JPH0443664B2 - - Google Patents

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 a distal end main body, and on one side of this distal end main body 1, an image transmission optical system 2 and a proof light transmission optical system 3 are provided, and on the other side, a treatment instrument protrusion of a treatment instrument guide accommodation chamber 4 is provided. A window 5 is provided. and,
A treatment instrument guide 7 that is rotatable about a rotating shaft 6 is provided in the treatment instrument guide storage chamber 4, and this treatment instrument guide 7 has a hand-operated part (not shown).
It is designed to be rotated, that is, raised and lowered, by an operating wire 8 connected to the terminal.

By the way, the height of the outer opening edge 9 of the treatment instrument projecting window 5 is almost the same as that of the first lens 10 of the image transmission optical system 2, and the tilting of the treatment instrument guide 7 and manufacturing A gap t is formed between the treatment instrument guide 7 and the inner wall of the treatment instrument guide accommodating 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
falls to the above-mentioned interval t. In this state,
When the treatment instrument guide is raised, the treatment instrument 12 is bent in an arcuate manner within the field of view 13 to aim at the target area, as shown in FIG. A phenomenon occurs in which the treatment instrument 12 jumps into the guide groove 11 of the treatment instrument guide 7 due to the elastic repulsive force. For this reason, the aiming operation of the treatment instrument 12 toward the target site is interrupted, which is an important problem in medical settings where accurate and prompt treatment is required.

This invention was made in view of the above-mentioned circumstances, and its purpose is to ensure that there is a gap between the treatment implement guide and the opening edge of the treatment implement protrusion window in order to ensure stable operation of the treatment implement guide. Even if a gap is provided, the treatment instrument will not fall into this gap, and the treatment instrument can be reliably guided by the opening edge and the guide groove for guiding the treatment instrument, and the treatment instrument can be accurately guided to the target area. It is an object of the present invention to provide an endoscope that can be guided quickly.

The present invention will be described below based on an embodiment shown in the drawings. 1 in FIGS. 4 to 9 is the insertion portion of the endoscope, which 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. . This tip body 22
is a main body 23 and a cover 2 fitted to this main body 23.
It is composed of 4. This cover 24 is molded from a synthetic resin material such as epoxy, polycarbonate, or polysulfone, and is made of the main body 2.
An opening 26 corresponding to the flat surface 25 of No. 3 is provided. Furthermore, a treatment instrument guiding accommodation 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 on the left side, an identification light transmission optical system 28 and an image transmission optical system 29 are provided in order from the distal end side. Optical member 2
8a and 29a are provided. Note that the outer surfaces of these optical members 28a and 29a are the same as the flat surface 25.
Although the surface is almost the same as that of the flat surface 25, it may protrude from the flat surface 25 by about 0.2 to 0.4 mm to prevent water droplets from accumulating in the recess. Further, the treatment instrument guide housing chamber 27 is arranged at an angle α inward from the vertical line a of the main body 23.
The treatment instrument guide 3 is installed at the bottom of this slope.
0 is rotatably pivoted by a support shaft 31. 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. Furthermore, a mounting hole 33 is bored in the free end of the treatment instrument guide 30.
Rotating rings 34a and 34b are rotatably fitted to the edges of both openings. An operating wire 35 passes through one of the rotating rings 34a, and its tip is fixed to the other rotating ring 34b by brazing or the like. Further, the operating wire 35 is bent at the outer surface of the treatment instrument guide 30, and is connected to a through hole 36 bored in the main body 23 and inserted into the insertion portion 21.
It passes through a guide pipe 37 installed inside and is connected to an operating section (not shown). Furthermore, a stopper pin 38 protrudes from the outer surface adjacent to the attachment hole 33 on the treatment instrument guide 30, and a stopper pin 38 is formed by cutting out the main body 23 at the lower end of the rotation trajectory of the stopper pin 38. A lower end stopper 39 is provided, and an upper end stopper 40 is provided at the upper end, which is an adjustment screw screwed into the main body 23. Therefore, the rotation range of the treatment instrument guide 30 that is rotated by the operating wire 35 is restricted by the stopper pin 38 and the lower end blocking portion 39 and the upper end blocking portion 40, and when it is collapsed, Lower end stop portion 39
In addition, when raised, the upper end abutment portions 40 are adapted to abut against each other. Then, the treatment instrument guide 30
The treatment instrument inductor storage chamber 27 that accommodates the main body 2
It communicates with a treatment instrument channel 42 installed inside the insertion section 21 via a through passage 41 drilled in the axial direction of No. 3 . A rear wall 43 of the treatment tool guide housing chamber formed by cutting out the main body 23 in an arc shape is provided at the upper part of the through passage 41, and forms a treatment tool bending fulcrum 44 without an arcuate surface.

Further, the cover 24 is provided with a treatment instrument protrusion window 45 corresponding to the treatment instrument guide housing chamber 27 . The optical member 28 of this treatment instrument protruding window 45
The opening edge 46 on the opposite side to a and 29a, that is, the right side when viewed from the operating section side, is gently raised higher than the outer surface of the optical members 28a and 29a from the tip side, and the extent of this swell is higher than the tip main body 22. When viewed from a direction perpendicular to the central axis and included in the outer surfaces of the optical members 28a, 29a, the treatment instrument guide 30 is formed at a height that is almost hidden even in the raised position. Further, an inner surface 47 of the opening edge 46 of the cover 24 faces the treatment instrument guide 30 with a gap t therebetween, and has a flat surface 47a at its upper end and a conical surface 47b at its midpoint. There is. The conical surface 47b forms a relief part for the operating wire 35 and the stopper pin 38 that protrude from the treatment instrument guide 30, and in case the treatment instrument 48 shifts laterally during insertion due to a bend or the like. It also functions to guide the endoscope smoothly through the endoscope. However, cover 2
Even if the opening edge 46 of No. 4 is made higher than the outer surfaces of the optical members 28a and 29a, if the distance t between the treatment instrument guide 30 and the inner surface 47 is increased by W as shown by the broken line in FIG. There is a problem that the treatment instrument 48 falls into the gap W. Therefore, it is necessary to reduce the above-mentioned distance W as well. The smaller the distance W is, the less the treatment tool 48 will fall.In this embodiment, the outer diameter of the operating wire 35 is approximately 0.6 mm, so that the outer diameter of the operating wire 35 is approximately 0.6 mm, so that the outer diameter of the operating wire 35 is approximately 0.6 mm, so that the outer diameter of the operating wire 35 is approximately 0.6 mm, so that the outer diameter of the operating wire 35 is approximately 0.6 mm. Opening edge 4 of treatment instrument protruding window 45
6 is formed to be narrower than the outer diameter of the operating wire 35. Note that the distance t between the treatment instrument guide 30 and the inner surface 47 of the cover 24 is approximately 0.6 mm at most, taking into account the tilting of the treatment instrument guide 30 and manufacturing tolerances of the cover 24 as well as assembly errors. is set so that the treatment instrument guide 30 operates stably.

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. This treatment instrument inductor 30
Since the treatment instrument 48 is provided with a guide groove 32 for guiding the treatment instrument 48, the treatment instrument 48 moves forward while sliding on the guide groove 32, and the tip of the instrument 48 moves forward through the treatment instrument protruding window as shown by the solid line in FIG. It protrudes from 45. In this state, when the operation wire 35 is pulled by the operation section (not shown) of the operation section (not shown), the treatment instrument guide 30 rotates about the support shaft 31 and rises, and when the operation wire 35 is pushed, the treatment device The tool inductor 30 is laid down. Therefore, the treatment tool guide 30 can be lowered and raised by pushing and pulling the operation wire 35, and the treatment tool 48 inserted along the guide groove 32 can be bent and directed in any direction. be able to. At this time,
Since the treatment instrument 48 moves while its side surface is in sliding contact with the opening edge 46 of the treatment instrument protrusion window 45, the treatment instrument 48 moves between
It is controlled by the guide groove 32 and the opening edge 46, so that the target area can be shot accurately and quickly.

Therefore, this effect is particularly noticeable in the case of a duodenoscope whose main purpose is retrograde pancreaticochleangiography. That is, as shown in FIG. 10, in order to properly oppose the optical member 29a of the image transmission optical system 29 in the distal end body 22 of the endoscope to the pancreaticobiliary duct opening (duodenal papilla) 50 located on the rear wall of the duodenum 49. If a light curve is applied in addition to the so-called up curve at the same time, the distance of PQ will be shorter than the RS on the opposite side, so the tip body 22 will be twisted counterclockwise around the central axis when viewed from the operating unit side, and the pancreas will be properly aligned. It faces the bile duct opening 50. For this reason, the treatment tool 4
8 always elastically strongly hits the opening edge 46 of the treatment instrument protruding window 45, so that at this time, conventionally, the treatment instrument 48
However, since the opening edge 46 of the present invention is raised, this problem has been solved.

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. Without,
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 that covers the main body 23 is formed of a synthetic resin material, and the cover 24 is integrally provided with an opening edge 46, thereby electrically insulating between the treatment instrument guide 30 and the body cavity wall. When the active electrode of the treatment instrument 48 is not touching the affected area and the treatment instrument inductor 30 is touching the body cavity wall, high-frequency current is erroneously applied, and the endoscope is removed from the treatment instrument 48. 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 leaked high-frequency current is eliminated.

As explained above, the present invention has a structure in which the distance 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 opposite thereto is determined by the outer diameter of the operating wire for raising the treatment instrument guide. Because it was formed narrowly,
〓 between the treatment instrument guide and the opening edge of the treatment instrument protrusion window.
The treatment tool can be reliably guided by the opening edge and the guide groove of the treatment tool guide without the treatment tool falling in between, and the treatment tool can be guided to the target site accurately and quickly. Moreover, 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. The effect is that there is no

[Brief explanation of drawings]

FIG. 1 is a plan view showing the main body of the distal end of a conventional endoscope; FIG. 2 is a partially cutaway perspective view;
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, FIG. 5 is a sectional view taken along the line V-V in FIG. 4, and FIG. Figure-
7 is a cross-sectional view taken along the line of FIG. 6, FIG. 8 is a half cross-sectional view of the tip body, and FIG. 9 is a half cross-sectional view of the tip body for explaining the action. The cross-sectional view and FIG. 10 are also action explanatory views. 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 protrusion window, 46... Opening edge,
48...Treatment tool.

Claims (1)

[Scope of Claims] 1. 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 proximal 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. In the endoscope configured to be set in the lead-out direction, the distance 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 narrower than the outer diameter of the operating wire. An endoscope characterized by: