JP7532459B2 - Adapter, sheathed adapter, and lacrimal endoscope - Google Patents

Description

The present invention relates to an adapter, a sheathed adapter, and a lacrimal endoscope.

Lacrimal endoscopes are used by inserting a long, thin insertion section into the lacrimal duct through the lacrimal punctum of the human body. Lacrimal endoscopes are used in a procedure called SEP (Sheathguided Endoscopic Probing). SEP is a procedure in which a tubular sheath member through which the insertion section of the lacrimal endoscope is inserted is inserted into the lacrimal duct, and the sheath member alone is moved toward the tip while the insertion section is fixed, thereby perforating an obstructed area in the lacrimal duct. Patent Document 1 describes a lacrimal endoscope in which a sheath member is attached while the insertion section is inserted through the sheath member.

The lacrimal endoscope described in Patent Document 1 has an inlet port for supplying saline to the end face of the grip. A sheath member attached to the lacrimal endoscope has a mouthpiece formed on one end. The sheath member is attached so that the mouthpiece covers the end face of the grip of the lacrimal endoscope. During the procedure, saline is supplied from the inlet port through the gap between the insertion section and the sheath member, and is supplied from the tip of the sheath member to the patient's lacrimal duct.

Patent No. 6899316

However, when performing the SEP procedure using the lacrimal endoscope described in Patent Document 1, in order to move only the sheath member toward the tip while keeping the insertion section fixed, it is necessary to detach the mouthpiece of the sheath member from the gripping section. If saline is delivered in this state, saline leaks from the gap between the sheath member and the gripping section, and it is not possible to deliver saline to the lacrimal duct.

The present invention was made in consideration of the above circumstances, and aims to provide a technology that enables water to be delivered to a lacrimal endoscope equipped with a sheath even when the sheath is moved.

To solve the above problems, an adapter is provided that is attached to a lacrimal endoscope having an elongated insertion section, a grip section having an attachment section to which the insertion section is connected, and a water supply port provided on an end surface of the attachment section, the adapter comprising: a tubular main body section that is slidably attached to the attachment section of the lacrimal endoscope; a fitting section provided at one end of the main body section for fitting a nozzle of a sheath through which the insertion section is inserted; and an operating section provided on the outer peripheral surface of the main body section.

According to the present invention, in a lacrimal endoscope equipped with a sheath, water can be delivered even when the sheath is moved.

1 is a schematic diagram showing the overall configuration of a lacrimal endoscopy system 100. FIG. 4 is a cross-sectional view illustrating a grip portion 204. FIG. 2A and 2B are cross-sectional and arrow views illustrating the details of the lacrimal endoscope 200. FIG. 7 is a perspective view of the adapter 700. 2 is a perspective view showing the lacrimal endoscope 200 with the adapter 700 attached. FIG. A cross-sectional view showing the lacrimal endoscope 200 with the adapter 700 attached. 11A and 11B are cross-sectional and arrow views illustrating details of the lacrimal endoscope 200 with the adapter 700 attached. 8 is a cross-sectional view of a state in which the adaptor 700 has been moved from FIG. 7 . FIG. 2 is a perspective view of a sheathed adapter 800. 1 is a perspective view showing a lacrimal endoscope 200 with a sheathed adapter 800 attached. FIG. 11A and 11B are cross-sectional and arrow views illustrating the details of the lacrimal endoscope 200 with a sheathed adapter 800 attached. 12 is a cross-sectional view showing a state in which the sheathed adapter 800 has been moved from FIG. 11 .

Below, an embodiment of the present invention will be described with reference to the drawings. However, the embodiment described below has various limitations that are technically preferable for implementing the present invention, but the scope of the present invention is not limited to the following embodiment and illustrated examples.

First Embodiment
[Overview of the Lacrimal Endoscopy System]
1 is a schematic diagram showing an overall configuration of a lacrimal endoscopy system 100. The lacrimal endoscopy system 100 includes a lacrimal endoscope 200, an imaging system 400, and a monitor 500.

The lacrimal endoscope 200 is an endoscope for observing the inside of the lacrimal duct. The lacrimal endoscope 200 is connected to an imaging system 400. The imaging system 400 has an image processing device and a light source device (neither shown). The image processing device processes the image obtained by the lacrimal endoscope 200. The image processing device displays the processed image on a monitor 500 connected to the imaging system 400. The light source device generates illumination light that the lacrimal endoscope 200 uses to illuminate the inside of the lacrimal duct.

[Lacrimal endoscopy]
The lacrimal endoscope 200 has an insertion portion 202 , a grip portion 204 , and a cable portion 206 .

<Insertion section>
The insertion part 202 is an elongated member that is inserted into the lacrimal duct from the patient's lacrimal punctum. One end of the insertion part 202 is connected to an attachment part 220 of the grip part 204, which will be described later. An image guide fiber, a light guide fiber (neither of which are shown in the figure), and the like are provided inside the insertion part 202.

<Grip part>
2 is a cross-sectional view showing details of the grip portion 204. The grip portion 204 is a portion that is gripped by an operator when using the lacrimal endoscope 200. The grip portion 204 has an attachment portion 220, a water supply port 222, a water supply channel 224, and a water supply connector 226.

The attachment portion 220 protrudes from the grip portion 204 and is a portion to which the insertion portion 202 is connected. In this embodiment, the attachment portion 220 protrudes cylindrically from one end face of the grip portion 204. One end of the insertion portion 202 is connected to the attachment portion 220 (see FIG. 3). It is preferable that the length of the attachment portion 220 in the long axis direction is 10 millimeters or more. In FIG. 3, (a) is a cross-sectional view of the insertion portion 202 and grip portion 204 (part), and (b) is a cross-sectional view of B-B' shown in (a).

The water supply port 222 is an opening for supplying saline. The water supply port 222 is provided on the end surface 220a of the attachment portion 220. The water supply port 222 is provided at a position on the attachment portion 220 that is different from the position where the insertion portion 202 is connected.

The water supply channel 224 is a hole that connects the water supply port 222 and the water supply nozzle 226. The water supply channel 224 passes through the inside of the gripping portion 204. One end of the water supply channel 224 connects to the water supply port 222.

The water supply nozzle 226 is a portion to which a syringe (not shown) or the like is connected. The water supply nozzle 226 is provided at the end opposite the end of the gripping portion 204 where the attachment portion 220 is provided. The water supply nozzle 226 connects to the other end of the water supply channel 224. When a syringe filled with saline is connected to the water supply nozzle 226, saline is supplied from the syringe to the water supply channel 224.

<Cable section>
The cable portion 206 is a cable that connects the grip portion 204 and the imaging system 400. One end of the cable portion 206 is connected to the side of the grip portion 204 (see FIG. 1 ). The cable portion 206 branches midway, and an image guide fiber is provided inside one end, and a light guide fiber is provided inside the other end. The other ends of the cable portion 206 (the ends on the branched side) are both connected to the imaging system 400.

[sheath]
The sheath 600 is a member through which the insertion portion 202 is inserted (see FIG. 5 ). The sheath 600 is inserted into the patient's lacrimal duct with the insertion portion 202 inserted therethrough. The sheath 600 has an inner diameter larger than the outer diameter of the insertion portion 202. In this embodiment, the sheath 600 is made of a biocompatible resin. The sheath 600 has a tube 602 and a ferrule 604.

The tube 602 is a tubular section with an inner diameter larger than the outer diameter of the insertion section 202. The tube 602 covers the side of the insertion section 202. The length of the tube 602 is formed so that, when attached to the lacrimal endoscope 200 via the adapter 700 described below, one end of the tube 602 is positioned slightly behind the tip of the insertion section 202 or is flush with the tip of the insertion section 202. A base 604 is provided near the other end of the tube 602.

The base 604 is a cap-shaped part. The base 604 has openings at both ends. The diameter of the opening formed at one end of the base 604 is smaller than the diameter of the opening formed at the other end. The base 604 is attached to the tube 602 by joining the inner peripheral surface of the opening at one end of the base 604 to the outer peripheral surface near the other end of the tube 602. As a result, the inside of the base 604 communicates with the pipe of the tube 602. The base 604 is not particularly limited as long as it is cylindrical with an inner peripheral surface, but if the inner peripheral surface is formed in a tapered shape with the inner diameter decreasing from the other end side to the one end side, the area of contact with the outer peripheral surface of the fitting portion 704 of the adapter 700 described later becomes large, which is effective in making it difficult for the base 604 to come off the fitting portion 704.

[adapter]
The adaptor 700 is a member that is attached to the lacrimal endoscope 200. Fig. 4 is a perspective view of the adaptor 700. The adaptor 700 has a main body portion 702, a fitting portion 704, and an operation portion 706.

The main body 702 is a cylindrical part that is slidably attached to the attachment part 220. In this embodiment, the main body 702 is formed in a cylindrical shape. It is preferable that the length of the main body 702 in the long axis direction is such that, when the main body 702 is attached to the attachment part 220, the length of the attachment part 220 inserted into the main body 702 is at least 10 millimeters.

The fitting portion 704 is a portion for fitting the ferrule 604 of the sheath 600. In this embodiment, the fitting portion 704 is formed in a cylindrical shape. The fitting portion 704 is provided so as to protrude from one end of the main body portion 702 in the longitudinal direction of the main body portion 702. The fitting portion 704 is not particularly limited as long as it is cylindrical, but if the outer peripheral surface of the fitting portion 704 is formed in a tapered shape in which the outer diameter decreases from one end on the main body portion 702 side to the other end, the contact area between the outer peripheral surface of the fitting portion 704 and the inner peripheral surface of the ferrule 604 becomes large, which is effective in making it difficult for the ferrule 604 to come off from the fitting portion 704.

The operating unit 706 is a portion provided on the outer circumferential surface of the main body 702. In this embodiment, the operating unit 706 protrudes from the outer circumferential surface of the main body 702 toward the radially outer side of the main body 702. The operating unit 706 is also provided on the other end of the main body 702 (the end on the side where the fitting portion 704 is not provided).

[Adapter attached to endoscope]
5 shows a state in which the adapter 700 is attached to the lacrimal endoscope 200. The adapter 700 is attached to the lacrimal endoscope 200 with the attachment portion 220 inserted into the main body 702. Here, the inner diameter of the main body 702 is slightly larger than the outer diameter of the attachment portion 220, so that the main body 702 can slide in the longitudinal direction of the attachment portion 220. In addition, the sheath 600 is fitted to the adapter 700 with the fitting portion 704 inserted inside the mouthpiece 604. Therefore, the sheath 600 and the adapter 700 are integrated.

6 is a cross-sectional view of the adapter 700 attached to the lacrimal endoscope 200. FIG. 7(a) is a cross-sectional view of the sheath 600 and the adapter 700 including the insertion section 202 and the grip section 204 (part), FIG. 7(b) is a view in the direction of the arrow A shown in FIG. 7(a), and FIG. 7(c) is a cross-sectional view of B-B' shown in FIG. 7(a). As described above, since the sheath 600 and the adapter 700 are integrated, the internal space of the main body 702, the internal space of the fitting section 704, the internal space of the ferrule 604, and the internal space of the tube 602 are connected to each other. The insertion section 202 is inserted into these connected internal spaces. Here, since the inner diameter of the tube 602, which has the smallest diameter in the sheath 600 and the adapter 700, is larger than the outer diameter of the insertion section 202, a gap 600a is formed between the main body 702, the fitting section 704, the ferrule 604, and the tube 602 and the insertion section 202.

The attachment portion 220 is disposed in the internal space of the main body portion 702 of the adapter 700. Therefore, the water supply port 222 provided on the end face 220a of the attachment portion 220 communicates with the internal space of the main body portion 702 and the internal space of the fitting portion 704. The water supply nozzle 226 and the gap 600a communicate with each other through the water supply channel 224, the water supply port 222, the internal space of the main body portion 702, the internal space of the fitting portion 704, and the internal space of the nozzle 604.

[Installing the adapter]
Next, an example of a method for attaching the adapter 700 to the lacrimal endoscope 200 will be described. Specifically, the surgeon moves the adapter 700 along the insertion portion 202 while inserting the tip of the insertion portion 202 into the inside of the main body portion 702 of the adapter 700. Next, the surgeon moves the adapter 700 along the insertion portion 202 to the vicinity of the grip portion 204. Finally, the surgeon inserts the attachment portion 220 into the inside of the main body portion 702 to attach the adapter 700 to the attachment portion 220. In this manner, the adapter 700 is attached to the lacrimal endoscope 200. After that, the surgeon attaches the sheath 600 to the adapter 700 attached to the attachment portion 220. Specifically, the surgeon moves the sheath 600 along the insertion portion while inserting the tip of the insertion portion 202 into the inside of the mouthpiece 604 of the sheath 600. Then, the surgeon inserts the fitting portion 704 into the inside of the mouthpiece 604 to attach the sheath 600 to the adapter 700. The surgeon may attach the adapter 700 with the sheath 600 attached to the lacrimal endoscope 200 .

[SEP procedure]
Next, a procedure for SEP using the lacrimal endoscope 200 will be described. First, the surgeon prepares the lacrimal endoscope 200 to which the above-mentioned sheath 600 and adapter 700 are attached. Next, the surgeon connects a syringe (not shown) filled with physiological saline to the water supply nozzle 226. Next, the surgeon inserts the insertion portion 202 and the sheath 600 into the patient's lacrimal duct.

Next, the surgeon starts the SEP. The surgeon moves only the sheath 600 relative to the insertion section 202 without moving the insertion section 202 inserted into the patient's lacrimal duct. Specifically, the surgeon moves the adapter 700 in the longitudinal direction of the attachment section 220 to move the sheath 600 integrated with the adapter 700 along the insertion section 202. The surgeon moves the adapter 700 away from the gripping section 204 side of the attachment section 220 to move the sheath 600 away from the attachment section 220 along the insertion section 202. As a result, the tip 602a of the tube 602 of the sheath 600 protrudes from the tip of the insertion section 202 (see FIG. 8). On the other hand, the surgeon moves the adapter 700 closer to the gripping section 204 side of the attachment section 220 to move the sheath 600 closer to the attachment section 220 along the insertion section 202. As a result, the length by which the tip 602a of the tube 602 of the sheath 600 protrudes from the tip of the insertion section 202 is shortened. When the surgeon moves the adapter 700, the surgeon moves the adapter 700 by hooking his/her finger on the operating section 706. Because the operating section 706 is provided on the main body section 702 so as to protrude radially outward from the main body section 702, the surgeon can easily hook his/her finger on the operating section 706.

When the surgeon performs SEP, the surgeon feeds saline from the syringe to the lacrimal endoscope 200. As described above, the water supply nozzle 226 to which the syringe is connected communicates with the gap 600a via the water supply port 222, so the surgeon can feed saline from the syringe to the tip 602a of the tube 602 without leaking. In addition, even if the surgeon moves the adapter 700 to move the sheath 600 along the insertion section 202, no gap is generated between the adapter 700 and the attachment section 220. Therefore, even when the adapter 700 is moved, the surgeon can feed saline from the syringe to the tip 602a of the tube 602 without leaking. In other words, the surgeon can feed saline from the opening of the tip 602a of the tube 602 when performing SEP.

[effect]
The adapter 700 of this embodiment is attached to a lacrimal endoscope 200 which has an elongated insertion portion 202, a gripping portion 204 having an attachment portion 220 to which the insertion portion is connected, and a water supply port 222 provided on an end face 220a of the attachment portion 220, and comprises a cylindrical main body portion 702 which is slidably attached to the attachment portion 220 of the lacrimal endoscope 200, an engagement portion 704 provided at one end of the main body portion 702 for engaging with the nozzle 604 of the sheath 600 through which the insertion portion 202 is inserted, and an operating portion 706 provided on the outer surface of the main body portion 702.

According to the adapter 700 of this embodiment, the main body 702 is slidably attached to the attachment portion 220 of the lacrimal endoscope 200, so that no gap is generated between the main body 702 and the attachment portion 220 even when the adapter 700 is moved in the longitudinal direction of the attachment portion 220. In addition, since the fitting portion 704 of the adapter 700 fits into the mouthpiece 604 of the sheath 600, no gap is generated between the fitting portion 704 and the mouthpiece 604 even when the adapter 700 is moved in the longitudinal direction of the attachment portion 220, and the adapter 700 and the sheath 600 move together. Therefore, when the adapter 700 is moved in the longitudinal direction of the attachment portion 220, no gap is generated between the adapter 700 and the attachment portion 220 and between the adapter 700 and the sheath 600, so that physiological saline does not leak from the gap when physiological saline is fed from the water supply port 222 of the lacrimal endoscope 200 to the internal space of the sheath 600. In other words, by using the adapter 700, saline can be delivered to the lacrimal endoscope 200 to which the sheath 600 is attached, even if the sheath 600 is moved.

In addition, according to this embodiment, the adapter 700 is attached to the attachment portion 220 provided at one end of the grip portion 204, so the distance between the adapter 700 and the grip portion 204 is short. Therefore, while holding the grip portion 204 with one hand, the surgeon can hook the fingers of the holding side on the operating portion 706 to move the adapter 700 in the longitudinal direction of the attachment portion 220. As described above, since the adapter 700 and the sheath 600 move together, the surgeon can move the sheath 600 relative to the insertion portion 202 while holding the grip portion 204 with one hand.

In addition, the operating unit 706 according to this embodiment protrudes from the other end of the main body unit 702 in the radial direction of the main body unit 702.

With the above-described configuration, the operating unit 706 protrudes from the other end of the main body 702 (the end on the gripping unit 204 side) in the radial direction of the main body 702, so that the surgeon can easily hook the fingers of the side holding the gripping unit 204 onto the operating unit 706 while holding the gripping unit 204 with one hand. Therefore, while holding the gripping unit 204 with one hand, the surgeon can easily move the sheath 600 relative to the insertion unit 202 via the adapter 700 without using the other hand.

In addition, the outer peripheral surface of the fitting portion 704 in this embodiment is tapered from one end on the main body portion 702 side to the other end.

The above-described configuration can increase the contact area between the inner peripheral surface of the mouthpiece 604 and the outer peripheral surface of the fitting portion 704. Therefore, the mouthpiece 604 fits in a state of closer contact with the fitting portion 704, so that the mouthpiece 604 is less likely to come off the fitting portion 704. In addition, when saline is delivered from the lacrimal endoscope 200 to the internal space between the mouthpiece 604 and the fitting portion 704, the saline does not leak from between the mouthpiece 604 and the fitting portion 704.

The lacrimal endoscope 200 according to this embodiment also includes an elongated insertion section 202, a gripping section 204 having an attachment section 220 to which the insertion section 202 is connected, a water supply port 222 provided on the end surface 220a of the attachment section 220, a sheath 600 through which the insertion section 202 is inserted, and an adapter 700.

According to the above configuration, the sheath 600 is fitted to the adapter 700 with the insertion section 202 inserted. Then, with the sheath 600 fitted, the adapter 700 is attached to the attachment section 220 of the lacrimal endoscope 200. Therefore, when the adapter 700 moves in the longitudinal direction of the attachment section 220, the sheath 600 integrated with the adapter 700 moves relative to the insertion section 202. At this time, no gap is generated between the attachment section 220 and the adapter 700, and between the adapter 700 and the sheath 600. Therefore, even if the adapter 700 moves in the longitudinal direction of the attachment section 220 to move the sheath 600 relative to the insertion section 202 while physiological saline is being fed into the internal space of the sheath 600 from the water supply port 222 of the lacrimal endoscope 200, physiological saline does not leak between the attachment section 220 and the adapter 700, and between the adapter 700 and the sheath 600. Therefore, in the lacrimal endoscope 200 to which the sheath 600 is attached, saline can be delivered even when the sheath 600 is moved relative to the insertion section 202.

Second Embodiment
Next, a lacrimal endoscope 200 according to the second embodiment will be described with reference to Figs. 9 to 12. In the following description, description of members and configurations common to the first embodiment will be omitted. The lacrimal endoscope 200 has a sheath-equipped adapter 800 instead of the adapter 700 and the sheath 600, which will be described below.

[Sheathed adapter]
9 is a perspective view of the sheathed adapter 800. The sheathed adapter 800 is a member attached to the lacrimal endoscope 200. The sheathed adapter 800 is an adapter integrated with a sheath. The sheathed adapter 800 is formed of a biocompatible metal. The sheathed adapter 800 has an adapter portion 810 and a sheath 820.

<Adapter part>
The adapter unit 810 has a main body unit 812 and an operation unit 816 .

The main body 812 is a tubular portion that is slidably attached to the attachment portion 220. In this embodiment, the main body 812 is formed in a cylindrical shape. It is preferable that the length of the main body 812 in the longitudinal direction is such that, when the main body 812 is attached to the attachment portion 220, the length of the attachment portion 220 inserted into the main body 812 is at least 10 millimeters. A sheath 820 is provided from one end of the main body 812.

The operating unit 816 is a portion provided on the outer circumferential surface of the main body 812. In this embodiment, the operating unit 816 protrudes from the outer circumferential surface of the main body 812 toward the radially outer side of the main body 812. The operating unit 816 is also provided at the other end of the main body 812 (the end on the side where the sheath 820 is not provided).

<Sheath>
The sheath 820 is a tubular member provided from one end of the main body portion 812, through which the insertion portion 202 is inserted. The sheath 820 has a tube 822 and a tapered portion 824.

The tube 822 is a tubular portion having an inner diameter larger than the outer diameter of the insertion portion 202. The tube 822 covers the side of the insertion portion 202. The length of the tube 822 is formed so that the position of the tip 822a of the tube 822 is slightly behind the tip of the insertion portion 202 or is equal to the tip of the insertion portion 202 when the sheathed adapter 800 is attached to the lacrimal endoscope 200.

The tapered portion 824 is a portion that connects the tube 822 and the main body portion 812. The tapered portion 824 connects one end of the tube 822 (the end opposite the tip 822a) to one end of the main body portion 812. The tapered portion 824 is formed in a tapered shape in which the diameter decreases from the main body portion 812 side to the tube 822 side. One side of the internal space of the tapered portion 824 is connected to the internal space of the tube 822, and the other side is connected to the internal space of the main body portion 812. In other words, the internal space of the main body portion 812 and the internal space of the tube 822 are connected through the internal space of the tapered portion 824.

[Sheathed adapter attached to endoscope]
10 shows a state in which the sheathed adapter 800 is attached to the lacrimal endoscope 200. The sheathed adapter 800 is attached to the lacrimal endoscope 200 with the attachment portion 220 inserted into the main body portion 812. Here, the inner diameter of the main body portion 812 is slightly larger than the outer diameter of the attachment portion 220, so that the main body portion 812 can slide in the longitudinal direction of the attachment portion 220.

11 is a cross-sectional view of the sheathed adapter 800 attached to the lacrimal endoscope 200. FIG. 12(a) is a cross-sectional view of the sheathed adapter 800 including the insertion section 202 and the grip section 204 (part), FIG. 12(b) is a view in the direction of the arrow A shown in FIG. 12(a), and FIG. 12(c) is a cross-sectional view of B-B' shown in FIG. 12(a). As described above, the internal space of the main body 812, the internal space of the tapered section 824, and the internal space of the tube 822 are connected to each other. The insertion section 202 is inserted into these connected internal spaces. Here, since the inner diameter of the tube 822, which has the smallest diameter in the sheathed adapter 800, is larger than the outer diameter of the insertion section 202, a gap 800a is formed between the main body 812, the tapered section 824, and the tube 822 and the insertion section 202.

The attachment portion 220 is disposed in the internal space of the main body portion 812 of the sheathed adapter 800. Therefore, the water supply port 222 provided on the end surface 220a of the attachment portion 220 communicates with the internal space of the main body portion 812 and the internal space of the tapered portion 824. The water supply nozzle 226 and the gap 800a communicate with each other through the water supply channel 224, the water supply port 222, the internal space of the main body portion 812, and the internal space of the tapered portion 824.

[Attaching the sheathed adapter]
Next, an example of a method for attaching the sheathed adapter 800 to the lacrimal endoscope 200 will be described. The surgeon moves the sheathed adapter 800 along the insertion portion 202 while inserting the tip of the insertion portion 202 into the inside of the main body portion 812 of the sheathed adapter 800. Next, the surgeon moves the sheathed adapter 800 along the insertion portion 202 to the vicinity of the grip portion 204. Finally, the surgeon inserts the attachment portion 220 into the inside of the main body portion 812 and attaches the sheathed adapter 800 to the attachment portion 220. In this manner, the sheathed adapter 800 is attached to the lacrimal endoscope 200.

[SEP procedure using a sheathed adapter]
Next, a procedure for SEP using the lacrimal endoscope 200 and the sheathed adapter 800 will be described. First, the surgeon prepares the lacrimal endoscope 200 to which the above-mentioned sheathed adapter 800 is attached. Next, the surgeon connects a syringe (not shown) filled with physiological saline to the water supply nozzle 226. Next, the surgeon inserts the insertion section 202 and the tube 822 of the sheath 820 of the sheathed adapter 800 into the patient's lacrimal duct.

Next, the surgeon starts the SEP. That is, the surgeon moves the tube 822 relative to the insertion section 202 without moving the insertion section 202 inserted into the patient's lacrimal duct. Specifically, the surgeon moves the main body 812 in the longitudinal direction of the attachment section 220 to move the tube 822 along the insertion section 202. The surgeon moves the main body 812 away from the gripping section 204 side of the attachment section 220 to move the tube 822 away from the attachment section 220 along the insertion section 202. As a result, the tip 822a of the tube 822 protrudes from the tip of the insertion section 202 (see FIG. 12). On the other hand, the surgeon moves the main body 812 closer to the gripping section 204 side of the attachment section 220 to move the tube 822 closer to the attachment section 220 along the insertion section 202. As a result, the length by which the tip 822a of the tube 822 protrudes from the tip of the insertion section 202 is shortened. When the surgeon moves the sheathed adapter 800, the surgeon moves the sheathed adapter 800 by hooking his/her finger on the operating section 816. Because the operating section 816 is provided on the main body section 812 and protrudes radially outward from the main body section 812, the surgeon can easily hook his/her finger on the operating section 816.

When the surgeon performs SEP, the surgeon feeds saline from the syringe to the lacrimal endoscope 200. As described above, the water supply nozzle 226 to which the syringe is connected communicates with the gap 800a via the water supply port 222, so the surgeon can feed saline from the syringe to the tip 822a of the tube 822 without leaking. In addition, even if the surgeon moves the main body 812 to move the tube 822 along the insertion section 202, no gap is generated between the main body 812 and the attachment section 220. Therefore, even when the main body 812 is moved, the surgeon can feed saline from the syringe to the tip 822a of the tube 822 without leaking. In other words, the surgeon can feed saline from the opening of the tip 822a of the tube 822 when performing SEP.

In the second embodiment, the sheathed adapter 800 is attached to a lacrimal endoscope 200 having an elongated insertion section 202, a gripping section 204 having an attachment section 220 to which the insertion section 202 is connected, and a water supply port 222 provided on an end surface 220a of the attachment section 220. The sheathed adapter 800 is cylindrical and includes a main body section 812 that is slidably attached to the attachment section 220 of the lacrimal endoscope 200, and a sheath 820 that is tubularly provided from one end of the main body section 812 and through which the insertion section 202 is inserted.

According to the above-mentioned sheathed adapter 800, the main body 812 is slidably attached to the attachment portion 220 of the lacrimal endoscope 200, so that even if the sheathed adapter 800 is moved in the longitudinal direction of the attachment portion 220, no gap is generated between the main body 812 and the attachment portion 220. In addition, since the sheath 820 is provided from one end of the main body 812, even if the sheathed adapter 800 is moved in the longitudinal direction of the attachment portion 220, no gap is generated between the main body 812 and the sheath 820. Therefore, when the sheathed adapter 800 is moved in the longitudinal direction of the attachment portion 220, no gap is generated between the sheathed adapter 800 and the attachment portion 220 and between the main body 812 and the sheath 820, so that when physiological saline is fed from the water supply port 222 of the lacrimal endoscope 200 to the internal space of the sheath 820, physiological saline does not leak from the gap. In other words, by using the sheathed adapter 800, the lacrimal endoscope 200 can deliver saline even when the sheath 820 is moved.

Conventionally, when a sheath is attached to a lacrimal endoscope for use, the sheath is disposable. However, with the above-described configuration, the sheath 820 is provided at one end of the main body 812, and the main body 812 and the sheath 820 are integrated. Therefore, the sheathed adapter 800 can be used repeatedly by sterilizing or disinfecting the main body 812 and the sheath 820.

The lacrimal endoscope 200 according to the second embodiment includes an elongated insertion section 202, a gripping section 204 having an attachment section 220 to which the insertion section 202 is connected, a water supply port 222 provided on the end surface 220a of the attachment section 220, and a sheathed adapter 800.

According to the above configuration, the lacrimal endoscope 200 includes the sheathed adapter 800 in which the adapter portion 810 and the sheath 820 are integrated, so that the sheath 820 moves relative to the insertion portion 202 by moving the main body portion 812 of the sheathed adapter 800 in the longitudinal direction of the attachment portion 220. At this time, no gap is generated between the attachment portion 220 and the sheathed adapter 800. Therefore, even if the main body portion 812 moves in the longitudinal direction of the attachment portion 220 to move the sheath 820 relative to the insertion portion 202 in a state in which saline is fed from the water feed port 222 of the lacrimal endoscope 200 to the internal space of the sheath 820 via the internal space of the main body portion 812, saline does not leak between the attachment portion 220 and the main body portion 812. Therefore, in the lacrimal endoscope 200 using the sheathed adapter 800, saline can be fed even when the sheath 820 is moved relative to the insertion portion 202.

<Modification>
The modifications described below may be applied in combination.

(1) Modification 1
In the above embodiment, the mounting portion 220 has a cylindrical shape. However, the mounting portion 220 may have a rectangular column shape. Furthermore, the main body portion 702 or the main body portion 812 attached to the mounting portion 220 may have a rectangular tube shape.

(2) Modification 2
In the above embodiment, the operation unit 706 protrudes radially outward from the outer circumferential surface of the main body 702. However, the operation unit 706 may be a groove, a dent, a non-slip member, or the like provided on the outer circumferential surface of the main body 702. Similarly, the operation unit 816 may be a groove, a dent, a non-slip member, or the like provided on the outer circumferential surface of the main body 812.

(3) Modification 3
The outer circumferential surface of the main body portion 702 and the outer circumferential surface of the main body portion 812 may be coated with a material that can withstand a sterilization process.

100... Lacrimal endoscope system, 200... Lacrimal endoscope, 202... Insertion section, 204... Grip section, 206... Cable section, 220... Attachment section, 220a... End face, 222... Water supply port, 224... Water supply channel, 226... Water supply mouthpiece, 400... Imaging system, 500... Monitor, 600... Sheath, 600a... Gap, 602... Tube, 602a... Tip, 604... Mouthpiece, 700... Adapter, 702... Main body section, 704... Fitting section, 706... Operation section, 800... Sheathed adapter, 800a... Gap, 810... Adapter section, 812... Main body section, 816... Operation section, 820... Sheath, 822... Tube, 822a... Tip, 824... Tapered section

Claims (4)

An adapter to be attached to a lacrimal endoscope, the adapter comprising: an elongated insertion portion; a grip portion having an attachment portion to which the insertion portion is connected; and a water supply port provided on an end surface of the attachment portion,
A main body portion having a cylindrical shape and slidably attached to a mounting portion of the lacrimal endoscope;
a fitting portion provided at one end of the main body portion for fitting a ferrule of a sheath through which the insertion portion is inserted;
An operation unit provided on an outer circumferential surface of the main body;
An adapter comprising: The adapter according to claim 1, wherein the operating part protrudes from the other end of the main body in the radial direction of the main body. The adapter according to claim 1, wherein the outer peripheral surface of the engagement portion is tapered from one end of the main body portion to the other end. An elongated insertion portion;
A gripping portion having an attachment portion to which the insertion portion is connected;
A water supply port provided on an end surface of the mounting portion;
a sheath through which the insertion portion is inserted;
An adapter according to any one of claims 1 to 3;
A lacrimal endoscope comprising:

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