WO2018229982A1 - Gaine d'endoscope et système d'endoscope - Google Patents

Gaine d'endoscope et système d'endoscope Download PDF

Info

Publication number
WO2018229982A1
WO2018229982A1 PCT/JP2017/022372 JP2017022372W WO2018229982A1 WO 2018229982 A1 WO2018229982 A1 WO 2018229982A1 JP 2017022372 W JP2017022372 W JP 2017022372W WO 2018229982 A1 WO2018229982 A1 WO 2018229982A1
Authority
WO
WIPO (PCT)
Prior art keywords
endoscope
sheath
distal end
longitudinal axis
curved
Prior art date
Application number
PCT/JP2017/022372
Other languages
English (en)
Japanese (ja)
Inventor
善朗 岡崎
尚也 杉本
和敏 熊谷
俊二 武井
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2017/022372 priority Critical patent/WO2018229982A1/fr
Publication of WO2018229982A1 publication Critical patent/WO2018229982A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005—Flexible endoscopes
    • A61B1/01—Guiding arrangements therefore

Definitions

  • the present invention relates to an endoscope sheath and an endoscope system.
  • the bending portion of the tip of the endoscope is arranged so that the tip of the endoscope is located at a position away from the heart surface. It is necessary to bend the tip of the endoscope to the pericardium side.
  • a force pressing to the heart side acts from the pericardium.
  • the distal end portion of the endoscope can receive force from the heart. Due to the force from the pericardium and the heart, there is a problem that the curved distal end portion of the endoscope falls on the heart surface.
  • the present invention has been made in view of the above-described circumstances, and is an endoscope that can stably observe the heart by preventing the bent distal end portion of the endoscope from falling in the pericardial cavity.
  • An object is to provide a mirror sheath and an endoscope system.
  • a tubular sheath body having an endoscope channel that penetrates in a direction along a longitudinal axis and into which an endoscope is inserted, and the endoscope in a first radial direction of the sheath body.
  • an endoscope channel that penetrates in a direction along a longitudinal axis and into which an endoscope is inserted, and the endoscope in a first radial direction of the sheath body.
  • a support portion that supports a side surface of the distal end portion of the endoscope that is curved, and the support portion has a longitudinal axis of the endoscope in the endoscope channel of the curved distal end portion. It is the sheath for endoscopes which controls rotation around.
  • the sheath body is disposed in the pericardial cavity such that the first radial direction is substantially parallel to the surface of the heart, and is disposed in the endoscope channel of the sheath body.
  • the distal end portion of the endoscope that is curved on the distal end side of the sheath body is arranged in the endoscope channel by supporting the side surface in the direction substantially orthogonal to the bending direction by the support portion. It is regulated by the support portion so as not to rotate around the longitudinal axis of the endoscope. As a result, it is possible to prevent the curved distal end portion from falling down due to a force from the pericardium or the heart and to observe the heart stably.
  • the support portion may be disposed in a plane parallel to the second radial direction. In this way, the side surface of the curved distal end portion of the endoscope can be more stably supported by the support portion.
  • the support portion may be provided on both sides of the endoscope channel in the first radial direction. In this way, the curved tip portion is supported by the support portions on both sides, so that the bent tip portion can be more reliably prevented from falling.
  • the support portion may be provided outside the longitudinal axis of the endoscope channel in the second radial direction. In this way, the support portion is provided at the position of the curved distal end portion at a position radially spaced from the longitudinal axis of the endoscope in the endoscope channel that is the rotation center of the curved distal end portion. Support the side. Thereby, the support part can generate a larger second moment of cross section that resists the force received from the curved tip part, and can more reliably prevent the curved tip part from falling over.
  • the support portion can be elastically deformed into a linear shape that is curved in the second radial direction and extends in a direction along the longitudinal axis, and can project and retract from the distal end of the sheath body. It may be provided in the sheath body. By doing in this way, in the state which protruded from the front-end
  • a wire having a tip portion curved in one direction is provided, the support portion is formed of the tip portion of the wire, and the sheath penetrates in a direction along the longitudinal axis, and the wire May have a wire channel inserted so as to be movable in the longitudinal direction.
  • a general purpose wire like a guide wire generally used in cardiac surgery can be used as a support part.
  • the diameter of the sheath body can be reduced by using a thin wire as the support portion.
  • a wire is provided, and the sheath body has a wire channel that penetrates in the direction along the longitudinal axis and is inserted so that the wire can move in the longitudinal direction, and a distal end portion of the wire channel However, it may be inclined outward in the second radial direction toward the tip of the sheath body.
  • the distal end portion of the wire channel since the distal end portion of the wire channel is inclined, the distal end portion of the wire protruding from the wire channel extends in the longitudinal direction of the sheath body so as to extend substantially along the curved distal end portion of the endoscope. And can function as a support portion.
  • a general-purpose wire such as a guide wire generally used in cardiac surgery can be used as the support portion.
  • the diameter of the sheath body can be reduced by using a thin wire as the support portion.
  • an endoscope having a distal end portion that is deformable between a curved shape that is curved in a direction intersecting the longitudinal axis and a linear shape that extends along the longitudinal axis. It is an endoscope system provided with the described sheath for endoscopes.
  • the endoscope has rigidity lower than that of the sheath body, and the distal end portion of the endoscope has the curved shape in a free state and is elastically deformed into the linear shape. It may be possible. By doing so, the distal end portion of the endoscope extends linearly when it is housed in the endoscope channel of the sheath body and spontaneously curves when it protrudes from the distal end of the sheath body. As a result, a mechanical mechanism for bending the distal end portion of the endoscope becomes unnecessary, and the diameter of the endoscope can be reduced.
  • a rotation restricting portion that restricts rotation of the endoscope around the longitudinal axis in the endoscope channel may be provided.
  • the present invention it is possible to prevent the curved distal end portion of the endoscope from falling in the pericardial cavity and to observe the heart stably.
  • FIG. 1B is a perspective view showing a state where a bending portion of the endoscope is curved in the endoscope system of FIG. 1A.
  • FIG. 1A It is a perspective view of the front-end
  • FIG. 10B is a perspective view showing a state where the bending portion of the endoscope is bent in the endoscope system of FIG. 10A.
  • FIG. 10A is a longitudinal cross-sectional view of the front-end
  • FIG. 10B is a perspective view of the distal end portion of a modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a perspective view of the distal end portion of another modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a perspective view of the distal end portion of another modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a perspective view of the distal end portion of another modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a perspective view of the distal end portion of another modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a perspective view of the distal end portion of another modification of the endoscope sheath of FIG. 10A.
  • FIG. 10B is a side view of the distal end portion of another modification of the endoscope sheath of FIG. 10A. It is a longitudinal cross-sectional view of the front-end
  • FIG. 19B is a longitudinal sectional view of the endoscope sheath showing a state in which a bending portion of the endoscope is bent in the endoscope system of FIG. 19A. It is a longitudinal cross-sectional view of the front-end
  • FIG. 21B is a perspective view showing a state where the bending portion of the endoscope is curved in the endoscope system of FIG. 21A.
  • an endoscope sheath 1 and an endoscope system 100 according to a first embodiment of the present invention will be described below with reference to FIGS. 1A to 9B.
  • an endoscope system 100 according to the present embodiment includes an endoscope 2 and an endoscope sheath 1 into which the endoscope 2 can be inserted.
  • the endoscope 2 includes a soft and long insertion portion 3 that can be inserted into the pericardial cavity, and a distal end portion of the insertion portion 3 that intersects the longitudinal axis of the insertion portion 3. And a bending portion 4 that can be bent in the direction.
  • the bending portion 4 can be bent in at least one direction. The bending operation of the bending section 4 can be controlled by operating an operation section (not shown) connected to the proximal end of the insertion section 3.
  • the endoscope sheath 1 protrudes in a direction along the longitudinal axis of the sheath body 5 from the distal end of the sheath body 5 and a long tubular sheath body 5 having an endoscope channel 5a into which the insertion portion 3 is inserted. And a hood (support portion) 6 to be used.
  • the endoscope sheath 1 has a radial direction orthogonal to the longitudinal axis and a vertical direction (second radial direction) and a horizontal direction (first radial direction) orthogonal to each other.
  • the vertical direction is the direction in which the endoscopic sheath 1 is used in the pericardial cavity, and is disposed in the thickness direction of the pericardial cavity (opposite direction between the pericardium and the heart), and particularly on the heart side.
  • the side to be placed is the lower side, and the side placed on the pericardial side is the upper side.
  • the sheath body 5 has higher rigidity than the insertion portion 3, and the torsional rigidity around the longitudinal axis of the sheath body 5 is higher than the torsional rigidity around the longitudinal axis of the insertion portion 3.
  • the endoscope channel 5a penetrates the sheath body 5 in the direction along the longitudinal axis, and the outer diameter of the insertion portion 3 is such that the insertion portion 3 can move in the longitudinal direction within the endoscope channel 5a. Also has a large inner diameter. Further, the endoscope channel 5a is formed at a position eccentric to the upper side with respect to the longitudinal axis of the sheath body 5, as shown in FIGS. 2A and 2B.
  • the hood 6 has a substantially cylindrical shape extending in the longitudinal direction from the annular distal end surface of the sheath body 5 and resists the force received from the pericardium in the pericardial cavity. It has rigidity that can maintain the shape.
  • the hood 6 has a groove 6a continuous with the endoscope channel 5a in the longitudinal direction.
  • the groove 6 a extends in the vertical direction from the lower side surface to the upper side, and is formed over the entire length in the longitudinal direction from the distal end surface to the proximal end surface of the hood 6.
  • the hood 6 has a substantially U-shape that is disposed on the upper side and both the left and right sides of the endoscope channel 5a when viewed from the distal end side, and projects from the distal end opening of the endoscope channel 5a and is disposed in the groove 6a.
  • the upper side and both left and right sides of the bent portion 4 are covered with the hood 6.
  • the corners between the inner surface of the groove 6a and the tip surface and side surface of the hood 6 are preferably chamfered.
  • the front end of the hood 6 can be observed by extending the curved portion 4 arranged in the groove 6a linearly.
  • the length of the hood 6 is designed so that the hood 6 does not enter the field of view of the endoscope 2 in a state where the curved portion 4 is linearly arranged in the groove 6a.
  • the hood 6 has such a length that the distal end of the hood 6 and the distal end of the insertion portion 3 are disposed at substantially the same position in the longitudinal direction in a state where the entire curved portion 4 is disposed in the groove 6a.
  • the bending portion 4 arranged in the groove 6a is bent downward, so that the heart arranged on the lower side of the hood 6 is passed through the opening of the groove 6a. Can be observed.
  • the width of the groove 6a in the left-right direction is such that the distal end of the insertion part 3 can protrude radially outward from the opening of the groove 6a when the bending part 4 is bent at a large angle. It is larger than the outer diameter.
  • the inner surface of the groove 6a has two flat support surfaces 6b and 6c which are located on the left and right sides of the distal end opening of the endoscope channel 5a and are parallel to each other in the vertical direction.
  • the support surfaces 6b and 6c extend downward from the endoscope channel 5a, and the side surfaces of the curved portion 4 curved downward in the groove 6a are connected to the insertion portion 3 in the endoscope channel 5a. It is supported below the longitudinal axis A.
  • the hood 6 is configured to hold the curved portion 4 so that the curved curved portion 4 does not fall in the left-right direction due to the twist around the longitudinal axis A of the insertion portion 3.
  • the position indicated by the thick solid line indicates the position where the bending portion 4 is supported by the support surfaces 6 b and 6 c of the hood 6.
  • the sheath body 5 is inserted into the body from under the xiphoid process and placed into the pericardial cavity, and the sheath body 5
  • the insertion part 3 of the endoscope 2 is inserted from the outside of the body into the pericardial cavity through the endoscope channel 5a.
  • the rotation angle around the longitudinal axis of the sheath body 5 is adjusted so that the upper side of the sheath body 5 is disposed on the pericardium Y side and the lower side is disposed on the heart X side. As a result, as shown in FIG.
  • the pericardium Y is lifted away from the heart X by the hood 6 having high rigidity, and the distal end of the insertion portion 3 is arranged at a position away from the heart X.
  • the heart X can be observed by the endoscope 2 by bending the bending portion 4 downward in the groove 6a so that the distal end of the insertion portion 3 faces the heart X.
  • the beating heart X may come into contact with the distal end of the insertion portion 3.
  • a force that rotates the bending bending portion 4 around the longitudinal axis A of the insertion portion 3 in the endoscope channel 5a Is acting on the distal end of the insertion portion 3 from the heart X, the bending portion 4 is bent to the left or right side by twisting the insertion portion 3 in the endoscope channel 5a according to the force from the heart X. Lying on the surface of heart X.
  • the curved bending portion 4 supports the hood 6 even in a state where the rotational force around the longitudinal axis A of the insertion portion 3 is acting by contact with the heart X. It is prevented from falling by being supported by the surfaces 6b and 6c.
  • the insertion portion in the endoscope channel 5a. 3 is applied to the support surfaces 6 b and 6 c of the hood 6 from the curved portion 4.
  • the hood 6 that comes into contact with the bending portion 4 at a position spaced downward from the longitudinal axis A of the insertion portion 3 generates a second moment of cross section that resists the pressing force, and collapses the bending portion 4 on which the rotational force acts. You can hold it down.
  • the rotational force around the longitudinal axis A is also transmitted to the sheath body 5 through the hood 6, but the sheath body 5 having higher torsional rigidity than the insertion portion 3 resists the pressing force without being twisted. Therefore, the hood 6 that receives the pressing force on the support surfaces 6b and 6c is stably supported by the sheath body 5 and does not rotate around the longitudinal axis A.
  • the posture of the curved portion 4 that is curved is stably maintained by the hood 6, there is an advantage that the heart X can be observed stably.
  • the endoscope channel 5a is provided at a position deviated upward with respect to the longitudinal axis of the sheath body 5, the area of the side surface of the bending portion 4 supported by the support surfaces 6b and 6c is increased. The falling of the part 4 can be prevented more reliably.
  • a support part can be provided, without increasing the number of members by making the hood 6 for lifting the pericardium Y function also as a support part.
  • the endoscope channel 5 a is provided at a position that is eccentric with respect to the longitudinal axis of the sheath body 5, but may be provided concentrically with the longitudinal axis of the sheath body 5. . Even if it does in this way, compared with the case where the endoscope channel 5a is eccentric, the contact area of the support surfaces 6b and 6c and the side surface of the bending portion 4 is reduced, but the hood 6 prevents the bending portion 4 from falling down. The effect can be demonstrated.
  • the hood 6 is provided on the upper side and the left and right sides of the endoscope channel 5a so that the support surfaces 6b and 6c are disposed on the left and right sides of the endoscope channel 5a.
  • the hood 6 is disposed on the upper side of the endoscope channel 5 a and the support surface 6 b or 6 c is disposed only on the left side or only on the right side of the endoscope channel 5 a. It may be provided only on either the left or right side.
  • the endoscope sheath 1 penetrates in the longitudinal direction from the distal end surface of the hood 6 to the proximal end portion of the sheath body 5, and the lumen 1 a into which the guide wire 20 is inserted. You may have.
  • the pericardium can be lifted from the surface of the heart not only by the hood 6 but also by the distal end portion of the guide wire 20 protruding from the distal end surface of the hood 6.
  • the lumen 1a is opened above the groove 6a on the distal end surface of the hood 6 so that the distal end portion of the guide wire 20 can reliably lift the pericardium to a position farther from the heart than the distal end of the insertion portion 3.
  • it is.
  • a wire 62 may be provided in the endoscope sheath, and the side surface of the bending portion 4 may be supported by the wire 62 instead of the hood 6.
  • the hood 61 is provided only on the upper side of the endoscope channel 5 a so as to cover only the upper side of the bending portion 4.
  • the wire 62 is disposed from the distal end portion of the hood 61 through the sheath body 5 to the proximal end side of the sheath body 5, and the distal end of the wire 62 is fixed to the distal end portion of the hood 61.
  • the wire 62 is made of a shape memory alloy such as nickel titanium, and the tip portion of the wire 62 stores a substantially semicircular arc shape protruding downward.
  • the distal end portion of the wire 62 extends straight along the longitudinal direction of the hood 61 when the proximal end portion of the wire 62 is pulled, and is curved in an arc shape when the proximal end portion of the wire 62 is pressed. It protrudes downward.
  • the arc shape of the distal end portion of the wire 62 so as to support the side surface of the bending portion 4 where the wire 62 is bent below the longitudinal axis A of the insertion portion 3 in the endoscope channel 5a. Is designed.
  • the sheath body 5 and the hood 6 may be provided with lumens 1b for various uses.
  • a lumen 1b for supplying or sucking a fluid or inserting a treatment instrument may be provided.
  • two lumens 1b are provided, but the number of lumens 1b may be only one, or three or more.
  • the endoscope sheath 1 has a circular tube shape, but the endoscope sheath 1 may have another long shape.
  • an endoscope sheath in which the cross-sectional shape of the hood 63 and the sheath body is substantially fan-shaped may be employed.
  • other medical devices can be used by effectively utilizing the space in the access sheath 30 for guiding the endoscope sheath between the outside of the body and the pericardial cavity.
  • a sheath or a treatment instrument can also be disposed in the access sheath 30 together with the endoscope sheath.
  • the rotation restriction that restricts the rotation of the insertion portion 3 around the longitudinal axis A in the endoscope channel 5a so that the lower side of the sheath body 5 and the bendable direction of the bending portion 4 coincide.
  • a part may be provided.
  • the rotation restricting portion includes a projection 71 provided in a part of the circumferential direction of the side surface of the insertion portion 3 on the proximal side of the bending portion 4 and protruding radially outward. And a groove 72 provided in a part of the inner surface of the endoscope channel 5a in the circumferential direction and into which the protrusion 71 is fitted.
  • the protrusion 71 and the groove 72 are provided at positions where the protrusion 4 and the groove 72 are fitted to each other in a state where the curved portion 4 is disposed in the groove 6a of the hood 6, and a part in the longitudinal direction of the insertion portion 3 and the endoscope channel 5a. It may be provided only for each, or may be provided over the entire length. As shown in FIG. 9B, the protrusion 71 may be provided on the inner surface of the endoscope channel 5 a and the groove 72 may be provided on the side surface of the insertion portion 3.
  • FIGS. 10A to 18 an endoscope sheath 10 and an endoscope system 101 according to a second embodiment of the present invention will be described with reference to FIGS. 10A to 18.
  • a configuration different from that of the first embodiment will be described, and a configuration common to the first embodiment will be denoted by the same reference numeral and description thereof will be omitted.
  • This embodiment is different from the first embodiment in that the upper sides of the curved portions 41 and 42 protruding from the endoscope channel 5a are opened.
  • the endoscope system 101 includes an endoscope 21 and an endoscope sheath 10 into which the endoscope 21 can be inserted.
  • the endoscope 21 includes a flexible and long insertion portion 31 that can be inserted into the pericardial cavity, and a distal end portion of the insertion portion 31 that intersects the longitudinal axis of the insertion portion 31.
  • Two bending portions 41 and 42 that can be bent in the direction are provided.
  • the first curved portion 41 on the distal end side and the second curved portion 42 on the proximal end side can be curved in opposite directions so as to form a substantially S shape, as shown in FIGS. 10B and 11A. is there.
  • the bending operations of the bending portions 41 and 42 can be controlled by operating an operation unit (not shown) connected to the proximal end of the insertion unit 31.
  • the endoscope sheath 10 includes a sheath body 5 and two projecting portions 8 that project from the distal end of the sheath body 5 in a direction along the longitudinal axis of the sheath body 5.
  • the protrusion 8 is a semi-cylindrical member extending along the longitudinal direction from the distal end surface of the sheath body 5, and has a curved support surface 8 a on the radial outer side and a flat support surface 8 a on the radial inner side.
  • the two protruding portions 8 are provided on both the left and right sides of the endoscope channel 5a so as to cover both the left and right sides of the curved portions 41 and 42 protruding from the distal end opening of the endoscope channel 5a.
  • the first bending portion 41 protruding above the protruding portion 8 by bending the second bending portion 42 upward between the two protruding portions 8 and bending the first bending portion 41 downward.
  • the pericardium can be lifted to a position away from the surface of the heart, and the heart can be observed with the distal end of the insertion portion 31 facing downward.
  • each protrusion 8 is parallel to the vertical direction, and the side surfaces of the curved portions 41 and 42 that are curved in a substantially S shape in a plane substantially parallel to the vertical direction are provided in the endoscope channel 5a.
  • the insertion portion 31 is supported above the longitudinal axis A.
  • the position shown by a thick solid line has shown the position where the curved parts 41 and 42 are supported by the support surface 8a. Therefore, the support surface 8a is provided at least above the longitudinal axis of the endoscope channel 5a, and preferably provided both above and below the longitudinal axis of the endoscope channel 5a.
  • the pericardium Y is located on the upper side and the heart X is located on the lower side, as in the first embodiment.
  • the sheath body 5 is placed in the pericardial cavity.
  • the bending portions 41 and 42 are disposed between the two protruding portions 8, the second bending portion 42 is bent toward the pericardium Y side, and the first bending portion 41 is bent toward the heart X side. Accordingly, as shown in FIG.
  • the pericardium Y is lifted away from the heart X by the first curved portion 41 protruding from the protruding portion 8 toward the pericardium Y side, and the distal end of the insertion portion 31 is By being directed to the heart X, the heart X can be observed.
  • the first bending portion 41 that is in contact with the pericardium Y is provided with bending portions 41 and 42 that are curved in a substantially S shape in the insertion portion 31 in the endoscope channel 5a.
  • a force in the direction of rotation about the longitudinal axis A acts from the pericardium Y.
  • the pressing force around the longitudinal axis A of the insertion portion 31 in the endoscope channel 5a acts on the support surface 8a from the curved portions 41 and 42.
  • the support surface 8a that is in contact with the curved portions 41 and 42 at a position spaced upward from the longitudinal axis A of the insertion portion 31 generates a cross-sectional secondary moment against the pressing force, and the rotational force is increased.
  • the acting curved portions 41 and 42 can be pressed so as not to fall down.
  • the curved curved portions 41 and 42 are prevented from falling by the contact with the pericardium Y by the support surface 8a, and the curved curved portions 41 and 42 are prevented from falling.
  • the posture is stably maintained by the support surface 8a.
  • the rotation restricting portions 71 and 72 described in the first embodiment may be provided.
  • the endoscope sheath 10 may have a lumen that opens at the tip of the protruding portion 8 and into which a wire is inserted. By doing in this way, a space can be secured in front of the tip of the protrusion 8 by lifting the pericardium with the wire protruding in the longitudinal direction from the tip of the protrusion 8.
  • the support surfaces 8a are arranged on both the left and right sides of the endoscope channel 5a, but instead, as shown in FIG. 13, only the left side or the right side of the endoscope channel 5a. Only the support surface 8a may be arrange
  • the endoscope 21 including the two bending portions 41 and 42 that can be bent in opposite directions is used, but instead of this, a single unit is used as in the first embodiment.
  • An endoscope 2 including a bending portion 4 may be used.
  • the support surface 8a is provided at least on the lower side of the longitudinal axis of the endoscope channel 5a, and the side surface of the curved portion 4 curved downward is inserted into the insertion portion in the endoscope channel 5a. It is comprised so that it may support below the longitudinal axis A of 31.
  • the protruding portion 8 is formed integrally with the sheath body 5, but instead, the protruding portion 81 is separate from the sheath body 5 as shown in FIG. There may be provided so as to be able to project and retract from the tip of the sheath body 5.
  • the protrusion 81 is disposed in a cylindrical space between the side surface of the insertion portion 31 and the inner surface of the endoscope channel 5a, and the position housed in the endoscope channel 5a and the distal end surface of the sheath body 5 It may be provided so as to be movable in the longitudinal direction between the position protruding from the position. By doing in this way, when the protrusion 81 is unnecessary, the protrusion 81 can be retracted into the sheath body 5.
  • a general-purpose endoscope sheath can be used as the sheath body 5.
  • the protruding portion 81 may have a linear shape extending along the longitudinal direction of the sheath body 5, but may be curved downward as shown in FIG. 15 has an arcuate curved shape in a free state where no external force is applied, and can be deformed into a linear shape by its elasticity.
  • the projecting portion 83 having flexibility may be configured to be deformed between the linear shape and the curved shape integrally with the curved portion 4.
  • the projecting portion 83 is connected to the side surface of the bending portion 4 by a connecting tool 83 a such as a rivet at two positions of the distal end portion and the proximal end portion, and follows the bending of the bending portion 4. And may be configured to be bent.
  • the support portion 8a is configured from the flat side surface of the columnar protrusion 8.
  • the wire 84 may have a smaller diameter.
  • the wire 84 in FIG. 17 protrudes from the distal end surface of the sheath body 5 and forms a loop in a plane substantially parallel to the vertical direction.
  • the diameter of the loop shape of the wire 84 increases as the distance from the distal end surface of the sheath body 5 increases.
  • the wire 84 may be fixed to the distal end surface of the sheath body 5, but may be provided so as to be movable with respect to the sheath body 5.
  • the wire 84 extends through the hole formed in the side wall of the sheath body 5 to the proximal end side of the sheath body 5, and pushes and pulls both ends of the wire 84 arranged on the proximal end side of the sheath body 5.
  • the protruding amount of the wire 84 from the distal end surface of the sheath body 5 may be adjustable. By doing so, the wire 84 can be retracted into the sheath body 5 when the support portion is unnecessary.
  • a linear general-purpose guide wire 85 may be used as shown in FIG.
  • the sheath body 5 is formed with a wire channel 5b that penetrates in the longitudinal axis direction and is inserted so that the guide wire 85 is movable in the longitudinal direction on both the left and right sides or one side of the endoscope channel 5a.
  • the distal end portion of the wire channel 5 b is inclined downward toward the distal end of the sheath body 5. Accordingly, the distal end portion of the guide wire 85 protruding from the wire channel 5b supports the side surface of the curved portion 4 that is curved below the longitudinal axis A of the insertion portion 31 in the endoscope channel 5a. It has become. In this manner, the distal end portion of the guide wire 85 protruding from the wire channel 5b can function as a support portion.
  • FIGS. 19A to 21B An endoscope sheath and endoscope system 102 according to a third embodiment of the present invention will be described with reference to FIGS. 19A to 21B.
  • configurations different from those in the first and second embodiments will be described, and configurations common to the first and second embodiments will be denoted by the same reference numerals and description thereof will be omitted.
  • the present embodiment is different from the first and second embodiments in that an endoscope 22 that does not include a bending portion is used.
  • the endoscope system 102 includes an endoscope 22, an endoscope sheath 1, and an endoscope channel 5 a of the endoscope sheath 1. And an inner sheath 9 to be inserted into the inner sheath 9.
  • the endoscope 22 includes a flexible and long insertion portion 32 that can be inserted into the pericardial cavity, and does not include a bending portion.
  • 19A and 19B show the endoscope sheath 1, but in this embodiment, any endoscope having support portions on the left and right sides described in the first and second embodiments. A mirror sheath can be employed.
  • the inner sheath 9 is a long circular tube having a lumen that penetrates in the direction along the longitudinal axis and into which the endoscope 22 is inserted.
  • the inner sheath 9 has an outer diameter smaller than the inner diameter of the endoscope channel 5a, and the inner sheath 9 is movable in the longitudinal direction within the endoscope channel 5a.
  • the lumen of the inner sheath 9 has an inner diameter larger than the outer diameter of the insertion portion 32, and the insertion portion 32 can move in the longitudinal direction within the lumen.
  • the distal end portion 9a of the inner sheath 9 is curved in a direction intersecting the longitudinal axis in a free state where no external force is acting, and can be deformed into a linear shape extending along the longitudinal axis by its elasticity. Further, the inner sheath 9 has lower rigidity than the sheath body 5 and higher rigidity than the insertion portion 32. Therefore, by rotating the inner sheath 9 around the longitudinal axis in the endoscope channel 5a, the deformation between the curved shape and the linear shape of the distal end portion 9a of the inner sheath protruding from the endoscope channel 5a is controlled. Accordingly, the bending of the distal end portion 32a of the insertion portion 32 can be controlled.
  • the distal end portion 9a is curved by rotating the inner sheath 9 about the longitudinal axis and arranging the curved side of the distal end portion 9a on the lower side.
  • the distal end portion 9a extends linearly by arranging the curved side of the distal end portion 9a on the left or right side while the hood 6 is present.
  • the distal end portion 32 a of the insertion portion 32 disposed at the distal end portion 9 a of the inner sheath 9 is also deformed between a curved shape and a linear shape according to the deformation of the distal end portion 9 a of the inner sheath 9.
  • the bending of the distal end portion 32a of the insertion portion 32 is controlled by the curved distal end portion 9a of the inner sheath 9, but instead of this, as shown in FIG.
  • the distal end portion 32a may be curved in a direction intersecting the longitudinal axis in a free state and deformable into a linear shape extending along the longitudinal axis by its elasticity.
  • the distal end portion 32a of the insertion portion 32 is linear in the endoscope channel 5a and gradually curves as it protrudes from the endoscope channel 5a. Even in this case, by rotating the insertion portion 32 around the longitudinal axis in the endoscope channel 5a, the distal end portion 32a of the insertion portion 32 protruding from the endoscope channel 5a is between the curved shape and the linear shape. Can be controlled. Specifically, the distal end portion 3a is curved by rotating the insertion portion 32 around the longitudinal axis so that the curved side of the distal end portion 3a is located on the lower side, and the hood 6 is present on the curved side of the distal end portion 3a. In addition, the tip 3a can be linearly extended by being arranged on the left or right side.
  • the distal end portion 32 a of the insertion portion 32 can swing around the axis 11 intersecting the longitudinal axis of the insertion portion 32, for example, the protrusion 8.
  • the support surface 8a may be supported.
  • the insertion portion 32 is bent between the distal end surface of the sheath body 5 and the shaft 11 by pressing the proximal end portion of the insertion portion 32. At this time, the distal end of the insertion portion 32 swings around the shaft 11 so that the distal end of the insertion portion 32 is directed downward.
  • the inner sheath 9 or the insertion portion 32 having a curved shape changes with time in the curved shape of the inner sheath 9 or the insertion portion 32 by repeating elastic deformation between the curved shape and the linear shape, for example, the curvature becomes small. there is a possibility.
  • the distal end portion 32a of the insertion portion 32 can be reliably bent by an angle corresponding to the pushing amount of the insertion portion 32.
  • the insertion portion 32 is not necessarily curved so as to protrude upward, and the insertion portion 32 may be curved so as to protrude downward and the tip of the insertion portion 32 may be directed upward. is there. Therefore, in order to curve the insertion portion 32 so as to protrude upward, a member for regulating the bending direction of the insertion portion 32 may be provided. For example, a member that prevents the insertion portion 32 from protruding downward may be provided below the endoscope channel 5a between the endoscope channel 5a and the shaft.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Endoscopes (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)

Abstract

L'invention concerne une gaine d'endoscope comprenant : un corps de gaine en forme de tube (5) comprenant un canal d'endoscope (5a) qui pénètre dans la direction le long de l'axe longitudinal et dans lequel est inséré un endoscope ; et une partie support (6) qui est disposée plus à l'extérieur que le canal d'endoscope (5a) dans une première direction radiale du corps de gaine (5), fait saillie à partir de la pointe du corps de gaine (5a) dans la direction le long de l'axe longitudinal, et supporte une face latérale d'une partie pointe (4) de l'endoscope, qui fait saillie à partir du canal d'endoscope (5a) et se courbe dans un plan qui est sensiblement parallèle à une seconde direction radiale orthogonale à la première direction radiale. La partie support (6) limite la rotation de la partie pointe incurvée (4) autour de l'axe longitudinal de l'endoscope à l'intérieur du canal d'endoscope (5a).
PCT/JP2017/022372 2017-06-16 2017-06-16 Gaine d'endoscope et système d'endoscope WO2018229982A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/022372 WO2018229982A1 (fr) 2017-06-16 2017-06-16 Gaine d'endoscope et système d'endoscope

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/022372 WO2018229982A1 (fr) 2017-06-16 2017-06-16 Gaine d'endoscope et système d'endoscope

Publications (1)

Publication Number Publication Date
WO2018229982A1 true WO2018229982A1 (fr) 2018-12-20

Family

ID=64660315

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2017/022372 WO2018229982A1 (fr) 2017-06-16 2017-06-16 Gaine d'endoscope et système d'endoscope

Country Status (1)

Country Link
WO (1) WO2018229982A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020179044A1 (fr) * 2019-03-07 2020-09-10 オリンパス株式会社 Dispositif médical
CN114151193A (zh) * 2021-12-16 2022-03-08 中国船舶重工集团公司第七一一研究所 探头安装组件、系统及发动机内窥式可视化系统

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010284503A (ja) * 2009-03-02 2010-12-24 Olympus Corp 内視鏡
JP2011010810A (ja) * 2009-07-01 2011-01-20 Mikihito Kuroda 内視鏡装置
JP2014121470A (ja) * 2012-12-21 2014-07-03 Olympus Corp 内視鏡システム
WO2016203606A1 (fr) * 2015-06-18 2016-12-22 オリンパス株式会社 Système d'endoscope péricardique

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2010284503A (ja) * 2009-03-02 2010-12-24 Olympus Corp 内視鏡
JP2011010810A (ja) * 2009-07-01 2011-01-20 Mikihito Kuroda 内視鏡装置
JP2014121470A (ja) * 2012-12-21 2014-07-03 Olympus Corp 内視鏡システム
WO2016203606A1 (fr) * 2015-06-18 2016-12-22 オリンパス株式会社 Système d'endoscope péricardique

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2020179044A1 (fr) * 2019-03-07 2020-09-10 オリンパス株式会社 Dispositif médical
CN114151193A (zh) * 2021-12-16 2022-03-08 中国船舶重工集团公司第七一一研究所 探头安装组件、系统及发动机内窥式可视化系统

Similar Documents

Publication Publication Date Title
KR101280065B1 (ko) 수술기구용 회전 관절 및 수술기구용 벤딩 관절
KR101364053B1 (ko) 미세수술기구용 가이드 튜브
US10149608B2 (en) Bending portion for endoscope and endoscope including bending portion for endoscope
US20210378648A1 (en) Steerable instrument comprising a tube element
JP6177021B2 (ja) 内視鏡
WO2016203606A1 (fr) Système d'endoscope péricardique
WO2017216835A1 (fr) Dispositif médical
WO2018229982A1 (fr) Gaine d'endoscope et système d'endoscope
JP2021532910A (ja) ジョイント
US11007347B2 (en) Deflectable insertion tool
JP2008220972A (ja) 処置具
JP2008220971A (ja) 処置具
KR101828289B1 (ko) 와이어를 이용한 연성 카테터
JP2005211683A (ja) 処置具
US10933214B2 (en) Method for producing a deflectable insertion tool
JP6713907B2 (ja) カテーテル、カテーテル用ガイドワイヤ、および内視鏡用処置具
JP6296869B2 (ja) 処置具および手術システム
WO2018109893A1 (fr) Endoscope et système d'endoscope
WO2017203582A1 (fr) Dispositif d'utilisation d'endoscope et système endoscopique
JP6697291B2 (ja) 内視鏡湾曲管
WO2020161857A1 (fr) Gaine de guidage destinée à être utilisée en chirurgie
JP2019034083A (ja) 医療用マニピュレーターの可撓チューブ及び屈曲構造体
US20210259529A1 (en) Guide tube, treatment system and guide-tube attachment method
WO2021153092A1 (fr) Cathéter
CN219021093U (zh) 内窥镜用管件、导引鞘、插入部及内窥镜

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 17913843

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 17913843

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: JP