WO2013021710A1 - 内視鏡補助具及び内視鏡 - Google Patents
内視鏡補助具及び内視鏡 Download PDFInfo
- Publication number
- WO2013021710A1 WO2013021710A1 PCT/JP2012/063796 JP2012063796W WO2013021710A1 WO 2013021710 A1 WO2013021710 A1 WO 2013021710A1 JP 2012063796 W JP2012063796 W JP 2012063796W WO 2013021710 A1 WO2013021710 A1 WO 2013021710A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- hood
- distal end
- endoscope
- auxiliary tool
- cylindrical member
- Prior art date
Links
- 238000003780 insertion Methods 0.000 claims abstract description 103
- 230000037431 insertion Effects 0.000 claims abstract description 103
- 210000000078 claw Anatomy 0.000 claims description 10
- 230000003100 immobilizing effect Effects 0.000 abstract 3
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- 238000012986 modification Methods 0.000 description 15
- 230000002093 peripheral effect Effects 0.000 description 15
- 238000004040 coloring Methods 0.000 description 11
- 239000011347 resin Substances 0.000 description 6
- 229920005989 resin Polymers 0.000 description 6
- 210000001519 tissue Anatomy 0.000 description 6
- 238000010586 diagram Methods 0.000 description 5
- 239000000853 adhesive Substances 0.000 description 4
- 230000001070 adhesive effect Effects 0.000 description 4
- 229910001220 stainless steel Inorganic materials 0.000 description 4
- 239000010935 stainless steel Substances 0.000 description 4
- 229920001971 elastomer Polymers 0.000 description 3
- 238000005286 illumination Methods 0.000 description 3
- 238000000465 moulding Methods 0.000 description 3
- 210000004400 mucous membrane Anatomy 0.000 description 3
- 230000008901 benefit Effects 0.000 description 2
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- 239000000463 material Substances 0.000 description 2
- 230000007246 mechanism Effects 0.000 description 2
- 230000035515 penetration Effects 0.000 description 2
- 230000001105 regulatory effect Effects 0.000 description 2
- 239000004809 Teflon Substances 0.000 description 1
- 229920006362 Teflon® Polymers 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000000806 elastomer Substances 0.000 description 1
- 238000001839 endoscopy Methods 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 229920000515 polycarbonate Polymers 0.000 description 1
- 239000004417 polycarbonate Substances 0.000 description 1
- 229920002379 silicone rubber Polymers 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
- 238000004804 winding Methods 0.000 description 1
- 230000037303 wrinkles Effects 0.000 description 1
Images
Classifications
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00087—Tools
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00089—Hoods
-
- 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
- A61B1/00064—Constructional details of the endoscope body
- A61B1/00071—Insertion part of the endoscope body
- A61B1/0008—Insertion part of the endoscope body characterised by distal tip features
- A61B1/00096—Optical elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00131—Accessories for endoscopes
- A61B1/00133—Drive units for endoscopic tools inserted through or with the endoscope
-
- 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
- A61B1/0016—Holding or positioning arrangements using motor drive units
-
- 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
- A61B1/04—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 combined with photographic or television appliances
- A61B1/05—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 combined with photographic or television appliances characterised by the image sensor, e.g. camera, being in the distal end portion
-
- 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
- A61B1/06—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 with illuminating arrangements
- A61B1/0661—Endoscope light sources
- A61B1/0676—Endoscope light sources at distal tip of an endoscope
-
- 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
- A61B1/005—Flexible endoscopes
- A61B1/0051—Flexible endoscopes with controlled bending of insertion part
- A61B1/0052—Constructional details of control elements, e.g. handles
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
Definitions
- the present invention relates to an endoscope auxiliary tool and an endoscope, and more particularly, to an endoscope auxiliary tool and an endoscope having a movable member attached to a distal end portion of an endoscope insertion portion.
- the distal end portion of the endoscope insertion portion is It is common practice to observe the inside of a body by attaching a cylindrical endoscope hood. With this hood, a predetermined distance can be ensured between the distal end portion and the subject, so that good observation with an endoscope becomes possible.
- the hood itself must be made of a material that is somewhat rigid so that the hood can slide back and forth at the distal end of the endoscope insertion portion. The surgeon must carefully insert or bend the protruding hard hood so that it does not hit the living tissue, resulting in long endoscopy time. There is a problem.
- the endoscope having the biasing means for biasing the hood forward is used, even if the hood that is hard to a certain extent hits a living tissue such as a mucous membrane, the hood moves backward due to its elastic force. The impact when hitting the tissue can be reduced, but since the biasing means must be provided at the distal end, the diameter of the distal end of the endoscope insertion portion becomes large and the space for arranging the biasing means Is also necessary, and there is a problem that the hard end portion becomes long.
- the present invention provides an endoscope auxiliary tool that can reduce the impact when the hood hits a living tissue without increasing the outer diameter of the distal end portion of the endoscope insertion portion and without lengthening the distal end hard portion. And it aims at providing an endoscope.
- An endoscope auxiliary tool is provided at a distal end portion of a cylindrical member and an insertion portion of the endoscope, and holds the cylindrical member movably along the axial direction of the insertion portion.
- a fixing portion that fixes a return force generating member that generates a return force that returns the cylindrical member to the protruding state when the cylindrical member receives a force in a proximal direction;
- the endoscope of one embodiment of the present invention has the endoscope auxiliary tool of one embodiment of the present invention.
- FIG. 3 is a perspective view of the endoscope distal end portion 2A in a state where the hood unit 21 is mounted and the hood 31 which is a movable member does not protrude from the hood unit 21 according to the embodiment of the present invention. It is a perspective view of 2 A of endoscope front-end
- FIG. 3 is a perspective view of the endoscope distal end portion 2A in a state where the hood unit 21 is mounted and the hood 31 which is a movable member does not protrude from the hood unit 21 according to the embodiment of the present invention. It is a perspective view of 2 A of endoscope front-end
- FIG. 5 is a cross-sectional view of a cross section passing through the axis of the distal end hard portion 11 along the line VV in FIG. 2.
- FIG. 6 is a cross-sectional view of a cross section passing through the axis of the distal end hard portion 11 along the line VI-VI in FIG. 2. It is the side view seen from the front end side of hood cover unit 31A concerning an embodiment of the invention. It is a front view of hood cover unit 31A concerning an embodiment of the invention.
- FIG. 9 is a cross-sectional view seen from the direction of arrow A4 along the line IX-IX in FIG. FIG.
- FIG. 4 is a cross-sectional view of a cross section passing through the axis of the endoscope distal end portion 2A along the line VII-VII in FIG. It is sectional drawing of the wire fixing
- FIG. 14 is a partial cross-sectional view of the distal end portion 2A in the region including the coloring ring 94, taken along line XIV-XIV in FIG. It is a fragmentary sectional view of 2 A of front-end
- FIG. 1 is a configuration diagram showing a configuration of an endoscope according to the present embodiment.
- the endoscope 1 includes an elongated insertion portion 2 to be inserted into a site to be observed, an operation portion 3 connected to a proximal end portion of the insertion portion 2, and a universal cable extending from a side surface of the operation portion 3. 4.
- the elongated insertion portion 2 has a distal end hard portion 11 on the distal end side thereof, and a bending portion 12 as a movable portion that can be bent is continuously provided on the proximal end side of the distal end hard portion 11. Further, a long and flexible flexible tube portion 13 formed of a tubular member having a soft surface is continuously provided on the proximal end side of the curved portion 12.
- the operation unit 3 is arranged in the vicinity of the operation unit main body 14 constituting the operation gripping unit, the folding unit 15 connected to the proximal end side of the flexible tube unit 13 of the insertion unit 2, and the folding unit 15. And an opening 16 of the auxiliary tool insertion channel in the inserted portion 2.
- a treatment instrument insertion port for inserting the treatment instrument is also provided in the vicinity of the folding preventing portion 15.
- a plurality of bending operation knobs 17 for bending the bending portion 12 of the insertion portion 2 are rotatably disposed in the operation portion main body 14 and are operated by a user for air supply / water supply and the like. Class 18 etc. are provided.
- the bending operation knob 17 includes a UD bending operation knob for bending the bending portion 12 in the up-down direction and an RL bending operation knob for bending the bending portion 12 in the left-right direction. It is arranged.
- a hood unit 21 can be attached to the distal end of the insertion portion 2.
- a wire cable 22 is connected to the hood unit 21, and the wire cable 22 is inserted from the auxiliary tool insertion port at the distal end of the insertion portion 21, passed through the auxiliary tool insertion channel, and the opening 16. It is fixed by the wire fixing part 24 which protrudes from the wire and fixes the wire cable 22.
- the hood unit 21, the wire cable 22, and the wire fixing portion 24 constitute an endoscope auxiliary tool.
- a hood 31 that is a movable member is provided on the distal end side of the hood unit 21.
- FIG. 2 is a perspective view of the endoscope distal end portion 2A in a state in which the hood unit 21 is mounted and the hood 31 that is a movable member does not protrude from the hood unit 21.
- FIG. 3 is a perspective view of the endoscope distal end portion 2 ⁇ / b> A in a state where the hood 31 protrudes from the hood unit 21.
- the cylindrical hood unit 21 is attached to the endoscope distal end 2A.
- a hood 31 that can protrude in the distal direction is provided on the distal end side of the hood unit 21.
- the hood 31 is a member having a cylindrical shape, that is, a cylindrical member, and as indicated by an arrow A3 in FIG. 3, the distal end direction of the endoscope distal end portion 2A (in the direction of the axis AX of the endoscope distal end portion 2A ( It is configured to protrude forward).
- the wire cable 22 includes a tube 22a and a wire 23 inserted through the tube 22a, and is connected to a hood 31.
- the wire 23 is made of stainless steel, and the tube 22a is made of resin such as Teflon (registered trademark).
- Teflon registered trademark
- the hood 31 is projected in the distal direction (forward) of the endoscope distal end portion 2A along the axis AX direction of the endoscope distal end portion 2A.
- the hood 31 is retracted in the proximal direction (rearward) of the endoscope distal end portion 2A along the axis AX direction of the endoscope distal end portion 2A. Therefore, the hood 31 is a movable member that can project and retract along the axial direction of the insertion portion 2.
- the outer peripheral surface of the wire 23 is covered with a tube 22a in order to insulate the wire 23.
- wire fixing portion 24 is fixed to the opening 16 from the direction indicated by the arrow A2 in FIG.
- FIG. 4 is a perspective view of the wire fixing part 24 showing a state of being fixed to the opening 16.
- the wire fixing unit 24 includes two operation units 25 and 26 and a connection unit 27.
- the operation unit 25 is an operation unit for fixing the wire cable 22.
- the operation unit 26 is an operation member for fixing at a desired position when the wire cable 22 is moved in the front-rear direction.
- the connecting portion 27 has a mechanism for attaching and fixing the wire fixing portion 24 to the opening portion 16.
- the surgeon attaches the wire fixing portion 24 to the opening 16 by the connecting portion 27 and fixes it, and then passes the wire cable 22 through the wire insertion channel of the wire fixing portion 24. Then, the surgeon fixes the wire cable 22 with the operation unit 25 and moves the wire cable 22 back and forth in the axial direction to project and retract the hood 31 and maintain the projecting and retracting state with the operation unit 26. Can do.
- FIG. 5 is a cross-sectional view of a cross section passing through the axis of the hard tip portion 11 along the line VV in FIG. 6 is a cross-sectional view of a cross section passing through the axis of the hard tip portion 11 along the line VI-VI in FIG.
- the distal end hard portion 11 of the endoscope insertion portion 2 includes a hard member 51 made of stainless steel that incorporates an imaging element, an objective optical system, an illumination portion, and the like.
- the proximal end portion of the hard member 51 is fitted to the inner diameter portion of one bending piece 52 of the bending portion 12, and the distal end portion of the soft rubber sheath member 53 covering the bending piece 52 is It is fixed to the hard member 51.
- the thread winding portion 54 is an area where a thread is wound and an adhesive is applied thereon.
- the distal end surface of the hard member 51 is provided with an auxiliary instrument insertion channel 51a of the auxiliary instrument insertion channel along with an observation window, an illumination window, and an opening of the treatment instrument insertion channel.
- the wire cable 22 of the hood unit 21 is inserted from the auxiliary tool insertion port 51a.
- the hood unit 21 is attached to the distal end portion 2A of the endoscope insertion portion 2 so as to cover the hard member 51.
- the hole 51b connected to the treatment instrument insertion port 51a is formed in the hard member 51, and the wire cable 22 is inserted into the hole 51b.
- a stainless steel pipe 55 is press-fitted to the base end side of the hole 51b, and a channel tube 57 for forming the auxiliary tool insertion channel 56 is connected so as to cover the outer periphery of the base end side of the pipe 55. Yes.
- the resin channel tube 57 is fixed to the pipe 55 with an adhesive or the like.
- the wire cable 22 is inserted into the channel tube 57.
- the hood unit 21 includes a unit main body 41 that is a main body portion, a cylindrical hood 31 that is a movable member, and a hood cover 42 that is a cylindrical cover member.
- the unit main body 41 is a cylindrical member having a step portion between the distal end side portion and the proximal end side portion, and having an inner diameter of the distal end side portion larger than an inner diameter of the proximal end side portion.
- the unit main body 41 is made of an elastomer or the like.
- a hood cover 42 is inserted inside the cylindrical portion at the tip end portion of the unit main body 41 and fixed with an adhesive.
- the unit main body 41 is configured such that the distal end portion 2A of the endoscope insertion portion 2 is attached in close contact with the inside of the cylindrical portion of the base end side portion of the unit main body 41.
- a cylindrical hood cover 42 is provided on the inner diameter side of the front end portion of the unit main body 41, and a cylindrical hood 31 that is a movable member is inserted on the inner diameter side of the hood cover 42.
- the hood cover 42 is a holding unit that holds the hood 31 in a movable manner. Furthermore, the hood cover 42 is a member for regulating the movement of the hood 31 as will be described later.
- the hood 31 is attached to the hood cover 42 so as to protrude and retract in the axial direction of the endoscope distal end portion 2A.
- the hood 31 and the hood cover 42 are made of a resin such as polycarbonate.
- the hood 31 can be fitted into the hood cover 42 by pushing the hood 31 from the front end side of the hood cover 42.
- the fitted hood 31 is movable along the axial direction of the insertion portion 2. Therefore, the hood cover 42 is provided at the distal end portion 2A of the insertion portion 2 of the endoscope 1 and constitutes a holding portion that holds the hood 31 movably along the axial direction of the insertion portion 2.
- the hood unit 21 When the hood unit 21 is attached to the distal end portion 2A of the insertion portion 2, the inner peripheral surface of the unit main body 41 is in close contact with the outer peripheral surface of the endoscope distal end portion 2A.
- the distal end portion of the hood cover 42 projects forward by a distance d1 from the distal end surface of the hard member 51.
- the hood unit 21 is configured. That is, the hood cover 42 as a holding portion has a protruding portion that protrudes in the distal direction of the distal end portion 2A from the distal end surface of the distal end portion 2A.
- the movement of the hood 31 in the direction perpendicular to the axis of the distal end portion 2A is restricted by the protruding portion of the hood cover 42 even in front of the hard member 51, and rattling when the hood 31 protrudes and sinks is prevented. Is done.
- FIG. 7 to 9 are views for explaining the hood cover unit 31A in which the hood 31 is inserted into the hood cover 42 and the wire cable 22 is attached.
- FIG. 7 is a side view of the hood cover unit 31A as viewed from the front end side.
- FIG. 8 is a front view of the hood cover unit 31A.
- FIG. 9 is a sectional view taken along the line IX-IX in FIG. 8 as seen from the direction of the arrow A4.
- FIG. 10 is a cross-sectional view of a cross section passing through the axis of the endoscope distal end portion 2A along the line VII-VII in FIG. 3 in a state where the hood 31 protrudes from the endoscope distal end portion 2A.
- the cylindrical hood 31 has an inward flange portion on the tip side. Furthermore, as shown in FIGS. 5 and 7, the hood 31 has a protruding portion 61 protruding toward the inner diameter side at a part of the inward flange portion.
- the protruding portion 61 has a columnar boss 62 for fixing the tip end portion of the wire cable 22 inside the cylindrical portion of the hood 31.
- a hole 62 a into which the distal end portion of the wire 23 in the wire cable 22 is inserted is formed at the proximal end portion of the boss 62 that is a fixing portion.
- the boss 62 has a size that can enter the hole 51 b of the hard member 51.
- the pipe 63 is provided on the boss 62 by insert molding, and the wire 23 is inserted into the pipe 63 and fixed by an adhesive.
- a tube 22a covering the wire 23 is attached so as to cover the outer peripheral portion on the proximal end side of the pipe 63.
- the hood 31 is a cylindrical member, and the distal end side is a cylindrical portion, but the proximal end side has a plurality of extending portions extending in the proximal direction, and a claw portion 31a is provided in each extending portion. ing. As shown in FIGS. 5 and 8, when the hood 31 is inserted into the hood cover 42, the plurality of claws so as to enter the plurality of rectangular holes 42 a provided in the hood cover 42 along the axial direction. A portion 31a is provided.
- three holes 42 a are provided around the axis of the hood cover 42 at intervals of 120 degrees.
- the hood 31 is provided with three claw portions 31a protruding in the outer diameter direction.
- the cylindrical hood cover 42 is also provided with a plurality of (here, three) holes 42b to prevent the unit from being removed from the unit main body 41.
- the hood cover 42 has an outward flange portion 42c on the distal end side and an inward flange portion 42d on the proximal end side.
- the hood cover 42 has a tapered portion TP along the outer periphery of the tip portion, and the hood 31 further has a curved portion R along the outer periphery of the tip portion.
- the hood unit 21 is configured so that the tangent lines DT of the curved portion R of the hood 31 substantially coincide with each other. Thereby, smooth hitting to the mucous membrane or the like in the body of the hood 31 can be realized.
- a part of the proximal end surface of the hood 31 is a base of the hole 42a of the hood cover 42 as shown in FIGS.
- the movement of the hood 31 is stopped by coming into contact with the inner peripheral wall 42f on the end side.
- the hood cover 42 that is a holding portion has a movement restricting portion that restricts the movement of the insertion portion 2 of the hood 31 along the axial direction.
- the hood 31 has a plurality of claw portions 31a, and the plurality of claw portions 31a abut on the inner peripheral wall of the hole 42a that is a restricting portion, thereby along the axial direction of the insertion portion 2 of the hood 31. Restrict the movement.
- the central axis O of the hood cover unit 31A and the distal end portion of the wire 23 are It arrange
- FIG. 11 is a cross-sectional view of the wire fixing portion 24 in a state of being attached to the opening 16.
- the connecting portion 27 of the wire fixing portion 24 is attached and fixed to the opening portion 16.
- An operation unit 26 is connected to the connection unit 27.
- the operation unit 25 is connected to the operation unit 26 on the side opposite to the connection unit 27.
- the operation portions 25 and 26 and the connection portion 27 each have a cylindrical shape, and a wire insertion channel 28 through which the wire cable 22 is inserted is formed at the axial center of the operation portions 25 and 26 and the connection portion 27 that are connected.
- the wire cable 22 protrudes from the opening 16 and is inserted into the wire insertion channel 28.
- the operation unit 25 has a cylindrical handle 71 that is gripped by the operator and operated so as to be rotated about the axis.
- a gripping portion 71a having an unevenness on the outer peripheral portion is formed so that the operator can easily operate.
- An opening 71b having a large inner diameter is provided on the inner side of the distal end side of the resin handle 71, and a stainless steel cylindrical member 71c is provided on the inner side of the opening 71b, that is, the base end side.
- the cylindrical member 71c has an inward flange portion 71c1 on the proximal end side.
- An elastic member 71d made of silicon rubber or the like is provided inside the cylindrical member 71c.
- An inward flange portion 71d1 is formed on the proximal end side of the elastic member 71d.
- a screw portion (not shown) is provided on the inner peripheral surface on the tip end side of the opening 71b.
- the operation unit 26 is a cylindrical resin body 81, a stainless connecting member 82 provided inside the cylinder portion of the body 81, and an outer periphery of the body 81, and slides in the axial direction. And a handle 84 that is provided on the outer periphery of the slider member 83 and rotates about its axis.
- the connecting member 82 has a protruding portion 82a having an outward flange portion on the proximal end side, and the inward flange portion 71d1 of the elastic member 71d and the outward flange portion of the protruding portion 82a are engaged.
- a screw portion (not shown) is formed on the outer peripheral surface on the distal end side of the connecting member 82, and is screwed with the screw portion on the distal end side of the handle 71 in the screwing region scr.
- the connecting member 82 moves toward the proximal side relative to the cylindrical member 71c by the screwing region scr.
- the elastic member 71d is compressed by the inward flange portion 71c1 and the connecting member 82, and the elastic member 71d presses the wire cable 22 from the outer periphery while being in close contact with the wire cable 22.
- the wire cable 22 is fixed to the handle 71.
- the elastic member 71d is not compressed by the inward flange portion 71c1 and the connecting member 82, so that the wire cable 22 is not pressed by the elastic member 71d.
- the wire cable 22 Is not fixed to the handle 71.
- the connecting member 82 is connected to the slider member 83 by a fixing member 81b through a slit 81a formed in the main body 81. Therefore, when the connecting member 82 moves in the axial direction, the slider member 83 also moves in the same direction. Further, since the connecting member 82 connects the slider member 83 and the elastic member 71d, when the handle 71 moves in the axial direction, the slider member 83 also moves in the same direction and is fixed to the handle member 71. The cable 22 also moves in the same direction.
- the slider member 83 has a cylindrical cylindrical portion 83a and a plurality of extending portions 83b extending from the cylindrical portion 83a in the distal direction.
- a screw portion (not shown) is provided on a part of the outer peripheral surface of the plurality of extending portions 83b of the slider member 83, and the inner peripheral surface of the handle 84 corresponds to the screw portion of the extending portion 83b.
- a screw portion (not shown) to be screwed is provided.
- a tapered portion 83c is formed on the outer peripheral surface of the extending portion 83b.
- a ring-shaped protrusion 84a that protrudes in the inner diameter direction is provided at a position that contacts the tapered portion 83c of the extension portion 83b.
- the handle 84 When the handle 84 is rotated about its axis by screwing the screw portion of the extending portion 83 b and the screw portion of the handle 84, the handle 84 moves relative to the slider member 83 in the axial direction.
- the protruding portion 84a of the handle 84 presses the tapered portion 83a of the extending portion 83b, or the protruding portion 84a moves away from the tapered portion 83a.
- the handle 84 moves relative to the slider member 83 in the proximal direction, and the projection 84a presses the tapered portion 83a.
- the slider member 83 can be fixed to the main body 81.
- the handle 84 moves relative to the slider member 83 in the distal direction, and the protrusion 84a tapers.
- the slider member 83 can be movable in the axial direction with respect to the main body portion 81.
- the front end side of the main body 81 is fixed to the base end portion of the connection portion main body 27 a of the connection portion 27 via a fixing portion 81 b for connection to the connection portion 27.
- a rubber member is provided inside the distal end portion 27b of the connection portion main body 27a, and the distal end portion 27b is detachably connected to the metal base 16a of the opening portion 16.
- the wire cable 22 is inserted from the opening portion 27 c of the distal end portion 27 b of the connection portion 27.
- the operation of the endoscope auxiliary tool having the above-described configuration is as follows.
- the surgeon inserts the proximal end portion of the wire cable 22 connected to the hood unit 21 constituting the endoscope assisting tool from the assisting device insertion port 51a of the endoscope distal end portion 2A, and enters the assisting device insertion channel 56. And project from the opening 16.
- the operator attaches the wire fixing portion 24 to the opening 16 by the connecting portion 27 and fixes it, and then inserts the proximal end portion of the wire cable 22 from the opening 27b on the distal end side of the wire fixing portion 24 to 25 and 26 and the wire insertion channel 28 in the connection part 27 are inserted, and it protrudes from the opening of the base end part of the operation part 25.
- the handle 71 When the wire cable 22 is pulled and the hood 31 is sunk, that is, in the retracted state, the handle 71 is rotated around the axis to fix the wire cable 22 to the handle 71. At this time, the handle 84 is also rotated around the axis, and the wire cable 22 is fixed to the wire fixing portion 24.
- the handle 84 When using the hood 31, the handle 84 is rotated in the opposite direction around the axis so that the wire cable 22 is not fixed to the wire fixing portion 24, the handle 71 is pressed, and the wire cable 22 is pushed out in the distal direction. . As a result, the hood 31 connected to the distal end of the wire cable 22 protrudes from the endoscope distal end portion 2A.
- FIG. 12 is a schematic diagram for explaining the operation of the endoscope auxiliary tool.
- the handle 84 is pivoted in the axial direction to release the slider member 83 from being fixed to the main body portion 81.
- the handle 71 is moved to the distal end side, the wire cable 22 is pushed into the opening 16 by a predetermined amount, the handle 84 is rotated again in a predetermined direction, and the slider member 83 is fixed to the main body 81.
- the hood 31 connected to the distal end portion of the wire cable 22 protrudes from the distal end portion 2A.
- the protrusion amount d0 of the hood 31 is regulated by the hood cover 42, it does not exceed a predetermined amount. As described above, since the claw portion 31a of the hood 31 contacts the inner wall on the tip side of the hole portion 42a of the hood cover 42, the hood 31 does not protrude further forward.
- the pushing amount di of the wire cable 22 ensures the protruding amount d0 of the hood 31 and the wire cable 22 generates an elastic force even if the shapes of the bending portion 12 and the insertion portion 2 of the endoscope 1 change. It is set to be larger than the protruding amount d0 of the hood 31 so that it can be made.
- the wire cable 22 When the wire cable 22 is pushed in by the pushing amount di, the wire cable 22 is bent and bent in the channel tube 57 as shown in FIG.
- the pushing amount di of the wire cable 22 in the wire fixing portion 24 is 10 mm or more.
- the wire cable 22 is fixed at the wire fixing portion 24, but the wire cable 22 is bent while being curved in the channel tube 57, In other words, it is in a state of being pressed from the base end side.
- the hood 31 retreats, that is, escapes in the proximal direction according to the applied external force.
- the hood 31 returns to the protruding position, which is the initial position. That is, due to the elastic force of the wire cable 22 itself, the hood 31 retreats with an elastic force against the reaction force when the hood 31 hits the body cavity wall, so that a strong impact is not given to the body cavity wall. .
- the wire cable 22 is a member that is parallel to the cylindrical axis of the hood 31 and that projects the hood 31 at the distal end portion 2A along the axial direction of the insertion portion 2, and the wire cable 22 has flexibility.
- a return force generating member that generates a return force that returns the hood 31 to the protruding state is configured.
- the wire fixing portion 24 constitutes a fixing portion that fixes the proximal end portion of the wire cable 22.
- the hood 31 can maintain the protruding state against the external force f from the radial direction of the hood 31, the hood 31 functions as a hood when holding a wrinkle in a body cavity or viewing a tangential lesion in front. Is maintained.
- the endoscope auxiliary tool and the endoscope that can reduce the impact when the hood hits the living tissue without increasing the outer diameter of the distal end portion of the insertion portion of the endoscope.
- a scope can be realized.
- Modification 1 When the wire cable 22 is inserted from the auxiliary instrument insertion port 51a of the auxiliary instrument insertion channel of the endoscope distal end portion 2A, the auxiliary instrument insertion port 51a is distinguished from the opening for the treatment instrument insertion channel. In addition, a color ring may be provided in the opening 51a.
- FIG. 13 is a perspective view of the distal end portion 2A when a coloring is provided in the auxiliary tool insertion port 51a.
- the hard member 51 includes an auxiliary instrument insertion port 51a of the auxiliary instrument insertion channel.
- a color different from the surrounding members for example, blue, yellow, red, etc. on the slightly proximal end side of the auxiliary instrument insertion port 51a
- a coloring 94 colored with the above is disposed.
- the coloring ring 94 is disposed at a position where the operator can visually recognize the distal end portion 2A.
- FIG. 14 is a partial cross-sectional view of the distal end portion 2A of the region including the coloring ring 94 along the line XIV-XIV in FIG.
- the hard member 51 has a cover member 51c, and a coloring ring 94 is attached to the periphery of the auxiliary tool insertion port 51a on the base end side of the cover member 51c. Therefore, the color ring 94 is provided on the hard member 51 by forming a step 51d around the opening 51a on the base end side of the cover member 51c and fitting the color ring 94 into the step 51d. it can.
- the coloring 94 it is possible to prevent the operator from erroneously inserting the wire cable 22 into the opening 93 of the treatment instrument insertion channel.
- the cover member 51c is provided with a stepped portion 51d and the coloring ring 94 is fitted into the stepped portion 51d.
- the color ring 94 may be provided on the cover member 51c by insert molding or outsurge and molding.
- the coloring ring 94 is provided in the auxiliary instrument insertion port 51a of the auxiliary instrument insertion channel.
- the coloring ring 94 is provided in the opening 93 of the treatment instrument insertion channel, and the auxiliary instrument insertion channel is inserted. You may make it not provide in the opening
- FIG. 15 is a partial cross-sectional view of the tip portion 2A in which the periphery of the opening 51a is illuminated.
- FIG. 15 is a cross-sectional view at substantially the same position as FIG.
- a transparent resin ring-shaped member 95 is provided around the auxiliary tool insertion opening 51a, and a light emitting diode (LED) element (hereinafter referred to as LED) 96 is in close contact with a part of the outer peripheral side of the ring-shaped member 95. Is provided.
- LED light emitting diode
- the tip of the light guide 98 from a light source device is disposed in the vicinity of the ring-shaped member 95 so that the light from the light guide 98 If it is introduced into the ring-shaped member 95, light is emitted from the ring-shaped member 95, so that the surgeon is prevented from accidentally inserting the wire cable 22 into the opening 93 of the treatment instrument insertion channel. Can do.
- Modification 3 Similarly to the first and second modifications, in order to prevent an operator from erroneously inserting the wire cable 22 into the opening 93 of the treatment instrument insertion channel, a sensor is provided in the auxiliary instrument insertion channel. You may make it detect insertion of the wire cable 22 to the insertion port 51a.
- FIG. 16 is a diagram for explaining the configuration of the third modification.
- a sensor 101 that detects insertion of the wire cable 22 in the auxiliary instrument insertion channel is provided in the vicinity of the auxiliary instrument insertion port 51a.
- the output of the sensor 101 is supplied to a control unit (not shown) (for example, a processor of the endoscope apparatus), and the sensor 101 detects the wire cable 22 when the wire cable 22 is inserted from the endoscope distal end portion 2A. Is notified to the surgeon by displaying on a monitor or sounding a buzzer.
- the sensor 101 is, for example, a photocoupler, a color sensor, or the like. According to the photocoupler, it is possible to detect that light is blocked by the wire cable 22. According to the color sensor, the color of the wire cable 22 can be detected.
- the sensor 102 may be provided in the vicinity of the opening 16.
- the insertion channel for the endoscope auxiliary tool is used to pass the wire cable 22 of the endoscope auxiliary tool.
- the insertion channel for the endoscope auxiliary tool is provided on the endoscope. You may utilize the treatment tool penetration channel of an endoscope, without providing.
- the insertion channel for the endoscope auxiliary tool for passing the wire cable 22 of the endoscope auxiliary tool is provided in the endoscope insertion portion 2.
- the insertion channel may be provided outside the endoscope insertion portion 2.
- a tube for passing the wire cable 22 may be provided on the outer periphery of the insertion portion 2, and the tube path of the tube may be used as an insertion channel for an endoscope auxiliary tool.
- the hood 31 is provided in the unit main body 41 attached to the distal end portion of the endoscope insertion portion.
- the hood 31 is disposed in the distal end hard portion 11 at the distal end portion of the endoscope insertion portion. You may make it provide in. That is, the hood 31 may be configured integrally with the hard tip portion 11.
- the hood cover 42 is provided on the hard tip portion 11, or a structure having the same function as the hood cover 42 described above. It is provided at the distal end hard portion 11. By doing in this way, there exists an advantage that the mounting
- the impact when the hood hits a living tissue without increasing the outer diameter of the distal end portion of the endoscope and without increasing the rigid distal end portion. It is possible to provide an endoscope auxiliary tool and an endoscope that can relieve the pain.
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Abstract
Description
そこで、日本特開2002-301011号公報に開示されているように、内視鏡挿入部の先端部でフードが突没する機構を有する内視鏡が提案されている。その提案に係る内視鏡によれば、必要なときだけ、フードを前に突出させ、必要でないときはフードを後退させておくことができる。
また、日本実開昭55-12953号公報に開示されているように、フードが前方に弾性的に付勢される付勢手段を有する内視鏡も提案されている。
なお、以下の説明に用いる各図においては、各構成要素を図面上で認識可能な程度の大きさとするため、各構成要素毎に縮尺を異ならせてあるものもあり、本発明は、これらの図に記載された構成要素の数量、構成要素の形状、構成要素の大きさの比率、及び各構成要素の相対的な位置関係のみに限定されるものではない。
内視鏡1は、観察対象部位へ挿入する細長の挿入部2と、この挿入部2の基端部に連設された操作部3と、この操作部3の側面より延設されたユニバーサルケーブル4と、を有して構成されている。
補助具挿通チャンネル内を通されて開口部16から突出したワイヤケーブル22の他端は、ワイヤ固定部24により固定される。ワイヤ固定部24は、図1において矢印A2で示す方向から、開口部16に固定される。
次にフードユニット21の構成について説明する。
図5は、図2のV-V線に沿った先端硬質部11の軸を通る断面の断面図である。図6は、図2のVI-VI線に沿った先端硬質部11の軸を通る断面の断面図である。
ユニット本体41は、先端側部分と基端側部分との間に段差部を有し、先端側部分の内径が基端側部分の内径よりも大きい筒状部材である。ユニット本体41は、エラストマ等からなる。ユニット本体41の先端側部分の筒状部の内側にフードカバー42が挿入されて接着剤で固定されている。ユニット本体41は、内視鏡挿入部2の先端部2Aがユニット本体41の基端側部分の筒状部の内側に密着して嵌合して取り付けられるように、構成されている。
なお、円筒状のフードカバー42には、ユニット本体41からの抜け防止のために、複数の、ここでは3つの、孔42bも設けられている。
さらに、フードカバー42は、先端側に外向フランジ部42cを有し、基端側に内向フランジ部42dを有する。
次にワイヤ固定部24の構成について説明する。
図11は、開口部16に取り付けられている状態のワイヤ固定部24の断面図である。ワイヤ固定部24の接続部27が、開口部16に装着され固定される。接続部27には、操作部26が連接されている。操作部26の接続部27とは反対側に、操作部25が連接されている。
以上のような構成に内視鏡補助具の作用は、次の通りである。術者は、内視鏡補助具を構成するフードユニット21に接続されたワイヤケーブル22の基端部を、内視鏡先端部2Aの補助具挿通口51aから挿入し、補助具挿通チャンネル56に通して、開口部16から突出させる。
(変形例1)
ワイヤケーブル22を内視鏡先端部2Aの補助具挿通チャンネルの補助具挿通口51aから挿入するときに、補助具挿通口51aと、処置具挿通チャンネルの開口部用の開口部とを区別するために、開口部51aにカラーリングを設けてもよい。
このように、カラーリング94を設けることにより、術者が、間違ってワイヤケーブル22を処置具挿通チャンネルの開口部93に挿入することを防止することができる。
変形例1と同様に、術者が、間違ってワイヤケーブル22を処置具挿通チャンネルの開口部93に挿入することを防止するために、補助具挿通チャンネルの補助具挿通口51aを光るようにしてもよい。
補助具挿通口51aの周囲には、透明な樹脂のリング状部材95が設けられており、リング状部材95の外周側の一部に発光ダイオード(LED)素子(以下、LEDという)96が密着して設けられている。LED96に配線97を介して電流を供給すると、LED96は発光し、リング状部材95内を通って、先端側から光が出射する。
よって、このような構成によっても、術者が、間違ってワイヤケーブル22を処置具挿通チャンネルの開口部93に挿入することを防止することができる。
変形例1及ぶ2と同様に、術者が、間違ってワイヤケーブル22を処置具挿通チャンネルの開口部93に挿入することを防止するために、補助具挿通チャンネル内にセンサを設けて、補助具挿通口51aへのワイヤケーブル22の挿入を検出するようにしてもよい。
なお、センサ102を開口部16の近傍に設けるようにしてもよい。
上述した各例では、内視鏡補助具のワイヤケーブル22を通すために、内視鏡補助具用の挿通チャンネルを利用しているが、内視鏡に内視鏡補助具用の挿通チャンネルを設けずに、内視鏡の処置具挿通チャンネルを利用してもよい。
上述した各例では、内視鏡補助具のワイヤケーブル22を通すための、内視鏡補助具用の挿通チャンネルは、内視鏡挿入部2内に設けられているが、内視鏡補助具用の挿通チャンネルは、内視鏡挿入部2の外側に設けるようにしてもよい。例えば、挿入部2の外周に、ワイヤケーブル22を通るためのチューブを設け、そのチューブの管路を内視鏡補助具用の挿通チャンネルとして利用するようにしてもよい。
上述した各例では、フード31は、内視鏡挿入部の先端部に装着されるユニット本体41内に設けられているが、フード31を内視鏡挿入部の先端部の先端硬質部11内に設けるようにしてもよい。すなわち、フード31が、先端硬質部11と一体的に構成するようにしてもよい
その場合、フードカバー42を先端硬質部11に設けるか、あるいは上述したフードカバー42と同様の機能を有する構造を先端硬質部11に設ける。このようにすることにより、フードユニットの装着作業が不要となる、というメリットがある。
また、フード31を内視鏡挿入部の先端硬質部11の外周に設けるようにしても良い。その場合には、フード31が先端硬質部11に対して長手軸方向に進退可能となるように、フード31の内周と先端硬質部11の外周に互いに係合する凸部及び凹部を設ける。このようにすることで、フードカバー42が不要となり、フード装着時の先端外径の細径化及びフードユニットの装着作業が不要となるメリットがある。
Claims (10)
- 円筒部材と、
内視鏡の挿入部の先端部に設けられ、前記挿入部の軸方向に沿って、前記円筒部材を移動可能に保持する保持部と、
前記円筒部材の軸に平行でかつ前記挿入部の軸方向に沿って前記円筒部材を前記先端部において突没させると共に、前記円筒部材が前記先端部の先端方向に突出した状態で、前記円筒部材が基端方向に力を受けたときに、前記円筒部材を前記突出した状態に回帰させる回帰力を発生させる回帰力発生部材を固定する固定部と、
を有することを特徴とする内視鏡補助具。 - 前記回帰力発生部材は、可撓性を有するワイヤであり、
前記ワイヤの先端部が、前記円筒部材に接続されていることを特徴とする請求項1に記載の内視鏡補助具。 - 前記ワイヤは、前記内視鏡の前記挿入部の先端部に設けられた硬質部材に接続されたチューブ内に挿通されていることを特徴とする請求項2に記載の内視鏡補助具。
- 前記保持部は、前記円筒部材の前記挿入部の軸方向に沿った動きを規制する動き規制部を有することを特徴とする請求項1に記載の内視鏡補助具。
- 前記円筒部材は、爪部を有し、
前記爪部が前記規制部に当接することにより、前記円筒部材の前記挿入部の軸方向に沿った動きが規制されることを特徴とする請求項4に記載の内視鏡補助具。 - 前記保持部は、本体部とカバー部材とからなり、
前記規制部は、前記カバー部材に設けられていることを特徴とする請求項5に記載の内視鏡補助具。 - 前記保持部は、前記先端部の先端面よりも、前記先端部の先端方向に突出した突出部を有することを特徴とする請求項1に記載の内視鏡補助具。
- 前記保持部は、本体部とカバー部材とからなり、
前記突出部は、前記カバー部材に設けられていることを特徴とする請求項7に記載の内視鏡補助具。 - 前記保持部は、本体部とカバー部材とからなり、
前記カバー部材は、先端部の外周に沿ってテーパ部が形成された円筒形状を有し、
前記円筒部材は、先端部の外周に沿って曲線部を有し、
前記円筒部材が前記先端部の基端側に後退したときに、前記カバー部材の前記テーパ部の傾斜ラインと、前記円筒部材の前記曲線部の接線は、略一致することを特徴とする請求項1に記載の内視鏡補助具。 - 請求項1から9のいずれか1つに記載の前記内視鏡補助具を有することを特徴とする内視鏡。
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JP2013502732A JP5341278B2 (ja) | 2011-08-09 | 2012-05-29 | 内視鏡補助具及び内視鏡 |
EP12821426.9A EP2676595B1 (en) | 2011-08-09 | 2012-05-29 | Endoscope auxiliary instrument and endoscope |
CN201280017253.9A CN103458762B (zh) | 2011-08-09 | 2012-05-29 | 内窥镜辅助器械和内窥镜 |
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CN106999001B (zh) * | 2014-10-18 | 2019-04-16 | 史赛克欧洲控股I有限责任公司 | 具有可选择性弯折的轴杆和选择性弯折该轴杆并且当轴杆弯折时处于张紧中的缆线的手术工具 |
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JP5489418B2 (ja) * | 2008-05-08 | 2014-05-14 | オリンパスメディカルシステムズ株式会社 | 超音波プローブ用フード及び超音波プローブ |
-
2012
- 2012-05-29 CN CN201280017253.9A patent/CN103458762B/zh active Active
- 2012-05-29 WO PCT/JP2012/063796 patent/WO2013021710A1/ja active Application Filing
- 2012-05-29 JP JP2013502732A patent/JP5341278B2/ja active Active
- 2012-05-29 EP EP12821426.9A patent/EP2676595B1/en not_active Not-in-force
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2013
- 2013-02-11 US US13/763,751 patent/US20130217963A1/en not_active Abandoned
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JPH1033467A (ja) * | 1996-07-25 | 1998-02-10 | Olympus Optical Co Ltd | 内視鏡 |
JP2003093325A (ja) * | 2001-09-25 | 2003-04-02 | Olympus Optical Co Ltd | 内視鏡用フード部材 |
JP2002301011A (ja) | 2002-03-22 | 2002-10-15 | Olympus Optical Co Ltd | 内視鏡装置と内視鏡用フード部材 |
JP2003290134A (ja) * | 2002-04-02 | 2003-10-14 | Olympus Optical Co Ltd | 内視鏡装置 |
JP2003093329A (ja) * | 2002-04-08 | 2003-04-02 | Olympus Optical Co Ltd | 内視鏡 |
JP2010012172A (ja) * | 2008-07-07 | 2010-01-21 | Hoya Corp | 内視鏡先端長調整システム、内視鏡フード |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20160235277A1 (en) * | 2014-04-23 | 2016-08-18 | Olympus Corporation | Holding mechanism for endoscope guide member, and endoscope |
US9770158B2 (en) * | 2014-04-23 | 2017-09-26 | Olympus Corporation | Holding mechanism for endoscope guide member, and endoscope |
Also Published As
Publication number | Publication date |
---|---|
CN103458762B (zh) | 2016-01-06 |
US20130217963A1 (en) | 2013-08-22 |
JPWO2013021710A1 (ja) | 2015-03-05 |
EP2676595A1 (en) | 2013-12-25 |
EP2676595B1 (en) | 2017-05-03 |
CN103458762A (zh) | 2013-12-18 |
JP5341278B2 (ja) | 2013-11-13 |
EP2676595A4 (en) | 2014-03-12 |
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