WO2002032296A1

WO2002032296A1 - Endoscope attachment and endoscope

Info

Publication number: WO2002032296A1
Application number: PCT/JP2001/009247
Authority: WO
Inventors: Ryoji Hattori
Original assignee: Ryoji Hattori
Priority date: 2000-10-20
Filing date: 2001-10-22
Publication date: 2002-04-25
Also published as: AU2002210916A1; JP2002125921A

Abstract

An endoscope attachment, comprising a tubular sucking device (4) detachably put onto the observation head part of an inspection tube and used stationarily, a plurality of sucking and blowing openings (9) provided in the side faces of the tubular sucking device, and an air delivery and discharge pipe (5) for the sucking operation, sucking release operation, and blowing operation of the sucking and blowing openings; an endoscope, wherein the portion thereof corresponding to the attachment is formed integrally with the tip part of the inspection tube of the endoscope.

Description

Endoscope accessories and endoscopes

Technical field

The present invention relates to an endoscope for the intestinal tract from the rectum to the sigmoid colon, the descending colon, the transverse colon, and the ascending colon, and more particularly to an accident during insertion into the intestinal tract and a patient's pain.

The present invention relates to an endoscope and an endoscope accessory that can be reduced. Endoscope of the present invention

Mirrors and endoscope accessories are also useful for small intestine endoscopes.

Technology background

An endoscope for a long and complex intestinal tract that includes the free intestine, such as the sigmoid colon and the transverse colon, which are anatomically mobile and highly extensible, and the fixed intestine, such as the ascending colon and the descending colon, which do not move much. In order to perform various other medical procedures such as inserting the endoscope's sight tube deep into the body for examination and performing other necessary medical procedures, advanced techniques and skills such as operation and observation of the endoscope are required. I need.

The free intestinal part is bent at the transition to the fixed intestine (ascending colon, descending colon) in order to bend and stretch the intestinal wall freely by pushing the sight tube. Curves are inevitably formed. There is a high risk of accidents such as breakage and breakage caused by the endoscope, which is a difficult point to prevent the invasion of the sight tube.

In general, the technique of endoscopic introduction is such that the practitioner looks at the observation head of the endoscope and checks the state of the lumen of the intestinal tract, while swinging the bendable section and operating the sight tube. A method in which both the forward and backward operations are performed together (hereinafter, referred to as the conventional method), that is, a method in which the user slightly climbs over the bend, decompresses the suction from the tip, draws the bend toward himself, and folds in. is there. However, this method tends to lose sense of direction while folding the meandering intestine, which is meandering with the mouse, up and down and up and down. In particular, in the case of prolonged colitis, even if the angle can be folded a long distance, if the angle is made a little obtuse, it will be easy to get out of the thrill, and it will take a long training time to master the shortening operation, and many case experiences are required. It was hot.

Moreover, such conventional methods have inefficient and irrational problems. For example, insufflation of the intestinal lumen when it is not visible may not always result in a desired endoscopic view. Rather, the diameter of the intestinal tract near the air supply port does not expand, and if the patient is in a left lateral position, the air supply flows upward and may go far in the direction of travel. As a result, the formation of the hairpin curve is further promoted, and the field of vision is rather lost, which is likely to cause difficulties in access. The subject often suffers from the extension of the intestinal wall, and it is safe and preferable to shorten the intestinal withdrawal operation performed by bending the bendable section. On the contrary, the work efficiency is poor on the deformable and elusive intestinal lining, and the orientation of the current position is easily lost. Moreover, due to the shortening, it is easy for the suction and decompression operation to be performed and the visual field to be blocked by the mucous membrane at the distal end of the visual tube is likely to be obstructed. If this is not possible, the mucosal tissue on the intestinal lining may be damaged. In particular, if the subject is suffering from prolonged colon disease, it takes more time and effort to process the hairpin curve, the burden on the subject is not small, and there is considerable experience in performing the operation of inserting the endoscope efficiently. The fact is that skill is required.

Therefore, there was a need for the development of a more efficient and more rational endoscope that requires less time for operation insertion.

The sight tube pushed into the free intestine physically has a strong tendency to always go straight and push the inner wall of the intestine like a rubber balloon wall. The sight tube can travel through the curved free intestine only by sliding on the gentle slope of the intestinal lining wall with the help of a lubricant such as jelly applied to the surface of the sight tube and mucus in the intestinal tract. Sight tube It is not easy to change the direction of travel no matter how the angle of entry is manipulated.

In other words, the conditions that enable the course of the sight tube to change are that the deflection due to the resistance to pressing against the hard tissue around the intestinal tract and the deflection due to the gravity applied to the tip of the sight tube are almost combined. The inventor's basic philosophy regarding the visual tube insertion operation is that the intestinal tract naturally bends as it bends.

Therefore, in order to solve the above-mentioned problems caused by the conventional method, the present inventor has sought to determine whether the property of the intestinal tract, which has been a bottleneck of the insertion operation, that is, the deformable easy-extensibility, can be used. It is thought that the intestinal tract deformation due to the above-mentioned bending of the tract and the deformation of the inner wall of the intestinal tract due to the suction operation from the side of the sight, which will be described later, that is, the phenomenon in which the inner wall of the intestinal tract is adsorbed and trapped around the insertion part of the sight tube by the above suction, may be used. However, as a result of producing a medium model of the movable space of the visual tube, I thought that there was no other way than to attract and capture the outer circumference of the tube.

As a result, a suction tool having a large number of suction holes is provided in a flexible portion on the outer side of the visual tube near the bendable portion so as to surround the same, and the inner end of the suction tube is connected to this suction tool. In addition, an endoscope (hereinafter referred to as an earlier application example) in which the other end of the suction tube extends along the flexible portion of the visual tube and is connected to an externally mounted suction pump device, It was provided and disclosed by the publication number W094 / 08966 (Japanese Patent Application No. 6-51-929).

The suction device of the above-mentioned prior application makes it possible to easily perform the insertion operation into the intestinal lumen without obstructing the visual field of the observation head, and the suction hole formed in the suction device applies suction. If the intestinal lumen from the proximal end of the visual tube insertion to the site where the suction device is located is equally depressurized to enable quick adsorption and capture, and if the visual tube is pulled in the captured state, the intestinal tract will be at hand. The intestinal tract, which is located in front of the observation head, is pulled back, and it is bent. Was gradually linearized.

This straightening makes it possible to correct and release loops and hairpin carps that occur in the free intestine quickly and skillfully, making it easier to secure the eyeway passage and transmitting the external force to the eyepiece. Thus, the insertion operation can be performed more easily and smoothly.

However, as disclosed in FIG. 5 (b) of the above-mentioned International Publication No. WO 94/10896, this prior application example discloses a suction device in a visual tube (in the publication, The bellows-like fold was not formed around the bendable portion (in the gazette, 1b) in the bending operation portion existing before 2).

Since the part where the bellows-like folded part is not formed is thus formed, it is easy to slip in this part, and it is easy to cause a phenomenon that the socks or slack comes off from the intestinal tract or the foot. Bending to the bent part formed on the inner wall of the intestinal tract. The operable part is caught or loose, and it becomes loose.This operation also requires advanced technology and skill, and these problems Improvement was urgently needed.

As described above, in the prior application, the bellows-like folded portion is provided around the bending operation portion (the reference numeral 1b) in the suction device (the reference numeral 2b in the publication). As a result, the long sight tube portion is pushed into the intestine as much as the stomach is not formed, and the inconvenience that the pain of the patient increases as much In addition, there is a structural defect that it is difficult to provide a suction tool because the mounting position of the suction tool is located at a distance from the tip by a small distance. The present invention solves the problem of easy occurrence, advanced technology, problems that still require skill, and other structural defects at once. SUMMARY OF THE INVENTION An object of the present invention is to provide a tubular suction device that is detachably mounted on an observation head of an optic tube without obstructing the field of view, and that a plurality of peripheral devices are provided on a side surface of the tubular suction device so as to face the intestinal wall. For the suction and blowout openings, suction operation, suction release operation and blowout operation can be selectively performed from outside the visual tube for these suction and blowout openings.

An object of the present invention is to provide an endoscope accessory having an air supply / exhaust pipe connected as possible.

Another object of the present invention is to provide a distal end portion of a visual tube having a bendable portion that can be bent and returned by an external operation, and an objective lens, a forceps hole, a ventilation portion, In a forward-looking endoscope with an observation head equipped with an optical part, a 冼诤 part, etc., the suction operation from outside, the suction release operation, and the blowing operation can be performed on the side of the observation head. An object of the present invention is to provide an endoscope having a large number of suction / blowout ports which can be provided. BRIEF DESCRIPTION OF THE FIGURES

! 5 Fig. 1 is a schematic diagram showing a suction tube attached to the tip of the visual tube.

FIG. 2 is a central partial cross-sectional view of FIG.

FIG. 3 is a cross-sectional view showing a state in which the intestinal tract is shortened by bending the operable portion and bending the intestinal wall by hooking the sight tube.

FIG. 4 is a perspective view showing the entire endoscope.

0 ′ FIG. 5 is an explanatory diagram showing a state when the visual tube reaches the transition between the sigmoid colon and the descending colon.

FIG. 6 is an explanatory view showing a state in which the sigmoid colon is folded.

FIG. 7 is an explanatory view showing a state where the observation head is inserted into the transverse colon. FIG. 8 is an explanatory view showing a state in which the transverse colon is folded.

FIG. 9 is an explanatory diagram showing a state where the observation head has reached the cecum.

Figure 10 (a) shows the sight tube inserted into the sigmoid colon and facing the anterior abdominal wall. FIG.

FIG. 10 (b) is a plan view of FIG. 10 (a).

FIG. 11 (a) is a front view showing a state where the visual tube or the left pelvic cavity has slipped through. FIG. 1 "1 (b) is a plan view of (b) FIG. 11 (a).

FIG. 12 (a) is a front view showing a state in which the visual tube has advanced to the transition part (S DJ).

FIG. 11 (b) is a plan view of FIG. 12 (a).

FIG. 13 (a) is a front view showing a state where a bellows-like fold of the S-shaped colon is formed.

FIG. 13 (b) is a plan view of FIG. 13 (a).

FIG. 14 (a) is a front view showing a state where the bendable section has been rotated 90 degrees in the left iliac fossa.

FIG. 14 (b) is a plan view of FIG. 14 (a).

FIG. 15 (a) is a front view showing a state where the lumen has begun to be seen by repeating subtle operations.

FIG. 15 (b) is a plan view of FIG. 15 (a).

Fig. 16 (a) is a front view showing a state in which the observation head has slipped over the transition part (S DJ) into the descending colon (D).

Figure 16 (b) is a plan view of Figure 6 (a).

FIG. 17 is a central partial sectional view corresponding to FIG. 2 of the endoscope of the present invention. BEST MODE FOR CARRYING OUT THE INVENTION

The accessory of the endoscope according to the present invention can be formed integrally with the endoscope so as not to be detachable without being separate from the endoscope, and the integral endoscope is also a detachable accessory that is detachable. In this case, substantially the same operation and effect as those of the endoscope provided with the lens can be obtained. According to the present invention, the observation head is inserted with the endoscope inserted to an appropriate position in the intestinal tract. By reducing the pressure in the intestinal tract by suction through a suction device provided on the outer periphery of the intestine, the intestinal tract is adsorbed and captured around the suction device, the bendable portion, and the insertion portion of the visual tube. The intestinal tract is folded by bending the operable part appropriately in the captured state, hooking the bent part on a hairpin curve, etc., and then pulling it.

5) After this folding, a small amount of water or air is supplied to eliminate the adsorption, and immediately after this elimination, the sight tube is inserted into the free intestine in such a way that the sight tube is quickly advanced while being appropriately rotated. Therefore, the operation, treatment, and observation are extremely easy as compared with the prior art as well as the prior application, so that the operation time can be greatly reduced and the burden on the patient can be significantly reduced. This will make a great contribution to solving many problems of physicians involved in digestive diseases.

Furthermore, in the endoscope of the present invention, since the suction port is provided around the observation head at the distal end of the viewing tube, the fine operation as described above can be performed without difficulty, which is suitable for eliminating accidents and mistakes. This is extremely effective in ensuring safety.

In addition, since the slightly curved shortest distance axis between the rectum and the SDJ could be realized by suction traction, this axis became an important anatomical index in the intestinal tract. It is very effective for orientation during operation without fluoroscopy. This or the value of simplifying scope operation will be highly appreciated by all operating physicians. In other words, it is completely different from a plane guide, and when guidance in a three-dimensional space is required, it is a common coordinate axis that can be relied upon at all.

In addition, during the operation of inserting the viewing tube, the suction device at the end of the viewing tube is subjected to gravity so that the bending of the viewing tube is likely to occur, so that the above-described shortest insertion can be labor-saving, shortened, and simplified. It is to be.

In addition, the attachment position of the suction tool, which is an accessory of the endoscope according to the present invention, is at the tip end, and can be attached by simple screwing or the like as in the embodiment. Compared to the earlier application where the suction device is attached at a position distant from It has the structural advantage of being easy and easy to install.

The present invention will be described in detail with reference to the drawings.

FIG. 1 to FIG. 4 show an endoscope equipped with the endoscope accessory of the present invention. Reference numeral〗 denotes a flexible viewing tube having a bending operable portion 2 at its distal end, which can be bent back by an external operation, and which can return the bending, and an objective lens on the distal end surface of the bending operable portion 2. 21, a forceps hole 22, a front air supply section 23, a light transmission section 24, and an observation head 3 provided with a washing section 25.

Reference numeral 4 denotes a cylindrical aluminum suction tool which is detachably mounted on the outer periphery of the observation head 3 and has a streamline shape for easy insertion and return. Reference numeral 5 denotes a suction pipe, one end of which is connected to the suction device 4 and the other end of which is connected to the suction pump device 6, and a Y-shaped branching device used for sending water or air at a location near the suction pump device 6. There are sixteen. Reference numeral 7 denotes a foot pedal switch provided on the suction pump device 6, and the pump device 6 is operated by the foot operation of the pedal switch 7. 8 is an operation unit of the endoscope main body.

As shown in FIG. 2, the suction tool 4 is screwed into a male screw 11 provided at the tip of the observation head 3 via a female screw 12 provided inside. Is mounted on the outer periphery of the front end of the head. The external shape of the suction tool 4 is a streamlined cylindrical shape with a narrowed tip and rear end, and a female screw 12 that is screwed to the male screw 11 is provided on the inner circumference of the tip. . The rear inclined surface 13 is provided with a number of suction ports 9 whose inner ends are opened on the inner peripheral surface of the cylindrical rest 14 and whose outer ends are opened diagonally rearward. The inner ends of 9 are connected to each other by an annular reservoir 10. In addition, the opening diameter of each suction box 9 is different so that the intestinal tract is sucked with the suction force averaged over the entire circumference.

The operation of the endoscope equipped with the suction tool 4 of the above embodiment will be described mainly with reference to FIGS.

First, the subject is placed in the left lateral position, and the sight tube 1 is inserted from the anus. Alternatively, advance while rotating counterclockwise and insert beyond the rectum into the sigmoid colon. The movement of the visual tube in the sigmoid colon is spontaneously guided.

That is, the distal end of the visual tube 1 is bent by the sacrum toward the anterior abdominal wall, curved along the resistance of the anterior abdominal wall and the gravitational force applied to the distal end, and proceeds along the left abdominal wall. In the direction of the left pelvic cavity, facing the entrance of the descending colon (D), ie, the transition (SDJ) between the sigmoid colon (S) and the descending colon (D). (See Figure 5).

After reaching this position, the pedal switch 7 (FIG. 4) is stepped on to operate the suction pump device 6 (FIG. 4), and suction is performed through the suction port 9 of the suction device 2. The lumen of the intestinal tract from the periphery of the suction device 4 to the rectum is decompressed, and the inner wall of the intestinal tract is adsorbed and captured over the inserted bendable section 2 and the entire outer periphery of the intestinal portion of the visual tube.

Subsequent to the adsorption and capture, the bendable section 1 is promptly bent by an external operation at a right angle or at an acute angle and hooked on the bent portion of the intestinal wall, and the sight tube 1 is pulled to the proximal side (outside) with the hooked state. I do. Then, the intestinal tract is pulled by the hooking and pulling, and is bent in the intestinal tract or in a bellows shape, and folded around the bendable portion 2 and around the intestinal part of the visual tube.

Further, when the sight tube 1 is towed, the curved loop-shaped tip is inserted into the left iliac cavity adjacent to the arcade of the internal iliac artery and vein (see FIG. 6). Here, the patient is carefully pushed into the descending colon (D) by performing the operations described in the anatomical details described below.

The sight tube entering the descending colon (D) in this way reaches the spleen curve approximately linearly going back through the intestinal lumen fixed to the retroperitoneal surface. At this position, perform bending operation of the bendable operation part 1 to search for the lumen of the transverse colon, confirm it in the endoscope field of view, advance the sight tube into the transverse colon through the splenic curve (See Figure 7). Here, suction is performed by the suction device 4 and the intestinal tract from the periphery of the suction device 4 to the rectum is sucked. The cavity is decompressed and the inner wall of the intestinal tract is bent to adsorb and capture the entire operable part 2 and the outer periphery of the visual tube part. Subsequent to the adsorption and capture, the bendable section 2 is promptly bent by an external operation at a right angle to a slight obtuse angle to be hooked on the bent portion of the intestinal wall, and the visual tube 1 is pulled to the proximal side. Then, by the hooking and towing, the intestinal tract is dragged by hand, shortening the transverse colon, and folded in a bellows-like manner. At this time, the bellows-like folding can be performed at the portion of the bendable portion 2.

Then, in the transverse colon, the patient slides through the optic tract using the resistance of the posterior abdominal wall, and in particular, in the case of an excessively long transverse colon, inserts while rotating the sight tube in a counterclockwise direction. To move forward. Eventually, a U-shaped hairpin curve is formed just before the hepatic curvature, and the endoscope field of vision is lost. In such a case, apply a counterclockwise rotation to the viewing tube and pull by suction and traction.

. Then, the U-shaped transverse colon is inverted to the inverted U-shape (see Fig. 8), and the hairpin curve is eliminated and the liver curve opens forward. At this position, the sight tube is sucked without being pushed in, and the sight tube 1 is pulled to orient the ascending colon in a direction in which it can be easily pushed in, and the bending operable portion 2 is turned forward and the suction tube is eliminated. Is inserted in small increments (at this time, it rotates clockwise due to the drag on the right abdominal wall) to reach the cecum. At this time, the visual tube assumes a figure 7 shape as shown in FIG.

When retracting the observation head 3 of the optic tract while performing return observation from the wrong location of the cecum, the short intestinal parts of the transverse colon and the S-shaped colon (S) are prevented from coming out at once. In order to perform this, suction and suction by the suction device 6 are appropriately used, and the necessary observation and medical treatment are performed while gradually retracting.

Next, anatomical details will be described with reference to FIGS. 10 (a) and (b) to 16 (a) and (b). In this section, we will explain how to reach the transverse colon, which is particularly difficult.

First, the sight tube 1, which was inserted from the anus, beyond the rectum, into the sigmoid colon, It is deflected by the sacrum and heads toward the anterior abdominal wall (see Fig. 10 (a) and (b)), curves along the left abdominal wall due to the resistance and gravity of the wall, and then moves along the left abdominal wall. It turns to the left pelvic cavity, passes through the left pelvic cavity (see Fig. 11 (a) and (b)), and then enters the descending colon (D), that is, the S-shaped colon (S) and descends Proceed to the junction (SDJ) with the colon (D) (see Figures 12 (a) and (b)). The sigmoid colon is a free intestine, so it grows inevitably when it is inserted. Therefore, the transition to the fixed intestine (SDJ) is reached with a steeply bent hairpin.

When this position is reached, the suction switch device 6 is operated by stepping on the pedal switch 7, and suction is performed from the suction device 2 provided in the bending operable portion 2. By this suction, the lumen of the intestinal tract from the periphery of the suction tool 4 to the rectum is decompressed, and the inner wall of the intestinal tract is adsorbed and captured over the entire outer periphery of the inserted operable portion 2 and the insertion portion of the flexible viewing tube. You.

Subsequent to the adsorption and capture, the bendable section 1 is quickly bent to a state close to a right angle for external operation (so-called UP angle operation angle of about 90 degrees) to bend the intestinal wall (so-called hairpin curve). With the wall open, pull the sight tube 1 toward the hand with the UP angle operation state. Then, the intestinal tract is dragged by the traction, and it is folded in a bellows shape and folded. Sharp hairpin bends disappear. At this time, a bellows-like fold is also formed around the bendable portion 2 (see FIGS. 13 (a) and 13 (b)). The inside of the bellows-like fold-forming portion is under negative pressure and does not stretch, facilitating the subsequent towing operation.

When the sight tube is pulled in this manner, the bending operable portion 2 which is in a state of a right angle or a little near an acute angle (about 80 degrees) is attached to the arc of the external iliac artery and vein. Locked into the cavity. This locking position is almost fixed, and for Japanese is 25 to 26 cm measured from the anus. Can be relatively easily secured. At this time, the free intestine is in the shortest state around the visual tube (25-26 cm tight ). This is an important three-dimensional coordinate axis in three-dimensional space.

Here, by rotating the viewing tube clockwise at the required angle (approximately 60 degrees) while maintaining the UP angle operation, the bending operable portion 2 is rotated in the left iliac cavity (FIG. 9 ( a) (see b)) and downward from upward. However, if you push it toward the SDJ here, it will move away from the SDJ at the curve of the sacrum. Pressing, adjusting the angle and putting it in and out loosely. When you push it in again, the intestine biologically adapts to the slight difference in angle between the descending colon (D) and the optic tract and slides in naturally. So-called twisting and sliding. At this time, the sigmoid colon is also maintained in its most shortened state, and acts favorably on the optic tract to smooth the slipping of the torsion (see Figs. 14 (a) and (b)). Adjust the scope angle so that it does not come off while pushing in and out of the fixed intestine with slight slight pulling in and out, ie, bending of the SDJ. In fact, the viewing tube and the axis of the descending colon have a slight angle difference. However, when the user adjusts the scope angle while performing the in-out movement, he slides in and pushes in (see Fig. 15 (a) and (b)). Then, the observation head 3 of the optic tract 1 is advanced and inserted, crosses the transition part (SDJ), reaches the center of the descending colon (D), and thereafter slides extremely smoothly to the upper end.

When this is confirmed, about 10 cc of water is sent from the suction tube 5 into the intestinal tract via the suction port 9 and flows into the SDJ, so that the lumen is clearly visible and the oil lubricity is improved. . At the same time, it helps to eliminate the adsorption function. Gently slide into and out of subtle movements and biological adaptations to the colon's optic tract to fit in.

The sight tube that has entered the descending colon (D) as a result of this indentation goes back approximately linearly through the intestinal lumen fixed to the posterior surface of the peritoneum by the subsequent pushing operation, and reaches the spleen curve. At this position, the bending operation is performed. After locating the lumen and confirming it in the endoscopic field of view, the sight tube is advanced into the transverse colon through the overturning curve as shown in FIGS. 7 and 16 (a) and (b).

As described above, suction is performed from the side via the suction tool 4 attached to the outer periphery of the intuition head 3, and the intestinal inner wall is adsorbed and captured around the introductory portion of the intestinal tract, and the sight tube is inserted while towing. As a result, the viewing tube can always be operated in a nearly linear state.

Therefore, as compared with the prior application, (〗) the external force applied from outside the operator's body to the tip of the observation head 3 of the visual tube is transmitted well, and (2) the operation is extremely easy and skillful. (3) For example, the time required to reach the cecum is extremely short compared to the time conventionally required. (4) The endoscope insertion operation can be performed safely without exerting extra pain or burden on the subject, and it has a remarkable effect. Incidentally, the intestinal wall is composed of four layers: the mucosal layer, the submucosal layer, the muscle layer, and the serosal layer, and the adsorbed layers are at most two layers, the mucosal layer and the submucosal layer. In other words, when the bendable portion is in a bent state, the inhalation of the intestinal mucosa is suppressed by suction by the suction hole of the suction device at the tip, horizontal movement is stopped, and human power applied to the visual tube or the entire intestinal tract is absorbed. It works effectively to reduce the length of the socks, and the phenomenon that the socks come loose and come off from the feet as described above does not occur. In addition, if the traction is performed while being bent, the muscle layer having the highest mechanical resistance is effectively folded by manual traction. In other words, mechanically, adsorption is mainly prevented by the parallel movement between the visual tube and mucous membrane, and human power acting near right angles is used to shorten the intestinal wall. In other words, since there is a suction hole around the observation head at the distal end of the viewing tube, it can be performed effectively.

FIG. 17 shows an endoscope in which a portion corresponding to an accessory consisting of the suction tool 4 and the suction tube 5 of the embodiment shown in FIGS. It is. The structure of the observation head 3 ′, the structure of the suction tube 5 ′ and the rear portion of the viewing tube 1 ′ are the same as those in the apparatus of the embodiment shown here. This endoscope is a separate suction tube. The operation and effect of the endoscope of FIG. 14 in which the suction tool 4 to which the drawing tube 5 is connected are detachably mounted are substantially the same as those of the endoscope of FIG. Di}

5 In Fig. 17, 1 'is the visual tube, 2' is the bendable section, 3 'is the head for inspection, 4' is the cylindrical suction tool, 5 'is the suction tube, 9' is the suction port, and 10 'Is a reservoir, 13' is an annular inclined surface, and 14 'is a swollen head corresponding to the tip end to which the cylindrical body 14 in the embodiment of FIGS. 1 to 4 is attached.

Fifteen

20

Claims

The scope of the claims

1. A cylindrical suction device that is detachably mounted on the observation head of the viewing tube without obstructing the field of view, and a plurality of suction and blowouts provided on the side of the cylindrical suction device so as to face the intestinal wall. Endoscope having an opening for air supply and a pipe for air supply and exhaust connected in such a way that suction operation, suction release operation and air blow operation can be selectively performed from the outside of the visual tube with respect to the suction and discharge openings. Accessories.

2. The distal end of the viewing tube has a bendable part that can be bent and returned by an external operation, and the distal end of the bendable part has an objective lens, a forceps hole, a vent, a light transmitter, a washing part, etc. In a forward-looking endoscope having an observation head provided with

Numerous suctions on the side of 10 that allow the user to selectively perform suction, release, and blowout operations from the outside. ■ Endoscope with blowout ports provided around it.

) Five