WO2022190234A1

WO2022190234A1 - Connection member for endoscopes, and traction device

Info

Publication number: WO2022190234A1
Application number: PCT/JP2021/009452
Authority: WO
Inventors: 雄哉松岡; 裕也樋高
Original assignee: オリンパスメディカルシステムズ株式会社
Priority date: 2021-03-10
Filing date: 2021-03-10
Publication date: 2022-09-15

Abstract

This connection member for endoscopes comprises: a main body which can be attached around an endoscope insertion part; and a tape which has an adhesive layer and is attached to the main body in a state in which at least a portion of the adhesive layer is not joined to the main body.

Description

Connecting member and traction device for endoscope

The present invention relates to an endoscope connecting member for attaching a treatment tool or the like to an endoscope. A traction device using this connecting member for an endoscope is also referred to.

An endoscopic treatment tool, a small-diameter second scope, etc. (hereinafter sometimes referred to as a "treatment tool, etc.") is attached along the insertion portion of the endoscope, and introduced into the body together with the endoscope. techniques are known.

In relation to the above procedure, Patent Document 1 describes attaching a C-shaped sleeve through which a tube for passing a treatment instrument, etc., is attached to the insertion portion of an endoscope, and fixing it by winding an adhesive tape or the like. ing.

U.S. Pat. No. 7,566,300

In the method described in Patent Document 1, when removing the sleeve after the procedure. Adhesive substances from the tape may remain on the endoscope, complicating cleaning.

In view of the above circumstances, it is an object of the present invention to provide an endoscope connecting member that can ensure sufficient fixing force and that can be easily washed after use.

A first aspect of the present invention comprises a main body that can be attached around an insertion portion of an endoscope, and a tape that has an adhesive layer and is attached to the main body in a state in which at least part of the adhesive layer is not joined to the main body. It is an endoscope connection member provided.

A second aspect of the present invention is an endoscope connecting member according to the first aspect, and a grasping mechanism supported movably back and forth with respect to the endoscope connecting member and capable of grasping a tissue. traction device.

According to the present invention, it is possible to provide an endoscope connection member that can ensure sufficient fixing force and can be easily washed after use.

1 is an overall view of a traction device according to a first embodiment of the invention; FIG. Fig. 4 is a perspective view of the main body of the sleeve according to the same traction device; It is a top view of the tape which concerns on the same traction device. It is a bottom view of the same tape, and has shown except release paper. It is a figure which shows the sticking aspect of the same tape with respect to the same main body. Figure 2 shows the same sleeve in use; FIG. 4 is a diagram showing an example of a jig used for attaching a rubber band; It is a figure which shows one form at the time of use of the same jig. It is a figure which shows one process of rubber band attachment using the same jig. It is a figure which shows one process of rubber band attachment using the same jig. It is a figure which shows one process of rubber band attachment using the same jig. FIG. 10 is a diagram showing a state in which a sleeve according to a modified example of the present invention is attached to an endoscope;

A first embodiment of the present invention will be described with reference to FIGS. 1 to 11. FIG.
FIG. 1 is an overall view of a traction device 1 according to this embodiment. The traction device 1 includes a channel tube 10, a grasping mechanism 20 passed through the channel tube 10, and a plurality of endoscope connection members fixed to the channel tube.
The traction device 1 is attached to various known endoscopes and used for tissue dissection procedures such as ESD (endoscopic submucosal dissection).

The channel tube 10 is a tubular member made of resin or the like, through which the gripping mechanism 20 is passed so as to be relatively movable. The length of the channel tube 10 is equal to or longer than the length of the insertion portion of the endoscope to which the channel tube 10 is attached. The traction device 1 is attached to the endoscope so that the proximal end of the channel tube 10 is positioned outside the body when the endoscope is inserted into the body.

As the gripping mechanism 20, a known gripping forceps structure can be adopted. The relationship between the gripping mechanism 20 and other parts will be described later.
A resin tube or the like can be used as the channel tube 10 . The inner diameter of the channel tube 10 is larger than the outer diameter of the gripping mechanism 20 , and the gripping mechanism 20 can freely advance and retreat inside the channel tube 10 .

In this embodiment, there are two types of endoscope connection members, the cap 30 and the sleeve 40 . The sleeve 40 is one aspect of the endoscope connecting member according to the present invention.

The cap 30 has a basic shape in which a part of the wall surface is removed on the base end side of the cylinder. The inner diameter of the basic shape is slightly larger than the outer diameter of the insertion section of the endoscope to be attached (hereinafter referred to as "endoscope insertion section"), and the endoscope insertion section can be passed through. The cap 30 has a hole 31 extending parallel (including substantially parallel, hereinafter the same) to the axis X1 of the basic shape on the outer peripheral surface of the proximal end. The tip of the channel tube 10 enters the hole 31 and is fixed to the cap 30 in the hole 31 with an adhesive or the like.

A link 32 is rotatably attached to the tip of the cap 30 . The link 32 is rotatably connected to the tip of the gripping mechanism 20 . With this structure, when the gripping mechanism 20 is advanced with respect to the channel tube 10, the gripping portion 21 provided at the distal end moves forward of the cap 30, and when the gripping mechanism 20 is retracted with respect to the channel tube 10, it is gripped. Part 21 moves above cap 30 .

A plurality of sleeves 40 are arranged at intervals behind the cap 30 . The traction device 1 of this embodiment has three sleeves, but the number of sleeves can be set as appropriate. The distance between the cap 30 and the sleeve 40 does not have to be the same, and can be set as appropriate.

Each sleeve 40 has a body 41 and a tape 60 attached to the body.
FIG. 2 is a perspective view of the main body 41 with the tape 60 removed. The main body 41 has a first hole 42 through which the endoscope insertion portion is passed and a second hole 46 through which the channel tube 10 is passed as internal spaces, and has a basic cylindrical shape. The first hole 42 and the second hole 46 are substantially cylindrical spaces, and the axis of the first hole 42 and the axis of the second hole 46 are parallel. The inner diameter of the first hole 42 is slightly larger on the front side than on the rear side, and strictly speaking, it forms a truncated conical space.

Although the material of the sleeve 40 can be determined as appropriate, it is preferable to use a material such as an elastomer that does not slip easily against the insertion portion of the endoscope. The sleeve 40 can be formed by injection molding or the like from selected materials. When the first hole 42 has the truncated conical shape as described above, it is easy to pull out the mandrel that is passed during molding to form the first hole 42, so that the manufacturing process can be carried out smoothly.

The sleeve 40 has a slit 43 communicating with the first hole 42 on its outer peripheral surface. The slit extends continuously from the front end to the rear end of the sleeve 40, and the outer peripheral surfaces facing each other with the slit 43 therebetween can be brought close to each other or separated from each other.
The width of the slit 43 is slightly larger on the front side than on the rear side and continuously decreases toward the rear side. As a result, when the outer peripheral surfaces facing each other across the slit 43 are brought into contact with each other, the inner diameter of the front side and the rear side of the first hole 42 become substantially the same, and the first hole 42 becomes a substantially cylindrical space.

The dimensions of the second hole 46 are about the same as the hole 31 of the cap 30, and the channel tube 10 can enter. The channel tube 10 is fixed to the sleeve 40 inside the second hole 46 with an adhesive or the like poured from the lateral hole 47 .

3 is a plan view of the tape 60. FIG. The basic structure of the tape 60 is well known, and has an adhesive layer on one side of a film-like or sheet-like base material. Part of the adhesive layer is covered with a release paper until use.

The tape 60 according to this embodiment has a strip shape extending in one direction in plan view. The width of the tape 60 (the dimension in the direction orthogonal to the longitudinal direction) is relatively small D1 in a certain range from the first end 61 and the second end 62, and relatively A large D2. In the following description, the portion of the width D1 on the first end 61 side is the first region 63, the portion of the width D2 connected to the first region 63 is the second region 64, and the portion from the end of the second region to the second end is A portion having the width D1 is referred to as a third region (non-bonding region) 65, respectively.
The first region 63 and the second region 64 each have the same width dimension throughout, but the width of the third region 65 gradually increases within a certain range from the second end 62 as it approaches the second end 62 . has decreased to

FIG. 4 is a bottom view of the tape 60, shown without the release paper. The bottom surface of the tape 60 is not entirely tacky, and there are areas with no tackiness. Specifically, a certain range of the third region 65 on the side of the second region 64 is a non-adhesive region 72, and the remainder of the third region 65 and the entirety of the first region 63 and the second region 64 are , the adhesive area 71 .
A specific configuration of the non-adhesive region 72 can be appropriately set based on a known technique. For example, the non-adhesive regions 72 may be formed by not providing an adhesive layer, or the non-adhesive regions 72 may be formed by providing an adhesive layer on the entire surface and then partially performing a known paste removal treatment. good too.

The tape 60 is bonded to the main body 41 with only the release papers of the first region 63 and the second region 64 peeled off. The lower surface of the third region 65 is protected by a release paper until use, and is kept in a non-bonded state with the main body 41 .
FIG. 5 shows the positional relationship between each region of the tape 60 and the main body 41. As shown in FIG. The first region 63 and the second region 64 are joined to a range R1 from the top of the main body 41 provided with the second hole 46 to the front of the slit 43 . The third region 65 is joined to a range R2 from the end of the second region 64 to the first region 63 when the traction device 1 is used. Overall, the length of the tape 60 is long enough to wrap around the main body 41 more than once, and the tape 60 is attached to the main body 41 so that the slit 43 is positioned within the non-adhesive area 72 . Attached.

The operation of using the traction device 1 configured as described above will be described. The traction device 1 is attached to the insertion section of the endoscope before being inserted into the body. The user attaches the cap 30 to the distal end of the endoscope in an appropriate positional relationship while considering the positions of the imaging mechanism, treatment instrument channel, etc. provided at the distal end of the endoscope.

Subsequently, the slit 43 of the sleeve 40 is widened, and the insertion portion is passed through the first hole 42. After determining the position of the sleeve 40 , the user holds the tape 60 and pulls it in a direction to wrap around the body 41 . By this operation, the parts of the main body 41 that face each other across the slit approach each other, the width of the slit 43 narrows, and the inner surface of the first hole 42 is strongly pressed against the insertion portion.

The user peels off the release paper covering the third area 65 and attaches the third area 65 while pulling the tape 60 . At this time, as shown in FIG. 6, the third region 65 is attached so as to pass between a pair of guides 48 protruding from the outer peripheral surface of the main body 41 . The distance between the pair of guides 48 is slightly longer than the width D1 of the first area 63 and the third area 65 .
When the third region 65 is joined to the main body 41 , the slit 43 is covered with the third region 65 . Furthermore, the state in which the inner surface of the first hole 42 is strongly pressed against the insertion section is maintained, and the sleeve 40 is fixed to the insertion section.

In the tape 60 according to the present embodiment, as shown in FIG. 3, a first index 68 is provided at a portion of the second region 64 near the first region, and a second index 69 is provided at a predetermined position in the third region 65. is provided. As shown in FIG. 6, by joining the third region 65 at a position where the second index 69 exceeds the first index 68, the sleeve 40 can be fixed to the insertion portion with a sufficient fixing force.
The appearance of the first index and the second index, the positional relationship when a predetermined fixing force is exerted, and the like are not limited to the aspects of the present embodiment, and can be set as appropriate.

If necessary, a rubber band may be attached to the cap 30 to reinforce the fixing force of the cap to the insertion portion.
FIG. 7 shows an example of a jig for easily attaching the rubber band. A jig 200 shown in FIG. 7 has a structure in which a first member 201 and a second member 202 are connected so as to be relatively rotatable. The front sides of the first member 201 and the second member 202 have shapes in which left and right ends 206 and 207 respectively protrude forward. The distance between the ends 206 and between the ends 207 is greater than the outer diameter of the endoscope insertion section to which it is attached.
Each

end

206 and 207 has a forwardly extending thin metal rod 210 .

When attaching the rubber band using the jig 200, first, as shown in FIG. 8, a ring-shaped rubber band B is arranged around the four metal rods 210. In this state, when the first member 201 and the second member 202 are relatively rotated so that the rear portion 201a of the first member 201 and the rear portion 202a of the second member 202 approach each other, as shown in FIG. 206 and end 207 are separated, and rubber band B is expanded.

After the rubber band B is sufficiently expanded, the distal end of the endoscope Es with the cap 30 attached is brought closer to the jig 200 and passed through the expanded rubber band B. At this time, since the

end portions

206 and 207 to which the rubber band B is pointed protrude in front of the jig 200, the endoscope Es and the jig 200 do not interfere.

When the rubber band B reaches the region of the cap 30 where the hole 31 is provided, the

ends

206 and 207 are brought closer to move the jig 200 away from the endoscope Es as shown in FIG. Then, as shown in FIG. 11, the metal rod 210 is removed from the rubber band B, and the rubber band B remains on the side of the endoscope Es to reinforce the fixing force of the cap 30 .

Many of the rubber bands attached to the endoscope are small in size to match the diameter of the insertion section, and many of them require a large amount of force for expansion. For this reason, it is not easy for the user to expand it by hand and attach it to the endoscope, but it can be easily attached by using the jig 200.
Instead of the metal rod 210, a member made of another material having sufficient rigidity to hold the rubber band B in the expanded state may be used. Making the surface of the structure corresponding to the metal rod 210 slippery facilitates the process of pulling out the jig from the rubber band.

Attaching the cap 30 and all sleeves 40 to the endoscope completes the installation of the traction device 1 . After mounting, the user inserts the endoscope into the body and performs a procedure on the site to be treated.
For example, when performing ESD, the grasping mechanism 20 is advanced to grasp the mucosal tissue, and then the grasping mechanism 20 is retracted to lift the grasped mucosal tissue and expose the underlying tissue. In this state, the ESD procedure can be performed smoothly by incising the submucosal layer with a high-frequency knife or the like protruding from the channel of the endoscope.

As described above, the sleeve 40, which is the endoscope connecting member according to the present embodiment, is provided with the main body 41 and the tape 60, so that it can be easily attached to the endoscope and exerts sufficient fixing force. can do. Therefore, by applying it to the traction device 1, the sleeve 40 can be suitably prevented from rotating with respect to the insertion portion of the endoscope during the procedure, and the procedure can be performed smoothly.

Also, by adjusting the pulling amount of the tape 60, the fixing force can be adjusted according to the usage environment, etc., and the sleeve 40 can be easily removed from the endoscope by simply peeling off the tape 60 after the procedure. The first index 68 and the second index 69 described above contribute to reliably generating a desired fixing force by an intuitive operation during mounting.

Furthermore, in the tape 60, the width of the third region 65, which is attached by the user at the time of installation, is narrower than the width of the second region 64, which is joined to the main body at the time of shipment. The third region 65 is prevented from protruding from the second region 64 and being directly attached to the insertion portion of the endoscope. As a result, it is possible to prevent the adhesive of the third region from adhering and remaining on the endoscope insertion portion.

When attaching the sleeve 40 to the endoscope insertion section, the slit 43 may not be completely closed depending on the diameter of the insertion section. If the slit 43 is not completely closed, the outer peripheral surface of the insertion portion of the endoscope is exposed at the slit. The adhesive does not stick to the endoscope insertion section even if it comes into contact with the surface.

In addition, since the main body 41 is provided with the guides 48 described above, the user can stick the third region 65 substantially parallel to the second region by passing the third region 65 between the guides 48 . can be attached. This also prevents the third area 65 from protruding from the second area 64 and sticking.
Furthermore, by passing the first region 63 between the guides 48 , the tape 60 is prevented from protruding from the main body 41 and sticking in the manufacturing process of the sleeve 40 .

Although one embodiment of the present invention has been described above, the technical scope of the present invention is not limited to the above-described embodiment. Various changes can be made to or deleted from . Below are some examples of changes, but they are not exhaustive. Also, a plurality of these can be combined as appropriate.

- In the tape, the width of the second region and the third region may be the same. Also, the first region may not be provided.
・In cases where the thickness of the main body exceeds a certain value, contact between the tape and the exposed endoscope insertion section can be suppressed by the thickness of the main body, so there is no need to provide a non-adhesive area on the bottom surface of the tape. .
- The portion of the tape that is previously bonded to the main body does not have to be bonded with an adhesive layer. For example, a portion of the tape may be joined to the main body by heat-sealing, and the adhesive layer may be provided only on the portion to which the user attaches when wearing.

- The main body may not have the second hole. A main body 41A of a modified example shown in FIG. 12 does not have the second hole, and the channel tube 10 is fixed to the main body 41A by a tape 60A.
・The main body does not have to always maintain the basic cylindrical shape. For example, the main body 41A described above may be in the form of a flat sheet before being attached to the endoscope Es, and may be configured to have a cylindrical shape by being attached so as to be wrapped around the endoscope Es.

- The main body may not have a guide. When the guide is provided, it is not limited to a three-dimensional one as described above, and may be a printed index or the like.

- A channel tube is not essential in the traction device according to the present invention. For example, a configuration in which the gripping mechanism 20 is directly passed through the second hole 46 of the main body 41, a configuration in which the gripping mechanism is supported by a tape on the main body 41A, and the like are conceivable. When the gripping mechanism is supported by tape on the main body 41A, the gripping mechanism can be configured to move back and forth by providing a non-adhesive region in the portion that contacts the gripping mechanism.
・In the traction device, the number of sleeves, arrangement intervals, etc. can be set as appropriate.

・In the traction device, the structure of the endoscope connection member according to the present invention is applied to the cap attached to the distal end of the endoscope by adjusting the size of the non-adhesive area provided on the tape. can.

- The connecting member for an endoscope according to the present invention can be widely applied not only to a traction device but also to attaching various mechanisms along an elongated insertion portion. For example, it can be used in constructing a flexible medical manipulator with multiple gripping mechanisms arranged along an elongated insertion section.

Reference Signs List 1 traction device 20 gripping mechanism 40 sleeve (connecting member for endoscope)
41, 41A main body 42 first hole (internal space)
43 slit 60, 60A tape 65 third region (adhesive layer, non-joining region)
68 first index 69 second index 72 non-adhesive area

Claims

a main body that can be attached around the insertion portion of the endoscope;
a tape having an adhesive layer and attached to the main body in a state in which at least part of the adhesive layer is not joined to the main body;
comprising
A connecting member for an endoscope.
The main body has a tubular shape with an internal space, and has a slit communicating with the internal space,
A non-bonded region of the tape that is not bonded to the main body is arranged at a position where it can be bonded to the main body while covering a part of the slit.
The connecting member for an endoscope according to claim 1.
The non-bonding area has a non-adhesive area in a portion covering the slit,
The connecting member for an endoscope according to claim 2.
The tape has a first index on a portion fixed to the main body and a second index on a non-bonded area that is not bonded to the main body.
The connecting member for an endoscope according to claim 1.
The connecting member for an endoscope according to claim 1;
a grasping mechanism that is movably supported by the endoscope connecting member and configured to grasp a tissue;
comprising
traction device.