JP6599669B2 - Detention device - Google Patents

Description

  The present invention relates to an indwelling instrument having a tube that can position a cylindrical instrument inside and having a tube inserted into a subject.

  In recent years, endoscopes have been widely used in the medical field. The endoscope can observe the inside of the subject by inserting an elongated insertion portion into the subject.

  In addition, as an endoscope, an observation window, an illumination unit, an opening end of a channel, and the like are provided on the distal end surface of the distal end portion provided on the distal end side of the insertion portion. Known direct-view type endoscopes for observing and treating a test site are well known.

  Furthermore, a direct-viewing endoscope having a very small diameter insertion portion, for example, a direct-viewing bronchoscope inserted into the bronchus is also well known.

  Here, when placing a stent that is a cylindrical instrument in the narrowed portion in order to expand the narrowed portion of the bronchus in the subject, for example, when the insertion portion is a small-diameter endoscope like the bronchoscope described above, Since the channel provided in the insertion portion is also very small in diameter, it is difficult to load the channel with a stent.

  Therefore, usually, first, a stent is loaded from the front of the outer tube into the duct of the rigid outer tube of the indwelling instrument, and then the outer tube is inserted into the subject under X-ray, for example, and then the outer tube is placed. A technique is used in which the stent is placed in the squeezed portion by pushing out the stent from behind the tube using a pusher.

  However, in the method using a mantle tube, since the placement of the stent is performed blindly under X-rays, it is difficult for the operator to predict the push-out position of the stent. There is a problem that an additional operation of inserting an endoscope into the dome and finely adjusting the position of the stent under the observation of the endoscope becomes necessary.

  Furthermore, in order to finely adjust the position of the stent, there is also a problem that if the bending portion of the insertion portion of the endoscope is bent in the duct of the hard mantle tube, the bending portion is easily damaged.

  The above problem is also caused by a technique in which a stent is loaded into a known rigid introducer in an indwelling device, the introducer is inserted into a conduit of a rigid mantle tube, and the stent is pushed out using a pusher. It is the same.

  In view of such problems, Patent Document 1 discloses a configuration in which an imaging assembly for imaging the inside of a subject is provided at the tip of a tube inserted into the subject of a mantle tube in an indwelling instrument. .

JP2015-77424A

  In the configuration of Patent Document 1, it is possible to place the stent under observation of the imaging assembly of the mantle tube.

  However, when loading and positioning the stent within the tube of the mantle tube, if the operator does not load the mantle tube imaging assembly, for example, with the upper direction and the upper direction of the stent aligned exactly, When the stent is pushed out using the pusher, there is a problem that the stent does not pop out accurately in a desired direction, and it is difficult to place the stent in the narrowed portion with high positional accuracy.

  In particular, in the case of a Y-shaped stent having a bifurcated branch portion, each branch portion of the Y-shaped stent does not jump out exactly in a desired direction, and it is difficult to place the stent with high positional accuracy in the branched narrowed portion. It was. The above problem is the same when the tubular device is other than the stent.

  The present invention has been made in view of the above problems, and an object thereof is to provide an indwelling instrument having a configuration capable of indwelling a cylindrical instrument in a narrowed portion in a subject with high positional accuracy under observation. .

An indwelling device according to an aspect of the present invention includes a tube that has a conduit in which a Y-shaped stent having a cut between a first branch portion and a second branch portion can be positioned, and is inserted into a subject. than the open end of the conduit definitive the distal end of the tube is provided at a position projecting forward, fitted in the slit of the Y-shaped stent which protrudes forward from the opening end with protruding inner diameter side of the conduit A straight line passing through the convex portion in the diameter direction of the pipe line when the front end of the tube is viewed from the front of the tube. An object image acquisition unit that is positioned above and enables the observation window to be positioned in a longitudinal hole provided in parallel with the conduit in the diametrical direction, and the convex portion in the longitudinal direction of the tube The first branch And it is formed to have the same length as the second branch portion.
Further, the indwelling device according to another aspect of the present invention is a conduit that can position a Y-shaped stent folded so that a break between the first branch portion and the second branch portion is smaller than a natural state. A tube that is inserted into the subject and is provided at the distal end of the tube, protrudes toward the inner diameter side of the conduit, and fits into the cut, and an observation window for observing the subject. When the front end of the tube is viewed from the front of the tube, the tube is positioned on a straight line passing through the convex portion in the diameter direction of the tube and is arranged in parallel with the tube in the diameter direction. An object image acquisition unit that enables positioning of the observation window in the longitudinal hole.

  ADVANTAGE OF THE INVENTION According to this invention, the instrument for indwelling which comprises the structure which can detain a cylindrical instrument with sufficient position accuracy in the narrowing part in a subject under observation can be provided.

The perspective view which shows the indwelling instrument of 1st Embodiment 1 is a side view of the indwelling device shown in FIG. The perspective view which shows the state by which the curved part of the tube of the indwelling instrument of FIG. 1 was curved upwards The perspective view which shows the Y-shaped stent positioned in the pipe line of the indwelling instrument of FIG. 1 is a partial cross-sectional view of a portion of the tube of the indwelling instrument of FIG. 1 surrounded by a V line in FIG. The partial perspective view which expands and shows the state which positioned the Y-shaped stent of FIG. 4 from the front to the pipe line of the tube of the indwelling instrument of FIG. The front view which looked at the tip of the tube of the indwelling instrument of FIG. 1 from the VII direction in FIG. The fragmentary perspective view which shows the state by which the image probe was penetrated by the longitudinal hole formed in the tube of the indwelling instrument of FIG. The perspective view which shows the state by which the curved part of the tube of the indwelling instrument of 2nd Embodiment was curved rightward. The perspective view which shows the state by which the insertion part of the endoscope was inserted in the pipe line of the tube of the indwelling instrument of FIG. The figure which shows the example of a display to the monitor to which the instrument for indwelling the bronchi imaged by the subject image acquisition part of the instrument for indwelling of FIG. 1 was connected.

  Embodiments of the present invention will be described below with reference to the drawings.

(First embodiment)
1 is a perspective view showing the indwelling device of the present embodiment, FIG. 2 is a side view of the indwelling device of FIG. 1 as viewed from the direction II in FIG. 1, and FIG. 3 is a view of the indwelling device of FIG. It is a perspective view which shows the state by which the curved part of the tube was curved upward.

  4 is a perspective view showing a Y-shaped stent positioned in the conduit of the indwelling device of FIG. 1. FIG. 5 is a view of the outer skin of the tube of the indwelling device of FIG. 1 surrounded by the V line in FIG. FIG.

6 is an enlarged partial perspective view showing a state in which the Y-shaped stent of FIG. 4 is positioned from the front in the tube line of the tube of the indwelling device of FIG. 1, and FIG. 7 is a view of the indwelling device of FIG. It is the front view which looked at the front-end | tip of a tube from the VII direction in FIG.
FIG. 11 is a diagram showing a display example on a monitor to which a bronchial indwelling device imaged by the subject image acquisition unit of the indwelling device of FIG. 1 is connected.

  As shown in FIGS. 1 to 3, the indwelling instrument 1 includes an elongated tube 2 to be inserted into a subject and an operation unit 5 provided at the proximal end of the tube 2.

  A tube 15 in which a stent as a cylindrical instrument, for example, a Y-shaped stent 20 as shown in FIG. 4 can be positioned as shown in FIG. 6, is formed from the distal end 2s to the proximal end of the tube 2 in the tube 2. Yes. Therefore, as shown in FIGS. 1 to 3 and 7, an opening end 15 s of the pipe line 15 is formed at the tip 2 s of the tube 2. In addition, a cylindrical instrument is not limited to a stent.

  The Y-shaped stent 20 can be loaded by folding the first branch portion 20a and the second branch portion 20b from the front end 2s of the tube 2 to the duct 15 through the open end 15s so that the cut 20d is reduced. It has become.

  Further, at the distal end side of the tube 2, at least one bending portion 3 that can be bent in the bending direction is provided. Specifically, in the present embodiment, the bending direction of the bending portion 3 can be bent in two predetermined directions, for example, an upward (UP) direction and a downward (DOWN) direction.

  The bending portion 3 is provided in the operation portion 5 and is configured to be vertically bent by a known configuration when a bending operation member 7 formed of, for example, a lever is rotated by an operator. ing. In addition, the bending part 3 may be freely bendable only upward or downward.

  Moreover, as shown in FIGS. 1 to 3 and 7, the distal end 2 s of the tube 2 protrudes forward from the opening end 15 s to any direction side in the bending direction of the bending portion 3, for example, the upward direction side. A protruding portion 2t is provided.

  Furthermore, the convex part 2d which protrudes in the internal diameter side of the pipe line 15 is provided in the surface at the side of the pipe line 15 of the protrusion part 2t.

  The protruding portion 2t is provided at either end of the bending portion 3 at the distal end of the tube 2 when the protruding portion 2t is provided on the upper side as in the present embodiment, for example. This is because, when the bending portion 3 is bent upward as shown in FIG. 3, the protruding portion 2 t is likely to enter in advance with respect to the narrowed portion in the subject. That is, it is because the projecting part 2t enters the narrowed part more easily when the part where the projecting part 2t is provided coincides with the bending direction.

Further, as shown in FIG. 2, in the tube 2, the longitudinal hole 10 in which the subject image acquisition unit 13 is embedded is arranged in parallel with the conduit 15 in the diameter direction Q of the conduit 15 at least in the protruding portion 2 t. Has been.
Specifically, the subject image acquiring unit 13 is positioned on a straight line P passing through the convex portion 2d in the diameter direction Q of the conduit 15 when the front end 2s of the tube 2 is viewed from the front of the tube 2 and the tube. It is embedded in the longitudinal hole 10 arranged in parallel with the path 15.
Therefore, the bending direction of the bending portion 3 coincides with the diameter direction Q having the straight line P connecting the convex portion 2 d and the long hole 10.

  As shown in FIGS. 1, 3, and 7, the subject image acquisition unit 13 is provided at the distal end of the subject image acquisition unit 13 and observes the inside of the subject and configures the subject image acquisition unit 13. The observation window 11 is positioned so that 11 is exposed from the tip 2ts of the protruding portion 2t. The subject image acquisition unit 13 may be an image guide fiber or an imaging unit including an imaging element such as a CCD or CMOS.

  Therefore, the surgeon can perform the indwelling operation of the Y-shaped stent 20 while confirming the narrowed portion in the subject imaged by the subject image acquiring unit 13 through the observation window 11.

  If the observation window 11 is positioned in the upward direction, the Y-shaped stent 20 pushed out from the opening end 15s of the duct 15 from the front becomes an image popping out from the lower side on the observation screen (not shown). There is an advantage that a sense of direction in the subject can be easily grasped.

  As shown in FIGS. 1, 3, and 7, an illumination unit 12 that emits illumination light into the subject is provided at the tip 2ts of the protruding portion 2t.

  Although not shown, the illumination unit 12 is positioned opposite to the tip of the light guide that is inserted into the tube 2 and transmits illumination light emitted from the light source. Moreover, the illumination part 12 may be comprised from light-emitting bodies, such as LED. Furthermore, the illumination unit 12 is not limited to the tip 2ts, and may be provided at the tip 2s.

  The convex portion 2d defines the position in the circumferential direction C of the Y-shaped stent 20 that is folded and loaded in the duct 15 through the open end 15s so that the cut 20d is reduced as shown in FIG. is there.

  Specifically, as shown in FIG. 6, the convex portion 2d is inserted into the cut 20d between the first branch portion 20a and the second branch portion 20b of the Y-shaped stent 20, so that the convex portion 2d is The movement of the Y-shaped stent 20 folded in the path 15 and densely loaded in the duct 15 is restricted in the circumferential direction C.

  More specifically, the convex portion 2 d matches the upward direction of the Y-shaped stent 20 loaded in the conduit 15 with the upward direction of the tube 2. Note that the upward direction of the Y-shaped stent 20 is either side in the direction orthogonal to the branch direction when the first branch portion 20a and the second branch portion 20b branch in the left-right direction.

  In addition, since the convex part 2d is a site | part inserted in the cut | interruption 20d, in the longitudinal direction N of the tube 2, it is the same length as the length A of the 1st branch part 20a of the Y-shaped stent 20, and the 2nd branch part 20b. It is preferable that it is formed. It should be noted that the length of the convex portion 2d in the longitudinal direction N is not necessarily the same as the length A, and may be formed shorter than the length A by being formed only in the protruding portion 2t. It may be formed longer than the length A by being formed over the entire length of the conduit 15.

  In addition, the outer skin 2g of the tube 2 is not limited to a hard one, but the outer skin 2g of the tube 2 may have a soft configuration that can be freely bent by applying an external force. I do not care.

  Specifically, as shown in FIG. 5, the outer skin 2 g has, for example, a bellows shape in which a coil 26 is coated on the outer periphery of a Teflon (registered trademark) tube 27 and a nickel titanium tube 25 is coated on the outer periphery of the coil 26. By having the configuration, it may have a flexible configuration that can expand and contract in the longitudinal direction N and passively bend, and can maintain the curved shape. The configuration in which the tube 2 is passively bendable is not limited to the configuration in FIG.

  In this way, if the proximal end side of the tube 2 is softer than the bending portion 3, the portion other than the bending portion 3 in the tube 2 can be bent. In addition to improving the insertability of the tube 2 when the tube 2 is inserted into the tube, the operability in the treatment inside the subject is improved, so the burden on the subject can be reduced.

  Further, an insertion portion 101 (see FIG. 10) of the endoscope 100 described later can be inserted into and removed from the tube 15 of the tube 2 from the proximal end of the tube 15.

  Furthermore, an endoscope connecting portion 5a for positioning the endoscope inserted in the conduit 15 in the longitudinal direction N and the circumferential direction C with a known configuration is provided on the operation portion 5 provided at the proximal end of the tube 2. Is provided.

  Therefore, the indwelling instrument 1 can be used together with the endoscope 100 because the insertion portion 101 of the endoscope 100 can be inserted into and removed from the duct 15 of the tube 2.

  Accordingly, the treatment in the subject is further improved, and the position of the endoscope 100 in the longitudinal direction N and the circumferential direction C can be fixed by the endoscope connecting portion 5a. Operability is improved. Furthermore, the endoscope 100 has a configuration that can prevent the endoscope 100 from being damaged due to the movement of the endoscope 100 in the duct 15 during the treatment.

  In addition, since the structure of the other indwelling instrument 1 is the same as the structure of the conventional indwelling instrument, the description is abbreviate | omitted.

  As described above, in the present embodiment, it is shown that the observation window 11 for observing the inside of the subject is provided at the tip 2ts of the protruding portion 2t provided on the upper side of the tube 2.

  Further, by projecting toward the inner diameter side of the conduit 15 at the projecting portion 2t and fitting into the cut 20d of the Y-shaped stent 20 tightly folded and loaded in the conduit 15, the Y in the conduit 15 It has been shown that the convex portion 2d that defines the position in the circumferential direction C of the Y-shaped stent 20 is provided by matching the upward direction of the U-shaped stent 20 with the upward direction of the tube 2.

  According to this, the surgeon can perform the indwelling operation of the Y-shaped stent 20 while viewing the observation image of the narrowed portion in the subject imaged by the subject image acquiring unit 13 through the observation window 11. it can.

  Further, when the surgeon loads the Y-shaped stent 20 into the duct 15 from the front of the distal end 2s of the tube 2 through the open end 15s, the surgeon loads the Y-shaped stent 20 so that the convex portion 2d fits into the cut 20d. By simply doing, the upward direction of the tube 2 and the upward direction of the Y-shaped stent 20 can be made to exactly coincide with each other, and the Y-shaped stent 20 is then moved in the circumferential direction C in the duct 15 by the convex portion 2d. Never move on.

  Therefore, after that, the surgeon inserts a known pusher into the duct 15 from the proximal end side of the duct 15, and observes the observation image in the subject via the subject image acquisition unit 13 while viewing the Y-shaped stent. When 20 is pushed out and the Y-shaped stent 20 is placed in the squeezed portion, the positions of the first branch portion 20a and the second branch portion 20b of the Y-shaped stent 20 after being pushed out can be easily predicted.

Specifically, the first branch part 20a and the second branch part 20b are pushed out while opening in the left (LEFT) direction and the right (RIGHT) direction with respect to the upward direction. For example, the Y-shaped stent 20 can be easily placed in the stenosis of the left bronchus and the right bronchus.
More specifically, if the upward direction of the convex portion 2d coincides with the upward direction of the observation window 11, the Y-shaped stent 20 is positioned in the duct 15 by the convex portion 2d as described above. When the Y-shaped stent 20 is pushed into the left bronchus and the right bronchus and the first branch 20a and the second branch 20b are pushed out and placed, as shown in FIG. 11, the monitor 200 to which the placement device 1 is connected is placed. On the other hand, if each bronchus K1, K2 is imaged by the subject image acquisition unit 13 so that the left bronchus K1 and the right bronchus K2 are displayed side by side, the operator can push out the stent 20 in this state. For example, the first branch 20a can be accurately placed in the left bronchus K1, and the second branch 20b can be placed in the right bronchus K2.

  From the above, it is possible to provide an indwelling instrument 1 having a configuration in which a stent can be indwelled with high positional accuracy in a narrowed portion in a subject under observation.

  Hereinafter, modifications will be described. In the present embodiment described above, the protruding portion 2t is provided, for example, on the upper side in the bending direction of the bending portion 3 that bends in the vertical direction at the distal end 2s of the tube 2, and the protruding portion 2t has a convex portion. By providing 2d, it was shown that the convex part 2d was also provided on the upper side in the bending direction.

  However, the present invention is not limited to this, and even if the protruding portion 2t and the protruding portion 2d are provided on the lower side in the bending direction of the bending portion 3, the same effects as those of the above-described embodiment can be obtained.

  Further, when the bending portion 3 can be bent in the left-right direction, the same effect as that of the present embodiment described above can be obtained if the protruding portion 2t and the convex portion 2d are provided in either the left-right direction in the bending direction. be able to.

  Further, in the present embodiment described above, the Y-shaped stent 20 is shown as an example of the stent. However, the present invention is not limited to this, and even in the case of a stent having a straight shape, the convex portion 2d can The position of the stent in the circumferential direction C can be defined.

  From this, since the stent which has linear form can be accurately extruded in a desired direction using a pusher, the effect similar to this Embodiment mentioned above can be acquired.

  Hereinafter, another modification will be described with reference to FIG. FIG. 8 is a partial perspective view showing a state in which the image probe is inserted into a longitudinal hole formed in the tube of the indwelling instrument of FIG.

  In the present embodiment described above, the subject image acquisition unit 13 is embedded in the longitudinal hole 10, and as a result, the observation window 11 is positioned at the protruding portion 2t.

  Not limited to this, as shown in FIG. 8, an image probe having a subject image acquisition unit 13, an observation window 11, and an illumination unit 12 with respect to the longitudinal hole 10 formed to have a larger diameter than that of the first embodiment. Since 50 is inserted in the longitudinal direction N so as to be movable back and forth, the subject image acquisition unit 13 is inserted into the longitudinal hole 10 so as to be able to advance and retract. As a result, the observation window 11 can be positioned at the protruding portion 2t. It doesn't matter.

  Even with such a configuration, the same effect as the above-described embodiment can be obtained, and the image probe 50 can protrude forward from the tip 2ts of the protruding portion 2t. When the subject image acquisition unit 13 is embedded, it is possible to observe a part in the subject that cannot be approached, so that the observability of the indwelling instrument 1 is further improved.

  In the configuration shown in FIG. 8, when the amount of illumination light emitted from the illuminating unit 12 of the small-diameter image probe 50 is insufficient for observation, as in the present embodiment, the protruding portion 2t An illumination unit 12 may be further provided at the tip 2ts.

(Second Embodiment)
FIG. 9 is a perspective view showing a state in which the curved portion of the tube of the indwelling instrument of the present embodiment is bent in the right direction, and FIG. 10 is a diagram of the endoscope in the tube line of the indwelling instrument of FIG. It is a perspective view which shows the state by which the insertion part was inserted.

  The configuration of the indwelling device of the second embodiment is that the bending portion of the tube can be bent in the left-right direction as compared with the indwelling device of the first embodiment shown in FIGS. Is different.

  Therefore, only this difference will be described, the same reference numerals are given to the same components as those in the first embodiment, and the description thereof will be omitted.

  As shown in FIG. 9, in this Embodiment, the bending part 3 of the tube 2 of the indwelling instrument 1 can be bent in the left-right direction which is two predetermined directions. Also in the present embodiment, the bending portion 3 may be bent only in one direction, the left direction or the right direction.

  Thus, for example, if the subject is a bronchus, the left bronchus and the right bronchus are more easily observed along with the bending of the bending portion 3 in the left or right direction, and the left bronchus and the right bronchus constriction are improved. This makes it easier to place the stent.

  In the present embodiment, as shown in FIG. 10, the insertion portion 101 of the endoscope 100 is inserted into the conduit 15 of the tube 2, and the endoscope connection portion 5 a provided in the operation portion 5 is inserted. When a part of the endoscope 100 is connected, the upward direction of the endoscope 100 is matched with the upward direction of the tube 2 by a known configuration provided in the endoscope connecting portion 5a. The position of the insertion portion 101 in the pipe 15 in the circumferential direction C is defined, and an endoscope bending portion (hereinafter simply referred to as a bending portion) 103 provided in the insertion portion 101 that can be bent in two vertical directions. Is defined to project forward from the opening end 15 s of the pipe line 15.

  As a result, when a part of the endoscope 100 is connected to the endoscope connecting portion 5a, the bending portion 103 is not positioned in the conduit 15 of the tube 2, and therefore the bending portion 103 is provided in the tube 2. It is possible to prevent the bending portion 103 from being damaged.

  In addition, the position of the insertion portion 101 in the circumferential direction C in the conduit 15 is defined by the endoscope connecting portion 5a so that the upward direction of the insertion portion 101 and the upward direction of the tube 2 coincide with each other. The portion 103 can be bent in the vertical direction, and the bending portion 3 can be bent in the left-right direction.

  From this, the endoscope 100 alone can bend only in the upper and lower directions, but when the bending portion 3 is bent in the left-right direction in a state where the insertion portion 101 is inserted in the duct 15, the insertion portion 101 can also be curved in the left-right direction. That is, since the distal end side of the insertion portion 101 can be curved in four directions, the observability and treatment properties in the subject are improved.

  In addition, the structure which uses the convex part 2d and indwells a stent in a narrowing part with sufficient position accuracy is the same as 1st Embodiment mentioned above.

  In addition, the present embodiment can also be applied to a configuration in which the bending portion 3 can be bent in the vertical direction and the bending portion 103 can be bent in the left-right direction, contrary to the present embodiment.

  Furthermore, in the present embodiment, as shown in FIGS. 9 and 10, the protruding portion 2 t and the protruding portion 2 d are located on the upper side even though the bending portion 3 can be bent in the left-right direction. As in the configuration of the first embodiment, the protruding portion 2t and the convex portion 2d are located on either side of the bending direction of the bending portion 3, that is, on either side in the left-right direction. It does not matter.

  Further, in the first and second embodiments described above, the tubular device has been illustrated by taking a stent as an example. However, the present invention is not limited to this and can be applied to a tubular device other than a stent.

DESCRIPTION OF SYMBOLS 1 ... Indwelling instrument 2 ... Tube 2d ... Convex part 2s ... Tip 2t ... Protrusion part (part provided with the convex part)
DESCRIPTION OF SYMBOLS 3 ... Bending part 5 ... Operation part 5a ... Endoscope connection part 7 ... Bending operation member 10 ... Longitudinal hole 11 ... Observation window 12 ... Illumination part 13 ... Subject image acquisition part 15 ... Pipe line 15s ... Open end 20 ... Stent (Tubular instrument)
20d ... Stent break 100 ... Endoscope 103 ... Endoscope bending portion C ... Circumferential direction N ... Longitudinal direction P ... Straight line Q ... Diameter direction

Claims (12)

A Y-shaped stent having a cut between the first branch portion and the second branch portion has a duct that can be positioned therein and inserted into the subject;
Than the conduit open end of which definitive the tip of the tube is provided at a position protruding forward, the cut of the Y-shaped stent which protrudes forward from the opening end with protruding inner diameter side of the conduit A convex portion to be inserted ,
An observation window for observing the inside of the subject is provided at the tip, and when the tip of the tube is viewed from the front of the tube in front, the tube is positioned on a straight line passing through the convex portion in the diameter direction of the conduit. A subject image acquisition unit capable of positioning the observation window in a longitudinal hole arranged in parallel with the conduit in the diameter direction;
Equipped with,
The said convex part is formed in the longitudinal direction of the said tube in the same length as the said 1st branch part and the said 2nd branch part, The indwelling instrument characterized by the above-mentioned. The tube is provided with a bending portion that can be bent in at least one bending direction,
The indwelling device according to claim 1, wherein the bending direction coincides with the diameter direction having the straight line connecting the convex portion and the longitudinal hole. 2. The indwelling device according to claim 1, wherein the convex portion defines a position in a circumferential direction of the Y-shaped stent positioned in the conduit. The bending portion can be bent in two predetermined directions,
The indwelling instrument according to claim 2, wherein the two predetermined directions are an upward direction and a downward direction of the bending direction. The bending portion can be bent in two predetermined directions,
The indwelling instrument according to claim 2, wherein the two predetermined directions are a right direction and a left direction of the bending direction. An endoscope can be further inserted into and removed from the duct,
The indwelling apparatus according to claim 4 , wherein an endoscope connecting portion for positioning in a longitudinal direction and a circumferential direction of the endoscope inserted into the conduit is provided at a proximal end of the tube. Appliances. The endoscope is provided with an endoscope bending portion that is bent in the vertical direction,
The endoscope connecting portion is configured to move upward in a bending direction of the endoscope bending portion and a portion of the bending portion of the tube when a part of the endoscope inserted into the conduit is connected. The indwelling apparatus according to claim 6 , wherein the bending direction of the endoscope coincides with the upward direction of the bending direction, and the endoscope bending portion is positioned so as to protrude forward from the opening end of the duct of the tube. Instruments.   The indwelling instrument according to claim 1, wherein the subject image acquisition unit is embedded in the longitudinal hole.   The indwelling instrument according to claim 1, wherein the subject image acquisition unit is inserted into the longitudinal hole so as to freely advance and retract. The indwelling instrument according to claim 8 , wherein an illumination unit that emits illumination light into the subject is provided at the tip of the tube.   The indwelling instrument according to claim 2, wherein an operation part having a bending operation member for operating the bending part is provided at a proximal end of the tube. A tube that has a conduit that can position the Y-shaped stent folded inside so that a break between the first branch portion and the second branch portion is smaller than the natural state, and is inserted into the subject;
Provided at the tip of the tube, projecting to the inner diameter side of the conduit, and a convex portion that fits into the cut,
An observation window for observing the inside of the subject is provided at the tip, and when the tip of the tube is viewed from the front of the tube in front, the tube is positioned on a straight line passing through the convex portion in the diameter direction of the conduit. A subject image acquisition unit capable of positioning the observation window in a longitudinal hole arranged in parallel with the conduit in the diameter direction;
An indwelling instrument characterized by comprising:

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