JPH11192203A - 内視鏡 - Google Patents
内視鏡Info
- Publication number
- JPH11192203A JPH11192203A JP10141116A JP14111698A JPH11192203A JP H11192203 A JPH11192203 A JP H11192203A JP 10141116 A JP10141116 A JP 10141116A JP 14111698 A JP14111698 A JP 14111698A JP H11192203 A JPH11192203 A JP H11192203A
- Authority
- JP
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- Prior art keywords
- endoscope
- distal end
- tube
- channel
- channel tube
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/0014—Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1495—Electrodes being detachable from a support structure
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Biomedical Technology (AREA)
- Medical Informatics (AREA)
- Optics & Photonics (AREA)
- Pathology (AREA)
- Radiology & Medical Imaging (AREA)
- Biophysics (AREA)
- Engineering & Computer Science (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Endoscopes (AREA)
- Surgical Instruments (AREA)
Abstract
内の複数のポリープ等の切除もしくは回収などの処置を
行う場合、内視鏡を体外に抜去することなく内視鏡を体
内に挿入したまま行えるようにすることを目的とする。 【解決手段】本発明は、チャンネルチューブ2の先端開
口部15を内視鏡挿入部3の先端より手元側に位置させ
て装着するものである。体腔内の複数のポリープ等の切
除もしくは回収などの処置を行う場合、その異物を内視
鏡挿入部3の先端より手元側に位置させて保留させてお
ける。内視鏡1による観察及び内視鏡チャンネル内を通
じて使用する切除具等の処置具の作業に支障をきたさな
い。
Description
収する場合等において使用する処置具を体腔内に案内す
るためのチャンネルを有した内視鏡に関する。
の内視鏡は、鉗子等の処置具を挿通するためのチャンネ
ルを形成した外付けチューブを、内視鏡本体とは別体の
ものとして設け、必要に応じて外付けチューブを内視鏡
本体に装着して使用するようにしたものである。この内
視鏡ではその外付けチューブが内視鏡の操作部から挿入
部の先端まで沿わせるような形で取り付けられ、内視鏡
挿入部の先端面と外付けチューブの先端面とが同一面に
なるように組み付けられるようになっている。また、外
付けチューブを通じて処置具を挿入したとき、処置具の
先端は内視鏡挿入部の先端に設けられた観察窓に近接し
た位置に隣接する。
ると、外付けチューブ内を通じて挿入した異物回収具に
より1個のポリープを把持すると、把持したポリープが
内視鏡の先端前方に位置し、観察視界や作業領域を狭め
てしまう。このため、通常、1つの異物を把持すると、
もう1つのポリープを切除する作業を行うことが困難に
なる。このため、1つのポリープを把持する都度、内視
鏡を抜去しなければならなかった。
であり、その目的とするところは、内視鏡と処置具を併
用する場合、体腔内の複数のポリープ等の切除もしくは
回収などの処置を行うに当たり、処置毎に内視鏡を体外
に抜去する必要がなく内視鏡を体内に挿入したまま、複
数のポリープ等の切除もしくは回収などの処置を続けて
行えるようにした内視鏡を提供することにある。
以上の内視鏡チャンネルと先端部に観察窓を有した内視
鏡において、少なくとも1つの内視鏡チャンネルの先端
開口部が、上記観察窓の位置よりも手元側に退避して設
けられたものである。体腔内の複数のポリープ等の切除
もしくは回収などの処置を行う場合、回収する異物等を
内視鏡挿入部の先端より手元側に位置させて保留してお
けるため、異物等や処置具が邪魔にならず、観察視野や
作業領域を確保する。処置毎に内視鏡を体外に引き抜く
ことなく、内視鏡を挿入したまま、続けて内視鏡による
観察及び他の内視鏡チャンネル内を通じて挿入した処置
具による作業を続行することが可能である。
を参照して、本発明の第1の実施形態を説明する。図1
は内視鏡1の本体に外付け式チャンネルチューブ2を取
り付けた状態の内視鏡の斜視図である。
を有している。挿入部3は先端側から順次配置される先
端部5、湾曲部6及び可撓管部7によって構成されてい
る。挿入部3の先端部5における先端面(内視鏡先端
面)8には観察光学系の観察窓9と内視鏡チャンネル1
0の先端開口10aが形成されている。先端面8にはこ
れらの他に照明窓やノズル等も設けられているが、ここ
では図示しない。
0に通じる処置具挿入口部11と、上記湾曲部6を湾曲
操作するためのアングルノブ12が設けられている。手
元操作部4にはライトガイドケーブル13が接続されて
いる。
視鏡1の挿入部3よりも細く比較的柔軟に曲がることが
可能な可撓性チューブ部材からなり、これは内視鏡1の
挿入部3の長手軸方向に沿うと共に、挿入部3の上面部
分に添って取り付けられている。
は挿入部3の湾曲部6に揃えられ、この両者はゴムバン
ド14により巻かれて結束固定されている。内視鏡に装
着した状態で、チャンネルチューブ2の先端開口部(開
口端面)15は内視鏡1の挿入部3の先端部5における
先端面8よりも軸方向の手元側へ退避し、いわゆる後退
した位置にある。先端開口部15は内視鏡1の先端面8
より5mm以上手元側へずれて位置する。先端開口部1
5は内視鏡1の挿入部3の前方を向いて開口している。
また、チャンネルチューブ2の手元端に設けられた挿入
用口部16は内視鏡1の手元操作部4付近に位置する。
は、テフロン、多孔質テフロン、ポリフッ化エチレン等
のフッ素樹脂や塩化ビニル、ウレタン等の比較的柔軟に
曲がることが可能な樹脂材料によって形成されている。
説明する。まず、図1で示す如く、内視鏡1の挿入部3
にチャンネルチューブ2を外付け装着し、この状態で内
視鏡1の挿入部3を体腔内に挿入する。ついで、図2
(a)で示す如く、チャンネルチューブ2内のチャンネ
ルを通じて、異物回収手段としてのバスケット式異物回
収具20のチューブシース21を導入する。そして、チ
ャンネルチューブ2の先端開口部15からチューブシー
ス21の先端部分を突き出す。さらに、バスケット式異
物回収具20の手元操作部22における操作ツマミ23
を前進させることで、バスケット24をチューブシース
21の先端開口から突き出す。突き出したバスケット2
4はそれ自身の弾性復元力によって拡開する。そこで、
開拡したバスケット24内に第1のポリープ26を取り
込む操作を行う。
ト式異物回収具20のチューブシース21を後退させる
ことにより、内視鏡1の先端部5における先端面8の位
置よりも手元側でチャンネルチューブ2の先端開口部1
5の前面に位置する所まで把持した第1のポリープ26
を後退させる。従って、内視鏡1の観察窓9の位置から
手元側へ退避し、観察視野が第1のポリープ26でけら
れることがない。また内視鏡チャンネル10を通じて先
端開口10aから突き出す処置具による作業を行う領域
が確保される。
ら内視鏡チャンネル10を通じて挿入した切除具、例え
ば高周波スネア31のチューブシース32を先端開口1
0aから突き出し、ワイヤ切除部33を体腔内の第2の
ポリープ34に掛ける。ついで、手元操作部35のスラ
イダ36を後退させることによりワイヤ切除部33で第
2のポリープ34を緊縛し、ワイヤ切除部33に高周波
電流を流すことにより第2のポリープ34を切除する。
33を退避させた上で、外付け式のチャンネルチューブ
2の先端開口部15から再びバスケット式異物回収具2
0を前進させ、その切除した第2のポリープ34をバス
ケット24内に取り込む。このように、2つのポリープ
26,34の両方をバスケット24内に取り込み、この
まま、バスケット式異物回収具20を内視鏡1と共に体
外に抜去してポリープ26,34を体外に回収する。
ューブ2は従来の内視鏡や処置具と併用して容易に使用
することが可能である。前述したように、バスケット式
異物回収具20のバスケット24内に取り込んだ複数の
ポリープ26,34を、内視鏡1の先端面8の位置より
も手元側(後ろ側)に位置させ、かつチャンネルチュー
ブ2の先端開口部15の前面の所まで後退させておけ
る。このため、ポリープ26,34やバスケット24が
観察視野または高周波スネア31による作業領域にかか
らない。つまり、内視鏡1による観察、及び内視鏡チャ
ンネル10内を通じて使用する他の切除具等の処置具の
作業に支障をきたさない。従って、複数のポリープの切
除もしくは回収等を、内視鏡1を体外に抜去することな
く続けて行うことができる。
の第2の実施形態を説明する。前述した第1の実施形態
に比べて、第2の実施形態は、前述した第1の実施形態
とは、内視鏡1の挿入部3に外付け式のチャンネルチュ
ーブ2を装着するための構造が以下の如く相違する。
部3における先端部5の位置にチャンネルチューブ2を
固定するようにする。つまり、図3(a)で示す如く、
チャンネルチューブ2の先端開口部15の下縁に、前方
へ突き出す取付け用舌片41を設け、この舌片41を、
内視鏡1の先端部5に添わせると共に、その先端部5と
舌片41の両者に固定テープ42を巻き付けて束ね、両
者を固定するようにしたものである。上記固定テープ4
2は特に粘着テープであることが望ましい。チャンネル
チューブ2の先端開口部15は前述した第1の実施形態
の場合と同様、内視鏡1の先端面8よりも軸方向の手元
側へずれた位置にある。
第1の実施形態と同様に使用することが可能である。図
3(b)は、チャンネルチューブ2からバスケット式回
収具20を突き出して第1のポリープ26を取り込んだ
状態を示す。
形態での効果に加えて、次のような効果が得られる。チ
ャンネルチューブ2の先端に設けた舌片41を挿入部3
の先端部5に添わせ、この両者にわたり固定テープ42
を巻き付けてその両者を固定するようにしたから、内視
鏡1の先端面8に対しての、チャンネルチューブ2の先
端開口部15の位置決めが容易である。また、固定構造
が簡単である。内視鏡1の本体にチャンネルチューブ2
を確実に固定して装着することができる。さらにチャン
ネルチューブ2を内視鏡1の本体に装着する際、チャン
ネルチューブ2の本体部分ではなく、そのチャンネルチ
ューブ2の先端から突き出した舌片41を利用し、この
舌片41に固定テープ42を巻き付けて固定するので、
チャンネルチューブ2のチャンネル部分を潰す虞がな
い。
の第3の実施形態を説明する。この第3の実施形態は前
述した第1の実施形態の変形例であって、内視鏡1の挿
入部3に外付け式のチャンネルチューブ2を装着する構
造に特徴がある。
如く、チャンネルチューブ2の先端にその開口端下縁か
ら前方へ突き出す突出し部51を設け、突出し部51の
先端部に、短管リング状の取付け用キャップ52を設け
たものである。取付け用キャップ52はチャンネルチュ
ーブ2の先端前方位置で、チャンネルチューブ2よりも
下方へ偏って設けられている。この取付け用キャップ5
2は内視鏡1の挿入部3における先端部5に密に被嵌し
て装着される。
(b)で示す如く、挿入部3の先端部5に嵌め込んで被
嵌させることによりその先端部5に固定される。もちろ
ん、取り外すことも可能である。
52を挿入部3の先端部5に嵌め込んで被嵌させること
により内視鏡1の挿入部3にチャンネルチューブ2を固
定的に装着できるため、他の固定部材が不要であり、そ
の装着作業が簡単である。
の第4の実施形態を説明する。この第4の実施形態は前
述した第3の実施形態の変形例である。
ブ2の先端部の部材を硬質部2aとしてなり、この硬質
部2aの先端に別部材のキャップ52を取付け固定した
ものである。キャップ52は、内視鏡1の先端部5に着
脱自在に嵌合されるものである。硬質部2aの、キャッ
プ52と反対側の上面部分は先端側一部が溝55となる
ように切り欠かれている。先端開口部15は溝55より
手元側に位置すると共に、硬質部2aの基端側部分に形
成されている。
3の実施形態と同様、内視鏡1の先端部5にキャップ5
2を被嵌することによりチャンネルチューブ2を内視鏡
1の本体に装着することができる。
ケット式異物回収具20を体腔内に突き出したり、後退
させたりする際には、そのチューブシース21の先端側
部分が溝55によって案内されるため、内視鏡1の湾曲
部6を湾曲させた状態でもチューブシース21が内視鏡
1の挿入部3の長手軸方向と平行な方向へ案内して進退
させることができる。
の第5の実施形態を説明する。この第5の実施形態は前
述した第3の実施形態の変形例である。
近部分に固定用クリップ61を設けたものである。この
固定用クリップ61はチャンネルチューブ2に取着する
リング状の基部62と、内視鏡1の挿入部3における湾
曲部6を挟み込む一対の挟持片63とを一体に形成して
なる。そして、内視鏡1の本体にチャンネルチューブ2
を装着する場合は、チャンネルチューブ2の取付け用キ
ャップ52を挿入部3の先端部5に嵌め込むと共に、チ
ャンネルチューブ2に取着した固定用クリップ61の一
対の挟持片63で内視鏡1の挿入部3における湾曲部6
を挟み込む。取付け用キャップ52と固定用クリップ6
1の両者で、チャンネルチューブ2を内視鏡1の本体に
装着するようにした。第5の実施形態によれば、チャン
ネルチューブ2を内視鏡1の挿入部3に装着する際、ワ
ンタッチでチャンネルチューブ2を装着できるだけでな
く、内視鏡1に外付け式のチャンネルチューブ2を確実
に固定することができる。
の第6の実施形態を説明する。この第6の実施形態は前
述した第3の実施形態の変形例である。
ネルチューブ2の先端付近に略同径のチューブ状の伸縮
部71を設けたものである。伸縮部71はそのチャンネ
ルチューブ2の長手軸方向に伸縮自在なものである。チ
ャンネルチューブ2の先端開口部15はその伸縮部71
の先端側に形成されているため、先端開口部15は軸方
向に進退自在なものとなっている。
部分と同一の材料(テフロン等)で蛇腹状に形成した構
造のもの、若しくはチャンネルチューブ2の他の部分の
材質よりも柔らかい材質、例えば低密度の材質のものと
する。
2を介して固定リング73が設けられており、固定リン
グ73は伸縮部71よりも手元側に位置するチャンネル
チューブ2の先端部外周に被嵌して装着されるようにな
っている。そして、内視鏡1の挿入部3における先端部
5の外周に固定リング73を被嵌することにより取付け
用キャップ52は内視鏡1に取り付けられる。
着して使用する場合において、図7(b)で示す如く、
チャンネルチューブ2を通じてバスケット式異物回収具
20を突き出すときには、チャンネルチューブ2の伸縮
部71の部分は伸長して前方へ延び、チャンネルチュー
ブ2の先端開口部15は内視鏡1の先端部5における先
端面8の位置近くに位置する。従って、先端開口部15
から繰り出すバスケット式異物回収具20の振れが抑制
され、バスケット式異物回収具21の操作性が向上す
る。
ケット24により第1のポリープ26を把持した状態
で、チューブシース21を引き、バスケット24を後退
させるときにはそれまで軸方向の前方へ伸びていた伸縮
部71が、図7(c)で示す如く、バスケット24によ
って押されて縮む。そして、内視鏡1の先端部5におけ
る先端面8の位置よりも手元側の位置まで、バスケット
24の部分が後退する。つまり、先端部5における先端
面8の位置よりも手元側に位置するところまで、第1の
ポリープ26を把持したバスケット24を後退させてお
けるので、ポリープ26及びバスケット24の部分が、
観察窓9を通じての視野または高周波スネア31の切除
部33の作業領域にかからない。
の第7の実施形態を説明する。この第7の実施形態は前
述した第1の実施形態におけるバスケット式異物回収具
20の変形例を示す。
ト24を構成する複数の弾性ワイヤ81の先端を先端チ
ップ82により結束する。各弾性ワイヤ81の基端側部
分はチューブシース21内に取り込まれると共に、その
チューブシース21内に挿通された操作ワイヤ(図示せ
ず)に接続されている。そして、各弾性ワイヤ81の基
端側部分はチューブシース21内に引き込まれ、または
突き出せるようになっている。また、バスケット24の
手元側部分はそれ自身の弾性復元力で他の部分より大き
く広がる取込み部24aを形成しており、バスケット2
4の先端側部分はそれに比べて狭まった収納部24bを
形成している。
る場合にはまず、図8(a)で示す如く、手元側部分の
取込み部24aの弾性ワイヤ81の隙間から第1のポリ
ープ26を取り込む。ついで、図8(b)で示す如く、
バスケット式異物回収具20の操作ワイヤを引くことに
より取込み部24aの部分がチューブシース21内に引
き込まれ、これにつれて第1のポリープ26は収納部2
4bに押し込まれ、収納部24b内に収納させられる。
この後、チューブシース21をチャンネルチューブ2内
に引き込み、第1のポリープ26を取り込んだバスケッ
ト24を挿入部3の先端部5の側方に退避させる。
する場合には、図8(c)で示す如く、バスケット式異
物回収具20のバスケット24を再び前方へ押し出し、
バスケット24を広げて取込み部24aから第2のポリ
ープ34を取り込む。ついで、上記同様の手順で、図8
(d)で示す如く、バスケット式異物回収具20をチャ
ンネルチューブ2に引き込むことによりバスケット24
の収納部24bに第2のポリープ34を押込み収納する
と共に、挿入部3の先端部5の側方に退避させる。
スケット24の収納部24bに第3のポリープ75を収
納することができる。このように収納部24bにはその
先端側から順番に第1のポリープ26、第2のポリープ
34、第3のポリープ75を収納することができる。従
って、この実施形態によれば、前述した各実施形態の効
果に加えて、バスケット式異物回収具20を体外に引き
出すことなく、バスケット24内に複数のポリープを一
度に収納可能となる。また、各ポリープは収納された順
番に重なり、採取したポリープの順番が明確になり、そ
の後、各ポリープを区別して検査することができて都合
がよい。
参照して本発明の第8の実施形態を説明する。この実施
形態は前述した第6の実施形態の変形例である。
チャンネルチューブ2は先端側に位置する外側チューブ
2aと後端側に位置する内側チューブ2bの2体のチュ
ーブによって構成したものである。先端側に位置する外
側チューブ2aの手元側部分に内側チューブ2bの先端
側部分を密に挿入し、両者は軸方向へスライド自在に嵌
合して連結されている。このような2体のチューブによ
ってチャンネルチューブ2を構成することで、このチャ
ンネルチューブ2は軸方向に伸縮可能なものである。ま
た、チャンネルチューブ2が軸方向に伸縮を許容する幅
としては使用する全ての医療用内視鏡の挿入部3の湾曲
部6の湾曲に対応できる、40〜80mmの範囲であ
る。また、外側チューブ2aと内側チューブ2bの間に
は図示しない抜け止め機構を設けることで、それぞれの
チューブ2a,2bが外れないようになっている。
2を介して固定リング73に固定的に連結されており、
固定リング73は外側チューブ2aの外周に嵌め込んで
固定的に装着されるようになっている。これにより取付
け用キャップ52は接続片72と固定リング73を介し
て外側チューブ2aに固定的に装着される。さらに、内
側チャンネルチューブ2bの先端付近部分にはリング状
の固定用クリップ61が嵌め込み状態で装着されてい
る。固定用クリップ61は内側チャンネルチューブ2b
の軸方向へスライド自在に装着される。
性樹脂を材料として構成されるが、ウレタン、シリコー
ンなどの軟性の樹脂や、ステンレス等の金属で形成する
ものでもよい。さらに固定用クリップ61の構造として
は内側チューブ2bを内側にしてその内側チューブ2b
の外周にスライド調整可能に取り付け得るものであれ
ば、テープ等の薄膜形状や、螺旋コイル形状のものでも
よい。
チューブ2を使用する場合について説明する。まず、内
視鏡1の挿入部3における先端部5の外周に取付け用キ
ャップ52を被嵌することにより装着し、また、固定用
クリップ61の一対の挟持片63を挿入部3における可
撓管部7の外周に係着して固定する。これにより外付け
式チャンネルチューブ2は内視鏡1の本体に装着され
る。また、必要ならば、固定用クリップ61よりも手元
側に位置する外側チューブ2aの部分を図示しない医療
用テープ等により挿入部3の可撓管部7の部分に固定す
る。
チャンネルチューブ2を取り付けた状態で、内視鏡1の
挿入部3を体腔内へ挿入して使用する。ここで、外側チ
ューブ2aと内側チューブ2bは軸方向にスライド自在
に連結されており、しかも固定用クリップ61が内側チ
ューブ2bの外周部にスライド自在に係着されているこ
とで、内視鏡1の挿入部3、特に湾曲部6が大きく湾曲
したとき、外付け式チャンネルチューブ2は軸方向に伸
縮する。内視鏡1の挿入部3の湾曲に応じて外付け式チ
ャンネルチューブ2が伸縮することにより、内視鏡1の
挿入部3の湾曲する動きを規制せず、湾曲操作がスムー
ズに行える。
明の第9の実施形態を説明する。この第9の実施形態は
内視鏡本体に全ての内視鏡チャンネルを形成するように
したものである。
を有している。挿入部3は先端側から順次配置される先
端部5、湾曲部6及び可撓管部7によって構成されてい
る。挿入部3の先端部5における先端面8には観察光学
系の観察窓9と内視鏡チャンネル81の先端開口81a
が形成されている。挿入部3の先端面8にはこれらの他
に照明窓やノズル等も設けられているが、ここでは図示
しない。
1に通じる処置具挿入口部11と、上記湾曲部6を湾曲
操作するためのアングルノブ12が設けられている。手
元操作部4にはライトガイドケーブル13が接続されて
いる。これまでの構成については第1の実施形態での内
視鏡1のものと同様のものである。
部5において、具体的には先端面8よりも10mm手元
側の位置には45゜の角度に背斜したもう1つの先端面
91が形成されている。この先端面91よりも前方に位
置する先端部5の周壁部分は切り欠かれており、段差の
ある凹部92を形成している。
81とは別のもう1つの内視鏡チャンネル93の先端開
口部93aが形成されている。この内視鏡チャンネル9
3の先端側部分は内視鏡1の挿入部3の軸方向に平行に
配置されている。このため、内視鏡チャンネル93の中
に収納された処置具を先端開口部93aから突き出す
と、内視鏡1の軸方向に平行に突き出し、段差のある凹
部92を通じて内視鏡1の前方へ突き出るようになって
いる。
先端面8から手元側へ10mm離れた位置に配置されて
いるが、この距離は少なくとも5〜20mmであること
が望ましく、5mmより小さいと、この内視鏡チャンネ
ル93を通じてこの先端開口部93aから突き出した把
持鉗子やバスケット式異物回収具等によりポリープ等の
異物を把持して退避させたとき、その処置具や異物が観
察窓9の視界を妨げて観察状況を悪くする。また、先端
面8から先端面91までの距離が、20mmよりも大き
い場合には内視鏡チャンネル93から突き出した処置具
が挿入部3の前方まで達する以前に途中で重力や外力を
受けて曲がり易く、挿入部3の軸方向と同方向に突き出
されず、途中で曲がった方向に突き出され易くなるな
ど、導出する方向が不安定になり、処置具の操作性が低
下する。
き、45゜の傾斜角で背斜しているが、この角度は30
゜〜90゜であれば、内視鏡1の挿入性を低下させるこ
とが無く、粘膜に与える影響も少なくできる。
作部4に形成された挿入用口部95に通じており、この
挿入用口部95より上記内視鏡チャンネル93に処置具
を挿入できるようになっている。挿入用口部95は導入
チューブ96と口金97によって形成されている。口金
97には封止栓(図示せず)が設けられ、通常、口金9
7は封止栓によって閉され、処置具を挿入するときには
気密的な状態で挿入できるようになっている。
て説明する。まず、内視鏡1の挿入部3を体腔内に導入
し、側方の内視鏡チャンネル93を通じて、例えば第1
の実施形態の場合と同様、バスケット式異物回収具20
を挿入し、体腔内に突き出する。このバスケット式異物
回収具20にポリープ26を取り込む。この後、ポリー
プ26を保持したまま、バスケット式異物回収具20が
先端面91に突き当たるまで後退させる。これによりバ
スケット式回収具20及びポリープ26の部分が前方の
先端面8よりも手元側に移動し、かつ凹部92内に位置
して、内視鏡1の観察視野から外れる。
ープ26が内視鏡1の観察窓9の視野にかかることがな
く、かつ内視鏡チャンネル93から突き出した他の処置
具の作業領域を確保する。また、内視鏡チャンネル93
の先端開口93aを形成した先端面91が背斜して配置
されていることで、体腔内への内視鏡1の挿入性を低下
させることがない。
れるものではない。上記説明によれば下記の事項の発明
が得られる。また、各項の組み合わせも可能である。 [付記] 1.1つ以上の内視鏡チャンネルと先端部に観察窓を有
する内視鏡において、少なくとも1つの内視鏡チャンネ
ルの先端開口部が、観察窓よりも手元側に退避して設け
られていることを特徴とする内視鏡。 2.内視鏡チャンネルの先端開口部を設けた面と、内視
鏡の先端面とが異なる平面上にあることを特徴とする、
第1項に記載の内視鏡。 3.内視鏡チャンネルの先端開口部を設けた面と、内視
鏡の先端面とが平行でない面にあることを特徴とする、
第1、2項に記載の内視鏡。 4.内視鏡チャンネルの先端開口部を設けた面が、手元
方向に背斜していることを特徴とする、第1、2、3項
に記載の内視鏡。
視鏡の先端と湾曲部との間に有することを特徴とする、
第1、2、3、4項に記載の内視鏡。 6.第1〜5項における内視鏡チャンネルが、内視鏡と
別体であり、内視鏡の挿入部に外付けするチャンネルチ
ューブにより形成したものであることを特徴とする内視
鏡。 7.第6項の内視鏡用外付け式チャンネルチューブにお
いて、内視鏡の挿入部にチャンネルチューブを接続およ
び位置決めする手段を、チャンネルチューブの先端付近
に設けたことを特徴とするもの。 8.第7項の内視鏡用外付け式チャンネルチューブにお
いて、チューブ部分が可撓性を有する細長いチューブ部
材からなり、内視鏡の挿入部と接続する手段が内視鏡の
挿入部の先端に着脱自在なキャップを有することを特徴
とするもの。
ネルチューブにおいて、内視鏡の挿入部の先端を除く部
分にチャンネルチューブを固定する手段を有し、この固
定する手段はチャンネルチューブが内視鏡の挿入部の軸
方向にスライド自在に保持するようにしたことを特徴と
するもの。 10.第6〜9項の内視鏡用外付け式チャンネルチュー
ブにおいて、チャンネルチューブの先端が硬質であるこ
とをを特徴とするもの。 11.第1項の内視鏡および第6〜10項の内視鏡用外
付け式チャンネルチューブにおいて、チャンネルの先端
開口部が挿入部の先端面より5mm以上、手元側に位置
して配置されていることを特徴とするもの。 12.第6〜11項の内視鏡用外付け式チャンネルチュ
ーブにおいて、チャンネルチューブがその軸方向に伸縮
可能なものであることを特徴とするもの。 13.第6〜12項の内視鏡用外付け式チャンネルチュ
ーブにおいて、チャンネルチューブがスライド自在な内
チューブと外チューブの2体から構成されて、伸縮する
ことを特徴とするもの。 14.少なくとも1つの内視鏡チャンネルの先端開口部
が、観察窓よりも手元側に退避して先端開口部が設けら
れ、この内視鏡チャンネルを通じて挿入され、その先端
開口部から突没自在な処置具が異物回収手段を有するも
のであることを特徴とする第1〜14項のもの。
視鏡と処置具を併用する場合、体腔内の複数のポリープ
等の切除もしくは回収などの処置を行う場合、回収する
異物等を内視鏡挿入部の先端より手元側に位置させて保
留しておけるため、内視鏡を処置毎にいちいち体外に抜
去することなく、内視鏡を体内に挿入したまま、続けて
内視鏡による観察及び他の内視鏡チャンネル内を通じて
挿入した処置具による作業を続行することが可能であ
る。
ーブを内視鏡本体に取り付けた状態の斜視図である。
ーブを内視鏡本体に取り付けて使用している状態の説明
図である。
ネルチューブを内視鏡本体に取り付けた状態の斜視図、
(b)はその使用状態の説明図である。
ネルチューブの斜視図、(b)はそのチャンネルチュー
ブの使用状態の説明図である。
ネルチューブの斜視図、(b)及び(c)はそのチャン
ネルチューブの使用状態の説明図である。
ネルチューブの斜視図、(b)はそのチャンネルチュー
ブを内視鏡本体に装着して使用している状態の説明図で
ある。
ネルチューブの斜視図、(b)及び(c)はそのチャン
ネルチューブの使用例の状態の説明図である。
係るものにおいてのバスケット式異物回収具の使用状態
の説明図である。
ネルチューブの斜視図、(b)はそのチャンネルチュー
ブの使用状態の説明図である。
る。
入部、4…手元操作部5…先端部、6…湾曲部、7…可
撓管部、8…先端面、9…観察窓、10…先端開口、1
1…処置具挿入口部、14…ゴムバンド、15…先端開
口部、20…バスケット式異物回収具、21…チューブ
シース、24…バスケット、26…第1のポリープ、3
1…高周波スネア、34…第2のポリープ。
Claims (1)
- 【請求項1】1つ以上の内視鏡チャンネルと先端部に観
察窓を有する内視鏡において、少なくとも1つの内視鏡
チャンネルの先端開口部が、観察窓の視野よりも手元側
に退避して設けられていることを特徴とする内視鏡。
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP14111698A JP4121615B2 (ja) | 1997-10-31 | 1998-05-22 | 内視鏡 |
US09/152,805 US6071233A (en) | 1997-10-31 | 1998-09-14 | Endoscope |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP9-300509 | 1997-10-31 | ||
JP30050997 | 1997-10-31 | ||
JP14111698A JP4121615B2 (ja) | 1997-10-31 | 1998-05-22 | 内視鏡 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH11192203A true JPH11192203A (ja) | 1999-07-21 |
JP4121615B2 JP4121615B2 (ja) | 2008-07-23 |
Family
ID=26473431
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP14111698A Expired - Fee Related JP4121615B2 (ja) | 1997-10-31 | 1998-05-22 | 内視鏡 |
Country Status (2)
Country | Link |
---|---|
US (1) | US6071233A (ja) |
JP (1) | JP4121615B2 (ja) |
Cited By (19)
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JP2002325722A (ja) * | 2001-05-02 | 2002-11-12 | Asahi Optical Co Ltd | 内視鏡の先端部 |
JP2003135379A (ja) * | 2001-11-07 | 2003-05-13 | Pentax Corp | 二チャンネル内視鏡 |
JP2003135377A (ja) * | 2001-10-31 | 2003-05-13 | Pentax Corp | 二チャンネル内視鏡 |
JP2004181031A (ja) * | 2002-12-05 | 2004-07-02 | Pentax Corp | 二チャンネル内視鏡 |
JP2005287963A (ja) * | 2004-04-02 | 2005-10-20 | Olympus Corp | 内視鏡治療装置 |
JP2005296412A (ja) * | 2004-04-13 | 2005-10-27 | Olympus Corp | 内視鏡治療装置 |
JP2005537867A (ja) * | 2002-09-06 | 2005-12-15 | シー・アール・バード・インク | 内視鏡付属品装着アダプタ |
JP2006087687A (ja) * | 2004-09-24 | 2006-04-06 | Olympus Corp | 内視鏡用処置具及び内視鏡処置システム並びに支持アダプタ |
JP2007268270A (ja) * | 2006-03-30 | 2007-10-18 | Ethicon Endo Surgery Inc | 内視鏡用付属装置取付器具 |
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