JPH1085227A - Guide device of medical instrument with flexible cord - Google Patents

Abstract

PROBLEM TO BE SOLVED: To accurately control the direction of a flexible-cord-equipped medical instrument inside a coelom. SOLUTION: The flexible cord 2 of a medical instrument 1 is attached to the insertion rod 11 of a guide device 10. The guide device 10 has the insertion rod 11 and a control part 12, a connection 15 is provided at the end of the insertion rod 11, and a mounting part 16 connected to a drive shaft 28 pushed and pulled by the movable gripping part 23 of the control part 12 is rotatably attached to the connection 15. Also, a guide pipe 30 is passed through the insertion rod 11, the mounting part 16 is provided with a through hole, and the flexible cord 2 is held passed through the through hole from the guide pipe 30. Also, the flexible cord 2 is secured by a clamp member 32 to a pushing element 19 provided at the first end of the drive shaft 18. When the mounting part 16 is rotated by operation of the movable gripping part 23, the flexible cord 2 is curved near the position of the fulcrum of rotation of the mounting part 16.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention has a flexible cord used to insert a medical device having a flexible cord into a body cavity and to control the direction of the medical instrument so that its tip is oriented in a desired direction. The present invention relates to a guide device for a medical instrument.

[0002]

2. Description of the Related Art Medical instruments which are inserted into a body cavity to perform examinations or treatments include, for example, an endoscope and an ultrasonic examination apparatus. Inject high-frequency treatment tools, chemical sprays, injections, etc.
There are tubes, pipes, and the like through which fluid flows for performing suction or the like. An endoscope or an ultrasonic inspection apparatus generally includes an insertion portion that is inserted directly into a body cavity from an oral cavity or the like. Since the insertion path in the body cavity is not straight, the distal end main body provided with the endoscope observation mechanism and ultrasonic observation mechanism at the distal end is a hard part, but with a configuration that can bend other than this distal end main body Has become. Then, of these bendable portions, the distal end body is bent in a desired direction by remote control so as to face the desired direction, and is a so-called angle portion, and a portion on the base end side from the angle portion is It is a flexible part that bends in any direction.

As described above, as a method of inserting an endoscope into a body cavity, as described above, in addition to the method of inserting the body into the body cavity from the mouth or the like, a body skin is pierced, and the body cavity is pierced from the perforated portion. There is also a method of inserting it inside. For example, an endoscope or an appropriate treatment tool can be inserted along an insertion path including a preformed perforated portion to perform a treatment such as a liver excision operation. This method does not require a large laparotomy and requires only a minimum incision to insert the guide tube.Therefore, there are various damages to the patient, such as quick recovery after surgery, etc. It has advantages and is a widely used technique in recent years. In this case, the endoscope and the treatment tool are not directly pierced into the perforated portion provided in the body epidermis, but a trocar made of a hard pipe is used in order to secure their insertion paths. As shown in the figure, a plurality of trocars T
(Three trocars T are shown in the drawing) and are swelled by filling intraperitoneal gas into the abdominal cavity or the like. Then, the endoscope S is inserted into one trocar T, for example, a forceps F is inserted into another trocar T, and an electric scalpel M is inserted into another trocar T.

Since the insertion path through the trocar T is straight, the endoscope S, forceps F, electric scalpel M and other medical instruments inserted into the body cavity through the trocar T require an insertion portion. However, the insert does not need to be bent. However, in the case of an endoscope, the end portion provided with the endoscope observation mechanism needs to be directed in a desired direction, and therefore, a configuration having an angle portion is also used. Further, the forceps has an insertion rod made of a hard member, and a gripping claw is attached to the tip of the insertion rod so as to be capable of opening and closing. For a high-frequency treatment tool such as an electric scalpel, the tip of the rod-shaped insertion rod is The electrodes are fixedly or rotatably connected to the electrodes. Further, a hard pipe is used as a mechanism for supplying a fluid or sucking a body fluid, and a needle tip is provided at a tip of the hard pipe when an injection solution is injected.

[0005]

As described above, since the insertion portion of the medical instrument inserted through the trocar is basically made of a hard member, stability during insertion can be obtained. However, the tip of the insertion portion can be oriented in a desired direction only by tilting the trocar or the like, so that it is difficult to control the orientation of the tip and it is fine and accurate. There is a problem that direction control cannot be performed. Also, as described above, there is an endoscope provided with an angle portion, and by controlling the angle portion, the direction of the distal end portion can be controlled. However, the angle portion is usually formed into a node ring structure by sequentially pivoting the angle rings, and is configured to bend in a desired direction by pushing and pulling this with an operation wire. Is complicated.

The present invention has been made in view of the above points, and has been made in a state where a medical device having a flexible cord is inserted into a body cavity without impairing the stability when the device is inserted into the body cavity. Therefore, an object of the present invention is to provide a guide device that can easily control the direction.

[0007]

SUMMARY OF THE INVENTION In order to achieve the above-mentioned object, the present invention relates to a method of connecting a mounting member to a distal end of an insertion rod made of a hard member so as to be rotatable in at least one direction, and At the end, a drive member for rotating the mounting member with respect to the insertion rod is mounted by moving the insertion rod in the axial direction of the insertion rod, and the mounting member is a medical instrument having a flexible cord. A feature is provided in which a mounting portion to which the vicinity of the distal end is connected is provided, and a fixing portion for fixing the flexible cord so as to be interlocked with the movement of the driving member is provided at a base end portion of the driving member. Is what you do.

Here, the driving member may be constituted by a wire or the like. However, from the viewpoint of responsiveness and the like, it is preferable that the driving member is constituted by a driving shaft made of a hard member extending in the axial direction of the insertion rod. preferable. The tip of the drive shaft can be connected to the mounting member by a lever mechanism or the like. The flexible cord of the medical device is attached to the guide device, and the distal end of the flexible cord is connected to the attaching portion provided on the attaching member, and the flexible cord is also fixed to the base portion of the driving member. Is provided. Here, the fixing part is fixedly held so that the flexible cord is interlocked with the movement of the driving member composed of the driving shaft and the like. It is preferable that a flexible cord is detachably connected to the mounting portion and the fixing portion so that the medical device mounted on the guide device can be replaced.

The medical device mounted on the guide device described above is a so-called treatment tool having treatment means such as forceps and an electric scalpel, as long as it has a flexible cord, even if it is an endoscope. May also be a tube through which a fluid flows. Further, an ultrasonic inspection apparatus having an ultrasonic observation mechanism at the tip may be provided. For endoscopes and ultrasonic inspection devices, it consists of a flexible insertion section in which a flexible member is connected to a distal end body provided with an endoscope observation mechanism or an ultrasonic observation mechanism, and a light guide or an image guide is provided inside the probe. , Signal cables and the like are inserted. In addition, among the treatment tools, those provided with a mechanical operating member such as a gripping claw in forceps, and a cord connected to this operating member include:
An operation wire or the like is inserted. On the other hand, a cable, such as an electric scalpel, for transmitting a certain kind of energy such as a high-frequency current to an operating member provided at the distal end is provided in the cord. Further, a tube having a passage for feeding a chemical solution or sucking a body fluid or the like can also be mounted on the guide device.

However, these medical instruments do not need to be provided with an angle portion. A mechanism for controlling the direction of the tip is provided on the guide device side.

[0011]

DESCRIPTION OF THE PREFERRED EMBODIMENTS One embodiment of the present invention will be described below with reference to FIGS. In this embodiment, the medical device mounted on the guide device is:
For example, there are the endoscope shown in FIG. 7, the ultrasonic inspection apparatus shown in FIG. 8, the forceps shown in FIG. 9, and the injection apparatus shown in FIG.

The medical device 1 has a distal end body 3 provided at the distal end of a flexible cord 2. As shown in FIGS. 1 and 2, a guide device 10 is used to guide the medical instrument 1 into a body cavity and control the direction of the distal end body 3. This guide device 10, as shown in FIG.
It has an insertion rod 11 as an insertion member that is directly inserted into the trocar T, and an operation unit 12 that is provided at a base end of the insertion rod 11 and performs a rotation operation of a distal end portion.

The insertion rod 11 is formed of a hollow member having a circular cross section, and is formed of a hard pipe or the like which is thinner than the inner diameter of the trocar T and is sufficiently longer than the inner diameter. As is clear from FIG. 3, the inside of the insertion rod 11 is divided into left and right substantially semicircular portions by a partition wall 13. On one side of the partition 13,
A rotation operation section 14 is provided. This rotation operation part 14
As shown in FIG. 4, the connecting portion 15 includes a connecting portion 15 fixed to the insertion rod 11 and an attaching portion 16 connected to the connecting portion 15 so as to be rotatable in a vertical direction. The connecting portion 15 is provided with a slit 15a at its tip, and the mounting portion 16 is provided with a lever portion 16a inserted into the slit 15a. The lever portion 16a is connected to a portion inserted into the slit 15a. It extends obliquely downward. And
The connecting portion 15 and the mounting portion 16 are connected by a pivot pin 17 so as to be relatively rotatable. Further, a distal end of a drive shaft 18 is connected to an end of the lever 16a or a position near the end of the lever 16a in the mounting portion 16.

The drive shaft 18 extends through the insertion rod 11,
A pushing piece 19 is connected to the end. Pushing piece 19
Is located above a pedestal portion 20 for fixing the insertion rod 11 in the operation portion 12, and the pedestal portion 20 is integrally provided with a fixed grip portion 21 constituting the operation portion 12. Further, a movable grip 23 is rotatably connected to the pedestal 20 by a fulcrum pin 22. As shown in FIG. 5, a drive lever 24 is integrally connected to the movable gripping part 23, and the pressing piece 19 is connected to the drive lever 24 by a connection pin 25. Therefore, the rotation operation by the movable grip portion 23 is performed by the rotation of the drive lever 24.
The pushing piece 19 moves substantially in the axial direction.
During this operation, the driving lever 24 moves in an arc, so that the pushing piece 19 moves not only in the axial direction but also in the vertical direction.
Can be absorbed by the flexure. If a vertically long hole is provided at the connecting portion between the drive lever 24 and the pushing piece 18, the pushing piece 18 does not move in the vertical direction.

The movable grip 23 is moved closer to the fixed grip 21.
When the pivoting operation is performed in the separating direction, the pushing piece 19 moves substantially in the axial direction, and the driving shaft 18 is pushed and pulled. As a result, the mounting portion 16 moves up and down a predetermined angle around the pivot pin 17 by a predetermined angle. For example, it is rotated at an angle of 90 ° or more. Here, the rotation angle of the mounting portion 16 is
And the distance between the pivot pin 17 and the connecting position of the drive shaft 18 to the mounting portion 16, the connecting portion to the pivot pin 17 and the drive shaft 18 with respect to the axis of the mounting portion 16. Is also restricted by the inclination angle with the connecting portion. Therefore, if the inclination angle is set to 45 ° or less and the stroke of the drive shaft 18 is sufficiently taken, the mounting portion 16 can rotate 90 ° or more.

The movable grip 23 is rotatably connected to the fulcrum pin 22, but is always kept open at a predetermined angle with respect to the fixed grip 21.
In order to maintain this expanded state, a pair of leaf springs 26a,
A biasing means 26 composed of 26b is mounted, and a stopper (not shown) for regulating the position of the movable gripper 23 in the opening direction is provided. The leaf spring 26a is attached to the fixed grip portion 21,
The leaf spring 26b is fixed to the movable holding portion 23 by connecting pins 27a and 27b, respectively.
a and 26b are curved on the way, and their front ends are engaged with each other so that their relative angles can be changed. When the movable gripping part 23 is in the most opened state, the mounting part 16 is oriented in the direction of the extension of the insertion rod 11 in the axial direction, and the whole is substantially linear.

When a gripping force is applied by gripping the operation unit 12,
The movable gripper 23 is displaced toward the fixed gripper 21 against the urging force of the urging means 26, whereby the drive lever 24 rotates and displaces the pushing piece 19 so as to push it out. , The drive shaft 18 is pushed out, and the
6 rotates with respect to the connecting portion 15. Then, the mounting portion 16
When the is rotated, the mounting portion 16 can be held at an arbitrary angle with respect to the connecting portion 15. To this end, a bracket 28 is rotatably connected to an end of the fixed grip portion 21 of the operation section 12, and a ratchet member 29 provided with ratchet teeth 29a is fixed to the bracket 28. On the other hand, the end of the movable gripping portion 23 has an engaging portion 23a that engages with the ratchet teeth 29a.
Are formed. Therefore, if the engaging portion 23a is engaged with the ratchet teeth 29a of the ratchet member 29 in a state where the movable holding portion 23 is rotated to a predetermined position, the movable holding portion 23 can be fixed at the corresponding position.

The medical device 1 is detachably mounted on the guide device 10. For this purpose, a guide pipe 30 is attached to the insertion rod 11 on the opposite side of the partition 13 from the part where the drive shaft 18 is inserted. The distal end portion of the mounting portion 16 is a distal bulging portion 16b, and the distal bulging portion 16b is provided with an insertion hole 31 extending in the axial direction of the insertion rod 11. Accordingly, the distal end bulging portion 16b having the insertion hole 31 serves as a mounting portion for the flexible cord 2, and the medical device 1 is inserted into the guide pipe 30, the distal end portion is passed through the insertion hole 31, and the distal end main body is formed. 3 and the length of the flexible cord at a part thereof on the distal end side is mounted so as to protrude from the insertion hole 31.

Further, the pushing piece 19 has a concave portion 19a for accommodating the medical instrument 1 in the axial direction of the insertion rod 11.
Is provided. As shown in FIG. 6, the pushing piece 19 is formed by bending a metal plate having spring properties.
A clamp member 32 having a distal end portion serving as an elastic locking portion 32a is connected to the clamp member 32. The clamp member 32 is connected to a shaft 33 provided on the pushing piece 19, and the center of the shaft 33 is shown in FIG. As shown by a solid line, the closed state can be displaced between a closed state in which the concave part 19a is engaged so as to cover the concave part 19a, and an open state separated from the concave part 19a as shown by a virtual line. In the closed state, the clamp member 32 elastically deforms the flexible cord 2 of the medical device 1 so as to press against the inner wall of the recess 19a, thereby fixing the flexible cord 2 so as not to move in the axial direction. Exhibits the function as a fixed part. Further, the elastic locking portion 3 of the clamp member 32
2a is bent inward in the free state, and when the clamp member 32 is closed, it is elastically deformed and pressed against the lower surface of the pushing piece 19 to hold the clamp member 32 so as not to open unnecessarily. Is done.

As described above, the medical device 1 is the guide device 1
0, inserted into the body cavity, and the required inspection, treatment, and other treatments are performed in a state where the distal end portion is directed in an appropriate direction. Similarly, an insertion path secured by the trocar T inserted into the body cavity is used.

First, a guide pipe 30 in which the flexible cord 2 of the medical device 1 is provided on the insertion rod 11 of the guide device 10.
And is inserted from the base end side so that the distal end main body 3 is inserted into an insertion hole 31 provided in the distal end bulging portion 16 b of the mounting portion 16, and protrudes from the insertion hole 31 by a predetermined length. Let it. In addition, the clamp member 32 is released, and the pushing piece 19 is released.
The base portion of the flexible cord 2 is housed in the concave portion 19 a of the flexible cord 2, and is sandwiched by the clamp member 32. by this,
The flexible cord 2 of the medical device 1 is connected to the pushing piece 19 and fixed so as not to relatively move in the axial direction.

In this way, the medical device 1 is
0, but the movable gripper 23 in the operation unit 12
Is opened by a predetermined angle with respect to the fixed grip portion 21 by the urging force of the urging means 26, and the mounting portion 16 is
In the axial direction of. Then, the medical instrument 1 can be operated by inserting it into the trocar T inserted into the body cavity and projecting at least the attachment portion 16 from the tip of the trocar T. Here, the medical device 1 has the flexible cord 2, but is mounted along the insertion rod 11, which is a hard member, in the guide device 10, so that the medical device 1 can be inserted straight into the trocar T. The insertion operability becomes extremely good.

Since the distal end body 3 is located on the extension of the insertion rod 11 in the guide device 10 in the axial direction, it is necessary to change the direction of the distal end body 3 as necessary. Here, when the operating portion 12 is gripped and a gripping force is applied to the movable gripping portion 23, the drive lever 24 rotates in conjunction with the rotation of the movable gripping portion 23.
Is pushed forward, and the drive shaft 18 connected to the pushing piece 19 is pushed out. As a result, drive shaft 1
The mounting portion 16 connected to the distal end of the mounting portion 8 rotates about the pivot pin 17 along the locus indicated by the imaginary line in FIG. 1 and is inserted through the insertion hole 31 provided in the mounting portion 16. The flexible cord 2 includes a guide pipe 30 and an insertion hole 31.
, And as a result, the direction of the distal end body 3 changes.

A predetermined treatment is performed in a state where the direction of the distal end body 3 is changed.
Direction must be fixed. For this purpose, a ratchet member 29 is provided, and the ratchet teeth 29a of the ratchet member 29 are engaged with the engaging portions 23a of the movable holding portion 23. As a result, the distal end main body 3 is held in that angular state. Therefore, without moving the trocar T,
The distal end main body 3 is held in a state where the distal end main body 3 is oriented in an optimal direction for performing a treatment, and a smooth treatment can be performed. As described above, although the flexible cord 2 is not provided with an angle portion, the distal end main body 3 at the distal end of the flexible cord 2 is oriented in a desired direction by operating the movable holding portion 23, and The state in which the direction control is performed can be maintained.

The flexible cord 2 is bent by the mounting portion 16. The greater the bending angle, the better the operability. However, if the flexible cord 2 is bent sharply, the flexible cord 2 will buckle.
By making the distance from the exit of the guide pipe 30 to the insertion hole 31 of the mounting portion 16 longer to a certain extent, it does not bend sharply and, for example, from 90 ° to 11 °.
By restricting the angle of the bend to about 0 °, the flexible cord 2 does not buckle. When the insertion rod 11 is turned around the axis, the distal end portion main body 3 is bent.
Can be directed in virtually any direction.

The flexible cord 2 of the medical device 1 is
Since the medical device 1 is detachably mounted on the guide device 10, the mounting portion 16 at the distal end of the guide device 10 rotates in the vertical direction in order to easily attach and detach the medical device 1. You need to be able to move. Here, the flexible cord 2 is inserted into the insertion hole 31 of the mounting portion 16.
There is no restriction between a part guided through the guide pipe 30 provided in the insertion rod 11 from a part inserted into the insertion rod 11. Therefore, when the mounting portion 16 rotates, the medical device 1
The part between the two parts does not bend so as to make a detour substantially at a right angle, but instead turns obliquely, as shown by a dashed line in FIG. The long portion is pushed out to the distal end side or pulled back into the guide pipe 30. At this time, the long portion comes into sliding contact with the insertion hole 31 or the edge at the end of the guide pipe 30, or an excessive bending force is applied. It may buckle.

However, the flexible cord 2 is not
The flexible cord 2 is pushed straight out of the guide pipe 30 together with the pushing piece 19 when the mounting portion 16 is rotated from the state where it is oriented in the axial direction of the insertion rod 11. Therefore, the portion where the flexible cord 2 bends is
It is located in front of the guide pipe 30 and is bent at substantially the same angle as the rotation angle of the mounting portion 16 near the connecting portion between the mounting portion 16 and the connecting portion 15, that is, near the position of the rotation fulcrum of the mounting portion 16. . Therefore, the guide pipe 3 in the flexible cord 2
The curved posture of the part from 0 to the insertion hole 31 is stable, and there is no risk of buckling or damage due to sliding contact with the insertion hole 31 and the edge of the guide pipe 30. Further, when returning the mounting portion 16 from the rotating state to the straight state, the pushing piece 19 is operated in the pulling-back direction, so that the flexible cord 2 is pulled back by the pushed amount. Also, there is no possibility that an excessive force is applied to the flexible cord 2, and the flexible cord 2 smoothly returns to the original straight state.

Here, as the medical instrument 1 having the flexible cord 2 in the distal end main body 3, first, the endoscope 40 shown in FIG.
There is. The endoscope 40 has an operation section 42 provided at the base end of an insertion section 41 into a body cavity. The insertion section 41 has a distal end main body 43 connected to a distal end of a flexible section 42 having flexibility. ing. Therefore, the flexible portion 42 is a flexible cord, and the flexible portion 42 has, for example, a light guide and an image guide inserted through the inside of the flexible tube, and the light guide and the image guide are bundled with a large number of thin optical fibers. And the whole is flexible. The distal end main body 43 is provided with an illumination lens facing the distal end of the light guide and an objective lens facing the distal end of the image guide. The distal end main body 43 is a hard member because of the provision of the illumination lens and the objective lens. ing. Note that a camera including a CCD or the like can be mounted instead of the image guide.

In the endoscope 40 described above, the insertion portion 41
In the above, the flexible portion 42 constituting the flexible cord is attached to the guide device 10, the insertion portion 41 is inserted into the guide pipe 30, and the distal end main body 43 is inserted through the insertion hole 31 of the attachment portion 16 by a predetermined length. Just protrude. And the soft part 42
Is clamped by the clamp member 32. The endoscope 40 attached to the guide device 10 in this manner is
The trocar T is inserted into a body cavity as an insertion path. Here, the insertion portion 41 of the endoscope 40 is made of a flexible member, but is held by the insertion rod 11 of the guide device 10 which is a hard member. As long as it is held, it is always kept in a straight state. Insertion part 4 of endoscope 40 incorporated in guide device 10
When the first member 1 is protruded from the trocar T by a predetermined length, the inside of the body cavity can be inspected by the observation means provided on the distal end main body 43. Then, when the movable grip 23 is operated, the direction of the distal end main body 43 is changed, whereby an observation visual field in an arbitrary direction is obtained. Moreover, when the tip main body 43 is oriented in a desired direction in this manner, the insertion portion 41
Since there is no need to provide an angle part to the endoscope 4
0, especially the configuration of the insertion portion 41 can be extremely simplified.

FIG. 8 shows an ultrasonic inspection apparatus 50 as another medical instrument. This ultrasonic inspection device 5
Numeral 0 has an insertion portion 51, and an ultrasonic vibrator 52 is disposed at the tip of the insertion portion 51. When performing radial scanning, a flexible shaft 53 composed of a close contact coil or the like is connected to the ultrasonic transducer 52, and the flexible shaft 53 is inserted into a flexible tube 54. A hard cap 55 is provided at the tip of the flexible tube 54.
Are connected, and the ultrasonic vibrator 52 is
5 is located within. Therefore, the insertion section 51 is constituted by a flexible tube 54 as a flexible cord and a distal end body composed of the cap 55. The signal cable 56 connected to the ultrasonic transducer 52 is inserted into the flexible shaft 53. An operation unit is connected to the base end of the insertion unit 51, a rotation mechanism and a rotation angle detection mechanism of the flexible shaft 53 are connected to the operation unit, and the signal cable 56 is connected to the rotary connector. Since these configurations are well known, they are not shown.

As described above, the ultrasonic inspection device 50 can also be mounted on the guide device 10 and guided into the body cavity via the trocar T to perform an ultrasonic inspection. Also in this case, similarly to the endoscope 40 described above, the portion of the flexible tube 54 in the insertion portion 51 is inserted from the guide pipe 30 into the insertion hole 31 of the attachment portion 16 to protrude the cap 55 by a predetermined length. Attach to the state. By controlling the direction of the mounting portion 16, the cap 55 provided with the ultrasonic transducer 52 can be brought into close contact with the inner wall of the body cavity. As a result, attenuation of the ultrasonic signal is suppressed, and a clear ultrasonic image can be obtained.

Further, the medical instrument shown in FIG.
The forceps 60 has a pair of gripping claws 61, 61 at the distal end, and the gripping claws 61, 61 are connected to a link mechanism 62 so as to be openable and closable. Link mechanism 62
Is connected to an operation cable 63 formed of a close contact coil or the like and bent in an arbitrary direction. An operation wire 64 for opening and closing the grip claws 61 is inserted into the operation cable 63. An opening / closing operation unit 65 is connected to a base end of the operation wire 64.
In the case of the forceps 60, the gripping claws 61, 61 and the link mechanism 62 correspond to the distal end body, and the operation wire 64
Is equivalent to the flexible cord.

The forceps 60 having such a configuration is also mounted on the guide device 10 with the gripping claws 61 and 61 and the link mechanism 62 projecting from the insertion hole 31 by a predetermined length. Is inserted into. Then, the movable grip 23 is operated in order to accurately turn the grip claws 61, 61 in the body cavity to a site to be treated, such as an affected part. As a result, the direction of the distal end body 43 changes, and when the movable gripper 23 is fixed, the gripper 6
1, 61 are fixed in a state facing a predetermined direction. Therefore, the grasping claws 61 can be reliably oriented in the direction in which the treatment is to be performed. In this state, the insertion rod 11 of the guide device 10 is further advanced into the trocar T, whereby the grasping claws 61 are reliably secured. Can be displaced to the site to be treated. Then, by operating the opening / closing operation section 65, the gripping claws 61, 61 are opened / closed, and required treatment can be performed.

FIG. 10 shows a state in which an injection device 70 as a medical device is mounted on the guide device 10. This injection device 70 is a long tube 71 constituting a flexible cord.
A hard needle point 72 constituting a distal end body is connected to the distal end of the needle, and an injection liquid pumping section 73 is connected to the proximal end. The injection device 70 is also inserted into the trocar T while being attached to the guide device 10 in the same manner as the above-described medical instruments, and the needle tip 7 is operated by operating the movable holding portion 23.
2 can be oriented in a desired direction. Therefore, the needle tip 7
2 can accurately aim at a site where an injection solution is to be injected.

Here, in order to share the guide device with the above-mentioned various medical devices, an insertion hole for inserting a flexible cord is not directly formed in a mounting portion connected to the tip of the drive shaft, but an insertion hole is formed. What is necessary is just to comprise so that the adapter which it has may be detachably fixed to a mounting part with a screw etc.

[0036]

As described above, according to the present invention, the mounting member is connected to the distal end of the insertion rod made of a hard member so as to be rotatable in at least one direction, and the base end of the insertion rod is A connecting member to which a driving member for rotating the mounting member relative to the insertion rod is mounted by moving the mounting member in the axial direction of the insertion rod, and the mounting member is connected to the vicinity of the distal end of a medical device having a flexible cord. In addition, the base portion of the driving member is provided with a fixing portion for fixing the flexible cord so as to be interlocked with the movement of the driving member, so that the direction of the tip portion cannot be controlled by itself. When the flexible cord is inserted into a body cavity from a trocar or the like, stability is achieved when the flexible cord is inserted into the body cavity despite its flexibility. Can be performed easily. That.

[Brief description of the drawings]

FIG. 1 is a front view showing a state where an ultrasonic probe is mounted on an insertion guide means.

FIG. 2 is a plan view of FIG.

FIG. 3 is a sectional view taken along line XX of FIG. 1;

FIG. 4 is an external view showing a connection mechanism between an attachment portion and a connection portion.

FIG. 5 is a configuration explanatory view showing an interlocking state between a movable gripper and a pushing piece in an operation unit.

FIG. 6 is a sectional view of a pushing piece.

FIG. 7 is an overall configuration diagram of an endoscope as an example of a medical device.

FIG. 8 is a cross-sectional view of an insertion portion of an ultrasonic inspection apparatus as another example of the medical device.

FIG. 9 is an overall configuration diagram of forceps as another example of the medical instrument.

FIG. 10 is an overall configuration diagram of an injection device as still another example of the medical device.

FIG. 11 is an explanatory diagram showing a state in which a treatment in a body cavity is performed using the trocar T;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Medical instrument 2 Flexible cord 3 Tip main body 10 Insertion guide means 11 Insertion rod 12 Operation part 15 Connecting part 16 Attachment part 18 Drive shaft 19 Pushing piece 21 Fixed holding part 23 Movable holding part 30 Guide pipe 31 Insertion hole 32 Clamp Member 40 Endoscope 41 Insertion part 42 Flexible part 42 Tip main body 50 Ultrasonic inspection device 51 Insertion part 52 Ultrasonic vibrator 53 Flexible shaft 54 Flexible tube 55 Cap 60 Forceps 61 Gripping claw 62 Link mechanism part 63 Operation cable 70 injection device 71 tube 72 needle point

Claims (4)

[Claims] An attachment member is connected to a distal end of an insertion rod made of a hard member so as to be rotatable in at least one direction, and a base end of the insertion rod is moved in an axial direction of the insertion rod. A driving member for rotating the mounting member with respect to the insertion rod is mounted, the mounting member is provided with a mounting portion to which a vicinity of a distal end of a medical instrument having a flexible cord is connected, and a base of the driving member is provided. A guide device for a medical instrument having a flexible cord, wherein a fixing portion for fixing the flexible cord so as to be interlocked with the movement of the driving member is provided at an end portion. 2. The drive member comprises a drive shaft extending in the axial direction of the insertion rod, and an operation lever for pushing and pulling the drive shaft is provided at a base end of the insertion rod; 2. The guide device for a medical instrument having a flexible cord according to claim 1, wherein the tip of the drive shaft and the operating member are provided with means for converting a push-pull operation into a rotational operation. 3. The flexible device according to claim 1, wherein the mounting portion is configured to allow the flexible cord to pass therethrough, and the fixing portion is a clamp member for clamping the flexible cord. A guide device for medical instruments with flexible cords. 4. The medical device having the flexible cord is any one of a flexible insertion portion provided with an inspection means at a tip, an operation cable provided with a treatment means at a tip, and a tube for supplying a fluid. 2. A guide device for a medical instrument having a flexible cord according to claim 1.