WO2011024901A1 - Dispositif d'aide à l'introduction d'un endoscope - Google Patents

Dispositif d'aide à l'introduction d'un endoscope Download PDF

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Publication number
WO2011024901A1
WO2011024901A1 PCT/JP2010/064492 JP2010064492W WO2011024901A1 WO 2011024901 A1 WO2011024901 A1 WO 2011024901A1 JP 2010064492 W JP2010064492 W JP 2010064492W WO 2011024901 A1 WO2011024901 A1 WO 2011024901A1
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WO
WIPO (PCT)
Prior art keywords
overtube
endoscope
inner cylinder
rear end
tip
Prior art date
Application number
PCT/JP2010/064492
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English (en)
Japanese (ja)
Inventor
清一 中島
大人 相馬
安晃 宮嵜
裕也 伊藤
裕太 青木
Original Assignee
国立大学法人大阪大学
株式会社トップ
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Application filed by 国立大学法人大阪大学, 株式会社トップ filed Critical 国立大学法人大阪大学
Publication of WO2011024901A1 publication Critical patent/WO2011024901A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion

Definitions

  • the present invention relates to an auxiliary tool used for inserting an endoscope into a body cavity.
  • an endoscope is inserted into a body cavity such as the mouth and vagina, the inner wall of the stomach and vagina is incised without incising the body surface as much as possible, and the endoscope is inserted into the affected area to treat the affected area.
  • the so-called NOTES (Natural Orifice Translumenal Endoscopic Surgery) procedure transluminal endoscopic surgery
  • NOTES procedure hardly incises the body surface, the burden on the patient is even smaller than incision surgery or conventional endoscopic surgery.
  • Patent Document 1 a flexible trocar sleeve and a flexible obturator inserted into the trocar sleeve (hereinafter referred to as an “inner cylinder”).
  • An instrument comprising: is disclosed.
  • Patent Document 1 discloses a means in which a cutting blade is provided at the distal end portion of the inner cylinder and a tissue (body cavity surface) is penetrated by the cutting blade as means for making a hole in the stomach wall.
  • the endoscope can be inserted into the inner cylinder, the tip of the inner cylinder is transparent, and the procedure is performed while observing the state of the surface of the body cavity through which a hole is made through a camera provided in the endoscope Is disclosed.
  • JP 2007-301364 A paragraphs 0040 to 0041, FIGS. 6A and 6B.
  • both the trocar sleeve and the inner cylinder are members having flexibility. Because it is formed, it is difficult for the surgeon's force to be transmitted to the tip, and there is a possibility that a hole cannot be made in the stomach wall as expected.
  • Patent Document 1 show an example in which a hole is provided at the tip of the inner cylinder.
  • the endoscope has a water supply function with this configuration, the cleaning liquid is supplied from the hole.
  • the treatment unit can be cleaned by sending it out.
  • some endoscopes do not have a water supply function, and in this case, the treatment section cannot be cleaned.
  • some endoscopes having a water supply function do not have a function of sucking a cleaning liquid. May interfere with visibility.
  • An object of the present invention is to improve an insertion assisting tool for an endoscope, and more specifically, in order to eliminate the inconvenience, when an endoscope is guided to the outside of a body cavity through an incision portion on the surface of the body cavity, the operator It is an object of the present invention to provide an insertion aid for an endoscope that can easily transmit the force of the endoscope.
  • Another object of the present invention is to provide an endoscope insertion aid that facilitates cleaning of the treatment section and suction of the cleaning liquid. Furthermore, another object of the present invention is to provide an endoscope insertion aid that can be held at a predetermined position without the assistance of an assistant.
  • an endoscope insertion aid is an aid used when an endoscope is inserted into a body through a body cavity, and is an endoscope having an objective lens at the tip.
  • An inner cylinder having an internal passage through which the inner cylinder can be inserted, and an overtube through which the inner cylinder can be inserted.
  • the overtube has flexibility and is curved in an arc shape in a side view.
  • the tip of the inner cylinder is tapered, and at least the front part of the objective lens is formed transparent, the objective lens A tip portion formed so that the surface of the body cavity can be visually observed, and when the inner cylinder is inserted into the overtube, the tip portion protrudes from a tip of the overtube and a rear end portion of the inner cylinder Projecting from a rear end portion of the overtube, the overtube is characterized in that it is deformed in a linear shape in a side view by the inner cylinder.
  • This insertion is a tapered shape provided at the distal end part of the inner cylinder in the insertion aid for endoscope of the present invention. This is done by extending the incision with the tip part.
  • the inner cylinder is formed of a hard member and linearly formed in a side view, the inner cylinder is inserted into the overtube.
  • the overtube is deformed linearly by the inner cylinder in a side view.
  • the operator can easily apply force when inserting the tip portion while expanding the incision portion, so that a smooth procedure can be performed.
  • an overtube is attached around the endoscope, only the endoscope is inserted into the body cavity, and then the overtube is inserted into the endoscope. It was the procedure of inserting it toward the body cavity along. At this time, the overtube is inserted into the body cavity while the outer tube slides on the outer peripheral surface of the endoscope that has been inserted first, but since the endoscope has already been inserted into the body cavity, the tip of the overtube is The overtube cannot be inserted with visual inspection. Therefore, in the conventional procedure, the surface of the body cavity is caught between the endoscope and the overtube, which may cause a burden on the patient.
  • the inner cylinder and the overtube can be inserted into the body cavity while the endoscope is mounted in the inner cylinder.
  • the tip portion at the tip of the inner cylinder is transparent, and the front can be seen with an endoscope attached inside. Therefore, according to the present invention, since the procedure can be performed while confirming the insertion state of the overtube with an endoscope, the surface of the body cavity can be prevented from being involved and a smooth procedure can be performed.
  • the inner cylinder is removed, the endoscope is inserted into the overtube, and the distal end portion of the endoscope is placed in the vicinity of the affected part that is the treatment portion together with the overtube. Move.
  • the overtube has flexibility and is formed in an arc shape, when moving the endoscope distal end or the overtube distal end, Arc-shaped bends can be used to avoid cape sacral angles or arteries or veins. Moreover, since the said overtube has flexibility, even if it is a case where it contacts a sacral cape angle etc., there will be little influence on those parts.
  • the tip portion is formed transparently at least in front of the objective lens of the endoscope, the situation around the tip portion can be viewed through the objective lens of the camera attached to the endoscope. Therefore, according to the endoscope insertion aid of the present invention, it is easy to find the incision portion provided on the body cavity surface by the tip portion of the inner cylinder and insert the tip of the tip portion into the incision portion. It becomes.
  • the tip portion is formed with a polygonal pyramid ridge line formed of a rod-shaped member, and includes an opening that communicates with the internal passage of the inner cylinder. It may be. According to the shape, when the incision portion provided on the surface of the body cavity is expanded and entered, the rod-shaped member has a stronger pressing force per unit area than the plate-shaped member, so that the procedure can be quickly performed. Can be done. Moreover, since it has the said opening part, an incision part can be confirmed with an endoscope directly.
  • the view of the endoscope may be hindered by bleeding from the incision, body fluid, etc.
  • the overtube may be provided with an auxiliary passage through which the liquid, gas, or treatment tool can be introduced into the body cavity along the axial direction thereof. preferable.
  • the outer peripheral surface of the overtube having a larger curvature radius that is, the outer curved surface is often in contact with the body cavity surface, and the body cavity surface is frequently pressed.
  • the outer peripheral surface on the side with a small radius of curvature that is, the surface curved inward, does not contact the body cavity surface so much, and even if it contacts, the body cavity surface is hardly pressed.
  • the auxiliary passage is an auxiliary tube provided on a surface on a side having a small curvature radius in a side view among the outer peripheral surfaces of the overtube. .
  • the auxiliary passage can be easily provided in the overtube, and the burden on the patient can be reduced as much as possible.
  • the endoscope further includes holding means that is held on the surface of the body cavity of the patient and holds the overtube, and the holding means is a cylindrical portion through which the overtube is inserted.
  • an attachment part that is attached to a patient and holds the cylindrical part, and the auxiliary tube from the surface of the overtube has a width equal to or larger than the width of the auxiliary tube on the inner peripheral surface of the cylindrical part.
  • a groove having a depth equal to or greater than the height of the cylindrical portion is provided, and the expansion and contraction can be held by pressing the overtube against the inner peripheral surface of the cylindrical portion on the inner peripheral surface of the cylindrical portion.
  • a free balloon is preferably provided.
  • the overtube is held by the holding means by inflating the balloon with the overtube inserted into the cylindrical portion of the holding means. For this reason, the position of the endoscope inserted into the overtube is also stabilized. Therefore, the operator can perform a procedure with the endoscope or the like being stable without holding the overtube or the endoscope by an assistant or the like.
  • the mounting part is made of cloth and is formed into a pants shape, and the cylindrical part is the mounting part.
  • the attachment part When attached to a patient, it may be attached to the attachment part so as to be placed in a front position of the vagina or anus.
  • the attachment of the tubular part to the patient is easy, and the position of the tubular part is stabilized even during attachment.
  • Various materials can be used for the pant-shaped mounting part as long as they are made of cloth, but a stretchable part such as a knit or non-woven fabric is preferable.
  • the mounting portion is formed of such a material, it can be adapted to many patients, and is preferable from the aspect of fixing the cylindrical portion.
  • the endoscope insertion assisting tool of the present invention further includes a deaeration prevention valve unit that is detachably attached to a rear end portion of the overtube, and the deaeration prevention valve unit is a traveling direction of the endoscope.
  • a valve body having a pair of inclined surfaces tapered toward the end and having a slit provided along the ridgeline of the tip, and a valve body side wall on both ends of the slit provided in the valve body It is preferable to include a deterring member that deters deformation.
  • valve body having a pair of tapered inclined surfaces has a resistance to pulling the endoscope back when the endoscope is pulled out due to friction with the endoscope surface when the endoscope is pulled out.
  • the valve member is prevented from being turned over by the restraining member, so that the resistance when the endoscope is pulled out from the overtube is smaller than that of the conventional one.
  • the deaeration prevention valve unit includes a ventilation valve that opens to an inner peripheral surface at a front position of the valve body and communicates the inside and the outside.
  • the tip portion may be provided with a spiral projection on the surface of the tip formed in the tapered shape. According to this configuration, the tip portion can easily spread the incision portion provided on the body cavity surface.
  • the auxiliary passage may be provided through the wall surface of the overtube. According to the said structure, since an auxiliary
  • the auxiliary passage may be provided on the inner surface of the overtube. Even with this configuration, the auxiliary passage does not contact the surface of the body cavity, so that it is possible to prevent the patient from being burdened by the contact.
  • a connector portion for coupling the rear end portion of the inner cylinder to the rear end portion of the overtube is provided. You may provide in the rear-end part of this inner cylinder, and the rear-end part of this overtube, respectively. According to this configuration, by connecting the rear end portion of the inner cylinder to the rear end portion of the overtube, the amount of protrusion of the tip portion from the tip of the overtube is kept constant, while the overtube of the overtube to the treatment portion is maintained. Insertion can be performed.
  • the deaeration prevention valve unit when the inner cylinder is inserted into the overtube, a connector portion for connecting the rear end portion of the inner cylinder to the rear end portion of the overtube is provided.
  • the deaeration prevention valve unit includes a connector portion connectable to a connector portion at a rear end portion of the overtube, and is provided at a rear end portion of the inner tube and a rear end portion of the overtube. Then, it may be detachably attached to the rear end of the overtube.
  • the connector portion at the rear end portion of the overtube can be used for both the connection with the rear end portion of the inner cylinder and the connection with the deaeration prevention valve unit.
  • a mark for confirming the bending direction of the overtube is provided on the surface of the rear end portion of the overtube on the side having a smaller curvature radius. It may be. According to the said structure, since an operator can confirm the curve direction of an overtube with a mark by hand, a procedure becomes easy.
  • the cleaning liquid is injected from one auxiliary passage, and the cleaning liquid after cleaning is sucked out from the other auxiliary passage.
  • the treatment portion may be cleaned by the endoscope. According to this configuration, even when the endoscope does not have a water supply function, the treatment section can be cleaned.
  • the ventilation valve and the auxiliary passage perform air supply through one of them, and suction through the other, so that the treatment section is operated by the endoscope. It may be possible to discharge smoke generated in According to this configuration, even when there is no ventilation channel in the endoscope, air is supplied from one of the ventilation valve or the auxiliary passage, and the gas is sucked from the other, which is generated in the treatment section. Smoke can be discharged to the outside.
  • a male connector is provided at one rear end of the auxiliary passage for injecting and sucking out the cleaning liquid
  • a female connector is provided at the other rear end. May be. According to this configuration, the cleaning liquid inlet and the suction port can be easily distinguished.
  • a plurality of the auxiliary passages are provided to supply gas into the body and to suck the gas from the body.
  • the overtube is integrally formed with a reinforcing core inside, and there is no reinforcing core near the tip of the overtube, You may make it soften compared with the part in which a reinforcing core material exists. According to the said structure, it can prevent that an excessive force is provided in a body cavity by the front-end
  • a stopcock for opening and closing the auxiliary passage is provided at a position exposed on the body surface side of the auxiliary passage. According to this configuration, by appropriately opening and closing the stopcock, the pressure inside the body can be easily controlled by the surgeon or assistant.
  • Explanatory drawing which shows an example of embodiment of the insertion assistance tool for endoscopes of this invention.
  • Explanatory perspective view which shows the state which inserted the endoscope in the inner cylinder in this embodiment.
  • Explanatory sectional drawing which shows the state of the front-end
  • Explanatory drawing which shows an example of the holder unit of this embodiment.
  • (A) is explanatory sectional drawing which shows the deaeration prevention unit of this embodiment
  • (b) is explanatory drawing which shows the support ring provided in the deaeration prevention unit.
  • Explanatory drawing which shows the front-end
  • Explanatory drawing which shows the holder unit of the other example of this embodiment.
  • Explanatory drawing which shows a mode that the three-way cock was connected to the auxiliary channel
  • the endoscope insertion aid 1 of this embodiment is mainly used for a transvaginal NOTES procedure in which a procedure is performed via the vagina, and is inserted into a body cavity (vagina) as shown in FIG.
  • the main body 21 is formed of a flexible synthetic resin tube, and a stainless steel reinforcing core member 22 is integrally formed therein to give a certain degree of rigidity.
  • the vicinity of the distal end portion of the main body 21 is in a state where there is no reinforcing core member 22 and is softer than a portion where the reinforcing core member 22 is present.
  • the shape of the overtube 20 is an arc shape that curves gently in a side view. Further, the outer diameter of the overtube 20 is formed to a thickness suitable for the transvaginal NOTES procedure. In the present embodiment, those having a diameter of about 2 cm to 6 cm are appropriately selected and used depending on the application location and the patient.
  • a pair of auxiliary tubes 23 and 24 are fixed to the surface of the overtube 20 having a smaller radius of curvature.
  • the auxiliary tubes 23 and 24 are flexible synthetic resin tubes, and the tip ends are inclined obliquely along the tip shape of the overtube 20, and the connectors 25 and 26 are provided at the rear ends. Is provided.
  • one connector 25 is a male connector and the other connector 26 is a female connector.
  • the auxiliary tubes 23 and 24 are fixed so that the distal end portion is located slightly rearward from the distal end portion of the overtube 20, and rearward along the surface of the overtube 20. It extends to the vicinity of the front end position of the connector portion 27 provided at the rear end portion of the overtube 20. Further, it is divided in the circumferential direction from the vicinity of the tip position of the connector portion 27 and extends to the opposite side of the overtube 20, and is separated from the overtube 20 and connected to the connectors 25 and 26.
  • the connector portion 27 is provided with an engagement groove 28 that engages with an engagement protrusion 34 provided on the connector portion 33 of the inner cylinder 30.
  • the connector portion 27 is provided with a display mark 29 on the surface of the overtube 20 on the side having a small curvature radius so that the bending direction of the overtube 20 can be confirmed at hand.
  • the inner cylinder 30 includes a cylindrical main body 31, a tip portion 32 provided at the front end portion of the main body 31, and a connector portion 33 provided at the rear end portion of the main body 31.
  • the main body 31 and the chip part 32 are formed of a transparent synthetic resin, and a polycarbonate resin is used in this embodiment. This polycarbonate resin is a relatively hard resin and can be bent somewhat, but is substantially rigid.
  • the inside of the main body 31 is an internal passage 31a through which the endoscope 60 is inserted (see FIG. 3).
  • the tip portion 32 has a substantially conical shape, and the tip portion is small and provided with a radius. Further, the rear end portion of the chip portion 32 is formed so as to have substantially the same size as the outer diameter of the main body 31.
  • the outer diameter of the inner cylinder 30 (main body 31) is slightly smaller than the inner diameter of the main body 21 of the overtube 20, and the inner cylinder 30 is inside the main body 21 of the overtube 20. Can be moved easily.
  • the gap between the surface of the inner cylinder 30 and the inner peripheral surface of the main body 21 of the overtube 20 is small, and the inner cylinder 30 and the overtube 20 are placed in the stomach via the patient's mouth and esophagus. It is formed so that the surface of the throat or esophagus is not pinched when inserted.
  • the connector portion 33 of the inner cylinder 30 is provided with an engagement protrusion 34, and is attached to the connector portion 27 of the overtube 20, and the engagement protrusion 34 is engaged with the engagement groove 28, so that the overtube 20 and the inner cylinder 30 can be connected to each other.
  • the endoscope 60 is inserted into the inside of the inner cylinder 30 up to the vicinity of the distal end portion, so that the endoscope 60 having a diameter generally used can be inserted into the inner passage 31a.
  • the outer diameter of the inner cylinder 30 has a plurality of types of thickness according to the inner diameter of the overtube 20, and is appropriately selected depending on the application location and the patient.
  • the endoscope insertion aid 1 of this embodiment includes a holder unit 40 shown in FIG. 4 and a deaeration prevention unit 50 shown in FIG. 5 in addition to the above configuration.
  • the holder unit 40 holds the overtube 20 and the endoscope 60 in a predetermined position at the time of surgery.
  • the holder unit 40 includes a flange portion 41 disposed in the vicinity of the opening of the patient's body cavity, a cylindrical portion 42 protruding from the flange portion 41 to one side, and a belt provided on the flange portion 41.
  • a fixing portion 43 and a polyurethane fixing belt 44 (mounting portion) are provided.
  • the cylindrical portion 42 is provided with a groove 42a formed in a shape in which the pair of auxiliary tubes 23 and 24 are accommodated, and a balloon 45 positioned on the opposite side of the groove 42a.
  • the inside of the balloon 45 communicates with the connection tube 46, and a connector 47 is attached to the distal end portion of the connection tube 46.
  • a syringe (not shown) having no injection needle can be connected to the connector 47, and air can be fed with the syringe to inflate the balloon 45. Further, a check valve (not shown) is provided inside the connector 47 so that air inside the balloon 45 does not leak outside even when the syringe is removed. When the air in the balloon 45 is evacuated, the air is evacuated by inserting a syringe into the connector 47 and pulling the plunger of the syringe.
  • the deaeration preventing unit 50 is made of rubber having a hole having a diameter smaller than the diameter of the endoscope at the center so that the endoscope 60 can be inserted into the main body 51.
  • a support ring 54 (suppressing member) mounted inside the deaeration prevention valve 53 and a spacer 55 for positioning and holding these members in the main body 51 are provided.
  • the deaeration preventing unit 50 is provided with a ventilation valve 57 that communicates the inside and the outside.
  • the ventilation valve 57 has a passage 57a formed therein, and in the deaeration prevention unit 50, an opening 57b is formed in front of the second deaeration prevention valve 53 (on the left side in FIG. 5A), and the communication between the passage 57a is blocked. And a switching valve 57c for switching between the two.
  • the first deaeration prevention valve 52 is formed in a ring shape that tapers in the traveling direction of the endoscope 60, and a radial protrusion 52a is formed on the surface thereof to reduce resistance when the endoscope 60 is inserted. Is provided.
  • the second deaeration prevention valve 53 is a valve formed in a mountain shape in a side view, and has a pair of inclined surfaces 53b provided with a ridge line 53a at the tip, and has a slit 53c provided along the ridge line 53a. is doing.
  • the slit 53c is closely closed by the pressure applied to the inclined surface 53b. Is prevented.
  • the support ring 54 is formed of a rigid synthetic resin, and is formed in a mountain shape in a side view in accordance with the shape of the side walls on both ends of the slit 53c of the second deaeration prevention valve 53. Has been.
  • the support ring 54 is provided with an engaging protrusion 54 a so as to be held by a spacer 55 mounted in the main body 51 of the deaeration preventing unit 50.
  • the deaeration prevention unit 50 is provided with a connector portion 56 that can be detachably attached to the connector portion 27 of the overtube 20.
  • the connector portion 56 is also provided with an engagement protrusion 56 a that can be engaged with the engagement groove 28 of the connector portion 27 of the overtube 20.
  • the endoscope insertion aid 1 of this embodiment will be described.
  • a method for using the inner cylinder 30 to spread the incision portion from the state where the incision portion for inserting the endoscope 60 is formed in the vagina wall near the affected area of the patient will be described.
  • the endoscope 60 used for the procedure is an endoscope that is generally widely used, and includes an objective lens 61 at the tip.
  • the endoscope 60 When the incision portion is pushed out by the inner cylinder 30, the endoscope 60 is inserted into the inner cylinder 30, and the distal end portion of the endoscope 60 is positioned near the rear end portion of the tip portion 32 as shown in FIG. Insert until The endoscope 60 is provided with an objective lens 61, and the objective lens 61 makes it possible to visually recognize what is in front of the tip portion 32.
  • the inner cylinder 30 and the endoscope 60 are inserted into the overtube 20, and the connector part 27 of the overtube 20 and the connector part 33 of the inner cylinder 30 are connected. .
  • the engagement protrusion 34 of the connector portion 33 is engaged with the engagement groove 28 of the connector portion 27.
  • the tip portion 32 of the inner cylinder 30 protrudes from the distal end portion of the overtube 20.
  • the overtube 20 is deformed when inserted into the flexible overtube 20 as shown in FIG. In a side view.
  • the holder unit 40 is fixed to the patient side.
  • the holder unit 40 is fixed such that the cylindrical portion 42 is positioned outside the patient with the flange portion 41 facing the patient, and the fixing belt 44 is wound around the patient's waist and thighs to fix the holder unit 40.
  • the balloon 45 is deflated.
  • the endoscope insertion aid 1 and the endoscope 60 set are inserted into the patient's body cavity through the cylindrical portion 42 of the holder unit 40.
  • the overtube 20 and the inner cylinder 30 can be inserted into the body cavity while visually confirming the inside of the body cavity with the objective lens 61 of the endoscope 60.
  • the insertion assisting tool 1 for endoscope inserts the operator's force when expanding the incision. It can be reliably transmitted to the part 32. Therefore, it is possible to quickly perform a procedure of expanding the incision provided on the surface of the body cavity.
  • the treatment section can be cleaned by the auxiliary tubes 23 and 24.
  • the treatment portion can be washed by injecting a cleaning solution such as physiological saline from one auxiliary tube 23 to wash the treatment portion, and sucking out the washing solution after washing from the other auxiliary tube 24.
  • the connectors 25 and 26 provided at the rear ends of the auxiliary tubes 23 and 24 are distinguished from male connectors and female connectors, so that it is easy to distinguish between injection and suction of the cleaning liquid.
  • the inner cylinder 30 is removed from the overtube 20 and the deaeration prevention unit 50 is attached to the connector portion 27 of the overtube 20. Then, the endoscope 60 is caused to enter the overtube 20 through the deaeration prevention unit 50. Then, while observing the state of the body with the endoscope 60, the tip of the overtube 20 is advanced to the vicinity of the affected part.
  • the venting valve 57 is provided in the deaeration preventing unit 50, and by connecting an automatic air feeding device to the venting valve 57, the body cavity is automatically maintained at a predetermined pressure. It is. Thereby, conventionally, air supply that has been manually performed from the air supply channel of the endoscope can be automatically performed via the overtube 20, and the labor of the operator is greatly reduced.
  • the surgeon pivots the overtube 20.
  • the positions of the overtube 20 and the distal end portion of the endoscope 60 are changed. Thereby, the surgeon can advance the tip of the overtube 20 to the vicinity of the affected part while avoiding the sacral cape angle of the patient.
  • the overtube 20 is curved in a circular arc shape, the operator can operate the direction of the tip of the overtube 20 in an arbitrary direction by rotating the connector portion 27. As a result, the range in which the endoscope 60 can enter is widened, so that a wide range of organs can be treated. In addition, since the operator can confirm the bending direction of the overtube 20 with the display mark 29, the procedure is facilitated.
  • the balloon 45 of the holder unit 40 is inflated to hold the overtube 20 in the holder unit 40.
  • the balloon 45 is inflated after the pair of auxiliary tubes 23 and 24 are positioned in the groove 42 a of the cylindrical portion 42.
  • auxiliary tubes 23 and 24 are provided, for example, in the case of a procedure using an electric scalpel, smoke or the like generated by using the electric scalpel can be discharged to the outside from the vicinity of the affected area.
  • the deaeration prevention unit 50 of the present embodiment has a support ring inside the second deaeration prevention valve 53. Since 54 is provided, when the endoscope 60 is pulled out, the second deaeration prevention valve 53 is not turned over and does not press the surface of the endoscope 60, so that the endoscope 60 can be pulled out easily.
  • auxiliary tubes 23 and 24 provided in the overtube 20 are two, it is good also as only one and it is good also as three or more multiple.
  • the auxiliary tubes 23 and 24 may be used to insert a treatment tool such as forceps in addition to injecting and suctioning the cleaning liquid.
  • auxiliary tubes 23 and 24 are provided in the outer peripheral surface of the overtube 20, as shown to Fig.7 (a), it is good also as the auxiliary channel
  • an auxiliary tube 23 b may be provided on the inner surface of the overtube 20.
  • the overtube 20 is not limited to the one having the reinforcing core material 22 and may be the one without the reinforcing core material 22 depending on the material.
  • the material of the inner cylinder 30 is not limited to polycarbonate as in the above embodiment, and an acrylic resin or other synthetic resin may be used.
  • the fixing belt 44 of the holder unit 40 can be made of any material such as silicone rubber or a hook-and-loop fastener other than the polyurethane belt as in the above embodiment.
  • each structure of the balloon 45 of the holder unit 40, the connection tube 46, and the connector 47 is applied to the mouthpiece conventionally used, and the overtube 20 and the inner cylinder 30 are taken from a patient's mouth. You may use for the procedure inserted in a stomach.
  • the overtube 20 and the inner cylinder 30 are inserted from the patient's mouth, treatment can be performed while confirming the situation with an endoscope.
  • the tip portion 32 of the inner cylinder 30 has a substantially conical shape, and the tip portion has a spherical shape.
  • the gap between the inner cylinder 30 and the overtube 20 is narrowed. For this reason, when passing through the throat, esophagus, or piriform fossa, the overtube 20 or the like can be inserted without damaging these portions, mucous membranes, and the like.
  • the tip portion 32 of the inner cylinder 30 has a substantially conical shape.
  • a configuration like the tip portion 32a may be used.
  • a spiral protrusion 35 is provided on the surface of the tip portion 32a. The protrusion 35 makes it easy for the tip portion 32a to spread the incision portion provided on the body cavity surface.
  • the tip 32b may be formed in a quadrangular pyramid shape with a rod-shaped member 36, and may be provided with an opening 37 that communicates with the inner passage 31a of the inner cylinder.
  • the rod-shaped member 36 may be formed into a triangular pyramid shape or another polygonal pyramid shape.
  • the incision portion provided on the surface of the body cavity is pushed and expanded by the tip portion 32b, the incision portion is directly viewed with the objective lens 61 of the endoscope 60 through the opening portion 37. Can do. Further, when the treatment instrument channel is provided in the endoscope 60, it is possible to perform treatment by extending the treatment instrument forward through the opening 37.
  • the holder unit 40 is fixed to the patient by the fixing belt 44.
  • the holder unit 40 may be configured as a holder unit 40a as shown in FIG.
  • the holder unit 40a uses a pant-shaped mounting portion 48 as a mounting portion.
  • the mounting portion 48 is formed using a knit material used for ordinary clothes.
  • the holder unit 40a has a cylindrical portion 42 having the same configuration as that of the above embodiment, and the shape of the flange portion 41a is different from that of the flange portion 40 of the above embodiment. Specifically, the flange portion 41a is curved along the shape of the mounting portion 48, and the belt fixing portion 43 as in the above embodiment is not provided. Since the other structure of the holder unit 40a is the same as the holder unit 40 of the said embodiment, the same code
  • the holder unit 40a having the above configuration is easy to be mounted on the patient because the mounting portion 48 is in a pants shape, and the flange portion 41a and the cylindrical portion 42 can be reliably positioned with respect to the patient.
  • a stopcock for opening and closing the flow to the auxiliary passage 24 may be provided at a location exposed on the body surface side of the auxiliary passage 24.
  • a stopcock for example, a three-way stopcock 80 that closes the connection port to which the handle 84 faces among the three connection ports 81 to 83 as shown in FIG. 9 can be used.
  • the auxiliary passage 24 is connected to the connection port 81 via the female connector 26.
  • Injection lines 85 and 86 for supplying air, cleaning liquid, and the like are connected to the connection ports 82 and 83, respectively.
  • connection to the auxiliary passage 24 from both the injection lines 85 and 86 can be blocked. Further, the direction of the handle 81 is directed to the connection port 82 or 83, so that the connection destination to the auxiliary passage 24 can be switched between the injection line 86 and the injection line 85.
  • the transvaginal NOTES procedure has been described as an example. However, this is a procedure for expanding an incision provided on the surface of the body cavity or providing an incision on the surface of the body cavity. As long as the procedure is performed using the formed instrument, the body cavity may be used for procedures such as the esophagus, rectum, and urethra.

Abstract

La présente invention concerne un dispositif d'aide à l'introduction d'un endoscope conçu pour permettre une introduction rapide d'un endoscope dans un site devant être traité, depuis une incision pratiquée à la surface d'une cavité de l'organisme, de façon à faciliter les choses pour le patient. Ledit dispositif d'aide à l'introduction d'un endoscope (1) comporte un surtube (20) qui est introduit dans une cavité de l'organisme (le vagin), un tube intérieur (30) qui est introduit à l'intérieur du surtube, un support (40) et une unité anti-fuites d'air (50). Le tube intérieur (30) présente une grande rigidité et lorsque le tube intérieur est introduit dans le surtube (20) qui est incurvé, cela entraîne une déformation du surtube qui devient rectiligne. Lorsque, à partir d'une incision pratiquée à la surface de la cavité de l'organisme, l'opérateur exerce une poussée pour introduire la partie terminale (32) au niveau de l'extrémité du tube intérieur (30), il peut facilement exercer une force sur ladite partie terminale.
PCT/JP2010/064492 2009-08-26 2010-08-26 Dispositif d'aide à l'introduction d'un endoscope WO2011024901A1 (fr)

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JP2009-195605 2009-08-26
JP2009195605 2009-08-26
JP2010096378A JP5521195B2 (ja) 2009-08-26 2010-04-19 内視鏡用挿入補助具
JP2010-096378 2010-04-19

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WO2011024901A1 true WO2011024901A1 (fr) 2011-03-03

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WO2017117312A3 (fr) * 2015-12-29 2017-08-10 CEEK Enterprises Manchon pouvant être introduit pour spéculum et son utilisation
CN107348933A (zh) * 2017-08-07 2017-11-17 何超 用于脑血肿钻孔引流手术内窥镜的辅助操作装置和内窥镜
CN112006729A (zh) * 2020-08-13 2020-12-01 山东省肿瘤防治研究院（山东省肿瘤医院） 一种软式内镜辅助器械专用外套管
US11147444B2 (en) 2015-12-29 2021-10-19 Ceek Women's Health, Inc. Speculum with secondary bills
USD986415S1 (en) 2020-09-11 2023-05-16 Ceek Women's Health, Inc. Speculum
US11931002B2 (en) 2015-12-29 2024-03-19 Ceek Women's Health, Inc. Sleeve for speculum and use thereof

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JP5637781B2 (ja) * 2010-08-30 2014-12-10 富士フイルム株式会社 ドレナージチューブ及びドレナージチューブ付内視鏡
WO2013094608A1 (fr) 2011-12-22 2013-06-27 オリンパスメディカルシステムズ株式会社 Raccord médical
WO2014156243A1 (fr) * 2013-03-29 2014-10-02 オリンパス株式会社 Dispositif de retenue d'un instrument médical flexible

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JP5245146B2 (ja) * 2006-11-21 2013-07-24 国立大学法人神戸大学 オーバーチューブ
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DE102007040358A1 (de) * 2007-08-27 2009-03-05 Technische Universität München Trokarrohr, Trokar, Obturator bzw. Rektoskop für die transluminale endoskopische Chirurgie über natürliche Körperöffnungen

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JPH03136630A (ja) * 1989-10-24 1991-06-11 Olympus Optical Co Ltd 内視鏡案内管
JP2007185495A (ja) * 2006-01-13 2007-07-26 Olympus Medical Systems Corp オーバーチューブ

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2017117312A3 (fr) * 2015-12-29 2017-08-10 CEEK Enterprises Manchon pouvant être introduit pour spéculum et son utilisation
US11147444B2 (en) 2015-12-29 2021-10-19 Ceek Women's Health, Inc. Speculum with secondary bills
US11896201B2 (en) 2015-12-29 2024-02-13 Ceek Women's Health, Inc. Insertable sleeve for speculum and use thereof
US11931002B2 (en) 2015-12-29 2024-03-19 Ceek Women's Health, Inc. Sleeve for speculum and use thereof
CN107348933A (zh) * 2017-08-07 2017-11-17 何超 用于脑血肿钻孔引流手术内窥镜的辅助操作装置和内窥镜
CN107348933B (zh) * 2017-08-07 2023-12-05 何超 用于脑血肿钻孔引流手术内窥镜的辅助操作装置和内窥镜
CN112006729A (zh) * 2020-08-13 2020-12-01 山东省肿瘤防治研究院（山东省肿瘤医院） 一种软式内镜辅助器械专用外套管
USD986415S1 (en) 2020-09-11 2023-05-16 Ceek Women's Health, Inc. Speculum

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