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WO2013065509A1 - Instrument insertion tool for use with endoscope - Google Patents

Instrument insertion tool for use with endoscope Download PDF

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Publication number
WO2013065509A1
WO2013065509A1 PCT/JP2012/077145 JP2012077145W WO2013065509A1 WO 2013065509 A1 WO2013065509 A1 WO 2013065509A1 JP 2012077145 W JP2012077145 W JP 2012077145W WO 2013065509 A1 WO2013065509 A1 WO 2013065509A1
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WO
WIPO (PCT)
Prior art keywords
endoscope
tool
treatment
insertion tool
treatment instrument
Prior art date
Application number
PCT/JP2012/077145
Other languages
French (fr)
Japanese (ja)
Inventor
大輔 菊池
義彦 日村
齋藤　浩
Original Assignee
株式会社トップ
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 株式会社トップ filed Critical 株式会社トップ
Priority to JP2013541704A priority Critical patent/JP5993864B2/en
Publication of WO2013065509A1 publication Critical patent/WO2013065509A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064—Constructional details of the endoscope body
    • A61B1/00066—Proximal part of endoscope body, e.g. handles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00147—Holding or positioning arrangements
    • A61B1/00154—Holding or positioning arrangements using guiding arrangements for insertion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments

Definitions

  • the present invention relates to an endoscope treatment instrument insertion tool.
  • Endoscopes are generally equipped with a forceps port, and a treatment tool such as a puncture needle or forceps is inserted through a forceps channel connected to the forceps port while grasping a region to be inspected or treated under the endoscope field of view. By doing so, treatments such as tissue sampling, foreign body extraction, hemostasis, crushed stone, or quarrying can be performed.
  • a treatment tool such as a puncture needle or forceps is inserted through a forceps channel connected to the forceps port while grasping a region to be inspected or treated under the endoscope field of view.
  • treatments such as tissue sampling, foreign body extraction, hemostasis, crushed stone, or quarrying can be performed.
  • the forceps channel is formed inside the endoscope and has a small diameter and a treatment tool that can be inserted is limited, a guide tube having a larger diameter along the axial direction is attached to the outside of the endoscope. A treatment instrument is also inserted through the guide tube.
  • an endoscope is inserted at the site to be treated.
  • the endoscope visual field is once fixed at the site, and then the right hand is released from the flexible portion, and the treatment tool is inserted through the forceps channel or the guide tube.
  • a slit is provided along the axial direction on the outer peripheral surface of the guide tube, and the treatment tool is held and fixed by a clip-shaped auxiliary tool inserted from the slit. What was made is known (refer patent document 1).
  • the conventional endoscope treatment tool insertion tool has a disadvantage in that when adjusting the endoscope visual field, the hand holding the flexible portion must be released in order to operate the clip-shaped auxiliary tool. There is.
  • the present invention eliminates such inconvenience and can fix the treatment tool while holding the flexible portion of the endoscope, and can adjust the endoscope visual field by moving the treatment tool forward and backward. It aims at providing the treatment tool insertion tool for endoscopes.
  • the present invention provides an endoscope that is attached to a guide tube that is attached along the axial direction to the outside of an endoscope and through which the treatment instrument is inserted, and that allows the treatment instrument to be operated in the axial direction.
  • a treatment instrument insertion tool for a mirror a hand operating part that is detachably connected to a proximal end part of the guide tube, a window part formed along an axial direction of the hand operating part, and along the window part And a fixing member that is slidably provided and fixes the treatment instrument.
  • the endoscope treatment tool insertion tool of the present invention fixes the treatment tool by a fixing member provided in the hand operation section. At this time, since the hand operation part is connected to the proximal end part of the guide tube, it can be grasped together with the flexible part of the endoscope. Therefore, according to the endoscope treatment tool insertion tool of the present invention, the treatment tool can be fixed while holding the flexible portion of the endoscope.
  • the treatment tool can be advanced and retracted within the range of the length of the window portion while the treatment tool is fixed. Therefore, according to the endoscope treatment tool insertion tool of the present invention, the endoscope visual field can be adjusted by moving the treatment tool forward and backward while holding the flexible portion of the endoscope.
  • the projection length of the treatment instrument with respect to the endoscope distal end portion is limited, and the treatment instrument is inadvertently projected. Can be prevented.
  • the hand operation unit is detachably attached to the proximal end portion of the guide tube, a guide tube having a different length can be selected according to a site to be examined or treated, or the endoscope It is possible to prevent erroneous insertion into the mouth of the subject together with the soft part.
  • the fixing member includes a first tubular portion through which the treatment tool is inserted and an elastic member pressed against the treatment tool; It is preferable to include a second tubular part through which the treatment tool is inserted and a second fixing tool including a pressure contact part that presses the elastic member against the treatment tool.
  • the second fixing tool is moved in the direction of the first fixing tool along the treatment tool, and the elastic member is pressed against the treatment tool by the pressing member,
  • the treatment tool can be fixed.
  • the first fixing tool and the second fixing tool are integrated by pressing the elastic member against the treatment tool by the pressing member. Therefore, it is possible to easily perform the operation of moving the treatment tool forward and backward by sliding the first and second fixing tools along the window portion.
  • the first fixing tool includes a plurality of elastic members protruding at a predetermined length from an end of the first tubular portion.
  • the second fixing member is disposed on the side of the first fixing member on which the elastic member protrudes, and is gradually contracted along the direction in which the elastic member protrudes on the inner surface side of the second tubular portion. It is preferable to provide a pressure contact portion made of a tapered surface that is diametrical.
  • the pressure contact portion formed of the tapered surface formed on the inner surface side of the second tubular portion is fitted into the elastic member of the second fixture.
  • the elastic member is pressed against the treatment instrument by the pressure contact portion and the diameter of the treatment instrument is within a range that can be inserted into the first and second tubular parts, the diameter of the treatment instrument is not affected.
  • the treatment tool can be fixed.
  • the first fixing tool includes a finger hook portion and the second fixing tool includes a rib protruding outward from the window portion.
  • the hand operation unit includes a mounting member to be mounted on an outer peripheral surface of the endoscope.
  • the hand operating part can be attached to the outer peripheral surface of the endoscope, so that the hand operating part can be easily grasped together with the flexible part of the endoscope.
  • the top view which shows the treatment tool insertion tool for endoscopes of this invention is a side view which shows the treatment tool penetration tool for endoscopes of this invention, (b) And (c) is explanatory sectional drawing which expands and shows a part of (a).
  • (A) is a top view of the treatment tool insertion tool for endoscopes of this invention, (b) is the III-III sectional view taken on the line of (a).
  • the top view which shows the state which hold
  • Explanatory sectional drawing which shows the action
  • the side view which shows one usage method of the treatment tool insertion tool for endoscopes of this invention.
  • the endoscope treatment instrument insertion tool 1 includes a hand operation section 3 that is detachably connected to a proximal end portion of a guide tube 2.
  • the guide tube 2 is inserted with a treatment instrument 4 such as a puncture needle and forceps, and is provided with a detachable hood 5 at the distal end, and the hood 5 is attached to the distal end of the endoscope 6 as shown in FIG. By being fitted to the part, it is attached to the outside of the endoscope 6 along the axial direction.
  • the inner peripheral surface 5a of the hood 5 may be parallel to the outer peripheral surface of the endoscope 6 as shown in FIG. 2 (b), and further taper to the tip as shown in FIG. 2 (c).
  • the guide surface 5b may be provided.
  • the guide surface 5b is reduced in diameter from the proximal end side toward the distal end side so as to become smaller in diameter toward the distal end side.
  • the treatment tool 4 protrudes in parallel to the outer peripheral surface of the endoscope 6 as shown in FIG.
  • the inner peripheral surface 5a of the hood 5 is provided with a tapered guide surface 5b at the distal end of the portion parallel to the outer peripheral surface of the endoscope 6, the treatment instrument 4 is guided by the guide surface 5b. It protrudes toward the center of the endoscope 6. Therefore, when the inner peripheral surface 5a of the hood 5 is provided with the guide surface 5b, the treatment instrument 4 can be made to appear and disappear in a state close to the case of protruding from the forceps opening of the endoscope 6.
  • the hand operation unit 3 includes a window portion 7 formed along the axial direction and a fixing member 8 provided slidably along the window portion 7.
  • the fixing member 8 includes a first fixing tool 9 and a second fixing tool 10.
  • the first fixture 9 includes a finger hook portion 9a outside the window portion 7.
  • the finger hook portion 9a includes a curved portion 9b formed in a streamlined shape toward the left side toward the tip portion, and a concave portion 9c on the top surface. It has a configuration that makes it easy to put a finger on it.
  • the second fixture 10 is disposed on the distal end side of the first fixture 9, and includes an operation portion 10a outside the window portion 7.
  • the operation portion 10a has a rib 10b protruding outward. It has.
  • the hand operation unit 3 includes a pair of mounting members 11 and 12 and is mounted on the outer peripheral surface of the endoscope 6 by the mounting members 11 and 12.
  • the mounting members 11 and 12 have, for example, an arc shape along the outer peripheral surface of the endoscope 6 and are formed by an elastic member that is biased toward the endoscope 6 side.
  • the hand operation unit 3 has a cylindrical shape, includes the window portion 7 on the top surface, an insertion port 13 into which the treatment instrument 4 is inserted at the proximal end portion, and a distal end portion.
  • a connection hole 14 to which the guide tube 2 is connected is provided.
  • the first fixture 9 includes a first tubular portion 9d that is connected to the finger rest portion 9a across the window portion 7.
  • the first tubular portion 9d is inserted with the treatment instrument 4 and is slidable along the axial direction of the treatment instrument 4.
  • a pair of elastic members 9e and 9f pressed against the treatment instrument 4 are provided at the distal end portion of the first tubular portion 9d so as to protrude with a predetermined length in the distal end portion direction.
  • the second fixing tool 10 includes a second tubular portion 10c that is connected to the operation portion 10a across the window portion 7.
  • the treatment instrument 4 is inserted through the second tubular portion 10 c and is slidable along the axial direction of the treatment instrument 4.
  • the inner peripheral surface of the second tubular portion 10c is a tapered surface 10d whose diameter decreases along the direction in which the elastic members 9e and 9f protrude, in other words, from the base end portion toward the tip end portion,
  • the tapered surface 10d forms a pressure contact portion that is fitted to the elastic members 9e and 9f and presses the elastic members 9e and 9f against the treatment instrument 4.
  • the endoscope treatment tool insertion tool 1 When operating the treatment instrument insertion tool 1 for an endoscope, for example, while operating the operation part (not shown) of the endoscope 6 with the left hand, the hand operating part 3 is grasped with the flexible part of the endoscope 6 with the right hand. Then, the endoscope 6 and the guide tube 2 are inserted into the body of the subject. A required treatment instrument 4 is inserted in the guide tube 2 in advance.
  • the hand operation unit 3 is held with the right hand H together with the endoscope 6 (not shown), and the second finger b of the right hand is placed on the bottom surface of the hand operation unit 3.
  • the fourth finger d and the fifth finger e grip the proximal end portion of the hand operation unit 3 together with the endoscope 6.
  • the third finger c holds the first fixture 9 by pressing the concave portion 9c via the curved portion 9b of the finger-hanging portion 9a, and the first finger a operates the rib 10b of the operation portion 10a.
  • the second fixture 10 is moved forward and backward with respect to the first fixture 9.
  • the treatment tool 4 is fixed with the endoscope visual field fixed.
  • the operation for fixing the treatment tool 4 is performed by operating the second fixing tool 10 in the vicinity of the first fixing tool 9 in the hand operation unit 3 as described above.
  • the tapered surface 10 d of the second fixture 10 is fitted into the elastic members 9 e and 9 f of the first fixture 9, and the elastic members 9 e and 9 f are attached to the treatment instrument 4.
  • the first and second fixtures 9 and 10 are integrated while being pressed.
  • the treatment tool 4 can be fixed by the first and second fixing tools 9 and 10 while holding the flexible portion of the endoscope 6.
  • the first and second fixtures 9 and 10 are slidable along the window portion 7, the first and second fixtures 9 and 10 are advanced and retracted along the window portion 7.
  • the treatment tool 4 can be advanced and retracted within the range of the length of the window portion 7 together with the first and second fixing tools 9 and 10.
  • the endoscope visual field can be adjusted while holding the flexible portion of the endoscope 6.
  • the treatment tool 4 is inserted through the guide tube in advance, and the operator can operate the endoscope 6 alone. Does not require personnel. Therefore, labor costs can be saved.
  • the pair of upper and lower elastic members 9e and 9f are provided so as to protrude in the distal end portion direction, but the elastic members 9e and 9f may be provided so as to protrude in the proximal end portion direction.
  • the second fixture 10 is disposed on the distal end side of the first fixture 9, and the tapered surface 10d is formed so as to reduce in diameter from the distal end portion toward the proximal end portion.
  • a larger number of the elastic members may be provided along the outer peripheral surface of the treatment instrument 4.
  • the fixing member 8 is composed of the first and second fixing tools 9 and 10, but instead of this, a clip-like auxiliary tool described in Patent Document 1 may be used. Moreover, it is good also as what fixes the treatment tool 4 penetrated by this ring with the screw which drilled the screw hole in the ring and screwed together to this screw hole.
  • the ring may have a circular shape in cross section, or an arc shape lacking a part of the circular shape.
  • the guide tube 2 is attached to the outside of the endoscope 6 along the axial direction by fitting the hood 5 provided at the distal end portion to the distal end portion of the endoscope 6. It is described as a thing.
  • the endoscope treatment tool insertion tool 1 may be used by inserting the guide tube 2 into the forceps port 6a of the endoscope 6 with the hood 5 removed, as shown in FIG.
  • the hand operating unit 3 is mounted on the outer peripheral surface of the endoscope 6 by the mounting members 11 and 12, and the guide tube 2 is looped and inserted into the forceps port 6a.

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Abstract

Provided is an instrument insertion tool for use with an endoscope, with which, while retaining a flexible part of an endoscope, it is possible to anchor an instrument, and to adjust the endoscope field of view, by extending and retracting the instrument. An instrument insertion tool (1) for use with an endoscope is mounted upon a guide tube (2) which is mounted upon an endoscope (6) along the axial direction and in which an instrument (4) is inserted, said instrument insertion tool (1) allowing manipulating the instrument (4) in the axial direction. The instrument insertion tool for use with the endoscope comprises a hand grip control part (3) which is detachably connected to a base end part of the guide tube (2), a window part (7) which is formed along the axial direction of the hand grip control part (3), and an anchor member (8) which is slidably disposed along the window part (7).

Description

内視鏡用処置具挿通具Endoscope insertion tool
　本発明は、内視鏡用処置具挿通具に関する。 The present invention relates to an endoscope treatment instrument insertion tool.
　内視鏡は一般に鉗子口を備えており、検査又は治療する部位を内視鏡視野下に捉えながら、該鉗子口に連設された鉗子チャンネルを介して穿刺針、鉗子等の処置具を挿入することにより、組織の採取、異物摘出、止血、砕石又は採石等の処置を行うことができる。また、前記鉗子チャンネルは内視鏡内部に形成されるために小径となり挿入できる処置具が限定されることから、内視鏡の外部に軸方向に沿ってより大径のガイドチューブを装着し、該ガイドチューブに処置具を挿通することも行われている。 Endoscopes are generally equipped with a forceps port, and a treatment tool such as a puncture needle or forceps is inserted through a forceps channel connected to the forceps port while grasping a region to be inspected or treated under the endoscope field of view. By doing so, treatments such as tissue sampling, foreign body extraction, hemostasis, crushed stone, or quarrying can be performed. In addition, since the forceps channel is formed inside the endoscope and has a small diameter and a treatment tool that can be inserted is limited, a guide tube having a larger diameter along the axial direction is attached to the outside of the endoscope. A treatment instrument is also inserted through the guide tube.
　内視鏡を操作する際には、例えば、左手で内視鏡の操作部を把持して内視鏡視野（カメラアングル）を調整しながら、右手で内視鏡の軟性部を把持して検査又は治療する部位に内視鏡を挿入する。ここで、前記処置具を使用する場合には、一旦前記部位で内視鏡視野を固定した後、前記軟性部から右手を離し、前記鉗子チャンネル又は前記ガイドチューブを介して該処置具を挿入する。 When operating the endoscope, for example, while holding the operation part of the endoscope with the left hand and adjusting the endoscope field of view (camera angle), hold the flexible part of the endoscope with the right hand for inspection. Alternatively, an endoscope is inserted at the site to be treated. Here, when the treatment tool is used, the endoscope visual field is once fixed at the site, and then the right hand is released from the flexible portion, and the treatment tool is inserted through the forceps channel or the guide tube. .
　ところが、このようにすると、前記軟性部が保持されていないため、体内の蠕動運動等により内視鏡視野がずれてしまうという問題がある。前記問題を解決するために、前記ガイドチューブに予め処置具を挿通しておくと共に、該処置具を所定の位置で固定しておく内視鏡用処置具挿通具が提案されている。 However, in this case, since the soft part is not held, there is a problem that the endoscope visual field is shifted due to peristaltic movement in the body. In order to solve the above problem, there has been proposed an endoscopic treatment instrument insertion tool in which a treatment instrument is inserted in advance into the guide tube and the treatment instrument is fixed at a predetermined position.
　前記内視鏡用処置具挿通具として、例えば、前記ガイドチューブの外周面に軸方向に沿ってスリットを設け、該スリットから挿入されるクリップ状の補助具により前記処置具を保持して固定するようにしたものが知られている（特許文献１参照）。 As the endoscope treatment tool insertion tool, for example, a slit is provided along the axial direction on the outer peripheral surface of the guide tube, and the treatment tool is held and fixed by a clip-shaped auxiliary tool inserted from the slit. What was made is known (refer patent document 1).
特開２０１１－１０６７１号公報JP 2011-10671 A
　しかしながら、前記従来の内視鏡用処置具挿通具は、内視鏡視野を調整するときには、前記クリップ状の補助具を操作するために前記軟性部を保持する手を離さざるを得ないという不都合がある。 However, the conventional endoscope treatment tool insertion tool has a disadvantage in that when adjusting the endoscope visual field, the hand holding the flexible portion must be released in order to operate the clip-shaped auxiliary tool. There is.
　本発明は、かかる不都合を解消して、内視鏡の軟性部を保持しながら、処置具を固定することができると共に、該処置具を進退させて内視鏡視野を調整することができる内視鏡用処置具挿通具を提供することを目的とする。 The present invention eliminates such inconvenience and can fix the treatment tool while holding the flexible portion of the endoscope, and can adjust the endoscope visual field by moving the treatment tool forward and backward. It aims at providing the treatment tool insertion tool for endoscopes.
　かかる目的を達成するために、本発明は、内視鏡の外部に軸方向に沿って装着され処置具が挿通されるガイドチューブに装着されて該処置具を軸方向に操作可能とする内視鏡用処置具挿通具において、該ガイドチューブの基端部に着脱自在に接続される手元操作部と、該手元操作部の軸方向に沿って形成された窓部と、該窓部に沿って摺動自在に設けられ該処置具を固定する固定部材とを備えることを特徴とする。 In order to achieve such an object, the present invention provides an endoscope that is attached to a guide tube that is attached along the axial direction to the outside of an endoscope and through which the treatment instrument is inserted, and that allows the treatment instrument to be operated in the axial direction. In a treatment instrument insertion tool for a mirror, a hand operating part that is detachably connected to a proximal end part of the guide tube, a window part formed along an axial direction of the hand operating part, and along the window part And a fixing member that is slidably provided and fixes the treatment instrument.
　本発明の内視鏡用処置具挿通具は、前記手元操作部に設けられた固定部材により前記処置具を固定する。このとき、前記手元操作部は前記ガイドチューブの基端部に接続されているので、内視鏡の軟性部と共に把持することができる。従って、本発明の内視鏡用処置具挿通具によれば、内視鏡の軟性部を保持しながら、前記処置具を固定することができる。 The endoscope treatment tool insertion tool of the present invention fixes the treatment tool by a fixing member provided in the hand operation section. At this time, since the hand operation part is connected to the proximal end part of the guide tube, it can be grasped together with the flexible part of the endoscope. Therefore, according to the endoscope treatment tool insertion tool of the present invention, the treatment tool can be fixed while holding the flexible portion of the endoscope.
　また、前記固定部材は前記窓部に沿って摺動自在とされているので、前記処置具を固定した状態のまま、該窓部の長さの範囲で該処置具を進退させることができる。従って、本発明の内視鏡用処置具挿通具によれば、内視鏡の軟性部を保持しながら、前記処置具を進退させて内視鏡視野を調節することができる。 In addition, since the fixing member is slidable along the window portion, the treatment tool can be advanced and retracted within the range of the length of the window portion while the treatment tool is fixed. Therefore, according to the endoscope treatment tool insertion tool of the present invention, the endoscope visual field can be adjusted by moving the treatment tool forward and backward while holding the flexible portion of the endoscope.
　また、前記処置具が前記窓部の長さの範囲で進退されることにより、内視鏡先端部に対する該処置具の突出長が限定されることとなり、不用意に該処置具が突出することを防止することができる。 Further, when the treatment instrument is advanced and retracted within the range of the length of the window portion, the projection length of the treatment instrument with respect to the endoscope distal end portion is limited, and the treatment instrument is inadvertently projected. Can be prevented.
　また、前記手元操作部は、前記ガイドチューブの基端部に着脱自在に装着されるので、検査又は治療する部位に応じて長さの異なるガイドチューブを選択することができ、或いは前記内視鏡の軟性部と共に被検者の口部に誤挿入されることを防止することができる。 In addition, since the hand operation unit is detachably attached to the proximal end portion of the guide tube, a guide tube having a different length can be selected according to a site to be examined or treated, or the endoscope It is possible to prevent erroneous insertion into the mouth of the subject together with the soft part.
　本発明の内視鏡用処置具挿通具において、前記固定部材は、前記処置具が挿通される第１の管状部と該処置具に圧接される弾性部材とを備える第１の固定具と、該処置具が挿通される第２の管状部と該弾性部材を該処置具に圧接する圧接部を備える第２の固定具とからなることが好ましい。 In the endoscope treatment tool insertion tool according to the present invention, the fixing member includes a first tubular portion through which the treatment tool is inserted and an elastic member pressed against the treatment tool; It is preferable to include a second tubular part through which the treatment tool is inserted and a second fixing tool including a pressure contact part that presses the elastic member against the treatment tool.
　前記固定部材によれば、前記第２の固定具を前記処置具に沿って前記第１の固定具の方向に移動させ、前記圧接部材により前記弾性部材を該処置具に圧接することにより、該処置具を固定することができる。また、前記固定部材によれば、前記圧接部材により前記弾性部材を前記処置具に圧接することにより、前記第１の固定具と前記第２の固定具とが一体化される。従って、前記第１及び第２の固定具を前記窓部に沿って摺動させて前記処置具を進退させる操作を容易に行うことができる。 According to the fixing member, the second fixing tool is moved in the direction of the first fixing tool along the treatment tool, and the elastic member is pressed against the treatment tool by the pressing member, The treatment tool can be fixed. According to the fixing member, the first fixing tool and the second fixing tool are integrated by pressing the elastic member against the treatment tool by the pressing member. Therefore, it is possible to easily perform the operation of moving the treatment tool forward and backward by sliding the first and second fixing tools along the window portion.
　前記第１及び第２の固定具を備える内視鏡用処置具挿通具において、前記第１の固定具は前記第１の管状部の端部から所定の長さで突出する複数の弾性部材を備え、前記第２の固定具は該第１の固定具の該弾性部材が突出する側に配設され、前記第２の管状部の内面側に該弾性部材が突出する方向に沿って次第に縮径するテーパ面からなる圧接部を備えることが好ましい。 In the endoscope treatment instrument insertion tool including the first and second fixing tools, the first fixing tool includes a plurality of elastic members protruding at a predetermined length from an end of the first tubular portion. The second fixing member is disposed on the side of the first fixing member on which the elastic member protrudes, and is gradually contracted along the direction in which the elastic member protrudes on the inner surface side of the second tubular portion. It is preferable to provide a pressure contact portion made of a tapered surface that is diametrical.
　このとき、前記第２の固定具を前記処置具に沿って前記第１の固定具の方向に移動させると、前記第２の管状部の内面側に形成された前記テーパ面からなる前記圧接部が、前記第２の固定具の前記弾性部材に嵌合される。この結果、前記弾性部材が前記圧接部により前記処置具に圧接され、前記処置具の直径が前記第１及び第２の管状部に挿通可能な範囲であれば、該処置具の直径によらず該処置具を固定することができる。 At this time, when the second fixing tool is moved along the treatment tool in the direction of the first fixing tool, the pressure contact portion formed of the tapered surface formed on the inner surface side of the second tubular portion. Is fitted into the elastic member of the second fixture. As a result, if the elastic member is pressed against the treatment instrument by the pressure contact portion and the diameter of the treatment instrument is within a range that can be inserted into the first and second tubular parts, the diameter of the treatment instrument is not affected. The treatment tool can be fixed.
　また、本発明の内視鏡用処置具挿通具において、第１の固定具は指掛け部を備え、第２の固定具は前記窓部の外方に突出するリブを備えることが好ましい。このようにすることにより、前記手元操作部を把持したときに、１つの指を前記指掛け部に掛けて前記第１の固定具を保持すると共に、他の指で前記リブを操作することにより、前記第２の固定具を容易に移動させることができる。 Moreover, in the endoscope treatment instrument insertion tool of the present invention, it is preferable that the first fixing tool includes a finger hook portion and the second fixing tool includes a rib protruding outward from the window portion. By doing in this way, when holding the hand operation unit, by holding one finger on the finger hanging unit to hold the first fixture, and operating the rib with another finger, The second fixture can be easily moved.
　また、本発明の内視鏡用処置具挿通具において、前記手元操作部は、前記内視鏡の外周面に装着される装着部材を備えることが好ましい。前記装着部材によれば、前記手元操作部を前記内視鏡の外周面に装着することができるので、該手元操作部を前記内視鏡の軟性部と共に容易に把持することができる。 Also, in the endoscope treatment instrument insertion tool of the present invention, it is preferable that the hand operation unit includes a mounting member to be mounted on an outer peripheral surface of the endoscope. According to the mounting member, the hand operating part can be attached to the outer peripheral surface of the endoscope, so that the hand operating part can be easily grasped together with the flexible part of the endoscope.
本発明の内視鏡用処置具挿通具を示す平面図。The top view which shows the treatment tool insertion tool for endoscopes of this invention. （ａ）は本発明の内視鏡用処置具挿通具を示す側面図、（ｂ）及び（ｃ）は（ａ）の一部を拡大して示す説明的断面図。(A) is a side view which shows the treatment tool penetration tool for endoscopes of this invention, (b) And (c) is explanatory sectional drawing which expands and shows a part of (a). （ａ）は本発明の内視鏡用処置具挿通具の平面図、（ｂ）は（ａ）のIII－III線断面図。(A) is a top view of the treatment tool insertion tool for endoscopes of this invention, (b) is the III-III sectional view taken on the line of (a). 本発明の内視鏡用処置具挿通具を把持した状態を示す平面図。The top view which shows the state which hold | gripped the treatment tool insertion tool for endoscopes of this invention. 本発明の内視鏡用処置具挿通具の作動を示す説明的断面図。Explanatory sectional drawing which shows the action | operation of the treatment tool insertion tool for endoscopes of this invention. 本発明の内視鏡用処置具挿通具の一使用方法を示す側面図。The side view which shows one usage method of the treatment tool insertion tool for endoscopes of this invention.
　次に、添付の図面を参照しながら本発明の実施の形態についてさらに詳しく説明する。 Next, embodiments of the present invention will be described in more detail with reference to the accompanying drawings.
　図１に示すように、本実施形態の内視鏡用処置具挿通具１は、ガイドチューブ２の基端部に着脱自在に接続される手元操作部３を備える。ガイドチューブ２は、穿刺針、鉗子等の処置具４が挿通されると共に、先端部に着脱自在のフード５を備え、図２（ａ）に示すように、フード５を内視鏡６の先端部に嵌着することにより、内視鏡６の外部に軸方向に沿って装着される。 As shown in FIG. 1, the endoscope treatment instrument insertion tool 1 according to the present embodiment includes a hand operation section 3 that is detachably connected to a proximal end portion of a guide tube 2. The guide tube 2 is inserted with a treatment instrument 4 such as a puncture needle and forceps, and is provided with a detachable hood 5 at the distal end, and the hood 5 is attached to the distal end of the endoscope 6 as shown in FIG. By being fitted to the part, it is attached to the outside of the endoscope 6 along the axial direction.
　このとき、フード５の内周面５ａは、図２（ｂ）に示すように内視鏡６の外周面に平行であってもよく、さらに図２（ｃ）に示すように先端部にテーパ状のガイド面５ｂを備えていてもよい。ガイド面５ｂは、基端側から先端側に向かって縮径されて、先端側ほど小径になるようにされている。 At this time, the inner peripheral surface 5a of the hood 5 may be parallel to the outer peripheral surface of the endoscope 6 as shown in FIG. 2 (b), and further taper to the tip as shown in FIG. 2 (c). The guide surface 5b may be provided. The guide surface 5b is reduced in diameter from the proximal end side toward the distal end side so as to become smaller in diameter toward the distal end side.
　フード５の内周面５ａが内視鏡６の外周面に平行であるときには、図２（ｂ）に示すように、処置具４は内視鏡６の外周面に平行に突出される。これに対して、フード５の内周面５ａが内視鏡６の外周面に平行な部分の先端部にテーパ状のガイド面５ｂを備えるときには、処置具４はガイド面５ｂに案内されて内視鏡６の中心方向に突出される。従って、ので、フード５の内周面５ａがガイド面５ｂを備えるときには、内視鏡６の鉗子口から突出する場合に近い状態で処置具４を出没させることができる。 When the inner peripheral surface 5 a of the hood 5 is parallel to the outer peripheral surface of the endoscope 6, the treatment tool 4 protrudes in parallel to the outer peripheral surface of the endoscope 6 as shown in FIG. On the other hand, when the inner peripheral surface 5a of the hood 5 is provided with a tapered guide surface 5b at the distal end of the portion parallel to the outer peripheral surface of the endoscope 6, the treatment instrument 4 is guided by the guide surface 5b. It protrudes toward the center of the endoscope 6. Therefore, when the inner peripheral surface 5a of the hood 5 is provided with the guide surface 5b, the treatment instrument 4 can be made to appear and disappear in a state close to the case of protruding from the forceps opening of the endoscope 6.
　手元操作部３は、軸方向に沿って形成された窓部７と、窓部７に沿って摺動自在に設けられた固定部材８とを備えている。固定部材８は、第１の固定具９と、第２の固定具１０とからなる。 The hand operation unit 3 includes a window portion 7 formed along the axial direction and a fixing member 8 provided slidably along the window portion 7. The fixing member 8 includes a first fixing tool 9 and a second fixing tool 10.
　第１の固定具９は窓部７の外部に指掛け部９ａを備えており、指掛け部９ａは先端部に向かって左側方に流線型に形成された湾曲部９ｂを備えると共に、天面に凹部９ｃを備えており、指を掛けやすい構成とされている。また、第２の固定具１０は、第１の固定具９の先端部側に配設され、窓部７の外部に操作部１０ａを備えており、操作部１０ａは外方に突出するリブ１０ｂを備えている。 The first fixture 9 includes a finger hook portion 9a outside the window portion 7. The finger hook portion 9a includes a curved portion 9b formed in a streamlined shape toward the left side toward the tip portion, and a concave portion 9c on the top surface. It has a configuration that makes it easy to put a finger on it. The second fixture 10 is disposed on the distal end side of the first fixture 9, and includes an operation portion 10a outside the window portion 7. The operation portion 10a has a rib 10b protruding outward. It has.
　また、手元操作部３は、１対の装着部材１１，１２を備え、装着部材１１，１２により内視鏡６の外周面に装着される。装着部材１１，１２は、例えば、内視鏡６の外周面に沿う円弧状を備え、内視鏡６側に付勢されている弾性部材により形成される。 Further, the hand operation unit 3 includes a pair of mounting members 11 and 12 and is mounted on the outer peripheral surface of the endoscope 6 by the mounting members 11 and 12. The mounting members 11 and 12 have, for example, an arc shape along the outer peripheral surface of the endoscope 6 and are formed by an elastic member that is biased toward the endoscope 6 side.
　手元操作部３は、図３に示すように円筒状であり、天面に前記窓部７を備えると共に、基端部には処置具４が挿入される挿入口１３を備え、先端部にはガイドチューブ２が接続される接続孔１４を備えている。 As shown in FIG. 3, the hand operation unit 3 has a cylindrical shape, includes the window portion 7 on the top surface, an insertion port 13 into which the treatment instrument 4 is inserted at the proximal end portion, and a distal end portion. A connection hole 14 to which the guide tube 2 is connected is provided.
　前記第１の固定具９は、窓部７を横断して指掛け部９ａに連設される第１の管状部９ｄを備えている。第１の管状部９ｄは処置具４が挿通され、処置具４の軸方向に沿って摺動自在とされている。また、第１の管状部９ｄの先端部には、処置具４に圧接される１対の弾性部材９ｅ，９ｆが先端部方向に所定の長さで突出して設けられている。 The first fixture 9 includes a first tubular portion 9d that is connected to the finger rest portion 9a across the window portion 7. The first tubular portion 9d is inserted with the treatment instrument 4 and is slidable along the axial direction of the treatment instrument 4. In addition, a pair of elastic members 9e and 9f pressed against the treatment instrument 4 are provided at the distal end portion of the first tubular portion 9d so as to protrude with a predetermined length in the distal end portion direction.
　また、前記第２の固定具１０は、窓部７を横断して操作部１０ａに連設される第２の管状部１０ｃを備えている。第２の管状部１０ｃは処置具４が挿通され、処置具４の軸方向に沿って摺動自在とされている。また、第２の管状部１０ｃの内周面は、弾性部材９ｅ，９ｆが突出する方向に沿って、換言すれば基端部から先端部に向かって縮径するテーパ面１０ｄとされており、テーパ面１０ｄにより、弾性部材９ｅ，９ｆに嵌合されて弾性部材９ｅ，９ｆを処置具４に圧接する圧接部が形成されている。 Further, the second fixing tool 10 includes a second tubular portion 10c that is connected to the operation portion 10a across the window portion 7. The treatment instrument 4 is inserted through the second tubular portion 10 c and is slidable along the axial direction of the treatment instrument 4. Further, the inner peripheral surface of the second tubular portion 10c is a tapered surface 10d whose diameter decreases along the direction in which the elastic members 9e and 9f protrude, in other words, from the base end portion toward the tip end portion, The tapered surface 10d forms a pressure contact portion that is fitted to the elastic members 9e and 9f and presses the elastic members 9e and 9f against the treatment instrument 4.
　次に、本実施形態の内視鏡用処置具挿通具１の操作方法について説明する。内視鏡用処置具挿通具１を操作するときには、例えば左手で内視鏡６の操作部（図示せず）を操作しつつ、右手で手元操作部３を内視鏡６の軟性部と共に把持して、被検者の体内に内視鏡６及びガイドチューブ２を挿入する。ガイドチューブ２には、予め所要の処置具４が挿通されている。 Next, an operation method of the endoscope treatment tool insertion tool 1 according to the present embodiment will be described. When operating the treatment instrument insertion tool 1 for an endoscope, for example, while operating the operation part (not shown) of the endoscope 6 with the left hand, the hand operating part 3 is grasped with the flexible part of the endoscope 6 with the right hand. Then, the endoscope 6 and the guide tube 2 are inserted into the body of the subject. A required treatment instrument 4 is inserted in the guide tube 2 in advance.
　このとき、手元操作部３は、図４に示すように、右手Ｈで内視鏡６（図示せず）と共に把持されており、右手の第２指ｂが手元操作部３の底面に副えられ、第４指ｄ及び第５指ｅが手元操作部３の基端部を内視鏡６と共に把持する。そして、第３指ｃが指掛け部９ａの湾曲部９ｂを介して凹部９ｃを押さえることにより第１の固定具９を保持すると共に、第１指ａが操作部１０ａのリブ１０ｂを操作することにより、第２の固定具１０を第１の固定具９に対して進退させる。 At this time, as shown in FIG. 4, the hand operation unit 3 is held with the right hand H together with the endoscope 6 (not shown), and the second finger b of the right hand is placed on the bottom surface of the hand operation unit 3. Then, the fourth finger d and the fifth finger e grip the proximal end portion of the hand operation unit 3 together with the endoscope 6. Then, the third finger c holds the first fixture 9 by pressing the concave portion 9c via the curved portion 9b of the finger-hanging portion 9a, and the first finger a operates the rib 10b of the operation portion 10a. The second fixture 10 is moved forward and backward with respect to the first fixture 9.
　次に、内視鏡６及びガイドチューブ２が、検査又は治療する部位に挿入されたならば、内視鏡視野を固定した状態で、処置具４を固定する。処置具４を固定する操作は、前記のようにして、手元操作部３において第２の固定具１０を第１の固定具９に近接させるように操作することにより行う。 Next, when the endoscope 6 and the guide tube 2 are inserted into a site to be examined or treated, the treatment tool 4 is fixed with the endoscope visual field fixed. The operation for fixing the treatment tool 4 is performed by operating the second fixing tool 10 in the vicinity of the first fixing tool 9 in the hand operation unit 3 as described above.
　このようにすると、図５に示すように、第２の固定具１０のテーパ面１０ｄが第１の固定具９の弾性部材９ｅ，９ｆに嵌合され、弾性部材９ｅ，９ｆを処置具４に圧接すると共に第１及び第２の固定具９，１０が一体化される。この結果、内視鏡６の軟性部を保持しながら、第１及び第２の固定具９，１０により、処置具４を固定することができる。 In this way, as shown in FIG. 5, the tapered surface 10 d of the second fixture 10 is fitted into the elastic members 9 e and 9 f of the first fixture 9, and the elastic members 9 e and 9 f are attached to the treatment instrument 4. The first and second fixtures 9 and 10 are integrated while being pressed. As a result, the treatment tool 4 can be fixed by the first and second fixing tools 9 and 10 while holding the flexible portion of the endoscope 6.
　また、第１及び第２の固定具９，１０は窓部７に沿って摺動自在とされているので、第１及び第２の固定具９，１０を窓部７に沿って進退させることにより、第１及び第２の固定具９，１０と共に処置具４を窓部７の長さの範囲で進退させることができる。この結果、内視鏡６の軟性部を保持しながら、内視鏡視野を調整することができる。 Further, since the first and second fixtures 9 and 10 are slidable along the window portion 7, the first and second fixtures 9 and 10 are advanced and retracted along the window portion 7. Thus, the treatment tool 4 can be advanced and retracted within the range of the length of the window portion 7 together with the first and second fixing tools 9 and 10. As a result, the endoscope visual field can be adjusted while holding the flexible portion of the endoscope 6.
　また、本実施形態の内視鏡用処置具挿通具１によれば、処置具４が予めガイドチューブに挿通されており、術者が単独で内視鏡６を操作することができるので、補助人員を必要としない。従って、人件費を節約することができる。 In addition, according to the endoscope treatment tool insertion tool 1 of the present embodiment, the treatment tool 4 is inserted through the guide tube in advance, and the operator can operate the endoscope 6 alone. Does not require personnel. Therefore, labor costs can be saved.
　尚、本実施形態では、上下１対の弾性部材９ｅ，９ｆが先端部方向に突出して設けられているが、弾性部材９ｅ，９ｆは基端部方向に突出して設けられていてもよい。この場合、第２の固定具１０は第１の固定具９の先端部側に配設されると共に、テーパ面１０ｄは先端部から基端部に向かって縮径するように形成される。また、前記弾性部材は処置具４の外周面に沿ってさらに多数設けられていてもよい。 In the present embodiment, the pair of upper and lower elastic members 9e and 9f are provided so as to protrude in the distal end portion direction, but the elastic members 9e and 9f may be provided so as to protrude in the proximal end portion direction. In this case, the second fixture 10 is disposed on the distal end side of the first fixture 9, and the tapered surface 10d is formed so as to reduce in diameter from the distal end portion toward the proximal end portion. Further, a larger number of the elastic members may be provided along the outer peripheral surface of the treatment instrument 4.
　また、本実施形態では、前記固定部材８を第１及び第２の固定具９，１０からなるものとしているが、これに代えて特許文献１記載のクリップ状の補助具としてもよい。また、リングにネジ孔を穿設し該ネジ孔に螺合したネジにより、該リングに挿通された処置具４を固定するものとしてもよい。前記リングは、断面視円形状であってもよく、円形状の一部を欠いた円弧状であってもよい。 Further, in the present embodiment, the fixing member 8 is composed of the first and second fixing tools 9 and 10, but instead of this, a clip-like auxiliary tool described in Patent Document 1 may be used. Moreover, it is good also as what fixes the treatment tool 4 penetrated by this ring with the screw which drilled the screw hole in the ring and screwed together to this screw hole. The ring may have a circular shape in cross section, or an arc shape lacking a part of the circular shape.
　また、本実施形態では、ガイドチューブ２は、先端部に備えられたフード５を内視鏡６の先端部に嵌着することにより、内視鏡６の外部に軸方向に沿って装着されるものとして説明している。しかし、内視鏡用処置具挿通具１は、図６に示すように、フード５を取り外した状態でガイドチューブ２を内視鏡６の鉗子口６ａに挿入して用いるようにしてもよい。このとき、手元操作部３は装着部材１１，１２により内視鏡６の外周面に装着され、ガイドチューブ２はループ状にされて鉗子口６ａに挿入される。 In the present embodiment, the guide tube 2 is attached to the outside of the endoscope 6 along the axial direction by fitting the hood 5 provided at the distal end portion to the distal end portion of the endoscope 6. It is described as a thing. However, the endoscope treatment tool insertion tool 1 may be used by inserting the guide tube 2 into the forceps port 6a of the endoscope 6 with the hood 5 removed, as shown in FIG. At this time, the hand operating unit 3 is mounted on the outer peripheral surface of the endoscope 6 by the mounting members 11 and 12, and the guide tube 2 is looped and inserted into the forceps port 6a.
　１…内視鏡用処置具挿通具、　２…ガイドチューブ、　３…手元操作部、　４…処置具、　６…内視鏡、　７…窓部、　８…固定部材、　９…第１の固定具、　９ｅ，９ｆ…弾性部材、　１０…第２の固定具、　１０ｄ…テーパ面（圧接部）。 DESCRIPTION OF SYMBOLS 1 ... Endoscope treatment tool insertion tool, 2 ... Guide tube, 3 ... Hand operation part, 4 ... Treatment tool, 6 ... Endoscope, 7 ... Window part, 8 ... Fixing member, 9 ... First fixing tool , 9e, 9f: elastic member, 10: second fixture, 10d: tapered surface (pressure contact portion).

Claims (6)

  1. 　内視鏡の外部に軸方向に沿って装着され処置具が挿通されるガイドチューブに装着されて該処置具を軸方向に操作可能とする内視鏡用処置具挿通具において、
    　該ガイドチューブの基端部に着脱自在に接続される手元操作部と、
    　該手元操作部の軸方向に沿って形成された窓部と、
    　該窓部に沿って摺動自在に設けられ該処置具を固定する固定部材とを備えることを特徴とする内視鏡用処置具挿通具。     In a treatment instrument insertion tool for an endoscope that is attached to a guide tube that is attached to the outside of an endoscope along the axial direction and the treatment instrument is inserted, and the treatment instrument can be operated in the axial direction.
    A hand operating part detachably connected to the proximal end of the guide tube;
    A window portion formed along the axial direction of the hand operation portion;
    An endoscope treatment tool insertion tool, comprising: a fixing member that is slidable along the window portion and fixes the treatment tool.
  2. 　請求項１記載の内視鏡用処置具挿通具において、前記固定部材は、前記処置具が挿通される第１の管状部と該処置具に圧接される弾性部材とを備える第１の固定具と、該処置具が挿通される第２の管状部と該弾性部材を該処置具に圧接する圧接部を備える第２の固定具とからなることを特徴とする内視鏡用処置具挿通具。 The endoscope treatment tool insertion tool according to claim 1, wherein the fixing member includes a first tubular portion through which the treatment tool is inserted and an elastic member pressed against the treatment tool. And a second fixture having a second tubular portion through which the treatment instrument is inserted and a pressure contact portion that presses the elastic member against the treatment instrument. .
  3. 　請求項２記載の内視鏡用処置具挿通具において、前記第１の固定具は前記第１の管状部の端部から所定の長さで突出する複数の弾性部材を備え、前記第２の固定具は該第１の固定具の該弾性部材が突出する側に配設され、前記第２の管状部の内面側に該弾性部材が突出する方向に沿って次第に縮径するテーパ面からなる圧接部を備えることを特徴とする内視鏡用処置具挿通具。 The endoscope treatment instrument insertion tool according to claim 2, wherein the first fixing tool includes a plurality of elastic members projecting at a predetermined length from an end portion of the first tubular portion. The fixing member is disposed on the side of the first fixing member on which the elastic member protrudes, and has a tapered surface that gradually decreases in diameter along the protruding direction of the elastic member on the inner surface side of the second tubular portion. An endoscopic treatment instrument insertion tool comprising a pressure contact portion.
  4. 　請求項１乃至請求項３のいずれか１項記載の内視鏡用処置具挿通具において、第１の固定具は指掛け部を備えることを特徴とする内視鏡用処置具挿通具。 The endoscope treatment tool insertion tool according to any one of claims 1 to 3, wherein the first fixing tool includes a finger hook portion.
  5. 　請求項１乃至請求項４のいずれか１項記載の内視鏡用処置具挿通具において、第２の固定具は前記窓部の外方に突出するリブを備えることを特徴とする内視鏡用処置具挿通具。 The endoscope treatment instrument insertion tool according to any one of claims 1 to 4, wherein the second fixing tool includes a rib projecting outward of the window portion. Treatment tool insertion tool.
  6. 　請求項１乃至請求項６のいずれか１項記載の内視鏡用処置具挿通具において、前記手元操作部は、前記内視鏡の外周面に装着される装着部材を備えることを特徴とする内視鏡用処置具挿通具。 The endoscope treatment instrument insertion tool according to any one of claims 1 to 6, wherein the hand operation unit includes a mounting member that is mounted on an outer peripheral surface of the endoscope. Endoscope treatment tool insertion tool.
PCT/JP2012/077145 2011-11-02 2012-10-19 Instrument insertion tool for use with endoscope WO2013065509A1 (en)

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EP3202345A4 (en) * 2014-09-30 2017-09-20 Fujifilm Corporation Endoscopic surgical device and mantle tube
US10188271B2 (en) 2014-12-10 2019-01-29 Olympus Corporation Assist device and endoscope system
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JP2016146961A (en) * 2015-02-12 2016-08-18 株式会社トップ Assist device for surgical treatment instrument
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CN117122356B (en) * 2023-08-23 2024-04-09 武汉柔内镜医疗科技有限公司 Soft tissue expanding device

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