JP3791790B2 - Endoscope device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope apparatus that includes a treatment instrument insertion channel that includes a treatment instrument insertion channel and guides a treatment instrument that protrudes from an opening of the treatment instrument insertion channel.
[0002]
[Prior art]
Conventionally, an elongated insertion part is inserted into a body cavity to observe an organ in the body cavity, or a lesion site in a body cavity is collected and collected using a treatment tool inserted into a treatment tool insertion channel provided in the insertion part. 2. Description of the Related Art Medical endoscope devices that are excised and diagnosed and treated are widely known.
[0003]
In this endoscope apparatus, a treatment instrument guide having a lumen-like treatment instrument insertion portion built in a distal end portion of an endoscope insertion section to be inserted into a body cavity is remotely operated with a single operation wire, There is an endoscope apparatus having a treatment instrument guide that can swing and guide a distal end of a treatment instrument inserted through a treatment instrument insertion portion (see, for example, Patent Document 1).
[0004]
[Patent Document 1]
Japanese Utility Model Publication No. 51-53789.
[0005]
[Problems to be solved by the invention]
In the endoscope apparatus proposed in Patent Document 1, when the treatment instrument guide is swung and rotated, and the treatment instrument is swung and guided, the treatment instrument guide is swung and rotated to the maximum. The root of the treatment instrument is sandwiched between the rear end opening of the treatment instrument guide and the channel opening of the treatment instrument insertion channel, and the treatment instrument in the maximum swing rotation state of the treatment instrument guide It is in a state where the forward / backward operation cannot be performed.
[0006]
For example, when the incision treatment instrument is swung left and right for incision of a lesion site, the tip of the incision treatment tool is swung in a substantially arc shape around the rocking rotation axis of the treatment tool guide base. In the central portion of the swing range and the left and right portions away from the central portion, the incision position of the lesion site is different, and there are portions that cannot be incised.
[0007]
In such a case, return the swing rotation of the treatment instrument guide table to a place where the incision treatment instrument can advance and retreat, advance and retract the incision treatment instrument, and change the amount of protrusion of the incision treatment instrument from the treatment instrument guide table, Since the incision operation is performed repeatedly by swinging and rotating the treatment instrument guide table again, the operation of the incision procedure is very complicated.
[0008]
Also, when pulling out to replace the treatment tool inserted into the treatment tool guide table, the treatment tool guide table is swung back to the place where the treatment tool can be advanced and retracted, and then pulled out, and a new treatment tool is inserted. In other words, the operation of replacing the treatment instrument is complicated.
[0009]
In order to enable the treatment instrument to be advanced and retracted and exchanged while the treatment instrument guide table is swung, the channel opening of the treatment instrument insertion channel provided at the distal end of the insertion section and the rear end side of the treatment instrument guide table It is necessary to install the position of the treatment tool so that the root of the treatment tool is not pinched. If the channel opening and the rear opening of the treatment tool guide are separated, the tip of the insertion part Miniaturization will be hindered.
[0010]
The present invention has been made in view of the above circumstances, is provided with a treatment instrument guide base in the vicinity of the channel opening of the treatment instrument insertion channel, and is small in size so that the treatment instrument can be easily moved forward and backward. An object of the present invention is to provide an endoscope apparatus with good treatment tool operability.
[0011]
[Means for Solving the Problems]
In the endoscope apparatus of the present invention, the channel opening of the treatment instrument insertion channel provided at the distal end portion of the endoscope insertion portion, and the treatment instrument inserted from the treatment instrument insertion channel into the channel opening penetrate. have a treatment instrument insertion portion of the substantially pipe luminal derived, by being swung induced, and treatment instrument derived table to a treatment instrument led out from the treatment instrument insertion portion inducible remotely swung, the Both the wall surfaces on the opening end surface of the channel opening and the both side portions of the opening on the rear end side of the treatment instrument insertion portion in the treatment instrument guide are formed so as to be able to abut on both wall surfaces on the opening end surface of the channel opening. A swing range restricting means constituted by a contact surface, a channel opening of the treatment instrument insertion channel, a rear end opening of a treatment instrument insertion section of the treatment instrument guide, in real aperture formed, the treated In total swing range of the induction stage, characterized by being formed above the minimum insertion width of the treatment instrument induction stage of the treatment instrument insertion portion.
[0012]
In the endoscope apparatus according to the present invention, the minimum insertion width is equal to or greater than a distal end side opening of the treatment instrument insertion portion of the treatment instrument guide.
[0013]
In addition, a distal end side opening of the treatment instrument insertion portion included in the treatment instrument guide base of the endoscope apparatus of the present invention is narrower than a channel opening of the treatment instrument insertion channel, and after the treatment instrument insertion section. The end opening is formed wider than the channel opening of the treatment instrument insertion channel.
[0014]
In the endoscope apparatus of the present invention, the channel opening portion of the treatment instrument insertion channel and the rear end side opening portion of the treatment instrument guide base can be provided close to each other, and the treatment instrument guide base is rotated to the maximum swing. The treatment tool that is swung on the treatment tool rocking table can be exchanged for forward and backward movement, and the distal end portion of the endoscope insertion portion can be reduced in size, and the operation efficiency of the treatment tool can be realized. The endoscopic treatment time can be shortened.
[0015]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. First, an embodiment of an endoscope apparatus according to the present invention will be described with reference to FIGS.
[0016]
FIG. 1 is a front view showing a configuration of a distal end portion of an endoscope insertion portion of an embodiment of an endoscope apparatus according to the present invention, and FIG. 2 is an endoscope of an embodiment of an endoscope apparatus according to the present invention. FIG. 3 is a perspective view showing a second treatment instrument guide table of an embodiment of an endoscope apparatus according to the present invention, and FIG. 4 is an internal view according to the present invention. FIG. 5 is a bottom view showing a second treatment instrument guide table according to an embodiment of the mirror device, and FIG. 5 shows a second treatment provided at the distal end portion of the endoscope insertion portion according to the embodiment of the endoscope device according to the present invention. Sectional drawing which shows the structure of an instrument guide stand, FIG. 6 is explanatory drawing explaining the operation state of the 1st and 2nd treatment instrument in one Embodiment of the endoscope apparatus which concerns on this invention, FIG. 7 concerns on this invention It is explanatory drawing explaining the endoscope treatment operation by an endoscope apparatus.
[0017]
Although not shown in the drawings, the endoscope apparatus of the present invention includes an elongated flexible insertion portion that is inserted into a body cavity, and an operation portion provided at the proximal end of the insertion portion, and the insertion portion has a distal end. It is composed of a distal end portion, a bending portion, and a flexible tube portion in order from the side, and an operation portion is provided at the proximal end of the flexible tube portion. The operation portion includes a bending operation mechanism that operates the bending portion, a treatment instrument insertion hole, It is composed of a treatment instrument raising operation mechanism, a universal cord incorporating a light guide and a signal cable, and the like.
[0018]
As shown in FIG. 1, the distal end portion 1 of the endoscope insertion portion of the endoscope apparatus is provided with an observation window 3 at a substantially central portion in front of the distal end portion 1. The observation window 3 is provided with an observation optical system 11 including an objective lens and a solid-state imaging device that converts an observation region image from the objective lens into an imaging signal.
[0019]
Two illumination windows 4 are provided at oblique positions in the figure with the observation window 3 interposed therebetween. The illumination window 4 is provided with an illumination optical system 13 including an illumination lens and a light guide fiber for guiding illumination light.
[0020]
An air / water supply nozzle 5 that sprays cleaning water onto the observation window 3 to clean the objective lens, or supplies air into the objective lens and the body cavity, and water can be supplied to the distal end portion 1 in the observation direction. A forward water supply port 6, a first treatment instrument guide 14, and a second treatment instrument guide 15 are provided.
[0021]
The first treatment instrument guide 14 is provided on the left side of the observation window 3 in the drawing, and is an endoscope that is remotely operated from an operation unit (not shown) by a first operation wire 18 and is observed by an operator. The image is swung in a substantially vertical direction. The second treatment instrument swinging table 15 is provided on the lower side of the observation window 3 in the figure, and is remotely operated from the operation unit by the two operation wires of the second operation wire 24 and the third operation wire 25. Thus, the endoscope image is swung in the substantially left-right direction.
[0022]
Note that the direction indicated by the arrow P in FIG. 1 indicates the substantially upward direction of the endoscopic image. That is, based on the imaging signal of the observation site imaged and generated by the solid-state imaging device constituting the observation optical system 11 of the observation window 3, the upward direction of the screen of the endoscopic image displayed on the reproduction display monitor is the arrow P direction. is there.
[0023]
The first treatment instrument guide 14 has an opening that is open from the front side to the side of the tip 1, and the second treatment tool guide 15 is an opening that is opened only on the front of the tip 1. Has a part. Note that the opening of the second treatment instrument guide 15 may be opened from the front to the side of the distal end portion 1 in the same manner as the opening of the first treatment tool guide 14.
[0024]
As shown in FIG. 1, one of the illumination windows 4 is disposed on the right side substantially at the position where the observation window 3 and the air / water noise 5 are disposed, and the other of the illumination windows 4 is the first window. It arrange | positions in the diagonally downward direction in the figure between the treatment tool guide 14 and the 2nd treatment tool guide 15. Further, the forward water supply port 6 is disposed on the substantially right side between the observation window 3 and the second treatment instrument guide 15.
[0025]
The distal end portion 1 of the endoscope insertion portion is covered with an electrically insulating cover 12, and the observation window 3, the illumination window 4, the air / water supply nozzle 5, the front water supply port 6, and the first treatment instrument guide table. 14 and the portion where the second treatment instrument guide 15 is disposed are open to the minimum necessary.
[0026]
The first treatment instrument guide 14 shown in FIG. 1 is in a completely inverted state, and the second treatment instrument guide 15 is in a state in which the neutral treatment instrument protrudes straight from the treatment instrument guide. Show.
[0027]
The internal configuration of the first treatment instrument guide 14 and the second treatment tool guide 15 at the distal end portion 1 will be described with reference to FIG. 2 is a longitudinal section of the distal end portion 1 of the endoscope insertion portion taken along the line AA ′ shown in FIG. 1 and viewed from the arrow direction.
[0028]
The distal end portion 1 includes a first channel opening 8 of the first treatment instrument insertion channel 7 and a second channel opening 10 of the second treatment instrument insertion channel 9 incorporated in the insertion portion. The first treatment instrument guide 14 is provided in the vicinity of the distal end side of the first channel opening 8, and the second treatment instrument guide is provided in the vicinity of the distal end side of the second channel opening 10. A table 15 is provided.
[0029]
The proximal side of the first treatment instrument insertion channel 7 and the second treatment instrument insertion channel 9 has a first treatment instrument insertion hole and a second treatment provided on the outer surface of the operation unit (not shown). It communicates with the tool insertion hole. That is, the treatment instrument inserted through the first and second treatment instrument insertion holes of the operation unit is inserted through the first and second treatment instrument insertion channels 7 and 9 to thereby open the first and second channel openings. The parts 8 and 10 are led out to the first and second treatment instrument guides 14 and 15.
[0030]
The first treatment instrument guide 14 and the second treatment instrument guide 15 are rotatably attached to the distal end component 2 by a first rotating shaft 16 and a second rotating shaft 22, respectively. In addition, the 1st treatment tool guide table 14 shown as a continuous line in the figure has shown the complete inverted state, and 1st treatment tool guide table 14 'shown with a dashed-two dotted line has shown the raising maximum state.
[0031]
The first treatment tool 26 protruding from the first treatment tool guide 14 is moved from the field of view of the endoscope observation range to the field of view and from the field of view to the field of view as indicated by a two-dot chain line in the figure. Swing is guided in a substantially vertical direction.
[0032]
The protrusion distance L from the distal end surface 43 of the distal end portion 1 to the distal end of the first treatment instrument 26 when the distal end of the first treatment instrument 26 is guided to swing out of the field of view is, for example, that of observation and treatment It is about 10 mm to 20 mm which is easy to do.
[0033]
On the other hand, the second treatment instrument guide 15 swings the second treatment instrument 27 indicated by a two-dot chain line in the drawing in the left-right direction (the front and back direction of the drawing in FIG. 2) within the field of view of the endoscope observation range. Induce.
[0034]
The distal end of the first operation wire 18 is provided on the first treatment instrument guide 14, and the second operation wire 24 and the third operation wire 25 (not shown) are provided on the second treatment instrument guide 15. The distal ends of the first operation wire 18, the second operation wire 24, and the third operation wire 25 are inserted through the insertion portion and guided to the treatment instrument. It is connected to a table operating mechanism and remotely operated by the treatment instrument guide table operating mechanism.
[0035]
The second rotating shaft 22 is inserted from the outer peripheral direction of the tip constituting portion 2 and is prevented from being detached by the electrically insulating cover 12.
[0036]
Next, the external configuration of the second treatment instrument guide 15 will be described with reference to FIG. The entire shape of the second treatment instrument guide 15 is a cylindrical body with a partial arc portion on the hand side cut away, and the second treatment tool 27 is inserted and penetrated in a diametrical direction from the side face where the arc is cut off. A treatment instrument insertion portion 28 is formed. A second rotation shaft hole 21 into which the second rotation shaft 22 is inserted is formed at the center of the lower surface 31 of the second treatment instrument guide 15.
[0037]
The upper treatment surface 15 and the lower surface 31 of the second treatment instrument guide table 15 have notch surfaces provided in different directions, and the second operation wire 24 and the third operation are provided on the notch surfaces. Each tip of the wire 25 is rotatably attached via wire terminal members 29a and 29b.
[0038]
That is, when the first operation wire 24 and the second operation wire 25 are operated, the first operation wire 24 and the second operation wire 25 are rotated in the left-right direction in the drawing around the first rotation shaft hole 21. The second treatment instrument guide 15 may be rotated by a single operation wire in addition to the above-described two operation wires (second and third operation wires 24 and 25). .
[0039]
Two surfaces of the upper surface 30 and the lower surface 31 of the second treatment instrument swing base 15 are slid with the distal end component 2 as sliding surfaces, and the areas of the upper surface 30 and the lower surface 31 are substantially the same. Are the same. The material forming the second treatment instrument guide 15 is not specified, but a metal material such as stainless steel or an electrically insulating member such as ceramic is desirable.
[0040]
As described above, the treatment instrument insertion portion 28 provided in the second treatment instrument guide base 15 is inserted with the second treatment instrument 27, and the distal end side opening 32 of the treatment instrument insertion section 28 is inserted. The rear end opening 33 is substantially oval in shape, and the front end opening 32 and the rear end opening 33 are formed with a smooth continuous surface, The target shape is substantially funnel-shaped.
[0041]
The mounting position relationship between the second operation wire 24 and the third operation wire 25 on the second treatment instrument guide 15 having such a configuration will be described with reference to FIG. FIG. 4 is a bottom view of the second treatment instrument guide 15 viewed from the direction of arrow Q shown in FIG.
[0042]
The wire terminal members 29a and 29b to which the ends of the second operation wire 24 and the third operation wire 25 are attached to the second treatment instrument guide 15 are distances M on the distal end side from the second rotation shaft hole 21. It is provided in the position.
[0043]
The ends of the second and third operation wires 24 and 25 are soldered or brazed to the wire terminal members 29a and 29b, respectively. Solder that penetrates the ends of the second and third operation wires 24 and 25 soldered to the wire terminal members 29a and 29b or silver brazing, or the penetration length of silver solder (the hatched portion in the figure) ) Is a position of a distance N from the end surface where the rear end opening 33 in the longitudinal direction of the treatment instrument insertion portion 28 of the second treatment instrument guide 15 is provided toward the second rotation shaft hole 21. Like that.
[0044]
An attachment configuration of the second treatment instrument guide 15 having such a configuration to the distal end portion 1 will be described with reference to FIG. FIG. 5 is a cross-sectional view taken along the line BB shown in FIG.
[0045]
The second treatment instrument guide 15 is provided in the vicinity of the distal end side of the second channel opening 10 of the second treatment instrument insertion channel 9 and is rotatably attached to the second rotation shaft 22. The ends of the second and third operation wires 24 and 25 are attached by wire terminal members 29a and 29b.
[0046]
When the second operation wire 24 and the third operation wire 25 are pulled, the second treatment instrument guide 15 is swung right and left about the second rotation axis center 41. The second rotation axis center 41 and the visual field center substantially coincide with each other.
[0047]
In the left / right rotation restriction of the second treatment instrument guide 15, the A surface of the distal component 2 in the figure and the rear end B surface of the second treatment tool guide 15 that has been cut off from the arc portion are abutted. Thus, the rotation can be restricted in both the left and right directions. That is, the rotation is restricted by the tip constituent portion 2 on both sides of the opening across the second channel opening 10.
[0048]
Further, the second operation wire 24 and the third operation wire 25 are such that the second treatment instrument guide 15 is in a neutral state (a treatment in which the treatment instrument insertion portion 28 of the second treatment instrument guide 15 is inserted and protruded). Even when the tool 27 is in a straight state), tension is applied to each of the tools 27 and the tools 27 are tensioned and are remotely operated by a guide table operating mechanism of an operating unit (not shown).
[0049]
The width E (diameter) of the distal end side opening 32 of the treatment instrument insertion portion 28 of the second treatment instrument guide 15 is equal to the width F (the longer oval side) of the rear end opening 33 of the treatment instrument insertion section 28. The width F of the rear end side opening 33 of the treatment instrument insertion portion 28 is smaller than the width G (diameter) of the second channel opening 10. Is also formed to be wide (F> G). That is, the relationship between the widths E and F of the distal end side opening 32 and the rear end side opening 33 of the treatment instrument insertion portion 28 and the width G of the second channel opening 10 is such that E <G <F. Is formed.
[0050]
The second treatment instrument 27 inserted from the second treatment instrument insertion hole of the operation section is inserted through the second treatment instrument insertion channel 9 to form the second channel opening 10 and the second treatment instrument. Through the rear end opening 33 of the treatment instrument insertion portion 28 of the guide table 15 and the distal end side opening 32 of the treatment instrument insertion portion 28 of the second treatment instrument guide table 15 to the front outside of the distal end surface 34 of the distal end portion 1. Protruding.
[0051]
As shown in the figure, the second treatment instrument 27 is swing-guided substantially in the left-right direction by the second treatment instrument guide 15 within a range that does not exceed the field of view of the observation range.
[0052]
The second treatment instrument 27 shown by the solid line in FIG. 5 shows a state in which maximum swinging is induced to the left side of the endoscopic image reproduced and displayed based on the imaging signal generated by the observation optical system 11. The second treatment instrument 27 ′ indicated by a two-dot chain line in the drawing shows a state in which maximum swinging is induced on the right side of the endoscopic image.
[0053]
As described above, the second treatment instrument guide 15 is formed by the rear end side opening 33 and the second channel opening 10 in the state where the second treatment instrument guide 15 is maximally swung to the left. The width H of the substantial opening 44 is set such that the relationship H ≧ E is equal to or greater than the width E of the distal end side opening 32 of the treatment instrument insertion portion 28.
[0054]
That is, when the second treatment instrument guide 15 is in the maximum swing guidance state, the insertion portion side surface 45 that is continuous from the rear end side opening 33 to the distal end side opening 32 of the treatment instrument insertion portion 28; The second channel opening 10 is formed so as to be substantially parallel to the opening side surface 46.
[0055]
That is, from the rear end side opening 33 of the treatment instrument insertion portion 28 in the state in which the second treatment instrument guide base 15 is maximally swung to the left or right, the insertion portion side face 45 and the second channel opening 10. Since the opening side surface 46 of the second treatment instrument is in a substantially parallel state, the second treatment instrument insertion channel 9 is inserted from the second treatment instrument insertion channel 9 into the second channel opening 10, and the treatment instrument insertion table 15 is inserted into the treatment instrument guide table 15. There is no pinching of the root portion of the second treatment instrument 27 that is inserted and projected from the rear end side opening 33 of the portion 28 to the front end side opening 32, and advance and retreat insertion in the longitudinal direction can be performed, and Even when the second treatment instrument 27 is replaced, the opening side surface 46 of the second channel opening 10 and the insertion part of the rear end side opening 33 of the second treatment instrument guide 15 in the maximum swing guiding state. Since the side surface 45 is substantially parallel, insertion is easy.
[0056]
In the endoscope apparatus having such a configuration, the image is reproduced and displayed on the monitor screen based on the imaging signal generated by the solid-state imaging device constituting the observation optical system 11 provided in the observation window 3 of the distal end portion 1. A first treatment tool 26 that is swing-guided by the first treatment tool guide 14 displayed in the endoscopic image, and a second treatment tool 27 that is swing-guided by the second treatment tool guide 15. Will be described with reference to FIG.
[0057]
An octagonal frame in the figure is the imaging screen range, and is a field frame that is the observation field range. The inside of the field frame is in the observation field and the outside of the field frame is outside the field of view.
[0058]
The distal end of the first treatment instrument 26 is moved in the vertical direction of the visual field by the first treatment instrument guide 14 and is guided to swing from the visual field to the outside of the visual field and from the outside of the visual field to the visual field. That is, the first treatment instrument 26 in the completely inverted state within the visual field indicated by the solid line in the figure and the first treatment instrument 26 ′ in the maximum raised state outside the visual field indicated by the two-dot chain line in the figure are swung. Be guided.
[0059]
The distal end of the second treatment instrument 27 is moved in the left-right direction of the visual field by the second treatment instrument guide 15 and is guided to swing without exceeding the visual field. That is, the second treatment instrument 27 indicated by a solid line in the drawing is the second treatment instrument guide base 15 in which the second treatment instrument guide base 15 is in the neutral state and the second treatment instrument 27 ′ indicated by a two-dot chain line is the second treatment instrument guide base 15. In this state, it is swung to the left or right.
[0060]
The visual field shape that is the imaging screen range is not limited to the octagon, but may be a quadrangle or a circle.
[0061]
An arrow I in FIG. 5 showing this imaging screen indicates how the water supplied from the front water supply port 6 enters and looks in the visual field, and the water is fed toward the approximate center of the visual field.
[0062]
Further, as shown by an arrow J in the drawing, the tip locus of the second treatment instrument 27 curves upward or downward from the central portion equally divided between the left and right sides to both periphery, in addition to the substantially straight line. It may be a curved line.
[0063]
A treatment operation for a diseased mucous membrane in a body cavity using the endoscope apparatus of the present invention described above will be described with reference to FIG.
[0064]
The aforementioned insertion part 34 of the endoscope apparatus of the present invention is inserted into a body cavity while viewing an endoscope image imaged and generated by a solid-state imaging device provided at the distal end of the insertion part 34. When the insertion section 34 reaches the vicinity of the lesion mucosa, a treatment instrument having an injection needle is inserted into the second treatment instrument insertion channel 9 of the insertion section 34 of the endoscope, and physiological saline or the like is placed under the lesion mucosa. Injecting the drug solution raises the mucosal layer including the lesioned mucosa.
[0065]
Next, as shown by the dotted line in FIG. 7, the lesioned mucous membrane or its periphery is gripped by using the grasping forceps 35 that is the first treatment tool 26 protruding from the first treatment tool insertion channel 7. When the diseased mucosa is grasped by the grasping forceps 35, as shown by a solid line in the figure, the grasping forceps 35 is guided to swing up and down by the first treatment instrument guide 14 to lift the mucosa including the diseased mucosa. With this grasping forceps 35, the tip of the grasping forceps 35 when the lesioned mucosa is lifted can be guided to swing out of the field of view of the endoscopic image.
[0066]
In this way, when the lesioned mucosa grasped by the grasping forceps 35 is lifted by the swinging up of the first treatment instrument swinging table 14, the injection needle is inserted into the second treatment instrument insertion channel 9. Instead of the provided forceps, an incision forceps 36 that is the second treatment tool 27 is inserted, and the second treatment tool guide 15 is guided to swing and swung left and right at the mucosal fold or the submucosal layer. Open the incision.
[0067]
When the second treatment instrument guide 15 is maximally guided to the left or right, as described with reference to FIG. 5, the rear end opening of the treatment instrument insertion portion 28 of the second treatment instrument guide 15. 33 and the width H of the substantial opening 44 formed by the second channel opening 10 is set to be equal to or larger than the width E of the distal end side opening 32, so that the second treatment instrument guide 15 is Even in a state where the maximum swinging is induced in the left or right direction, the incision forceps 36 as the second treatment instrument 27 can be advanced and retracted by pushing and pulling on the proximal side.
[0068]
That is, the second treatment instrument 27 such as the incision forceps 36 is sandwiched between the second treatment instrument guidance table 15 and the second channel opening 10 in the entire range of the swing guidance of the second treatment instrument guidance table 15. Without moving forward and backward, you can move forward and backward freely.
[0069]
Further, when replacing the incision forceps 36 with another forceps, for example, a hemostatic forceps, the second treatment instrument guide 15 can be exchanged with the hemostatic forceps in the state where the incision forceps 36 swings. .
[0070]
The operation of swinging the incision forceps 36 all the way to the left and right by the second treatment tool guide table 22 and the treatment tool replacement operation are always displayed in the field of view of the endoscopic image, and the treatment of the second treatment tool 27 is performed. Operation can be monitored constantly.
[0071]
Next, another embodiment of the endoscope apparatus according to the present invention will be described with reference to FIG. An endoscope apparatus according to another embodiment includes a distal end side opening portion 32 and a rear end side opening portion 33 of the treatment instrument insertion portion 28 provided in the second treatment instrument guide 15 provided in the distal end portion 1. The cross-sectional shape is different from the above-described embodiment, and other parts are the same.
[0072]
FIG. 8 is a front view of the second treatment instrument guide 15 in the neutral state as viewed from the second channel opening 10 from the distal end side.
[0073]
The shape of the distal end side opening portion 32 of the treatment instrument insertion portion 28 is rectangular, and is a shape in which arcs are formed at four corners of the rectangle, and the width E and the width S are in a relationship of E ≦ S. The width G (diameter) of the second channel opening 10 is formed so that the relation of G≈S is substantially equal to the vertical width S.
[0074]
Furthermore, the short diameter portion of the rear end side opening 33 of the treatment instrument insertion portion 28 is formed to be smaller than the vertical width S of the distal end side opening 32.
[0075]
In this way, the distal end side opening 32 and the rear end side opening 33 of the treatment instrument insertion portion 28 of the second treatment instrument guide 15 can be changed, and the operation of the treatment instrument is the same as that of the above-described embodiment. Is possible.
[0076]
As described above, in the endoscope apparatus of the present invention, the second treatment instrument guiding table is provided in the vicinity of the second channel opening, and the second treatment tool guiding table is maximally shaken in either the left or right direction. Even when the movement is guided, the treatment instrument insertion portion has a substantial opening width formed by the rear end opening width of the treatment instrument insertion portion provided on the second treatment instrument guide and the second channel opening width. Because it is more than the width of the distal end opening of the treatment tool, there is no pinching of the root part of the treatment tool, and the advancement / retraction operation and replacement operation of the treatment tool can be performed easily and quickly, and the distal end of the endoscope insertion part can be downsized. Is possible.
[0077]
Further, by making the width of the distal end side opening of the treatment instrument insertion portion narrower than the width of the second channel opening, it is possible to reduce the backlash of the second treatment instrument inserted into the treatment instrument insertion portion, A reliable incision work can be performed.
[0078]
Furthermore, in the maximum guiding state, the side surface of the insertion part forming the rear end side opening of the second treatment instrument guiding table and the side surface of the opening of the second channel opening are substantially parallel to each other. Even when swinging is guided, the treatment tool can be smoothly advanced and retracted with light power without being caught.
[0079]
Furthermore, since the rotation restriction of the second treatment instrument guide is integrally formed at both ends of the opening of the second channel opening by the tip component part, the sliding surface of the second treatment tool guide is provided. Since the upper and lower surfaces, which are the sliding surfaces of the second treatment instrument guide table, are set to have substantially the same area, the rotation of the treatment instrument guide table is small. It is possible to prevent tilting and smooth movement.
[0080]
In addition, the length of the solder or silver solder soaking from the wire terminal member is positioned on the inner side of the end surface with the rear end side opening of the treatment instrument insertion portion of the second treatment instrument guide, so that the hard portion Bending stress is not easily applied and durability can be improved.
[0081]
[Appendix]
According to the embodiment of the present invention described in detail above, the following configuration can be obtained.
[0082]
(Appendix 1)
A substantially luminal treatment through which a channel opening of a treatment instrument insertion channel provided at the distal end of the endoscope insertion portion and a treatment instrument inserted through the channel opening from the treatment instrument insertion channel are led out. In an endoscopic apparatus capable of guiding a treatment tool derived from the treatment tool insertion portion by swinging and guiding the treatment tool guide base having a treatment tool insertion portion and remote treatment of the treatment tool derived from the treatment tool insertion portion,
The substantial opening formed by the channel opening of the treatment instrument insertion channel and the rear end side opening of the treatment instrument insertion section of the treatment instrument guide is within the entire swing guidance range of the treatment instrument guide. An endoscope apparatus, wherein the endoscope apparatus is formed to have a width greater than a minimum insertion width of a treatment instrument insertion portion of the treatment instrument guide.
[0083]
(Appendix 2)
The endoscope apparatus according to claim 1, wherein the minimum insertion width is equal to or greater than a distal end side opening of the treatment instrument insertion portion of the treatment instrument guide.
[0084]
(Appendix 3)
The distal end side opening of the treatment instrument insertion portion of the treatment instrument guide is narrower than the channel opening of the treatment instrument insertion channel, and the rear end opening of the treatment instrument insertion section is for inserting the treatment instrument. The endoscope according to appendix 1, wherein the endoscope is formed wider than the channel opening of the channel.
[0085]
(Appendix 4)
A channel opening of a treatment instrument insertion channel provided at the distal end portion of the endoscope insertion portion, and a treatment instrument provided in the channel opening and inserted into the channel opening from the treatment instrument insertion channel is derived. A treatment instrument guiding table having a substantially luminal treatment instrument insertion portion, and an endoscope capable of swinging and guiding the treatment instrument guide table and remotely guiding the treatment instrument derived from the treatment instrument insertion portion In the device
The substantial opening width formed by the channel opening width of the treatment instrument insertion channel and the rear end opening width of the treatment instrument insertion portion of the treatment instrument guide located on the channel opening side is the treatment width. The treatment instrument guide table is formed to have a width greater than or equal to the minimum insertion width of the treatment instrument insertion portion of the treatment instrument guide table in the entire swing guidance range of the instrument guide table, and the treatment tool of the treatment instrument guide table is driven at the maximum swing drive. An endoscope apparatus characterized in that a side surface of a rear end side opening of the insertion portion is formed to be substantially parallel to a side surface of a channel opening portion of the treatment instrument insertion channel.
[0086]
(Appendix 5)
The endoscope apparatus according to appendix 4, wherein the minimum insertion width is equal to or greater than a distal end side opening of a treatment instrument insertion portion of a treatment instrument guide provided in the channel opening.
[0087]
(Appendix 6)
The distal end side opening of the treatment instrument insertion portion of the treatment instrument guide is narrower than the channel opening of the treatment instrument insertion channel, and the rear end opening of the treatment instrument insertion section is for inserting the treatment instrument. The endoscope according to appendix 4, wherein the endoscope is formed wider than the channel opening of the channel.
[0088]
(Appendix 7)
The endoscope apparatus according to any one of appendix 1 and appendix 4, wherein the proximal end surface of the treatment instrument guide is controlled to swing by contacting both sides of the opening of the channel opening. .
[0089]
(Appendix 8)
An operation wire terminal for swinging the treatment instrument guide is connected to an operation wire terminal member rotatably provided from the center of the treatment instrument guide to the distal end side. The leaching length of solder or silver solder on the attached operation wire is set to the inner side from the end surface of the rear end side opening of the treatment instrument guide base. Endoscopic device.
[0090]
【The invention's effect】
In the endoscope apparatus of the present invention, a treatment instrument guide is provided at the distal end of the endoscope insertion portion in the vicinity of the opening of the treatment instrument insertion channel, and the treatment instrument is driven to swing maximum by the treatment instrument guide. Even if the treatment tool is used, it is possible to form a miniaturized tip portion that can be easily advanced and retracted in the longitudinal direction of the treatment tool without being caught, and that the treatment tool can be replaced quickly.
[0091]
Thereby, the operation efficiency of the endoscopic treatment is improved, and the burden on the operator and the patient is reduced.
[Brief description of the drawings]
FIG. 1 is a front view showing a configuration of a distal end portion of an endoscope insertion portion of an embodiment of an endoscope apparatus according to the present invention.
FIG. 2 is a cross-sectional view showing an internal configuration of a distal end portion of an endoscope insertion portion of an embodiment of an endoscope apparatus according to the present invention.
FIG. 3 is a perspective view showing a second treatment instrument guiding table of an embodiment of the endoscope apparatus according to the present invention.
FIG. 4 is a bottom view showing a second treatment instrument guiding table of an embodiment of the endoscope apparatus according to the present invention.
FIG. 5 is a cross-sectional view showing a configuration of a second treatment instrument guide provided at the distal end portion of an endoscope insertion portion of an embodiment of an endoscope apparatus according to the present invention.
FIG. 6 is an explanatory diagram for explaining an operation state of the first and second treatment tools in the embodiment of the endoscope apparatus according to the present invention.
FIG. 7 is an explanatory diagram for explaining an endoscope treatment operation by the endoscope apparatus according to the present invention.
FIG. 8 is a front view showing a configuration of a second treatment instrument guiding table of another embodiment of the endoscope apparatus according to the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Tip part 2 ... Tip structure part 3 ... Observation window 7 ... 1st treatment tool penetration channel 8 ... 1st channel opening part 9 ... 2nd treatment tool penetration channel 10 ... 2nd channel opening part 14 ... 1st 1 treatment instrument guide 15 ... second treatment instrument guide 26 ... first treatment instrument 27 ... second treatment instrument 28 ... treatment instrument insertion part 32 ... distal end side opening 33 ... rear end side opening 44 ... substantial opening 45 ... insertion part side face 46 ... opening part side face

Claims (3)

A channel opening of a treatment instrument insertion channel provided at the distal end of the endoscope insertion portion;
By inserted through treatment tool to the channel opening from the treatment instrument insertion channel have a treatment instrument insertion portion of the substantially pipe luminal penetratingly derived, is swung derived, are derived from the treatment instrument insertion portion A treatment instrument guide that enables remote swing guidance of the treatment instrument,
Formed so as to be able to abut both wall surfaces on the opening end surface of the channel opening and both wall surfaces on the opening end surface of the channel opening on both sides of the opening on the rear end side of the treatment instrument insertion portion in the treatment instrument guide. An abutting surface formed, and a swing range regulating means comprising:
With
And the channel opening of the treatment instrument insertion channel, a rear end opening of the treatment instrument induction stage of the treatment instrument insertion portion, in the substantial opening formed in the entire swinging range of the treatment instrument induction stage, An endoscope apparatus, wherein the endoscope apparatus is formed to have a width greater than a minimum insertion width of a treatment instrument insertion portion of the treatment instrument guide.   The endoscope apparatus according to claim 1, wherein the minimum insertion width is equal to or greater than a distal end side opening of a treatment instrument insertion portion of the treatment instrument guide.   The distal end side opening of the treatment instrument insertion portion of the treatment instrument guide is narrower than the channel opening of the treatment instrument insertion channel, and the rear end opening of the treatment instrument insertion section is inserted into the treatment instrument insertion section. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is formed wider than the channel opening of the common channel.

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