TW201832716A - Endoscopic device - Google Patents

Abstract

The present invention improves the operability of an endoscope and increases the degrees of freedom in endoscopic surgery. An endoscopic device (1) is equipped with: an endoscope (1); a cylindrical retractor (20); and a connection support member (50) that connects the retractor (20) to a support means (5). The retractor (20) includes: a tube portion (22) into which the endoscope (10) and forceps (2) are inserted; and a spherical supported portion (25) that is provided to the tube portion (22). The outer peripheral surface of the supported portion (25) is shaped as a sphere. The connection support member (50) has a recessed spherical support seat surface (55) that receives the supported portion (25).

Description

Endoscope device

The present invention relates to an endoscope device that can insert an endoscope into a body while observing a surgical field of view, and more particularly to an endoscope device that secures a cylindrical insertion space with a cylindrical retractor.

In recent years, endoscopic surgery has been attracting attention, for example, as a low-invasive treatment for joint diseases such as disc herniation or spinal stenosis. For example, in Patent Document 1, a small hole is opened in the body of a patient, and a cylindrical retractor is inserted into the hole to secure the size of the hole. A surgical instrument such as an endoscope or a forceps is inserted into the retractor, and the surgical field of view is observed with an endoscope. [Prior Art Document] [Patent Document 1] [Patent Document 1] Japanese Laid-Open Patent Publication No. 2016-034412 (Fig. 10)

[Problems to be Solved by the Invention] The retractor of Patent Document 1 or the like is fixed to an operation table or the like via a support mechanism. On the other hand, the angle adjustment of the retractor is not easy. The present invention has been made in view of the circumstances, and an object thereof is to freely adjust an angle of a retractor and improve operability of an endoscope. [Means for Solving the Problems] In order to solve the above problems, the present invention provides an endoscope device characterized in that a cylindrical insertion space is secured in the body, and a surgical field of view in the depth of the cylindrical insertion space can be observed. And comprising: an endoscope; a retractor; and a connection support member supported by the retractor coupled to the support mechanism, wherein the retractor includes: a tube portion through which the endoscope and the surgical instrument are inserted; The support portion provided on the outer circumference of the tubular portion is formed in a spherical shape on the outer peripheral surface of the supported portion, and the connection support member has a concave seating surface that receives the concave portion of the supported portion. According to the endoscope device, the spherical surface is supported by the concave spherical support surface and the spherical support portion. Thereby, the retractor can be freely rotated in all directions of the front, rear, left and right directions to adjust the orientation. Thereby, the operability of the endoscope can be improved, and the degree of freedom of surgery under the endoscope can be improved. Preferably, the diameter of the support seat surface toward the insertion side peripheral end edge of the endoscope side of the endoscope is smaller than the diameter of the support side surface toward the hand-held side peripheral edge of the hand-held side of the endoscope. Thereby, the support seat surface of the connection support member can be supported by being inserted into the supported portion of the front end side receiving retractor. Preferably, the connection supporting member includes: a first half-side support having a half of the support seat surface; a second half support having the other half of the support seat; and an opening and closing mechanism for zooming The support of the seat surface is such that the first half support and the second half support are opened and closed. The support seat is zoomed by the operation of the opening and closing mechanism, and the retractor can be attached, detached, angled, or fixed at a desired angle. The opening and closing operation of the first and second half-side supports may be a rotation or a parallel movement. Preferably, the opening and closing mechanism includes an opening adjustment knob that supports the first half support and the second half between a slack position at which the retractor is detachable and a closed position at which the retractor is fixed. And the opening blocking portion prevents the operation from the relaxed position and the open side by the opening adjustment knob, and in the relaxed position, the supporting seat surface should face the handheld side of the endoscope The diameter of the side peripheral edge is larger than the outer diameter of the supported portion, and the diameter of the insertion seat surface toward the insertion end side of the endoscope side of the endoscope is smaller than the outer diameter of the supported portion. The angle of the retractor or the angle of the endoscope can be fixed by positioning the first and second half supports in the closed position. By positioning the first and second half-side supports at the relaxed position, the retractor can be withdrawn from the connection support member toward the hand-held side. Moreover, when placed in the relaxed position, the retractor can be prevented from falling through the support seat surface. Further, the first and second half-side supports can be opened only to the slack position by the operation of opening the blocking portion, and the retractor can be surely prevented from falling through the support seat surface. Preferably, the opening and closing mechanism further includes a locking knob operable between the locking position and the unlocking position, wherein the first half support and the second half support are locked to each other when the locking knob is in the locked position In the closed-loop state including the slack position and the closed position, when the lock knob is located at the unlock position, the first half support and the second half support are released from each other in the closed loop state. If the first and second half-side supports are to be opened beyond the relaxed position, it is necessary to operate a different locking knob than when opening and closing between the relaxed position and the closed position. Therefore, even if the operator inadvertently, it is possible to surely prevent the joint supporting member from opening beyond the relaxed position. By opening and closing the first and second half-side supports beyond the relaxed position, cleaning, decomposition, and the like of the connection support member can be easily performed. Preferably, the endoscope device further includes a holder that holds the endoscope between the protruding position and the retracted position in an axial direction of the tubular portion with respect to the retractor adjustment position, and the protrusion The front end of the insertion portion of the endoscope protrudes from the front end of the retractor, and the front end of the insertion portion retreats to the inside of the retractor at the retracted position. Thereby, for example, the retractor can be inserted into the patient while the end portion of the endoscope is retracted into the tubular portion while being viewed by the endoscope, and then the end portion of the endoscope is self-contained from the tubular portion. Prominent, while performing endoscopic surgery. Preferably, the endoscope device further includes a holder that detachably holds the endoscope, the holder having: a holder body having a fastening wall; and a fastening member Between the latching position of the endoscope and the buckle releasing position, the retaining member is displaceably disposed relative to the retainer body, and the latching member of the latching position is engaged with the latching member The wall is elastically engaged, and the elastic restoring force of the fastening wall is biased from the buckle release position toward the buckle position, and the elastic engagement is released at the buckle release position. Thereby, the buckle member at the fastening position is elastically pressed against the endoscope and can be surely buckled. As the biasing mechanism, it is possible to easily perform cleaning or the like without using a coil spring or a leaf spring. Preferably, the tubular portion includes a large-diameter cylinder portion and a small-diameter cylinder portion integrally connected to the large-diameter cylinder portion and having a smaller diameter portion of the larger-diameter cylinder portion, and the insertion portion of the endoscope is inserted into the small-diameter cylinder section. Surgical instruments such as forceps can be inserted into the large diameter tube. The tubular portion can be made into a small cross section as compared with the entire cylindrical portion. [Effect of the Invention] According to the endoscope device of the present invention, the angle of the retractor can be freely adjusted in all directions, and the operability of the endoscope can be improved.

Hereinafter, an embodiment of the present invention will be described based on the drawings. 2 and 3 show an endoscope device 1 according to an embodiment of the present invention. The endoscope device 1 is an endoscope device used for the operation of a joint disease (including surgery) such as a herniated disc or a spinal stenosis. As shown in simplified form in Figure 1, the flexible arm 5 (support mechanism) extends from or near the operating table. The endoscope device 1 is supported at the front end of the flexible arm 5. The front end of the endoscope device 1 is inserted into the surgical field 9a in the body of the patient 9 schematically shown in Fig. 1, and the operation is performed. As shown in FIG. 4, the endoscope device 1 includes an endoscope 10, a retractor 20, a holder 30, a nozzle unit 40, and a connection support member 50. The members 10 to 50 can be decomposed and assembled with each other. In the following description, the endoscope device 1 is in an assembled state unless otherwise specified. The endoscope 10 is a squint and rigid endoscope including a hand portion 11 and a rigid insertion portion 12. The eyepiece portion 13 and the optical connector 16 are provided in the hand portion 11. The insertion portion 12 extends straight from the hand portion 11 toward the insertion front end side (downward in FIG. 4). 10, the end surface of the insertion portion 12e and the inclined surface with respect to the axis of the insertion portion 12 of the previous 12 L ₁₂ orthogonal. Hereinafter, 12e along the direction perpendicular to the direction of the inclined front end face (the right and left directions in FIG. 2, a direction perpendicular to the paper surface of FIG. 10) referred to as "width direction" and, L ₁₂ and orthogonal to the width direction of the axis (the left and right direction in Fig. 3) The front end face 12e faces the side (the left side of Fig. 3) is referred to as the "front side" or the "front side", and the opposite side (the right side of Fig. 3) is referred to as the "rear side" and "rear side". Or "back". Further, the hand side (upper side in FIG. 2) of the endoscope device 1 is appropriately referred to as "upper side", and the insertion front end side (lower side in FIG. 2) is appropriately referred to as "lower side". 3, the observation field of view of the endoscope 10 relative to the axis L ₁₂ 1r obliquely downward and forward. The tube 12a outside the insertion portion 12 is made of metal and has a straight cylindrical shape. The front edge (lower end edge) of the outer tube 12a is inclined to constitute the outer edge of the inclined front end surface 12e. The image transport mechanism 14 and the illumination light transport mechanism 15 are housed in the outer tube 12a. As shown in FIG. 10, the image transfer mechanism 14 includes an image transfer tube 14a and a counter lens 14b. Based image transfer tube 14a made of metal, along the axis L ₁₂ extends straight. A counter lens 14b is provided at an end portion (lower end portion) of the image transfer tube 14a. The front end surface of the objective lens 14b and the front edge of the image transfer tube 14a are inclined to constitute a central portion of the inclined front end surface 12e. Although the detailed illustration is omitted, a relay lens or the like is appropriately housed inside the image transfer tube 14a. The hand-held side end portion (upper end portion) of the image transfer mechanism 14 is optically connected to the eyepiece portion 13. As shown in FIG. 1, a camera head 7 is connected to the eyepiece portion 13. A monitor 8 is connected to the camera head 7. The image field of the observation field 1r is transmitted from the objective lens 14b to the image transfer tube 14a, sent to the eyepiece unit 13, and signal-converted to the camera head 7 and the monitor 8. Thereby, the image of the observation field of view 1r is displayed on the monitor 8. As shown in FIG. 9, the illuminating light transmission mechanism 15 is composed of a bundle of optical fibers, and is housed in an annular space between the tube 12a and the image transfer tube 14a outside the insertion portion 12. As shown in FIG. 10, the front end portion (lower end portion) of the illumination light transmission mechanism 15 is curved so as to face the oblique direction of the observation visual field 1r. An annular portion between the outer edge and the central portion of the inclined front end surface 12e is formed by the front end surface (lower end surface) of the illumination light transmitting mechanism 15. Although the detailed illustration is omitted, the hand-held side (upper end portion) of the illumination light transmitting mechanism 15 is optically connected to the optical connector 16 of the hand-held portion 11. An illumination source 6 is connected to the optical connector 16. The illumination light from the illumination light source 6 is transmitted through the illumination light transmission mechanism 15, and is obliquely irradiated toward the observation visual field 1r from the front end of the illumination light transmission mechanism 15. Thereby, the observation field of view 1r can be illuminated. As shown in FIG. 4, the retractor 20 includes a tubular portion 22 and a supported portion 25. The tubular portion 22 is formed of a metal tube and extends straight along the axis L ₁₂ . As shown enlarged in Fig. 9, the tubular portion 22 includes a large-diameter cylinder portion 22a and a small-diameter cylinder portion 22b. The small-diameter cylinder portion 22b has a smaller diameter portion 22a. By the unit portions 22a, 22b being integrally connected, the tubular portion 22 has a cross-sectional shape of a reduced diameter double circle. The small-diameter cylinder portion 22b protrudes toward the rear side (the right side in Fig. 9) of the large-diameter cylinder portion 22a in the circumferential direction, and is disposed over the entire length of the large-diameter cylinder portion 22a in the axial direction. The endoscope 10 is inserted into the small-diameter cylinder portion 22b of the tubular portion 22. The surgical instrument such as the forceps 2 is inserted into the large diameter tube portion 22a. As shown in FIG. 2, the supported portion 25 is provided on the outer periphery of the upper end of the tubular portion 22. The supported portion 25 is made of metal. The outer peripheral surface of the supported portion 25 is spherical. The tubular portion 22 penetrates the supported portion 25 up and down. The portion of the tubular portion 22 that is higher on the upper side than the supported portion 25 is shorter, and is longer than the portion on the lower side of the supported portion 25. As shown in FIG. 3, the holder 30 is disposed above the supported portion 25. The endoscope 10 is coupled to the retractor 20 via a holder 30. The holder 30 includes a holder body 30x and a locking member 34. The holder body 30x includes a horizontal clamping portion 31 and a vertical cylindrical portion 32 which are L-shaped when viewed from the side. The material of the holder body 30x is preferably a resin having a desired elasticity. As shown in FIGS. 2 and 3, the sandwiching portion 31 extends in the front-rear direction, and a pair of holding plates 31a and 31b are provided at the front end portion thereof. The holding plates 31a and 31b are opposed to each other in the width direction (left and right in FIG. 2), and protrude from the nip portion 31 toward the front (to the left in FIG. 3). A portion of the tubular portion 22 that is higher than the supported portion 25 is sandwiched between the holding plates 31a, 31b. A semicircular recess 31c into which the tubular portion 22 is fitted is formed on the surfaces of the holding plates 31a and 31b facing each other. The front end portions (the left end of FIG. 3) of the holding plates 31a and 31b are coupled to each other by the nip pin 35. A clamping button 33 is provided on the one-side holding plate 31b. The clamp button 33 is coupled to the clamp coupling pin 35 and is rotatable about the axis of the coupling pin 35 between the clamp position (the solid line in FIG. 3) and the release position (the two-point chain line in FIG. 3). Although the detailed illustration is omitted, a cam mechanism is provided at a connecting portion between the grip button 33 and the coupling pin 35. When the grip button 33 is rotated, the holding plates 31a and 31b are brought closer to each other and separated by the cam mechanism. By providing the grip button 33 at the gripping position (solid line in FIG. 3), the grip plates 31a, 31b approach and hold the tub portion 22. By providing the grip button 33 at the release position (the two-point chain line of Fig. 3), the holding plates 31a and 31b are separated from each other, and the tubular portion 22 can be attached and detached and separated. The columnar portion 32 is connected to the rear end portion (the right end portion of FIG. 3) of the nip portion 31. The columnar portion 32 protrudes upward from the rear end portion of the nip portion 31. The columnar portion 32 is staggered on the rear side of the retractor 20 (on the right side of FIG. 3). The endoscope 10 is detachably mounted and height-adjustable by the columnar portion 32. As shown in FIG. 6(a), the hand piece 11 of the endoscope 10 is fitted to the upper end portion of the columnar portion 32. The hanging portion 11v of the hand portion 11 is inserted into the vertical hole 32v of the columnar portion 32. The insertion portion 12 is disposed along the front side surface (the left side surface of the same figure) of the columnar portion 32. Further, the fastening structure of the columnar portion 32 and the endoscope 10 will be described. As shown in Fig. 6(a), on the back surface of the hand-held portion 11 of the endoscope 10, two (plural) locking recesses 11b and 11d are formed. The plurality of latching recesses 11b and 11d are disposed apart from each other in the up and down direction (the direction parallel to the axis L ₁₂ ). As shown in Fig. 8, the two side faces in the width direction (upper and lower in the same drawing) of the upper detent recessed portion 11b are inclined faces that extend toward the rear (the right side of the same figure). Although not shown in the drawings, the same applies to the lower detent recess 11d. As shown in FIG. 4 and FIG. 5( a ), the back portion of the columnar portion 32 has a housing recess 32b that opens rearward, and has a U-shaped cross section. The locking member 34 is housed in the housing recess 32b. As shown in Fig. 5 (a), the locking member 34 has a substantially "く"-shaped curved shape at the center portion when viewed from the side. The upper end portion of the locking member 34 protrudes above the columnar portion 32. A locking claw 34b is formed at an upper end portion of the locking member 34. As shown in Fig. 8, the two side faces in the width direction (upper and lower in the same drawing) of the locking claws 34b are inclined toward each other as they protrude forward (to the left of the same figure). The center portion of the locking member 34 is coupled to the columnar portion 32 via the fastening coupling pin 36. Further, the locking member 34 is rotatable (displaceable) between the fastening position (Fig. 6 (a)) and the buckle releasing position (Fig. 5 (a)) around the fastening coupling pin 36. As shown in Fig. 5 (a), the locking member 34 is released from the endoscope 10 when the release position is released. That is, the locking claws 34b are separated from the locking recesses 11b and 11d. As shown in FIGS. 6(a) to 6(b), the locking member 34 is engaged with the endoscope 10 at the fastening position. Specifically, the locking claws 34b are engaged with any one of the locking recesses 11b and 11d. As shown in Fig. 6 (a), in a state where the locking claws 34b are engaged with the upper locking recesses 11b, the front end portion (lower end portion) of the insertion portion 12 slightly protrudes from the front end portion of the retractor 20, thereby The sight glass 10 becomes a protruding position. As shown in FIG. 6(b), in a state where the locking claws 34b are engaged with the lower side locking recesses 11d, the front end portion of the insertion portion 12 slightly enters the inside of the retractor 20 from the front end portion of the retractor 20, Thereby, the endoscope 10 becomes a retracted position. The endoscope 10 can advance and retreat (adjustable position) in two stages along the axis L ₁₂ with respect to the retractor 20 by selecting the detent recesses 11b, 11d that buckle the detent pawls 34b. The height difference between the locking recesses 11b and 11d and the height difference between the retracted position and the protruding position are, for example, about several mm to several tens of mm. As shown in Fig. 5(a), the partition housing recess 32b in the back portion of the columnar portion 32 and the back wall 32w (fastening wall) of the vertical hole 32v are released in a cantilever shape and are elastically deformable. A wall protrusion 32d is formed on the back surface of the back wall 32w. On the other hand, a fastening projection 34d is formed at a central portion of the front surface of the locking member 34. As shown in Fig. 7, when the locking member 34 is at the locking position, the engaging projection 34d is pressed against the wall projection 32d from the front end side (the lower side in the same drawing). Further, the back wall 32w is elastically deformed in such a manner as to be inclined toward the front side. Thereby, the fastening member 34 of the fastening position is elastically engaged with the back wall 32w, and the elastic restoring force of the back wall 32w is reversed counterclockwise in FIG. 7 (the direction from the buckle releasing position toward the fastening position) Bullet pressure. As shown in FIG. 5(b), when the locking member 34 is located at the releasing position with respect to the locking recesses 11b and 11d, the engaging projection 34d is located above the wall projection 32d. The back wall 32w is not elastically deformed and is in a vertical neutral state. The elastic engagement of the buckle member 34 and the back wall 32w is released. As shown in FIGS. 2 and 3, the nozzle unit 40 is further held by the holder 30. The nozzle unit 40 includes a head 41 and nozzles 42, 43. The head portion 41 includes main bodies 41a and 2 (plural) pipe joints 41b and 41d, and is formed in a substantially T-shape in a front view. The material of the head portion 41 is preferably made of a metal such as stainless steel which is known to have a low influence on the living body. Further, as the material of the head portion 41, a resin can also be used. As shown in Fig. 2, a longitudinal groove 41c is formed in a central portion in the width direction of the front surface of the main body 41a. Grooves 41c along a longitudinal axis L ₁₂ extends straight. The main body 41a is detachably fixed to the front side portion of the columnar portion 32 of the holder 30 (the front side of the paper surface of Fig. 2). As shown in FIG. 6(a), the hand piece 11 of the endoscope 10 is covered on the upper side of the body 41a. The insertion portion 12 passes through the vertical groove 41c. The body 41a is sandwiched between the insertion portion 12 and the columnar portion 32. As shown in Fig. 2, the pipe joints 41b and 41d are provided on both sides of the upper side of the body 41a so as to protrude from each other. The cleaning liquid supply pipe 4b is connected to the endoscope cleaning pipe joint 41b. Although not shown in the drawings, the upstream end of the cleaning liquid supply pipe 4b is connected to the supply source of the cleaning liquid 4w. The cleaning solution 4w may be physiological saline or a liquid medicine or the like. An auxiliary pipe 4d is connected to the auxiliary pipe joint 41d. As shown in FIG. 4, two nozzles 42, 43 are connected to the main body 41a. The materials of the nozzles 42 and 43 are made of a metal tube such as stainless steel. As shown in Fig. 2, inside the body 41a, the upper end portion of the endoscope cleaning nozzle 42 is connected to the endoscope cleaning tube joint 41b. Further, the upper end portion of the auxiliary nozzle 43 is connected to the auxiliary pipe joint 41d. As shown in FIG. 4, the nozzles 42, 43 are arranged in the width direction, and extend straight from the main body 41a downward (in the direction of the insertion end) in parallel with the insertion portion 12. As shown in FIG. 9, the nozzles 42, 43 are inserted into the small-diameter cylinder portion 22b of the tubular portion 22 together with the insertion portion 12. In the small-diameter cylinder portion 22b, the nozzles 42, 43 are disposed on both sides in the width direction (upper and lower in the same drawing) and obliquely forward (to the left in the same figure) with respect to the insertion portion 12. The nozzles 42 and 43 are disposed at positions symmetrical with each other with respect to a center line extending through the insertion portion 12 in the front and rear (left and right of FIG. 9). As shown in FIG. 2, the front end (lower end portion) of the nozzles 42, 43 reaches the vicinity of the front end portion of the insertion portion 12. As shown in Fig. 6(a), at the above-mentioned protruding position, the front end portions of the nozzles 42, 43 slightly protrude from the front end portion of the retractor 20. As shown in Fig. 6(b), at the above-mentioned retracted position, the front ends of the nozzles 42, 43 are slightly caught inside the retractor 20. The nozzle unit 40 (cleaning mechanism) including the endoscope cleaning nozzle 42 has a cleaning function of the front end surface 12e. Specifically, as shown in FIG. 10, a front end member 45 (front end portion) is provided at the front end portion (lower end portion) of the endoscope cleaning nozzle 42. The front end portion 45 and the front end portion of the endoscope cleaning nozzle 42 protrude slightly toward the front end side (lower side) of the axis L _{12 from} the insertion portion 12. As shown in Fig. 9, the distal end member 45 is disposed on the side or oblique side (here, obliquely forward (lower left in the same figure)) in the width direction orthogonal to the oblique direction of the front end surface 12e of the insertion portion 12. As shown in Fig. 9, the front end member 45 and the front end surface of the endoscope cleaning nozzle 42 (the surface on the near side of the paper surface of the same figure) are closed. As shown in Fig. 10, two (plural) ejection holes 45a are formed in the side surface of the peripheral surface of the tip end member 45 toward the distal end surface 12e. The discharge hole 45a has a slit shape. The two discharge holes 45a (slit) are arranged up and down (in the axial direction of the nozzle 42). At least a portion of the ejection holes 45a is located further below the front end surface 12e. As shown in FIGS. 10 and 11, each of the discharge holes 45a extends obliquely in the oblique direction of the distal end surface 12e. That is, the discharge hole 45a is inclined upward as it goes toward the front side (the left side of FIG. 11). Further, as shown in FIG. 12 and FIG. 13, each of the discharge holes 45a is inclined upward from the front end 45 or from the inner circumference of the nozzle 42 toward the outer circumference (on the side of the hand portion 11). Further, the opening of the discharge hole 45a toward the inner peripheral surface of the tip end member 45 is small, and the opening of the discharge hole 45a toward the outer peripheral surface of the tip end member 45 is large. The discharge hole 45a expands as it goes from the inner circumference of the nozzle 42 toward the outer circumference. As shown in FIG. 2, the front end surface (lower end surface) of the auxiliary nozzle 43 is orthogonal to the axis of the nozzle 43. The front end opening of the nozzle 43 is directed straight downward (the front side of the paper of Fig. 9). The endoscope device 1 is supported by the flexible arm 5 in the following manner. As shown in FIG. 1, a connection support member 50 is attached to the front end of the flexible arm 5. The retractor 20 or the endoscope 10 is coupled via the joint support member 50 and is supported by the bendable arm 5. As shown in Fig. 14 (a), the connection supporting member 50 includes a pair of half side supports 51, 52, and a bolt and nut unit 54 (opening and closing mechanism). The first half-side support body 51 has a half-side holding portion 51c and a connecting plate portion 51d. The half-edge holding portion 51c is formed in a semi-arc shape. The connecting plate portion 51d extends rearward from the half-holding portion 51c (on the right side of FIG. 14(a)). As shown in FIG. 1, the end part of the connection board part 51d is connected to the flexible arm 5. As shown in Fig. 14 (a), the second half-side support body 52 has a half-side holding portion 52c and a tail plate portion 52d. The half-edge holding portion 52c is formed in a semi-arc shape. The tail plate portion 52d extends rearward from the half-holding portion 52c (on the right side of FIG. 14(a)). As shown in FIGS. 14(a) and 14(b), the end portions of the front side (the left side of FIG. 14) of the half-holding portions 51c and 52c are rotatably coupled to each other by the rotating shaft 53. The connecting plate portion 51d and the tail plate portion 52d are coupled to each other by a bolt and nut unit 54. The pair of half-side supports 51, 52 are closed to each other and are annularly closed. Hereinafter, a state in which the half-side supports 51 and 52 or the connection support member 50 are annularly closed is referred to as a “closed-loop state”. Hereinafter, unless otherwise specified, the connection support member 50 is in a closed loop state. As shown in Fig. 14 (a), the inner peripheral surface of the half-side supports 51, 52 constitutes a support seat surface 55. The inner peripheral surface of the half-side holding portion 51c is a half seat surface 55a (half of the support seat surface 55). The inner peripheral surface of the half-edge holding portion 52c is a half seat surface 55b (the other half of the seat surface 55 is supported). As shown in Fig. 15 (a), the support seat surface 55 has a concave spherical shape. The center of the concave spherical surface constituting the support seat surface 55 is located above the central portion in the thickness direction of the half-side supports 51 and 52 (upper and lower directions in Fig. 15(a)). The caliber of the lower peripheral edge 55d (insertion side peripheral edge) of the lower surface of the support surface 55 is smaller than the diameter of the upper peripheral end edge 55c (handhold side peripheral edge). As shown in FIGS. 14(a) and 14(b), the half-side supports 51 and 52 are relatively rotated by a slight angle about the rotation shaft 53 by the bolt nut 54. Thereby, the half-side supports 51 and 52 are slightly open and closed between the relaxed position (Fig. 14 (b)) and the closed position (Fig. 14 (a)) in the range of the closed loop state. By slightly opening and closing the half-side supports 51, 52, the concave spherical support seat surface 55 is slightly scaled. As shown in Fig. 14 (a) and Fig. 15 (a), when the position is in the closed position, the concave spherical supporting seat surface 55 is formed in a perfect circular shape, and the diameter and curvature of the concave spherical surface supporting seat surface 55 are concave and convex. The spherical outer peripheral surface of the support portion 25 has the same diameter and curvature. As shown in FIG. 6(a), when the connection supporting member 50 is in the closed position, the supported portion 25 is supported by the support seat surface 55, and is fastened by the half-side supports 51, 52. Thereby, the retractor 20 or the endoscope 10 is fixed to the connection support member 50. As shown in Fig. 15 (a), in the closed position, the caliber of the upper peripheral edge 55c and the lower peripheral edge 55d of the support seat surface 55 are smaller than the outer diameter of the spherical supported portion 25. The supported portion 25 cannot pass through the support surface 55 to the insertion distal end side (below the same figure), and cannot pass through the hand-held side (above the same figure), and the connection support member 50 cannot be attached or detached. Further, by supporting the spherical surface of the seat surface 55 and the supported portion 25, the endoscope 10 can be fixed not only in the vertical posture (Fig. 15 (a)) but also as shown in Figs. 1 and 15(b). The endoscope 10 is fixed in a posture inclined in any direction of the front, rear, left, and right. As shown in Fig. 14(b), when in the relaxed position, the support seat surface 55 is slightly expanded in diameter compared to the closed position, and the connection support member 50 is slightly expanded. Therefore, the fastening of the supported portion 25 is relaxed, and the supported portion 25 can be rotated in any direction in the support seat surface 55, and the retractor 20 or the endoscope 10 can be angled in any direction in all directions. Adjustment. As shown in Fig. 16 (a) and Fig. 16 (b), when the slack position is located, the diameter of the upper peripheral edge 55c of the support seat surface 55 is larger than the outer diameter of the supported portion 25, and the peripheral edge 55d of the lower side of the support surface 55 is supported. The diameter is smaller than the outer diameter of the supported portion 25. Therefore, as shown in FIG. 16(a), the supported portion 25 can pass through the upper peripheral edge 55c of the support seat surface 55 toward the hand-held side (above the same figure), and the retractor 20 can be detachably attached to the joint supporting member 50. On the other hand, as shown in Fig. 16 (b), the supported portion 25 cannot pass through the lower end edge 55d of the support seat surface 55 to the insertion distal end side (below the same figure). Not only in the closed position (Fig. 14 (a)), but also in the relaxed position (Fig. 14 (b)), the connecting plate portion 51d and the tail plate portion 52d are connected to each other by the bolt and nut unit 54, the half support body 51, 52 are in a closed loop state with each other. The detailed construction of the bolt and nut unit 54 described above is as follows. As shown in FIGS. 18(a) and 18(b), the bolt and nut unit 54 includes a nut 54a and a T-bolt 54b. The nut 54a is attached to the tail plate portion 52d. The nut 54a is rotatable about the axis of the nut 54a with respect to the tail plate portion 52d, and is non-movably engaged in the axial direction of the nut 54a (upper and lower in Fig. 18). The nut 54a is provided with an opening adjustment knob 54c. As shown in Fig. 17 (a), a long hole 51b is formed in a side portion of the connecting plate portion 51d. The long axis of the long hole 51b faces the front and rear directions of the connection support member 50 (left and right in Fig. 17(a)). A fitting recess 51f is formed on the upper and lower sides of the long hole 51b on the side surface of the connecting plate portion 51d. As shown in Fig. 18, the T-bolt 54b is inserted into the long hole 51b. The head 54e (lock knob) of the T-bolt 54b has a square shape. When the connection support member 50 is in the closed loop state, the longitudinal direction of the bolt head portion 54e faces the vertical direction and is orthogonal to the long axis of the long hole 51b. The bolt head 54e is fitted into the fitting recess 51f, so that the bolt 54b cannot be restrained by being rotated with respect to the coupling plate portion 51d. That is, the bolt head 54e is located at the locked position. In the long hole 51b, the bolt 54b is screwed into the nut 54a. A retaining ring 54f is formed at an end of the bolt 54b. On the other hand, a step 54d is formed inside the nut 54a. As shown in FIGS. 18 and 19, the nut 54a is relatively movable by a specific distance with respect to the bolt 54b in the axial direction of the nut 54a and the bolt 54b (above and below in FIGS. 18 and 19). Further, the nut 54a cannot be separated from the bolt 54b. As shown in Fig. 18, when the nut 54a is screwed into the end of the bolt 54b to the fastening side, the tail plate portion 52d is closest to the connecting plate portion 51d, and the half-side supports 51, 52 are in a closed position. As shown in Fig. 14 (b), a leaf spring 56 (opening biasing mechanism) is provided between the connecting plate portion 51d and the tail plate portion 52d. The leaf spring 56 biases the tail plate portion 52d toward the direction away from the connecting plate portion 51d (the side below the figure). When the nut 54a is loosened by the opening adjustment knob 54c, the half-side supports 51 and 52 are gradually expanded by the above-described spring pressure of the leaf spring 56, and the support seat surface 55 is gradually expanded. As shown in Fig. 19, when the nut 54a is released to the state of the end on the slack side, the tail plate portion 52d is slightly separated from the connecting plate portion 51d when the tail plate portion 52d is in the closed position, and the half-side supports 51, 52 are located at the relaxed position. As shown in Fig. 19, at this time, the buckle ring 54f is fastened to the step 54d. Therefore, the nut 54a cannot be loosened more. Therefore, the first half support 51 and the second half support 52 are prevented from opening each other beyond the relaxed position. The buckle ring 54f and the step 54d constitute a blocking portion that blocks the operation from the slack position and the open side by the opening degree adjustment knob 54c. Further, the bolt 54b, the long hole 51b, and the fitting recess 51f constitute a lock mechanism that locks the half-side supports 51, 52 in a closed loop state and can be unlocked. In other words, when the bolt head 54e is located at the lock position (the state in which the fitting recess 51f is fitted and the rotation is restrained), the bolt 54b cannot be separated from the first half support 51, and the half supports 51 and 52 are locked in the closed loop state. (Figure 17). The bolt head 54e is operable between the locked position and the unlocked position as described below. As shown in Fig. 20, when the nut 54a is in a state corresponding to the slack position, and the half-side supports 51 and 52 are in a state corresponding to the closed position, the bolt head 54e is pulled out from the fitting recess 51f to be rotated. constraint. Preferably, only when the nut 54a is in a state corresponding to the slack position, and the half-side supports 51 and 52 are in a closed state, the rotation constraint is released. As shown in Fig. 17 (b) and Fig. 21, when the bolt 54b is rotated by 90 from the angle of the lock position in the above-described rotation restraint release state, the longitudinal direction of the bolt head 54e coincides with the long axis direction of the long hole 51b. Thereby, as shown in FIG. 22, the bolt head 54e is unlocked, and the long hole 51b can be inserted and inserted. Further, the bolts 54b are released from the first half-side support body 51, and the half-side supports 51 and 52 of the bolt-and-nut unit 54 are released from each other. As a result, as shown in FIG. 23, the closed-loop state of the half-side supports 51 and 52 is released and opened and closed. That is, the half-side supports 51, 52 can be expanded more than the relaxed position. Of course, it can also be closed to the closed position. The endoscope device 1 is used, for example, in the following manner. A small hole is made at a specific position of the body of the patient 9. A dilator (not shown) is inserted into the hole, and then the retractor 20 is inserted into the outer periphery of the dilator to be inserted into the hole. Thereafter, the dilator is withdrawn. By forming the tubular portion 22 as a cross-section of a reduced diameter double circle formed by the large-diameter cylinder portion 22a and the small-diameter cylinder portion 22b, the tubular portion can be formed as compared with the entire circular portion 22 formed into a perfect circular cross section. 22 is formed into a small section. Assembly of the endoscopic device 1 can be performed prior to insertion of the retractor 20 into the body of the patient 9, or after insertion. At the time of assembly, the upper end portion of the retractor 20 is held by the grip portion 31, and the grip button 33 is set to the gripping position (the solid line in Fig. 3) from the release position (the two-point chain line in Fig. 3). Thereby, the retractor 20 can be coupled to the holder 30 in a one-touch manner. Moreover, the nozzle unit 40 and the endoscope 10 are attached to the columnar portion 32, and the fastening member 34 is set to the fastening position (Fig. 6(a)). Thereby, the endoscope 10 and the nozzle unit 40 can be coupled to the holder 30 in a one-touch manner. At this time, it is preferable that the endoscope 10 is placed at the retracted position by the buckle member 34 being fastened to the lower engagement recess 11d (FIG. 6(b)). In particular, when the endoscope device 1 is pre-assembled before the retractor 20 is inserted into the body of the patient 9, the endoscope 10 is preferably placed in the retracted position during the assembly phase. Thereby, the retractor 20 can be inserted into the body of the patient 9 while being observed by the endoscope 10. Further, when the insertion portion 12 is retracted into the tubular portion 22, when the retractor 20 is inserted, the front end portion of the insertion portion 12 can be prevented from hooking or stabbing the body tissue. By positioning the endoscope 10 at the retracted position, the nozzles 42 and 43 are also at the retracted position, and the front end (lower end) of the nozzles 42 and 43 is retracted into the tubular portion 22. Thereby, when the retractor 20 is inserted, the front end of the nozzles 42, 43 can be prevented from hooking or stabbing body tissues. Furthermore, the joint support member 50 is supported by the bendable arm 5, and the retractor 20 is supported by the joint support member 50. Further, the endoscope device 1 is supported by the flexible arm 5. Before the retractor 20 is inserted into the body of the patient 9, the connecting plate portion 51d may be coupled to the flexible arm 5 in advance, and the half-side supporting members 51, 52 are placed in the relaxed position, and the retractor 20 is inserted into the half-side from above. Support bodies 51, 52. As shown in Fig. 16 (b), since the diameter of the side peripheral edge 55c above the slack position is larger than the outer diameter of the supported portion 25, the supported portion 25 can be inserted into the support seat surface 55 from above to be positioned. As shown in Fig. 16 (b), since the diameter of the side peripheral edge 55d below the slack position is smaller than the outer diameter of the supported portion 25, the retractor 20 can be prevented from falling through the support seat surface 55. Further, since the half-side supports 51, 52 are only opened to the slack position in accordance with the operation of the opening degree adjustment knob 54c, it is possible to surely prevent the retractor 20 from falling through the support seat surface 55. The connection support member 50 may be attached to the supported portion 25 after the retractor 20 is inserted into the body of the patient 9. In this case, by releasing the closed-loop state of the connection supporting member 50 (FIG. 23), the half-side supports 51 and 52 are largely opened to each other, and the connection supporting member 50 can be fitted into the supported portion 25 from the side. Next, while the half-side supports 51 and 52 are closed, the bolts 54b are passed through the long holes 51b and rotated by 90° so that the bolt heads 54e are at the locked positions. Thereby, the half-side supports 51, 52 are locked in a closed loop state. Further, the retractor 20 is supported by the flexible arm 5 via the joint support member 50. Further, the endoscope device 1 is supported by the flexible arm 5. Next, the end portion (lower end portion) of the insertion portion 12 is slightly protruded from the tubular portion 22 by positioning the endoscope 10 at the protruding position (Fig. 6 (a)). Specifically, the locking claws 34b of the locking member 34 are removed from the lower side locking recess 11d of the endoscope 10, so that the endoscope 10 is slightly lowered, and thereafter, the locking claws 34b are fastened to the upper side. The recess 11b. When the locking claws 34b are removed from the lower locking recess 11d, the wall projections 32d are passed over the engaging projections 34d from the bottom to the top. When passed, the back wall 32w and the fastening member 34 are elastically deformed. Mainly the back wall 32w is elastically deformed. When the upper side of the engaging projection 34d is over (Fig. 5(b)), the back wall 32w and the locking member 34 are elastically restored, and the internal stress is substantially eliminated. When the locking claws 34b are fastened to the upper locking recesses 11b, the wall projections 32d are passed over the engaging projections 34d from the top to the bottom. When passed, the back wall 32w and the fastening member 34 are elastically deformed. Mainly the back wall 32w is elastically deformed in such a manner as to bend forward (Fig. 7). The deformation of the back wall 32w remains without being removed after passing over the fastening projection 34d. Therefore, the back wall 32w is elastically restored to the rear, and the engaging projection 34d is biased downward via the wall projection 32d. Thereby, a rotational moment is given to the buckle member 34, and the buckle member 34 is centered on the buckle connection pin 36, and the biasing force is rotated counterclockwise in FIG. By the rotation biasing, the locking claws 34b are strongly pressed into the locking recesses 11b. Further, as shown in Fig. 8, both side faces in the width direction (upper and lower in the same drawing) of the locking claws 34b are strongly pressed against both side faces in the width direction (upper and lower in the same drawing) of the locking recessed portion 11b. As a result, it is possible to prevent the endoscope 10 from being loosened with respect to the holder 30 in the front-rear direction (left and right in FIG. 3) and the width direction (left and right in FIG. 2). Further, similarly, when the locking claws 34b are fitted into the lower locking recesses 11d, the locking claws 34b can be strongly pressed by the elastic elastic pressure of the back wall 32w, and the endoscope 10 can be prevented from being loosened. Since the back wall 32w of the holder 30 is provided as a biasing mechanism of the buckle member 34, it is not necessary to use a dedicated spring such as a coil spring or a leaf spring. Therefore, the troublesome spring cleaning operation can be omitted, and the holder 30 and the like can be cleaned relatively easily. By positioning the endoscope 10 in the protruding position, the nozzles 42, 43 are also in the protruding position, slightly protruding from the tubular portion 22. Thereafter, the endoscopic surgery can be performed while observing the surgical field of view 9a with the endoscope 10. By the retractor 20, the cylindrical insertion space 20c of the endoscope 10 and the forceps 2 can be secured. The surgical field of view 9a is disposed deep in the cylindrical insertion space 20c. The pliers 2 are inserted into the large diameter cylindrical portion 22a. The forceps 2 can be easily operated by setting the large diameter cylindrical portion 22a to a larger diameter of the smaller diameter cylindrical portion 22b. In the small-diameter cylindrical portion 22b disposed oblique endoscope 10, so that viewing angle relative to the axis L ₁₂ is inclined toward the front. Thereby, the surgical field of view 9a around the front end of the forceps 2 can be taken into the field of view of the endoscope 10, and the surgical field of view 9a can be surely observed. By arranging the nozzles 42 and 43 on the side or the oblique side in the width direction of the distal end surface 12e, it is possible to prevent the nozzles 42 and 43 from entering the observation visual field 1r. According to the endoscope device 1, the angle of the endoscope 10 can be adjusted in all directions. In other words, the opening adjustment knob 54c sets the connection support member 50 to a state in which the looser position is more closed and the closed position is slightly slack. Thereby, as shown in FIGS. 1 and 15(b), the supported portion 25 is rotatably supported in the support seat surface 55, and the retractor 20 or the endoscope 10 can be freely adjusted. That is, it can be tilted or rotated in all directions of forward, backward, left and right. Thereby, the operability of the endoscope 10 can be improved, and the degree of freedom of surgery under the endoscope can be improved. By closing the joint supporting member 50 more loosely, the diameter of the upper peripheral edge 55c becomes smaller than the outer diameter of the supported portion 25. Thereby, the spherical support portion 25 can be supported so as not to fall downward from the support seat surface 55, and it is not possible to draw upward from the support seat surface 55. When the connection support member 50 is placed in the closed position by the opening degree adjustment knob 54c, the supported portion 25 is fastened by the half-side supports 51, 52. Thereby, the angle of the retractor 20 or the endoscope 10 can be fixed. According to the endoscope device 1, during the operation, the distal end surface 12e can be cleaned while the endoscope 10 is inserted into the body of the patient 9. For example, when the objective lens 14b is dirty and it is difficult to view the surgical field of view 9a, the cleaning liquid 4w is introduced into the cleaning nozzle 42 from the tube 4b via the tube joint 41b. The cleaning liquid 4w flows down to the front end of the cleaning nozzle 42, and is then ejected from the upper and lower rows of ejection holes 45a. As shown by the arrowed line in Fig. 13, the discharge direction of the cleaning liquid 4w is matched with the slit shape and orientation of the discharge hole 45a, and is inclined obliquely rearward from the front end member 45. In other words, the cleaning liquid 4w is obliquely ejected from the side of the front end surface 12e and obliquely forward, and is slightly inclined downward from the front end surface 12e (front end side) toward the front end surface 12e. Further, as shown by the arrowed line in Fig. 11, the slit shape of the discharge cleaning liquid 4w and the discharge hole 45a is expanded in a planar shape or radially. The width direction orthogonal to the discharge direction of the discharge cleaning liquid 4w (the arrangement direction of the plurality of arrow lines 4w in Fig. 11) is inclined upward as it goes toward the front side (the left side in Fig. 11). That is, the discharge cleaning liquid 4w is inclined to expand in the oblique direction of the front end surface 12e. Thereby, the cleaning liquid 4w can be sprayed without any deviation in the front end surface 12e before the inclination. Further, by placing the discharge holes 45a in the upper and lower rows, two upper and lower discharge streams can be formed (FIG. 13). Thereby, even if the endoscope device 1 has a manufacturing error or an assembly error, the cleaning liquid 4w can surely come into contact with the front end surface 12e, and the front end surface 12e can be surely cleaned. Thereby, even if the front end surface 12e can be easily cleaned during the operation, it is not necessary to take out the endoscope 10 for cleaning, and the procedure of reinstalling is omitted. It is also not necessary to insert a cleaning catheter into the passage of the endoscope 10 for each cleaning. According to the endoscope device 1, the surgical field of view 9a can be infused by another nozzle 43. That is, the perfusion liquid of the other path is introduced into the nozzle 43 from the tube 4d via the pipe joint 41d. The perfusate is ejected straight downward from the opening of the front end (lower end) of the nozzle 43. Instead of the surgical field perfusion, the auxiliary nozzle 43 can also be used as a drainage passage. The washing liquid and other unnecessary substances after use may also be discharged from the surgical field 9a through the nozzle 43. After the end of the procedure, the endoscopic device 1 is withdrawn from the body of the patient 9. When the retractor 20 is removed from the connection support member 50, the connection support member 50 is set to the slack position by the opening degree adjustment knob 54c. Thereby, the supported portion 25 can be pulled upward from the upper peripheral edge 55c, and the retractor 20 can be separated from the connection supporting member 50. As described above, even if it is provided in the slack position, the supported portion 25 does not fall downward from the lower peripheral edge 55d, and the retractor 20 can be prevented from falling. If the joint supporting member 50 is to be opened beyond the slack position, it is necessary to perform an operation different from the case where the half-side supports 51, 52 are opened and closed between the slack position and the closed position. Therefore, even if the operator inadvertently, it is possible to surely prevent the joint supporting member 50 from opening beyond the relaxed position. That is, as shown in FIG. 20, when the nut 54a is loosened to the slack position, the connecting plate portion 51d and the tail plate portion 52d are brought closer to the position corresponding to the closed position against the leaf spring 56. Then, the bolt head portion 54e is disengaged from the fitting recess 51f. Therefore, the rotation constraint on the bolt 54b is released. As shown in FIGS. 17 and 21, by rotating the bolt 54b by 90 degrees, the longitudinal direction of the bolt head 54e coincides with the long axis of the long hole 51b (the left and right of FIG. 21(b)). Thereby, as shown in FIG. 22, the bolt 54b can be removed to the tail plate portion 52d side through the long hole 51b. As a result, as shown in FIG. 23, the closed-loop state of the connection support member 50 can be released, and the connection plate portion 51d and the tail plate portion 52d can be separated, and the connection support member 50 can be greatly expanded. The components of the endoscope device 1 can be discarded, that is, discarded once, or can be sufficiently cleaned before being used. The connection support member 50 can be easily cleaned or disassembled by being expandable (Fig. 23). The present invention is not limited to the above embodiments, and various changes can be made without departing from the spirit and scope of the invention. For example, the cross-sectional shape of the tubular portion 22 is not limited to the reduced-diameter double circle of the above embodiment, and may be a perfect circular shape or an elliptical shape or an oblong shape. As the biasing mechanism of the buckle member 34, a dedicated coil spring or a leaf spring may be used instead of the elastic restoring force of the fastening wall 32w. Only one of the locking recesses 11b and 11d may be formed in the hand-held portion 11, and three or more of them may be formed. The endoscope 10 may be of three or more phase adjustment section ₁₂ to the position of the retractor 20 along the axis L. The endoscope 10 is movable relative to the retractor 20 along axis L ₁₂ continuously adjusts the position. The number of the ejection holes 45a is not limited to two, and may be three or more, or only one. The structure of the slit-shaped ejection hole 45a of the endoscope cleaning nozzle 42 is not limited to the rigid endoscope for joint of the above-described embodiment, and can be applied to various endoscopes as long as the squint endoscope is inclined at the front end surface of the insertion portion. It can also be applied to a flexible endoscope with a flexible insertion portion. From the viewpoint of improving the degree of freedom in adjusting the angle of the retractor 20 or the endoscope 10, the endoscope device is provided with a spherical joint structure of the spherical supported portion 25 and the concave spherical support surface 55, and the cleaning mechanism is provided. 40. The biasing mechanism of the locking member 34 and the height (position) adjusting mechanism of the endoscope 10 may be omitted or may be changed to other configurations. [Industrial Applicability] The present invention is applicable to an endoscope for treating a joint disease such as a herniated disc or a spinal canal stenosis.

1‧‧‧Endoscope device

1r‧‧‧Viewing

2‧‧‧Pliers (surgical instruments)

4b‧‧‧Endoscope cleaning fluid supply tube

4w‧‧‧cleaning solution

5‧‧‧Flexible arm (support mechanism)

6‧‧‧Light source

7‧‧‧Camera head

8‧‧‧Monitor

9‧‧‧ patients

9a‧‧‧Surgery vision

10‧‧‧Endoscope

11‧‧‧Handheld Department

11b‧‧‧Upper side detent recess

11d‧‧‧Bottom side detent recess

11v‧‧‧hanging protrusion

12‧‧‧Insert Department

12a‧‧‧External management

12e‧‧‧ front face

13‧‧‧ Eyepieces Department

14b‧‧‧object lens

16‧‧‧ optical connectors

20‧‧‧Retractor

20c‧‧‧Cylinder insertion space

22‧‧‧ Tube

22a‧‧‧ Large diameter section

22b‧‧‧ small diameter tube section

25‧‧‧Supported Department

30‧‧‧Retainer

30x‧‧‧Retainer body

31‧‧‧Clamping Department

31a, 31b‧‧‧ clamping plate

31c‧‧‧ semicircular recess

32‧‧‧ Column

32b‧‧‧ Storage recess

32w‧‧‧Back wall (fastening wall)

32d‧‧‧ wall protrusion

32v‧‧‧Vertical holes

32w‧‧‧back wall

33‧‧‧Clamp button

34‧‧‧Blocking components

34b‧‧‧ buckle claw

34d‧‧‧Snap protrusion

35‧‧‧Links

36‧‧‧Deduction of the pin

40‧‧‧Nozzle unit (cleaning mechanism)

41‧‧‧ head

41a‧‧‧ Ontology

41b‧‧‧Endoscope cleaning pipe joint

41c‧‧‧Longitudinal slot

41d‧‧‧ pipe joint

42‧‧‧Endoscope cleaning nozzle

43‧‧‧Auxiliary nozzle

45‧‧‧Front end piece (front end)

45a‧‧‧Spray hole

50‧‧‧Link support components

51‧‧‧1st half support

51b‧‧‧ long hole

51c‧‧‧Half-holding department

51d‧‧‧Link Board

51f‧‧‧ fitting recess

52‧‧‧2nd half support

52c‧‧‧Half-holding department

52d‧‧‧ tail plate

53‧‧‧Rotary axis

54‧‧‧Bolt and nut unit (opening and closing mechanism)

54a‧‧‧Nuts

54b‧‧‧T-bolt

54e‧‧‧Bolt head (lock knob)

54c‧‧‧ opening adjustment knob

54d‧‧ ‧ step (opening block)

54f‧‧‧ buckle ring (opening block)

55‧‧‧Support seat

55a‧‧‧Half seat (half of concave spherical support seat)

55b‧‧‧Half-side seat (the remaining half of the concave spherical support seat)

55c‧‧‧ upper peripheral edge (handheld side peripheral edge)

55d‧‧‧lower peripheral edge (insertion side peripheral edge)

56‧‧‧ leaf spring (open side elastic mechanism)

L ₁₂ ‧‧‧ axis

Vb‧‧‧ Round

Fig. 1 is a side view schematically showing a state in which an endoscope apparatus according to an embodiment of the present invention is used. Fig. 2 is a front view of the above endoscope device. Figure 3 is a side view of the above endoscope device. Fig. 4 is an exploded perspective view of the above endoscope device. Fig. 5 (a) is a side view showing the hand-held side portion (upper side portion) of the endoscope device with the locking member at the buckle releasing position and taking a part of the cross section; Fig. 5 (b) is a view of Fig. 5 (a) An enlarged cross-sectional view of the round portion Vb. Figure 6 (a) shows a cross-sectional side view of the endoscope device with the locking member in the detent position and the endoscope in the protruding position; Figure 6 (b) shows the locking member in the detent position and The endoscope is located at the retracted position to display a cross-sectional side view of the above-described endoscope device. Fig. 7 is a side elevational cross-sectional view showing a portion of the endoscope device of Fig. 6(a) in an enlarged manner. Figure 8 is a plan sectional view taken along line VIII-VIII of Figure 7. Fig. 9 is a bottom plan view, taken along line IX-IX of Fig. 3, showing an enlarged front end portion of the above-described endoscope device. Figure 10 is a cross-sectional view of the front end portion of the above-described endoscope device taken along the line X-X of Figure 9. Fig. 11 is a view showing the arrow of the front end portion of the endoscope cleaning nozzle 42 of the above-described endoscope device taken along line X-X of Fig. 9. Fig. 12 is a view showing the arrow portion of the front end portion of the endoscope cleaning nozzle 42 taken along line XII-XII of Fig. 11; Figure 13 is a cross-sectional view taken along line XIII-XIII of Figure 11 . Fig. 14 (a) is a plan view showing the connection supporting member of the above-described endoscope device taken along the line XIVa-XIVa of Fig. 3 in a closed position. Fig. 14 (b) is a plan view showing the connection supporting member in a relaxed position. Fig. 15 (a) is a front view of the arrow which is rotated by 90 degrees along the XVa-XVa line of Fig. 14(a) in a state where the connection supporting member is placed at the closed position and the retractor is set to be vertical. Fig. 15 (b) is a cross-sectional view showing the connecting support member in a closed position and the retractor in a tilted state. Fig. 16 (a) is a cross-sectional view showing the connection supporting member in a relaxed position and being taken out into a supported portion; Fig. 16 (b) is a view in which the connecting support member is placed at a slack position and the supported portion is supported. The seat is positioned in a state before the cross-sectional view. Fig. 17 (a) is a partial side view showing a part of the joint supporting member of the bolt head (locking knob) of the bolt and nut unit in the locked position along the line XVIIa-XVIIa of Fig. 14 (a); Fig. 17 (b) is released The locked position shows the side view of the bolt head. Figure 18 (a) is a cross-sectional view of the bolt-and-nut unit (opening and closing mechanism) when the connecting support member of the line XVIIIa-XVIIIa of Figure 14 (a) is in the closed position; Figure 18 (b) is along the same figure (a) Cross-sectional view of the bolt and nut unit of the XVIIIb-XVIIIb wire. Figure 19 (a) is a cross-sectional view of the bolt-and-nut unit along the XIXa-XIXa line of Figure 14 (b) in the relaxed position; Figure 19 (b) is along the line XIXb-XIXb of Figure (a) A cross-sectional view of the bolt and nut unit. Fig. 20 (a) is a cross-sectional view showing the first stage of the unlocking operation of the bolt and nut unit; Fig. 20 (b) is a cross-sectional view taken along line XX-XXb of Fig. (a). Fig. 21 (a) is a cross-sectional view showing the second stage of the unlocking operation of the bolt and nut unit; Fig. 21 (b) is a cross-sectional view taken along the line XXI-XXIb of Fig. (a). Fig. 22 (a) is a cross-sectional view showing the third stage of the unlocking operation of the bolt and nut unit; Fig. 22 (b) is a cross-sectional view taken along the line XXII-XXIIb of Fig. (a). Fig. 23 is a plan view showing the connection supporting member in a state in which the closed loop state is released.

Claims (8)

An endoscope device characterized in that a cylindrical insertion space is secured in the body, and a surgical field of view deep in the cylindrical insertion space is observed, and includes: an endoscope; a retractor; and a connection supporting member The retractor is connected to the support mechanism, and the retractor includes a tubular portion through which the endoscope and the surgical instrument are inserted, and a supported portion provided on the outer circumference of the tubular portion. The outer peripheral surface of the portion is spherical, and the connecting support member has a concave seating surface that receives the concave portion of the supported portion. The endoscope device of claim 1, wherein the supporting seat surface is oriented toward the insertion side peripheral end edge of the insertion end side of the endoscope, and is smaller than the hand side peripheral end of the supporting seat surface facing the hand side of the endoscope. The caliber. The endoscope device of claim 1 or 2, wherein the connection supporting member comprises: a first half support having a half of the support seat surface; and a second half support having the other half of the support seat And an opening and closing mechanism that opens and closes the first half support and the second half support so as to extend the support surface. The endoscope device of claim 3, wherein the opening and closing mechanism comprises: an opening adjustment knob between the relaxed position at which the retractor is detachable and the closed position at which the retractor is fixed, and the first half The support body and the second half support body are opened and closed to each other; and the blocking portion is opened to prevent the operation from the slack position and the open side by the opening degree adjustment knob, and in the slack position, the support seat surface should be The diameter of the peripheral end edge of the hand-held side facing the hand-held side of the endoscope is larger than the outer diameter of the supported portion, and the diameter of the insertion side of the support seat surface toward the insertion front end side of the endoscope is smaller than the above-mentioned supported portion. path. The endoscope device of claim 4, wherein the opening and closing mechanism further comprises a locking knob operable between a locked position and an unlocked position, wherein the locking knob is located at the locking position, the first half support and the The second half support bodies are locked to each other in a closed loop state including the slack position and the closed position. When the lock knob is located at the unlock position, the first half support and the second half support are released from the closed loop state. Open and close freely. The endoscope device of claim 1 or 2, further comprising a holder for holding the endoscope between the protruding position and the retracted position in an axial direction of the tubular portion with respect to the retractor adjustment position In the protruding position, the front end of the insertion portion of the endoscope protrudes from the front end of the retractor, and the front end of the insertion portion retreats to the inside of the retractor at the retracted position. The endoscope device of claim 1 or 2, further comprising a holder, wherein the endoscope is detachably held by the retractor, the holder having: a holder body having a fastening wall; a stopping member that is displaceably provided with respect to the holder body between a locking position that is fastened to the endoscope and a buckled release position that is released, and a locking member of the fastening position The fastening wall is elastically engaged with the fastening wall, and the elastic restoring force of the fastening wall is biased from the buckle release position toward the fastening position, and the elastic engagement is released at the buckle release position. The endoscope device of claim 1 or 2, wherein the tubular portion comprises a large-diameter cylinder portion and a small-diameter cylinder portion integrally connected to the large-diameter cylinder portion and having a large diameter portion, wherein the inner mirror is The insertion portion is inserted into the small diameter cylinder portion.