WO2013137000A1 - Nasal endoscope - Google Patents

Nasal endoscope Download PDF

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Publication number
WO2013137000A1
WO2013137000A1 PCT/JP2013/055352 JP2013055352W WO2013137000A1 WO 2013137000 A1 WO2013137000 A1 WO 2013137000A1 JP 2013055352 W JP2013055352 W JP 2013055352W WO 2013137000 A1 WO2013137000 A1 WO 2013137000A1
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WO
WIPO (PCT)
Prior art keywords
component
inspection
auxiliary
distal end
wire
Prior art date
Application number
PCT/JP2013/055352
Other languages
French (fr)
Japanese (ja)
Inventor
裕一 多田
狩野 渉
Original Assignee
テルモ株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by テルモ株式会社 filed Critical テルモ株式会社
Publication of WO2013137000A1 publication Critical patent/WO2013137000A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/233Instruments 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 for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments 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
    • A61B1/00131Accessories for endoscopes
    • A61B1/0014Fastening element for attaching accessories to the outside of an endoscope, e.g. clips, clamps or bands

Definitions

  • the present invention relates to a transnasal endoscope having an inspection part having an imaging unit such as a camera and an auxiliary part having a forceps conduit.
  • transnasal endoscope in which a cable (long) inspection part equipped with a camera is inserted from an outer nostril to inspect a subject's body cavity (Patent Document 1).
  • Patent Document 1 A so-called transnasal endoscope is known in which a cable (long) inspection part equipped with a camera is inserted from an outer nostril to inspect a subject's body cavity.
  • Patent Document 1 since the cable enters the body cavity without touching the tongue base, the pharyngeal reflex is less likely to occur than the oral endoscope in which the cable is inserted from the mouth.
  • the load given to the subject is low, such as hardly causing nausea, demand has increased in recent years.
  • the present invention has been made in consideration of such a situation, and an object thereof is to provide a transnasal endoscope that can easily connect a test part and an auxiliary part in a body cavity.
  • the transnasal endoscope of the present invention is inserted into a body cavity from an elongated inspection part having an imaging unit inserted into a body cavity from one outer nostril and the body cavity from the other outer nostril. And a long auxiliary part connected to the inspection part. Furthermore, the moving engagement part which moves along the longitudinal direction of a test
  • the transnasal endoscope of the present invention includes a guide member having a guide wire in which a distal end engaging portion for engaging with an inspection component is formed at the distal end portion, and guides auxiliary components.
  • the transnasal endoscope of the present invention can easily connect an inspection part and an auxiliary part in a body cavity.
  • FIG. 1 is an explanatory diagram schematically showing a nasal endoscope 1 in the present embodiment
  • FIG. 2 schematically shows a configuration in the vicinity of the tips of an inspection component 10 and an auxiliary component 30 in the present embodiment. It is explanatory drawing shown.
  • the nasal endoscope 1 includes an inspection component 10 including an imaging unit including an imaging element such as a camera that images the inside of a body cavity of a subject, and forceps that delete an affected part in the body cavity.
  • the auxiliary component 30 includes a forceps conduit 34 for inserting a processing tool such as the above.
  • the transnasal endoscope 1 is connected with a light source device for supplying illumination light for illuminating the inside of the body cavity, a monitor for displaying an endoscopic image, a suction device for sucking a sputum and the like.
  • the inspection component 10 includes an insertion portion 11 to be inserted into the body cavity of the subject, and a hand operation portion 2 that is connected to the insertion portion 11 and is operated by an operator such as a doctor or a technician.
  • the insertion portion 11 includes a distal end portion 12, a bending portion 13, and a flexible portion 14.
  • the distal end portion 12 is formed of a hard metal material or the like, and a camera is disposed inside the distal end portion 12.
  • a camera guide for inserting a cable or the like for sending a signal obtained by the camera to the monitor and a light guide for guiding illumination light from the light source device are provided inside the inspection component 10.
  • the insertion part 11 of the inspection component 10 is formed in a tubular shape having an outer diameter of about 3 mm, and the camera guide is formed in a tubular shape having an inner diameter of about 2 mm.
  • the bending portion 13 is configured to bend vertically and horizontally in conjunction with the operation of the hand operation portion 2. Thereby, the inside of the body cavity can be observed with the distal end surface of the distal end portion 12 directed in a desired direction.
  • the flexible portion 14 is a cable-like long body portion that connects between the hand operating portion 2 and the bending portion 13 and has flexibility.
  • an observation window 17 and a pair of illumination windows 18 are provided on the distal end surface of the distal end portion 12 of the inspection component 10.
  • An imaging unit such as a camera is disposed on the back side of the observation window 17.
  • the illumination windows 18 are provided on both sides of the observation window 17 and irradiate light from the light source device supplied via the light guide toward the observation target.
  • the auxiliary component 30 has an insertion portion 31 to be inserted into the body cavity of the subject and a hand operation portion 3 for performing an operation connected to the insertion portion 31.
  • the insertion portion 31 is formed in a tubular shape having substantially the same outer diameter as the insertion portion 11 of the inspection component 10.
  • the insertion part 31 of the auxiliary component 30 includes a tip part 32 and a flexible part 33.
  • the tip portion 32 is formed of a hard material such as a metal, like the tip portion 12 of the inspection component 10.
  • the flexible portion 33 is formed in a long shape like the flexible portion 14 of the inspection component 10, has flexibility, and connects the distal end portion 32 and the hand operating portion 3.
  • a forceps conduit 34 for inserting various treatment tools such as forceps, a snare, and a biopsy needle is provided inside the auxiliary component 30, a forceps conduit 34 for inserting various treatment tools such as forceps, a snare, and a biopsy needle is provided.
  • the forceps conduit 34 is formed in a tubular shape having an inner diameter of about 3 mm, and is formed so as to have an inner diameter slightly smaller than the insertion portion 31 of the auxiliary component 30.
  • the forceps conduit 34 is also used as a suction conduit for aspirating air, residue, body fluid, etc. accumulated in the body cavity.
  • a forceps outlet 34 a is formed on the distal end surface of the distal end portion 32 of the auxiliary component 30 to guide the distal end of the treatment instrument inserted into the forceps conduit 34.
  • the forceps outlet 34 a allows the distal end of the treatment tool inserted into the forceps conduit 34 to be led out.
  • the transnasal endoscope 1 inserts the insertion part 11 of the inspection component 10 from one outer nostril, and inserts the insertion part 31 of the auxiliary component 30 from the other outer nostril where the inspection part 10 is not inserted.
  • a treatment tool having a size similar to that of an oral endoscope can be used.
  • FIG. 3 is a cross-sectional view of the inspection component 10 and the auxiliary component 30 cut in the longitudinal direction in order to schematically show the internal configuration of the transnasal endoscope 1 of the present embodiment.
  • the inspection component 10 is provided with a wire storage guide 21 as a guide passage.
  • the wire storage guide 21 is formed in the vicinity of the inside of the outer surface portion of the inspection component 10 and along the longitudinal direction of the inspection component 10.
  • the wire storage guide 21 is formed in a tubular shape having an inner diameter of about 1 mm.
  • a magnet 22 that is a first magnetic member as a moving engagement portion, a wire 23 coupled to the magnet 22, and a pulley 24 around which the wire 23 is wound are disposed inside the wire storage guide 21, a magnet 22 that is a first magnetic member as a moving engagement portion, a wire 23 coupled to the magnet 22, and a pulley 24 around which the wire 23 is wound are disposed.
  • the pulley 24 is fixed in the vicinity of the distal end surface of the distal end portion 12 of the inspection component 10.
  • a guide (not shown) is provided inside the inspection component 10.
  • the magnet 22 is configured to have an inner diameter smaller than that of the wire storage guide 21 so that the magnet 22 can move in the wire storage guide 21.
  • One end of the wire 23 is coupled to the magnet 22, and the other end is connected to the hand operation unit 2 via the pulley 24.
  • the operator can move the magnet 22 along the longitudinal direction of the inspection component 10 inside the wire storage guide 21 by pulling the wire 23 by the hand operation unit 2. Further, by pushing the wire 23 in accordance with the movement of the inspection component 10, it is possible to move only the inspection component 10 without changing the position of the magnet 22 in the wire storage guide 21.
  • a magnetic body 35 as a second magnetic member as a fixed engagement portion is provided on the outer peripheral surface of the distal end portion 32 of the auxiliary component 30.
  • the magnetic body 35 is formed in a streak shape along the longitudinal direction of the auxiliary component 30.
  • the magnetic body 35 is a thin film made of a magnetic material such as iron and has magnetism and flexibility.
  • the magnetic body 35 is mounted so as to be substantially flush with the side surface of the distal end portion 32 so that the magnetic body 35 is not caught by a body wall or the like when inserted into the body cavity.
  • the insertion part 11 of the test part 10 is inserted into the body cavity from one outer nostril, and the insertion part 11 of the test part 10 is placed in a wide space in the body cavity, here, the proximal end portion of the bronchus To place.
  • the magnet 22 in the wire storage guide 21 is preferably arranged in advance at a position away from the distal end portion 12 of the inspection component 10.
  • the insertion part 31 of the auxiliary part 30 is inserted into the body cavity from the other nostril and the hand operation part 3 is operated, so that the distal end part 32 of the auxiliary part 30 becomes the inspection part 10 as shown in FIG. 3B.
  • the magnetic body 35 of the auxiliary component 30 is magnetically attached to the magnet 22 disposed on the base end side of the inspection component 10 by making contact. Thereby, the inspection component 10 and the auxiliary component 30 are coupled.
  • the inspection component 10 is advanced in a state where the auxiliary component 30 is coupled to the inspection component 10, and the distal end portion 12 reaches the target lesion site in the body. At that time, the wire 23 is drawn into the wire storage guide 21 by a distance moved by the inspection component 10.
  • the wire 23 is pulled by the hand operation unit 2, and the magnet 22 in the wire storage guide 21 is moved to the distal end portion 12 of the inspection component 10.
  • the auxiliary component 30 moves along the outer surface of the inspection component 10 along with the movement of the magnet 22, and as shown in FIG. The tip surface moves to a position that matches the tip surface of the tip portion 12 of the inspection component 10.
  • the distal end portion 12 can be easily approached by operating only the inspection component 10. Thereafter, by guiding the auxiliary component 30, the auxiliary component 30 can be surely reached the erasure site. Then, a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
  • a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
  • the treatment tool is pulled out from the auxiliary component 30, and then the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 are slowly pulled out from the body. In the middle of this, the coupling between the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is released.
  • the release of the coupling is performed, for example, by pulling only the insertion part 31 of the auxiliary component 30 and releasing the magnetic adhesion between the magnetic body 35 and the magnet 22.
  • the magnet 22 is moved from the distal end portion 12 of the inspection component 10 by pulling the auxiliary component 30 back to the base end side in a state where the inspection component 10 is fixed, and the distal end portion 32 of the auxiliary component 30 is moved to the distal end portion of the inspection component 10. After separating from 12, the magnetic attachment between the magnetic body 35 and the magnet 22 may be released.
  • the inspection part 10 is provided with the magnet 22 and the auxiliary part 30 is provided with the magnetic body 35.
  • the present invention is not limited to this, and the inspection part 10 is provided with a magnetic body and the auxiliary part 30 is provided with the magnetic body 35.
  • a magnet may be provided, or both may be magnets.
  • the magnet is not limited to a permanent magnet, and may be an electromagnet.
  • the magnet 22 is described as moving in the wire storage guide 21.
  • the present invention is not limited to this, and a guide groove is provided in the longitudinal direction of the inspection component 10. You may comprise so that a groove
  • the transnasal endoscope 1 of the present embodiment only the distal end portion 12 of the test component 10 can be brought close to the target lesion site.
  • the distal end portion 12 of the test component 10 can be inserted into the body cavity through a complicated path. That is, even when the target lesion site is in the back of the body cavity, for example, like the peripheral portion of the lung, the distal end portion 12 of the test component 10 can be reliably brought closer.
  • a treatment such as collection of the lesion site can be performed accurately.
  • FIG. 4 is an explanatory diagram schematically showing the configuration of the distal end of the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 in the present embodiment.
  • a snare that accommodates a snare 25 that is a moving wire member including a wire 23 and a loop 25 a that is an annular portion is housed in the inspection component 10 of the nasal endoscope 1 according to the present embodiment.
  • a storage guide 26 and a snare lumen 27 through which the wire 23 is inserted are formed.
  • the snare storage guide 26 is a groove provided on the outer surface of the inspection component 10 and is formed so as to extend in the longitudinal direction of the inspection component 10.
  • the snare lumen 27 is a through-hole formed along the longitudinal direction of the inspection component 10, and is formed in a tubular shape having an inner diameter of 1 mm.
  • a projection 28 for folding the wire 23 along the longitudinal direction of the inspection component 10 is provided in the vicinity of the distal end surface of the distal end portion 12 of the inspection component 10.
  • a snare auxiliary member 29 that is movable along the snare storage guide 26 is engaged with the snare storage guide 26.
  • the snare auxiliary member 29 includes a foot portion 29 a that matches the groove shape of the snare storage guide 26 and a head portion 29 b that extends upward.
  • a hole 39a for inserting the wire 23 is formed in the foot portion 29a, and a hole 39b for inserting and removing the loop 25a is formed in the head portion 29b.
  • the hole 39 a and the hole 39 b penetrate through the snare auxiliary member 29.
  • the wire 23 connected to the loop 25a protrudes from the hole 39b of the head portion 29b, and the other end of the wire 23 protrudes from the hole 39a of the foot portion 29a.
  • the wire 23 protruding from the hole 39a of the foot portion 29a is folded back by a projection 28 as a folded portion, and is connected to the hand operating portion 2 through the snare lumen 27.
  • the diameter of the loop 25a is formed to be larger than the diameter of the auxiliary component 30 so that the tip of the auxiliary component 30 can be inserted. Further, the loop 25a is formed by bending the end portion of the wire 23, so that it has elasticity and returns to its original shape even if it is slightly deformed. The loop 25a is deformed into a narrowed state when pulled into the snare auxiliary member 29 from the hole 39b of the head 29b, and returns to a loop shape when pushed out from the hole 39b.
  • an engagement groove 37 for engaging the loop 25a is formed on the outer peripheral surface of the distal end portion 32 of the auxiliary component 30 as an engagement groove.
  • the engagement groove 37 is formed along the circumferential direction of the outer surface of the auxiliary component 30.
  • the soft portion 33 of the auxiliary component 30 is called a flex tube that protects the inside while maintaining flexibility in order from the inside, and a blade that covers the screw tube and holds the resin of the outer layer.
  • the engaging groove 37 is formed by removing only the outer layer portion of the auxiliary component 30, for example.
  • the insertion portion 11 of the inspection component 10 is inserted into the body cavity from one outer nostril, and the distal end portion 12 of the inspection component 10 is arranged in a wide place in the body cavity while checking with the camera 15. To do.
  • the position of the loop 25a is preferably arranged in advance at a position away from the tip 12 of the inspection component 10.
  • the insertion portion 31 of the auxiliary component 30 is inserted into the body cavity where the distal end portion 12 of the test component 10 is disposed from the other outer nostril, and the distal end portion 32 of the auxiliary component 30 is operated by the hand operation portion 3. Is brought close to the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is passed through the loop 25 a protruding from the outer surface of the inspection component 10.
  • the bending portion 13 of the inspection component 10 is bent by the hand operation portion 2, and the loop 25 a of the snare 25 is engaged with the engagement groove 37 of the auxiliary component 30.
  • the wire 23 is pulled, and the loop 25a is drawn into the snare auxiliary member 29 to reduce the diameter of the loop 25a.
  • the aperture / auxiliary component 30 and the inspection component 10 are combined.
  • the wire 23 is pulled by the hand operation unit 2, and the snare auxiliary member 29 is moved along the snare storage guide 26 of the inspection component 10.
  • the tip 12 Since the auxiliary component 30 is engaged with the loop 25a, the auxiliary component 30 also moves along the outer surface of the inspection component 10 along with the movement of the snare auxiliary component 29. As shown in FIG. The tip surface of 32 moves to a position that matches the tip surface of the tip portion 32 of the inspection component 10.
  • the distal end portion 12 can be easily approached by operating only the inspection component 10. Thereafter, by guiding the auxiliary component 30, the auxiliary component 30 can be surely reached the erasure site. Then, a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
  • a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
  • the treatment tool is pulled out from the auxiliary component 30, and then the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 are slowly pulled out from the body. In the middle of this, the coupling between the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is released.
  • the wire 23 is pushed out by the hand operation unit 2
  • the loop 25a is moved out of the snare auxiliary member 29 and the diameter of the loop 25a is expanded, and then only the insertion part 31 of the auxiliary component 30 is pulled strongly. This is done by releasing the engagement between the engagement groove 37 and the engagement groove 37.
  • the transnasal endoscope 1 of the present embodiment only the distal end portion 12 of the test component 10 can be brought close to the target lesion site.
  • the distal end portion 12 of the test component 10 can be inserted into the body cavity through a complicated path. That is, even when the target lesion site is in the back of the body cavity, for example, like the peripheral portion of the lung, the distal end portion 12 of the test component 10 can be reliably brought closer.
  • the distal end portion 32 of the auxiliary component 30 can be reliably brought close to the target lesion site, treatment such as collection of the lesion site can be performed accurately.
  • FIG. 6 is an explanatory diagram schematically showing the nasal endoscope 100 according to the present embodiment
  • FIG. 7 schematically shows a configuration near the tips of the inspection component 110 and the auxiliary component 130 according to the present embodiment. It is explanatory drawing shown.
  • the nasal endoscope 100 includes a test part 110 including an imaging unit including an imaging element such as a camera that images the inside of a body cavity of a subject, and forceps that deletes an affected area in the body cavity.
  • the inspection component 110 of the nasal endoscope 100 includes a light source device for supplying illumination light for illuminating the inside of the body cavity, a video processor for constructing an endoscopic image, and an endoscope constructed by a video processor.
  • a monitor for displaying a mirror image, a suction device for sucking a bag, and the like are connected.
  • the inspection component 110 includes an insertion portion 111 that is inserted into the body cavity of the subject, and a hand operation portion 102 that is connected to the insertion portion 111 and is operated by an operator such as a doctor or a technician. . Further, inside the inspection component 110, a camera guide for inserting a long body such as a cable for sending a signal obtained by the camera to the video processor and a light guide for guiding illumination light from the light source device are provided. ing.
  • the insertion part 111 of the inspection component 110 is formed in a tubular shape having an outer diameter of about 3 mm.
  • the insertion part 111 of the inspection component 110 includes a tip part 112, a bending part 113, and a soft part 114.
  • the distal end portion 112 is formed of a hard metal material, a resin material, or the like, and a camera is disposed inside the distal end portion 112.
  • the bending portion 113 is configured to bend vertically and horizontally in conjunction with the operation of the hand operation portion 102. As a result, the inside of the body cavity can be observed with the distal end surface of the distal end portion 112 oriented in a desired direction.
  • the soft part 114 is a long part that connects between the hand operation part 102 and the bending part 113 and has flexibility.
  • an observation window 117 and a pair of illumination windows 118 are provided on the distal end surface of the distal end portion 112 of the inspection component 110.
  • An imaging unit such as a camera is disposed on the back side of the observation window 117.
  • the illumination windows 118 are provided on both sides of the observation window 117, and irradiate light from the light source device supplied via the light guide toward the observation target.
  • the groove part 150 as a locking part is formed in the front-end
  • the groove portion 150 has an inclined portion 152 that is inclined toward the bottom portion 151.
  • a loop 142 is engaged with the groove 150, and the guide member 140 is locked.
  • the auxiliary component 130 includes an insertion portion 131 that is inserted into the body cavity of the subject and a hub that is connected to the insertion portion 131 and can connect a Y-shaped connector, a check valve, and the like. 103.
  • the insertion part 131 is formed in a tubular shape having substantially the same outer diameter as the insertion part 111 of the inspection component 110.
  • the insertion part 131 of the auxiliary component 130 includes a tip part 132 and a soft part 133.
  • the tip portion 132 is formed of a hard material such as metal or resin, like the tip portion 112 of the inspection component 110.
  • the flexible portion 133 is formed in a long shape similarly to the flexible portion 114 of the inspection component 110, has flexibility, and connects between the distal end portion 132 and the hub 103.
  • a forceps conduit 134 for inserting various treatment tools such as forceps and snare is provided.
  • the forceps conduit 134 is formed in a tubular shape having an inner diameter of about 3 mm, and is formed so as to have an inner diameter slightly thinner than the insertion portion 131 of the auxiliary component 130.
  • a forceps outlet 134 a is formed on the distal end surface of the distal end portion 132 of the auxiliary component 130 to guide the distal end of the treatment instrument inserted into the forceps conduit 134. Further, the end of the guide wire 141 of the guide member 140 is inserted into the forceps outlet 134a.
  • the forceps conduit 134 is also used as a suction conduit for aspirating air, residue, body fluid, etc. accumulated in the body cavity.
  • the guide member 140 includes a linear guide wire 141 and a loop 142 connected to one end of the guide wire 141.
  • a wire cover 143 is provided on the straight portion of the guide member 140 so as to cover the guide wire 141.
  • the wire cover 143 is a tubular member having a through hole through which the guide wire 141 is inserted.
  • the guide wire 141 is made of a superelastic alloy such as a nickel titanium alloy. In addition, you may use stainless steel and the connection composite material containing them.
  • the length of the guide wire 141 is configured to be longer than the total length of the auxiliary component 130 and the inspection component 110.
  • the length of the wire used in this embodiment is in the range of 2000 mm to 4000 mm, and the length is changed according to the purpose of use.
  • the diameter of the wire is in the range of 0.3 mm to 1.0 mm. In this embodiment, a wire having a diameter of 0.5 mm is used.
  • the loop 142 as the tip annular portion is formed by processing a part of the guide wire 141 into an annular shape, and the diameter of the loop 142 can be changed.
  • the diameter of the loop 142 of the present embodiment is configured to be changeable within a range of 1.0 mm to 5.0 mm. The operator operates the guide member 140 by grasping the end portion of the guide wire 141 opposite to the side where the loop 142 is formed.
  • a through-hole penetrating the forceps conduit 134 may be formed in the insertion part 131 of the auxiliary component 130 so that the guide wire 141 in the forceps conduit 134 is released to the outside of the auxiliary component 130.
  • the end portion of the guide wire 141 inserted into the forceps outlet 134 a passes through the forceps conduit 134 and protrudes outside the auxiliary component 130 from the through hole.
  • the place where the through hole is formed is preferably a place that is about 200 mm away from the distal end portion 132 of the auxiliary component 130.
  • the transnasal endoscope 100 inserts the insertion part 111 of the inspection part 110 from one outer nostril, and inserts the insertion part 111 of the inspection part 110 in a wide space in the body cavity, here, the proximal part of the pharynx or trachea To place.
  • the loop 142 of the guide member 140 is inserted and pushed forward from the other outer nostril into which the test part 110 is not inserted, and the loop 142 is similarly reached to the proximal part of the pharynx or trachea.
  • the loop 142 of the guide member 140 can be easily brought close to the distal end portion 112 of the inspection component 110.
  • the guide member 140 is pushed forward so that the loop 142 is located on the back side with respect to the distal end portion 112 of the inspection component 110.
  • the guide member 140 is operated to insert the loop 142 into the distal end portion 112 of the inspection component 110.
  • the guide member 140 is engaged with the inspection component 110 by being caught in the groove 150.
  • the loop 142 can be easily hooked on the groove 150.
  • the groove part 150 has the inclination part 152, the loop 142 can be hooked easily. Then, with the guide member 140 engaged with the test component 110, the distal end portion 112 of the test component 110 reaches the target lesion site.
  • the end portion of the guide wire 141 of the guide member 140 protruding from the outer nostril is inserted into the forceps outlet 134a of the auxiliary component 130, and the insertion portion 131 of the auxiliary component 130 is pushed into the body cavity along the guide wire 141. .
  • the auxiliary component 130 is guided by the guide wire 141 of the guide member 140, the distal end portion 132 of the auxiliary component 130 is placed near the lesion site only by pushing the insertion portion 131 forward. It can be brought close to the part 112.
  • a treatment tool such as a biopsy forceps can be projected from the forceps outlet 134a of the auxiliary component 130 to perform a treatment such as deletion of a lesion site.
  • the distal end portion 132 of the auxiliary component 130 can be obtained by simply engaging the guide member 140 and the inspection component 110 and pushing the auxiliary component 130 along the guide member 140. Can be matched with the tip 112 of the inspection component 110.
  • the forceps conduit is provided in the auxiliary part 130, the diameter of the forceps conduit can be increased to some extent, and a treatment instrument having the same size as an oral endoscope can be used.
  • the treatment tool is pulled out from the auxiliary component 130, and then the inspection component 110 and the auxiliary component 130 are slowly pulled out from the body cavity. In the middle of this, the engagement between the inspection component 110 and the auxiliary component 130 is released. The engagement is released by operating the guide member 140 to release the lock between the loop 142 and the groove 150.
  • FIG. 8 is an explanatory diagram schematically showing a configuration near the tip of the auxiliary component 130 in another embodiment.
  • a wire guide 105 for inserting a guide wire may be provided on the outer surface portion of the auxiliary component 130.
  • the wire guide 105 is a tubular member having an inner diameter of 0.3 mm to 1.0 mm, and is attached along the longitudinal direction of the auxiliary component 130.
  • a wire guide 105 having an inner diameter of 0.5 mm is used.
  • One end portion 105 a of the wire guide 105 is located in the vicinity of the distal end portion 132 of the auxiliary component 130, and the other end portion is located in the vicinity of the hub 103.
  • the wire guide 105 may be molded integrally with the flexible portion 133, or the wire guide 105 may be manufactured separately and attached to the outer surface of the auxiliary component 130 using an adhesive or the like.
  • the end portion of the guide wire 141 protruding from the outer nostril is inserted into the end portion 105 a of the wire guide 105, and the insertion portion 131 of the auxiliary component 130 is moved along the guide wire 141 together with the wire guide 105. Push it into the body cavity.
  • an insertion hole for directly inserting the guide wire 141 may be formed inside the outer surface portion of the auxiliary component 130.
  • the insertion hole is formed in the thick part of the outer layer of the auxiliary component 130 along the longitudinal direction of the auxiliary component 130.
  • the diameter of an insertion hole should just have a larger diameter than a guide wire. Then, the end portion of the guide wire 141 protruding from the outer nostril is inserted into the insertion hole, and the insertion portion 131 of the auxiliary component 130 is pushed into the body cavity along the guide wire 141.
  • FIG. 9 is a cross-sectional view for explaining the guide member 140 in the present embodiment.
  • the guide member 140 is configured by forming a loop 142 in the middle of one wire and folding back at the loop portion. Therefore, the part other than the loop is a state in which two linear wires are arranged in parallel.
  • the wire cover 143 is provided so as to cover the linear wire portion of the guide member 140.
  • FIG. 10 is a cross-sectional view for explaining a guide member 140 ′ according to another embodiment.
  • the guide member 140 ′ forms a loop 142 by forming a knot 146 at the tip of the guide wire and inserting the guide wire through the knot 46.
  • the knot 146 is fixed to the end of the wire cover 143.
  • the diameter of the loop 142 can be freely expanded and reduced. For example, when it is desired to reduce the diameter of the loop 142, the wire cover 143 is moved so as to approach the loop 142, and a part of the wire forming the loop 142 is inserted into the through hole 145. Make it smaller. Further, when it is desired to increase the diameter from the state where the diameter of the loop 142 is reduced, the wire cover 143 is moved away from the loop 142 and a part of the wire accommodated in the through hole 145 is set as a part of the loop 142. Then, the diameter of the loop 142 is returned to the original state.
  • the wire cover 143 is moved to reduce the diameter of the loop 142, thereby strengthening the engagement between the guide member 140 and the inspection component 110. it can.
  • FIG. 11A shows the structure of the inspection component 110 and the entire structure of the guide member 140 according to the fourth embodiment of the present invention
  • FIG. 11B is an explanatory view showing a state where the guide member 140 is engaged with the inspection component 110. is there.
  • a tip groove portion 160 as a bulging locking portion that locks a bulging portion described later from the tip surface along the longitudinal direction of the testing component 110 is provided at the tip portion 112 of the testing component 110. Is formed.
  • the tip groove portion 160 is formed along the longitudinal direction of the outer peripheral surface from the tip of the inspection component 110 and constitutes a bulging portion locking groove portion.
  • the tip groove portion 160 has a V-shaped cross section, and is configured such that the depth of the groove becomes shallower as the distance from the tip surface increases.
  • the guide member 140 is composed of a linear guide wire 141 and a bulging portion 144 as a tip engaging portion connected to one end of the guide wire 141.
  • the bulging portion 144 is spherical and is formed to have a diameter larger than the diameter of the guide wire 141.
  • the transnasal endoscope 100 inserts the insertion part 111 of the inspection part 110 from one outer nostril, and inserts the insertion part 111 of the inspection part 110 in a wide space in the body cavity, here, the proximal part of the pharynx or trachea To place.
  • the bulging portion 144 of the guide member 140 is inserted and pushed forward from the other nostril where the test part 110 is not inserted, and the bulging portion 144 reaches the pharynx or the proximal end portion of the trachea.
  • the bulging portion 144 of the guide member 140 can be easily brought close to the distal end portion 112 of the inspection component 110 even in the body cavity. At this time, the guide wire 141 is pushed forward so that the bulging portion 144 is located behind the tip portion 112 of the inspection component 110.
  • the guide member 140 is operated to hook the guide wire 141 on the leading end groove 160 as shown in FIG. 11B, and then the guide wire 141 is pulled. By doing so, the bulging portion 144 is locked to the tip groove portion 160 and the guide member 140 is engaged with the inspection component 110.
  • the bulging portion 144 can be easily locked to the distal end groove portion 160. Then, with the guide member 140 engaged with the test component 110, the tip 112 of the test component 110 is brought close to the target lesion site.
  • the end of the guide wire 141 protruding from the outer nostril is inserted into the forceps outlet 134a of the auxiliary part 130, and the insertion part 131 of the auxiliary part 130 is pushed into the body cavity along the guide wire 141.
  • the auxiliary component 130 is guided by the guide wire 141 of the guide member 140, the distal end portion 112 of the inspection component 110 disposed at the lesion site is simply moved forward by pushing the insertion portion 131. Can be approached.
  • the tip 132 of the auxiliary component 130 can be brought close to the tip 112 of the inspection component 110 only by pushing the auxiliary component 130 along the guide member 140 without performing a confirmation operation using a monitor or the like. it can.
  • a treatment tool such as a biopsy forceps can be projected from the forceps outlet 134a of the auxiliary component 130 to perform a treatment such as deletion of a lesion site.
  • the nasal endoscope according to the fourth embodiment also engages the guide member 140 and the inspection component 110 in the same manner as described for the nasal microscope according to the third embodiment.
  • the auxiliary component 130 By simply pushing the auxiliary component 130 along the guide member 140, the distal end portion 132 of the auxiliary component 130 can be matched with the distal end portion 112 of the inspection component 110.
  • FIG. 12 is an explanatory view schematically showing a lock mechanism 163 in the fourth embodiment, and is a cross-sectional view taken along line AA of the inspection component 110 in FIG. 11B.
  • a lock mechanism 163 as a fixed holding portion is provided at the bottom of the tip groove portion 160.
  • the lock mechanism 163 includes a recess 164 for housing the bulging portion 144 and a shutter member that opens and closes the space of the recess 164.
  • the shutter member is composed of a set of spring members 166 having a ball portion 166a at the tip.
  • the spring member 166 is disposed above the recessed portion 164 with the ball portion 166a protruding from the recessed portion 164.
  • the bulging portion 144 of the guide member 140 comes into contact with the ball portion 166a of the spring member 166, and the bulging portion 144 overcomes the urging force of the spring member 166 and passes between the ball portions 166a. And stored in the recess 164.
  • the bulging portion 144 passes between the sphere portions 166a, the sphere portion 166a returns to the original state by the urging force of the spring member 166, the bulging portion 144 is fixedly held in the tip groove portion 160, and the guide member 140 is Fixed to the inspection component 110. Further, when releasing the fixed holding, the holding of the bulging portion 144 in the concave portion 164 can be easily removed by pushing the guide wire 141 forward.
  • FIG. 13 shows the structure of the inspection component 110 and the auxiliary component 130 in the fifth embodiment of the present invention.
  • a magnetic body 171 is provided on the outer surface portion of the inspection component 110 as a bonding portion that connects and bonds the inspection component 110 and the auxiliary component 130.
  • the magnetic body 171 is formed in a rectangular shape that extends in the longitudinal direction of the inspection component 110.
  • the magnetic body 171 is a thin film of a magnetic material such as iron and has magnetism and flexibility. Further, the magnetic bodies 171 are arranged at equal intervals along the circumferential direction of the outer surface portion of the inspection component 110.
  • the magnetic body 171 is mounted so as to be substantially flush with the side surface of the distal end portion 112 so that the magnetic body 171 is not caught by a body wall or the like when inserted into the body cavity.
  • a magnetic body 172 as a joint portion is provided on the outer surface portion of the auxiliary component 130.
  • the magnetic body 172 is formed in a rectangular shape in the longitudinal direction of the auxiliary component 130.
  • the magnetic body 172 is a thin film of a magnetic material such as iron and has magnetism and flexibility.
  • the magnetic bodies 172 are arranged at equal intervals along the circumferential direction of the outer surface portion of the auxiliary component 130.
  • the magnetic body 172 is mounted so as to be substantially flush with the side surface of the distal end portion 132 so that the magnetic body 172 is not caught by a body wall or the like when inserted into the body cavity.
  • the magnetic body 171 of the inspection component 110 and the magnetic body 172 of the auxiliary component 130 are magnetically attached, so that the inspection component 110 and the auxiliary component 130 can be joined in a connected state. Further, when the joining is released after the procedure is finished, the bending portion 113 is bent in the direction in which the inspection component 110 is separated from the auxiliary component 130 by operating the hand operation unit 102 of the inspection component 110, and the magnetic body 171 and the magnetic body 171 are magnetically coupled. The body 172 can be detached.
  • the distance from the distal end surface of the distal end portion 112 of the inspection component 110 to the magnetic body 171 is equal to the distance from the distal end surface of the distal end portion 132 of the auxiliary component 130 to the magnetic body 172.
  • the inspection component 110 and the auxiliary component 130 can be joined in a state where the distal end portion 112 of the inspection component 110 and the distal end portion 132 of the auxiliary component 130 are matched. Can be accurately grasped, and an accurate treatment can be performed.
  • a wire hole 173 communicating with the forceps conduit 134 is formed on the outer surface portion of the auxiliary component 130 at a position facing the groove 150 of the inspection component 110. This eliminates the need to bypass the guide wire from the forceps outlet 134a when the tips of the inspection component 110 and the auxiliary component 130 are matched. Thereby, it is possible to prevent the guide wire from sagging in the forceps conduit 134 and to effectively use the diameter of the forceps conduit 134.
  • the wire hole may be formed by providing a cut extending from the tip surface of the auxiliary component 130 to a position facing the groove 150.
  • the guide wire 141 is operated to increase the diameter of the loop 142 so that the engagement between the guide member 140 and the inspection component 110 is released, and the guide member 140 is moved. You may make it collect
  • FIG. 14 shows the structure of the inspection component 110 and the auxiliary component 130 in the sixth embodiment of the present invention
  • FIG. 15 is an enlarged view of the locking mechanism 183 in the sixth embodiment.
  • a protrusion 182 is provided on the outer surface portion of the auxiliary component 130 as a bonding portion that connects and bonds the inspection component 110 and the auxiliary component 130.
  • a spherical portion 182 a is provided at the tip of the protrusion 182.
  • a concave portion 184 into which the ball portion 182a is inserted is formed on the outer surface portion of the inspection component 110.
  • a lock mechanism 183 is provided inside the recess 184 as a joint for connecting and joining the inspection component 110 and the auxiliary component 130.
  • the lock mechanism 183 includes a recess 184 for housing the ball portion 182a and a shutter member 185 provided on the upper portion of the recess 184.
  • the shutter member 185 is composed of a pair of spring members 188 having a spherical portion 188a at the tip, and opens and closes the space of the recess 184.
  • the spring member 188 is disposed above the recess 184 with the ball portion 188 a protruding from the recess 184.
  • the ball portion 182a presses the ball portion 188a, and the spring member 188 is biased. It overcomes and passes between the ball parts 188a.
  • the ball portion 182a is housed in the recess 184, and the ball portion 188a returns to its original state by the biasing force of the spring, and holds the protrusion 182. Thereby, the inspection component 110 and the auxiliary component 130 are joined in a connected state.
  • the bending portion 113 is bent in the direction in which the inspection component 110 is separated from the auxiliary component 130 by operating the hand operation unit 102 of the inspection component 110, and the ball portion 182a is recessed. 184 can be desorbed.
  • the distance from the distal end surface of the distal end portion 112 of the inspection component 110 to the concave portion 184 and the distance from the distal end surface of the distal end portion 132 of the auxiliary component 130 to the protrusion 182 are configured to be equal. .
  • the inspection component 110 and the auxiliary component 130 can be joined in a state where the distal end portion 112 of the inspection component 110 is aligned with the distal end portion 132 of the auxiliary component 130.
  • the distance from the forceps outlet 134a of the auxiliary component 130 to the lesion site can be accurately grasped, and appropriate treatment can be performed.
  • the guide member 140 and the inspection component 110 are engaged with each other in the same manner as the nasal microscope according to the third embodiment.
  • the inspection component 110 and the auxiliary component 130 can be joined simply by pushing the auxiliary component 130 along.
  • the nasal endoscope of the present invention is not limited to the above-described embodiments, but the thickness of the insertion part of the inspection part and the insertion part of the auxiliary part, the shape of the inspection part and the auxiliary part, the camera guide It goes without saying that various modifications and changes can be made without departing from the configuration of the present invention in terms of the size of the inner diameter, the shape of the magnet and the magnetic body, the number of illumination windows, the shape of the magnetic body, and other materials and configurations.
  • the auxiliary component is not limited to a circular shape in cross section, and may be a semicircular shape.
  • the lock mechanism is not limited to the above-described mechanism as long as the shutter has a mechanism for opening and closing.
  • the tip surface of the auxiliary component is more than the tip surface of the inspection component.
  • it may be slightly located on the back side or the near side.
  • ..Soft part 134 Forceps conduit 134 a. Forceps outlet 140. Guide member 141. Guide wire 142. Loop 143 Wire cover 144. -Bulge part, 145 ... through hole, 146 ... knot, 150 ... groove part, 151 ... bottom part, 152 ... inclined part, 160 ... tip groove part, 163 ... lock mechanism 164 ... recess, 166 ... spring member 66a ... sphere part, 171 ... magnetic body, 172 ... magnetic body, 173 ... wire hole, 182 ... projection, 182a ... sphere part, 183 ... lock mechanism, 184. ..Recess, 185 ... Shutter member, 188 ... Spring member, 188a ... Sphere

Abstract

The present invention provides a nasal endoscope which is configured so that an examination component and an auxiliary component can be easily connected within a body cavity. This nasal endoscope comprises: a long examination component which is provided with an image-capturing section to be inserted into a body cavity from one nostril; and a long auxiliary component which is inserted into the body cavity through the other nostril and connected to the examination component.

Description

経鼻内視鏡Transnasal endoscope
 本発明は、カメラ等の撮像部を備えた検査部品と鉗子管路等を備えた補助部品を有する経鼻内視鏡に関する。 The present invention relates to a transnasal endoscope having an inspection part having an imaging unit such as a camera and an auxiliary part having a forceps conduit.
 外鼻孔からカメラを備えたケーブル(長尺)状の検査部品を挿入して被検者の体腔内の検査を行う、いわゆる経鼻内視鏡が知られている(特許文献1)。このような経鼻内視鏡は、ケーブルが舌根に触れることなく体腔内に入っていくので、ケーブルを口から挿入する経口内視鏡に比べて咽頭反射が起きにくい。その結果、ほとんど吐き気を催さないなど被検者に与える負荷が低いため、近年、需要が増加している。 2. Description of the Related Art A so-called transnasal endoscope is known in which a cable (long) inspection part equipped with a camera is inserted from an outer nostril to inspect a subject's body cavity (Patent Document 1). In such a transnasal endoscope, since the cable enters the body cavity without touching the tongue base, the pharyngeal reflex is less likely to occur than the oral endoscope in which the cable is inserted from the mouth. As a result, since the load given to the subject is low, such as hardly causing nausea, demand has increased in recent years.
 一方、外鼻孔から挿入するためケーブルの径が細くなるので、経口内視鏡と同程度の生検量を得るために、鉗子管路等を有するケーブル状の補助部品を別に設け、検査部品の先端部と補助部品の先端部を体腔内で連結させる経鼻内視鏡が知られている(特許文献2)。
特開2006-68030号公報 特開2010-75269号公報
On the other hand, since the diameter of the cable is narrowed because it is inserted from the nostril, in order to obtain a biopsy amount equivalent to that of an oral endoscope, a cable-like auxiliary part having a forceps conduit is provided separately, and the tip of the inspection part 2. Description of the Related Art A transnasal endoscope is known in which a head part and a tip part of an auxiliary part are connected in a body cavity (Patent Document 2).
JP 2006-68030 A JP 2010-75269 A
 しかしながら、別々に挿入された検査部品の先端部と補助テーブルの先端部を体腔内で連結することは難しく、特許文献2に開示されているように、検査部品の先端部に形成された溝と補助部品の先端部に形成された突起物とを係合させて連結することは、極めて困難であった。 However, it is difficult to connect the tip of the inspection component inserted separately and the tip of the auxiliary table in the body cavity, and as disclosed in Patent Document 2, the groove formed in the tip of the inspection component It was extremely difficult to engage and connect the protrusion formed on the tip of the auxiliary component.
 本発明は、このような状況を考慮してなされたものであり、体腔内において、検査部品と補助部品を容易に連結できる経鼻内視鏡を提供することを目的とする。 The present invention has been made in consideration of such a situation, and an object thereof is to provide a transnasal endoscope that can easily connect a test part and an auxiliary part in a body cavity.
 上記目的を達成するため、本発明の経鼻内視鏡は、一方の外鼻孔から体腔内に挿入される撮像部を備えた長尺状の検査部品と、他方の外鼻孔から体腔内に挿入され、検査部品と連結する長尺状の補助部品とを備える。さらに、検査部品の長手方向に沿って移動する移動係合部と、補助部品に設けられた、移動係合部と係合する固定係合部とを備える。 In order to achieve the above object, the transnasal endoscope of the present invention is inserted into a body cavity from an elongated inspection part having an imaging unit inserted into a body cavity from one outer nostril and the body cavity from the other outer nostril. And a long auxiliary part connected to the inspection part. Furthermore, the moving engagement part which moves along the longitudinal direction of a test | inspection component and the fixed engagement part which engages with the movement engagement part provided in the auxiliary | assistant part are provided.
 また、本発明の経鼻内視鏡は、先端部に検査部品と係合するための先端係合部が形成されたガイドワイヤーを有するガイド部材を備え、補助部品をガイドする。 Further, the transnasal endoscope of the present invention includes a guide member having a guide wire in which a distal end engaging portion for engaging with an inspection component is formed at the distal end portion, and guides auxiliary components.
 本発明の経鼻内視鏡は、体腔内において、検査部品と補助部品を容易に連結することができる。 The transnasal endoscope of the present invention can easily connect an inspection part and an auxiliary part in a body cavity.
本発明の第1の実施の形態における経鼻内視鏡を概略的に示す説明図である。It is explanatory drawing which shows roughly the transnasal endoscope in the 1st Embodiment of this invention. 本発明の第1の実施の形態における検査部品及び補助部品の先端付近の構成を概略的に示す説明図である。It is explanatory drawing which shows roughly the structure of the front-end | tip vicinity of the test | inspection component and auxiliary | assistant component in the 1st Embodiment of this invention. 本発明の第1の実施の形態における検査部品と補助部品の内部の構成を概略的に示す縦断面図である。It is a longitudinal cross-sectional view which shows schematically the structure inside the test | inspection component and auxiliary component in the 1st Embodiment of this invention. 本発明の第2の実施の形態における検査部品及び補助部品の先端付近の構成を概略的に示す説明図である。It is explanatory drawing which shows roughly the structure of the front-end | tip vicinity of the test | inspection component and auxiliary | assistant component in the 2nd Embodiment of this invention. 本発明の第2の実施の形態で使用されるスネア補助部材の全体斜視図である。It is a whole perspective view of the snare auxiliary member used in the second embodiment of the present invention. 本発明の第3の実施の形態における経鼻内視鏡を概略的に示す説明図である。It is explanatory drawing which shows roughly the transnasal endoscope in the 3rd Embodiment of this invention. 本発明の第3の実施の形態における検査部品及び補助部品の先端付近の構成を概略的に示す説明図である。It is explanatory drawing which shows roughly the structure of the test | inspection component and auxiliary | assistant component vicinity in the 3rd Embodiment of this invention. 他の実施形態における補助部品の先端付近の構成を概略的に示す説明図である。It is explanatory drawing which shows roughly the structure of the front-end | tip vicinity of the auxiliary component in other embodiment. 本発明の第3の実施の形態で使用するガイド部材を説明するための概略断面図である。It is a schematic sectional drawing for demonstrating the guide member used in the 3rd Embodiment of this invention. 他の実施形態のガイド部材を説明するための概略断面図である。It is a schematic sectional drawing for demonstrating the guide member of other embodiment. 本発明の第4の実施の形態における検査部品とガイド部材を概略的に示す説明図である。It is explanatory drawing which shows roughly the test components and guide member in the 4th Embodiment of this invention. 本発明の第4の実施の形態におけるロック機構を説明するための概略断面図である。It is a schematic sectional drawing for demonstrating the locking mechanism in the 4th Embodiment of this invention. 本発明の第5の実施の形態における検査部品と補助部品とを接合させた状態を示す説明図である。It is explanatory drawing which shows the state which joined the test | inspection component and auxiliary component in the 5th Embodiment of this invention. 本発明の第6の実施の形態における検査部品と補助部品とを接合させた状態を示す説明図であるIt is explanatory drawing which shows the state which joined the test component and auxiliary component in the 6th Embodiment of this invention. 本発明の第6の実施の形態におけるロック機構を概略的に示す説明図である。It is explanatory drawing which shows roughly the locking mechanism in the 6th Embodiment of this invention.
 以下、本発明の第1の実施の形態について、図面を参照して説明する。なお、各図において共通の部材には、同一の符号を付している。
[第1の実施の形態]
 図1は、本実施の形態における経鼻内視鏡1を概略的に示す説明図であり、図2は、本実施の形態における検査部品10及び補助部品30の先端付近の構成を概略的に示す説明図である。
Hereinafter, a first embodiment of the present invention will be described with reference to the drawings. In addition, the same code | symbol is attached | subjected to the common member in each figure.
[First Embodiment]
FIG. 1 is an explanatory diagram schematically showing a nasal endoscope 1 in the present embodiment, and FIG. 2 schematically shows a configuration in the vicinity of the tips of an inspection component 10 and an auxiliary component 30 in the present embodiment. It is explanatory drawing shown.
 図1に示すように、経鼻内視鏡1は、被検者の体腔内を撮影するカメラ等の撮像素子からなる撮像部を備えた検査部品10と、体腔内の患部等を削除する鉗子等の処理具を挿入するための鉗子管路34等を備えた補助部品30とで構成されている。経鼻内視鏡1には、体腔内を照明するための照明光を供給するための光源装置や、内視鏡画像を表示するモニタ、痰などを吸引する吸引装置等が接続される。 As shown in FIG. 1, the nasal endoscope 1 includes an inspection component 10 including an imaging unit including an imaging element such as a camera that images the inside of a body cavity of a subject, and forceps that delete an affected part in the body cavity. The auxiliary component 30 includes a forceps conduit 34 for inserting a processing tool such as the above. The transnasal endoscope 1 is connected with a light source device for supplying illumination light for illuminating the inside of the body cavity, a monitor for displaying an endoscopic image, a suction device for sucking a sputum and the like.
 検査部品10は、被検者の体腔内に挿入される挿入部11と、挿入部11に連設され、医師や技師などの術者が操作を行うための手元操作部2を有している。挿入部11は、先端部12、湾曲部13、及び軟性部14からなる。先端部12は、硬質な金属材料などで形成されており、先端部12の内部には、カメラが配置されている。 The inspection component 10 includes an insertion portion 11 to be inserted into the body cavity of the subject, and a hand operation portion 2 that is connected to the insertion portion 11 and is operated by an operator such as a doctor or a technician. . The insertion portion 11 includes a distal end portion 12, a bending portion 13, and a flexible portion 14. The distal end portion 12 is formed of a hard metal material or the like, and a camera is disposed inside the distal end portion 12.
 また、検査部品10の内部には、カメラで得られた信号をモニタに送るケーブル等を挿通するためのカメラガイドと、光源装置からの照明光を案内するライトガイドが設けられている。なお、検査部品10の挿入部11は、約3mmの外径を有する管状に形成されており、カメラガイドは、約2mmの内径を有する管状に形成されている。 In addition, a camera guide for inserting a cable or the like for sending a signal obtained by the camera to the monitor and a light guide for guiding illumination light from the light source device are provided inside the inspection component 10. The insertion part 11 of the inspection component 10 is formed in a tubular shape having an outer diameter of about 3 mm, and the camera guide is formed in a tubular shape having an inner diameter of about 2 mm.
 湾曲部13は、手元操作部2の操作に連動して上下左右に湾曲するように構成されている。これにより、先端部12の先端面を所望の方向に向けて、体腔内の観察を行うことができる。軟性部14は、手元操作部2と湾曲部13との間を接続するケーブル状の長尺体部分であり、可撓性を有している。 The bending portion 13 is configured to bend vertically and horizontally in conjunction with the operation of the hand operation portion 2. Thereby, the inside of the body cavity can be observed with the distal end surface of the distal end portion 12 directed in a desired direction. The flexible portion 14 is a cable-like long body portion that connects between the hand operating portion 2 and the bending portion 13 and has flexibility.
 図2に示すように、検査部品10の先端部12の先端面には、観察窓17、一対の照明窓18が設けられている。観察窓17の裏側には、カメラなどの撮像部が配置されている。照明窓18は、観察窓17を挟んだ両側に設けられ、ライトガイドを介して供給される光源装置からの光を観察対象に向けて照射する。 As shown in FIG. 2, an observation window 17 and a pair of illumination windows 18 are provided on the distal end surface of the distal end portion 12 of the inspection component 10. An imaging unit such as a camera is disposed on the back side of the observation window 17. The illumination windows 18 are provided on both sides of the observation window 17 and irradiate light from the light source device supplied via the light guide toward the observation target.
 図1に示すように、補助部品30は、被検者の体腔内に挿入される挿入部31と、挿入部31に連設された操作を行うための手元操作部3を有している。挿入部31は、検査部品10の挿入部11と略同一の外径を有する管状に形成されている。 As shown in FIG. 1, the auxiliary component 30 has an insertion portion 31 to be inserted into the body cavity of the subject and a hand operation portion 3 for performing an operation connected to the insertion portion 31. The insertion portion 31 is formed in a tubular shape having substantially the same outer diameter as the insertion portion 11 of the inspection component 10.
 補助部品30の挿入部31は、先端部32と軟性部33とで構成されている。先端部32は、検査部品10の先端部12と同様に、金属などの硬質な材料で形成されている。軟性部33は、検査部品10の軟性部14と同様に長尺状に構成されており、可撓性を有し、先端部32と手元操作部3との間を接続する。 The insertion part 31 of the auxiliary component 30 includes a tip part 32 and a flexible part 33. The tip portion 32 is formed of a hard material such as a metal, like the tip portion 12 of the inspection component 10. The flexible portion 33 is formed in a long shape like the flexible portion 14 of the inspection component 10, has flexibility, and connects the distal end portion 32 and the hand operating portion 3.
 補助部品30の内部には、鉗子やスネア、生検針などといった各種の処置具を挿通するための鉗子管路34が設けられている。
 鉗子管路34は、約3mmの内径を有する管状に形成されており、補助部品30の挿入部31よりも僅かに細い内径を有するように形成されている。なお、鉗子管路34は、体腔内に溜まった空気や残渣、体液などを吸引するための吸引管路としても用いられる。
Inside the auxiliary component 30, a forceps conduit 34 for inserting various treatment tools such as forceps, a snare, and a biopsy needle is provided.
The forceps conduit 34 is formed in a tubular shape having an inner diameter of about 3 mm, and is formed so as to have an inner diameter slightly smaller than the insertion portion 31 of the auxiliary component 30. The forceps conduit 34 is also used as a suction conduit for aspirating air, residue, body fluid, etc. accumulated in the body cavity.
 補助部品30の先端部32の先端面には、鉗子管路34に挿入された処置具の先端を導出させる鉗子出口34aが形成されている。鉗子出口34aは、鉗子管路34に挿入された処置具の先端を導出させる。 A forceps outlet 34 a is formed on the distal end surface of the distal end portion 32 of the auxiliary component 30 to guide the distal end of the treatment instrument inserted into the forceps conduit 34. The forceps outlet 34 a allows the distal end of the treatment tool inserted into the forceps conduit 34 to be led out.
 経鼻内視鏡1は、一方の外鼻孔から検査部品10の挿入部11を挿入するとともに、検査部品10が挿入されていない他方の外鼻孔から補助部品30の挿入部31を挿入し、これらを体腔内で組み合わせて使用する。検査部品10と別体にした補助部品30に形成した鉗子管路34を通じて患部の削除等の処置を行うことにより、経口内視鏡と同程度の大きさの処置具を使用することができる。 The transnasal endoscope 1 inserts the insertion part 11 of the inspection component 10 from one outer nostril, and inserts the insertion part 31 of the auxiliary component 30 from the other outer nostril where the inspection part 10 is not inserted. Are used in combination in the body cavity. By performing treatment such as deletion of the affected area through the forceps conduit 34 formed on the auxiliary component 30 that is separate from the test component 10, a treatment tool having a size similar to that of an oral endoscope can be used.
 図3は、本実施の形態の経鼻内視鏡1の内部構成を概略的に示すために、検査部品10と補助部品30を長手方向に切断した際の断面図である。
 図3Aに示すように、検査部品10には、ガイド通路としてのワイヤー収納ガイド21が設けられている。ワイヤー収納ガイド21は、検査部品10の外面部の内側近傍であって、検査部品10の長手方向に沿って形成されている。ワイヤー収納ガイド21は、約1mmの内径を有する管状に形成されている。
FIG. 3 is a cross-sectional view of the inspection component 10 and the auxiliary component 30 cut in the longitudinal direction in order to schematically show the internal configuration of the transnasal endoscope 1 of the present embodiment.
As shown in FIG. 3A, the inspection component 10 is provided with a wire storage guide 21 as a guide passage. The wire storage guide 21 is formed in the vicinity of the inside of the outer surface portion of the inspection component 10 and along the longitudinal direction of the inspection component 10. The wire storage guide 21 is formed in a tubular shape having an inner diameter of about 1 mm.
 ワイヤー収納ガイド21の内部には、移動係合部としての第1の磁性部材である磁石22と、磁石22に結合したワイヤー23と、ワイヤー23が掛け回された滑車24が配置されている。滑車24は、検査部品10の先端部12の先端面近傍に固定されている。また、検査部品10の内部には、ワイヤー収納ガイド21と平行に、カメラ15で得られた信号をモニタに送るケーブル等を挿通するためのカメラガイド15aと光源装置からの照明光を案内するライトガイド(図示せず)が設けられている。 Inside the wire storage guide 21, a magnet 22 that is a first magnetic member as a moving engagement portion, a wire 23 coupled to the magnet 22, and a pulley 24 around which the wire 23 is wound are disposed. The pulley 24 is fixed in the vicinity of the distal end surface of the distal end portion 12 of the inspection component 10. Further, inside the inspection component 10, a light guide for guiding illumination light from the light source device and a camera guide 15 a for inserting a cable or the like for sending a signal obtained by the camera 15 to the monitor in parallel with the wire storage guide 21. A guide (not shown) is provided.
 磁石22は、ワイヤー収納ガイド21内を移動できるように、ワイヤー収納ガイド21よりも小さい内径を有するように構成されている。ワイヤー23は、一端が磁石22と結合し、他端が滑車24を介して手元操作部2と接続している。これにより、操作者が、手元操作部2によりワイヤー23を牽引することによって、ワイヤー収納ガイド21の内部において、検査部品10の長手方向に沿って磁石22を移動させることができる。また、検査部品10の移動に合わせて、ワイヤー23を押し出すことにより、ワイヤー収納ガイド21内の磁石22の位置を変えずに、検査部品10のみを移動させることができる。 The magnet 22 is configured to have an inner diameter smaller than that of the wire storage guide 21 so that the magnet 22 can move in the wire storage guide 21. One end of the wire 23 is coupled to the magnet 22, and the other end is connected to the hand operation unit 2 via the pulley 24. Thereby, the operator can move the magnet 22 along the longitudinal direction of the inspection component 10 inside the wire storage guide 21 by pulling the wire 23 by the hand operation unit 2. Further, by pushing the wire 23 in accordance with the movement of the inspection component 10, it is possible to move only the inspection component 10 without changing the position of the magnet 22 in the wire storage guide 21.
 図2に示すように、補助部品30の先端部32の外周面には、固定係合部としての第2の磁性部材である磁性体35が設けられている。磁性体35は、補助部品30の長手方向に沿って筋状に形成されている。磁性体35は、鉄などの磁性材料の薄膜であり、磁性及び可撓性を有している。また、この磁性体35は、体腔内に挿入する際に体壁などに引っ掛からないよう、先端部32の側面と略面一になるように装着されている。 As shown in FIG. 2, a magnetic body 35 as a second magnetic member as a fixed engagement portion is provided on the outer peripheral surface of the distal end portion 32 of the auxiliary component 30. The magnetic body 35 is formed in a streak shape along the longitudinal direction of the auxiliary component 30. The magnetic body 35 is a thin film made of a magnetic material such as iron and has magnetism and flexibility. The magnetic body 35 is mounted so as to be substantially flush with the side surface of the distal end portion 32 so that the magnetic body 35 is not caught by a body wall or the like when inserted into the body cavity.
 本実施の形態では、まず、一方の外鼻孔から検査部品10の挿入部11を体腔内へ挿入して、検査部品10の挿入部11を体腔内の広い場所、ここでは気管支の基端側部分に配置する。ワイヤー収納ガイド21内の磁石22は、予め、検査部品10の先端部12から離れた位置に配置しておくのが好ましい。 In the present embodiment, first, the insertion part 11 of the test part 10 is inserted into the body cavity from one outer nostril, and the insertion part 11 of the test part 10 is placed in a wide space in the body cavity, here, the proximal end portion of the bronchus To place. The magnet 22 in the wire storage guide 21 is preferably arranged in advance at a position away from the distal end portion 12 of the inspection component 10.
次に、他方の外鼻孔から補助部品30の挿入部31を体腔内へ挿入し、手元操作部3を操作して、図3Bに示すように、補助部品30の先端部32を検査部品10に接触させて、補助部品30の磁性体35を検査部品10の基端側に配置された磁石22に磁着させる。これにより、検査部品10と補助部品30とが結合する。 Next, the insertion part 31 of the auxiliary part 30 is inserted into the body cavity from the other nostril and the hand operation part 3 is operated, so that the distal end part 32 of the auxiliary part 30 becomes the inspection part 10 as shown in FIG. 3B. The magnetic body 35 of the auxiliary component 30 is magnetically attached to the magnet 22 disposed on the base end side of the inspection component 10 by making contact. Thereby, the inspection component 10 and the auxiliary component 30 are coupled.
次に、カメラ15で確認を行ないながら、補助部品30を検査部品10に結合させた状態で検査部品10のみを前進させて、先端部12を体内の目的の病変部位まで到達させる。その際に、ワイヤー23は、検査部品10が移動した距離だけワイヤー収納ガイド21に引き込まれる。 Next, while confirming with the camera 15, only the inspection component 10 is advanced in a state where the auxiliary component 30 is coupled to the inspection component 10, and the distal end portion 12 reaches the target lesion site in the body. At that time, the wire 23 is drawn into the wire storage guide 21 by a distance moved by the inspection component 10.
 次に、検査部品10の先端部12を目的の病変部位に到達させた状態で、手元操作部2でワイヤー23を牽引し、ワイヤー収納ガイド21内の磁石22を検査部品10の先端部12へ移動させる。磁石22と磁性体35は磁着しているので、補助部品30は、磁石22の移動とともに検査部品10の外面に沿って移動し、図3Cに示すように、補助部品30の先端部32の先端面が、検査部品10の先端部12の先端面と合致する位置に移動する。 Next, in a state where the distal end portion 12 of the inspection component 10 has reached the target lesion site, the wire 23 is pulled by the hand operation unit 2, and the magnet 22 in the wire storage guide 21 is moved to the distal end portion 12 of the inspection component 10. Move. Since the magnet 22 and the magnetic body 35 are magnetically attached, the auxiliary component 30 moves along the outer surface of the inspection component 10 along with the movement of the magnet 22, and as shown in FIG. The tip surface moves to a position that matches the tip surface of the tip portion 12 of the inspection component 10.
 本実施の形態では、目的の病変部位が、気管支の抹消部位のような経路が細い場所にあっても、検査部品10のみを操作することで、先端部12を容易に近づけることができる。その後、補助部品30を案内することで、確実に補助部品30を抹消部位に到達させることができる。そして、生検鉗子などの処置具を、補助部品30の鉗子管路34に挿入し、鉗子出口34aから導出させて、必要な処置又は治療を行う。 In the present embodiment, even if the target lesion site is located in a narrow path such as a bronchial extirpation site, the distal end portion 12 can be easily approached by operating only the inspection component 10. Thereafter, by guiding the auxiliary component 30, the auxiliary component 30 can be surely reached the erasure site. Then, a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
 治療又は処置を終了した後には、補助部品30から処置具を引き抜き、しかる後に、検査部品10の挿入部11及び補助部品30の挿入部31を体内からゆっくりと引き抜いていく。この途中、検査部品10の先端部12と補助部品30の先端部32との結合を解除する。結合の解除は、例えば、補助部品30の挿入部31のみを強く引き、磁性体35と磁石22との磁着を解除することによって行われる。また、検査部品10を固定した状態で、補助部品30を基端側に引き戻すことで磁石22を検査部品10の先端部12から移動させ、補助部品30の先端部32を検査部品10の先端部12から離した後、磁性体35と磁石22との磁着を解除するようにしてもよい。 After the treatment or treatment is completed, the treatment tool is pulled out from the auxiliary component 30, and then the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 are slowly pulled out from the body. In the middle of this, the coupling between the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is released. The release of the coupling is performed, for example, by pulling only the insertion part 31 of the auxiliary component 30 and releasing the magnetic adhesion between the magnetic body 35 and the magnet 22. Further, the magnet 22 is moved from the distal end portion 12 of the inspection component 10 by pulling the auxiliary component 30 back to the base end side in a state where the inspection component 10 is fixed, and the distal end portion 32 of the auxiliary component 30 is moved to the distal end portion of the inspection component 10. After separating from 12, the magnetic attachment between the magnetic body 35 and the magnet 22 may be released.
 なお、本実施の形態では、検査部品10に磁石22を設け、補助部品30に磁性体35を設けるようにしたが、これに限ることなく、検査部品10に磁性体を設け、補助部品30に磁石を設けるようにしてもよいし、両者を磁石としてもよい。また、磁石は、永久磁石に限らず、電磁石としてもよい。なお、ワイヤー収納ガイド21内の磁石22の位置を移動させる手段としては、ワイヤー23を用いる他に、媒体を用いて油圧、空気圧、水圧等により移動させることが考えられる。 In the present embodiment, the inspection part 10 is provided with the magnet 22 and the auxiliary part 30 is provided with the magnetic body 35. However, the present invention is not limited to this, and the inspection part 10 is provided with a magnetic body and the auxiliary part 30 is provided with the magnetic body 35. A magnet may be provided, or both may be magnets. The magnet is not limited to a permanent magnet, and may be an electromagnet. As a means for moving the position of the magnet 22 in the wire storage guide 21, it is conceivable to use a medium and move it by hydraulic pressure, pneumatic pressure, water pressure, etc. in addition to using the wire 23.
 また、本実施形態では、磁石22がワイヤー収納ガイド21の内部において移動する構成で説明されているが、これに限定されず、検査部品10の長手方向にガイド溝が設けられ、磁石22がガイド溝を移動可能なように構成しても良い。ガイド溝は磁石22との間で、長軸方向の動きは制限せず、長軸方向と直行する2方向の動き規制するような勘合をしていることが好ましい。この場合、磁石22と磁性体35とが直接的に接続されることで接着力を向上させることができるとともに、検査部品10と補助部品30との間の摺動抵抗を減少させることができる。また、ガイド溝が形成されていることにより磁石22の長軸方向の移動が案内されるため、補助部品30の追従性を向上させることができる。 In the present embodiment, the magnet 22 is described as moving in the wire storage guide 21. However, the present invention is not limited to this, and a guide groove is provided in the longitudinal direction of the inspection component 10. You may comprise so that a groove | channel can be moved. It is preferable that the guide groove does not restrict the movement in the major axis direction between the magnet 22 and is fit so as to restrict the movement in two directions perpendicular to the major axis direction. In this case, the adhesive force can be improved by directly connecting the magnet 22 and the magnetic body 35, and the sliding resistance between the inspection component 10 and the auxiliary component 30 can be reduced. Further, since the movement of the magnet 22 in the major axis direction is guided by the formation of the guide groove, the followability of the auxiliary component 30 can be improved.
 以上説明したように、本実施の形態の経鼻内視鏡1によれば、検査部品10の先端部12のみを目的の病変部位に近づけることができる。これにより、微小なトルクで検査部品10の湾曲部13を湾曲させることによって、検査部品10の先端部12を、複雑な経路を通して体腔内の奥へ挿入することができる。すなわち、目的の病変部位が、例えば、肺の末梢部分のように体腔内の奥にあるような場合であっても、確実に検査部品10の先端部12を近づけることができる。さらに、補助部品30の先端部32を、確実に目的の病変部位に近づけることができるので、病変部位の採取等の処置を正確に行うことができる。 As described above, according to the transnasal endoscope 1 of the present embodiment, only the distal end portion 12 of the test component 10 can be brought close to the target lesion site. As a result, by bending the bending portion 13 of the test component 10 with a small torque, the distal end portion 12 of the test component 10 can be inserted into the body cavity through a complicated path. That is, even when the target lesion site is in the back of the body cavity, for example, like the peripheral portion of the lung, the distal end portion 12 of the test component 10 can be reliably brought closer. Furthermore, since the distal end portion 32 of the auxiliary component 30 can be reliably brought close to the target lesion site, a treatment such as collection of the lesion site can be performed accurately.
[第2の実施の形態]
 次に、本発明の第2の実施の形態について説明する。なお、上記の実施の形態と機能・構成が同一のものについては、同符号を付し、詳細な説明を省略する。 図4は、本実施の形態における検査部品10の挿入部11と補助部品30の挿入部31の先端の構成を概略的に示す説明図である。
[Second Embodiment]
Next, a second embodiment of the present invention will be described. Note that components having the same functions and configurations as those of the above-described embodiment are denoted by the same reference numerals, and detailed description thereof is omitted. FIG. 4 is an explanatory diagram schematically showing the configuration of the distal end of the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 in the present embodiment.
 図4Aに示すように、本実施の形態の経鼻内視鏡1の検査部品10の内部には、ワイヤー23と環状部であるループ25aからなる移動ワイヤー部材であるスネア25が収納されるスネア収納ガイド26と、ワイヤー23が挿通されるスネアルーメン27が形成されている。スネア収納ガイド26は、検査部品10の外面に設けられた溝であり、検査部品10の長手方向に延びるように形成されている。スネアルーメン27は、検査部品10の長手方向に沿って形成された貫通孔であり、1mmの内径を有する管状に形成されている。また、スネア収納ガイド26内において、検査部品10の先端部12の先端面近傍には、ワイヤー23を検査部品10の長手方向に沿って折り返すための突起28が設けられている。 As shown in FIG. 4A, a snare that accommodates a snare 25 that is a moving wire member including a wire 23 and a loop 25 a that is an annular portion is housed in the inspection component 10 of the nasal endoscope 1 according to the present embodiment. A storage guide 26 and a snare lumen 27 through which the wire 23 is inserted are formed. The snare storage guide 26 is a groove provided on the outer surface of the inspection component 10 and is formed so as to extend in the longitudinal direction of the inspection component 10. The snare lumen 27 is a through-hole formed along the longitudinal direction of the inspection component 10, and is formed in a tubular shape having an inner diameter of 1 mm. Further, in the snare storage guide 26, a projection 28 for folding the wire 23 along the longitudinal direction of the inspection component 10 is provided in the vicinity of the distal end surface of the distal end portion 12 of the inspection component 10.
 スネア収納ガイド26には、スネア収納ガイド26に沿って移動可能なスネア補助部材29が係合されている。スネア補助部材29は、図5に示すように、スネア収納ガイド26の溝の形状に合致した足部29aと上方へ延びる頭部29bとで構成されている。足部29aには、ワイヤー23を挿通するための孔39aが形成され、頭部29bには、ループ25aを出し入れするための孔39bが形成されている。孔39aと孔39bは、スネア補助部材29の内部で貫通している。 A snare auxiliary member 29 that is movable along the snare storage guide 26 is engaged with the snare storage guide 26. As shown in FIG. 5, the snare auxiliary member 29 includes a foot portion 29 a that matches the groove shape of the snare storage guide 26 and a head portion 29 b that extends upward. A hole 39a for inserting the wire 23 is formed in the foot portion 29a, and a hole 39b for inserting and removing the loop 25a is formed in the head portion 29b. The hole 39 a and the hole 39 b penetrate through the snare auxiliary member 29.
 頭部29bの孔39bからは、ループ25aが連結したワイヤー23が突出しており、足部29aの孔39aからは、ワイヤー23の他端が突出している。足部29aの孔39aから突出したワイヤー23は、折り返し部としての突起28で折り返されて、スネアルーメン27を通って手元操作部2に接続している。 The wire 23 connected to the loop 25a protrudes from the hole 39b of the head portion 29b, and the other end of the wire 23 protrudes from the hole 39a of the foot portion 29a. The wire 23 protruding from the hole 39a of the foot portion 29a is folded back by a projection 28 as a folded portion, and is connected to the hand operating portion 2 through the snare lumen 27.
 ループ25aの径は、補助部品30の先端が挿入できるように、補助部品30の径よりも大きくなるように形成されている。また、ループ25aは、ワイヤー23の端部を曲げて形成することにより、弾性を有するとともに、多少変形したとしても元の形状に戻るように構成されている。ループ25aは、頭部29bの孔39bからスネア補助部材29の内部に引き込まれた状態では窄まった状態に変形し、孔39bから押し出された状態では、ループ状に戻るようになっている。 The diameter of the loop 25a is formed to be larger than the diameter of the auxiliary component 30 so that the tip of the auxiliary component 30 can be inserted. Further, the loop 25a is formed by bending the end portion of the wire 23, so that it has elasticity and returns to its original shape even if it is slightly deformed. The loop 25a is deformed into a narrowed state when pulled into the snare auxiliary member 29 from the hole 39b of the head 29b, and returns to a loop shape when pushed out from the hole 39b.
 図4に示すように、補助部品30の先端部32の外周面には、係合用溝部として、ループ25aが係合するための係合溝37が形成されている。係合溝37は、補助部品30の外面の周方向に沿って形成されている。なお、一般に、補助部品30の軟性部33は、内側より順に可撓性を保ちながら内部を保護するフレックスと呼ばれる螺管と、この螺管の上に被覆され外層の樹脂を保持するブレードと呼ばれるネットと、このネット上に樹脂を被着した外層で構成されているが、係合溝37は、例えば補助部品30の外層部分のみ除去して形成される。 As shown in FIG. 4, an engagement groove 37 for engaging the loop 25a is formed on the outer peripheral surface of the distal end portion 32 of the auxiliary component 30 as an engagement groove. The engagement groove 37 is formed along the circumferential direction of the outer surface of the auxiliary component 30. In general, the soft portion 33 of the auxiliary component 30 is called a flex tube that protects the inside while maintaining flexibility in order from the inside, and a blade that covers the screw tube and holds the resin of the outer layer. Although it comprises a net and an outer layer in which resin is deposited on the net, the engaging groove 37 is formed by removing only the outer layer portion of the auxiliary component 30, for example.
 本実施の形態では、まず、一方の外鼻孔から検査部品10の挿入部11を体腔内へ挿入し、カメラ15で確認を行いながら、体腔内の広い場所に検査部品10の先端部12を配置する。ループ25aの位置は、予め、検査部品10の先端部12から離れた位置に配置しておくのが好ましい。 In the present embodiment, first, the insertion portion 11 of the inspection component 10 is inserted into the body cavity from one outer nostril, and the distal end portion 12 of the inspection component 10 is arranged in a wide place in the body cavity while checking with the camera 15. To do. The position of the loop 25a is preferably arranged in advance at a position away from the tip 12 of the inspection component 10.
 次に、他方の外鼻孔から補助部品30の挿入部31を、検査部品10の先端部12が配置されている体腔内へ挿入し、手元操作部3の操作によって、補助部品30の先端部32を検査部品10の先端部12に近づけて、検査部品10の外面から突出しているループ25aに補助部品30の先端部32を貫通させる。 Next, the insertion portion 31 of the auxiliary component 30 is inserted into the body cavity where the distal end portion 12 of the test component 10 is disposed from the other outer nostril, and the distal end portion 32 of the auxiliary component 30 is operated by the hand operation portion 3. Is brought close to the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is passed through the loop 25 a protruding from the outer surface of the inspection component 10.
 次に、手元操作部2によって、検査部品10の湾曲部13を湾曲させて、スネア25のループ25aを補助部品30の係合溝37に係合させる。 Next, the bending portion 13 of the inspection component 10 is bent by the hand operation portion 2, and the loop 25 a of the snare 25 is engaged with the engagement groove 37 of the auxiliary component 30.
 次に、手元操作部2によって、ループ25aと補助部品30の溝37を係合させた状態で、ワイヤー23を牽引して、ループ25aをスネア補助部材29の内部に引き込んでループ25aの径を絞り、補助部品30と検査部品10とを結合させる。 Next, in the state where the loop 25a and the groove 37 of the auxiliary component 30 are engaged by the hand operation unit 2, the wire 23 is pulled, and the loop 25a is drawn into the snare auxiliary member 29 to reduce the diameter of the loop 25a. The aperture / auxiliary component 30 and the inspection component 10 are combined.
次に、カメラ15で確認を行ないながら、補助部品30を検査部品10に結合させた状態で検査部品10のみを移動させて、先端部12を目的の病変部位まで到達させる。その際に、ワイヤー23は検査部品10が移動した距離だけスネア収納ガイド26に引き込まれる。 Next, while checking with the camera 15, only the inspection part 10 is moved in a state where the auxiliary part 30 is coupled to the inspection part 10, and the distal end portion 12 reaches the target lesion site. At that time, the wire 23 is drawn into the snare storage guide 26 by the distance moved by the inspection component 10.
 次に、検査部品10の先端部12を目的の病変部位に到達させた状態で、手元操作部2でワイヤー23を牽引し、スネア補助部材29を、スネア収納ガイド26に沿って検査部品10の先端部12へ移動させる。補助部品30はループ25aと係合しているので、スネア補助部品29の移動とともに、補助部品30も検査部品10の外面に沿って移動し、図4Bに示すように、補助部品30の先端部32の先端面が、検査部品10の先端部32の先端面と合致する位置に移動する。 Next, in a state where the distal end portion 12 of the inspection component 10 has reached the target lesion site, the wire 23 is pulled by the hand operation unit 2, and the snare auxiliary member 29 is moved along the snare storage guide 26 of the inspection component 10. Move to the tip 12. Since the auxiliary component 30 is engaged with the loop 25a, the auxiliary component 30 also moves along the outer surface of the inspection component 10 along with the movement of the snare auxiliary component 29. As shown in FIG. The tip surface of 32 moves to a position that matches the tip surface of the tip portion 32 of the inspection component 10.
 本実施の形態では、目的の病変部位が、気管支の抹消部位のような経路が細い場所にあっても、検査部品10のみを操作することで、先端部12を容易に近づけることができる。その後、補助部品30を案内することで、確実に補助部品30を抹消部位に到達させることができる。そして、生検鉗子などの処置具を、補助部品30の鉗子管路34に挿入し、鉗子出口34aから導出させて、必要な処置又は治療を行う。 In the present embodiment, even if the target lesion site is located in a narrow path such as a bronchial extirpation site, the distal end portion 12 can be easily approached by operating only the inspection component 10. Thereafter, by guiding the auxiliary component 30, the auxiliary component 30 can be surely reached the erasure site. Then, a treatment tool such as a biopsy forceps is inserted into the forceps conduit 34 of the auxiliary component 30 and led out from the forceps outlet 34a to perform a necessary treatment or treatment.
 治療又は処置を終了した後には、補助部品30から処置具を引き抜き、しかる後に、検査部品10の挿入部11及び補助部品30の挿入部31を体内からゆっくりと引き抜いていく。この途中、検査部品10の先端部12と補助部品30の先端部32との結合を解除する。結合の解除は、手元操作部2によってワイヤー23を押し出して、ループ25aをスネア補助部材29から外に出してループ25aの径を広げた後、補助部品30の挿入部31のみを強く引き、ループ25aと係合溝37との係合を解除することによって行われる。 After the treatment or treatment is completed, the treatment tool is pulled out from the auxiliary component 30, and then the insertion portion 11 of the inspection component 10 and the insertion portion 31 of the auxiliary component 30 are slowly pulled out from the body. In the middle of this, the coupling between the tip 12 of the inspection component 10 and the tip 32 of the auxiliary component 30 is released. To release the coupling, the wire 23 is pushed out by the hand operation unit 2, the loop 25a is moved out of the snare auxiliary member 29 and the diameter of the loop 25a is expanded, and then only the insertion part 31 of the auxiliary component 30 is pulled strongly. This is done by releasing the engagement between the engagement groove 37 and the engagement groove 37.
 以上説明したように、本実施の形態の経鼻内視鏡1によれば、検査部品10の先端部12のみを目的の病変部位に近づけることができる。これにより、微小なトルクで検査部品10の湾曲部13を湾曲させることによって、検査部品10の先端部12を、複雑な経路を通して体腔内の奥へ挿入することができる。すなわち、目的の病変部位が、例えば、肺の末梢部分のように体腔内の奥にあるような場合であっても、確実に検査部品10の先端部12を近づけることができる。さらに、補助部品30の先端部32を目的の病変部位に確実に近づけることができるので、病変部位の採取等の処置を正確に行うことができる。 As described above, according to the transnasal endoscope 1 of the present embodiment, only the distal end portion 12 of the test component 10 can be brought close to the target lesion site. As a result, by bending the bending portion 13 of the test component 10 with a small torque, the distal end portion 12 of the test component 10 can be inserted into the body cavity through a complicated path. That is, even when the target lesion site is in the back of the body cavity, for example, like the peripheral portion of the lung, the distal end portion 12 of the test component 10 can be reliably brought closer. Furthermore, since the distal end portion 32 of the auxiliary component 30 can be reliably brought close to the target lesion site, treatment such as collection of the lesion site can be performed accurately.
[第3の実施の形態]
 次に、本発明の第3の実施形態について、図面を参照して説明する。
 図6は、本実施の形態における経鼻内視鏡100を概略的に示す説明図であり、図7は、本実施の形態における検査部品110及び補助部品130の先端付近の構成を概略的に示す説明図である。
[Third Embodiment]
Next, a third embodiment of the present invention will be described with reference to the drawings.
FIG. 6 is an explanatory diagram schematically showing the nasal endoscope 100 according to the present embodiment, and FIG. 7 schematically shows a configuration near the tips of the inspection component 110 and the auxiliary component 130 according to the present embodiment. It is explanatory drawing shown.
 図6に示すように、経鼻内視鏡100は、被検者の体腔内を撮影するカメラ等の撮像素子からなる撮像部を備えた検査部品110と、体腔内の患部等を削除する鉗子等の処置具を挿入するための鉗子管路134を備えた補助部品130と、ガイドワイヤー141と先端係合部としてのループ142を備えたガイド部材140と、で構成されている。経鼻内視鏡100の検査部品110には、体腔内を照明するための照明光を供給するための光源装置や、内視鏡画像を構築するビデオプロセッサー、ビデオプロセッサーにて構築された内視鏡画像を表示するモニタ、痰などを吸引する吸引装置等が接続される。 As shown in FIG. 6, the nasal endoscope 100 includes a test part 110 including an imaging unit including an imaging element such as a camera that images the inside of a body cavity of a subject, and forceps that deletes an affected area in the body cavity. An auxiliary component 130 having a forceps conduit 134 for inserting a treatment instrument such as a guide member 140 and a guide member 140 having a guide wire 141 and a loop 142 as a tip engaging portion. The inspection component 110 of the nasal endoscope 100 includes a light source device for supplying illumination light for illuminating the inside of the body cavity, a video processor for constructing an endoscopic image, and an endoscope constructed by a video processor. A monitor for displaying a mirror image, a suction device for sucking a bag, and the like are connected.
 検査部品110は、被検者の体腔内に挿入される挿入部111と、挿入部111に連設され、医師や技師などの術者が操作を行うための手元操作部102を有している。また、検査部品110の内部には、カメラで得られた信号をビデオプロセッサーに送るケーブルなどの長尺体を挿通するためのカメラガイドと、光源装置からの照明光を案内するライトガイドが設けられている。なお、検査部品110の挿入部111は、約3mmの外径を有する管状に形成されている。 The inspection component 110 includes an insertion portion 111 that is inserted into the body cavity of the subject, and a hand operation portion 102 that is connected to the insertion portion 111 and is operated by an operator such as a doctor or a technician. . Further, inside the inspection component 110, a camera guide for inserting a long body such as a cable for sending a signal obtained by the camera to the video processor and a light guide for guiding illumination light from the light source device are provided. ing. The insertion part 111 of the inspection component 110 is formed in a tubular shape having an outer diameter of about 3 mm.
 検査部品110の挿入部111は、先端部112、湾曲部113、及び軟性部114からなる。先端部112は、硬質な金属材料や樹脂材料などで形成されており、先端部112の内部には、カメラが配置されている。 The insertion part 111 of the inspection component 110 includes a tip part 112, a bending part 113, and a soft part 114. The distal end portion 112 is formed of a hard metal material, a resin material, or the like, and a camera is disposed inside the distal end portion 112.
 湾曲部113は、手元操作部102の操作に連動して上下左右に湾曲するように構成されている。これにより、先端部112の先端面を所望の方向に向けて、体腔内の観察を行うことができる。軟性部114は、手元操作部102と湾曲部113との間を接続する長尺状の部分であり、可撓性を有している。 The bending portion 113 is configured to bend vertically and horizontally in conjunction with the operation of the hand operation portion 102. As a result, the inside of the body cavity can be observed with the distal end surface of the distal end portion 112 oriented in a desired direction. The soft part 114 is a long part that connects between the hand operation part 102 and the bending part 113 and has flexibility.
 図7に示すように、検査部品110の先端部112の先端面には、観察窓117、一対の照明窓118が設けられている。観察窓117の裏側には、カメラなどの撮像部が配置されている。照明窓118は、観察窓117を挟んだ両側に設けられ、ライトガイドを介して供給される光源装置からの光を観察対象に向けて照射する。 As shown in FIG. 7, an observation window 117 and a pair of illumination windows 118 are provided on the distal end surface of the distal end portion 112 of the inspection component 110. An imaging unit such as a camera is disposed on the back side of the observation window 117. The illumination windows 118 are provided on both sides of the observation window 117, and irradiate light from the light source device supplied via the light guide toward the observation target.
 検査部品110の先端部112には、外面部の周方向に沿って、係止部としての溝部150が形成されている。溝部150は、底部151に向かって傾斜する傾斜部152を有している。この溝部150には、ループ142が係合し、ガイド部材140が係止される。 The groove part 150 as a locking part is formed in the front-end | tip part 112 of the test | inspection component 110 along the circumferential direction of an outer surface part. The groove portion 150 has an inclined portion 152 that is inclined toward the bottom portion 151. A loop 142 is engaged with the groove 150, and the guide member 140 is locked.
 図6に示すように、補助部品130は、被検者の体腔内に挿入される挿入部131と、挿入部131に連設され、Y字コネクターや逆止弁などを連結させることができるハブ103を有している。挿入部131は、検査部品110の挿入部111と略同一の外径を有する管状に形成されている。 As shown in FIG. 6, the auxiliary component 130 includes an insertion portion 131 that is inserted into the body cavity of the subject and a hub that is connected to the insertion portion 131 and can connect a Y-shaped connector, a check valve, and the like. 103. The insertion part 131 is formed in a tubular shape having substantially the same outer diameter as the insertion part 111 of the inspection component 110.
 補助部品130の挿入部131は、先端部132と軟性部133とで構成されている。先端部132は、検査部品110の先端部112と同様に、金属や樹脂などの硬質な材料で形成されている。軟性部133は、検査部品110の軟性部114と同様に長尺状に構成されており、可撓性を有し、先端部132とハブ103との間を接続する。 The insertion part 131 of the auxiliary component 130 includes a tip part 132 and a soft part 133. The tip portion 132 is formed of a hard material such as metal or resin, like the tip portion 112 of the inspection component 110. The flexible portion 133 is formed in a long shape similarly to the flexible portion 114 of the inspection component 110, has flexibility, and connects between the distal end portion 132 and the hub 103.
 補助部品130の内部には、鉗子やスネアなどといった各種の処置具を挿通するための鉗子管路134が設けられている。鉗子管路134は、約3mmの内径を有する管状に形成されており、補助部品130の挿入部131よりも僅かに細い内径を有するように形成されている。補助部品130の先端部132の先端面には、鉗子管路134に挿入された処置具の先端を導出させる鉗子出口134aが形成されている。また、鉗子出口134aには、ガイド部材140のガイドワイヤー141の端部が挿入される。なお、鉗子管路134は、体腔内に溜まった空気や残渣、体液などを吸引するための吸引管路としても用いられる。 In the auxiliary part 130, a forceps conduit 134 for inserting various treatment tools such as forceps and snare is provided. The forceps conduit 134 is formed in a tubular shape having an inner diameter of about 3 mm, and is formed so as to have an inner diameter slightly thinner than the insertion portion 131 of the auxiliary component 130. A forceps outlet 134 a is formed on the distal end surface of the distal end portion 132 of the auxiliary component 130 to guide the distal end of the treatment instrument inserted into the forceps conduit 134. Further, the end of the guide wire 141 of the guide member 140 is inserted into the forceps outlet 134a. The forceps conduit 134 is also used as a suction conduit for aspirating air, residue, body fluid, etc. accumulated in the body cavity.
 図6に示すように、ガイド部材140は、直線状のガイドワイヤー141と、ガイドワイヤー141の一端に連設されたループ142と、で構成されている。ガイド部材140の直線部分には、ガイドワイヤー141を覆うようにワイヤーカバー143が設けられている。ワイヤーカバー143は、ガイドワイヤー141を挿通させるための貫通孔を有する管状の部材である。 As shown in FIG. 6, the guide member 140 includes a linear guide wire 141 and a loop 142 connected to one end of the guide wire 141. A wire cover 143 is provided on the straight portion of the guide member 140 so as to cover the guide wire 141. The wire cover 143 is a tubular member having a through hole through which the guide wire 141 is inserted.
 ガイドワイヤー141は、ニッケルチタン合金のような超弾性合金で構成されている。なお、ステレンス鋼や、それらを含めた連結複合材を用いてもよい。ガイドワイヤー141の長さは、補助部品130と検査部品110の合計長よりも長くなるように構成されている。本実施の形態で使用するワイヤーの長さは2000mm~4000mmの範囲であって、使用目的に応じて長さを変更する。また、ワイヤーの直径は0.3mm~1.0mmの範囲であって、本実施の形態では直径が0.5mmのワイヤーを使用する。 The guide wire 141 is made of a superelastic alloy such as a nickel titanium alloy. In addition, you may use stainless steel and the connection composite material containing them. The length of the guide wire 141 is configured to be longer than the total length of the auxiliary component 130 and the inspection component 110. The length of the wire used in this embodiment is in the range of 2000 mm to 4000 mm, and the length is changed according to the purpose of use. The diameter of the wire is in the range of 0.3 mm to 1.0 mm. In this embodiment, a wire having a diameter of 0.5 mm is used.
 先端環状部としてのループ142は、ガイドワイヤー141の一部を環状に加工して形成されており、ループ142の径を変えることができる。本実施の形態のループ142の径は、1.0mm~5.0mmの範囲で変更可能に構成されている。術者は、ループ142が形成されている側と反対側のガイドワイヤー141の端部を把持して、ガイド部材140の操作を行う。 The loop 142 as the tip annular portion is formed by processing a part of the guide wire 141 into an annular shape, and the diameter of the loop 142 can be changed. The diameter of the loop 142 of the present embodiment is configured to be changeable within a range of 1.0 mm to 5.0 mm. The operator operates the guide member 140 by grasping the end portion of the guide wire 141 opposite to the side where the loop 142 is formed.
 また、鉗子管路134に貫通する貫通孔を補助部品130の挿入部131に形成し、鉗子管路134内のガイドワイヤー141を、補助部品130の外側へ逃がすように構成してもよい。これにより、鉗子出口134aに挿入されたガイドワイヤー141の端部は、鉗子管路134を通り、貫通孔から補助部品130の外側へ突出する。なお、貫通孔を形成する場所は、補助部品130の先端部132から200mm程度離れた場所が好ましい。これにより、ガイドワイヤー141の長さを、検査部品110の長さに200mmを加えた長さよりも若干長い程度に抑えることができる。 Alternatively, a through-hole penetrating the forceps conduit 134 may be formed in the insertion part 131 of the auxiliary component 130 so that the guide wire 141 in the forceps conduit 134 is released to the outside of the auxiliary component 130. As a result, the end portion of the guide wire 141 inserted into the forceps outlet 134 a passes through the forceps conduit 134 and protrudes outside the auxiliary component 130 from the through hole. The place where the through hole is formed is preferably a place that is about 200 mm away from the distal end portion 132 of the auxiliary component 130. Thereby, the length of the guide wire 141 can be suppressed to a length slightly longer than the length obtained by adding 200 mm to the length of the inspection component 110.
 経鼻内視鏡100は、一方の外鼻孔から検査部品110の挿入部111を挿入して、検査部品110の挿入部111を体腔内の広い場所、ここでは咽頭部もしくは気管の基端側部分に配置する。次に、検査部品110が挿入されていない他方の外鼻孔からガイド部材140のループ142を挿入して押し進め、ループ142を同様に咽頭部もしくは気管の基端側部に到達させる。本実施の形態では、径の細いガイドワイヤー141のみを操作すればよいので、ガイド部材140のループ142を検査部品110の先端部112に容易に近づけることができる。このとき、ループ142が検査部品110の先端部112よりも奥側に位置するように、ガイド部材140を押し進める。 The transnasal endoscope 100 inserts the insertion part 111 of the inspection part 110 from one outer nostril, and inserts the insertion part 111 of the inspection part 110 in a wide space in the body cavity, here, the proximal part of the pharynx or trachea To place. Next, the loop 142 of the guide member 140 is inserted and pushed forward from the other outer nostril into which the test part 110 is not inserted, and the loop 142 is similarly reached to the proximal part of the pharynx or trachea. In the present embodiment, since only the guide wire 141 having a small diameter needs to be operated, the loop 142 of the guide member 140 can be easily brought close to the distal end portion 112 of the inspection component 110. At this time, the guide member 140 is pushed forward so that the loop 142 is located on the back side with respect to the distal end portion 112 of the inspection component 110.
 次に、検査部品110のカメラからの映像をモニタで確認しながら、ガイド部材140を操作して、ループ142を検査部品110の先端部112に挿入し、図7に示すように、ループ142を溝部150にひっかけて、ガイド部材140を検査部品110に係合する。本実施の形態では、径の細いガイドワイヤー141を操作すればよいので、ループ142を溝部150に容易にひっかけることができる。また、溝部150は傾斜部152を有しているので、ループ142を簡単にひっかけることができる。そして、ガイド部材140を検査部品110に係合させた状態で、検査部品110の先端部112を目的の病変部位に到達させる。 Next, while confirming an image from the camera of the inspection component 110 on the monitor, the guide member 140 is operated to insert the loop 142 into the distal end portion 112 of the inspection component 110. As shown in FIG. The guide member 140 is engaged with the inspection component 110 by being caught in the groove 150. In the present embodiment, since the guide wire 141 having a small diameter may be operated, the loop 142 can be easily hooked on the groove 150. Moreover, since the groove part 150 has the inclination part 152, the loop 142 can be hooked easily. Then, with the guide member 140 engaged with the test component 110, the distal end portion 112 of the test component 110 reaches the target lesion site.
 次に、補助部品130の鉗子出口134aに、外鼻孔から突出しているガイド部材140のガイドワイヤー141の端部を挿入し、ガイドワイヤー141に沿って補助部品130の挿入部131を体腔内へ押し進める。このとき、補助部品130がガイド部材140のガイドワイヤー141にガイドされているため、挿入部131を押し進めるだけで、補助部品130の先端部132を病変部位の近くに配置された検査部品110の先端部112に近づけることができる。そして、補助部品130の鉗子出口134aから生検鉗子等の処置具を突出させて、病変部位の削除等の処置を行うことができる。 Next, the end portion of the guide wire 141 of the guide member 140 protruding from the outer nostril is inserted into the forceps outlet 134a of the auxiliary component 130, and the insertion portion 131 of the auxiliary component 130 is pushed into the body cavity along the guide wire 141. . At this time, since the auxiliary component 130 is guided by the guide wire 141 of the guide member 140, the distal end portion 132 of the auxiliary component 130 is placed near the lesion site only by pushing the insertion portion 131 forward. It can be brought close to the part 112. Then, a treatment tool such as a biopsy forceps can be projected from the forceps outlet 134a of the auxiliary component 130 to perform a treatment such as deletion of a lesion site.
 本実施の形態に係る経鼻内視鏡100によれば、ガイド部材140と検査部品110とを係合し、ガイド部材140に沿って補助部品130を押し進めるだけで、補助部品130の先端部132を検査部品110の先端部112に合致させることができる。なお、補助部品130に鉗子管路を設けているので、鉗子管路の径をある程度大きくし、経口内視鏡と同程度の大きさの処置具を使用することができる。 According to the nasal endoscope 100 according to the present embodiment, the distal end portion 132 of the auxiliary component 130 can be obtained by simply engaging the guide member 140 and the inspection component 110 and pushing the auxiliary component 130 along the guide member 140. Can be matched with the tip 112 of the inspection component 110. In addition, since the forceps conduit is provided in the auxiliary part 130, the diameter of the forceps conduit can be increased to some extent, and a treatment instrument having the same size as an oral endoscope can be used.
 処置を終了した後には、補助部品130から処置具を引き抜き、しかる後に、検査部品110及び補助部品130を体腔内からゆっくりと引き抜いていく。この途中、検査部品110と補助部品130との係合を解除する。係合の解除は、ガイド部材140を操作して、ループ142と溝部150との係止を解除することによって行われる。 After the treatment is completed, the treatment tool is pulled out from the auxiliary component 130, and then the inspection component 110 and the auxiliary component 130 are slowly pulled out from the body cavity. In the middle of this, the engagement between the inspection component 110 and the auxiliary component 130 is released. The engagement is released by operating the guide member 140 to release the lock between the loop 142 and the groove 150.
 図8は、他の実施形態における補助部品130の先端付近の構成を概略的に示す説明図である。
 図8に示すように、ガイドワイヤーを挿通するためのワイヤーガイド105を補助部品130の外面部に設けてもよい。ワイヤーガイド105は、0.3mm~1.0mmの内径を有する管状の部材であり、補助部品130の長手方向に沿って取り付けられている。本実施の形態では、内径が0.5mmのワイヤーガイド105を使用する。ワイヤーガイド105の一端部105aは、補助部品130の先端部132の近傍に位置し、他端部はハブ103の近傍に位置する。ワイヤーガイド105は、軟性部133と一体に成型してもよいし、ワイヤーガイド105を別に製造し、接着剤等を用いて補助部品130の外面に装着してもよい。
FIG. 8 is an explanatory diagram schematically showing a configuration near the tip of the auxiliary component 130 in another embodiment.
As shown in FIG. 8, a wire guide 105 for inserting a guide wire may be provided on the outer surface portion of the auxiliary component 130. The wire guide 105 is a tubular member having an inner diameter of 0.3 mm to 1.0 mm, and is attached along the longitudinal direction of the auxiliary component 130. In this embodiment, a wire guide 105 having an inner diameter of 0.5 mm is used. One end portion 105 a of the wire guide 105 is located in the vicinity of the distal end portion 132 of the auxiliary component 130, and the other end portion is located in the vicinity of the hub 103. The wire guide 105 may be molded integrally with the flexible portion 133, or the wire guide 105 may be manufactured separately and attached to the outer surface of the auxiliary component 130 using an adhesive or the like.
 この実施形態では、ワイヤーガイド105の端部105aに、外鼻孔から突出しているガイドワイヤー141の端部を挿入し、補助部品130の挿入部131を、ワイヤーガイド105とともに、ガイドワイヤー141に沿って体腔内へ押し進める。これにより、ガイドワイヤー141を鉗子管路134に挿通させる必要がなくなるので、鉗子管路134の径と同じ大きさの処置具を使用するなど、鉗子管路134の径を有効に利用することができる。 In this embodiment, the end portion of the guide wire 141 protruding from the outer nostril is inserted into the end portion 105 a of the wire guide 105, and the insertion portion 131 of the auxiliary component 130 is moved along the guide wire 141 together with the wire guide 105. Push it into the body cavity. This eliminates the need for the guide wire 141 to be inserted into the forceps conduit 134, so that the diameter of the forceps conduit 134 can be used effectively, such as using a treatment instrument having the same size as the diameter of the forceps conduit 134. it can.
 ワイヤーガイド105を用いずに、補助部品130の外面部の内側に、直接ガイドワイヤー141を挿入するための挿通孔を形成してもよい。挿通孔は、補助部品130の外層の肉厚部分に、補助部品130の長手方向に沿って形成する。なお、挿通孔の径は、ガイドワイヤーよりも大きい径を有していればよい。そして、外鼻孔から突出しているガイドワイヤー141の端部を挿通孔に挿入し、補助部品130の挿入部131をガイドワイヤー141に沿って体腔内へ押し進める。 Instead of using the wire guide 105, an insertion hole for directly inserting the guide wire 141 may be formed inside the outer surface portion of the auxiliary component 130. The insertion hole is formed in the thick part of the outer layer of the auxiliary component 130 along the longitudinal direction of the auxiliary component 130. In addition, the diameter of an insertion hole should just have a larger diameter than a guide wire. Then, the end portion of the guide wire 141 protruding from the outer nostril is inserted into the insertion hole, and the insertion portion 131 of the auxiliary component 130 is pushed into the body cavity along the guide wire 141.
 図9は、本実施の形態におけるガイド部材140を説明するための断面図である。
 図9に示すように、ガイド部材140は、一本のワイヤーの途中でループ142を形成し、ループ部分で折り返すことにより構成されている。従って、ループ以外の部分は、二本の直線状のワイヤーが並行に配置された状態である。ワイヤーカバー143は、ガイド部材140の直線状のワイヤー部分を覆うように設けられている。
FIG. 9 is a cross-sectional view for explaining the guide member 140 in the present embodiment.
As shown in FIG. 9, the guide member 140 is configured by forming a loop 142 in the middle of one wire and folding back at the loop portion. Therefore, the part other than the loop is a state in which two linear wires are arranged in parallel. The wire cover 143 is provided so as to cover the linear wire portion of the guide member 140.
 図10は、他の実施の形態におけるガイド部材140´を説明するための断面図である。
 図10に示すように、ガイド部材140´は、ガイドワイヤーの先端部に結び目146を形成し、この結び目に46にガイドワイヤーを挿通することにより、ループ142を形成する。結び目146は、ワイヤーカバー143の端部に固定されている。
FIG. 10 is a cross-sectional view for explaining a guide member 140 ′ according to another embodiment.
As shown in FIG. 10, the guide member 140 ′ forms a loop 142 by forming a knot 146 at the tip of the guide wire and inserting the guide wire through the knot 46. The knot 146 is fixed to the end of the wire cover 143.
 ワイヤーカバー143を、ガイドワイヤーに沿って移動させることにより、ループ142の径を自由自在に拡径、縮径することができる。例えば、ループ142の径を小さくしたい場合には、ワイヤーカバー143をループ142に近づくように移動させて、ループ142を形成している一部のワイヤーを貫通孔145に挿入し、ループ142の径を小さくする。また、ループ142の径を小さくした状態から径を大きくしたい場合には、ワイヤーカバー143をループ142から遠ざけて、貫通孔145の中に収納されているワイヤーの一部をループ142の一部として供給し、ループ142の径を元の状態に戻す。 By moving the wire cover 143 along the guide wire, the diameter of the loop 142 can be freely expanded and reduced. For example, when it is desired to reduce the diameter of the loop 142, the wire cover 143 is moved so as to approach the loop 142, and a part of the wire forming the loop 142 is inserted into the through hole 145. Make it smaller. Further, when it is desired to increase the diameter from the state where the diameter of the loop 142 is reduced, the wire cover 143 is moved away from the loop 142 and a part of the wire accommodated in the through hole 145 is set as a part of the loop 142. Then, the diameter of the loop 142 is returned to the original state.
 このように、ループ142を検査部品110に係合させた後に、ワイヤーカバー143を移動させてループ142の径を小さくすることにより、ガイド部材140と検査部品110との係合を強くすることができる。 As described above, after the loop 142 is engaged with the inspection component 110, the wire cover 143 is moved to reduce the diameter of the loop 142, thereby strengthening the engagement between the guide member 140 and the inspection component 110. it can.
〔第4の実施の形態〕
 次に、図11及び図12を用いて、本発明の第4の実施の形態について説明する。なお、第4の実施の形態において、第3の実施の形態と構成が同一の部分については、重複した説明を省略する。
[Fourth Embodiment]
Next, a fourth embodiment of the present invention will be described with reference to FIGS. Note that in the fourth embodiment, a description of the same components as those in the third embodiment will be omitted.
 図11Aは、本発明の第4の実施の形態における検査部品110の構造及びガイド部材140の全体構造を示し、図11Bは、ガイド部材140が検査部品110に係合した状態を示す説明図である。 FIG. 11A shows the structure of the inspection component 110 and the entire structure of the guide member 140 according to the fourth embodiment of the present invention, and FIG. 11B is an explanatory view showing a state where the guide member 140 is engaged with the inspection component 110. is there.
 図11Aに示すように、検査部品110の先端部112には、先端面から検査部品110の長手方向に沿って、後述する膨出部を係止する膨出係止部としての先端溝部160が形成されている。先端溝部160は、検査部品110の先端から外周面の長手方向に沿って形成されており、膨出部係止用溝部を構成する。先端溝部160は、断面がV字形状に形成されており、先端面から遠ざかるにつれて溝の深さが浅くなるように構成されている。 As shown in FIG. 11A, a tip groove portion 160 as a bulging locking portion that locks a bulging portion described later from the tip surface along the longitudinal direction of the testing component 110 is provided at the tip portion 112 of the testing component 110. Is formed. The tip groove portion 160 is formed along the longitudinal direction of the outer peripheral surface from the tip of the inspection component 110 and constitutes a bulging portion locking groove portion. The tip groove portion 160 has a V-shaped cross section, and is configured such that the depth of the groove becomes shallower as the distance from the tip surface increases.
 ガイド部材140は、直線状のガイドワイヤー141と、ガイドワイヤー141の一端に連設された先端係合部としての膨出部144とで構成されている。膨出部144は、球状であって、ガイドワイヤー141の径よりも大きい径を有するように形成されている。 The guide member 140 is composed of a linear guide wire 141 and a bulging portion 144 as a tip engaging portion connected to one end of the guide wire 141. The bulging portion 144 is spherical and is formed to have a diameter larger than the diameter of the guide wire 141.
 経鼻内視鏡100は、一方の外鼻孔から検査部品110の挿入部111を挿入して、検査部品110の挿入部111を体腔内の広い場所、ここでは咽頭部もしくは気管の基端側部分に配置する。次に、検査部品110が挿入されていない他方の外鼻孔からガイド部材140の膨出部144を挿入して押し進め、膨出部144を咽頭部もしくは気管の基端側部分に到達させる。本実施の形態では、径の細いガイドワイヤー141のみを操作すればよいので、体腔内においても、ガイド部材140の膨出部144を検査部品110の先端部112に容易に近づけることができる。このとき、膨出部144が検査部品110の先端部112よりも奥側に位置するように、ガイドワイヤー141を押し進める。 The transnasal endoscope 100 inserts the insertion part 111 of the inspection part 110 from one outer nostril, and inserts the insertion part 111 of the inspection part 110 in a wide space in the body cavity, here, the proximal part of the pharynx or trachea To place. Next, the bulging portion 144 of the guide member 140 is inserted and pushed forward from the other nostril where the test part 110 is not inserted, and the bulging portion 144 reaches the pharynx or the proximal end portion of the trachea. In the present embodiment, since only the guide wire 141 having a small diameter needs to be operated, the bulging portion 144 of the guide member 140 can be easily brought close to the distal end portion 112 of the inspection component 110 even in the body cavity. At this time, the guide wire 141 is pushed forward so that the bulging portion 144 is located behind the tip portion 112 of the inspection component 110.
 次に、検査部品110のカメラからの映像をモニタで確認しながら、ガイド部材140を操作して、図11Bに示すように、ガイドワイヤー141を先端溝部160にひっかけた後に、ガイドワイヤー141を牽引することにより、膨出部144を先端溝部160に係止してガイド部材140を検査部品110に係合する。本実施の形態では、径の細いガイドワイヤー141を操作すればよいので、容易に膨出部144を先端溝部160に係止することができる。そして、ガイド部材140を検査部品110に係合させた状態で、検査部品110の先端部112を目的の病変部位に近づける。 Next, while confirming the image from the camera of the inspection component 110 on the monitor, the guide member 140 is operated to hook the guide wire 141 on the leading end groove 160 as shown in FIG. 11B, and then the guide wire 141 is pulled. By doing so, the bulging portion 144 is locked to the tip groove portion 160 and the guide member 140 is engaged with the inspection component 110. In the present embodiment, since the guide wire 141 having a small diameter may be operated, the bulging portion 144 can be easily locked to the distal end groove portion 160. Then, with the guide member 140 engaged with the test component 110, the tip 112 of the test component 110 is brought close to the target lesion site.
 次に、外鼻孔から突出しているガイドワイヤー141の端部を、補助部品130の鉗子出口134aに挿入し、ガイドワイヤー141に沿って補助部品130の挿入部131を体腔内へ押し進める。このとき、補助部品130がガイド部材140のガイドワイヤー141にガイドされているため、挿入部131を押し進めるだけで、補助部品130の先端部132を病変部位に配置された検査部品110の先端部112に近づけることができる。このように、モニタ等を用いた確認作業を行わなくても、ガイド部材140に沿って補助部品130を押し進めるだけで、補助部品130の先端部132を検査部品110の先端部112に近づけることができる。そして、補助部品130の鉗子出口134aから生検鉗子等の処置具を突出させて、病変部位の削除等の処置を行うことができる。 Next, the end of the guide wire 141 protruding from the outer nostril is inserted into the forceps outlet 134a of the auxiliary part 130, and the insertion part 131 of the auxiliary part 130 is pushed into the body cavity along the guide wire 141. At this time, since the auxiliary component 130 is guided by the guide wire 141 of the guide member 140, the distal end portion 112 of the inspection component 110 disposed at the lesion site is simply moved forward by pushing the insertion portion 131. Can be approached. As described above, the tip 132 of the auxiliary component 130 can be brought close to the tip 112 of the inspection component 110 only by pushing the auxiliary component 130 along the guide member 140 without performing a confirmation operation using a monitor or the like. it can. Then, a treatment tool such as a biopsy forceps can be projected from the forceps outlet 134a of the auxiliary component 130 to perform a treatment such as deletion of a lesion site.
 この第4の実施の形態に係る経鼻内視鏡によっても、第3の実施の形態に係る経鼻顕微鏡について説明したのと同様にして、ガイド部材140と検査部品110とを係合し、ガイド部材140に沿って補助部品130を押し進めるだけで、補助部品130の先端部132を検査部品110の先端部112に合致させることができる。 The nasal endoscope according to the fourth embodiment also engages the guide member 140 and the inspection component 110 in the same manner as described for the nasal microscope according to the third embodiment. By simply pushing the auxiliary component 130 along the guide member 140, the distal end portion 132 of the auxiliary component 130 can be matched with the distal end portion 112 of the inspection component 110.
 図12は、第4の実施の形態におけるロック機構163を概略的に示す説明図であり、図11Bにおける検査部品110のA-A線断面図である。 
 図12に示すように、先端溝部160の底部には、固定保持部としてのロック機構163が設けられている。ロック機構163は、膨出部144を収納するための凹部164と、凹部164の空間を開閉するシャッタ部材とで構成されている。シャッタ部材は、先端に球部166aを有する1組のばね部材166で構成されている。ばね部材166は、球部166aを凹部164より突出させた状態で、凹部164の上方に配置されている。
FIG. 12 is an explanatory view schematically showing a lock mechanism 163 in the fourth embodiment, and is a cross-sectional view taken along line AA of the inspection component 110 in FIG. 11B.
As shown in FIG. 12, a lock mechanism 163 as a fixed holding portion is provided at the bottom of the tip groove portion 160. The lock mechanism 163 includes a recess 164 for housing the bulging portion 144 and a shutter member that opens and closes the space of the recess 164. The shutter member is composed of a set of spring members 166 having a ball portion 166a at the tip. The spring member 166 is disposed above the recessed portion 164 with the ball portion 166a protruding from the recessed portion 164.
 ガイドワイヤー141を牽引すると、ガイド部材140の膨出部144がばね部材166の球部166aに当接し、膨出部144は、ばね部材166の付勢力に打ち勝って球部166aの間を通過して凹部164に収納される。膨出部144が球部166aの間を通過すると、球部166aは、ばね部材166の付勢力によって元の状態に戻り、膨出部144が先端溝部160に固定保持されて、ガイド部材140が検査部品110に固定保持される。また、固定保持を解除する際には、ガイドワイヤー141を前方に押し出すことによって、膨出部144の凹部164への保持は簡単に外すことができる。 When the guide wire 141 is pulled, the bulging portion 144 of the guide member 140 comes into contact with the ball portion 166a of the spring member 166, and the bulging portion 144 overcomes the urging force of the spring member 166 and passes between the ball portions 166a. And stored in the recess 164. When the bulging portion 144 passes between the sphere portions 166a, the sphere portion 166a returns to the original state by the urging force of the spring member 166, the bulging portion 144 is fixedly held in the tip groove portion 160, and the guide member 140 is Fixed to the inspection component 110. Further, when releasing the fixed holding, the holding of the bulging portion 144 in the concave portion 164 can be easily removed by pushing the guide wire 141 forward.
〔第5の実施の形態〕
 次に、図13を用いて、本発明の第5の実施の形態について説明する。なお、第5の実施の形態において、第3の実施の形態と構成が同一の部分については、重複した説明を省略する。
[Fifth Embodiment]
Next, a fifth embodiment of the present invention will be described with reference to FIG. Note that in the fifth embodiment, a redundant description of portions having the same configuration as that of the third embodiment will be omitted.
 図13は、本発明の第5の実施の形態における検査部品110及び補助部品130の構造を示すものである。
 図13に示すように、検査部品110の外面部には、検査部品110と補助部品130を連結して接合する接合部としての磁性体171が設けられている。磁性体171は、検査部品110の長手方向に延びるような矩形状に形成されている。磁性体171は、鉄などの磁性材料の薄膜であり、磁性及び可撓性を有している。また、磁性体171は、検査部品110の外面部の周方向に沿って等間隔に配置されている。この磁性体171は、体腔内に挿入する際に体壁などに引っ掛からないよう、先端部112の側面と略面一になるように装着されている。
FIG. 13 shows the structure of the inspection component 110 and the auxiliary component 130 in the fifth embodiment of the present invention.
As shown in FIG. 13, a magnetic body 171 is provided on the outer surface portion of the inspection component 110 as a bonding portion that connects and bonds the inspection component 110 and the auxiliary component 130. The magnetic body 171 is formed in a rectangular shape that extends in the longitudinal direction of the inspection component 110. The magnetic body 171 is a thin film of a magnetic material such as iron and has magnetism and flexibility. Further, the magnetic bodies 171 are arranged at equal intervals along the circumferential direction of the outer surface portion of the inspection component 110. The magnetic body 171 is mounted so as to be substantially flush with the side surface of the distal end portion 112 so that the magnetic body 171 is not caught by a body wall or the like when inserted into the body cavity.
 補助部品130の外面部には、接合部としての磁性体172が設けられている。磁性体172は、補助部品130の長手方向に矩形状に形成されている。磁性体172は、鉄などの磁性材料の薄膜であり、磁性及び可撓性を有している。磁性体172は、補助部品130の外面部の周方向に沿って等間隔に配置されている。この磁性体172は、体腔内に挿入する際に体壁などに引っ掛からないよう、先端部132の側面と略面一になるように装着されている。 A magnetic body 172 as a joint portion is provided on the outer surface portion of the auxiliary component 130. The magnetic body 172 is formed in a rectangular shape in the longitudinal direction of the auxiliary component 130. The magnetic body 172 is a thin film of a magnetic material such as iron and has magnetism and flexibility. The magnetic bodies 172 are arranged at equal intervals along the circumferential direction of the outer surface portion of the auxiliary component 130. The magnetic body 172 is mounted so as to be substantially flush with the side surface of the distal end portion 132 so that the magnetic body 172 is not caught by a body wall or the like when inserted into the body cavity.
 本実施の形態によれば、検査部品110の磁性体171と補助部品130の磁性体172とを磁着させることにより、検査部品110と補助部品130とを連結した状態で接合させることができる。また、手技終了後に接合を解除する場合には、検査部品110の手元操作部102を操作することにより、検査部品110が補助部品130から離れる方向に湾曲部113を湾曲させ、磁性体171と磁性体172を離脱させることができる。 According to the present embodiment, the magnetic body 171 of the inspection component 110 and the magnetic body 172 of the auxiliary component 130 are magnetically attached, so that the inspection component 110 and the auxiliary component 130 can be joined in a connected state. Further, when the joining is released after the procedure is finished, the bending portion 113 is bent in the direction in which the inspection component 110 is separated from the auxiliary component 130 by operating the hand operation unit 102 of the inspection component 110, and the magnetic body 171 and the magnetic body 171 are magnetically coupled. The body 172 can be detached.
 また、本実施の形態では、検査部品110の先端部112の先端面から磁性体171までの距離と、補助部品130の先端部132の先端面から磁性体172までの距離が等しくなるように構成されている。これにより、検査部品110の先端部112と補助部品130の先端部132を一致させた状態で、検査部品110と補助部品130を接合させることができるので、補助部品130の鉗子出口134aから病変部位までの距離を正確に把握することができ、正確な処置を行うことができる。 Further, in the present embodiment, the distance from the distal end surface of the distal end portion 112 of the inspection component 110 to the magnetic body 171 is equal to the distance from the distal end surface of the distal end portion 132 of the auxiliary component 130 to the magnetic body 172. Has been. Accordingly, the inspection component 110 and the auxiliary component 130 can be joined in a state where the distal end portion 112 of the inspection component 110 and the distal end portion 132 of the auxiliary component 130 are matched. Can be accurately grasped, and an accurate treatment can be performed.
 また、補助部品130の外面部には、検査部品110の溝部150と対向する位置に、鉗子管路134と連通するワイヤー孔173が形成されている。これにより、検査部品110と補助部品130の先端部を一致させた場合に、ガイドワイヤーを鉗子出口134aから迂回させる必要がなくなる。これにより、鉗子管路134内でガイドワイヤーがたるむことを防ぎ、鉗子管路134の径を有効に利用することができる。なお、ワイヤー孔は、補助部品130の先端面から溝部150に対向する位置までに延びる切り込みを設けることによって形成してもよい。 Also, a wire hole 173 communicating with the forceps conduit 134 is formed on the outer surface portion of the auxiliary component 130 at a position facing the groove 150 of the inspection component 110. This eliminates the need to bypass the guide wire from the forceps outlet 134a when the tips of the inspection component 110 and the auxiliary component 130 are matched. Thereby, it is possible to prevent the guide wire from sagging in the forceps conduit 134 and to effectively use the diameter of the forceps conduit 134. The wire hole may be formed by providing a cut extending from the tip surface of the auxiliary component 130 to a position facing the groove 150.
 また、検査部品110と補助部品130を接合させた状態で、ガイドワイヤー141を操作してループ142の径を大きくしてガイド部材140と検査部品110との係合を解除し、ガイド部材140を回収するようにしてもよい。これにより、鉗子管路134内のガイドワイヤー141を取り除き、鉗子管路134の径を最大限に利用することができる。 Further, in a state where the inspection component 110 and the auxiliary component 130 are joined, the guide wire 141 is operated to increase the diameter of the loop 142 so that the engagement between the guide member 140 and the inspection component 110 is released, and the guide member 140 is moved. You may make it collect | recover. Thereby, the guide wire 141 in the forceps conduit 134 can be removed, and the diameter of the forceps conduit 134 can be utilized to the maximum.
〔第6の実施の形態〕
 次に、図14及び図15を用いて、本発明の第6の実施の形態について説明する。なお、第6の実施の形態において、第5の実施の形態と構成が同一の部分については、重複した説明を省略する。
[Sixth Embodiment]
Next, a sixth embodiment of the present invention will be described with reference to FIGS. Note that in the sixth embodiment, a description of the same components as those in the fifth embodiment will be omitted.
 図14は、本発明の第6の実施の形態における検査部品110及び補助部品130の構造を示すものであり、図15は、第6の実施形態におけるロック機構183の拡大図である。
 図14に示すように、補助部品130の外面部には、検査部品110と補助部品130とを連結して接合する接合部としての突起182が設けられている。突起182の先端には、球部182aが設けられている。また、検査部品110の外面部には、球部182aが挿入される凹部184が形成されている。
FIG. 14 shows the structure of the inspection component 110 and the auxiliary component 130 in the sixth embodiment of the present invention, and FIG. 15 is an enlarged view of the locking mechanism 183 in the sixth embodiment.
As shown in FIG. 14, a protrusion 182 is provided on the outer surface portion of the auxiliary component 130 as a bonding portion that connects and bonds the inspection component 110 and the auxiliary component 130. A spherical portion 182 a is provided at the tip of the protrusion 182. Further, a concave portion 184 into which the ball portion 182a is inserted is formed on the outer surface portion of the inspection component 110.
 図15に示すように、凹部184の内部には、検査部品110と補助部品130を連結して接合する接合部としてのロック機構183が設けられている。ロック機構183は、球部182aを収納するための凹部184と、凹部184の上部に設けられたシャッタ部材185とで構成されている。シャッタ部材185は、先端に球部188aを有する1組のばね部材188で構成されており、凹部184の空間を開閉する。ばね部材188は、球部188aを凹部184より突出させた状態で、凹部184の上方に配置されている。 As shown in FIG. 15, a lock mechanism 183 is provided inside the recess 184 as a joint for connecting and joining the inspection component 110 and the auxiliary component 130. The lock mechanism 183 includes a recess 184 for housing the ball portion 182a and a shutter member 185 provided on the upper portion of the recess 184. The shutter member 185 is composed of a pair of spring members 188 having a spherical portion 188a at the tip, and opens and closes the space of the recess 184. The spring member 188 is disposed above the recess 184 with the ball portion 188 a protruding from the recess 184.
 ガイドワイヤー141を牽引しながら補助部品130を推し進めることにより、補助部品130の突起182を検査部品110の凹部184に挿入すると、球部182aが球部188aを押圧し、ばね部材188の付勢力に打ち勝って、球部188aの間を通過する。球部182aは、凹部184に収納されるとともに、球部188aがばねの付勢力によって元の状態に戻り、突起182を挟持する。これにより、検査部品110と補助部品130とを連結させた状態で接合する。また、手技終了後に接合を解除する場合には、検査部品110の手元操作部102を操作することにより、検査部品110が補助部品130から離れる方向に湾曲部113を湾曲させ、球部182aを凹部184から脱着することができる。 When the protrusion 182 of the auxiliary component 130 is inserted into the recess 184 of the inspection component 110 by pushing the auxiliary wire 130 while pulling the guide wire 141, the ball portion 182a presses the ball portion 188a, and the spring member 188 is biased. It overcomes and passes between the ball parts 188a. The ball portion 182a is housed in the recess 184, and the ball portion 188a returns to its original state by the biasing force of the spring, and holds the protrusion 182. Thereby, the inspection component 110 and the auxiliary component 130 are joined in a connected state. Further, when the joining is released after the procedure is finished, the bending portion 113 is bent in the direction in which the inspection component 110 is separated from the auxiliary component 130 by operating the hand operation unit 102 of the inspection component 110, and the ball portion 182a is recessed. 184 can be desorbed.
 本実施の形態では、検査部品110の先端部112の先端面から凹部184までの距離と、補助部品130の先端部132の先端面から突起182までの距離とが等しくなるように構成されている。突起182を凹部184に挿入するだけで、検査部品110の先端部112と補助部品130の先端部132とを一致させた状態で、検査部品110と補助部品130を接合することができる。これにより、補助部品130の鉗子出口134aから病変部位までの距離を正確に把握することができ、適切な処置を行うことができる。 In the present embodiment, the distance from the distal end surface of the distal end portion 112 of the inspection component 110 to the concave portion 184 and the distance from the distal end surface of the distal end portion 132 of the auxiliary component 130 to the protrusion 182 are configured to be equal. . By simply inserting the protrusion 182 into the recess 184, the inspection component 110 and the auxiliary component 130 can be joined in a state where the distal end portion 112 of the inspection component 110 is aligned with the distal end portion 132 of the auxiliary component 130. Thereby, the distance from the forceps outlet 134a of the auxiliary component 130 to the lesion site can be accurately grasped, and appropriate treatment can be performed.
 この第6の実施の形態に係る経鼻内視鏡によっても、第3の実施の形態に係る経鼻顕微鏡と同様にして、ガイド部材140と検査部品110とを係合し、ガイド部材140に沿って補助部品130を押し進めるだけで、検査部品110と補助部品130とを接合することができる。 Also in the nasal endoscope according to the sixth embodiment, the guide member 140 and the inspection component 110 are engaged with each other in the same manner as the nasal microscope according to the third embodiment. The inspection component 110 and the auxiliary component 130 can be joined simply by pushing the auxiliary component 130 along.
 なお、本発明の経鼻内視鏡は、上述の各形態に限定されるものではなく、検査部品の挿入部及び補助部品の挿入部の太さ、検査部品及び補助部品の形状、カメラガイドの内径の大きさ、磁石及び磁性体の形状、照明窓の数、磁性体の形状、その他材料、構成等において本発明の構成を逸脱しない範囲において種々の変形、変更が可能であることはいうまでもない。例えば、補助部品は、断面の形状が円形のものに限られず、半円形のものであってもよい。また、ロック機構としては、シャッタが開閉する機構を有するものであれば、上述した機構に限定されるものではない。 Note that the nasal endoscope of the present invention is not limited to the above-described embodiments, but the thickness of the insertion part of the inspection part and the insertion part of the auxiliary part, the shape of the inspection part and the auxiliary part, the camera guide It goes without saying that various modifications and changes can be made without departing from the configuration of the present invention in terms of the size of the inner diameter, the shape of the magnet and the magnetic body, the number of illumination windows, the shape of the magnetic body, and other materials and configurations. Nor. For example, the auxiliary component is not limited to a circular shape in cross section, and may be a semicircular shape. The lock mechanism is not limited to the above-described mechanism as long as the shutter has a mechanism for opening and closing.
 また、検査部品と補助部品とを接合させる際には、検査部品の先端面と補助部品の先端面を正確に合致させる必要はなく、例えば、補助部品の先端面が、検査部品の先端面よりもわずかに奥側もしくは手前側に位置するようにしてもよい。 In addition, when joining the inspection component and the auxiliary component, it is not necessary to accurately match the tip surface of the inspection component and the tip surface of the auxiliary component. For example, the tip surface of the auxiliary component is more than the tip surface of the inspection component. Alternatively, it may be slightly located on the back side or the near side.
1・・・経鼻内視鏡、2、3・・・手元操作部、10・・・検査部品、11・・・挿入部、12・・・先端部、13・・・湾曲部、14・・・軟性部、15・・・カメラ、15a・・・カメラガイド、17・・・観察窓、18・・・照明窓、21・・・ワイヤー収納ガイド、22・・・磁石、23・・・ワイヤー、24・・・滑車、25・・・スネア、25a・・・ループ、26・・・スネア収容ガイド、27・・・スネアルーメン、28・・・突起、29・・・スネア補助部材、29a・・・足部、29b・・・頭部、30・・・補助部品、31・・・挿入部、32・・・先端部、33・・・軟性部、34・・・鉗子管路、34a・・・鉗子出口、35・・・磁性体、37・・・係合溝、39a、39b・・・孔、100・・・経鼻内視鏡、102・・・操作部、103・・・ハブ、105・・・ワイヤーガイド、105a・・・ワイヤー端部、110・・・検査部品、111・・・挿入部、112・・・先端部、113・・・湾曲部、114・・・軟性部、117・・・観察窓、118・・・照明窓、130・・・補助部品、131・・・挿入部、132・・・先端部、133・・・軟性部、134・・・鉗子管路、134a・・・鉗子出口、140・・・ガイド部材、141・・・ガイドワイヤー、142・・・ループ、143・・・ワイヤーカバー、144・・・膨出部、145・・・貫通孔、146・・・結び目、150・・・溝部、151・・・底部、152・・・傾斜部、160・・・先端溝部、163・・・ロック機構、164・・・凹部、166・・・ばね部材166a・・・球部、171・・・磁性体、172・・・磁性体、173・・・ワイヤー孔、182・・・突起、182a・・・球部、183・・・ロック機構、184・・・凹部、185・・・シャッタ部材、188・・・ばね部材、188a・・・球部 DESCRIPTION OF SYMBOLS 1 ... Transnasal endoscope, 2, 3 ... Hand operation part, 10 ... Test | inspection part, 11 ... Insertion part, 12 ... Tip part, 13 ... Bending part, 14. ..Soft part, 15 ... camera, 15a ... camera guide, 17 ... observation window, 18 ... illumination window, 21 ... wire storage guide, 22 ... magnet, 23 ... Wire, 24 ... pulley, 25 ... snare, 25a ... loop, 26 ... snare accommodation guide, 27 ... snare lumen, 28 ... projection, 29 ... snare auxiliary member, 29a ... Foot part, 29b ... Head part, 30 ... Auxiliary part, 31 ... Insertion part, 32 ... Tip part, 33 ... Soft part, 34 ... Forceps conduit, 34a ... Forceps outlet, 35 ... Magnetic body, 37 ... Engagement groove, 39a, 39b ... Hole, 100 ... Transnasal endoscope DESCRIPTION OF SYMBOLS 102 ... Operation part, 103 ... Hub, 105 ... Wire guide, 105a ... Wire end part, 110 ... Inspection component, 111 ... Insertion part, 112 ... Tip part, 113 ... Bending part, 114 ... soft part, 117 ... observation window, 118 ... illumination window, 130 ... auxiliary parts, 131 ... insertion part, 132 ... tip part, 133 ... ..Soft part 134... Forceps conduit 134 a. Forceps outlet 140. Guide member 141. Guide wire 142. Loop 143 Wire cover 144. -Bulge part, 145 ... through hole, 146 ... knot, 150 ... groove part, 151 ... bottom part, 152 ... inclined part, 160 ... tip groove part, 163 ... lock mechanism 164 ... recess, 166 ... spring member 66a ... sphere part, 171 ... magnetic body, 172 ... magnetic body, 173 ... wire hole, 182 ... projection, 182a ... sphere part, 183 ... lock mechanism, 184. ..Recess, 185 ... Shutter member, 188 ... Spring member, 188a ... Sphere

Claims (14)

  1.  一方の外鼻孔から体腔内に挿入される撮像部を備えた長尺状の検査部品と、
     他方の外鼻孔から体腔内に挿入され、前記検査部品と連結する長尺状の補助部品と、を備えた経鼻内視鏡であって、
     前記検査部品に設けられた、前記検査部品の長手方向に沿って移動する移動係合部と、
     前記補助部品に設けられた、前記移動係合部と係合する固定係合部と、を備えた
    経鼻内視鏡。
    A long test component with an imaging unit inserted into the body cavity from one nostril; and
    A transnasal endoscope comprising a long auxiliary part inserted into the body cavity from the other nostril and connected to the test part,
    A moving engagement portion that is provided in the inspection part and moves along a longitudinal direction of the inspection part;
    A transnasal endoscope provided with a fixed engagement portion that is provided on the auxiliary part and engages with the moving engagement portion.
  2.  前記移動係合部は磁性を有する第1の磁性部材であり、前記固定係合部は前記第1の磁性部材と磁着する第2の磁性部材で構成されている
    請求項1に記載の経鼻内視鏡。
    The warp according to claim 1, wherein the moving engagement portion is a first magnetic member having magnetism, and the fixed engagement portion is constituted by a second magnetic member that is magnetically attached to the first magnetic member. Nasal endoscope.
  3.  前記移動係合部は、環状部を有する移動ワイヤー部材である
    請求項1に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 1, wherein the moving engagement portion is a moving wire member having an annular portion.
  4.  前記固定係合部は、前記補助部品の外面に形成された係合用溝部である
    請求項3に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 3, wherein the fixed engagement portion is an engagement groove formed on an outer surface of the auxiliary component.
  5.  前記検査部品に形成されたガイド通路と、
     前記ガイド通路に配置された前記移動係合部と、
     前記移動係合部に連結したワイヤーと、
     前記ワイヤーを前記検査部品の長手方向に折り返す折り返し部と、を備えた
    請求項1に記載の経鼻内視鏡。
    A guide passage formed in the inspection part;
    The moving engagement portion disposed in the guide passage;
    A wire connected to the moving engagement portion;
    The transnasal endoscope according to claim 1, further comprising a folded portion that folds the wire in a longitudinal direction of the inspection component.
  6.  一方の外鼻孔から体腔内に挿入される撮像部を備えた長尺状の検査部品と、
     他方の外鼻孔から体腔内に挿入され、前記検査部品と連結する長尺状の補助部品と、
     先端部に前記検査部品と係合するための先端係合部が形成されたガイドワイヤーを有する、前記補助部品をガイドするガイド部材と、を備えたこと
     を特徴とする経鼻内視鏡。
    A long test component with an imaging unit inserted into the body cavity from one nostril; and
    An elongated auxiliary component inserted into the body cavity from the other nostril and connected to the test component;
    A transnasal endoscope comprising: a guide member that guides the auxiliary component, the guide member having a guide wire having a distal end engaging portion for engaging the inspection component at the distal end portion.
  7.  前記先端係合部は、径が可変な先端環状部であること
     を特徴とする請求項6に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 6, wherein the distal end engaging portion is a distal end annular portion having a variable diameter.
  8.  前記検査部品は、前記先端係合部を係止するための係止部を有すること
     を特徴とする請求項7に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 7, wherein the inspection component includes a locking portion for locking the tip engagement portion.
  9.  前記係止部は、前記検査部品の外面の周方向に形成された係止用溝部であること
     を特徴とする請求項8に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 8, wherein the locking portion is a locking groove formed in a circumferential direction of the outer surface of the inspection component.
  10.  前記先端係合部は、前記ガイドワイヤーの径よりも大きい径を有する膨出部であること
     を特徴とする請求項6に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 6, wherein the distal end engaging portion is a bulging portion having a diameter larger than a diameter of the guide wire.
  11.  前記検査部品は、前記膨出部を係止するための膨出係止部を有すること
     を特徴とする請求項10に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 10, wherein the inspection component includes a bulging locking portion for locking the bulging portion.
  12.  前記膨出係止部は、前記検査部品の先端から外周面の長手方向に沿って形成された膨出部係止用溝部であること
     を特徴とする請求項11に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 11, wherein the bulge locking portion is a bulging portion locking groove formed along the longitudinal direction of the outer peripheral surface from the tip of the inspection component. .
  13.  前記検査部品は、前記膨出係止部に係止された前記先端係合部を固定して保持するための固定保持部を有すること
     を特徴とする請求項7に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 7, wherein the inspection component has a fixed holding portion for fixing and holding the distal end engaging portion locked to the bulging locking portion. .
  14.  前記検査部品と前記補助部品を連結して固定するための接合部を有すること
     を特徴とする請求項6に記載の経鼻内視鏡。
    The transnasal endoscope according to claim 6, further comprising a joint for connecting and fixing the inspection component and the auxiliary component.
PCT/JP2013/055352 2012-03-12 2013-02-28 Nasal endoscope WO2013137000A1 (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITUA20161644A1 (en) * 2016-03-14 2017-09-14 Carboni Stefano Checcacci MEDICAL ASSEMBLY
CN113425235A (en) * 2021-08-11 2021-09-24 兰州大学第二医院 Three chamber radiography pipe system of biliary tract

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