JPH0632084Y2 - Mantle for endoscopy - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial field of application] The present invention relates to a mantle for an endoscope for injecting a drug into a raised lesion such as a polyp or varicose vein formed in the body to cure the drug.

[Prior Art] In the medical field, esophageal varices sclerotherapy, in which a drug is injected into an esophageal varix and hardened, has been tried. Japanese Patent Laid-Open No. Sho 63-174802 discloses a procedure in which an endoscope and a treatment mantle are used in combination for such treatment under observation of the endoscope.

FIG. 7 shows a conventional outer tube, which is provided with an intake hole 2 on the outer periphery of the distal end portion of the tube body 1, and the intake hole 2
To the base end of the tube body 1 from the tube body 1
A treatment instrument insertion passage 3 is formed on the inner surface of the tube, and the esophageal varix 5 is taken in through the intake hole 2 under observation of the endoscope 4 inserted in the tube body 1, and further treated from the proximal end side of the tube body 1. By puncturing the esophageal varices 5 with the injection needle 6 inserted into the tool insertion passage 3 and injecting a drug, the esophageal varices 5 are hardened to completely disappear.

By the way, when such a mantle tube is inserted into the esophagus 7, if there is a large gap between the esophageal wall 7a and the tube body 1, the esophageal varices 5 can be sufficiently taken into the intake hole 2. However, if the esophageal varix 5 is small, it cannot be treated. Therefore, the conventional mantle tube is the esophageal wall 7a
The tube body 1 is made thick so that the gap between the tube body 1 and the tube body 1 does not become too large, and the esophageal varix 5 is placed in the intake hole 2.
Was made easy to take in.

[Problems to be solved by the device]

As described above, in the conventional method in which the intake hole 2 of the tube body 1 is pushed into the esophageal varix 5 and the esophageal varix 5 is taken into the tube body 1, the tube body 1 is thickened to some extent with respect to the esophageal wall 7a. Otherwise, the esophageal varices 5 cannot be taken in sufficiently. Therefore, a thick mantle tube must be placed on the patient, resulting in increased pain to the patient.

The present invention has been made in view of the above circumstances, and its purpose is to reduce the pain to the patient by making the outer diameter small, and yet to sufficiently incorporate the prominent lesion to make it small. Another object of the present invention is to provide an endoscope mantle tube capable of surely treating.

[Means and Actions for Solving the Problems]

In the endoscope outer tube of the present invention, the outer diameter of the tube main body is made as thin as possible while ensuring a space into which the insertion portion of the endoscope can be inserted, and the base end opening of the tube main body. Portion and the treatment instrument insertion passage open to the proximal end opening portion are closed by a seal member, and when the insertion portion of the endoscope is inserted from above the seal member, the insertion portion and the seal member come into close contact with each other. By removing air in and out, and by inhaling through the suction channel of the endoscope insertion part in the tube body, the tip opening of the tube body is blocked by the wall of the body cavity to create a negative pressure inside the tube body. Even if the uptake hole provided on the outer periphery of the tip of the main body is not pressed against the elevated lesion, the lesion is forcibly sucked into the uptake hole.

〔Example〕

A first embodiment of the present invention will now be described with reference to FIGS.
It will be described with reference to the drawings.

FIG. 2 shows the outer appearance of the mantle for treatment of esophageal varices, and the tube body 11 is made of polyurethane resin or the like and is flexible and long and transparent. Further, as shown in FIG. 1, an uptake hole 13 for taking in a bulging lesion, here, an esophageal varix 12 is formed on the outer circumference of the distal end of the tube body 11, and in the vicinity of this uptake hole 13. To the base end opening 11a of the tube body 11 from the tube body 11
A treatment instrument insertion passage 15 for passing a treatment instrument, here, the injection needle 14 is formed along the axial direction on the inner surface of the. Here, in addition to the space for the treatment instrument insertion passage 15, a space in which the insertion portion 16 of the endoscope can be inserted is provided in the tube body 11. It should be noted that this endoscope has a suction channel (not shown), and a channel port is opened at the distal end surface of the insertion portion 16 thereof.

A flange portion 17 is provided on the outer circumference of the base end portion of the tube body 11 along the circumferential direction, and the base end opening portion 11a of the tube body 11 covers the flange portion 17 and the inside of the tube body 11 and A seal member 18 made of an elastic member that simultaneously seals the inside of the treatment instrument insertion passage 15 is attached. That is, the seal member 18 here is an integrally-molded die that includes a portion that closes the proximal end opening 11 a of the tube body 11 and a portion that closes the proximal end opening 15 a of the treatment instrument insertion passage 15. An insertion hole 19 having a diameter substantially the same as the outer diameter of the endoscope insertion portion 16 or slightly smaller than the outer diameter of the endoscope insertion portion 16 is formed in a portion of the seal member 18 facing the proximal end opening portion 11a of the tube body 11. The insertion portion 19 of the endoscope is inserted into the insertion hole 19.
6 is elastically inserted and therefore the insertion part 16 of the endoscope
Is hermetically inserted into the tube body 11. On the other hand, the injection needle 14 inserted into the treatment instrument insertion passage 15 is punctured as it is with respect to the seal member 18, and therefore the injection needle 14 is also airtightly inserted into the treatment instrument insertion passage 15. .

Next, a case will be described in which the esophageal varices 12 formed in the esophagus 20 of a patient are treated under the observation of an endoscope using the treatment mantle having such a configuration.

First, the tube body 11 of the mantle tube is inserted into the esophagus 20. At this time, the insertion portion 16 of the endoscope is inserted into the tube body 11.
It is inserted inside, and the intake hole 13 of the tube body 11 is directed toward the esophageal varices 12 under the observation of the endoscope. Next, suction is performed through the suction channel of the endoscope insertion portion 16 inside the tube body 11. Then, the proximal end opening 11 a of the tube body 11 and the proximal end opening 15 of the treatment instrument insertion passage 15 are provided.
Since a is sealed by the seal member 18, the inside of the tube body 11 becomes a negative pressure, whereby the esophageal wall 20a sticks to the tip opening 11b of the tube body 11,
The esophageal wall 20a closes the tip opening 11b.
Then, the inside of the tube body 11 is completely sealed except for the intake hole 13, and since the inside of the tube body 11 has a negative pressure, the esophageal varices 12 near the intake hole 13 are Even if the intake hole 13 is not pressed against the esophageal varix 12, the intake hole 13 is forcibly sucked into the intake hole 13.

In this way, when the esophageal varix 12 is sucked into the intake hole 13 to an appropriate depth, the injection needle 14 is pierced into the seal member 18 of the tube body 11 to insert the treatment tool insertion passage 15
Then, the injection needle 14 is pierced into the esophageal varices 12 to inject a drug.

Thus, unlike the conventional method of pressing the intake hole 13 of the tube body 11 against the esophageal varices 12 and taking the esophageal varices 12 into the intake holes 13, the suction channel of the endoscope is used. The esophageal varices 12 are forcibly sucked into the intake holes 13 by making the inside of the tube body 11 into a negative pressure, so that even if there is a large gap between the esophageal wall 20a and the tube body 11, The esophageal varices 12 can be sufficiently taken into the holes 13, and any small esophageal varices 12 can be treated reliably and easily. Therefore, even if the outer diameter of the tube main body 11 is made as thin as possible while ensuring a space into which the insertion portion 16 of the endoscope can be inserted, the esophageal varices 12 can be reliably treated. When the mantle is placed on the patient, the pain to the patient can be reduced.

FIG. 3 shows a second embodiment of the present invention.

In this embodiment, a treatment instrument insertion hole 21 communicating with the treatment instrument insertion passage 15 is provided on the outer periphery of the proximal end portion of the tube body 11 coaxially with the intake hole 13 and a part of the seal member 18 is extended. The insertion hole 21 is closed. The other basic structure is the same as that of the first embodiment.

Here, since the insertion portion 16 of the endoscope is inserted into the proximal end opening 11a of the tube body 11 and the operator grips the proximal end portion of the tube body 11, the proximal end portion of the treatment instrument insertion passage 15 is formed. Is opened at the proximal end opening 11a of the tube body 11, it becomes difficult for an assistant to insert the injection needle 14 into the treatment instrument insertion passage 15. However, here, the treatment instrument insertion hole 21 is formed at the base end of the tube body 11. Since it is provided on the outer circumference of the portion, the assistant can more easily insert the injection needle 14 into the treatment instrument insertion passage 15 through the insertion hole 21.

FIG. 4 shows a third embodiment of the present invention.

In this embodiment, the distal end opening portion 15b communicating with the intake hole 13 of the treatment instrument insertion passage 15 formed on the inner surface of the tube body 11 is provided with
The second embodiment is the same as the second embodiment except that a seal member 25, which is separate from the seal member 18 attached to the base end opening 11a of the tube body 11, is packed and fixed. However, the treatment instrument insertion hole 21 provided on the outer periphery of the proximal end portion of the tube body 11 is not closed by the seal member 18 and is open to the outside. The seal member here is the seal member 18 that closes the proximal end opening 11a of the tube body 11.
And a seal member 25 for closing the distal end opening 15b of the treatment instrument insertion passage 15 are formed separately.

With this configuration, the distal end opening portion 15 of the treatment instrument insertion passage 15 is formed.
Since the seal member 25 is provided in b, it is possible to prevent dirt such as body fluid from entering the treatment instrument insertion passage 15 through the intake hole 13 when the outer tube is used. It is possible to prevent filth from being left behind in the tool insertion passage 15 and sticking firmly.

5 and 6 show a fourth embodiment of the present invention.

In this embodiment, an opening / closing plug 3 is provided on the outer periphery of the base end portion of the tube body 11 for quickly releasing the negative pressure state in the tube body 11.
1 is provided. That is, the mounting hole 3 communicating with the inside of the tube body 11 is formed on the outer periphery of the base end portion of the tube body 11.
2, an opening / closing plug 31 made of an elastic member such as rubber or cork is detachably fitted into the mounting hole 32. The opening / closing plug 31 is connected to the seal member 18 attached to the proximal end opening 11a of the tube body 11 by a string 33. When the opening / closing plug 31 is removed from the mounting hole 32, the opening / closing plug 31 is connected to the tube body 11 It is designed to be completely separated from and not lost. When it is necessary to keep the inside of the tube body 11 airtight, the opening / closing plug 31 is fitted into the mounting hole 32, and when it is desired to release the airtightness, the opening / closing plug 31 is removed from the mounting hole 32.

By doing so, when it is desired to release the negative pressure state in the tube body 11, it is quicker to remove the opening / closing plug 31 from the mounting hole 32 than to send a minute air from the channel of the endoscope insertion portion 16. The negative pressure state in the main body 11 can be released, so that the esophageal varices 12 can be released immediately from the intake hole 13 of the tube main body 11, and the pain time given to the patient can be further shortened.

[Effect of device]

As described above, according to the endoscope outer tube of the present invention, unlike the conventional method in which the uptake hole of the tube body is pressed against the elevated lesion area and the lesion area is taken into the uptake hole, By using the suction channel of the endoscope to create a negative pressure in the tube body and forcibly sucking the lesioned part into the intake hole, even if there is a large gap between the body cavity wall and the tube body. As a result, the lesion can be sufficiently taken into the intake hole, and any small lesion can be treated reliably and easily. Therefore, even if the outer diameter of the tube main body is made as thin as possible while ensuring a space in which the insertion part of the endoscope can be inserted, the lesion can be surely treated, and thus the mantle tube can be applied to the patient. It is possible to reduce the pain caused to the patient when the patient is put on.

[Brief description of drawings]

FIGS. 1 and 2 show a first embodiment of the present invention. FIG. 1 is a sectional view of the outer tube in a used state taken along the line II in FIG. 2, and FIG. 2 is a perspective view of the outer tube. FIG. 3 is a vertical sectional view of an outer tube showing a second embodiment of the present invention, and FIG. 4 is a vertical sectional view of an outer tube showing a third embodiment of the present invention, FIG. 5 and FIG. FIG. 5 shows a fourth embodiment of the present invention, FIG. 5 is a perspective view of a mantle tube, FIG. 6 is a sectional view taken along the line VI-VI in FIG. 5, and FIG. 7 is the use of a conventional mantle tube. It is a longitudinal cross-sectional view in a state. 11 ... Tube body, 13 ... Intake hole, 14 ... Injection needle (treatment instrument), 15 ... Treatment instrument insertion passage, 16 ... Endoscope insertion portion, 18, 25 ... Sealing member.

Claims (1)

[Scope of utility model registration request] 1. An intake hole is provided on the outer periphery of the distal end portion of a tube body into which an insertion portion of an endoscope having a suction channel can be inserted.
An endoscope outer tube having a treatment tool insertion passage formed in an inner wall portion of a tube body between the intake hole and a base end portion of the tube body, wherein the tube body is provided at the base end portion of the tube body and An endoscope mantle tube for sealing the inside of the treatment instrument insertion passage and providing a seal member capable of airtightly inserting the insertion portion of the endoscope and the treatment instrument.