JPH0390126A - Endoscope - Google Patents

Abstract

PURPOSE:To lead a processing tool to an aimed part correctly and speedily by forming the gap between the side wall of the operating wire connection part of a processing tool leading element and the opened port edge of a processing tool projecting window opposed to the side wall, which gap is narrower than the outside diameter of an operating wire. CONSTITUTION:The gap (t) between the side wall of the operating wire connection part of a processing tool leading element 30 and the opened port edge 46 of a processing tool projecting window 45 opposed to the side wall, is formed narrower than the outside diameter of an operating wire 35. When the operating wire 35 is pulled by an operating part, the processing tool leading element 30 is turned around a supporting shaft 31 and raised, and when the operating wire 35 is pushed, the processing tool leading element 30 is turned down. Therefore, the processing tool leading element 30 can be raised and turned down by the pushing an pulling of the operating wire 35, and a processing tool 48 inserted along a leading groove 32 is curved and directed in an arbitrary direction. Since, at this time, the processing tool 48 shifts, having the side surface sliding in contact with the opened port edge 46 of the processing tool projecting window 45, the processing tool 48 is prevented from dropping into the gap (t) during rising, and the processing too 48 is controlled by the leading groove 32 and the opened port edge 46, and the shooting at an aimed part can be carried out correctly and speedily.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an endoscope with an improved function of guiding a treatment tool such as a catheter or forceps.

As a device for guiding the tip of a treatment tool such as a catheter or forceps inserted into a treatment tool channel of an endoscope to a desired site in a body cavity, there is a known device in which a treatment tool guide is provided in the main body of the tip end of an insertion section. There is. An endoscope equipped with this treatment instrument guiding function has conventionally been configured as shown in FIGS. 1 and 2. That is, 1 is the tip body, and this tip body 1
An image transmission optical system 2 and an illumination light transmission optical system 3 are provided on one side, and a treatment instrument protruding window 5 of the treatment instrument guider housing chamber 4 is provided on the other side.
is provided. Then, the treatment instrument inductor storage chamber 4
Inside is a treatment instrument guide 7 that is rotatable around a rotation axis 6.
The treatment instrument guide 7 is rotated, raised, and lowered by an operation wire 8 connected to a hand-held operation section (not shown).

By the way, the height of the outer opening edge 9 of the treatment instrument protruding window 5 is almost the same as that of the first lunion 10 of the image transmission optical system 2, and the tilting of the treatment instrument guide 7 and the manufacturing A gap t is formed between the treatment instrument guide 7 and the inner wall of the treatment instrument guide preparation chamber 4 in order to ensure stable operation in consideration of dimensional errors and the like.

Therefore, if an attempt is made to introduce a treatment instrument 12 such as a catheter along the guide groove 11 with the treatment instrument guide 7 laid down, the treatment instrument 12 will fall into the gap t. In this state, when the treatment instrument guide 7 is raised,
As shown in FIG. 3, the treatment instrument 12 is bent in an arcuate manner within the visual field 13 in order to aim at the target area, but at this time, the elastic repulsive force accumulated in the treatment instrument 12 causes the treatment instrument 12 to A phenomenon occurs in which the needle jumps into the guide groove 11 of the treatment instrument guide 7. For this reason, the aiming operation of the treatment tool 120 toward the target site is interrupted, which is an important problem in medical settings that require accurate and prompt treatment.

This invention was made in view of the above-mentioned circumstances, and its purpose is to ensure that there is no gap between the treatment instrument guide and the opening edge of the treatment instrument protrusion window in order to ensure stable operation of the treatment instrument guide. The treatment tool will not fall into this gap even if a The aim is to provide an endoscope that can

The present invention will be described below based on an embodiment shown in the drawings. 2t in Figures 4 to 9 is the insertion part of the endoscope;
It is covered with an electrically insulating outer cover made of rubber or synthetic resin, and a tip main body 22 is provided at the tip. The tip main body 22 is composed of a main body 23 and a cover 24 fitted to the main body 23. This cover 24 is molded from a synthetic resin material such as epoxy, polycarbonate, or polysulfone.
An opening 26 corresponding to the flat surface 25 is provided.

Furthermore, a treatment instrument guide housing chamber 27 is provided on the right side of the flat surface 25 of the main body 23 when viewed from the operating section side, and an illumination light transmission optical system 28 and an image transmission optical system 29 are provided on the left side in order from the distal end side. Optical members 28a and 29a are provided. The outer surfaces of these optical members 28a and 29a are almost flush with the flat surface 25, but may protrude from the flat surface 25 by about 0.2 to 0.4 s+m to prevent water droplets from accumulating in the recesses. There is also. Furthermore, the treatment instrument guide storage chamber 27 is inclined inward by an angle α from the vertical line a of the main body 23, and one end of the treatment instrument guide 30 is rotatably mounted on a support shaft 31 at the bottom of the chamber 27. It is pivoted. The treatment instrument guide 30 has a generally fan-like shape with a wider tip end when viewed from the side, and a concave arc-shaped guide groove 32 is provided on its upper surface. Further, a mounting hole 33 is bored in the free end of the treatment instrument guide 30, and rotary rings 34a and 34b are rotatably fitted into both opening edges of the mounting hole 33. An operating wire 35 passes through one rotating ring 34a, and its tip is fixed to the other rotating ring 34b by brazing or the like. The operating wire 35 is bent at the outer surface of the treatment instrument guide 30, passes through a through hole 36 formed in the main body 23 and a guide pipe 37 installed in the insertion section 21, and passes through the operating section (not shown). )It is connected to the. Further, the treatment instrument guide 30 is provided with a stopper bin 38 that protrudes from the outer surface adjacent to the attachment hole 33, and is formed by cutting out the main body 23 at the lower end of the stopper bin 38 on the rotation trajectory. A lower end blocking portion 39 is provided at the upper end, and the main body 2
3 is provided with an upper end stop 40 consisting of an adjusting screw threaded into the upper end. Therefore, the rotation range of the treatment instrument guide 30 that is rotated by the operating wire 35 is restricted by the lower end blocking portion 39 and the upper end blocking portion 40 that collide with the stopper bin 38, and when it is collapsed, the lower end blocking portion 39 In addition, when raised, the upper end abutment portions 40 are adapted to abut each other. The treatment tool guide storage chamber 27 that accommodates the treatment tool guide 30 communicates with a treatment tool channel 42 installed in the insertion section 21 via a through passage 41 bored in the axial direction of the main body 23. . A treatment instrument guide housing chamber rear wall 43 formed by cutting out the main body 23 in an arc shape is provided at the upper part of the through passage 41, and a treatment instrument dII fulcrum 4 is provided on this arcuate surface.
4 is formed.

Further, the cover 24 is provided with a treatment instrument protrusion window 45 corresponding to the treatment instrument guide housing chamber 27, and the optical member 28a of the treatment instrument protrusion window 45.

The opening edge 46 on the opposite side to 29a, that is, the right side when viewed from the operating section side, gently extends optical members 28a and 29a from the tip side.
The extent of this bulge is such that the treatment instrument guide 30 is raised when viewed from a direction perpendicular to the central axis of the distal end main body 22 and included in the outer surfaces of the optical members 28a and 29a. It is formed at a height that allows it to be almost hidden from view. Moreover, the opening edge 4 of this cover 24
The inner surface 47 at 6 faces the treatment instrument guide 30 through a gap t, and its upper end is formed into a flat surface 47a, and its midway portion is formed into a conical surface 47b. The conical surface 47b forms a relief part for the operation wire 35 and the stopper bin 38 that protrude from the treatment instrument guide 30, and also serves as a relief when the treatment instrument 48 is deviated laterally during insertion due to a bend or the like. It functions to guide the endoscope through smoothly. However, even if the opening edge 46 of the cover 24 is made higher than the outer surfaces of the optical members 28a and 29a, the gap between the treatment instrument guide 30 and the inner surface 47 is increased by W as shown by the broken line in FIG. Then, there is a problem that the treatment instrument 48 falls into the gap W. Therefore, the gap W also needs to be made smaller. The smaller the gap W is, the less the treatment tool 48 will fall.In this embodiment, the outer diameter of the operating wire 35 is about 0.6 +++ m, so the side wall of the operating wire connecting portion of the treatment tool guide 30 and the opposite A gap t between the opening edge 46 of the treatment instrument protruding window 45 and the opening edge 46 is formed to be narrower than the outer diameter of the operating wire 35.

Note that the gap t between the treatment instrument guide 30 and the inner surface 47 of the cover 24 is set to a maximum of 0.6 in consideration of the tilting of the treatment instrument guide 30, manufacturing tolerances of the cover 24, and assembly errors. am setting, and the treatment instrument inductor 3
0 provides stable operation.

When the insertion section 21 of the endoscope is inserted into the body cavity, when a treatment tool 48 such as a catheter or forceps is inserted from the operation section (not shown), the treatment tool 48 passes through the treatment tool channel 42. , is guided to the treatment instrument guide 30 via the through passage 41 of the distal end main body 22. Since the treatment instrument guide 30 is provided with a guide groove 32 for guiding the treatment instrument 48, the treatment instrument 48 moves forward while sliding in the guide groove 32, and the tip thereof is as shown by the solid line in FIG. The treatment instrument protrudes from the protrusion window 45. In this state, when the operating wire 35 is pulled by the operating section (not shown), the treatment instrument guide 30 rotates and rises about the support shaft 31, and when the operating wire 35 is pushed, the treatment instrument guider 30 is raised. Child 30 falls down. Therefore, the treatment instrument guide 30 can be lowered and raised by pushing and pulling the operation wire 35, and the treatment instrument 48 inserted along the guide groove 32 can be bent and directed in any direction. At this time, the treatment instrument 48 moves while sliding its side surface against the opening edge 46 of the treatment instrument protrusion window 45, so that the treatment instrument 48 does not fall into the gap t as shown by the two-dot chain line in FIG. There is no guide groove 32
and the aperture edge 46, and the target area can be targeted accurately and quickly.

Therefore, this effect is particularly noticeable in the case of duodenal scoping, whose main purpose is retrograde pancreatocholangiography. That is, as shown in FIG. 10, the optical member 29a of the image transmission optical system 29 in the distal end body 22 of the endoscope is inserted into the pancreaticobiliary duct opening (-duodenal papilla) 50 located on the rear wall of the duodenum 49. In order to make them face each other correctly, if a right curve is applied in addition to a so-called up curve at the same time, the distance of PQ will be shorter than R3 on the opposite side, so the tip body 22 will rotate counterclockwise around the central axis when viewed from the operating unit side. twisted to properly oppose the pancreaticobiliary orifice 50. For this reason, the treatment instrument 48 always elastically strongly hits the opening edge 46 of the treatment instrument protruding window 45, and at this time conventionally the treatment instrument 48 fell into the gap t, but in this invention the opening edge 46 is raised. This point was resolved.

Further, the opening edge 46 of the treatment instrument protruding window 45 is gently raised from the distal end side and does not protrude outward beyond the cross-sectional shape of the base of the main body 23, so there is no risk of damaging the body cavity wall. Further, since the opening edge 46 is separated from the illumination light transmission optical system 28 and the image transmission optical system 29, light is not blocked.

Furthermore, the cover 24 covering the main body 23 is formed of a synthetic resin material, and the opening edge 46 is integrally provided on the cover 24, so that it has the ability to electrically insulate between the treatment instrument guide 30 and the body cavity wall. When the active electrode of the treatment instrument 48 is in contact with the affected area and the treatment instrument inductor 30 is in contact with the body cavity wall, high-frequency current is erroneously applied, and from the treatment instrument 48 to the endoscope. The conventional inconvenience of causing burns to the body cavity wall at the contact point of the treatment instrument inductor 30 to the body cavity wall due to the high-frequency current generated by the treatment instrument is eliminated.

As described above, the present invention makes the gap between the side wall of the operation wire connection part of the treatment instrument guide and the opening edge of the treatment instrument protruding window facing there narrower than the outer diameter of the operation wire that operates to raise the treatment instrument guide. This prevents the treatment instrument from falling into the gap between the treatment instrument guide and the opening edge of the treatment instrument protrusion window.
The treatment instrument can be reliably guided by the opening edge and the guide groove of the treatment instrument guide, and the treatment instrument can be guided to the target site accurately and quickly. Furthermore, since one side of the treatment instrument guide is covered by the opening edge even in the raised position, the treatment instrument guide will not sink into the body cavity wall, and will not damage the body cavity wall even if the endoscope is moved back and forth. It has the effect of never happening.

[Brief explanation of drawings]

Figure 1 is a plan view showing the main body of the distal end of a conventional endoscope;
The figure is a perspective view with a part cut away, FIG. 3 is an explanatory view of the operation, FIG. 4 is a plan view of the tip main body showing an embodiment of the present invention, and FIG. 5 is FIG. A cross-sectional view along V&I, Figure 6 is a cross-sectional view along the line ■-■ in Figure 4, and Figure 7 is a cross-sectional view along the line ■-■ in Figure 4.
Figure 8 is a half-cross sectional view of the tip body, Figure 9 is a half-cross sectional view of the tip body for explaining the action, and Figure 10 is the same action. It is an explanatory diagram. 22... Tip body, 27... Treatment instrument guide storage chamber, 28... Illumination light transmission optical system, 29... Image transmission optical system, 28a, 29a... Optical member, 30...・Treatment instrument guide, 31... Support shaft, 35... Operation wire, 45
...Treatment instrument protruding window, 46...Opening edge, 48...Treatment instrument.

Claims (1)

[Scope of Claims] A treatment instrument guide is pivotally supported on a support shaft provided in a treatment instrument guide housing chamber of the distal end main body of an endoscope, and the tip of an operating wire is connected to the treatment instrument guide. In addition to attaching the end to the operating section, a treatment tool protruding window is provided in the treatment tool guide storage chamber where the treatment tool channel opens, and the treatment tool guide is rotated by pushing and pulling with this operating wire, and the treatment tool is guided out. In the endoscope, the gap between the side wall of the operating wire connecting portion of the treatment instrument guide and the opening edge of the treatment instrument protruding window facing therebetween is made narrower than the outer diameter of the operating wire. Characteristic endoscope.