JPH09322880A - Guidance device for endoscope - Google Patents

Abstract

(57) Abstract: A plurality of tubular members inserted and arranged in an outer tube for guiding an endoscope and the like have a sufficient strength even if they are thin and have sufficient strength to prevent deformation and displacement. To provide a high guide device for an endoscope. SOLUTION: A plurality of elongated tubular members 31, 36, 37 for guiding an endoscope 101 and the like are integrally connected and fixed by connecting members 13, 35 on the proximal side and the tip end portion.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope guide device in which a plurality of elongated tubular members for guiding an endoscope and the like are inserted and arranged in an outer tube.

[0002]

2. Description of the Related Art A guide device for an endoscope of this type is generally
A plurality of elongated tubular members for guiding the endoscope and sending water to the distal end portion are inserted side by side from the rear end side of the outer sheath tube whose front and rear ends are open to the distal end of the outer sheath tube. The tubular members are integrally connected and fixed on the proximal side by a connecting member.

[0003]

However, since the tubular member is thin and elongated, the structure in which only the proximal sides of a plurality of tubular members are connected and fixed to each other may not be sufficient in terms of strength, and each tubular member at the distal end of the outer tube may be difficult to solve. The position of the outlet opening of the tubular member was unstable. Further, since the distal end of the tubular member projects from the distal end of the mantle tube, the distal end of the tubular member may damage the mucosal surface in the body cavity of the patient.

Therefore, the present invention is highly reliable in that a plurality of tubular members, which are inserted through the outer tube for guiding the endoscope and the like, are thin and have sufficient strength so as not to be deformed or displaced. An object is to provide a guide device for an endoscope.

[0005]

In order to achieve the above object, in the endoscope guiding apparatus of the present invention, a plurality of elongated tubular members for guiding the endoscope are opened at both front and rear ends. In the endoscope guide device arranged side by side in the outer tube portion from the rear end side of the outer tube portion to the position reaching the vicinity of the tip of the outer tube portion, the plurality of tubular members are
It is characterized in that it is integrally connected and fixed by a connecting member at the proximal side and the tip portion.

The outer tube may be cylindrical, and the tip connecting member may be formed so as to be inscribed in the outer tube within a range of a half circumference or more. Further, the plurality of tubular members may be connected and fixed by the connecting member also in the intermediate portion. In that case, the outer tube has a cylindrical shape, and the intermediate connecting member has the outer tube within a range of a half circumference or more. It may be formed so as to be inscribed in the tube.

The plurality of tubular members may be joined and fixed by a joining material at the intermediate portion. Further, it is preferable that the plurality of tubular members are arranged close to each other in the mantle tube so that the treatment tool is inserted into the remaining space in the mantle tube. In that case, the treatment tool is placed in the mantle tube. It is preferable that a treatment instrument insertion opening for inserting the treatment instrument is formed in the outer tube, and a space into which the treatment instrument is inserted is provided so as to be aligned with the treatment instrument insertion opening.

When the tubular member is fully inserted into the outer tube, the distal end of the tubular member is located in the outer tube with a space from the distal end of the outer tube, and the distal end of the outer tube is pressed against the outer tube. It is preferable that the affected area can be observed with an endoscope passed through the tubular member.

[0009]

Embodiments of the present invention will be described with reference to the drawings. 1 to 6 show an outer tube device 10 and
The endoscope guide device 30 for guiding the rigid endoscope 101 and the like, the rigid endoscope 101, and the treatment tool 201 are shown in a combined state in the outer tube device 10.

Further, FIGS. 7 to 10 show the outer tube device 10.
11 to 14 show a state in which the outer tube device 10 and the endoscope guide device 30 are combined, and FIGS. 15 to 21 show the endoscope guide device 30 and the rigid endoscope 101.
FIG. 22 shows an example of a treatment tool 201 used in the apparatus.

FIG. 7 is a side sectional view of the outer tube device 10, FIG.
FIG. 9 is a bottom view showing a part of which is cut away, FIG. 9 is a right side view, and FIG. 10 is a sectional view taken along line XX. The outer tube 11 forming the main body of the outer tube device 10 is formed of, for example, a straight stainless steel pipe material. Further, both ends of the outer tube 11 are straightly opened as they are as raw materials, and a smooth R chamfer is applied to the ridge line portion on the distal end side.

A hard endoscope guide tube 31 of an endoscope guide apparatus 30 is inserted into the outer sheath tube 11 as shown in FIGS. 11 and 1, and the hard endoscope guide tube 31 is shown in FIG. The tip position when the outer tube device 10 is fully inserted is shown by a broken line.

The position of the tip of the rigid scope guide tube 31 at this time is slightly inside the outer sheath tube 11 from the tip of the outer sheath tube 11, and the affected part or the like to which the outer sheath tube 11 is pressed is placed in the rigid endoscope guide tube 31. The rigid endoscope 101 that has been passed through allows observation at an appropriate distance.

A treatment instrument insertion opening 12 for inserting the treatment instrument 201 into the outer sheath tube 11 is formed in a side wall of a portion of the outer sheath tube 11 near the rear side. The treatment instrument 201 inserted into the outer sheath tube 11 through the treatment instrument insertion opening 12 is inserted into the outer sheath tube 11 along the outer surface of the rigid endoscope guide tube 31, as shown in FIG.

Returning to FIG. 7, a guide device connection mouthpiece 13 for connecting and connecting the endoscope guide device 30 is fixed to the proximal end side of the outer tube 11. Reference numeral 14 is a positioning pin for positioning the connected endoscope guide device 30 in the rotation direction.

When the outer tube device 10 is supported and fixed, the collar portion of the guide device connection mouthpiece 13 is sandwiched and held and fixed by the distal end device gripping portion of an arm-shaped surgical device fixing device (not shown).

In the mantle tube device 10 having the above-described structure, as shown in FIG. 7, when the rigid endoscope guide tube 31 is fully inserted into the mantle tube 11, the rigid endoscope guide tube 31 is inserted.
The distance from the distal end of the treatment instrument insertion opening 12 to the front end of the treatment instrument insertion opening 12 is L1, and the length of the treatment instrument insertion opening 12 in the axial direction is L2.
And the treatment tool insertion opening 12 so that L1 ≦ L2.
Is formed long. Therefore, the treatment instrument insertion opening 1
The treatment instrument 201 can be easily inserted into the second treatment device 2, and the operation after the insertion is also easy.

Further, as shown in FIGS. 8 and 10,
The width of the treatment instrument insertion opening 12 is B1, and the treatment instrument insertion opening 1
When the outer diameter of the sheath of the treatment instrument 201 inserted into the outer tube 11 from 2 is B2, the treatment instrument insertion opening 12 is wide so that B1 ≧ 2 × B2. Therefore, the treatment instrument 201 can be easily inserted into the treatment instrument insertion opening 12, and the operation after the insertion is also easy.

In this embodiment, as shown in the rear view of FIG. 9, the treatment instrument insertion opening 12 is formed with a width B1 from the rear end of the outer tube 11 to the guide device connection mouthpiece 13. Is missing from the rear.

However, the present invention does not necessarily have to be configured as such, and the rear end portion of the treatment instrument insertion opening 12 may be closed as long as L1≤L2.

When water is supplied through a water supply pipe 37, which will be described later, the water is sent out to the inside of the distal end portion of the mantle tube 11 and flows back through the mantle tube 11, overflowing from the treatment instrument insertion opening 12 to the outside. The water pressure near the tip of the mantle tube 11 decreases.

Therefore, a certain amount of water overflowing from the treatment instrument insertion opening 12 is pressed from the outside, and the mantle tube 11 is received.
Liquid receiving cover 16 for reducing water pressure drop at the tip
Is attached to the outer peripheral surface of the outer tube 11. By securing the water pressure at such a tip portion, an organ facing the tip of the mantle tube 11 is prevented from entering the mantle tube 11,
It is possible to secure a field of view during endoscopic observation.

As shown in FIG. 7, the liquid receiving cover 16 is formed in the shape of a truncated cone, and its inner end portion is fitted to the outer peripheral surface of the outer tube 11 and is fixed by a fixing screw 17. It is fixed to the pipe 11. 18 is a liquid receiving cover 16
It is an O-ring for sealing the fitting part between the outer tube 11 and the outer tube 11.

As shown in FIG. 7, the liquid receiving cover 16
Is attached so that the fitting portion with the outer tube 11 does not cover the treatment instrument insertion opening 12 portion and covers the portion of the treatment instrument insertion opening 12 near the tip.

However, by loosening the fixing screw 17, the fixing position of the liquid receiving cover 16 can be arbitrarily moved to adjust the water pressure at the tip of the outer tube 11, or the liquid receiving cover 16 can be replaced with one having a different shape and capacity. can do.

FIG. 11 shows a state in which the endoscope guide device 30 is attached to the outer tube device 10, and FIG.
The state where the rigid endoscope 101 is set in the endoscope guide device 30 is shown.

The rigid endoscope guide tube 31 of the endoscope guide device 30
Is formed of, for example, a straight stainless steel pipe, and its rear end proximal side is connected to the guide device connection mouthpiece 13 of the outer tube device 10 by a positioning connection mouthpiece 3
2 is fixed.

As shown in FIG. 11, the tubular portion of the positioning connection base 32 is the guide device connection base 1 of the outer tube device 10.
The pin 14 fitted and connected to the guide device 3 and protruding from the guide device connection mouthpiece 13 engages with the positioning slit 33 formed on the tubular portion of the positioning connection mouthpiece 32, thereby connecting the guide device. Rotation around the axis between the base 13 and the positioning connection base 32 is restricted.

As a result, the orientation of the positioning connection mouthpiece 32 with respect to the guide device connection mouthpiece 13 is determined, and the position of the rigid endoscope guide tube 31 with respect to the mantle tube device 10 is positioned at a predetermined position. In addition, the positioning connection mouthpiece 32 is provided with a slit 34 (see FIG. 20) having a shape continuous with the treatment instrument insertion opening 12 of the outer tube device 10 over the entire length in the axial direction. 40 is a fixing nut for fixing the positioning connection base 32 to the guide device connection base 13.

As shown in FIG. 16, the rigid endoscope guide tube 3
1, a flexible probe guide tube 36 and a water supply tube 37 are arranged close to a half portion of the inner cavity of the outer tube 11 away from the treatment instrument insertion opening 12, and they are arranged at one end. It is fixed to the tip connecting piece 35.

The flexible probe guide pipe 36 and the water supply pipe 37 are made of stainless steel pipe, for example. The tip side surface of the tip connecting piece 35 is a flat surface, so that even if the mucous membrane of the organ enters from the tip of the outer tube 11 and comes into contact with the tip connecting piece 35, there is no risk of damage.

As shown in FIG. 12, the tip connecting piece 35 has an outer edge shape in contact with the circular inner peripheral surface of the outer tube 11. Reference numeral 31a is a rigid mirror projection opening, 36a is a soft probe projection opening, and 37a is a water supply opening.

As shown in FIG. 17, the outer edge line of the tip connecting piece 35 inscribed in the outer tube 11 is set to θ1 ≧ 180 ° so as to contact the outer tube 11 for more than half the circumference. Therefore, the tip connecting piece 35 does not rattle in the outer tube 11.

Further, as shown in FIG. 18, the rigid endoscope guide tube 31, the flexible probe guide tube 36, and the water supply tube 37 are long in the middle portion of the outer tube 11 so as not to shift their positional relationship. The appropriate range of directions is integrally joined by the joining material 38.

As the joining material 38, for example, solder, silver braze, synthetic resin or the like can be used.
Since the flexible probe guide pipe 36 and the water supply pipe 37 are integrally fixed not only at the front and rear ends but also at the intermediate portion, the strength against external force is secured.

As shown in FIGS. 11 and 15, a threaded rod 41 is projected rearward from the arm portion projecting from the positioning connection mouthpiece 32 as shown in FIG. A rigid endoscope support cylinder 42 for supporting a connecting portion (hereinafter, referred to as a “neck portion”) between the eyepiece portion and the insertion portion of the rigid endoscope 101 is fixed to the screw rod 41.

The neck portion of the rigid endoscope 101 is fitted into the cylindrical recess 46 of the rigid endoscope support tube 42, and the fixing screw 47 is attached.
Is pressed and fixed. Penetration holes 48 and 49 for inserting the optical rod of the rigid endoscope 101 are formed in the rigid endoscope support tube 42 and the positioning connection base 32 on the axis of the rigid endoscope guide tube 31.

In the rigid scope support tube 42, the arms protruding laterally are fixed to the threaded rod 41 by a pair of fixing nuts 44, and the fixing position can be arbitrarily adjusted in the axial direction. Thus, the position of the rigid endoscope 101 in the axial direction is adjusted.

As shown in FIG. 16, the rear end of the flexible probe guide tube 36 is fixed to the positioning connection mouthpiece 32, and the flexible probe guide pipe 51 made of, for example, a stainless steel pipe is connected to the positioning connection mouthpiece 32 for positioning connection. It is fixed to the base 32.

By thus providing the soft probe guide tube 36 through which the soft probe 102 is inserted and the soft probe guide pipe 51 separately, the linear soft probe guide tube 36 has a small inner diameter with a small clearance with the soft probe 102. The flexible probe guide pipe 51 that prevents bending of the flexible probe 102 and bends
Can be used to lighten the insertion / removal of the soft probe 102 (for example, when the outer diameter of the soft probe 102 is 2.4 mm, the flexible guide tube can be used). The inner diameter of 36 is 2.8 mm
And the inner diameter of the flexible probe guide pipe 51 is 3 mm).

As shown in FIGS. 13 and 14, the probe insertion mouthpiece 52 provided on the free end side of the flexible probe guide pipe 51 includes a flexible probe guide pipe 51.
The base 521 is fixed to the base 521, and the holding ring 523 is screwed into the base 521 and crushes the sealing O-ring 522.

Therefore, the probe insertion mouthpiece 52 can receive the insertion tube of the flexible probe 102 (for example, a flexible endoscope) so as to be movable back and forth in the axial direction with the mouth of the flexible probe guide pipe 51 sealed.

On the other hand, the water supply pipe 37 extends from the front end side to the rear part through the fixing portion to the positioning connection mouth ring 32, and is attached to the end portion thereof as shown in FIGS. 19 and 21. Water can be supplied from the water supply tube 103 into the water supply pipe 37 by connecting the water supply tube 103 to the luer mouthpiece type water supply mouthpiece 53.

FIG. 22 shows an example of a treatment instrument 201 which is used in combination with the above-mentioned device, and shows a rigid sheath 20.
1a is a biopsy forceps. The sheath 201a is bent halfway, but the bending angle θ2 is 90 ° or less. θ2 is, for example, about 30 ° and is generally 30 ° ± 1
5 ° is easy to use.

FIGS. 1 to 6 show a state in which the above devices are all combined, in which the rigid endoscope 101 is inserted into the rigid endoscope guide tube 31 and the flexible probe 102 not shown in FIG. Is inserted into the flexible probe guide tube 36, and observation can be performed from the tip connecting piece 35 portion located inside the tip of the outer tube 11.

Then, the tip of the water supply pipe 37 (the water supply port 37
The pressure of water delivered from a) and accumulated in the tip of the mantle tube 11 prevents the mucous membrane surface of the organ that abuts the tip of the mantle tube 11 from entering the mantle tube 11, and thus the endoscope 1
A field of view of 01 (and 102) is secured.

The treatment instrument 201 is directly inserted into the outer tube 11 through the treatment instrument insertion opening 12, and as shown in FIGS. 2 and 3, a rigid endoscope guide tube 31 and a flexible probe guide tube 36.
And the outer tube device 1 passing through the lower half of the outer tube 11 that does not interfere with the water supply tube 37 and along the outer surface such as the rigid endoscope guide tube 31.
Reach the tip of 0. In this way, since the treatment tool 201 is directly passed through the outer tube 11, the space is efficiently used.

Here, assuming that the length of the distal end side linear portion of the treatment instrument 201 is L3 as shown in FIG. 22, the treatment instrument 20
L3 ≧ L so that the tip of 1 reaches the tip of the mantle tube 11.
It is set to 1. 5 is a V-V cross section, and FIG. 6 is a plan cross-sectional view showing the flexible probe guide pipe 36 and the water supply pipe 37.

The present invention is not limited to the above-mentioned embodiment, and for example, as shown in FIG. 23, the rigid endoscope guide tube 31, the flexible probe guide tube 36, and the water supply tube 37 are provided in the outer tube 11. It may be fixed to the intermediate connecting piece 138 made of metal or plastic at the intermediate portion of the.

In this case, if there is no risk of rattling in the outer tube 11, as shown in FIG. 24, the outer tube 1
It is also possible to use the intermediate connecting piece 238 in which the arc portion of the outer peripheral edge inscribed in 1 is less than 180 °.

In the present invention, as shown in FIG. 25, the flexible probe guide tube 36 is attached to the positioning connection mouthpiece 3.
It is also possible to continuously form the probe insertion cap 52 at the rear of 2 with a hard pipe material guide.

In this case, as the soft probe guide tube 36, a thick one having a large clearance with the soft probe 102 is used so that the soft probe 102 can be easily inserted and removed, and the soft probe protruding port of the tip connecting piece 35 portion. Three
The diameter of 6a may be made small so as to have a small clearance with the flexible probe 102 to prevent the flexible probe 102 from wobbling (for example, when the outer diameter of the flexible probe 102 is 2.4 mm, the inner diameter of the protrusion 36a is 2.6 mm, and the inner diameter of the flexible probe guide tube 36 is 3 mm).

Any treatment tool 201 may be used, and in FIG. 26, the probe 1 is provided in the sheath 201a.
27 shows an example of the treatment instrument 201 in which 04 is inserted and removed, and FIG.
[Fig. 4] is a bottom view of the entire apparatus in a state where the treatment tool 201 is used.

Regarding the rigid endoscope guide tube 31, the flexible probe guide tube 36, the water supply pipe 37, etc., the number of pipes, the thickness, and the setting of the pipes to be passed are changed according to the purpose of use of the device. be able to.

[0055]

According to the present invention, a plurality of elongated tubular members which are inserted through the outer tube for guiding the endoscope and the like are integrated by the connecting member not only on the proximal side but also on the distal end portion. Since each tubular member is thin, it has sufficient strength as a whole to ensure high reliability without deformation or misalignment, and the tip connecting member can be installed inside the outer tube within a range of more than half circumference. By the contact, the tubular member does not rattle in the outer tube.

If a plurality of tubular members are connected and fixed by the connecting member also in the intermediate portion and fixed by the joining material, the overall strength is further improved and the reliability against deformation and displacement is further improved. Rising,
The tubular member is prevented from rattling in the outer tube by making the intermediate connecting member inscribe the inner tube in the range of more than half the circumference.

Further, when the tubular member is fully inserted in the outer tube, the distal end of the tubular member is arranged so that the distal end of the tubular member is located in the outer tube with a gap from the distal end of the outer tube, and the distal end of the outer tube is pressed. By making it possible to observe the affected area with an endoscope passed through the tubular member, there is no risk of damaging the mucous membrane in the body cavity, etc. at the tip of the tubular member,
Increases safety.

[Brief description of drawings]

FIG. 1 is a side sectional view showing a state in which all the devices according to the first embodiment of the present invention are combined.

FIG. 2 is a front view of a state in which all the devices according to the first embodiment of the present invention are combined.

FIG. 3 is a sectional view taken along line III-III in FIG.

FIG. 4 is a plan sectional view of a near side portion in FIG.

FIG. 5 is a sectional view taken along line VV in FIG. 1;

FIG. 6 is a rear view showing a state where all the devices according to the first embodiment of the present invention are combined.

FIG. 7 is a side sectional view of the mantle tube device according to the first embodiment of the present invention.

FIG. 8 is a bottom view of the outer tube device according to the first embodiment of the present invention.

FIG. 9 is a rear view of the outer tube device according to the first embodiment of the present invention.

10 is a sectional view taken along line XX in FIG.

FIG. 11 is a side cross-sectional view of a state in which the outer tube device and the endoscope guide device according to the first embodiment of the present invention are combined.

FIG. 12 is a front view of a state in which the outer tube device and the endoscope guide device according to the first embodiment of the present invention are combined.

FIG. 13 is a partial plan cross-sectional view of a state in which the outer tube device and the endoscope guide device according to the first embodiment of the present invention are combined.

FIG. 14 is a rear view of the state in which the outer tube device and the endoscope guide device according to the first embodiment of the present invention are combined.

FIG. 15 is a side sectional view showing a state in which a rigid endoscope is mounted on the endoscope guide device according to the first embodiment of the present invention.

FIG. 16 is a cross-sectional plan view of the endoscope guiding device according to the first embodiment of the present invention with a rigid endoscope attached thereto.

FIG. 17 is a front view of the endoscope guiding device according to the first embodiment of the present invention with a rigid endoscope attached thereto.

18 is a sectional view taken along line XVIII-XVIII in FIG.

FIG. 19 is a partial plan cross-sectional view showing a state in which a rigid endoscope is mounted on the endoscope guide device according to the first embodiment of the present invention.

20 is a sectional view taken along line XX-XX in FIG.

21 is a sectional view taken along the line XXI-XXI in FIG.

FIG. 22 is a side view of an example of a treatment tool used in the present invention.

FIG. 23 is a front cross-sectional view of the endoscope guide device according to the second embodiment of the present invention.

FIG. 24 is a front sectional view of an endoscope guide device according to a third embodiment of the present invention.

FIG. 25 is a plan sectional view of an endoscope guide device according to a fourth embodiment of the present invention.

FIG. 26 is a side view of another example of the treatment tool used in the present invention.

FIG. 27 is a bottom view of the entire apparatus in a state where the treatment tool shown in FIG. 26 is used.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Outer tube device 11 Outer tube 30 Endoscope guide device 31 Rigid endoscope guide tube 35 Tip connection piece 36 Flexible probe guide tube 37 Water supply pipe 38 Joining material 101 Hard endoscope 138, 238 Intermediate connection piece

Claims (8)

[Claims] 1. An outer tube having a plurality of elongated tubular members for guiding an endoscope and the like extending from a rear end side of an outer tube portion whose front and rear ends are open to a position near a tip of the outer tube portion. In the endoscope guiding device inserted and arranged side by side in the section, the plurality of tubular members are integrally connected and fixed by a connecting member at the proximal side and the distal end portion. Guidance device. 2. The endoscope guide device according to claim 1, wherein the outer tube has a cylindrical shape, and the tip connecting member is formed so as to be inscribed in the outer tube within a range of a half circumference or more. 3. The plurality of tubular members are connected and fixed by a connecting member also in an intermediate portion.
Or the guide device for an endoscope according to 2. 4. The endoscope guiding apparatus according to claim 3, wherein the outer tube has a cylindrical shape, and the intermediate connecting member is formed so as to be inscribed in the outer tube within a range of a half circumference or more. 5. The endoscope guide apparatus according to claim 1, wherein the plurality of tubular members are joined and fixed by a joining material at an intermediate portion. 6. The method according to claim 1, wherein the plurality of tubular members are arranged close to each other in the outer tube, and the treatment instrument is inserted into the remaining space in the outer tube. Guide device for endoscopes. 7. A treatment instrument insertion opening for inserting a treatment instrument into the outer sheath tube is formed in the outer sheath tube, and a space into which the treatment instrument is inserted is aligned with the treatment instrument insertion opening. The endoscope guide device according to claim 6, which is provided. 8. When the tubular member is fully inserted into the outer tube, the distal end of the tubular member is located inside the outer tube with a space from the distal end of the outer tube, and the distal end of the outer tube is pressed against the outer tube. The endoscope guide device according to any one of claims 1 to 7, wherein the affected area can be observed by an endoscope passed through the tubular member.