is fitted and assembled on the outer circumference thereof. The tightening ring 9
9a is a cylindrical member, which is formed by integrating a female screw portion 99b and a taper portion 99c.

The internal shape of the tapered portion 99c is substantially the same as the tapered shape of the cylindrical elastic member 99,
When the tightening ring 99a is screwed into the male screw portion 98b of the tightening screw 98, the cylindrical elastic member 99 is elastically deformed and the sheath 10 is inserted.
Tighten and fix 1. Female thread portion 99b of tightening ring 99a
Can be fixed to an arbitrary position of the sheath 101 by an operation of screwing with the male screw portion 98b of the tightening screw 98.

The stopper 97 is provided with a notch 97a for allowing the treatment tool to be mounted from the side surface over all side surfaces of the tightening ring 99a, the cylindrical elastic member 99, and the tightening screw 98.

Even if the stopper 97 does not have to have the above structure, the stopper 97 may be provided on the sheath 101, and may be provided integrally with the sheath 101, for example.

Next, with reference to FIG. 14, the lock mechanism 110 of the upper left cover 64 will be described as an example. The lock mechanism 110 is adapted to fix the movement of the upper left cover 64 and to release the fixing while the upper left cover 64 is closed. That is, the release button attachment holding member 111 is provided on the front wall portion of the upper right portion cover 51 of the grip cover 26. The button pressing member 111 is fixedly attached to the upper right cover 51 with a plurality of screws 112. Further, a through hole 113 having a relatively small diameter is formed in the front wall of the upper right cover 51. A mounting hole 114 having a relatively large diameter is formed in steps over the front wall portion of the right upper cover 51 and the button pressing member 111 coaxially with the through hole 113. The large-diameter mounting hole 114 is the tubular portion 11 of the button pressing member 111.
It is formed concentrically within 1a.

A release button 115 is mounted in the mounting hole 114. The release button 115 is provided in the through hole 11
3 has a locking shaft 116 penetrating therethrough, and a cylindrical button portion 117 is integrally formed at the outer end thereof.
A disk-shaped flange 118 is formed at the inner end of the button portion 117 so as to be slidable in the mounting hole 114. The button portion 117 has the same outer shape as the outer end hole portion of the mounting hole 114. The release button 115 may be rotatable around its axis, but may be configured such that, for example, the shape of the fitting portion is changed to a non-rotating state.

A coil spring 119 is wound around the outer circumference of the locking shaft 116 while being housed in the mounting hole 114. The coil spring 119 has a flange 1 at one end thereof.
18, the other end of the coil spring 119 is attached to the mounting hole 1
The release button 115 hits the step end surface 120 of 14 and elastically biases the release button 115 in the upward projecting direction. In the standby state shown in FIG. 14, the flange 118 of the release button 115 is in contact with the flange 121 formed on the outer edge of the mounting hole 114.

Locking shaft 1 penetrating through hole 113
A cover rod 122, which is a rod-shaped member, is provided at the tip portion of 16.
A hole 123 is provided to pass through. Cover rod 122
Is provided movably in the longitudinal axis direction on the inner surface of the upper right cover 51. A flange 124 that is bent upward is formed at one end of the cover rod 122, and a rod 125 is provided so as to project from the flange 124. A coil spring 126, which is interposed between the upper right cover 51 and the flange 124 of the cover rod 122, is wound around the rod 125.

A locking projection (hook) 127 is integrally provided at an intermediate portion of the cover rod 122. This protrusion 1
Reference numeral 27 denotes a right-angled triangular shape having a rising wall and a slope, the rising wall serving as a locking end 127a and the slope serving as a guide surface 127b. That is, when the cover rod 122 is moved to the right side in FIG. 12, the locking projection 127 penetrates through the hole 123 in the locking shaft 116 of the release button 115 and the locking end 127 a of the locking projection 127 is holed. It is held by hitting the outer surface of the peripheral edge of 123 and locking it. At this time, the coil spring 119
Is in a compressed state. Release button 11 from this state
When 5 is pushed in, the locking end 127a is released, and the cover rod 122 moves to the left side in FIG. 12 by the elastic biasing force of the coil spring 119. When the cover rod 122 is moved to the right side in FIG. 12, the locking shaft 116 of the release button 115 is pulled down by the guide surface 127b, and the locking end 127a is locked to the outer peripheral surface of the hole 123 of the shaft 116. Returning to the position, the release button 115 is automatically lifted and returned by the coil spring 119.

The other end 128 of the cover rod 122 is integrally connected to the cover rod connecting arm 65 of the upper left cover 64. In FIG. 14, the upper left cover 64 is in a closed state, and in this closed state, the cover rod 122 can pass through the hole 123 in the locking shaft 116 of the release button 115. Left upper cover 6
In the state where 4 is closed, the locking projection 127 is caught,
The hole 123 cannot be passed unless the release button 115 is pushed. That is, if the upper left cover 64 is fixed in the closed state and the release button 115 is operated, the fixation can be released.

The release mechanism by the release button 115 is merely an example, and in short, it is sufficient that at least one of the left and right upper covers is opened by operating the release button 115. Alternatively, even if the upper cover is not automatically opened by the release button 115, a click is provided when opening the upper cover so that the upper cover does not open easily, and a stopper or the like is provided to prevent the upper cover from opening, and the cover is manually opened. You may use the structure which opens with.

(Operation) The insertion length of the treatment instrument 100 is input to the control circuit (not shown) by the insertion length setting switch 95 according to the model of the endoscope 1 to be used. Next, the adjustment dial 81 is adjusted according to the diameter of the sheath 101 of the treatment tool 100 to be used, and the adjustment roller 72 causes the coil spring 79 to move.
Adjust the amount of force applied by. After closing the left upper cover 64, the distal end of the treatment tool 100 is inserted into the insertion opening 91, and is inserted until the sheath 101 is sandwiched between the drive roller 31 and the adjustment roller 72.

At this stage, the connecting arms 85 and 86 are attached to the endoscope 1
The treatment tool insertion opening 10 is fitted, and the hook portions 85a and 86a of the connection arms 85 and 86 are attached and attached to the connection groove 12 thereof. After this connection, when the drive switch 96 is pressed, the control circuit receives the signal and rotates the motor 29.

The driving force of the motor 29 is transmitted to the driving roller 31 via the gear train. At this time, since the encoder 32 also rotates via the gear train, the encoder 32
The pulse signal from is sent to the control circuit.

As a result, the control circuit calculates the rotation speed of the drive roller 31 and rotates the motor 31 until the rotation speed is preset by the insertion length setting switch 95.

When the drive roller 31 is rotated with the sheath 101 of the treatment instrument 100 being sandwiched between the drive roller 31 and the adjusting roller 72, the treatment instrument 100 causes the treatment instrument 100 to pass through the delivery port 92 and the forceps plug of the endoscope 1. It is further inserted into the forceps channel through the hole 11a of No. 11.

When the number of rotations set by the insertion length setting switch 95 is reached, the power supply to the motor 29 is stopped.

If this rotation speed is set correctly, the treatment tool 100 will not protrude from the opening 9d of the forceps channel of the endoscope 1 to such an extent as to damage the body cavity.

Even if the treatment instrument 100 is inserted tentatively, the stopper 97 abuts against the edge of the insertion opening 91. Therefore, when the upper left cover 64 is closed, no further insertion amount is inserted. .

When the button portion 117 of the release button 115 is pushed after the insertion is completed, the projection 127 of the cover rod 122 is
Since it passes through the hole 123 of the release button 115, the cover rod 122 is pushed by the urging force of the coil spring 126,
As a result, the upper left cover 64, which is integrated with the cover rod 122, is opened.

At this time, since the adjusting roller 72 moves integrally with the upper left cover 64, the sheath 101 of the treatment instrument 100 is released from the state of being sandwiched between the adjusting roller 72 and the drive roller 31.

Further, since the outside and the inside of the cover communicate with each other by opening the upper left cover 64, the treatment instrument 100 can be easily removed without moving back and forth into the forceps channel.

At the same time, the connecting arm 86 also covers the upper left portion cover 6
Since it moves integrally with 4, the connection with the connection groove 12 of the endoscope 1 is released at the same time, and the endoscope 1 is also removed.

After use, the mounting screw 55 is removed, the treatment instrument mounting portion 90 is removed from the grip cover 26, and cleaning / disinfection is performed.

By preparing a large number of treatment tool mounting portions 90 that have been collectively sterilized in advance, the treatment tool mounting portions 90 are prepared.
The disinfection work can be completed simply by changing the parts.
Therefore, even in a facility where many cases are performed every day, it is not necessary to prepare a plurality of treatment instrument insertion / extraction devices for disinfection work, and the efficiency of the examination can be improved. Further, if the treatment instrument mounting portion 90 is made of all sterilized disposable items, disinfection work itself becomes unnecessary.

Plural types of treatment instrument mounting portions 90 attachable to the grip cover 26 may be prepared. As an example, a treatment tool mounting portion that can accommodate treatment tool insertion opening 10 having different properties that cannot be adjusted by the adjustment dial 81, an inexpensive version of the treatment tool mounting portion that does not have an adjustment dial, or a disposable treatment tool mounting portion. It is conceivable to prepare multiple types such as departments. According to this, it becomes possible to deal with various treatment tools only by changing the treatment tool mounting portion.

If it is desired to upgrade an inexpensive device with limited functions to a highly functional device, or conversely to make an inexpensive device from a highly functional device, simply replace the treatment instrument mounting portion. Therefore, a single type of device can easily meet a wide range of user needs.

(Effect) Button section 11 of release button 115
The endoscope treatment tool insertion / extraction device 25 can be easily removed from the treatment tool 100 by simply pressing 7.

Second Embodiment (Structure) In the first embodiment, at least one of the left and right upper covers is moved to open and close the opening.
Here, as shown in FIG. 15, an opening 131 is fixedly formed in the upper cover 130, and an opening / closing mechanism that opens and closes the opening 131 with a slidable opening / closing member 132 is provided. The opening / closing member 132 is fixed and released by the lock mechanism described above, and the release of the fixation is performed by the release button 115. Further, a structure in which the opening / closing member 132 is opened / closed by hand may be used. Further, unlike the first embodiment, the hooks 85a and 86a are protrusions, not hooks, so that they can be easily removed from the mounted state.

(Operation) After inserting the treatment tool, the opening / closing member 132
And the treatment tool can be removed through the opening 131.

(Effect) Since only the opening / closing member 132 is opened and closed, the coil spring 119 of the lock mechanism can be made smaller than that of the first embodiment, and the device can be downsized.

<Third Embodiment> (Structure) The upper right portion cover 51 in the first embodiment,
The left upper cover 64 and the release button 115 attached to it
The upper cover 141 in which the upper right cover 51 and the upper left cover 64 are integrated is provided as shown in FIG. The upper cover 141 is provided with an opening 142 through which the treatment tool can be removed. Others may be the same as the configuration of the first embodiment.

(Operation) According to this, after inserting the treatment tool,
The treatment tool can be removed through the opening 142.

(Effect) Compared with the first embodiment, the structure is simple and the cost can be reduced.

Fourth Embodiment (Structure) In this embodiment, as shown in FIG. 17, the upper cover 141 and the stopper 9 in the third embodiment described above are used.
It is the one that lost 7.

(Operation) After inserting the treatment instrument, the sheath 101 of the treatment instrument 100 sandwiched between the drive roller 31 and the adjusting roller 72 can be easily removed.

(Effect) According to this embodiment, the cost can be further reduced as compared with the third embodiment.

<Fifth Embodiment> (Structure) This is the same as the third embodiment without the opening 142 of the upper cover 141 (FIG. 1).
8). Further, the grip 103 can be attached to and detached from the sheath 101 of the treatment instrument 100 (FIG. 19).

(Operation) After the treatment instrument 100 is inserted into the forceps channel of the endoscope 1 by the endoscope treatment instrument insertion / removal device,
The grip 103 of the treatment instrument 100 is removed from the sheath 101.

Next, the endoscopic treatment tool insertion / removal device 25 is pulled out toward the hand side along the axis of the sheath portion 101, and the treatment tool 1 is removed.
The endoscope treatment tool insertion / extraction device 25 is removed from 00.

After removing the treatment tool inserting / extracting device 25, the grip portion 103 is reconnected to the sheath 101 to perform treatment. In the present embodiment, the entire grip 103 is removed, but the point is that the treatment tool 100 can completely pass through the insertion port 91 and the delivery port 92, and these sizes are larger than the outer shape of the grip 103. If it is large, it is not necessary to make the grip portion 103 removable.

Further, for example, by removing only the finger-holding type handle portion 104 of the grip portion 103, it is possible to remove a part that causes the outer shape of the handle portion 103 to be large, or by folding the finger-holding portion 104. The outer shape may be reduced.

As another method, a mechanism in which the size of the insertion port 91 and the delivery port 92 can be changed to a size that allows the grip portion 103 to pass therethrough may be used. Specifically, it is possible to make the size of the delivery port 92 variable by a movable window member 145 as shown in FIG. The insertion port 91
With respect to, the size can be changed by a similar mechanism.

(Effect) The treatment tool is usually operated by a caregiver, but since the device 25 can be removed in the direction of the caregiver who operates the treatment tool, it is necessary to purposely prepare a caregiver for the treatment tool insertion / removal device. Absent.

[Supplementary Notes] A treatment instrument for an endoscope including a mechanism for inserting and removing a treatment instrument from a channel of the endoscope through an insertion opening formed in an operation portion of the endoscope, for example, a drive mechanism for performing at least one of insertion and removal of the treatment instrument. In the insertion / removal device, with the treatment tool inserted in the channel of the endoscope, the connection between the treatment tool insertion / removal device and the treatment tool is released, and the body of the treatment tool insertion / removal device can be removed from the endoscope. A device for inserting and removing an endoscopic treatment tool. According to this, after inserting the treatment tool into the channel of the endoscope, the automatic insertion / removal device can be removed from the treatment tool. Since at least the main body of the endoscopic treatment tool insertion / extraction device can be detached from the endoscope side, the operability of the treatment tool inserted into the channel of the endoscope is not impaired.

2. In the above-mentioned additional item 1, at least an insertion port for guiding the treatment tool into the device, a delivery port for guiding the treatment tool from the device into the endoscope channel, and at least connecting the insertion port and the delivery port and communicating with the outside. A treatment instrument insertion / extraction device for an endoscope, comprising: one opening. According to this, since the structure is simple, the production cost is low.

3. The treatment instrument insertion / removal device for an endoscope according to the second aspect, wherein an opening connecting the insertion port and the delivery port is openable / closable. According to this, since the opening is closed when the treatment tool is inserted or withdrawn, it is possible to prevent splashing of the dirt attached to the treatment tool during operation. Also, after inserting the treatment tool, open the opening,
The automatic insertion / extraction device can be removed from the treatment instrument through the opening.

4. The treatment instrument insertion / removal device for an endoscope according to the first aspect, wherein a portion of the treatment instrument passing through the device is exposed to the outside. According to this, the production cost becomes lower. 5. In the above-mentioned additional item 1, at least a part of the device is detached laterally with respect to the insertion direction of the treatment instrument in the channel of the endoscope in a state where the treatment instrument is inserted in the channel of the endoscope. A treatment tool insertion / extraction device for an endoscope, which is characterized in that This makes it easy to remove the treatment tool.

6. In the above-mentioned Supplementary Item 1, at least part of the device is detached from the endoscope and the treatment tool at the same time with the treatment tool being inserted into the channel of the endoscope. Insertion / extraction device. According to this,
After inserting the treatment tool, the endoscope insertion / removal device can be simultaneously removed from the endoscope and the treatment tool. Since the connection with the treatment tool and the connection with the endoscope can be released all at once, the amount of work can be reduced.

7. In the above Supplementary Item 1, at least a part of the device is removed in a direction in which the treatment tool is removed with the treatment tool inserted in the channel of the endoscope. apparatus. According to this, since the device can be removed in the direction of the assistant who is in charge of operating the treatment instrument, one assistant can concurrently perform the assistance work for the treatment instrument inserting / extracting device and the operation instrument operation. Reduction can be achieved.

8. In the additional item 7, the opening communicating with the outside is configured by an insertion port for guiding the treatment tool into the device and a delivery port for guiding the treatment tool from the device into the endoscope channel. Endoscope treatment instrument insertion / extraction device.

According to this, after inserting the treatment tool, the endoscope treatment tool insertion / removal device can be removed in the longitudinal axis direction of the treatment tool. Since the structure is simple, the production cost is low.

9. In the additional item 8, the insertion opening and the delivery opening have a size such that at least a grip portion can completely pass through the treatment instrument. apparatus. According to this, since it is not necessary to devise to remove the grip of the treatment tool or a part of the grip, the cost of the treatment tool is reduced.

10. In the above-mentioned Supplementary Note 8, the insertion port and the delivery port are changed from a size equal to or larger than the maximum outer diameter of the sheath portion of the treatment instrument and smaller than or equal to the maximum outer diameter of the grip portion to a shape larger than the maximum outer diameter of the grip portion. An endoscopic treatment instrument insertion / removal device characterized by: According to this, after inserting the treatment instrument, by making the insertion opening and the delivery port larger than the maximum outer diameter of the treatment instrument gripping portion, the endoscope treatment instrument insertion / extraction device is moved in the longitudinal axis direction of the treatment instrument. It can be removed. It is also possible to deal with a treatment tool having a large outer diameter of the grip portion.

11. The endoscope treatment instrument insertion / removal device according to the first aspect, wherein the treatment instrument attachment portion including at least the treatment instrument contact portion is attachable to and detachable from the apparatus main body. According to this, the expensive component is provided inside the apparatus main body, for example, the grip cover, and the treatment instrument mounting portion 10 is provided.
Since 7 is relatively cheap, it is easy to prepare many. By making part of the treatment tool automatic insertion / extraction device removable,
It is possible to eliminate the trouble of preparing a plurality of endoscope automatic insertion / extraction devices.

12. The accessory insertion / extraction device for an endoscope as set forth in the appendix 11, wherein the accessory mounting portion is a sterilized disposable product. The disinfection work itself becomes unnecessary.

13. The accessory insertion / extraction device for an endoscope according to the appendix 11, wherein there are a plurality of types of the accessory attachment portions. According to this, various treatment tools can be supported, and it is possible to easily upgrade the version of the function or, conversely, convert it to an inexpensive one with limited functions, so that one type of device can meet a wide range of user needs. Can handle.

[0116]

As described above, according to the endoscopic treatment instrument insertion / extraction device of the present invention, after inserting the treatment instrument into the channel of the endoscope, the automatic insertion / extraction device can be removed from the treatment instrument. . Since at least the main body of the endoscopic treatment tool insertion / extraction device can be detached from the endoscope side, the operability of the treatment tool inserted into the channel of the endoscope is not impaired.

[Brief description of drawings]

FIG. 1 is a cross-sectional view of a treatment instrument insertion / extraction device for an endoscope according to a first embodiment.

FIG. 2 is an explanatory diagram showing a system configuration of an endoscope device.

FIG. 3 is a perspective view of a treatment tool for an endoscope.

FIG. 4 is a cross-sectional view of a holding force adjusting portion of the endoscopic treatment instrument insertion / extraction device.

FIG. 5 is a schematic perspective view of an upper right portion cover of the endoscopic treatment tool insertion / extraction device.

FIG. 6 is a cross-sectional view of an assembled state of the upper right cover and the upper left cover.

FIG. 7 is a schematic perspective view of the upper left portion cover.

FIG. 8 is a perspective view of a portion of a means for mounting the treatment instrument insertion / extraction device on an endoscope.

FIG. 9 is a perspective view of a portion of another means for mounting the treatment instrument insertion / extraction device on the endoscope.

FIG. 10 is a perspective view of a portion of still another means for mounting the treatment instrument insertion / extraction device on an endoscope.

FIG. 11 is a perspective view of the entire treatment instrument insertion / extraction device for the endoscope.

FIG. 12 is an explanatory diagram of a treatment tool stopper.

FIG. 13 is a sectional view of the treatment tool stopper.

FIG. 14 is a cross-sectional view of the lock mechanism portion of the upper left cover.

FIG. 15 is an explanatory diagram of a second embodiment of an opening / closing mechanism that opens and closes an opening.

FIG. 16 is a perspective view of a third embodiment showing another example of forming an opening.

FIG. 17 is a perspective view of a fourth embodiment showing another example of forming an opening.

FIG. 18 is a perspective view of a fifth embodiment showing another example of forming an opening.

FIG. 19 is a perspective view of another treatment tool.

FIG. 20 is a perspective view showing another example of forming an opening.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Operation part, 10 ... Treatment tool insertion port part, 25
... Endoscope treatment tool insertion / extraction device, 26 ... Grip cover, 3
1 ... Drive roller for inserting / removing treatment tool, 51 ... Cover for upper right portion, 6
4 ... upper left cover, 72 ... adjusting roller, 100 ... treatment tool.

Claims (1)

[Claims] 1. A treatment tool insertion / removal device for an endoscope, comprising a mechanism for inserting / removing a treatment tool into / from a channel of an endoscope from an insertion opening formed in an operation portion of the endoscope, in a channel of the endoscope. The endoscope treatment tool, wherein the treatment tool insertion / removal device and the treatment tool are disengaged from each other and the main body of the treatment tool insertion / removal device is removable from the endoscope side with the treatment tool inserted. Insertion / extraction device.