JPWO2016017264A1 - Endoscope cap - Google Patents

Abstract

The endoscope cap includes a cap body, a mounting part, and a pair of elastically deformed due to an external force applied to the pressing area in the circumferential direction of the cap body at the distal end of the cap body. And a non-pressing region located on the opposite side of the pressing region across the pair of first deforming portions, the pressing region having higher rigidity than the non-pressing region, and the cap The main body is elastically deformed so that the pair of first deforming portions are separated radially outward of the cap body as the external force is applied to the pressing area, and the pressing area and the non-pressing area Close to each other and elastically deform so that the opening area of the tip of the cap body becomes narrow.

Description

  The present invention relates to an endoscope cap attached to a distal end portion of an endoscope. This application claims priority on July 30, 2014 based on Japanese Patent Application No. 2014-155275 for which it applied to Japan, and uses the content here.

  When performing treatment using a treatment instrument while observing the surgical site with an endoscope, in order to secure a field of view for the endoscope and a space for performing treatment, the endoscope is inserted at the distal end of the insertion portion of the endoscope. A mirror cap may be attached.

  For example, Patent Document 1 discloses an endoscope hood having a substantially cylindrical cap portion and mounting the proximal end of the cap portion to the distal end portion of the insertion portion of the endoscope. In Patent Document 1, the opening at the distal end of the cap portion of the endoscope hood is pressed against the mucous membrane and sucked with a suction device, so that the pressure inside the endoscope hood is negative and the mucosa is pulled into the cap portion. A procedure is disclosed. The endoscope hood disclosed in Patent Document 1 has a hardness that does not cause a large deformation when pressed against the mucous membrane or when sucked.

  As a treatment to remove living tissue such as mucous membrane using an endoscope, in order to remove the lesion on the surface of the digestive tract, the normal mucous membrane outside the lesion is completely incised and then the submucosal layer is peeled off Endoscopic submucosal dissection (ESD) such as excision of a lesion is known. In ESD, the tip of an endoscope provided with a cap is inserted between the incised submucosa and muscle layers, and in this state, the incision of the submucosa is advanced using a high-frequency knife, and finally the lesioned part Peel off.

Japanese Unexamined Patent Publication No. 2002-45369 Japanese Unexamined Patent Publication No. 2010-22568

  When the submucosal layer is incised and peeled from the muscle layer in ESD, the incision area of the submucosal layer is small immediately after the incision of the submucosal layer is started. Therefore, the submucosal layer separated from the muscle layer by incision has a small pleat shape, and the endoscope hood disclosed in Patent Document 1 can be inserted between the incised submucosa and muscle layer. difficult. On the other hand, for example, in the endoscope treatment tool disclosed in Patent Document 2, a hood attached to the insertion portion of the endoscope, a substantially cylindrical cap fixed to the hood, and an outer periphery of the cap are provided. A treatment is disclosed in which a mucosa is incised by a high-frequency knife arranged in a cap while the treatment tool is provided and the mucous membrane is gripped by the treatment tool. The endoscope treatment tool disclosed in Patent Document 2 grips the mucous membrane in front of the cap with the treatment tool and pulls up the mucosa so as to cover the opening on the distal end side of the cap, so that the distal end portion of the endoscope is incised. It is possible to easily enter between the submucosa layer and the muscle layer. However, there is a high need for a simpler configuration that can be easily operated.

  It is an object of the present invention to provide an endoscope cap that can be easily operated to allow the distal end of an endoscope apparatus to be inserted between a submucosal layer and a muscular layer, and that can raise the submucosal layer. Objective.

  An endoscope cap according to a first aspect of the present invention includes a cap body having a cylindrical shape that has a distal end and a proximal end that are open and communicates from the distal end to the proximal end, and the proximal end of the cap body is disposed inside. A mounting portion to be attached to the distal end of the insertion portion of the endoscope, and a partial area in the circumferential direction of the cap body at the distal end portion of the cap body, and an external force is applied by being pressed against the living tissue A pair of first deforming portions that elastically deform so as to be separated from each other due to an external force applied to the pressing region by sandwiching the pressing region in the circumferential direction of the tip portion of the cap body, A non-pressing region located on the opposite side of the pressing region across the pair of first deforming portions in the circumferential direction of the cap body, the pressing region, with the pair of first deforming portions as a boundary, Non-pressing The cap body is elastically deformed so that the pair of first deformation portions are separated from each other as the external force is applied to the pressing area, and the pressing area and the non-pressing area The cap body is elastically deformed so that the opening area at the tip of the cap body is narrowed close to the region.

  According to a second aspect of the present invention, in the endoscope cap according to the first aspect, the cap body has different rigidity between the pressing region and the non-pressing region with the pair of first deforming portions as a boundary. The pressing area may be formed of a material having higher rigidity than the non-pressing area.

  According to a third aspect of the present invention, in the endoscope cap according to the first aspect, the cap body has a thickness in which the pressing area and the non-pressing area are different from each other with the pair of first deforming portions as a boundary. The thickness of the pressing area may be greater than the thickness of the non-pressing area.

  According to a fourth aspect of the present invention, in the endoscope cap according to the first or second aspect, the pair of first deforming portions of the cap body is formed with a recess so as to be thin. Also good.

  According to a fifth aspect of the present invention, in the endoscope cap according to the first or second aspect, at least the distal end portion of the cap main body of the pair of first deformable portions is not the cap main body. It may be formed of a material having a lower rigidity than the region.

  According to a sixth aspect of the present invention, in the endoscope cap according to the first or second aspect, the cap main body includes the pair of first deformation portions, and the distal end of the cap main body is the base end. A notch that is recessed in the direction may be formed.

  According to a seventh aspect of the present invention, in the endoscope cap according to any one of the first to sixth aspects, the cap body is elastically deformed so that the pair of first deformable portions are separated from each other. When the external force applied to the pressing area is released in a state where the pressing area and the non-pressing area are close to each other and elastically deformed so that the opening area of the tip of the cap body is narrowed, The distal end of the cap body may be restored to the initial shape opened along the shape of the proximal end.

  According to this endoscope cap, the distal end of the endoscope apparatus can be easily inserted between the submucosa and the muscle layer and the submucosa can be raised by a simple operation.

It is a perspective view which shows the cap for endoscopes which concerns on 1st Embodiment of this invention. It is the front view which looked at the cap for endoscopes of Drawing 1 from the tip side. It is a schematic diagram which shows the usage example of the cap for endoscopes which concerns on 1st Embodiment of this invention. It is a schematic diagram which shows the effect | action which the cap for endoscopes which concerns on 1st Embodiment of this invention elastically deforms. It is a schematic diagram which shows the usage example of the cap for endoscopes which concerns on 1st Embodiment of this invention. It is a schematic diagram which shows the usage example of the cap for endoscopes which concerns on 1st Embodiment of this invention. It is a front view showing the 1st modification of the cap for endoscopes concerning a 1st embodiment of the present invention. It is a perspective view showing the 1st modification of the cap for endoscopes concerning a 1st embodiment of the present invention. It is a perspective view showing the 2nd modification of the cap for endoscopes concerning a 1st embodiment of the present invention. It is a perspective view which shows the 3rd modification of the cap for endoscopes which concerns on 1st Embodiment of this invention. It is a perspective view which shows the cap for endoscopes which concerns on 2nd Embodiment of this invention. It is a front view of the cap for endoscopes of FIG. It is a perspective view which shows the 1st modification of the cap for endoscopes which concerns on 2nd Embodiment of this invention. It is a perspective view showing the 2nd modification of the cap for endoscopes concerning a 2nd embodiment of the present invention. It is a perspective view which shows the cap for endoscopes which concerns on 3rd Embodiment of this invention. It is a schematic diagram which shows the process in which the cap for endoscopes which concerns on 3rd Embodiment of this invention deform | transforms. It is a schematic diagram which shows the state which the cap for endoscopes which concerns on 3rd Embodiment of this invention deform | transformed.

[First Embodiment]
An endoscope cap according to a first embodiment of the present invention will be described. FIG. 1 is a perspective view showing an endoscope cap 1 according to the present embodiment. The endoscope cap 1 has a proximal end opening 31 (mounting portion), a cap body 2, and a distal end opening 61, and is formed in a substantially cylindrical shape that communicates from the distal end 6 to the proximal end 3. . The proximal end opening 31 is formed at the proximal end 3 of the cap body 2. The endoscope cap 1 according to this embodiment is attached to a distal end portion of an endoscope insertion portion 100 of an endoscope (not shown). The proximal end opening 31 is attached to the distal end portion of the endoscope insertion portion 100 by a known method. When the proximal end opening 31 is attached to the endoscope insertion portion 100, the distal end opening 61 protrudes in the distal direction relative to the endoscope insertion portion 100.

  The cap body 2 is made of an elastically deformable material. In the natural state, the cap body 2 maintains a substantially cylindrical shape in which the tip opening 61 is circular as shown in FIG. On the other hand, the cap body 2 can be elastically deformed by applying an external force so that the distance between the pressing region 4 and the non-pressing region 5 is reduced and the opening area of the tip opening 61 is reduced. Furthermore, when the applied external force is released, the cap body 2 is restored to the substantially cylindrical initial shape again. Details of the mode in which the endoscope cap 1 is elastically deformed will be described later.

  FIG. 2 is a front view of the endoscope cap shown in FIG. 1 as viewed from the distal end side. In the circumferential direction of the cap body 2, a pressing area 4, a pair of first deformable portions 8, and a non-pressing area 5 are formed.

  A pair of 1st deformation | transformation parts 8 are provided in the position which pinches | interposes the press area | region 4 in the circumferential direction of the front-end | tip part 9 (refer FIG. 1) of the cap main body 2. FIG. In the present modification, the pair of first deformable portions 8 are located on a straight line L <b> 2 that includes the central axis L <b> 1 of the cap body 2 and extends in the radial direction of the cap body 2. Specifically, the pair of first deformable portions 8 are regions including a point P on the straight line L2 (hereinafter sometimes referred to as “first elastic deformation point P”). The first elastic deformation point P is a position serving as a reference point for elastically deforming the cap body 2 outward in the radial direction.

  The pressing region 4 is a partial region in the circumferential direction of the cap body 2 in the tip opening 61 of the cap body 2. The pressing area 4 is located between the pair of first deformable portions 8 in the circumferential direction of the cap body 2. When the pressing region 4 is attached to the endoscope insertion unit 100 and inserted into the living body, an external force is applied by being pressed against the living tissue. The non-pressing region 5 is located on the opposite side of the pressing region 4 with the pair of first deformable portions 8 interposed therebetween in the circumferential direction of the cap body 2. The non-pressing area 5 is formed of a material having lower rigidity than the pressing area 4.

  The material which comprises the cap main body 2 is an acrylic elastomer, for example. The cap body 2 of the present embodiment performs a known crosslinking process to crosslink the acrylic elastomer so that the non-pressing area 5 has lower rigidity than the pressing area 4.

  For example, in the cap body 2, the portion that becomes the non-pressing region 5 is cross-linked by adding relatively less cross-linking agent than the portion that becomes the pressing region 4 and irradiating with ionizing radiation. Alternatively, by making the addition amount of the crosslinking agent at the tip of the cap body 2 uniform and reducing the dose of ionizing radiation applied to the non-pressing region 5 as compared with the pressing region 4, the rigidity of the non-pressing region 5 is reduced to the pressing region. 4 so as to be lower than the rigidity of 4.

  As shown in FIG. 2, the cap body 2 of the present embodiment has a substantially circular cross-sectional shape perpendicular to the central axis L <b> 1 of the tip opening 61. Located in. That is, in the circumferential direction of the cap body 2, one of the regions divided by the pair of first deformable portions 8 as a boundary is the pressing region 4, and the other is the non-pressing region 5.

  Next, an aspect in which the endoscope cap 1 according to the present embodiment is elastically deformed will be described with reference to FIGS. 3 to 6. As an example of use of the endoscope cap according to the present embodiment, an endoscope (not shown) provided with the endoscope cap 1 at the distal end portion of the endoscope insertion portion 100 is used to perform submucosal layer 200 in ESD. Is described with an example of performing a treatment of cutting with a high-frequency knife (not shown).

  In the ESD, the normal mucous membrane around the region including the lesioned part 202 formed in the digestive tract is incised all around, and then the lesioned part 202 inside thereof is excised. Specifically, the endoscope insertion portion 100 of the endoscope to which the endoscope cap 1 is attached is advanced between the incised normal mucosa submucosal layer 200 and the muscle layer 201 to be used for the endoscope. Inside the cap 1, the incision is advanced so as to separate the submucosal layer 200 from the muscle layer 201 using a treatment tool such as a high-frequency knife.

  First, as shown in FIG. 3, the distal end 6 of the endoscope cap 1 is disposed in the vicinity of the end 200a of the entire circumferential incision portion of the normal mucous membrane incised from the outer peripheral side of the entire circumferential incision portion. At this time, it arrange | positions so that the press area | region 4 of the cap 1 for endoscopes may contact | abut to the mucous membrane 200b of an outer peripheral side rather than a perimeter incision part. The incision area of the incised submucosa 200 after the entire circumference incision is small. Therefore, it is difficult to insert the endoscope cap 1 between the incised end portion 200 a of the normal mucous membrane and the muscle layer 201. However, in the endoscope cap 1 according to the present embodiment, as shown in FIG. 5, the distal end portion 9 of the cap body 2 can be elastically deformed so that the distance between the pressing region 4 and the non-pressing region 5 becomes small. Therefore, the endoscope cap 1 can be easily inserted between the submucosa 200 and the muscle layer 201.

  Here, with reference to FIG. 4, the effect | action which elastically deforms the front-end | tip part 9 of the cap for endoscopes in this invention is demonstrated. FIG. 4 is a schematic diagram for explaining the action of elastically deforming the endoscope cap. As shown in FIGS. 1 and 2, the endoscope cap 1 according to the present embodiment has a distal end opening 61 that opens in a substantially circular shape in a natural state. When the endoscope insertion portion 100 is moved and the tip 6 of the endoscope cap 1 is pressed toward the living tissue side in a state where the pressing region 4 is in contact with the living tissue (such as the submucosa 200), an external force is applied to the pressing region 4. (Reaction force from the living tissue side) is added. At this time, the pressing region 4 of the endoscope cap 1 according to the present embodiment has higher rigidity than the non-pressing region 5 with the pair of first deforming portions 8 (first elastic deformation points P) as a boundary. Therefore, in the circumferential direction of the distal end portion 9 of the cap body 2, the first deformable portion 8 becomes a stiffness change point. Therefore, when the pressing area 4 receives an external force, first, the pair of first deformable portions 8 having rigidity smaller than that of the pressing area 4 is elastically deformed. The first deformable portion 8 is formed on the first elastic deformation point P, and the cap body 2 has a pressing region 4, a non-pressing region 5, and a pair of first deforming portions 8 located therebetween. Therefore, the first deforming portion 8 is elastically deformed so that the radius of curvature decreases toward the radially outer side of the cap body 2 (the direction of the arrow B shown in FIG. 4). That is, when the pressing region 4 receives an external force, the pair of first deformable portions 8 are elastically deformed in a direction away from each other. Accordingly, the pressing area 4 and the non-pressing area 5 are elastically deformed so that the respective radii of curvature become large. In this state, when the endoscope insertion portion 100 is further pushed toward the living tissue side, the pressing area 4 and the non-pressing area 5 approach each other, and the width in the direction of the arrow C shown in FIG. (Opening width of the tip opening 61 in the direction of arrow C) is reduced. As a result, as shown in FIG. 5, the distal end portion 9 of the cap body 2 can be easily inserted between the submucosa 200 and the muscle layer 201, and the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle layer. 201 can be entered. When the external force to the pressing area 4 is not applied, the pair of first deformable portions 8 and the non-pressing area 5 are also restored to the initial shape following the restoring force of the pressing area 4 as shown in FIG. It's easy to do.

In the present embodiment, the pressing area 4 is formed to have higher rigidity than the pair of first deformable portions 8 and the non-pressing area 5. As a result, the tip 9 of the cap body 2 is easily elastically deformed into a desired shape. That is, when an external force is applied to the pressing region 4, the pair of first deformable portions 8 are separated from each other, and the pair of first deformable portions 8 are elastically deformed so that the radius of curvature decreases toward the radially outer side. At this time, since the non-pressing region 5 has lower rigidity than the pressing region 4 with the pair of first deforming portions 8 as a boundary, the non-pressing region 5 also follows the elastic deformation in which the pair of first deforming portions 8 are separated. It easily elastically deforms in the direction of arrow D in FIG. 4 so that the radius of curvature becomes large, and the non-pressing area 5 approaches the pressing area 4. When an external force is continuously applied to the pressing area 4, the pressing area 4 is elastically deformed so that the radius of curvature increases with the elastic deformation of the first deformable portion 8 and the non-pressing area 5.
As a result, the distance between the pressing area 4 and the non-pressing area 5 is easily reduced. Moreover, if it will be in the state where the external force to the press area | region 4 is not applied, following a restoring force of the press area | region 4, a pair of 1st deformation part 8 and the non-pressing area | region 5 will also be easy to restore | restore to an initial shape.

  Returning to the description of the usage example of the endoscope cap according to the present embodiment. As shown in FIG. 3, in the state where the distal end 6 of the endoscope cap 1 is arranged on the outer peripheral side of the entire circumferential incision portion and in the vicinity of the end portion 200a of the entire circumferential incision portion of the incised normal mucous membrane, The mirror insertion part 100 is pushed toward the distal end side, and the pressing region 4 of the distal end part 9 of the endoscope cap 1 is pushed toward the living tissue side. As a result, the shape of the distal end portion 9 of the endoscope cap 1 is elastically deformed by the action described with reference to FIG. When the endoscope insertion portion 100 is advanced in a state where the shape of the distal end portion 9 of the endoscope cap 1 is elastically deformed, the endoscope is inserted between the submucosa 200 and the muscle layer 201 as shown in FIG. The mirror insertion part 100 can be entered.

  Subsequently, when the distal end 6 of the endoscope cap 1 is advanced to a position where the submucosal layer 200 is to be incised, the pressing of the endoscope insertion portion 100 toward the living tissue is released. As a result, no external force is applied to the pressing region 4. Since the cap body 2 is configured to be elastically deformable when an external force is applied and to be restored to a predetermined curved shape when the external force is released, as shown in FIG. Restore the initial shape. Further, the non-pressing region 5 has such a rigidity that it can maintain a certain shape even when the cut mucosal layer 200 contacts. In addition, since the submucosal layer 200 is a very soft tissue, even when the submucosal layer 200 contacts the non-pressing region 5 in the state illustrated in FIG. 6, the non-pressing region 5 is not elastically deformed by an external force. When the external force is released and the endoscope cap 1 is restored to the initial shape, the submucosal layer 200 incised in the non-pressing region 5 can be raised. Thus, the endoscope cap 1 secures an observation field of view by the endoscope, and prevents the treatment by the incised submucosal layer 200 when the treatment target site is treated by the treatment tool such as a high-frequency knife. This can be prevented and treatment can be performed smoothly. After the endoscope cap 1 is restored to the initial shape, a treatment tool such as a high-frequency knife is protruded from the distal end of the endoscope insertion portion 100 to incise the submucosal layer 200.

  In the endoscope cap 1 according to the present embodiment, the distal end portion 9 of the endoscope cap 1 is not pressed against the pressing region 4 by a simple operation of pressing the endoscope insertion portion 100 toward the living tissue side. It can be elastically deformed so as to be close to the region 5. In addition, in the state where the endoscope cap 1 elastically deformed so that the pressing region 4 and the non-pressing region 5 are close to each other is disposed between the submucosal layer and the muscle layer, the living body of the endoscope insertion unit 100 When the pressure on the tissue side is released, the submucosa can be lifted easily.

  The configuration of the cap body 2 in which the rigidity of the non-pressing area 5 is lower than the rigidity of the pressing area 4 with the pair of first deformable portions 8 as a boundary is a material whose rigidity is lower than the material forming the pressing area 4 as in the above embodiment. In addition to the configuration in which the non-pressing region 5 is formed, for example, a configuration in which the pressing region 4 and the non-pressing region 5 are made of the same material and the thickness of the cap body 2 is set as in the following first modification. Can be considered.

[First Modification of Endoscope Cap According to First Embodiment]
7 and 8 show a first modification of the endoscope cap 1 according to the present embodiment. FIG. 7 is a front view showing an endoscope cap 1a of a first modification. FIG. 8 is a perspective view showing an endoscope cap 1a according to a first modification. In this modification, the configuration for making the rigidity of the non-pressing region 5 lower than the rigidity of the pressing region 4 with the pair of first deforming portions 8 as a boundary is different from that of the first embodiment.

  As shown in FIG. 7, the endoscope cap 1 a in the present modified example has a pressing region such that the thickness of the pressing region 4 is greater than the thickness of the non-pressing region 5 with the pair of first deforming portions 8 as a boundary. 4 and a non-pressing area 5 are formed. As a result, the rigidity of the non-pressing area 5 is lower than the rigidity of the pressing area 4. In this respect, the present modification is different from the first embodiment. As shown in FIG. 8, in the cap body 2, the non-pressing area 5 is formed thinner than the pressing area 4 from the distal end opening 61 to the vicinity of the proximal end opening 31. In the present modification, a step is formed at the position of the pair of first elastic deformation points P on the inner peripheral surface of the cap body 2. As described above, the pressing region 4, the non-pressing region 5, and the pair of first deformable portions are made of the same material, and the thickness of the pressing region 4 is made thicker than the thickness of the non-pressing region 5. Is lower than the rigidity of the pressing region 4. The endoscope cap 1a according to the present modification can obtain the same effects as those of the first embodiment. In addition, in this modification, although the example which thickens the thickness of the press area | region 4 was shown so that a level | step difference might be formed in the internal peripheral surface of the cap main body 2, it is not limited to this. For example, the pressing region 4 may have a configuration in which the thickness increases on the outer peripheral surface side of the cap body 2 or a configuration in which the pressing region 4 increases in thickness on the inner surface and the outer surface of the cap body 2.

[Second Modification of Endoscope Cap According to First Embodiment]
FIG. 9 shows a second modification of the endoscope cap 1 according to this embodiment. In the present modification, the thickness of the pressing area 4 is made thicker than the non-pressing area 5 only at the tip 9 of the cap body 2. That is, this is an example in which the pressing region 4 having higher rigidity than the other regions is formed only at the tip 9 of the cap body 2. The cap body 2 of this modification is made of the same material as that of the first modification. According to the endoscope cap 1b of the present modified example, since the pressing area 4 having high rigidity is formed only at the distal end portion 9 of the cap body 2, when an external force is applied to the pressing area 4, other than the pressing area 4 This area is easily elastically deformed. Therefore, the opening area of the distal end opening 61 of the endoscope cap 1a can be easily changed, and the operability is excellent. Further, the endoscope cap 1b according to the present modification can obtain the same effects as those of the first embodiment.

[Third Modification of Endoscope Cap According to First Embodiment]
A third modification of the endoscope cap 1 according to this embodiment is shown in FIG. In the present modification, only the tip 9 of the cap body 2 in the pressing area 4 is formed using a material having higher rigidity than the other areas of the cap body 2. That is, this is an example in which a region having higher rigidity than the non-pressing region 5 is formed only in the pressing region 4 of the distal end portion 9 of the cap body 2. The cap main body 2 of this modification is formed so that the pressing area 4 of the distal end portion 9 is higher than the rigidity of the non-pressing area 5 by the same bridging process as in the first embodiment.

  According to the endoscope cap 1c of the present modification, a region having high rigidity is formed only in the distal end portion 9 of the cap body 2 in the pressing region 4, so that when an external force is applied to the pressing region 4, Areas other than the pressing area 4 are easily elastically deformed. Therefore, the opening area of the distal end opening 61 of the endoscope cap 1c can be easily changed, and the operability is excellent. Further, the endoscope cap 1c according to the present modification can obtain the same effects as those of the first embodiment.

[Second Embodiment]
Next, an endoscope cap 11 according to a second embodiment of the present invention will be described. In the following description, the same reference numerals are given to the same components and the like as those in the first embodiment, and duplicate descriptions are omitted. FIG. 11 is a perspective view showing an endoscope cap 11 according to the second embodiment. 12 is a front view of the endoscope cap 11 shown in FIG. 11 as viewed from the distal end side.

  In the present embodiment, the pair of first deformable portions 8 are formed with concave portions 81 that are recessed in the radial direction of the cap body 2 on the inner peripheral surface of the cap body 20. The recess 81 is formed from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1). In the endoscope cap 11 according to the present embodiment, since the concave portion 81 is formed in the pair of first deformable portions 8, the cap body 20 is thin in the concave portion 81, and the pair of first deformable portions 8. The rigidity is lower than the rigidity of the pressing area 4. The pair of first deformable portions 8 are elastically deformed so as to be separated from each other toward the radially outer side of the cap body 20 (in the direction of arrow A shown in FIG. 12) with elastic deformation of the pressing region 4.

  Here, with reference to FIG. 4, the effect | action which elastically deforms the front-end | tip part 9 of the cap for endoscopes in this invention is demonstrated. As shown in FIGS. 11 and 12, the endoscope cap 11 according to the present embodiment has a distal end opening 61 that opens in a substantially circular shape in a natural state. When the endoscope insertion portion 100 is moved and the tip 6 of the endoscope cap 11 is pressed toward the living tissue side in a state where the pressing region 4 is in contact with the living tissue, an external force (from the living tissue side) is applied to the pressing region 4. Reaction force). At this time, in the endoscope cap 11 according to the present embodiment, the pair of first deformable portions 8 are formed with concave portions 81 that are recessed in the radial direction of the cap body 2 on the inner peripheral surface of the cap body 2. That is, the recess 81 has the lowest rigidity in the circumferential direction of the cap body 2. Therefore, when the pressing region 4 receives an external force, first, the pair of first deformable portions 8 are elastically deformed so that the radius of curvature decreases toward the radially outer side of the cap body 2 (in the direction of arrow B shown in FIG. 4). . That is, the pair of first deformable portions 8 is elastically deformed in a direction away from each other. Accordingly, the pressing area 4 and the non-pressing area 5 are each pulled toward the pair of first deformable portions 8 and elastically deformed so that the respective radii of curvature become large. In this state, when the endoscope insertion portion 100 is further pushed toward the living tissue side, the pressing area 4 and the non-pressing area 5 approach each other, and the width in the direction of the arrow C shown in FIG. (Opening width of the tip opening 61 in the direction of arrow C) is reduced. As a result, as in the first embodiment, the distal end portion 9 of the cap body 20 can be easily embedded between the submucosa 200 and the muscle layer 201, and the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle. It can enter between the layers 201. Moreover, if it will be in the state where the external force to the press area | region 4 is not applied, following a restoring force of the press area | region 4, a pair of 1st deformation part 8 and the non-pressing area | region 5 will also be easy to restore | restore to an initial shape.

  That is, in the first embodiment, the cap body 20 is configured such that the rigidity of the non-pressing region 5 is smaller than the rigidity of the pressing region 4 with the pair of first deformable portions 8 as a boundary. This embodiment is different from the first embodiment in that the rigidity of the pair of first deformable portions 8 is configured to be smaller than the rigidity of the pressing region 4. The endoscope cap 11 according to the present embodiment sets the pair of first deformable portions 8 to the cap body by setting the rigidity of at least the pair of first deformable portions 8 to be smaller than the rigidity of the pressing region 4. It has the structure which is easy to be elastically deformed in the direction which mutually space | intersects 20 radial outside. As a result, the tip portion 9 of the endoscope cap 11 is elastically deformed so that the pressing area 4 and the non-pressing area 5 are close to each other by a simple operation of pressing the endoscope insertion section 100 toward the living tissue. Can be made. The endoscope cap 11 according to the present embodiment can obtain the same effects as those of the first embodiment.

  In the present embodiment, the pair of first deformable portions 8 are configured to bend and form a concave portion 81 extending from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1). The main body 20 should just be the structure which has the press area | region 4, a pair of 1st deformation | transformation part 8, and the non-press area | region 5 at the front-end | tip part 9 at least. That is, it is sufficient that at least the tip 9 can be elastically deformed to reduce the opening area of the tip. In addition, if the base end 3 side is configured not to be elastically deformed, it can be easily restored to the initial shape after the external force applied to the endoscope cap 11 is released.

  The recesses 81 of the pair of first deformable portions 8 may be configured to be formed on the outer peripheral surface of the cap body 20 in addition to the example formed on the inner peripheral surface of the cap body 20 as in the present embodiment. . When the concave portion 81 is formed on the outer peripheral surface of the cap main body 20, the first deformable portion 8 is easily bent radially outward of the cap main body 2, and the concave portion 81 can be easily formed when the endoscope cap 1 is manufactured. It is. In the present embodiment, the concave portion 81 is formed from the distal end to the proximal end in the longitudinal direction of the cap body 20, but the concave portion 81 only needs to be formed at least at the distal end portion 9.

[First Modification of Endoscope Cap According to Second Embodiment]
FIG. 13 shows a first modification of the endoscope cap 11 according to this embodiment. The endoscope cap 11a of the present modification is different in configuration from the pair of first deformable portions 8 in the second embodiment. In 2nd Embodiment, it comprised so that the rigidity of a pair of 1st deformation | transformation part 8 might become lower than the press area | region 4 by forming the recessed part 81 in the material which forms a pair of 1st deformation | transformation part 8. FIG. In the present modification, the concave portion 81 is not formed, and the first deformation portion 8a is formed of a material having lower rigidity than the material forming the pressing region 4. The pair of first deformable portions 8a includes a pair of regions including the first elastic deformation point P in the cap body 20 and extending from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1). , Formed of a material having lower rigidity than the other regions (the pressing region 4 and the non-pressing region 5). Other configurations are the same as those of the endoscope cap 11 according to the second embodiment. The endoscope cap 11a according to this modification can obtain the same effects as those of the second embodiment.

  In the present modification, an example in which the pair of first deformable portions 8a is provided from the distal end 6 to the proximal end 3 of the cap body 2 is shown. However, the pair of first deformable portions 8a only need to be formed at least on the distal end portion 9 side. For example, the structure from the substantially intermediate | middle part in the center axis | shaft L1 direction of the cap main body 2 to the front-end | tip opening part 61 may be comprised from a material whose rigidity is lower than another area | region.

[Second Modification of Endoscope Cap According to Second Embodiment]
FIG. 14 shows a second modification of the endoscope cap 11 according to this embodiment. In the endoscope cap 11b of the present modification, instead of the first deformable portion 8 having the concave portion 81 of the second embodiment, the cutout portion 10 is formed in the distal end opening 61 of the cap body 2 in the first deformable portion 8b. Is formed. The notch 10 is formed only at the tip 9. Furthermore, the notch 10 has a circumferential position of the cap body 20 including the first elastic deformation point P, and extends from the distal end 6 toward the proximal end 3 in the direction of the central axis L1 of the cap body 20. A tip opening 61 is formed by cutting out. The notch 10 has a curved surface formed from the distal end opening 61 toward the deepest portion (proximal end portion) of the notch 10 when the endoscope cap 11b is viewed from the side. .

  As described above, when the pressing region 4 is pressed, the distal end portion of the cap body 20 is increased by increasing the inclination of the endoscope cap 11 with respect to the living tissue (the inclination of the endoscope insertion portion 100 with respect to the living tissue). 9 is curved. When an external force is applied to the pressing region 4, the notch 10 at the tip 6 of the cap body 20 has lower rigidity in the direction of the external force applied to the cap body 20 than other regions. For this reason, the first deformable portion 8b has a structure that is easily bent. The endoscope cap 11b according to this modification can obtain the same effects as those of the second embodiment.

  In the endoscope cap 11 according to the present embodiment, in addition to the configuration in which the pair of first deformable portions 8 are provided with the concave portions 81, the region of the first deformable portion 8 is changed to another region as in the first modified example. You may combine the structure used as material with low rigidity compared with. Similarly, in the second modification example of the present embodiment, the configuration of the second modification example in which the region of the pair of first deformation portions 8 is made of a material having lower rigidity than the other regions may be combined.

[Third Embodiment]
Next, with reference to FIGS. 15 to 17, an endoscope cap 12 according to a third embodiment of the present invention will be described. FIG. 15 is a perspective view showing an outline of the endoscope cap 12 according to the present embodiment. The present embodiment is different from the first and second embodiments in that a pressing region side protrusion is provided at the tip of the pressing region, and a non-pressing region side protrusion is further provided at the tip of the non-pressing region. In the following description, the same reference numerals are given to the same components and the like as those in the first and second embodiments, and redundant description is omitted.

  The endoscope cap 12 according to this embodiment includes a proximal end opening 31 (mounting portion), a cap body 21, a distal end opening 61, a pressing region side protruding portion 71, and a non-pressing region side protruding portion 72. And have. The endoscope cap 12 according to the present embodiment is formed in a substantially cylindrical shape that communicates from the distal end 6 to the proximal end 3.

  The distal end opening 61 is provided to extend from the proximal end opening 31 so as to protrude more distally than the endoscope insertion portion 100. The pressing region side protrusion 71 is provided to extend from the pressing region 4 in the tip opening 61 in the distal direction of the cap body 21 (the direction of arrow E shown in FIG. 15). The non-pressing area side protrusion 72 is provided to extend from the non-pressing area 5 in the tip opening 61 in the distal direction of the cap body 21 (in the direction of arrow E shown in FIG. 15). The pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 each have a shape curved in an arc shape along the cylindrical shape of the cap body 21. The pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 are provided at positions facing each other.

  In other words, the endoscope cap 12 according to the present embodiment is further provided at the distal end of the endoscope caps 1 and 11 according to the first embodiment and the second embodiment, and further on the pressing area side protruding portion 71 and the non-pressing area side protrusion. An auxiliary member that forms the portion 72 and smoothly realizes elastic deformation so that the opening area of the distal end opening 61 of the endoscope caps 1 and 11 according to the first and second embodiments is reduced. is there.

  The cap body 21 is made of the same material that can be elastically deformed. In the natural state, the cap main body 21 maintains a substantially cylindrical shape in which the cross-sectional shape of the tip opening 61 in a cross section orthogonal to the central axis L1 of the cap main body 21 is circular. On the other hand, the cap body 21 can be elastically deformed so that the distance between the pressing region 4 and the non-pressing region 5 is reduced when an external force is applied. To be restored.

  With reference to FIGS. 15 to 17, the action of elastically deforming the distal end portion 9 of the endoscope cap 12 according to the present embodiment will be described. FIG. 15 is a perspective view showing an initial shape of the endoscope cap 12 according to the present embodiment. As shown in FIG. 15, the endoscope cap 12 according to the present embodiment has a distal end opening 61 that opens in a substantially circular shape in a natural state.

  When the endoscope insertion portion 100 is moved and the pressing region side protrusion 71 of the endoscope cap 12 is pressed toward the living tissue while the pressing region 4 is in contact with the living tissue, the pressing region side protruding portion 71 includes External force (reaction force from the living tissue side) is applied. When an external force is applied to the pressing region side protrusion 71, the pressing region side protrusion 71 is bent in a direction intersecting the central axis L1 of the cap body 21, as shown in FIG. A broken line portion 71b is formed at the distal end portion 71a.

  The region 71c on the distal end portion 71a side of the broken line portion 71b of the pressing region side protruding portion 71 is elastically deformed from a curved shape to a flat shape. The area 71c elastically deformed into a flat shape of the pressing area side protrusion 71 has an outer peripheral surface that abuts on the living tissue. In this state, the pressing region 4 of the distal end portion 9 of the endoscope cap 12 is pressed toward the living tissue side. Specifically, the endoscope insertion portion 100 is further pushed to the living tissue side in a state where the flat-shaped pressing region side protruding portion 71 is in contact with the living tissue.

  As a result, the broken line portion 71b is positioned at the first elastic deformation point P of the tip opening 61, and the pressing region side protrusion 71 is elastically deformed. That is, the pressing region side protruding portion 71 is elastically deformed so as to have a flat shape. At this time, in the endoscope cap 12 according to the present embodiment, the pair of first deformable portions 8 is radially outward of the cap body 21 (in the direction indicated by the arrow F shown in FIG. 17) by the operation described with reference to FIG. 4. ) Elastically deforms so that the radius of curvature becomes smaller. That is, the pair of first deformable portions 8 is elastically deformed in a direction away from each other.

  Accompanying the elastic deformation of the pair of first deformable portions 8, each of the pressing region 4, the non-pressing region 5, and the non-pressing region side protrusion 72 expands in an arc shape and is elastically deformed into a flat shape. In this state, the pressing area 4 and the non-pressing area 5 are close to each other, and the pressing area side protruding portion 71 and the non-pressing area side protruding portion 72 are close to each other, so that the opening width of the tip opening 61 of the cap body 2 is increased. Get smaller.

  As a result, as in the first embodiment, the distal end portion 9 of the cap body 21 can be easily inserted between the submucosa 200 and the muscle layer 201, and the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle. It can enter between the layers 201. Moreover, when it will be in the state where the external force to the press area | region 4 is not added, following the restoring force of the press area | region 4 and the non-press area | region 5, a pair of 1st deformation | transformation part 8, the press area | region side protrusion part 71, and a non-press area | region The side protrusion 72 is restored to the initial shape. And the non-pressing area | region side protrusion part 72 and the non-pressing area | region 5 can raise the cut | disconnected submucosa 200. FIG. Therefore, as in the first embodiment, when the observation field of view by the endoscope is ensured and the treatment target site is treated by the treatment tool such as a high-frequency knife, the incised submucosal layer 200 prevents the treatment. Can be prevented.

  The endoscope cap 12 according to the present embodiment is configured to elastically deform the pressing region side protruding portion 71 before the pressing region 4 when pressed to the living tissue side, and the pressing region side protruding portion 71. Functions as a guide for elastically deforming the pair of first deformable portions 8 radially outward.

  The endoscope cap 12 according to the present embodiment can be elastically deformed so that the pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 are flat and close to each other. Therefore, the distal end portion of the endoscope cap 12 can be formed in a substantially flat plate shape, and the endoscope cap 12 can easily enter between the end portion 200a of the submucosal layer 200 and the muscle layer 201.

  In this embodiment, the cap main body 21 showed the example formed with the same material. However, as described above, the pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 are provided in order to more smoothly elastically deform the distal end portion 9 of the cap body 21. Therefore, the configuration of the cap body 21 is not limited to the configuration of the present embodiment. For example, the pressing region side protruding portion 71 and the non-pressing region side are formed on the distal end portion 9 of the cap body 2 according to the first embodiment and the second embodiment. The structure which provides the protrusion part 72 may be sufficient.

  In the said embodiment, the example which forms a cap main body with an acrylic elastomer was shown. However, the material forming the cap body is not limited to this, and a known soft material used for an endoscope cap can be used. Moreover, in the said embodiment, the example which makes the rigidity of the non-pressing area | region 5 small compared with the rigidity of the pressing area | region 4 by bridge | crosslinking process, and the example which makes the thickness of the pressing area | region 4 thicker than the non-pressing area | region 5 were shown. However, the means for making the rigidity of the non-pressing region 5 smaller than the rigidity of the pressing region 4 is not limited to this, and the non-pressing region 5 and the pressing region 4 can be formed by combining materials having relatively different rigidity. is there.

  In the above embodiment, the pair of first deformable portions 8 are arranged at positions including the first elastic deformation point P located on the straight line L2 including the central axis L1 of the cap body 2 and extending in the radial direction of the cap body 2. An example is shown, but the present invention is not limited to this. A pair of 1st deformation | transformation part may be the structure provided in the position which is located on the straight line parallel to the diameter of the cap main body 2, and the press area | region 4 in the circumferential direction of the front-end | tip part 9 of the cap main body 2. For example, a configuration in which the pair of first deforming portions are located on a straight line between the central axis L1 and the pressing region 4 or between the central axis L1 and the non-pressing region 5 and parallel to the straight line L2 may be employed.

As mentioned above, although embodiment of this invention was explained in full detail with reference to drawings, the concrete structure is not restricted to this embodiment, The design change etc. of the range which does not deviate from the summary of this invention are included.
In addition, the constituent elements shown in the above-described embodiments and modifications can be combined as appropriate.

  It is possible to provide an endoscope cap that is easy to perform an operation of causing the distal end of the endoscopic device to be submerged between the submucosal layer and the muscular layer and can raise the submucosal layer.

DESCRIPTION OF SYMBOLS 1 Endoscope cap 2 Cap main body 4 Press area | region 8 1st deformation part 5 Non-pressing area | region 6 Tip 7 Base end 31 Base end opening part (mounting part)
81 Concave part 100 Endoscope insertion part 9 Tip part L1 Center axis 10 Notch part

An endoscope cap according to a first aspect of the present invention includes a cap body having a cylindrical shape that has a distal end and a proximal end that are open and communicates from the distal end to the proximal end, and the proximal end of the cap body is disposed inside. a mounting portion for mounting to the distal end of the insertion portion of the endoscope is formed at the tip portion of the cap body, a first modified portion of a pair which is provided at a position apart in the circumferential direction, of the tip portion of the cap body A first region that extends in the circumferential direction and includes an outer peripheral surface to which an external force is applied by being pressed from a living tissue, and is formed from one to the other of the pair of first deformable portions with a predetermined rigidity, and a tip of the cap body A second region that extends in a circumferential direction of the portion, is disposed at a position facing the first region, and is formed from one to the other of the pair of first deformable portions with lower rigidity than the first region .

A second aspect of the present invention is the endoscope cap according to the first aspect, the cap body, and a front Symbol first region and before Symbol second region of the first deformation portion of the pair as a boundary stiffness are formed of different materials, before Symbol first region, prior Symbol stiffness than the second region may be formed of a material having a high.

A third aspect of the present invention is the endoscope cap according to the first aspect, the cap to the body, as a boundary said pair of first deformable portion, before Symbol first region and the front Stories second it is formed such that the region is different thicknesses, pre Symbol thickness of the first region may be greater than the previous SL thickness of the second region.

According to a fourth aspect of the present invention, in the endoscope cap according to the first aspect, the pair of first deforming portions of the cap body may be formed with a recess so as to be thin.

In the fifth aspect of the present invention, the pair of first deformable portions may be formed of a material having lower rigidity than other regions of the cap body.

According to a sixth aspect of the present invention, in the endoscope cap according to the first aspect, the distal end of the cap body is recessed in the proximal direction in the pair of first deformation portions. A notch may be formed.

A seventh aspect of the present invention is the endoscope cap according to the first aspect, the cap body is elastically deformed such that the first deforming portion of the pair are separated from each other, before Symbol first region when in the state where the opening area of the front end is elastically deformed to be narrower before Symbol the cap body and the second region are close, when the previous SL external force applied to the first region is released, the cap You may restore | restore to the initial shape which the said front-end | tip of the main body opened along the shape of the said base end.

Claims (7)

A cap body having a cylindrical shape with a distal end and a proximal end opened and communicating from the distal end to the proximal end;
An attachment portion for attaching the proximal end of the cap body to the distal end of the insertion portion of the endoscope;
A partial region in the circumferential direction of the cap body at the tip of the cap body, and a pressing region to which an external force is applied by being pressed against the biological tissue;
A pair of first deforming portions that elastically deform so as to be separated from each other due to an external force applied to the pressing region with the pressing region sandwiched in the circumferential direction of the tip portion of the cap body,
A non-pressing region located on the opposite side of the pressing region across the pair of first deformation portions in the circumferential direction of the cap body;
With
The pressing region is higher in rigidity than the non-pressing region with the pair of first deforming portions as a boundary,
The cap body is elastically deformed so that the pair of first deforming portions are separated from each other as the external force is applied to the pressing area, and the pressing area and the non-pressing area are close to each other. An endoscope cap that is elastically deformed so that an opening area of the tip of the cap body is narrowed. The cap body is formed of a material having different rigidity between the pressing region and the non-pressing region with the pair of first deforming portions as a boundary,
The endoscope cap according to claim 1, wherein the pressing area is formed of a material having higher rigidity than the non-pressing area. The cap body is formed such that the pressing region and the non-pressing region have different thicknesses with the pair of first deforming portions as a boundary,
The endoscope cap according to claim 1, wherein a thickness of the pressing region is larger than a thickness of the non-pressing region.   The endoscope cap according to claim 1 or 2, wherein the pair of first deformable portions of the cap body is formed with a recess so as to be thin.   3. The internal view according to claim 1, wherein at least the distal end portion of the cap main body of the pair of first deformable portions is formed of a material having lower rigidity than other regions of the cap main body. Mirror cap.   The endoscope according to claim 1, wherein the cap main body has a notch portion in which the distal end of the cap main body is recessed in the proximal direction in the pair of first deformable portions. Cap.   The cap body is elastically deformed so that the pair of first deforming portions are separated from each other, and the pressing area and the non-pressing area are close to each other so that the opening area of the tip of the cap body is narrowed. 7. Any one of claims 1 to 6, wherein when the external force applied to the pressing region is released in an elastically deformed state, the distal end of the cap body is restored to an initial shape opened along the shape of the proximal end. Endoscope cap according to any one of the above.

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