JP2009195321A - Endoscope and endoscope system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope allowing smooth insertion even if being inserted into a bent body cavity; and an endoscope system. <P>SOLUTION: A substantially annular-shaped fixed member 51 is fixed to the outer circumferential face of the rear end of a curving section 13 which curves freely and is provided at the distal end side of an insertion section 8, a distal end guide member 53 which is slidable via a tip end side expansion/contraction portion 52a being freely expanded/contracted, at the front side of the fixing member 51, and a retaining member 54 which has a radially inflating/deflating balloon 55 attached thereto is provided via a rear-end expansion/contraction portion 52b in the rear side of the fixed member 51. An operation of curving the curving section 13 in the curving direction and operations of inflating/deflating the balloon 55, and expansion/contraction of the tip end side expansion/contraction portion 52a and the rear end side expansion/contraction portion 52b allow the smooth insertion of the endoscope into bent body cavity. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an endoscope and an endoscope apparatus that are inserted into a body cavity and perform endoscopy.

In recent years, endoscopes have been widely used in the medical field and the like. In particular, a bendable bending portion is provided on the distal end side of the elongated insertion portion in order to facilitate insertion into a bent body cavity. FIG. 12 shows a state where the insertion portion 91 of the conventional endoscope is inserted into the deep colon 85 side of the deep portion of the sigmoid colon 83 in order to inspect the bent large intestine 81.
The surgeon inserts the distal end portion 92 of the insertion portion 91 from the anus 82 and inserts it into the deep portion on the side of the sigmoid colon 83 that is tortuous. At this time, the flexible portion 94 of the insertion portion 91 is bent in accordance with the large bent shape of the sigmoid colon 83. Then, as shown in FIG. 12 (A), the distal end portion 92 can be inserted to a position reaching the front of the SD junction 84 at the boundary between the sigmoid colon 83 and the descending colon 85.
After the insertion up to this position, the operator bends the bending portion 93 and inserts it into the descending colon 85 side of the deep side of the SD junction 84.

This state is shown in FIG. As shown in FIG. 12B, the distal end 92 is in a state slightly exceeding the SD junction 84, and therefore the sigmoid colon 83 cannot be linearized in this state.
In this state, the flexible portion 94 is bent along the bend of the sigmoid colon 83, and the distal end side of the insertion portion 91 is bent in the opposite direction with respect to the bend.
In the conventional endoscope, even if an operation of pushing in the insertion portion 91 is performed from this state, the flexible portion 94 is pushed against the intestinal wall of the bent sigmoid 83, and the SD junction 84 is used for that purpose. By making it steep, it becomes difficult for the pushing operation to be transmitted to the distal end side of the insertion portion 91, and it becomes difficult to insert it further to the deep portion side.
On the other hand, for example, Japanese Patent Application Laid-Open No. 08-089476 discloses a self-propelled endoscope apparatus that is inserted into a lumen.

This self-propelled endoscope apparatus includes a front balloon fixed to the distal end region of the insertion portion, a bellows-shaped axial expansion / contraction portion (extension / contraction means) fixed to the rear end of the front balloon and expandable backward. A rear balloon is provided at the rear end portion of the axially extending / contracting portion and is slidably provided on the outer peripheral surface of the insertion portion.
It is described that a coarsely wound coil spring is provided in the bellows, and that the bellows and the coil spring are compressed by pulling a pulling wire, so that they are biased in the extending direction (the direction in which the two balloons are pulled apart).
Then, this self-propelled endoscope apparatus is configured such that the front balloon is brought into contact with and fixed to the lumen by inflating the front balloon as shown in FIG. The rear balloon is moved forward, and then the rear balloon is inflated and fixed in contact with the lumen, and then the front balloon is contracted and the distal end side of the insertion portion is moved forward by the urging force of the coarse coil spring. .
In this conventional example, two balloons are inflated and deflated, and the insertion portion is advanced by pulling the pulling wire.
Japanese Patent Application Laid-Open No. 08-089476

The conventional example of the above publication discloses that the two balloons are inflated and deflated, and the insertion portion is advanced by using the pulling action of the pulling wire, and many controls are required for the advancement. It has a configuration.
When inserting into a body cavity that is bent like the large intestine, it is necessary to bend and insert the bending portion on the distal end side of the insertion portion according to the bending, so do not consider bending the bending portion, The conventional example of the above publication in which the insertion portion is simply advanced is difficult to apply to insertion into a bent body cavity. For this reason, it is desired to realize an endoscope that can be smoothly inserted into a bent body cavity.

(Object of invention)
The present invention has been made in view of the above points, and provides an endoscope and an endoscope apparatus that enable smooth insertion even when inserted into a body cavity bent like a large intestine. With the goal.

The present invention provides an endoscope having an elongated insertion portion and a bending portion provided on the distal end side thereof.
A fixing member arranged to be fixed at a predetermined position on the distal end side of the insertion portion;
One end is fixed to the distal end portion of the fixing member, the other end is slidably provided along the longitudinal direction of the insertion portion, and the distal end side expansion / contraction portion is extendable from the fixing member to the distal end side;
One end is fixed to the rear end portion of the fixing member, the other end is slidably provided along the longitudinal direction of the insertion portion, and a rear end side elastic portion that is extendable from the fixing member to the rear end side;
A tip guide member provided at the other end of the tip-side expansion and contraction portion and slidable along the longitudinal direction of the insertion portion;
A radial expansion / contraction part provided at the other end of the rear end side expansion / contraction part and capable of expansion / contraction in a substantially radial direction of the insertion part;
It is characterized by comprising.

An endoscope apparatus according to the present invention includes a fixing member that is fixedly disposed at a predetermined position on the distal end side of an insertion portion provided with a bending portion on the distal end side, and one end that is fixed to the distal end portion of the fixing member. An end is slidably provided along the longitudinal direction of the insertion portion, a distal-side expansion / contraction portion that can expand and contract from the fixing member to the distal end side, one end is fixed to the rear end portion of the fixing member, and the other end is A rear end side extendable portion that is provided slidably along the longitudinal direction of the insertion portion and is extendable from the fixed member to the rear end side;
Provided at the other end of the distal-side expansion / contraction part, and provided at the other end of the rear-end-side expansion / contraction part, a distal-end guide member that is slidable along the longitudinal direction of the insertion part, An endoscope comprising a radial expansion / contraction portion capable of expansion / contraction in the radial direction;
Fluid can be supplied / sucked independently to the front end side stretchable part, the rear end side stretchable part and the radial expansion / contraction part, and the front end side stretchable part and the rear end side stretchable part A drive unit capable of arbitrarily operating an expansion / contraction operation and an expansion / contraction operation of the radial expansion / contraction member;
It is characterized by comprising.

  According to the present invention, even when inserting into a bent body cavity like the large intestine, smooth insertion is possible.

Embodiments of the present invention will be described below with reference to the drawings.
Example 1
1 to 9 relate to a first embodiment of the present invention, FIG. 1 shows the overall configuration of an endoscope system including the first embodiment of the present invention, and FIG. 2 controls the telescopic unit by supplying and discharging air. FIG. 3 shows the structure of the control system, FIG. 3 shows the structure of the expansion / contraction unit provided on the distal end side of the insertion portion in the endoscope of the first embodiment, and FIG. 4 shows the expansion / contraction of the balloon of the expansion / contraction unit. And each state which extended / shrinked (stretched) the back end side expansion-contraction part is shown.
FIG. 5 shows a first operation example when the insertion portion is inserted into the large intestine, FIG. 6 shows a second operation example when the insertion portion is inserted into the large intestine, and FIG. 7 shows the insertion portion within the large intestine. FIG. 8 shows the structure of the telescopic unit provided on the distal end side of the insertion portion in the endoscope of the modified example, and FIG. 9 shows an example of the operation according to the modified example.
As shown in FIG. 1, an endoscope system 1 as an endoscope apparatus according to Embodiment 1 of the present invention includes an endoscope 2 provided with a telescopic unit 11.

The endoscope system 1 includes an endoscope 2 according to the first embodiment, a first control device 3 that performs imaging and illumination control, and a second control device 4 that serves as an expansion / contraction unit control device that controls the expansion / contraction unit 11. And a monitor 5 for displaying an endoscopic image, and a pump 6 as a supply source of fluid (in the specific example, air) to the telescopic unit 11.
The endoscope 2 includes an elongated insertion portion 8, an operation portion 9 provided at the rear end of the insertion portion 8, and a universal cord 10 extending from a side portion of the operation portion 9.
Further, in the endoscope 2 of the present embodiment, a telescopic unit 11 is provided at a predetermined position on the distal end side of the insertion portion 8 so as to facilitate the smooth insertion of the insertion portion 8 into a bent body cavity. . The insertion portion 8 includes a hard distal end portion 12, a bendable bending portion 13, and a flexible long flexible portion 14 in order from the distal end side. The bending portion 13 is configured by connecting a bending piece (not shown) so as to be rotatable in the longitudinal direction of the insertion portion 8.

The telescopic unit 11 is attached to the insertion portion 8 so that the vicinity of the rear end of the bending portion 13 in the insertion portion 8 is approximately the center in the longitudinal direction.
The operation unit 9 includes a tube relay box 15 provided at a position near the rear end of the insertion unit 8, a grasping unit 16 grasped by an operator, and a main operation unit 17 as an operation instruction unit. ing. The tube relay box 15 is a box that relays a tube for driving the telescopic unit 11 as will be described later.
Then, as will be described later, the balloon 55 of the expansion / contraction unit 11 is inflated / contracted via the air tubes 37a to 37c as drive conduits inserted into the insertion portion 8, and the distal end side expansion / contraction portion 52a is expanded / contracted. The expansion / contraction of the expansion / contraction part 52b can be independently activated.

The main operation section 17 includes a bending operation knob 18 that bends the bending section 13 of the insertion section 8 in four directions, up and down, and left and right (the reference direction of the endoscopic image captured by the endoscope 2 is the upward direction), and a fluid Are provided with operation buttons 19 for performing a feeding operation and suction operation, operation switches 20 for operating an optical system related to imaging, illumination, and the like, and a balloon switch 21.
The balloon switch 21 is a switch for instructing an operation of inflating / deflating the balloon 55 constituting the expansion / contraction unit 11. Each time the user operates the balloon switch 21, the control unit 32 to be described later controls supply / discharge (or supply / suction) of, for example, air (air) as a fluid into the balloon 55.

The bending operation knob 18 includes an up / down bending operation knob 18a for operating the bending portion 13 in the up / down direction of the endoscopic image, and a left / right bending operation for operating the bending portion 13 in the left / right direction of the endoscopic image. It consists of two operation knobs with the knob 18b.
Each of the operation knobs 18a and 18b is formed in a substantially disk shape. The two operation knobs 18a and 18b are rotatably arranged on the exterior surface of the main operation unit 17 of the operation unit 9 in a state where they are coaxially overlapped.
The up / down bending operation knob 18a is disposed at a position near the exterior surface of the main operation portion 17, and the left / right bending operation knob 18b is disposed coaxially in a state of being overlapped therewith.
A connector (not shown) at the end of the universal cord 10 extending from the operation unit 9 is detachably connected to the first control device 3.

The first control device 3 controls the driving of the illumination system of the endoscope 2 and the imaging system. The first control device 3 controls the illumination system, drives the imaging system, and performs image processing, and also performs drive control based on various switch operations of the main operation unit 17.
Moreover, the 1st control apparatus 3 is connected with the 2nd control apparatus 4 by the back side here though it is not illustrated. That is, an operation instruction to the second control device 4 by the balloon switch 21 disposed in the main operation unit 17 is sent from the universal cord 10 to the second control device 4 via the first control device 3. Communicated with.
In addition to the power switch, various operation members such as an illumination system are disposed on the front surface of the first control device 3.
The first control device 3 is electrically connected to the monitor 5. The monitor 5 is a display device that displays an endoscopic image acquired by the imaging system of the endoscope 2.

The operation buttons 19 that are operation instruction means disposed on the exterior surface of the main operation unit 17 are operated when an unnecessary object such as a body fluid in the subject is aspirated from the distal end portion 12 of the endoscope 2. An aspiration button 19a and an air / water supply button 19b that is operated when supplying gas or supplying liquid from the distal end portion 12 of the endoscope 2 into the subject are provided.
An air supply / water supply tube (not shown) and a suction pipe (not shown) opened in the distal end portion 12 are inserted into the insertion portion 8 and connected to the control device 3 and the control device 4 via the operation portion 9 and the universal cord 10. ing.

On the other hand, from the tube relay box 15, three tubes 23 inserted into the insertion portion 8 are extended. These three tubes 23 are a balloon tube 23a, a distal end side stretchable portion tube 23b, and a rear end side stretchable portion tube (hand side stretchable portion tube) 23c.
The end portions of the three tubes 23a to 23c are connected to predetermined positions on the front surface of the second control device 4 through detachable connectors (the pressure in the second control device 4 in FIG. 2). Connected to the control unit 36).

A water supply tank 24 is detachably attached to the second control device 4. Distilled water, physiological saline, and the like are stored in the water supply tank 24.
When a predetermined operation of the air / water supply button 19b of the main operation unit 17 is performed, a pump (not shown) is operated under the control of the first control device 3 to supply distilled water or physiological saline from the water supply tank 24. It is sent to the water supply tube. And it ejects from the nozzle which is not illustrated formed in the front-end | tip part 12, and the deposit | attachment of the outer surface of the observation window of an imaging system can be removed, and it can be in a clean state.
By operating the suction button 19a of the main operation unit 17 of the endoscope 2, suction can be performed via the suction conduit.
In addition, a foot switch 25 is connected to the second control device 4 via a switch cable 26.
As the foot switch 25, a front end side expansion / contraction part switch 25a for expanding / contracting the front end side expansion / contraction part 52a in the expansion / contraction unit 11, and a rear end side expansion / contraction part switch 25b for extending / contracting the rear end side expansion / contraction part (or hand side expansion / contraction part) 52b. And are provided.
Next, the structure of the 2nd control apparatus 4 provided with the drive means (drive control means) of the expansion-contraction unit 11 is demonstrated with reference to FIG.
The second control device 4 that drives and controls the telescopic unit 11 includes a control unit 32 that drives and controls each unit in response to a driving instruction from the external driving instruction unit 31 by a user such as an operator. The external drive instruction unit 31 includes a balloon switch 21 and a foot switch 25 for a user to give a drive instruction.
Then, by operating the balloon switch 21, the second control device 4 can operate the distal end side elastic part 52 a and the rear end side elastic part 52 b independently by inflating / deflating the balloon 55 and operating the foot switch 25. A driving means for driving is formed.

Further, in the second control device 4, air (air) from the pump 6 is branched into three pipelines 34a, 34b, 34c via a pipeline 34 provided with a regulator 33, and each of these pipelines 34a. , 34b, 34c are supplied to a balloon electromagnetic valve 35a, a front end side expansion / contraction part electromagnetic valve 35b, and a rear end side expansion / contraction part electromagnetic valve 35c, respectively.
The opening and closing of the balloon electromagnetic valve 35a, the front end side expansion / contraction part electromagnetic valve 35b, and the rear end side expansion / contraction part electromagnetic valve 35c are controlled by the control unit 32 in accordance with a driving instruction from the user.

For example, when a driving instruction operation for inflating the balloon 55 is performed by the balloon switch 21, the control unit 32 opens the balloon electromagnetic valve 35 a and supplies air from the pump 6 to the pressure control unit 36 side.
The pressure supplied to the pipes 34a, 34b, 34c through the balloon solenoid valve 35a, the front-end side extension / retraction part solenoid valve 35b, and the rear-end side extension / retraction part solenoid valve 35c is reduced by the pressure control unit 36. It is controlled within an appropriate range, and is used for the expansion of the balloon 55, the extension of the front end side extendable part 52a, and the extension of the rear end side extendable part 52b.

The pipes 34a, 34b, 34c, in which the internal air pressure is controlled by the pressure control unit 36, are connected to the operation unit of the endoscope 2 by the tubes 23a, 23b, 23c connected to the pressure control unit 36 at one end. 9 is connected to a tube relay box 15 provided in the vicinity of the front end of 9.
Then, it is relayed by the tube relay box 15 and inserted into the insertion portion 8 of the endoscope 2, and into the hollow portions 59a, 59b, and 59c of the balloon 55, the distal end side contraction portion 52a, and the rear end side contraction portion 52b. A balloon air tube 37a serving as a driving pipe line, each of which is connected at the tip, is connected to the rear ends of the tip-side stretchable part air tube 37b and the rear-end-side stretchable part air tube 37c.
In FIG. 2, the balloon air tube 37 a inserted into the insertion portion 8, the front-end-side stretchable portion air tube 37 b, and the rear-end-side stretchable portion air tube 37 c include three tubes 38 a, 38 b, A pipe 38c is connected to each of the pipes 34a, 34b, 34c on the pressure control unit 36 side. In FIG. 2, the connecting portion is indicated by a balloon, a distal end side stretchable portion, and a rear end side stretchable portion.

It should be noted that a pressure setting unit for selecting and setting a pressure value for inflating the balloon 55 in the expansion / contraction unit 11 and extending the front end side expansion / contraction part 52a and the rear end side expansion / contraction part 52b from a plurality of pressure values is provided. Anyway.
Next, the configuration of the distal end side of the insertion portion 8 of the endoscope 2 will be described with reference to FIG.
For example, two illumination windows and an observation window are provided on the hard tip body 41 constituting the tip 12. Each illumination window is provided with an illumination lens 42 that forms an illumination system, and each illumination lens 42 expands and emits illumination light emitted from the tip surface of a light guide 43 that transmits illumination light. .
The rear end of the light guide 43 is connected to a light source device (not shown) provided in the first control device 3 of FIG. The illumination light from the light source device is supplied (incident) to the rear end of the light guide 43. In addition, without providing the light guide 43, an LED may be disposed in front of the illumination lens 42, and the LED light may be used as illumination light.

A site such as a diseased part in a body cavity illuminated by illumination light emitted from the illumination window is used as an image sensor disposed at the imaging position by an objective lens 44 constituting an imaging system attached to the observation window. An optical image is formed on the imaging surface of the CCD 45.
Note that the observation window is provided in the vicinity of the center of the circular tip surface, for example. Then, as will be described later, when the tip guide member 53 of the telescopic unit 11 is slid to the front side of the tip portion 12, the state is caught in the observation field of view and the state in which the tip guide member 53 is projected is confirmed. It is made easy.
The CCD 45 is connected to a CCD drive circuit (not shown) and an image processing circuit in the first control device 3 of FIG. 1 via signal lines.

Then, the CCD 45 outputs a CCD output signal obtained by photoelectric conversion to the image processing circuit by applying a CCD drive signal. The image processing circuit performs image processing, generates a video signal, and outputs it to the monitor 5. Then, an image captured by the CCD 45 is displayed on the display surface of the monitor 5 as an endoscopic image.
A bendable bending portion 13 is formed at the rear end of the distal end portion 12. The surgeon can bend the bending portion 13 in a desired direction by operating the bending operation knob 18 of the operation portion 9.
In the present embodiment, the substantially annular fixing member 51 constituting the expansion / contraction unit 11 is disposed at a predetermined position on the distal end side of the insertion portion 8, more specifically, near the rear end of the bending portion 13. Is fixed to an annular connecting member connected to a rear end of a bending piece (not shown) inside the outer skin 50 or inside thereof.

The fixing member 51 is expanded and contracted at one end on the distal end side thereof and is connected to the distal end guiding member 53 via a distal end side expandable portion 52a that is slidable along the longitudinal direction of the outer peripheral surface of the insertion portion 8. The rear end side (hand side) expands and contracts and is connected to the holding member 54 via a rear end side extendable part 52b that is slidable along the longitudinal direction of the outer peripheral surface of the insertion part 8.
The holding member 54 is attached with a balloon 55 that forms a radially inflating / contracting portion capable of expanding and contracting in the radial direction.
The fixing member 51 has one end of a cylindrical first elastic member 56a that forms a distal end side stretchable portion 52a fixed to the outer peripheral surface of the front end (tip) portion, and the other end of the first elastic member 56a. The tip guide member 53 is slidably movable (in the longitudinal direction along the outer peripheral surface of the insertion portion 8) disposed on the tip side.

The tip guide member 53 is made of, for example, a hard material and has a substantially cylindrical shape. In the state of FIG. 3, the tip guide member 53 is located on the rear side of the tip portion 12, but in a state where the tip side expansion / contraction portion 52 a is extended, For example, as shown in FIG. Further, the distal end guiding member 53 has a tapered shape on the distal end side so that it can be easily inserted into a tubular body cavity.
Inside the first elastic member 56a, a first outer elastic member 57a and a first inner elastic member 58a, which are each expandable and bellows-shaped, are disposed, and the rear ends and front ends of the elastic members 57a and 58a are The fixing member 51 and the tip guide member 53 are fixed respectively.
The distal-side stretchable portion 52a provided at the rear end of the distal-end guide member 53 is formed of a member having high stretchability and a flexible member that is easily bent. And it makes it easy to insert along the bent shape in the bent body cavity.

Further, the fixing member 51 is disposed on the rear end side of the outer peripheral surface of the rear end portion via the cylindrical second elastic member 56b forming the rear end-side stretchable portion 52b (along the outer peripheral surface of the insertion portion 8). A) It is connected to the distal end portion of the slidable holding member 54.
Inside the second elastic member 56b, a second bellows-shaped second outer stretchable member 57b and a second inner stretchable member 58b are disposed, respectively, and the leading and trailing ends of these stretchable members 57b and 58b are respectively The fixing member 51 and the holding member 54 are respectively fixed.
Further, the holding member 54 formed of a hard member is formed with a recess in which a central portion in the longitudinal direction is cut out from the outer peripheral side. The holding member 54 has an annular shape (short cylinder) so as to cover the concave portion and form a hollow portion 59a, and can be expanded and contracted by a member having a high elasticity such as latex rubber or elastomer. A special balloon 55 is attached.

The balloon 55 covers the central concave portion of the holding member 54 from the outer peripheral side, so that the balloon 55 is inflated in the radial direction and is restricted in the axial direction (in other words, inflated only in the radial direction). ).
The tip guide member 53, the fixing member 51, and the holding member 54 are set to have almost the same outer diameter, and the tip guide member 53 and the holding member 54 are hollow inner diameters slightly larger than the outer diameter of the insertion portion 8. And is slidable in the axial direction (longitudinal direction) of the outer peripheral surface of the insertion portion 8.
The tip guide member 53 and the fixing member 51 are connected by a cylindrical first elastic member 56a disposed therebetween, and the fixing member 51 and the holding member 54 are cylindrical second members disposed therebetween. Are connected by the elastic member 56b. Note that the end portions of the elastic members 56a and 56b are fixed to the outer peripheral surfaces of the tip guide member 53, the fixing member 51, and the holding member 54 by, for example, thread binding and an adhesive.

Further, the outer elastic members 57a and 57b have a bellows shape in the elastic members 56a and 56b, and are disposed in the elastic members 56a and 56b, respectively, in a state where a part thereof is substantially in contact therewith.
The inner elastic members 58a and 58b are elastic in a state of being bellows inside the elastic members 56a and 56b and inside the outer elastic members 57a and 57a, and a part of which is substantially in contact with the outer peripheral surface of the insertion portion 8. It arrange | positions in the members 56a and 56b.
The expansion / contraction unit 11 is formed with airtight hollow portions 59a, 59b, and 59c in the balloon 55, the front-end-side expansion / contraction portion 52a, and the rear-end-side expansion / contraction portion 52b. The hollow portion 59b is formed between the outer elastic member 57a and the inner elastic member 58a, and the hollow portion 59c is formed between the outer elastic member 57b and the inner elastic member 58b. The outer elastic members 57a and 57b and the inner elastic members 58a and 58b are made of a synthetic resin such as polyester.
In these hollow portions 59a, 59b, 59c, the ends of the air tubes inserted through the insertion portion 8, that is, the balloon air tube 37a, the distal end side stretchable portion air tube 37b, and the rear end side stretchable portion air tube 37c are opened. is doing.

Specifically, the balloon air tube 37a inserted through the insertion portion 8 extends rearward through a guide hole formed in the inner peripheral surface near the center of the fixing member 51, and further, the second outer elastic member. After passing through 57b and the second inner elastic member 58b, the end of the hollow portion 59a in the balloon 55 is opened through the guide hole of the holding member 54.
In the middle, bushes 60a, 60b, 60c are inserted between the guide holes so as to keep airtightness.
Further, the distal-side expansion / contraction portion air tube 37b inserted through the insertion portion 8 extends to the distal end side through a guide hole formed in the inner peripheral surface near the center of the fixing member 51, and the first outer expansion / contraction member 57a. And the edge part is opening to the hollow part 59b in the 1st inner side expansion-contraction member 58a.
And in the middle, bushes 60d and 60e are inserted between the guide holes so as to keep airtightness.

Further, the rear end side expansion / contraction part air tube 37c inserted through the insertion part 8 is extended rearward through a guide hole formed in the inner peripheral surface near the center of the fixing member 51, and the second outer extension member. The ends of the hollow portions 59c in the 57b and the second inner elastic member 58b are opened.
And in the middle, bushes 60f and 60g are inserted between the guide holes so as to keep airtightness.
Also, O-rings 61 a and 61 b for maintaining airtightness are inserted between the inner peripheral surface of the fixing member 51 and the outer peripheral surface of the insertion portion 8.
3 and 4A show a contracted state in which air is not supplied to the hollow portion 59a in the balloon 55, the hollow portion 59b of the distal end side stretchable portion 52a, and the hollow portion 59c of the rear end side stretchable portion 52b (usually normal). The telescopic unit 11 is shown in a state or standard state).

  Then, as shown in FIGS. 4A to 4E, the balloon 55 can be expanded and contracted, the distal end side stretchable portion 52a can be stretched and the rear end side stretchable portion 52b can be stretched independently. 4 (C) to 4 (E) show a state in which the pressure value to be expanded or expanded is expanded or expanded in a state where the allowable maximum pressure value is set to about 70%, for example, Further, it can be expanded and expanded.

Since the outer elastic members 57a and 57b and the inner elastic members 58a and 58b are formed in a bellows shape, when the hollow portions 59b and 59c are pressurized, there is little deformation in the radial direction and they can be expanded and contracted in the axial direction. it can. In order to reliably prevent deformation in the radial direction, the outer elastic members 57a and 57b and the inner elastic members 58a and 58b may be made of a synthetic resin with a plurality of metal rings embedded therein.
As shown in FIG. 3, in a state where air is not supplied to the hollow portions 59b and 59c, the first elastic member 56a is in a state where the first outer elastic member 57a and the first inner elastic member 58a are contracted. The second elastic member 56b has an elastic force to maintain the state in which the second outer elastic member 57b and the second inner elastic member 58b are contracted.

3 or 4A, the balloon 55 can be inflated in the radial direction by supplying air into the hollow portion 59a in the balloon 55 by operating the balloon switch 21.
In addition, since the front end and the rear end of the short cylinder (or ring) shape of the balloon 55 are fixed to the front end and the rear end of the rigid holding member 54, the insertion portion 8 is supplied when air is supplied. In the state restricted so as not to expand in the axial direction (front-rear direction), it expands outward in the radial direction.
The state in which the balloon 55 is inflated is shown in FIGS. 4 (B) to 4 (E).
The balloon switch 21 for inflating / deflating the balloon 55 functions as a switch for inflating when the user performs an operation to be turned on, and stops when the user is turned off. Further, for example, after reaching the maximum pressure value, even if it keeps turning on, it does not expand beyond the maximum pressure value allowed and stops in that state.

Next, when it is pressed to turn it from OFF to ON, it functions as a switch for contraction. That is, the control unit 32 performs control so that the air in the hollow portion 59a is discharged (or sucked) and the balloon is deflated. Accordingly, every time the user operates the balloon switch 21, the balloon 55 repeats inflation → stop → deflation.
Further, by operating the distal end side expansion / contraction section switch 25a in the foot switch 25, the inside of the hollow section 59b of the distal end side expansion / contraction section 52a, that is, the hollow section 59b between the first outer expansion / contraction member 57a and the first inner expansion / contraction member 58a. By supplying air to the first elastic member 56a, the first outer elastic member 57a and the first inner elastic member 58a can be extended against the elastic force of the first elastic member 56a. This state is shown in FIGS. 4C and 4E.

When the supply of air to the hollow portion 59b is released, that is, when the operation is performed so that air is discharged (or sucked) from the hollow portion 59b, the air is contracted by the elastic force of the first elastic member 56a, for example, FIG. Returning to the state of (A), FIG. 4 (B), and FIG. 4 (D).
Further, by operating the rear end side stretchable part switch 25b in the foot switch 25, a hollow part in the hollow part 59c of the rear end side stretchable part 52b, that is, between the second outer stretchable member 57b and the second inner stretchable member 58b. By supplying air into 59c, the second outer elastic member 57b and the second inner elastic member 58b can be extended against the elastic force of the second elastic member 56b. This state is shown in FIGS. 4D and 4E.
When the supply of air to the hollow portion 59c is released, that is, when the operation is performed to discharge air from the hollow portion 59c, the air is contracted by the elastic force of the second elastic member 56b, for example, FIG. The state shown in FIG.

In addition, even when the foot switch 25 is pressed (stepped on with a foot), when it is first pressed from OFF to ON, it functions as a switch that expands by supplying air and does not reach the maximum pressure value. When it is turned OFF at, it stops in an extended state corresponding to the pressure value. Next, when it is pushed from OFF to ON, it functions as a switch for contraction.
Also in this case, as in the case of the balloon switch 21, the front end side stretchable part 52 a and the rear end side stretchable part 52 b repeat extension → stop → retraction each time the foot switch 25 is operated.
A user such as a surgeon operates the balloon switch 21 and the foot switch 25 (the distal end side expansion / contraction section switch 25a and the rear end side expansion / contraction section switch 25b) to operate the balloon 55 as described above. The expansion / contraction of the part 52a and the expansion / contraction of the rear end side expansion / contraction part 52b can be independently controlled independently.

Further, by simultaneously stepping on the front end side expansion / contraction section switch 25a and the rear end side expansion / contraction section switch 25b in the foot switch 25, it is possible to simultaneously expand and contract.
4A to 4E show the state of the distal end side of the insertion portion 8 with reference to (ie, aligned with) the position of the fixing member 51, for example. In use, there is a case where the position of the inflated balloon 55 is operated as a reference.
In the body cavity, for example, after the balloon 55 inflated in the state shown in FIG. 4B comes into contact with the intestinal wall and the balloon 55 is fixed to the intestinal wall (or the intestinal wall is fixed by the balloon 55), for example, When the operation of extending the rear end side extension / contraction part 52b is performed, the extension / contraction unit 11 is in the state shown in FIG.

In this case, in the state shown in FIG. 4B, the fixing member 51 moves forward on the opposite side of the balloon 55 by the extension of the rear end side expansion / contraction portion 52b (the fixing member 51 is fixed to the insertion portion 8). Therefore, the insertion portion 8 also moves forward by the amount of movement of the fixing member 51.
When the intestinal wall is movable, the intestinal wall side moves in the direction opposite to the fixing member 51. In the case where the intestinal wall is stretched, the stretched intestinal wall can be set in a relaxed state.
Similarly, in the state of FIG. 4B, when an operation of extending the front end side elastic part 52a and the rear end side elastic part 52b is performed, the operation of extending the rear end side elastic part 52b is performed. From this case, the distal end side expansion / contraction part 52a in the expansion / contraction unit 11 further moves forward.

Next, an operation for inserting the endoscope 2 of the present embodiment into the large intestine 81 will be described with reference to FIGS.
The distal end side of the insertion portion 8 is inserted from the anus 82 by the same operation as in the case of a normal endoscope while the telescopic unit 11 is kept in the normal state of FIG. 3 or FIG. The operator inserts the distal end side of the insertion portion 8 to the front of the SD junction 84 at the boundary between the sigmoid colon 83 and the descending colon 85 as shown in FIG. 5A by the same operation as described in FIG. can do.
In FIG. 5A, the intestinal wall portion of the sigmoid colon 83 is stretched (stretched) by an insertion operation that pushes the distal end side of the insertion portion 8.
Next, the surgeon turns on the balloon switch 21 to inflate the balloon 55 at the rear end portion of the telescopic unit 11. A state where the balloon 55 is inflated is shown in FIG. The balloon 55 is inflated in the radial direction, and the inflated balloon 55 is brought into contact with the intestinal wall on the deep side of the sigmoid colon 83 so that the portion is further depressed by applying pressure.

The distal end side of the insertion portion 8 is fixed to the intestinal wall by the balloon 55 that grips the intestinal wall at the pressed portion or is pressed against the intestinal wall.
Next, the surgeon performs the operation of bending the bending portion 13 in the direction of the bending portion of the SD junction 84, and steps on both the switches by stepping with the foot at the same time as the front-end-side expansion / contraction switch 25a and the rear-end-side expansion / contraction switch 25b. 25a and 25b are turned ON, and the front end side elastic part 52a and the rear end side elastic part 52b are extended. This state is shown in FIG.
Since the balloon 55 at the rear end position of the telescopic unit 11 is fixed to the intestinal wall, as described above, the fixing member 51 on the front side of the balloon 55 is on the front side and the intestinal wall on which the balloon 55 is fixed. Acts so that it can be pulled back.

Further, the insertion portion 8 moves forward by the amount of extension of the distal side expansion / contraction portion 52a. Therefore, as shown in FIG. 5C, the intestinal wall is set to a loose state from the extended state of FIG. 5B, and the bending of the bent portion of the SD junction 84 is relaxed. In FIG. 5C, the dotted line indicates the state of the distal end side of the insertion portion 8.
Further, in this case, the distal end side expansion / contraction portion 52a at the rear end of the distal end guide member 53 is formed of a flexible member that is sufficiently easily bent, so that the distal end guide member 53 is located on the front side of the distal end portion 12. When projecting and moving, the tip guide member 53 moves so as to be bent and inserted along the bent portion of the SD junction 84 toward the deep side thereof.
As described above, in this embodiment, the telescopic unit 11 is configured to be easily inserted into a body cavity having a bent tip.

After inserting the distal end side of the insertion portion 8 into the deep side of the bent portion of the SD junction 84 as shown in FIG. 5C, the state where the intestinal wall is gripped is released as shown in FIG. 5D. You may do it.
Alternatively, when the distal end portion 12 of the insertion portion 8 can be set to a state where it is inserted to some extent on the deep side of the bent portion of the SD junction 84 (the bent portion 13 is further bent so that the distal end portion The insertion portion 8 may be pulled to make the sigmoid colon 83 close to a straight line (so-called linearized state) (this state will be described later).
First, the case of the first procedure for releasing the state of gripping the intestinal wall in the state of FIG. 5C will be described.
In this case, the surgeon operates the balloon switch 21 to contract the balloon 55, and simultaneously steps, for example, the front end side expansion / contraction part switch 25a and the rear end side expansion / contraction part switch 25b of the foot switch 25 with the foot. The front end side elastic part 52a and the rear end side elastic part 52b are contracted.

Then, the balloon 55, the distal end side stretchable portion 52a, and the rear end side stretchable portion 52b contract, and the distal end side of the insertion portion 8 is located deeper than the bent portion of the SD junction 84 as shown in FIG. It will be inserted.
Further, in this state, by further repeating the operations shown in FIGS. 5B and 5C, the distal end side of the insertion portion 8 can be inserted deeper than the bent portion of the SD junction 84. it can. Thereafter, as described above, the rear end side of the insertion portion 8 is pulled to straighten the sigmoid colon 83 (see FIG. 6D described later for the state of the straightening).
As a second technique, in the state of FIG. 5C described above, if the surgeon has already been inserted to some extent on the deep side of the bent portion of the SD junction 84, the operator changes the bending portion 13 to a more curved state. The insertion operation can also be performed by pulling the proximal side of the insertion portion 8 so that the sigmoid colon 83 is in a state close to a straight line.

Thus, according to the present embodiment, the distal end side of the insertion portion 8 of the endoscope 2 can be smoothly inserted into the deep portion side of the SD junction 84 with a simple operation.
Further, it can be inserted into the large intestine 81 by an operation different from the operation shown in FIGS. 5 (A) to 5 (D). An example will be described below.
In the above description, after setting the state shown in FIG. 5B, the front end side stretchable portion 52a and the rear end side stretchable portion 52b have been stretched simultaneously. 52b may be extended. 6A to 6D are explanatory diagrams in this case. FIG. 6A corresponds to FIG.
Then, after setting the state shown in FIG. 6 (A), when the rear end side expansion / contraction part 52b is extended while the bending part 13 is bent, the state shown in FIG. 6 (B) is obtained. When the rear end side expansion / contraction part 52b is extended, it is possible to set the sigmoid colon 83 side from the extended state to the loose state, and to move the distal end side of the insertion part 8 forward. Accordingly, the state shown in FIG. 6B can be set by extending the rear end side expansion / contraction part 52b while bending the bending part 13.

In the example of FIG. 6B, the distal end portion 12 is inserted in the vicinity of a position slightly beyond the bent portion of the SD junction 84.
Thereafter, by extending the distal end side expansion / contraction part 52a, as shown in FIG. 6C, the distal end side of the insertion part 8 and the distal end side of the expansion / contraction unit 11 are inserted deeper than the bent part of the SD junction 84. can do. This state is the same as the state of FIG. When the state shown in FIG. 6B is set to the state shown in FIG. 6C, the distal side expansion / contraction part 52a is extended with the bending state of the bending part 13 set to the state shown in FIG. 6B. Thus, the bending portion 13 and the distal end portion 12 can be inserted into the SD junction 84 on the deep side in the bent state.
Moreover, since the distal end side expansion / contraction portion 52a at the rear end of the distal end guide member 53 is sufficiently bent, the distal end guide member 53 moves to the front side along the curved shape of the bending portion 13.

As described above, in the state shown in FIG. 6C, that is, in the state shown in FIG. 5C, there is an option for performing the insertion operation by setting as shown in FIG.
Further, in this state, the surgeon makes the bending portion 13 more curved so that the bending portion of the SD junction 84 can be easily locked, and pulls the rear end side of the insertion portion 8 to obtain the state shown in FIG. As shown, the sigmoid colon 83 side may be set to a state close to a straight line.
Thus, after setting the sigmoid colon 83 side to a state close to a straight line, the fixation of the balloon 55 to the intestinal wall is released. Specifically, the balloon 55 is contracted, and the front end side stretchable part 52a and the rear end side stretchable part 52b are contracted. Then, by inserting the insertion portion 8, the insertion portion 8 can be inserted into the deep side of the descending colon 85.

In the description using FIGS. 6A to 6D, in the state of FIG. 5B, the operation of extending the rear end side elastic part 52b first is performed. It may be extended. FIG. 7A to FIG. 7C show operation explanatory diagrams in this case.
FIG. 7A shows the same state as FIG. 5B or FIG. In this state, the surgeon can set the state shown in FIG. 7B by extending the distal end side expansion / contraction portion 52 a while bending the bending portion 13 in the direction of the bending portion of the SD junction 84.
In this case, since the distal end side expansion / contraction part 52a of the expansion / contraction unit 11 extends, the front side moves forward from the fixing member 51 of the expansion / contraction unit 11 in the state of FIG. 7A, and the fixing member 51 is fixed at that time. The inserted portion 8 also moves forward.
In the example of FIG. 7B, the distal end portion of the telescopic unit 11 is inserted to a position slightly beyond the bent portion of the SD junction 84.

Next, the surgeon can set the state of FIG. 7C by extending the rear end side expansion / contraction part 52b in a state where the bending part 13 is bent in the direction of the bending part of the SD junction 84. This state is the same as FIG. 5C or FIG.
After this state, as described above, the selection for performing the linearization operation or the balloon 55 is deflated, and then the operation from FIG. May be inserted into the SD junction 84 at a deeper side and then linearized.
Thus, according to the present embodiment, the distal end side of the insertion portion 8 of the endoscope 2 can be smoothly inserted into the deep portion side of the SD junction 84 with a simple operation.
Next, a modification of this embodiment will be described. FIG. 8 illustrates a configuration on the distal end side of a modification of the endoscope 2 according to the first embodiment. FIG. 8 shows an expansion / contraction unit 11 provided on the distal end side of the insertion portion 8 as shown in FIG. 3 and further provided with a second balloon 55B as a second radial expansion / contraction portion on the distal end side. Unit 11B is formed.

For example, the tip guide member 53B shown in FIG. 3 is made to be a tip guide member 53B which is elongated in the longitudinal direction, and a concave portion cut out from the outer peripheral side is provided so as to function also as a balloon holding member.
And this recessed part is covered with the annular balloon 55B.
Further, a fourth air tube 37d is inserted into the insertion portion 8 in addition to the air tube 37a for supplying / discharging air to / from the hollow portion 59a of the balloon 55 on the rear side described above. The air tube 37d is bent in the fixing member 51 and passed through the guide hole, and the distal end opening is disposed in the hollow portion 59d in the balloon 55B.
Further, bushes 60h, 60i, 60j are inserted between the guide holes in the middle so as to keep airtightness.

As a modification, for example, after the state shown in FIG. 5C is set, the balloon 55B is inflated as shown in FIG. 9, and the descending colon 85 on the deep side of the SD junction 84 is inflated by the inflation of the balloon 55B. The telescopic unit 11B may be fixed to the intestinal wall on the side.
Then, after setting as shown in FIG. 9, the balloon 55 on the rear side is deflated and the proximal side of the insertion portion 8 is pulled, so that the sigmoid colon 83 can be straightened to facilitate insertion. After the straightening, the balloon 55B can be inserted in the contracted state like a normal endoscope. In this modification, the sigmoid colon 83 can be straightened more reliably by inflating the balloon 55B as shown in FIG.

Then, the SD junction 84 can be inserted into the deep side. Therefore, according to this modification, the options for the insertion operation further increase, and the options for smooth insertion increase.
In the above description, the operation of inserting into the deep side of the SD junction 84 has been described. However, when the liver curve bent from the transverse colon is passed through the splenic curve on the deep side of the descending colon 85 Similarly, it can be smoothly inserted into the ascending colon side of the deep part by a simple operation.

(Example 2)
Next, Embodiment 2 of the present invention will be described with reference to FIG. FIG. 10 shows a schematic configuration of main parts in the endoscope system 1B of the second embodiment.
In the second embodiment of the present invention, for example, the expansion / contraction of the balloon 55, the expansion / contraction of the front end side expansion / contraction part 52a, and the expansion / contraction of the rear end side expansion / contraction part 52b in the expansion / contraction unit 11 of the first embodiment are detected. Moreover, it displays so that the approximate shape of the detected state can be confirmed. By providing display means for the general state of the telescopic unit 11, the operability for the user is improved.
In the first embodiment, for example, by operating the balloon switch 21 in the deflated state, the balloon 55 is set to the maximum inflated state after a predetermined time, but it is not possible to grasp the state of being inflated in the middle. This is improved by the present embodiment.
In addition, the present embodiment makes it possible to grasp the extended state in the same manner even when the front end side elastic part 52a and the rear end side elastic part 52b are extended.

Also in the first embodiment, when the distal end side expansion / contraction part 52a and the like are expanded and the distal end guiding member 53 at the distal end of the expansion / contraction unit 11 is expanded to a state of protruding forward from the distal end part 12, The object lens 44 can be confirmed within the observation field of view, and the operability when inserted is improved.
In the present embodiment, even when it is not captured in the observation visual field, the general state can be confirmed, and the operability is further improved.
For this reason, in this embodiment, as shown in FIG. 10, pressure sensors 71 a to 71 c that detect the pressure of air (as fluid to be supplied) in the hollow portions 59 a to 59 c in the telescopic unit 11 of the first embodiment. Are arranged respectively. The detection signals from the pressure sensors 71 a to 71 c are input to the pressure control unit 36 and the control unit 32 in the second control device 4 via signal lines 72 a to 72 c inserted through the insertion unit 8.

The pressure control unit 36 uses the detection signals from the pressure sensors 71a to 71c to utilize the air supply / discharge pressure control. The pressure control of air supply / discharge can be controlled by a detection signal from a pressure sensor (not shown) provided in the pressure control unit 36.
Further, the control unit 32 or the pressure control unit 36 may open / close an exhaust valve (not shown) or an electromagnetic valve so as not to exceed the maximum allowable pressure, for example, based on detection signals from the pressure sensors 71a to 71c. The opening and closing of 35a-35c is controlled.
The detection signals from the pressure sensors 71 a to 71 c input to the control unit 32 are input from the control unit 32 to the state detection unit 74 of the expansion / contraction unit 11 in the first control device 3 via the communication line 73. .

The detection signals from the pressure sensors 71 a to 71 c may be input to the state detection unit 74 via the signal lines 72 a to 72 c without passing through the control unit 32.
The state detection unit 74 detects the inflated / deflated state of the balloon 55, the expanded / contracted state of the distal end side expandable portion 52a, and the expanded / contracted state of the rear end side expanded / contracted portion 52b from the values of the detection signals from the pressure sensors 71a to 71c.
Further, for example, in the ROM 75 as information storage means connected to the state detection unit 74, the degree of inflation / deflation of the balloon 55 (the amount of inflation of the balloon 55 or the amount of inflation of the balloon 55 is determined based on the detection signal values of the pressure sensors 71a to 71c. (Expansion volume), information on the rate or amount of expansion from the contracted state of the front end side expansion / contraction part 52a, and information on the ratio or expansion amount of the rear end side expansion / contraction part 52b expanded from the contraction state are stored in advance.

Then, the state detection unit 74 obtains, for example, data on the amount of expansion of the balloon 55, the amount of expansion / contraction of the front end side expansion / contraction part 52a, and the amount of expansion / contraction of the rear end side expansion / contraction part 52b from the detection signal values of the pressure sensors 71a to 71c. The detected data is output to the shape image generator 76.
The shape image generation unit 76 is, for example, standard state image data of the expansion / contraction unit 11 of FIG. 1 or FIG. Image data or the like obtained by expanding the expansion / contraction part 52b to the maximum value is stored in its internal memory.
Then, the shape image generation unit 76 generates a video signal corresponding to the image of the approximate shape of the expansion / contraction unit 11 at each time state when the data is input, from the data input from the state detection unit 74. Output to the monitor 5 via 77.

Further, the CCD 45 built in the distal end portion 12 of the insertion portion 8 is driven by a CCD drive circuit 78 in the first control device 3.
Then, the CCD output signal photoelectrically converted by the CCD 45 by the application of the CCD drive signal is subjected to image processing by the image processing circuit 79 in the first control device 3, and an image corresponding to the optical image formed on the CCD 45. A signal is generated. This video signal is output to the monitor 5 via the mixer 77 and displayed as an endoscopic image in the endoscopic image display area 5a of the monitor 5.
The monitor 5 also receives a video signal corresponding to the image of the approximate shape of the expansion / contraction unit 11 generated by the shape image generation unit 76, and the shape display area 5 b of the monitor 5 has an outline of the expansion / contraction unit 11. An image of the shape is displayed.

For example, in the monitor 5 of FIG. 10, when the expansion / contraction unit 11 is in a standard state (see FIG. 3 or FIG. 4A), the balloon switch 21 is turned on and the time after t seconds elapses from the ON. An image of a schematic shape when the detected pressure in the hollow portion 59a is detected to be, for example, about 60% of the maximum value is shown as a display example.
In the display example of FIG. 10, for example, the maximum value of the balloon 55 is indicated by a two-dot chain line, and the shape of the balloon 55 actually detected is indicated by a diagonal line, and this display changes with time (for example, Will expand). Other configurations are the same as those of the first embodiment.
The surgeon can grasp (confirm) how the telescopic unit 11 is inflated by looking at the monitor 5. Therefore, when the expansion amount desired by the surgeon is reached, the next operation can be performed immediately. Therefore, useless waiting time can be eliminated.

In this embodiment, as well as setting the maximum expansion amount, when the expansion amount desired by the surgeon is reached, the balloon switch 21 can be turned OFF to set the expansion amount. In addition, although the expansion amount of the balloon 55 has been described, the expansion amount of the front end side expansion / contraction part 52a and the expansion amount of the rear end side expansion / contraction part 52b can be similarly controlled.
Thus, according to the present embodiment, even when the surgeon operates to change and set the expansion amount and the expansion / contraction amount, the expansion amount and the expansion / contraction amount can be variably set as actually observing the expansion / contraction unit 11. it can.
Therefore, the operability is greatly improved as compared with the case where the state of the telescopic unit 11 cannot be grasped.
The other effects are the same as those of the first embodiment.
When applied to the extendable unit 11B of FIG. 8, a pressure sensor may be provided in the hollow portion 59d. Note that the expansion amount and the expansion amount may be displayed numerically in addition to the shape display or simply. For example, when the balloon 55 is inflated, the balloon 55 at the time t may be displayed up to about 60% of the maximum inflated amount (or inflated from the deflated state to OOcm).

FIG. 11 shows a schematic configuration of main parts in an endoscope system 1C according to a modification of the second embodiment. In this modification, the amount of expansion / contraction of the distal end side expansion / contraction part 52a is applied to, for example, the inner surface of the outer expansion / contraction member 57a or the outer surface of the inner expansion / contraction member 58a constituting the distal end side expansion / contraction part 52a of the expansion / contraction unit 11 in the second embodiment. Detection means for detecting is provided.
Specifically, as detection means for detecting the amount of expansion / contraction, strain sensors 80a to 80d that detect the amount of expansion / contraction as the amount of distortion are attached to positions corresponding to the four directions of the bending portion 13 in the vertical and horizontal directions.
In FIG. 11, the strain sensors 80 a to 80 d correspond to the four directions of up and down, left and right (of the curved portion 13) on the inner surface in the circumferential direction of the outer elastic member 57 a (the circle in FIG. 11 indicates the inner surface of the outer elastic member 57 a). It shows schematically that it is attached to the place to do. For example, the strain sensor 80a corresponds to the upward position of the bending portion 13 (the same applies to the other sensors 80b to 80d).

The detection signals of the strain sensors 80a to 80d are input to the state detection unit 74B via signal lines 72d to 72g inserted through the insertion unit 8.
For example, when the distal side expansion / contraction part 52a is extended in a state where the bending part 13 is curved, the distal side expansion / contraction part 52a is extended to the front side of the distal end part 12 of the insertion portion 8 along the curved shape. It becomes like this.
For this reason, the state detection unit 74B outputs, to the shape image generation unit 76, data that detects in which direction the distal side expansion / contraction part 52a is bent and extended based on the detection signals of the strain sensors 80a to 80d.
The shape image generation unit 76 generates a corresponding shape image and outputs it to the monitor 5. In the shape display area 5b of the monitor 5, an image of the shape of the extendable unit 11 is displayed.

The monitor 5 in FIG. 11 shows a display example of an image displayed when the distal side expansion / contraction part 52a is expanded in a state where the bending part 13 is further bent downward, for example, from the display state of FIG.
According to the present modification, in addition to the effects of the second embodiment, when the distal side expansion / contraction part 52a is extended, the bending direction can be grasped, so that the operator can easily perform the insertion operation. Therefore, the operability when performing the insertion operation is improved.
Note that embodiments configured by partially combining the above-described embodiments also belong to the present invention.

  This can be used when the distal end side of the insertion portion is inserted into a bent body cavity such as the large intestine for endoscopic examination.

The figure which shows the whole endoscope system structure provided with Example 1 of this invention. The figure which shows the structure of the control system which controls an expansion-contraction unit by supply / exhaust of air. The longitudinal cross-sectional view which shows the structure of the expansion-contraction unit provided in the front end side of the insertion part in the endoscope of Example 1 of this invention. The figure which shows each state which expanded / contracted the balloon of the expansion-contraction unit, and expanded / contracted the front end side expansion-contraction part and the rear end side expansion-contraction part. The figure which shows the 1st operation example in the case of inserting an insertion part in large intestine. The figure which shows the 2nd operation example in the case of inserting an insertion part in large intestine. The figure which shows the 3rd operation example in the case of inserting an insertion part in large intestine. The longitudinal cross-sectional view which shows the structure of the expansion-contraction unit provided in the front end side of the insertion part in the endoscope of a modification. The figure which shows the operation example by a modification. The figure which shows the schematic structure of the principal part in the endoscope system provided with Example 2 of this invention. The figure which shows the structure of the outline of the principal part in the endoscope system provided with the modification of Example 2. FIG. Operation | movement explanatory drawing in the case of inserting in a large intestine with the endoscope of a prior art example.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1, 1B, 1C ... Endoscope system, 2 ... Endoscope, 3 ... 1st control apparatus, 4 ... 2nd control apparatus, 5 ... Monitor, 6 ... Pump, 8 ... Insertion part, 11, 11B ... Telescopic unit, 12 ... distal end portion, 13 ... curved portion, 14 ... flexible portion, 21 ... balloon switch, 25 ... foot switch, 32 ... control unit, 36 ... pressure control unit, 37a-37c ... air tube, 51 ... fixed Member 52a ... front end side elastic part, 52b ... rear end side elastic part, 53 ... front end side guiding member, 54 ... holding member, 55 ... balloon, 56a ... first elastic member, 57a ... first outer elastic member, 58a ... first inner elastic members 56a, 56b ... second elastic member, 57b ... second outer elastic member, 58b ... second inner elastic member, 59a-59c ... hollow part, 71a-71c ... pressure sensor, 76 ... shape image generation unit, 80a- 0d ... strain sensor

Claims (8)

In an endoscope having an elongated insertion portion and a bending portion provided on the distal end side thereof,
A fixing member arranged to be fixed at a predetermined position on the distal end side of the insertion portion;
One end is fixed to the distal end portion of the fixing member, the other end is slidably provided along the longitudinal direction of the insertion portion, and the distal end side expansion / contraction portion is extendable from the fixing member to the distal end side;
One end is fixed to the rear end portion of the fixing member, the other end is slidably provided along the longitudinal direction of the insertion portion, and a rear end side elastic portion that is extendable from the fixing member to the rear end side;
A tip guide member provided at the other end of the tip-side expansion and contraction portion and slidable along the longitudinal direction of the insertion portion;
A radial expansion / contraction part provided at the other end of the rear end side expansion / contraction part and capable of expansion / contraction in a substantially radial direction of the insertion part;
An endoscope comprising:   The drive pipe line which enables each of the front end side stretchable part, the rear end side stretchable part, and the radial expansion / contraction part to be independently and independently operated is provided. The endoscope described.   Further, a sensor for detecting a pressure of a fluid supplied by the driving pipe line is provided in each of the distal side expansion / contraction part, the proximal side expansion / contraction part, and the radial expansion / contraction part. Item 3. The endoscope according to Item 2.   The distal-side expansion / contraction part that connects the distal-end guide member so as to be slidable has flexibility to bend easily, and when extended, the distal-end guide member projects forward from the distal end of the insertion part. The endoscope according to any one of claims 1 to 3.   Furthermore, the said front-end | tip guide member is provided with the 2nd radial expansion / contraction part which can be expanded / contracted in the substantially radial direction of the said insertion part, The claim in any one of Claim 1 to 4 characterized by the above-mentioned. The endoscope according to 1.   Furthermore, the said front end side expansion-contraction part is provided with the sensor which detects the expansion | extension from the contracted state of this front end side expansion / contraction part in the circumferential location in this front end side expansion / contraction part. The endoscope according to any one of the claims. A fixing member that is fixedly arranged at a predetermined position on the distal end side of the insertion portion provided with a bending portion on the distal end side, one end is fixed to the distal end portion of the fixing member, and the other end is in the longitudinal direction of the insertion portion. A distal end side stretchable portion that is slidably movable along the distal end side from the fixing member, one end is fixed to the rear end portion of the fixing member, and the other end is along the longitudinal direction of the insertion portion. A rear end side extendable portion that is slidably movable and is extendable from the fixed member to the rear end side;
Provided at the other end of the distal-side expansion / contraction part, and provided at the other end of the rear-end-side expansion / contraction part, a distal-end guide member that is slidable along the longitudinal direction of the insertion part, An endoscope comprising a radial expansion / contraction portion capable of expansion / contraction in the radial direction;
Fluid can be supplied / sucked independently to the front end side stretchable part, the rear end side stretchable part and the radial expansion / contraction part, and the front end side stretchable part and the rear end side stretchable part A drive unit capable of arbitrarily operating an expansion / contraction operation and an expansion / contraction operation of the radial expansion / contraction member;
An endoscope apparatus comprising:   The endoscope apparatus according to claim 7, further comprising a shape image generation unit configured to generate a schematic shape image of the distal side expansion / contraction part, the proximal side expansion / contraction part, and the radial expansion / contraction part.

Images