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JP2005131211A - Externally mounted channel for endoscope - Google Patents

Externally mounted channel for endoscope Download PDF

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JP2005131211A
JP2005131211A JP2003372353A JP2003372353A JP2005131211A JP 2005131211 A JP2005131211 A JP 2005131211A JP 2003372353 A JP2003372353 A JP 2003372353A JP 2003372353 A JP2003372353 A JP 2003372353A JP 2005131211 A JP2005131211 A JP 2005131211A
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endoscope
external channel
main body
distal end
channel
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Koji Nakamoto
孝治 中本
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Olympus Corp
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Olympus Corp
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Abstract

<P>PROBLEM TO BE SOLVED: To be capable of confirming the protruding amount and the protruding direction of a treating tool or the like from an externally mounted channel body when operating an endoscope to which an externally mounted channel is mounted in the body cavity even when enlargement of the diameter of the externally mounted channel body is attempted. <P>SOLUTION: The flexible externally mounted channel 2 which is attachably and detachably disposed in an insertion part provided on the soft type endoscope 1, and which is equipped with the externally mounted channel body 2a and a fixing part 30 which mounts the tip part 32 of the externally mounted channel body 2a to the tip end of the insertion part in a protruded state so as to enable confirming in the observation field of vision of the endoscope, and the endoscope 1 using this are offered. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

本発明は、内視鏡本体に着脱可能な外付けチャンネル及びこれを備えた内視鏡に関するものである。   The present invention relates to an external channel that can be attached to and detached from an endoscope main body, and an endoscope including the same.

従来、人体の消化管内に挿入可能な内視鏡の用途は診断から治療へとその適用範囲は拡大している。また、治療内容も癌を切除する内視鏡的粘膜切除術,内視鏡的止血及び内視鏡的胃痩造設術など多様化しており、これら治療を行うための処置具を挿通する処置用チャンネルに求められる要求も多様化している。さらに、内視鏡の基本機能である患部洗浄,送気,送水等を行うためのチャンネルも重要である。
このような状況の中、多様化するこれら処置用チャンネルの要求に応えるため、従来の内視鏡を活用しながら効率的に治療を行うことを目的として、内視鏡の挿入部に着脱自在に併設される外付けチャンネルが考案されている。
Conventionally, the scope of applications of endoscopes that can be inserted into the digestive tract of the human body has expanded from diagnosis to treatment. In addition, treatment contents are diversified, such as endoscopic mucosal resection to remove the cancer, endoscopic hemostasis, and endoscopic gastrostomy. For treatment to insert treatment tools for performing these treatments The demands on the channel are also diversifying. In addition, a channel for performing cleaning of the affected area, air supply, water supply and the like, which are basic functions of the endoscope, is also important.
Under these circumstances, in order to respond to the diversifying demands of these treatment channels, the insertion part of the endoscope can be detachably attached for the purpose of efficiently performing treatment while utilizing a conventional endoscope. An external channel has been devised.

この外付けチャンネルとして、例えば、外付けチャンネルに挿通されたポリープ回収用処置具が他の治療の作業性を向上させるため、外付けチャンネルの先端部を内視鏡観察視野に見えないように手元側に退避して設けたものが提案されている(例えば、特許文献1参照。)。
また、外付けチャンネルを容易に内視鏡の挿入部に装着でき、内視鏡の挿入部の外径に関わらず任意の位置および方向に取り付けられることを目的としたものも提案されている(例えば、特許文献2参照。)。この特許文献2に記載の外付けチャンネルは、先端部にシート状の可撓性を有する取付部を備え、この取り付け部の装着側に粘着層等の止着層を設けたものである。
さらに、可撓性を有する内視鏡の挿入部に外付けチャンネルを取り付けても挿入部の湾曲に対して柔軟に対応できるようにしたものも提案されている(例えば、特許文献3参照。)。この特許文献3に記載の外付けチャンネルは、外付けチャンネル本体の外周に凸部を設けるとともに、外付けチャンネルを内視鏡の挿入部に取り付けるための固定具に外付けチャンネル本体の可動を所定範囲内に規制する手段を設けたものである。
特開平11−192203号公報 実用考案登録第2558354号公報 実開昭58−28813号公報
As this external channel, for example, a polyp collection treatment tool inserted into the external channel improves the workability of other treatments, so that the distal end of the external channel is not visible in the endoscopic observation field. The thing which retracted and provided in the side is proposed (for example, refer patent document 1).
There has also been proposed an external channel that can be easily attached to the insertion portion of the endoscope and can be attached to any position and direction regardless of the outer diameter of the insertion portion of the endoscope ( For example, see Patent Document 2.) The external channel described in Patent Document 2 is provided with a sheet-like flexible attachment portion at the tip, and a fastening layer such as an adhesive layer is provided on the attachment side of the attachment portion.
Further, there has been proposed one that can flexibly cope with the bending of the insertion portion even if an external channel is attached to the insertion portion of the endoscope having flexibility (see, for example, Patent Document 3). . In the external channel described in Patent Document 3, a convex portion is provided on the outer periphery of the external channel main body, and the external channel main body is movable to a fixture for attaching the external channel to the insertion portion of the endoscope. Means for regulating within the range is provided.
JP 11-192203 A Utility Device Registration No. 2558354 Japanese Utility Model Publication No. 58-28813

しかしながら、上記従来の技術には以下のような課題が残されている。
内視鏡的治療への要求の高まりと適応拡大を考慮すると外付けチャンネル本体の管路径の拡大は今後重要になると考えられている。この場合、管路径の拡大により、外径の拡大された外付けチャンネル本体を備えた外付けチャンネルを内視鏡の挿入部に取り付けると、体腔内に挿入される外付けチャンネルを含む内視鏡の挿入部の直径はさらに太径化し、患者にかかる負担も大きくなる。
However, the following problems remain in the conventional technology.
Considering the growing demand for endoscopic treatment and the expansion of indications, it is considered that the expansion of the diameter of the external channel body will become important in the future. In this case, an endoscope including an external channel to be inserted into a body cavity when an external channel having an external channel body having an enlarged external diameter is attached to the insertion portion of the endoscope due to an increase in the diameter of the duct. The diameter of the insertion portion is further increased, which increases the burden on the patient.

また、従来の技術はいずれにおいても、処置時における操作性の向上,外付けチャンネルの取り付け作業性の向上及び可動性の向上等の機能面に着眼されて考案されたものである。しかし、これらは、内視鏡の挿入部に装着される外付けチャンネル本体の径が小さい場合には有効であるが、外付けチャンネルの太径化に伴い、実質上の内視鏡挿入部も太くなってしまう。さらに、外付けチャンネルが手元側に退避した位置に設けられているため、外付けチャンネル本体から処置具等を目的の部位に突出させるのは困難である。
本発明は上述した事情に鑑みてなされたものであって、外付けチャンネル本体の径の太径化を図った場合においても、外付けチャンネルを取り付けた内視鏡を体腔内において操作する際、外付けチャンネル本体から処置具等の突出量及び突出方向を確認することが可能となる外付けチャンネル及びこれを備えた内視鏡を提供ことを目的とする。
In addition, any of the conventional techniques has been devised focusing on functional aspects such as improvement in operability during treatment, improvement in workability of attaching an external channel, and improvement in mobility. However, these are effective when the diameter of the external channel body attached to the insertion portion of the endoscope is small, but as the diameter of the external channel is increased, the substantial insertion portion of the endoscope is also increased. It gets thick. Furthermore, since the external channel is provided at a position retracted to the hand side, it is difficult to project the treatment tool or the like from the external channel main body to the target site.
The present invention has been made in view of the above-described circumstances, and even when the diameter of the external channel body is increased, when operating the endoscope with the external channel attached in the body cavity, It is an object of the present invention to provide an external channel capable of confirming the amount and direction of protrusion of a treatment instrument or the like from an external channel main body and an endoscope including the external channel.

上記目的を達成するために、本発明は、以下の手段を提供する。
本発明の外付けチャンネルは、軟性式内視鏡に設けられた挿入部に、着脱自在に併設され可撓性を有する外付けチャンネルにおいて、外付けチャンネル本体と、前記挿入部の先端に前記外付けチャンネル本体の先端部を内視鏡観察視野内で確認可能に突出状態で取り付ける固定部とを備えることを特徴とする。
In order to achieve the above object, the present invention provides the following means.
The external channel of the present invention is a flexible external channel that is detachably attached to an insertion portion provided in a flexible endoscope. The external channel main body and the external channel at the distal end of the insertion portion. And a fixing portion that is attached in a protruding state so that the distal end portion of the attached channel body can be confirmed in the endoscope observation field of view.

この発明によれば、外付けチャンネルの先端部が内視鏡観察視野から確認できる位置に配されているため、外付けチャンネル本体内部に把持鉗子等の処置具を挿通させた際、処置具の突出方向及び突出量を確認することが可能となる。   According to the present invention, since the distal end portion of the external channel is disposed at a position where it can be confirmed from the endoscopic observation visual field, when a treatment tool such as a grasping forceps is inserted into the external channel main body, It is possible to confirm the protruding direction and the protruding amount.

また、本発明の外付けチャンネルは、前記固定部に対して前記外付けチャンネル本体がその基端側へ移動をすること規制する固定手段を設けることが好ましい。
この発明によれば、固定手段を設けることにより、固定部に対する外付けチャンネル本体の移動が規制されることになるため、外付けチャンネル本体の固定部からの最小突出量を規定することができる。したがって、外付けチャンネル本体を内視鏡観察画面で常に確認しながら処置を行うことができる。
Moreover, it is preferable that the external channel of the present invention is provided with a fixing means for restricting the external channel body from moving toward the base end side with respect to the fixing portion.
According to the present invention, since the movement of the external channel main body with respect to the fixing portion is restricted by providing the fixing means, the minimum protrusion amount from the fixing portion of the external channel main body can be defined. Therefore, the treatment can be performed while always confirming the external channel main body on the endoscope observation screen.

また、本発明の外付けチャンネルは、前記内視鏡視野内に表示される前記先端部の大きさを内視鏡観察視野の5分の1以下とすることが好ましい。
この発明によれば、内視鏡挿入時に必要な視野は十分に確保した状態で、病変部位等の処置を行うことができる。
In the external channel according to the present invention, it is preferable that the size of the distal end portion displayed in the endoscope visual field is set to 1/5 or less of the endoscope observation visual field.
According to the present invention, it is possible to treat a lesion site or the like in a state where a visual field necessary for inserting an endoscope is sufficiently secured.

また、本発明の外付けチャンネルは、前記外付けチャンネル本体が、吸引,送気,送水及び処置具の挿通を行う機能を有することが好ましい。
この発明によれば、外付けチャンネル本体に多機能を持たせることにより、外付けチャンネル本体を通じて様々な処置を行うことができるため、機能性に優れた装置にすることが可能となる。
In the external channel of the present invention, it is preferable that the external channel body has a function of performing suction, air supply, water supply, and insertion of a treatment instrument.
According to the present invention, by providing the external channel body with multiple functions, various treatments can be performed through the external channel body, so that it is possible to obtain a device with excellent functionality.

本発明の内視鏡は、上記本発明の外付けチャンネルを備えていることを特徴とする。
この発明によれば、内視鏡によって体腔内を観察しながら、外付けチャンネルに処置具等を挿入し病変部位等の処置を行うことが可能となる。
An endoscope according to the present invention includes the external channel according to the present invention.
According to the present invention, it is possible to treat a lesion site or the like by inserting a treatment tool or the like into an external channel while observing the inside of a body cavity with an endoscope.

本発明に係る外付けチャンネルによれば、外付けチャンネル本体の先端部を内視鏡観察視野内で確認できる位置に設けることによって、体腔内を処置している際、外付けチャンネル本体を常に術者が確認できる。したがって、処置具の突出方向及び突出量を確認しながら処置を行うことができるため、目的の部位に処置具等を突出させることが可能となる。   According to the external channel according to the present invention, the distal end of the external channel main body is provided at a position where it can be confirmed in the endoscopic observation visual field, so that the external channel main body is always operated during treatment of the body cavity. Can confirm. Therefore, since the treatment can be performed while confirming the protruding direction and the protruding amount of the treatment tool, the treatment tool or the like can be protruded to the target site.

以下、本発明の第1実施形態に係る外付けチャンネルについて図1から図9を参照して説明する。
本実施形態に係る内視鏡1は、図1に示す内視鏡1の本体に、図2に示す外付けチャンネル2を装着させて使用するものである。
内視鏡1の本体は、図1に示すように、可撓性の挿入部11を有しており、これは、硬質の内視鏡先端部12と、この内視鏡先端部12の基端に設けられた湾曲自在の湾曲部13と、この湾曲部13の後端から内視鏡操作部14まで伸びる長尺の可撓管部15とから構成されている。
Hereinafter, an external channel according to the first embodiment of the present invention will be described with reference to FIGS.
The endoscope 1 according to this embodiment is used by attaching the external channel 2 shown in FIG. 2 to the main body of the endoscope 1 shown in FIG.
As shown in FIG. 1, the main body of the endoscope 1 includes a flexible insertion portion 11, which includes a rigid endoscope distal end portion 12 and a base of the endoscope distal end portion 12. It comprises a bendable bending portion 13 provided at the end, and a long flexible tube portion 15 extending from the rear end of the bending portion 13 to the endoscope operation portion 14.

内視鏡先端部12には、CCD(図示略)に観察画像を結像するための観察窓16と、暗い体腔内に照明光を照射する照明窓17と、観察窓16に付着した体液等を取り除くためのノズル18と、吸引,把持鉗子等の処置具等を挿通し処置を行うためのチャンネル19とが設けられている。   At the endoscope distal end 12, an observation window 16 for forming an observation image on a CCD (not shown), an illumination window 17 for irradiating illumination light into a dark body cavity, a body fluid adhering to the observation window 16, and the like And a channel 19 for inserting a treatment tool such as suction and grasping forceps to perform a treatment.

内視鏡操作部14には、内視鏡先端部12に設けられたノズル18に空気や水を送り込む操作を行うための送気・送水ボタン20と、チャンネル19からの吸引操作を行うための吸引ボタン21と、湾曲部13を上下における任意の方向に湾曲操作するアングルノブ22と、先端側には可撓管部15内に配設されチャンネル19に連通した処置具を挿入するための処置具挿入口部23とが設けられている。
また、観察窓16により観察した画像は、図5に示すように、内視鏡観察画面24に表示されるようになっている。
The endoscope operation unit 14 includes an air / water supply button 20 for performing an operation of feeding air and water to a nozzle 18 provided at the endoscope distal end 12, and a suction operation from the channel 19. A suction button 21, an angle knob 22 for bending the bending portion 13 in an arbitrary direction in the vertical direction, and a treatment for inserting a treatment instrument disposed in the flexible tube portion 15 and communicating with the channel 19 on the distal end side. A tool insertion opening 23 is provided.
The image observed through the observation window 16 is displayed on the endoscope observation screen 24 as shown in FIG.

外付けチャンネル2は、図2に示すように、内視鏡1の本体の挿入部11と略同程度の長さを有する外付けチャンネル本体2aと、内視鏡先端部12に装着可能に形成された先端固定部(固定部)30と、外付けチャンネル本体2aに対して係合しプラスチック等の樹脂からなる複数の係止部31とを備えている。
外付けチャンネル本体2aの手元側には、外付けチャンネル本体2a内部に処置具を挿入したり、吸引のための三方活栓性体を取り付けたりするためのチャンネル口金35が接着などで固定されて取り付けられている。また、外付けチャンネル本体2aの先端側に設けられ開口部を有する先端開口部(先端部)32の外周部は、図3に示すように、r状の面取りが施されており、外付けチャンネル2を内視鏡1の本体に取り付けて体腔内に挿入する際に体壁を傷つけないような配慮がなされた構成になっている。
As shown in FIG. 2, the external channel 2 is formed so as to be attachable to the external channel main body 2 a having substantially the same length as the insertion portion 11 of the main body of the endoscope 1 and the endoscope distal end portion 12. And a plurality of locking portions 31 that are engaged with the external channel body 2a and are made of a resin such as plastic.
A channel base 35 for inserting a treatment instrument into the external channel main body 2a or attaching a three-way stopcock for suction is fixed to the proximal side of the external channel main body 2a by bonding or the like. It has been. Further, as shown in FIG. 3, the outer peripheral portion of the tip opening portion (tip portion) 32 provided on the tip side of the external channel body 2a has an r-shaped chamfer as shown in FIG. When the 2 is attached to the main body of the endoscope 1 and inserted into the body cavity, consideration is given so as not to damage the body wall.

先端固定部30は、外付けチャンネル本体2aに対して接着などで固定されゴム等の弾性体からなっている。また、外付けチャンネル本体2aの材質としては、ポリフッ化エチレン等のフッ素樹脂,塩化ビニル及びウレタン等の比較的柔軟に湾曲可能な樹脂材料によって形成されている。
係止部31は、内視鏡1の本体の湾曲部13及び可撓管部15に係合可能なC字状のアーム部31aと、外付けチャンネル本体2aが挿通されるガイド部31bとを備えている。
The tip fixing portion 30 is fixed to the external channel main body 2a by adhesion or the like and is made of an elastic body such as rubber. The material of the external channel body 2a is formed of a resin material that can be bent relatively flexibly, such as a fluororesin such as polyfluorinated ethylene, vinyl chloride, and urethane.
The locking portion 31 includes a C-shaped arm portion 31a that can be engaged with the bending portion 13 and the flexible tube portion 15 of the main body of the endoscope 1, and a guide portion 31b through which the external channel main body 2a is inserted. I have.

次に、外付けチャンネル2を内視鏡1の本体に取り付ける方法について図4から図6を参照して説明する。
まず、先端固定部30を内視鏡先端部12に取り付ける方法を説明する。図4(a)示すように、内視鏡先端部12が装着される先端固定部30の開口部33の内径aと内視鏡先端部12の外径bとの寸法関係をa<bに設定している。このため、先端固定部30を内視鏡先端部12に装着した場合、弾性体による締め付け力によって強固に固定される。また、先端固定部30の先端側には突き当て面34が設けられており、さらに、先端固定部30からの外付けチャンネル本体2aの突出量をあらかじめ所定の設定寸法cに固定している。このため、突き当て面34を内視鏡先端部12に突き当たるまで挿入することによって装着することにより、内視鏡先端部12からの外付けチャンネル本体2aの突出量も一定に保つことが可能となっている。
このとき、図4(b)に示すように、観察窓16の視野角はθであり、図5に示すように、内視鏡観察画面24における内視鏡視野dに対する先端開口部32の突出量eは5分の1以下に抑えられており、内視鏡挿入時に必要な視野は十分に確保できている。
Next, a method for attaching the external channel 2 to the main body of the endoscope 1 will be described with reference to FIGS.
First, a method for attaching the distal end fixing portion 30 to the endoscope distal end portion 12 will be described. As shown in FIG. 4A, the dimensional relationship between the inner diameter a of the opening 33 of the distal end fixing portion 30 to which the endoscope distal end portion 12 is mounted and the outer diameter b of the endoscope distal end portion 12 is a <b. It is set. For this reason, when the distal end fixing portion 30 is attached to the endoscope distal end portion 12, the distal end fixing portion 30 is firmly fixed by the tightening force of the elastic body. Further, an abutting surface 34 is provided on the distal end side of the distal end fixing portion 30, and the protruding amount of the external channel main body 2a from the distal end fixing portion 30 is fixed to a predetermined set dimension c in advance. For this reason, it is possible to keep the amount of protrusion of the external channel body 2a from the endoscope distal end 12 constant by inserting the abutting surface 34 until it abuts against the endoscope distal end 12. It has become.
At this time, as shown in FIG. 4B, the viewing angle of the observation window 16 is θ, and as shown in FIG. 5, the projection of the distal end opening 32 with respect to the endoscope field of view d in the endoscope observation screen 24. The amount e is suppressed to 1/5 or less, and a sufficient field of view is ensured when the endoscope is inserted.

次に、係止部31を内視鏡1本体の湾曲部13及び可撓管部15に取り付ける方法を説明する。図6に示すように、アーム部31aの開口幅gと湾曲部13及び可撓管部15の外径hとの寸法関係をg<hに設定しているため、係止部31を湾曲部13及び可撓管部15に装着しようとした場合、図6の(b)に示すように、湾曲部13及び可撓管部15の外径hより小さい開口幅gのC字状のアーム部31aが弾性変形によって湾曲部13及び可撓管部15と嵌合可能となる。これにより、装着後は容易に係止部31が湾曲部13及び可撓管部15から外れることはない構成となっている。   Next, a method of attaching the locking portion 31 to the bending portion 13 and the flexible tube portion 15 of the endoscope 1 main body will be described. As shown in FIG. 6, since the dimensional relationship between the opening width g of the arm portion 31a and the outer diameter h of the bending portion 13 and the flexible tube portion 15 is set to g <h, the locking portion 31 is set to the bending portion. 13 and the flexible tube portion 15, as shown in FIG. 6B, the C-shaped arm portion having an opening width g smaller than the outer diameter h of the bending portion 13 and the flexible tube portion 15. 31a can be fitted to the bending portion 13 and the flexible tube portion 15 by elastic deformation. As a result, the engaging portion 31 is not easily detached from the bending portion 13 and the flexible tube portion 15 after being mounted.

また、ガイド部31bの内径には、図6(a)に示すように、外付けチャンネル本体2aの挿入時にすき間fを設定している。したがって、図7に示すように、外付けチャンネル本体2aの後端側はフリーであり、ガイド部31b間を軸方向に移動可能であるため、外付けチャンネル本体2aが先端固定部30を経由して内視鏡先端部12に固定されている状態で湾曲操作を行っても抵抗感のないスムースな湾曲操作を行うことが実現できる。   Further, as shown in FIG. 6A, a gap f is set in the inner diameter of the guide portion 31b when the external channel body 2a is inserted. Accordingly, as shown in FIG. 7, the rear end side of the external channel body 2 a is free and can move in the axial direction between the guide portions 31 b, so that the external channel body 2 a passes through the tip fixing portion 30. Thus, it is possible to realize a smooth bending operation without resistance even if the bending operation is performed while being fixed to the endoscope distal end portion 12.

次に、以上の構成からなる本実施形態の外付けチャンネル及び内視鏡の使用方法について図8を参照して、以下に説明する。
まず、外付けチャンネル2の先端固定部30の開口部33に内視鏡先端部12を装着し、内視鏡1の本体の挿入部11にアーム部31aを装着する。内視鏡1の本体の挿入部11を体腔内に挿入した後、目的の病変に到達したところで、内視鏡1の本体のチャンネル19内に高周波メス41を挿通させ、外付けチャンネル本体2a内部に把持鉗子40を挿通する。
次に、内視鏡観察画面24に患部をとらえた際、把持鉗子40及び高周波メス41をそれぞれから突出させ、高周波メス41により切開した粘膜42を把持鉗子40で持ち上げながら粘膜の下層を切除する。
Next, a method of using the external channel and endoscope of the present embodiment having the above-described configuration will be described below with reference to FIG.
First, the endoscope distal end portion 12 is attached to the opening 33 of the distal end fixing portion 30 of the external channel 2, and the arm portion 31 a is attached to the insertion portion 11 of the main body of the endoscope 1. After inserting the insertion portion 11 of the main body of the endoscope 1 into the body cavity and reaching the target lesion, the high-frequency knife 41 is inserted into the channel 19 of the main body of the endoscope 1 and the inside of the external channel main body 2a The grasping forceps 40 is inserted through.
Next, when the affected part is captured on the endoscope observation screen 24, the grasping forceps 40 and the high-frequency knife 41 are protruded from each, and the mucosa 42 incised by the high-frequency knife 41 is lifted by the grasping forceps 40, and the lower layer of the mucosa is excised. .

すなわち、本実施形態に係る外付けチャンネル2及び内視鏡1によれば、外付けチャンネル2の先端開口部32が内視鏡観察画面24から確認できる位置に配されているため、把持鉗子40等の処置具の突出方向及び突出量が確認でき、目的の部位に把持鉗子40等の処置具を突出させることが可能となる。また、操作性に優れた内視鏡的粘膜切除術を提供することができる。
なお、本実施形態において、積極的に体壁を傷付けないようにするには、図9に示すように、先端開口部32が外周に進むにしたがって傾斜した形状とすることにより可能となる。
That is, according to the external channel 2 and the endoscope 1 according to the present embodiment, since the distal end opening 32 of the external channel 2 is arranged at a position that can be confirmed from the endoscope observation screen 24, the grasping forceps 40 Thus, it is possible to confirm the protruding direction and the protruding amount of the treatment instrument such as the grasping forceps 40 and the like at the target site. In addition, an endoscopic mucosal resection with excellent operability can be provided.
In the present embodiment, in order not to damage the body wall positively, as shown in FIG. 9, it is possible to make the tip opening 32 have an inclined shape as it goes to the outer periphery.

次に、本発明の第2実施形態に係る外付けチャンネル及び内視鏡について図10から図13を参照して説明する。
本実施形態に係る外付けチャンネル50及び内視鏡1において、外付けチャンネル50と内視鏡1の係止手段として係止部51が薄膜状のカバー部52を用いたこと及びガイド部53を備える点及び外付けチャンネル50にストッパ部(固定手段)54が形成されている点で第1の実施形態と相違している。
Next, an external channel and an endoscope according to a second embodiment of the present invention will be described with reference to FIGS.
In the external channel 50 and the endoscope 1 according to the present embodiment, the locking portion 51 uses the thin film-like cover portion 52 as the locking means for the external channel 50 and the endoscope 1, and the guide portion 53. This is different from the first embodiment in that the stopper portion (fixing means) 54 is formed on the external channel 50.

カバー部52は、図10に示すように、外付けチャンネル50の先端固定部30の後端側に設けられており、接着等により強固に先端固定部30に固定されている。ガイド部53は、アーチ状にカバー部52に複数個取り付けられている。これらにより、カバー部52とガイド部53との間に外付けチャンネル本体50aが移動可能な状態で挿通されている。
また、カバー部52は、挿入部11と略同程度の長さを有し、また、略同程度の内径を有しているため、湾曲部13及び可撓管部15を被覆可能となっている。さらに、カバー部52の後端部は、図12に示すように、手術用のテープ等の粘着テープ56によって内視鏡1の挿入部11に固定可能となっている。
先端固定部30には挿通部30aが設けられており、この挿通部30aは外付けチャンネル本体50aを挿通可能とし、外付けチャンネル本体50aが摺動可能な内径となっている。
As shown in FIG. 10, the cover portion 52 is provided on the rear end side of the front end fixing portion 30 of the external channel 50, and is firmly fixed to the front end fixing portion 30 by adhesion or the like. A plurality of guide portions 53 are attached to the cover portion 52 in an arch shape. Thus, the external channel main body 50a is inserted between the cover portion 52 and the guide portion 53 in a movable state.
Further, since the cover portion 52 has substantially the same length as the insertion portion 11 and has an approximately same inner diameter, the cover portion 52 and the flexible tube portion 15 can be covered. Yes. Furthermore, as shown in FIG. 12, the rear end portion of the cover portion 52 can be fixed to the insertion portion 11 of the endoscope 1 by an adhesive tape 56 such as a surgical tape.
The distal end fixing portion 30 is provided with an insertion portion 30a. The insertion portion 30a has an inner diameter that allows the external channel main body 50a to be inserted and allows the external channel main body 50a to slide.

ストッパ部54は、外付けチャンネル本体50aの先端側の外周に突出して形成されており、接着などにより外付けチャンネル本体50aに対して固定されている。これにより、外付けチャンネル本体50aの先端固定部30からの最小突出量は規制されている。すなわち、開口部32からiの位置にストッパ部54を設けることにより、先端固定部30を内視鏡先端部12に固定した場合、図11に示すように、内視鏡先端部12からの最小突出量をiとして規制することが可能となる。このとき、観察窓16の視野角はθであり、外付けチャンネル本体50aを内視鏡観察画面24で確認できる寸法に設定している。   The stopper portion 54 is formed to protrude from the outer periphery on the distal end side of the external channel main body 50a, and is fixed to the external channel main body 50a by adhesion or the like. Thereby, the minimum protrusion amount from the front-end | tip fixing | fixed part 30 of the external channel main body 50a is controlled. That is, when the distal end fixing portion 30 is fixed to the endoscope distal end portion 12 by providing the stopper portion 54 at a position i from the opening 32, as shown in FIG. It is possible to regulate the protrusion amount as i. At this time, the viewing angle of the observation window 16 is θ, and the external channel main body 50 a is set to a size that can be confirmed on the endoscope observation screen 24.

次に、外付けチャンネル50を内視鏡1に取り付ける方法について図12を参照して説明する。
まず、外付けチャンネル50の先端固定部30と内視鏡先端部12とを第1実施形態と同様に取り付ける。次に、カバー部52を内視鏡1の本体の挿入部11の全長にわたって被覆し、後端部は粘着テープ56によって固定する。
Next, a method for attaching the external channel 50 to the endoscope 1 will be described with reference to FIG.
First, the distal end fixing portion 30 of the external channel 50 and the endoscope distal end portion 12 are attached in the same manner as in the first embodiment. Next, the cover portion 52 is covered over the entire length of the insertion portion 11 of the main body of the endoscope 1, and the rear end portion is fixed by the adhesive tape 56.

次に、以上の構成からなる本実施形態の外付けチャンネル50及び内視鏡1の使用方法について図13を参照して、以下に説明する。
まず、外付けチャンネル50の先端固定部30を装着し、カバー部52を装着する。そして、内視鏡1の挿入部11を体腔内に挿入し、内視鏡1のチャンネル19内に止血用ヒートプローブ55を挿通する。
次に、体腔内の患部の止血を行う際、外付けチャンネル本体50aを出血部位に押し出し、血液を吸引する。そして、内視鏡観察画面24で患部を確認しながら、内視鏡1の本体のチャンネル19に挿通した止血用ヒートプローブ55により止血を行う。
Next, a method of using the external channel 50 and the endoscope 1 of the present embodiment having the above-described configuration will be described below with reference to FIG.
First, the tip fixing part 30 of the external channel 50 is attached, and the cover part 52 is attached. Then, the insertion portion 11 of the endoscope 1 is inserted into the body cavity, and the hemostasis heat probe 55 is inserted into the channel 19 of the endoscope 1.
Next, when hemostasis is performed on the affected part in the body cavity, the external channel body 50a is pushed out to the bleeding site, and the blood is sucked. Then, hemostasis is performed by the hemostasis heat probe 55 inserted into the channel 19 of the main body of the endoscope 1 while confirming the affected part on the endoscope observation screen 24.

すなわち、本実施形態に係る外付けチャンネル50及び内視鏡1によれば、外付けチャンネル本体50aを最小突出量i以上であれば任意の軸方向に位置させることが可能となる。したがって、外付けチャンネル本体50aを内視鏡観察画面24で必ず確認できる位置において軸方向の移動が可能となるため、目的の部位に処置具等を突出させ、その突出量及び突出方向を確認しながら処置を行うことが可能な内視鏡的処置を提供することができる。また、複数個の係止部を挿入部11に装着する必要がないので、外付けチャンネル50を内視鏡1の本体に取り付ける作業がより簡便になる。   That is, according to the external channel 50 and the endoscope 1 according to the present embodiment, the external channel main body 50a can be positioned in an arbitrary axial direction as long as it is not less than the minimum protrusion amount i. Therefore, since the external channel body 50a can be moved in the axial direction at a position where the external channel main body 50a can always be confirmed on the endoscope observation screen 24, a treatment instrument or the like is projected at the target site, and the projection amount and the projection direction are confirmed. It is possible to provide an endoscopic treatment that can be performed while performing treatment. Further, since it is not necessary to attach a plurality of locking portions to the insertion portion 11, the work of attaching the external channel 50 to the main body of the endoscope 1 becomes easier.

次に、本発明の第3実施形態に係る外付けチャンネル及び内視鏡について図14を参照して説明する。
本実施形態に係る外付けチャンネル60及び内視鏡1において、外付けチャンネル60の先端固定部(固定手段)61の形状で第1,第2の実施形態と相違している。
先端固定部61は、外付けチャンネル本体60aの先端に設けられ切り欠き部62aが形成された固定部62と、溝部12aが形成された内視鏡先端部12bと、熱収縮チューブからなるバンド部63とを備えている。この切り欠き部62a及び溝部12aは、固定部62及び内視鏡先端部12bの外周の約半周にわたって設けられており、長さ方向の幅が略同寸法に設定されている。また、固定部62は、図14(b)に示すように、先端開口部32を内視鏡1の本体の観察窓16から確認できる位置に固定されている。
バンド部63は、外周の一部に設けられた把持部63aと、把持部63aの両端に設けられた切り溝部63bとから構成されている。
Next, an external channel and an endoscope according to a third embodiment of the present invention will be described with reference to FIG.
The external channel 60 and the endoscope 1 according to this embodiment are different from the first and second embodiments in the shape of the distal end fixing portion (fixing means) 61 of the external channel 60.
The distal end fixing portion 61 is provided at the distal end of the external channel main body 60a and has a fixing portion 62 in which a notch 62a is formed, an endoscope distal end portion 12b in which a groove portion 12a is formed, and a band portion made of a heat shrinkable tube. 63. The cutout portion 62a and the groove portion 12a are provided over approximately half of the outer periphery of the fixed portion 62 and the endoscope distal end portion 12b, and the width in the length direction is set to be approximately the same size. Moreover, the fixing | fixed part 62 is being fixed to the position which can confirm the front-end | tip opening part 32 from the observation window 16 of the main body of the endoscope 1, as shown in FIG.14 (b).
The band part 63 includes a gripping part 63a provided at a part of the outer periphery and kerf parts 63b provided at both ends of the gripping part 63a.

ここで、外付けチャンネル本体60aの先端部を内視鏡先端部12に取り付ける場合、切り欠き部62aと溝部12aとにバンド部63を被覆し、バンド部63を過熱し収縮させて、外付けチャンネル本体60aの先端部と内視鏡先端部12とを固定する。
一方、外付けチャンネル本体60aの先端部と内視鏡先端部12とを取り外す場合、把持部63aを摘んで切り溝部63bに沿う方向に引っ張ることによって、バンド部63を破損させ、外付けチャンネル本体60aの先端部と内視鏡先端部12とを取り外すことが可能となる。
Here, when the distal end portion of the external channel main body 60a is attached to the endoscope distal end portion 12, the notch portion 62a and the groove portion 12a are covered with the band portion 63, and the band portion 63 is overheated and contracted to be externally attached. The distal end portion of the channel body 60a and the endoscope distal end portion 12 are fixed.
On the other hand, when the distal end portion of the external channel body 60a and the endoscope distal end portion 12 are removed, the band portion 63 is damaged by gripping the grip portion 63a and pulling it in the direction along the cut groove portion 63b. It becomes possible to remove the distal end portion of 60a and the distal end portion 12 of the endoscope.

すなわち、本実施形態に係る外付けチャンネル60及び内視鏡1によれば、外付けチャンネル60を内視鏡観察画面24で必ず確認できる位置に設定することが可能となる。また、外付けチャンネル本体60aの先端部と内視鏡先端部12とがバンド部63により固定されているため、外付けチャンネル本体60aの先端部と内視鏡先端部12との取り付け及び取り外しを容易に行うことが可能となる。
なお、本実施形態において、バンド部63として熱収縮チューブを用いたが、外付けチャンネル本体60aの先端部と内視鏡先端部12とを圧着できれば良いため、例えば、ゴム等の弾性材料を有するものであっても良い。
また、本発明の技術範囲は上記実施の形態に限定されるものではなく、本発明の趣旨を逸脱しない範囲において種々の変更を加えることが可能である。
That is, according to the external channel 60 and the endoscope 1 according to the present embodiment, it is possible to set the external channel 60 at a position that can be surely confirmed on the endoscope observation screen 24. Further, since the distal end portion of the external channel main body 60a and the endoscope distal end portion 12 are fixed by the band portion 63, the distal end portion of the external channel main body 60a and the endoscope distal end portion 12 are attached and detached. It can be easily performed.
In the present embodiment, the heat shrinkable tube is used as the band portion 63. However, since it is sufficient that the distal end portion of the external channel main body 60a and the endoscope distal end portion 12 can be pressure-bonded, for example, an elastic material such as rubber is used. It may be a thing.
The technical scope of the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention.

本発明の第1実施形態に係る内視鏡を示す斜視図である。1 is a perspective view showing an endoscope according to a first embodiment of the present invention. 本発明の第1実施形態に係る外付けチャンネルを示す斜視図である。1 is a perspective view showing an external channel according to a first embodiment of the present invention. 本発明の第1実施形態に係る外付けチャンネルの先端開口部を示す断面図である。It is sectional drawing which shows the front-end | tip opening part of the external channel which concerns on 1st Embodiment of this invention. 本発明の第1実施形態に係る外付けチャンネルの先端固定部を内視鏡先端部に(a)取り付ける前、(b)取り付けた後の状態を示す要部を破断した断面図である。It is sectional drawing which fractured | ruptured the principal part which shows the state after attaching (a) the front-end | tip fixing | fixed part of the external channel which concerns on 1st Embodiment of this invention to an endoscope front-end | tip part, (b). 本発明の第1実施形態に係る外付けチャンネルを内視鏡の本体に取り付けた後、内視鏡観察画面の映像を示す模式図である。It is a schematic diagram which shows the image | video of an endoscope observation screen, after attaching the external channel which concerns on 1st Embodiment of this invention to the main body of an endoscope. 本発明の第1実施形態に係る外付けチャンネルの係止部を内視鏡湾曲部及可撓管部に(a)取り付ける前、(b)取り付けた後の状態を示す要部を破断した断面図である。The cross section which fractured | ruptured the principal part which shows the state after (a) attaching the latching | locking part of the external channel which concerns on 1st Embodiment of this invention to an endoscope bending part and a flexible tube part, (b) after attachment. FIG. 本発明の第1実施形態に係る外付けチャンネルを内視鏡に取り付けて湾曲部を湾曲させた状態を示す要部を破断した断面図である。It is sectional drawing which fractured | ruptured the principal part which shows the state which attached the external channel which concerns on 1st Embodiment of this invention to the endoscope, and curved the curved part. 本発明の第1実施形態に係る外付けチャンネル及び内視鏡を用いて内視鏡的粘膜切除術を示す斜視図である。It is a perspective view which shows endoscopic mucosal resection using the external channel and endoscope which concern on 1st Embodiment of this invention. 図3に示す外付けチャンネルの先端開口部を変形例を示す断面図である。It is sectional drawing which shows the modification of the front-end | tip opening part of the external channel shown in FIG. 本発明の第2実施形態に係る外付けチャンネルを示す斜視図である。It is a perspective view which shows the external channel which concerns on 2nd Embodiment of this invention. 本発明の第2実施形態に係る外付けチャンネルの先端固定部を内視鏡先端部に取り付けた後の状態を示す要部を破断した断面図である。It is sectional drawing which fractured | ruptured the principal part which shows the state after attaching the front-end | tip fixing | fixed part of the external channel which concerns on 2nd Embodiment of this invention to the endoscope front-end | tip part. 本発明の第2実施形態に係る外付けチャンネルを内視鏡の本体に取り付けた状態を示す斜視図である。It is a perspective view which shows the state which attached the external channel which concerns on 2nd Embodiment of this invention to the main body of the endoscope. 本発明の第2実施形態に係る外付けチャンネル及び内視鏡を用いて内視鏡的止血術を示す斜視図である。It is a perspective view which shows endoscopic hemostasis using the external channel and endoscope which concern on 2nd Embodiment of this invention. 本発明の第3実施形態に係る外付けチャンネルの先端部を内視鏡先端部に(a)取り付ける前、(b)取り付けた後の状態を示す斜視図である。It is a perspective view which shows the state after attaching (a) the front-end | tip part of the external channel which concerns on 3rd Embodiment of this invention to an endoscope front-end | tip part, (b).

符号の説明Explanation of symbols

d 内視鏡観察視野
1 内視鏡
2,50,60 外付けチャンネル
2a,50a,60a 外付けチャンネル本体
11 内視鏡挿入部
30 先端固定部(固定部)
32 先端開口部(先端部)
54 ストッパ部(固定手段)
61 先端固定部(固定手段)

d Endoscopic observation field 1 Endoscope 2, 50, 60 External channel 2a, 50a, 60a External channel main body 11 Endoscope insertion part 30 Tip fixing part (fixing part)
32 Tip opening (tip)
54 Stopper (fixing means)
61 Tip fixing part (fixing means)

Claims (5)

軟性式内視鏡に設けられた挿入部に、着脱自在に併設され可撓性を有する外付けチャンネルにおいて、
外付けチャンネル本体と、
前記挿入部の先端に前記外付けチャンネル本体の先端部を内視鏡観察視野内で確認可能に突出状態で取り付ける固定部とを備えることを特徴とする内視鏡用の外付けチャンネル。
In the externally attached channel that is detachably attached to the insertion portion provided in the flexible endoscope,
The external channel body,
An external channel for an endoscope, comprising: a fixing portion that attaches the distal end portion of the external channel main body in a protruding state so that the distal end portion of the external channel main body can be confirmed in an endoscope observation field of view.
前記固定部に対して前記外付けチャンネル本体がその基端側へ移動をすること規制する固定手段を設けたことを特徴とする請求項1に記載の内視鏡用の外付けチャンネル。   2. The endoscope external channel according to claim 1, further comprising fixing means for restricting movement of the external channel main body toward the base end side with respect to the fixing portion. 前記内視鏡視野内に表示される前記先端部の大きさを内視鏡観察視野の5分の1以下としたことを特徴とする請求項1または請求項2に記載の内視鏡用の外付けチャンネル。   3. The endoscope for an endoscope according to claim 1, wherein the size of the tip portion displayed in the endoscope visual field is set to one fifth or less of the endoscope observation visual field. External channel. 前記外付けチャンネル本体が、吸引,送気,送水及び処置具の挿通を行う機能を有することを特徴とする請求項1から請求項3のいずれか1項に記載の内視鏡用の外付けチャンネル。   The external attachment for an endoscope according to any one of claims 1 to 3, wherein the external channel main body has a function of performing suction, air supply, water supply, and insertion of a treatment instrument. Channel. 請求項1から請求項4のいずれか1項に記載の外付けチャンネルを備えていることを特徴とする内視鏡。

An endoscope comprising the external channel according to any one of claims 1 to 4.

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US12137901B2 (en) 2023-05-01 2024-11-12 Cilag Gmbh International Surgical staples having compressible or crushable members for securing tissue therein and stapling instruments for deploying the same
US12133648B2 (en) 2023-10-05 2024-11-05 Cilag Gmbh International Surgical instrument with cartridge release mechanisms

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