JPH0817767B2 - Endoscope device - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to an endoscope apparatus in which flexibility of an insertion portion can be adjusted and insertability is good.

[Problems to be Solved by Conventional Techniques and Inventions] In recent years, by inserting an elongated insertion portion into a body cavity, observation of the inside of the body cavity is possible without using an incision, and a therapeutic treatment using a treatment tool is performed. Endoscopic endoscopes have become widely used.

The insertion portion of the endoscope has flexibility so that it can be inserted into a bent insertion path, but due to this flexibility, the orientation on the distal end side is not fixed with respect to the hand side. ,
It may be difficult to introduce in the target direction. In order to cope with this, for example, in JP-A-62-30211 and JP-A-58-101602, a flexible adjusting member (a stylet or a leading cord or the like) is provided in an endoscope insertion portion. , Which is insertable and removable, thereby changing the flexibility of the insertion part and improving the insertability into the large intestine or the like.

However, when a hard stylet is inserted into the insertion portion, other built-in objects such as an image guide, a light guide, and an air / water supply tube are easily damaged. Especially when the stylet is inserted into the curved part, if the built-in object such as the image guide or the light guide is weak in strength, it may come into contact with the tube that inserts the rigid stylet. May cause serious damage. Furthermore, there is a risk of damaging the bending tube itself forming the bending portion in some cases. In the worst case, inserting the stylet in a curved state may break through the curved tube and puncture the body cavity.

[Object of the Invention] The present invention has been made in view of the above circumstances, and makes it possible to maintain the resistance of the insertion portion internal component and adjust the flexibility of the insertion portion, thereby improving the insertability and the insertion operation. An object is to provide an endoscopic device that can be measured.

[Means and Actions for Solving Problems] An endoscope apparatus of the present invention includes a flexible adjusting member so that the distal end portion is located closer to the hand side than the bending portion formed at the distal end of the insertion portion. Is.

That is, the flexibility of only the soft portion continuously provided on the proximal side of the bending portion is adjusted.

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

1 to 4 relate to a first embodiment of the present invention. FIG. 1 is an explanatory view of the internal structure of an endoscope, and FIG. 2 is an A in FIG.
FIG. 3 is an enlarged cross-sectional view in the −A ′ direction, FIG. 3 is a cross-sectional view of the tip end portion of the flexibility adjusting member, and FIG. 4 is an explanatory diagram of the entire endoscope apparatus.

In FIG. 4, an endoscope apparatus 1 includes an endoscope 2, a light source unit that supplies illumination light to the endoscope 2, and a signal processing unit that processes an image signal sent from the endoscope 2. It comprises a control device 3 and a monitor 4 for displaying a video signal output from the control device 3 on a screen.

The endoscope 2 includes an elongated insertion portion 6, a large-diameter operation portion 7 connected to the rear end side of the insertion portion 6, a light guide and a signal extending from the side portion of the operation portion 7. Cable 8
It has and.

A rigid tip portion 9 is provided on the tip end side of the insertion portion 6, and a bending portion adjacent to the tip end portion 9 and capable of bending to the rear side.
11 are provided. Furthermore, behind the curved portion 11,
A flexible flexible portion 12 is continuously provided. The curved portion 11 is
By operating the bending operation knob 13 provided on the operation portion 7, it is possible to bend in the vertical / horizontal directions.

A light guide and signal connector 14 is provided at the rear end of the light guide and signal cable 8 and is connected to the control device 3.

The control device 3 is connected to the monitor 4 by a signal cable 16.

In FIG. 1, the tip portion 9 is provided with a tip portion main body 17 formed of a hard material in a substantially cylindrical shape. The tip end portion main body 17 is parallel to the longitudinal direction of the insertion portion 6 with forceps. A channel through hole 18 and an observation through hole 19 are provided.
A connecting tube 21 is fitted into the forceps channel through hole 18, and a flexible forceps channel is formed in which a forceps channel 22 is formed in the rear portion of the connecting tube 21 protruding rearward from the tip end main body 17. Tube 23 is connected. The forceps channel tube 23 is inserted through the insertion portion 6 and the operation portion 7
It is adapted to communicate with a forceps port 24 provided on the.

An objective lens system 26 is provided in front of the observation through-hole 19 and a solid-state image pickup device 27 is provided at an image forming position of the objective lens system 26. A signal line 28 capable of transmitting an image signal is extended at the rear end of the solid-state image pickup device 27, and the signal line 28 is inserted through the insertion portion 6 and inside the operation portion 7, the light guide and the signal cable 8. And the contact 29 provided on the light guide and signal connector 14 via the. The light guide and signal connector 14 is provided with a light guide entrance end 32 to which a light guide 31 is connected so that the illumination light emitted from a light source (not shown) can enter. This Light Guide 31
Is inserted into a light guide through hole (not shown) provided in the tip end main body 17 through the light guide and signal cable 8, the operation section 7 and the insertion section 6, so that the observation site can be irradiated with illumination light. There is.

In the bending portion 11, a plurality of substantially annular joint pieces 33 ... Are rotatably arranged in the longitudinal direction of the insertion portion 6, and the joint piece 33 at the tip of the joint piece 33 ... Is the tip portion. It is externally fitted and fixed to the rear end of the main body 17. An annular connecting member 34 provided at the tip of the flexible portion 12 is fitted in the joint piece 33 at the rear end of the plurality of joint pieces 33. The bending knob 13 is connected to the rear end of the tip end main body 17 inside the angle wire guide 36 formed by a metal coil pipe.
An angle wire 37, such as a flexible stranded wire, extended to the end is supported so that it can be pulled and loosened, and by rotating the bending knob 13, the tip portion 9 can be directed in the vertical / horizontal directions. ing.

The stylet 35 as a flexibility adjusting member is inserted into the insertion portion 6, and the stylet channel tube 39 forming the stylet channel 38 has a tip end portion on the proximal side of the bending portion 11. It is provided so as not to reach the curved portion 11. The rear end portion of the stylet channel tube 39 is adapted to be inserted into a stylet insertion opening 41 provided in the operation portion 7. The rear end portion of the stylet channel tube 39 is fixed to the operation portion 7 and is not fixed inside the insertion portion 6.

In FIG. 2 and FIG. 3, the forceps channel tube 23 is a composite tube having, for example, an expandable tetrafluoroethylene resin tube (trade name GORE-TEX) as a main structure and has airtightness and a diameter. It also has strength against compressive force from the direction. The stylet channel tube 39 is inserted adjacent to the forceps channel tube 23. Tube for this stylet channel
39 is highly flexible, slippery, and has high resistance to compression in the radial direction, and does not remain crushed even when compressed in the radial direction, and completely restores, for example, foamable tetrafluoroethylene resin, etc. Is formed by. The stylet channel tube 39 is preferably made of a fluororesin in terms of slipperiness.

At the tip of the stylet channel tube 39,
A lid 42, which is a stopper member for preventing the insertion of the tip of the stylet 35, is fitted inside and adhered and fixed in a watertight manner. This stylet channel tube 39 is not airtight but watertight, so the stylet channel
38 is watertight with respect to the inside of the insertion portion 6. In addition,
The tip of the lid 42 does not reach the curved portion 11.

The forceps channel tube 23 is surrounded by the forceps channel tube 23 and the stylet channel tube 39.
The flexible spiral tube 46 formed by spirally winding a thin plate member having an inner diameter slightly larger than the sum of the outer diameter of the tube 39 and the outer diameter of the stylet channel tube 39 is surrounded. ing.

A mesh tube 47 is formed on the outer circumference of the spiral tube 46, and a flexible tube 48 formed of resin or the like for fitting and housing the mesh tube 47.
Is provided.

The inside of the spiral tube 46 is bisected in the longitudinal direction of the insertion section 6 by the forceps channel tube 23 and the stylet channel tube 39, and the signal line 28 and the light are written in one of the bisected spaces. The guide 31 and the angle wire guide 36 are inserted into the other space, and the air supply tube 49, the water supply tube 51, and the angle wire guide 36 are inserted into the other space. It should be noted that a relatively mechanically weak internal material such as the water supply tube 51 and the air supply tube 49 may be covered with the protective tube.

Since the forceps channel tube 23 and the stylet channel tube 39 divide the inside of the insertion portion 6 into two parts, the internal components do not intersect or are entangled with each other, and therefore the durability of the internal components is improved. Can be improved. Further, since the stylet channel 38 and the stylet 35 are restricted to a relatively constant position inside the insertion portion 6, the elastic force and hardness of the stylet 35 are directly reflected as the elastic force and hardness of the insertion portion 6. It is supposed to be done.

The signal line 28 is composed of a plurality of shield lines 43,
The binding resin 44 is dipped into a bundle. The light guide 31 is covered with a protective tube 52, such as foamable tetrafluoroethylene resin, which has good flexibility and slidability, and has a strong resistance to compression in the radial direction.

The stylet 35 inserted into the stylet channel 38 is, for example, seven flexible metal pipes 53 covered with an outer cover 54.
The proximal side of 54 is a large diameter portion 56 that abuts the stylet insertion opening 41.
It is fixed to. The metal pipe 53 and the outer skin 54 have a large diameter portion 56.
Stylet because it is not fixed axially except
When 35 is curved, the relative position in the axial direction between the metal pipe 53 and the outer skin 54 is locally displaced. At the tip of the stylet 35, a tip tip 57, which is tapered so as to have a small diameter toward the front, is internally fitted and fixed to the outer cover 54. When the insertion portion 6 is bent, the tip tip 57 does not contact the lid 42, and the metal pipe 53 is the tip tip.
The length is set so that it does not touch 57.

The operation of the endoscope device 1 configured as above will be described.

In the case of a large intestine examination, the insertion part 6 of the endoscope 2 from the anus of the patient
Insert. When the insertion is started, better flexibility is easier to insert, but when the insertion is advanced, the large intestine is complicatedly curved and the insertion portion 6 forms a loop, which makes it difficult to insert. In such a case, the stylet 35, which is harder than the insertion portion 6 and harder in elasticity than the stylet insertion port 41, is inserted. By inserting the stylet 35, the hardness and elasticity of the insertion portion 6 are increased and the insertion portion 6 is linearized to facilitate the insertion. It is sufficient that the insertion portion 6 is not completely straightened, and if necessary, the insertion portion 6 may be locally hard in the axial direction.

In addition, as a method of use, an experienced doctor prefers that the insertion portion 6 is hard, and a beginner has a soft insertion portion 6 in advance because the insertion portion 6 may cause great pain to the patient. A plurality of stylets 35 having different hardness and elasticity from the endoscope 2 may be prepared and the optimum stylet 35 may be used according to the user's selection.

Further, since the insertion portion 6 of the endoscope 2 becomes soft with repeated use, a plurality of stylets 35 having different hardnesses should be prepared, and the hardness of the insertion portion 6 can be kept constant by appropriately selecting and using them. You may keep it. Also, a plurality of stylets 35 may be prepared according to the length of the insertion portion 6.

Furthermore, the hardness and elasticity of the stylet 35 can be set to a desired value by appropriately selecting the number of metal pipes 53, the thickness of the metal pipes 53, the material, and the like.
Further, the metal pipe 53 may be a stainless pipe, a phosphor bronze pipe, or the like. The metal pipe 53 does not necessarily have to be provided over the entire length of the stylet 35, and the hardness of the stylet 35 may be partially changed by partially changing the number thereof. Furthermore, metal pipe
The 53 may be fixed to each other by soldering or the like, or the hardness may be partially changed.

According to the present embodiment, the hardness and elasticity of the insertion portion 6 can be changed by selectively inserting and removing the stylet 35, and the insertion operation of the endoscope 2 can be performed according to the usage situation. it can.

Further, according to the present embodiment, since the electronic scope uses the solid-state image pickup device 27, the image guide which is most easily damaged in the insertion portion 6 is not used. Therefore, it is possible to obtain the endoscope 2 in which the image guide does not break and has excellent durability. In addition, since the signal line 28 is a bundle, mechanical durability can be improved.

When cleaning the endoscope 2 and disinfecting it with a chemical solution, the entire endoscope 2 is immersed in a liquid. At that time, a plugging member such as a rubber cap is attached to the stylet insertion port 41 to attach the stylet channel 38. The liquid may not enter the inside. Even if a liquid enters the stylet channel 38 where the plugging member has been forgotten, the stylet channel 38 is watertight and will not leak, but the liquid will not spoil in the stylet channel 38. It is better to discharge the liquid immediately and dry it.
The stylet channel 38 and stylet 35 do not come into contact with the patient and thus do not become an infection route.

The configuration of the stylet 35 is not limited to this embodiment, and a plurality of pipes may be concentrically stacked.
The hardness may be changed by twisting the heavy coil.

Further, when a plurality of endoscopes 2 having different lengths and a plurality of stylets 35 having different lengths are prepared and used, the length of the endoscope 2 is increased in the vicinity of the stylet insertion opening 41 and the stylet 35. An identification mark regarding the height may be provided. Also,
An erroneous insertion prevention mechanism may be provided, and the identification mark may be provided even when the stylet channel 38 and the stylet 35 having different outer diameters are prepared.

When the stylet 35 is inserted into the stylet channel 38, the stylet channel 38 may be plugged in the vicinity of the contact portion between the stylet insertion opening 41 and the large diameter portion 56.

In this case, change stylet 35 to stylet channel
Alternatively, the stylet 35 may be removed only when it is desired to make the insertion portion 6 soft, in which case the state of being inserted into the body 38 is set as a normal state, and cleaning, disinfection and gas sterilization are performed in that state.

Further, in this embodiment, the stylet channel 38 is set to 1
Although a plurality of stylet channels 38 are provided and the number of stylets 35 to be inserted allows the insertion portion 6 to be inserted.
You may change the hardness of.

FIG. 5 is a cross-sectional view of the soft part according to the second embodiment of the present invention.

A thin plate-like member is spirally wound so as to surround a built-in object such as a stylet channel 38 provided in the longitudinal direction of the insertion portion 6 in the flexible portion 12 constituting the insertion portion 6 of the endoscope 2. A flexible spiral tube 46 formed by the above is inserted.
The spiral tube 46 is formed of a material having good solder wettability or is plated with a material having good solder wettability (nickel, chromium, tin, etc.).

The outer circumference of the spiral tube 46 is covered with a mesh tube 47, and the outer circumference of the mesh tube 47 is covered with a flexible tube 48 so as to accommodate the mesh tube 47.

An inner peripheral surface of the spiral tube 46 is formed so as to surround the stylet channel tube 39, and a stylet channel guide 58 such as a non-close-wound coil which is plated with solder spirals a part of the periphery. The inner peripheral surface of the pipe 46 is appropriately soldered and inserted. Since the stylet channel guide 58 and the stylet channel tube 39 are not fixed in the insertion portion 6, only the radial force of the stylet 35 is transmitted to the flexible portion 12.

In the assembly of the insertion portion 6, a part of the outer periphery of the stylet channel guide 58 and the inner peripheral surface of the spiral tube 46 are brought into contact with each other with a jig in the state where the flexible tube 48 is not provided, and the portion is attached to the soldering point. It is irradiated with laser light and heated.
The solder plated on the stylet channel guide 58 is melted by heating, and the spiral tube 46 and the stylet channel guide 58 are fixed. In this case, spiral tube 46 and mesh tube 47
And are not fixed, the flexibility of the insertion portion 6 is not affected. Note that paste solder, UV adhesive, or the like may be poured through the gap of the spiral tube 46 through the mesh tube 47 to heat or irradiate with UV to fix the same.

 Other configurations and operations are similar to those of the first embodiment.

According to this embodiment, the stylet channel guide 58
Since the insertion position of the stylet channel tube 39 is regulated by providing, the stylet channel 38 does not move inside the flexible portion 12 and other internal components are not damaged. Further, since the elasticity of the stylet 35 is transmitted to the flexible portion 12 more directly through the stylet channel guide 58, the linearizing effect is great.

 Other effects are similar to those of the first embodiment.

In each of the above embodiments, the stylet channel is provided as a dedicated channel for the stylet, but the stylet channel and the forceps channel may be combined. In this case, an endoscope having two channels can use forceps or the like even when a stylet is used. However, since the forceps are often used when the endoscope is removed after the endoscope is inserted, the one-channel endoscope does not have a great influence.

When the forceps channel is also used as the stylet channel, the inner diameter of the forceps channel in front of the curved portion may be reduced so that the stylet is not inserted in front of the curved portion.

The present invention is not limited to the above embodiments, but may be applied to a fiberscope.

[Effects of the Invention] As described above, according to the present invention, it is possible to maintain the resistance of the insertion portion internal component, adjust the flexibility of the insertion portion, and improve the insertability and insertion operation. .

[Brief description of drawings]

1 to 4 relate to a first embodiment of the present invention.
FIG. 2 is an explanatory view of the internal structure of the endoscope, and FIG. 2 is A- in FIG.
A'direction enlarged sectional view, FIG. 3 is a sectional view of the distal end portion of the flexibility adjusting member, FIG. 4 is an overall explanatory view of the endoscope apparatus, and FIG. 5 is a second embodiment of the present invention. It is sectional drawing of a soft part. 1 …… Endoscope device 2 …… Endoscope 6 …… Insertion part 7 …… Operation part 11 …… Bending part 35 …… Stylet 38 …… Stylet channel

Claims (1)

[Claims] 1. An endoscope having a curved portion near the tip of an insertion portion and having an insertion channel for a flexible adjusting member in the insertion portion, and being insertable into and removable from the insertion channel for a flexible adjusting member. The flexibility adjustment member is provided, and the flexibility of the insertion portion can be adjusted by placing the flexibility adjustment member in an inserted state or a withdrawn state. An endoscope apparatus, wherein a stopper member for preventing insertion of a tip of a flexibility adjusting member is provided in a member insertion channel at a position closer to a hand side than a bending portion.