JP2003079564A - Endoscope apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope apparatus making it possible to efficiently operate an endoscope and a treatment tool inserted through independent at-hand openings of a plurality of treatment tool passing channels. SOLUTION: The endoscope apparatus 1 includes the treatment-tool passing channels 6a and 6b passing through an insertion tube/working length 3; the at-hand openings 41 and 42 of the cannels 6a and 6b provided closer to an end than to a grip part 4b; treatment-tool oscillating stands 31 and 32 positioned at or near the end openings of the channels 6a and 6b; the endoscope 2 provided with oscillating knobs 44 and 45 for independently operating the treatment-tool oscillating stands 31 and 32; channel tubes 81 and 82 of predetermined size for extending the openings; and opening extension tools 8A and 8B secured to the ends of the tubes 81 and 82 and each having a connection 8a that can be removably attached to the at-hand openings 41 and 42, an extension opening 8b secured to the rear end portions of the tubes 81 and 82, and a holding part 8c for positioning the extension opening 8b near the oscillating members 44 and 45.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention provides an operating section with openings for two treatment instrument insertion channels disposed in an insertion section, and provides a distal end opening of each of the treatment instrument insertion channels with an operating section. The present invention relates to an endoscope apparatus including an endoscope in which a treatment tool rocking table that can be rocked individually by two independent operation knobs is provided.

[0002]

2. Description of the Related Art Conventionally, by inserting an elongated insertion portion into a body cavity, an organ in the body cavity can be observed, and if necessary, various treatment procedures can be performed using a treatment instrument inserted into a treatment instrument channel. Medical endoscopes that can be used are widely used.

In recent years, a technique of providing a plurality of treatment instrument insertion channels on an endoscope and inserting different treatment instruments into the respective treatment instrument insertion channels to endoscopically excise a lesion site in a body cavity, etc. Is widely recognized as useful.

For example, Japanese Unexamined Patent Publication No. 9-234182 discloses an endoscope having a plurality of treatment instrument insertion channels, each of which has a treatment instrument swinging table at its tip opening.

[0005]

However, in the endoscope disclosed in Japanese Unexamined Patent Publication No. 9-234182, a swing operation for remotely operating each of the treatment instrument swinging tables provided in the treatment instrument insertion channels. No description has been given regarding the operation knobs, which are the members, the proximal-side openings of the treatment instrument insertion channels, and the like. That is, no mention is made of the importance of the positional relationship between the treatment instrument swinging table, the operation knob, and the proximal opening of the treatment instrument insertion channel. Therefore, when the operation knob and the proximal side opening of the treatment instrument insertion channel are configured to be separated from each other, the operability of the treatment instrument deteriorates.

The present invention has been made in view of the above circumstances, and it is possible to efficiently operate an endoscope and a treatment instrument inserted from an independent proximal opening of each of a plurality of treatment instrument insertion channels. An object is to provide an endoscope device.

[0007]

The endoscope apparatus of the present invention comprises:
Two treatment instrument insertion channels arranged in the insertion portion of the endoscope, and a proximal opening in each of the two treatment instrument insertion channels provided below the grip portion in the operation portion of the endoscope. And a treatment instrument swinging table disposed at the tip opening of the two treatment instrument insertion channels or in the vicinity of the tip opening, and a treatment instrument swinging table provided on the upper side of the grip portion of the operation section. It has two rocking operation members that can be operated independently and a channel inside,
The opening of the distal end portion is detachably attached to the proximal side opening portion of the treatment instrument insertion channel, and when the distal end portion is attached to the proximal side opening portion, the proximal end portion is located in the vicinity of the swing operation member. And an opening extension formed as described above.

Further, the opening extension body is a treatment instrument insertion channel provided with a rocking base operated by a rocking operation member at least on a side far from the gripping portion among the two proximal openings. It is removably attached to the opening on the proximal side.

Further, the two treatment instrument insertion channels provided in the insertion portion of the endoscope and the two treatment instrument insertion channels provided below the grip portion of the operation portion of the endoscope are provided. A hand side opening in each, a treatment instrument rocking table respectively disposed in the tip opening of the two treatment instrument insertion channels or in the vicinity of the tip opening, and provided on the upper side of the grip portion in the operation portion, A first swing operation member that swings one of the treatment tool swing bases when operated by the operator's left hand, and a first swing operation member provided on the upper side of the grip portion of the operation unit and operated by the operator's right hand. And a second swing operation member that swings the other of the treatment instrument swing bases by moving the treatment tool swing base. The two grips are on the upper side and the insertion section is on the lower side. When the side opening is viewed from the front, the first swing operation is performed. A treatment instrument swinging table swung by the second swinging operation member is provided on the right side of the proximal side opening of the treatment instrument insertion channel provided with the treatment instrument swinging table. The treatment instrument insertion channel is arranged such that the proximal opening is located on the left side.

According to these configurations, by attaching the opening extension to the proximal opening of the endoscope, the proximal opening located on the lower end side of the grip of the operating section is replaced with the operating section of the operating section. Endoscopic treatment can be performed by changing to the vicinity of the swing operation member provided above the grip portion.

Further, one of the two rocking operation portions is provided on the operation portion such that one is operated by the left hand and the other is operated by the right hand, and the two proximal openings are provided on a predetermined axis orthogonal to the longitudinal axis. When placed in parallel to the inside, the proximal side opening of the treatment instrument insertion channel provided with the treatment instrument swing base that is swung by the swing operation section operated by the left hand is set to the right side. The endoscope and treatment tool can be held and handled reliably and smoothly.

[0012]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 relate to an embodiment of the present invention, FIG. 1 is a diagram for explaining an endoscope and an opening extension tool that constitute an endoscope device, and FIG. 2 is a table for rocking a second treatment tool rocking table. FIG. 3 is a diagram for explaining a state in which the medical fluid is injected into the submucosal layer of the lesion by moving it, FIG. 3 is a diagram for explaining a state in which the lesion mucosal part is lifted by swinging the first treatment rocking table, and FIG. 4 is a second treatment. It is a figure explaining the state which excises a lesion mucous membrane by rocking a tool rocker.

As shown in FIG. 1, an endoscope apparatus 1 according to this embodiment includes an endoscope 2 and an opening extension tool 8 which is an opening extension body.
It consists of and. First, the endoscope 2 will be described.

The endoscope 2 has an elongated insertion portion 3 and an operation portion 4 which also serves as a grip portion which is connected to the base end portion of the insertion portion 3.
And the universal cord portion 5 extending from the side portion of the operation portion 4 are mainly configured.

The insertion portion 3 has a rigid distal end forming portion 3a, a plurality of bending pieces (not shown) connected in sequence from the distal end side, a bendable bending portion 3b, and a flexible and flexible flexible tube portion 3c. There is. Two treatment instrument insertion channel tubes 61, 62 forming two treatment instrument insertion channels 6 a, 6 b are inserted and arranged in the insertion portion 3.

The treatment instrument insertion channel tube 61, and
A channel tip-side opening (hereinafter abbreviated as tip-side opening) communicating with 62 is formed, and the first treatment tool rocking table that rocks in the direction of arrow A is formed at or near the tip-side opening. (Hereinafter, abbreviated as a first rocking table) 31 and a second treatment tool rocking table (hereinafter, referred to as a second rocking table) that rocks in a direction of an arrow B.
A rocking table) 32 is arranged. Note that reference numeral 33 is an observation window forming an observation optical system.

The operation portion 4 has a first proximal opening portion (hereinafter abbreviated as first opening) 41 and a second proximal opening portion (hereinafter second A treatment tool insertion portion 4a having an opening 42), a grip portion 4b held by an operator, and an operation portion main body 4c. The gripping portion 4b is usually held by the left hand.

The first opening portion 41 and the second opening portion 42 of the treatment instrument insertion portion 4a are provided with the treatment instrument insertion channels 6a, 6 respectively.
Each of the treatment instrument insertion channel tubes 61 and 62 constituting b is communicated. Further, a bending operation knob 43 for remotely performing a bending operation of the bending portion 3b, and the first swing base 3 are provided on one surface side of the operation portion main body 4c of the operation portion 4.
The first rocking table operating knob 44, which is a rocking operating member for performing the remote rocking operation, and the second rocking table, which is a rocking operating member for performing the remote rocking operation of the second rocking table 32. An operation knob 45 is provided. The second rocking table operating knob 45 is provided with an engagement 46 for adjusting the amount of rotational force of the second rocking table operating knob 45.

The first opening 41 and the second opening 42 of the treatment instrument insertion portion 4a are arranged in parallel to a predetermined axis orthogonal to the longitudinal axis, and the second opening 42 is formed. Operation section body 4c provided with the first swing table operation knob 44 and the like
It is placed on one side. That is, the first in FIG.
When the opening 41 and the second opening 42 are viewed from the hand side, the opening located on the left side is the first opening 41.

As shown in the figure, the second swing base operating knob 45 is provided at a position farther from the treatment instrument insertion portion 4a than the first swing base operating knob 44. Also,
The first rocking table operating knob 44 and the first rocking table 31 are connected via a first treatment tool rocking mechanism (not shown), and the second rocking table operating knob 44 and the second rocking table 31 are connected to each other.
The rocking table operating knob 45 and the first rocking table 32 are connected via a second treatment tool rocking mechanism (not shown).

Further, when the grip portion 4b is held by the left hand as described above, the bending operation knob 43 and the first swing base operation knob 44 are normally operated by the left hand, and the second operation table 44 is operated by the left hand.
The rocking table operating knob 45 is operated by the right hand.

Then, by operating the first swing base operating knob 44 to swing the first swing base 31,
The treatment tool supported by the first rocking base 31 moves in a substantially vertical direction on the screen of a display device (not shown). On the other hand, the second rocking table operating knob 45 is operated to operate the second rocking table 3
By swinging 2, the treatment tool supported by the second swing base 32 moves in the substantially left-right direction on the screen of the display device (not shown).

Next, the opening extension tool 8 will be described. The opening extension tool 8 is a first opening extension channel tube 81 and a first opening extension channel tube 81 which is an opening extension conduit formed by forming a stainless pipe material or a Teflon (registered trademark) tube into a predetermined length dimension. A second opening extension channel tube 82 formed to have a predetermined length dimension longer than that of the opening extension channel tube 81, and the endoscope fixedly attached to the tip ends of the opening extension channel tubes 81, 82. A connecting portion 8a that is detachably attached to the two opening portions 41 and 42, and the opening extending channel tubes 81 and 8
It is composed of an extension opening 8b fixed to the base end of No. 2 and a holding portion 8c for arranging the extension opening 8b near the rocking table operation knobs 44 and 45.

The holding portion 8c is adapted to be fitted into a mounting hole 48 formed in the operation portion main body 4c, and has a first opening extension provided with the first opening extension channel tube 81. The connecting portion 8a of the tool 8A is connected and fixed to the first opening 41, and the connecting portion 8a of the second opening extension tool 8B having the second opening extension channel tube 82 is provided.
Is connected to the second opening 42. As a result, the second rocking table operation knob 45 operated by the right hand
The opening extension 8B is arranged on the right side when viewed from the hand side,
The first opening extension 8A corresponding to the first swing base operating knob 44 operated by the left hand is in a positional relationship of being arranged on the left side when viewed from the hand side.

Channel tube 8 for extending the opening
The lengths of 1 and 82 are the same as those of the connecting portion 8a of the first opening extension tool 8A and the second opening extension tool 8B, respectively.
By connecting the holding portion 8c to the mounting hole 48 in a state of being connected to the first and second members 1, 42,
The extension openings 8b provided in the opening extension tool 8A and the second opening extension tool 8B are respectively rocker table operation knobs 44,
It is set to be located near 45.

In the present embodiment, the Teflon (registered trademark) tubes are used as the opening extension channel tubes 81 and 82, but any member may be used as long as it has good slipperiness. In addition, the first opening 4
The structure for attaching / detaching the connecting portion 8a to / from the first and second openings 42 is, for example, a structure using an elastic member or a screwing structure using screws. Further, the attachment / detachment of the holding portion 8c and the mounting hole 48 and the holding structure are also a structure using an elastic member, a screwing structure with a screw or the like. Alternatively, the holding portion 8c may not be provided, and the rigidity of the channel tubes 81 and 82 themselves may define the position of the extension opening portion 8b.

The operation of the endoscope apparatus 1 configured as described above will be described. First, while fixing the connecting portion 8a of the opening extension tools 8A and 8B to the first opening portion 41 and the second opening portion 42 provided in the treatment instrument insertion portion 4a of the endoscope 2, the operation portion main body 4c is fixed. The holding portions 8c of the opening extension tools 8A and 8B are fixed to the mounting holes 48 provided.

As a result, the first opening 4 is provided in the vicinity of the first rocking table operating knob 44 for rocking the first rocking table 31.
The extension opening 8b provided in the first opening extension 8A communicating with the first swing extension 32 is disposed in the vicinity of the second swing base operating knob 45 that swings the second swing base 32. The extension opening portion 8b provided in the second opening portion extension tool 8B that is communicated with is disposed.

Next, the insertion portion 3 of the endoscope 2 is inserted into the body cavity. Then, the distal end surface of the endoscope 2 is made to face the lesioned mucous membrane, and endoscopic observation is performed. Then, for example, the second opening 42
The injection needle, which is a treatment tool, is inserted through the extension opening 8b of the second opening extension 8B connected to.

Then, as shown in FIG. 2, the injection needle 7a is led out into the body cavity through the second treatment tool insertion channel 6b. Here, the second swing base operating knob 45 located in the vicinity of the extension opening 8b of the second opening extension 8B is operated to swing the second swing base 32. When the tip of the injection needle 7a supported by the second swing table 32 faces the target site, the injection needle 7a is held and the tip of the injection needle 7a is pierced into the submucosal layer, and the saline solution A medicinal solution such as is injected to elevate the mucosal layer including the affected mucosa. After that, when the injection of the drug solution is completed, the injection needle 7a is removed from the second treatment instrument insertion channel 6b.

Then, a first opening extension 8A connected to the first opening 41 for cutting off the raised mucosal layer.
The grasping forceps 7b, which is a treatment tool, is inserted through the extension opening 8b of the first opening extension 8B of the first opening extension tool 8B.
The incision tool 7c is inserted into the second treatment tool insertion channel 6b from which the injection needle 7a is removed via b.

Then, as shown in FIG. 3, the grasping forceps 7b is drawn out into the body cavity to grasp the mucous membrane of the lesion, and then the first swing table operating knob 44 is operated to raise the first swing table 31. Then, the lesion mucous membrane grasped by the grasping forceps 7b is pulled up so as to be pulled up.

Next, as shown in FIG. 4, while the mucous membrane of the lesion is pulled up, the second rocking table operating knob 45 is operated to rock the second rocking table 32, and this second rocking is performed. The tip of the incision tool 7c supported by the table 32 is swung left and right to proceed to incise the lesioned mucosa or its submucosal layer.

That is, when performing an endoscopic treatment, delicate advance / retreat operations of the respective treatment tools 7a, 7b, 7c and the respective rocking bases 3 are performed.
Swing base operation knobs 44 and 45 for subtly swinging 1 and 32
Operations with and are performed alternately and frequently.

As described above, by disposing the extension openings in the vicinity of the respective rocking table operation knobs using the opening extending tool, a delicate forward / backward operation with respect to the treatment tool and a rocking motion of rocking the rocking table. It can be performed smoothly by coordinating the subtle operation of the platform control knob.

Further, by arranging the two openings provided in the treatment instrument insertion portion in consideration of workability, regardless of whether or not the opening extension is attached to the proximal side opening,
It is possible to perform an operation by arranging the hand side opening and the swing base operation knob related to the hand side opening on the same side.

In addition, when the endoscope is not held by the left hand but held by a stand or the like, the operation of the treatment instrument and the operation of the rocking table operation knob are concentrated on the left hand side and the right hand side, respectively. Can be done by

Further, since each opening extension is detachably attached to the treatment instrument insertion section and is arranged outside the operation section, the opening extension is directly opened to the grip section of the operation section or the operation main body section. Since it is not necessary to provide a section or to arrange a branch pipe line to the opening, it is possible to reduce the diameter of the operation section.

Further, by providing the second rocking table operating knob with the engagement, the rotational force amount of the second rocking table operating knob can be changed, so that the rocking of the second rocking table can be performed according to the operator's preference. You can adjust the speed.

In the above-described embodiment, when disposing the treatment tool insertion portion 4a, the first opening 41 and the second opening 42, the first opening 41 is positioned on the left side when viewed from the hand side. Thus, the configuration in which the opening extension tools 8A and 8B are connected to the respective opening portions 41 and 42 is shown, but as shown in the figure showing the other configuration of the endoscope apparatus in FIG. 5, the first treatment tool insertion channel is shown. The first opening 41, which is the opening of 6a, is arranged on the right side when viewed from the hand side, and the second opening extension 8B is detachably attached only to the second opening 42. Good.

It is also possible to dispose the first opening portion extension tool 8A in the first opening portion 41 by providing a square portion at the end portion of the first opening portion 41. Further, in this case, only the mounting holes 48 corresponding to the second opening extension tools are provided.

As a result, since the first swing table operating knob can be operated by the left hand thumb, the left hand side and the right hand side can be respectively operated.
It is possible to intensively perform the operation of the rocking table operation knob and the operation of the treatment tool.

The present invention is not limited to the embodiments described above, and various modifications can be made without departing from the spirit of the invention.

[0044]

As described above, according to the present invention, the operation of the endoscope and the operation of the treatment instrument inserted through the independent hand side openings of the plurality of treatment instrument insertion channels can be performed efficiently. An endoscope apparatus can be provided.

[Brief description of drawings]

1 to 4 relate to an embodiment of the present invention,
FIG. 1 is a diagram illustrating an endoscope and an opening extension tool that constitute an endoscope device.

FIG. 2 is a diagram illustrating a state in which a second treatment tool swing table is swung to inject a liquid medicine into a submucosal layer of a lesion.

FIG. 3 is a diagram illustrating a state in which a lesion mucosal part is lifted by rocking a first treatment rocking table.

FIG. 4 is a diagram illustrating a state in which a lesion mucosa is excised by rocking a second treatment tool rocking table.

FIG. 5 is a diagram showing another configuration of the endoscope apparatus.

[Explanation of symbols]

1 ... Endoscopic device 2 ... Endoscope 31 ... First treatment tool rocking table 32 ... Second treatment tool rocking table 4 ... Operation part 4a ... Treatment instrument insertion section 4b ... Grip 44 ... First rocking table operation knob 45 ... 2nd swing operation knob 8A ... first opening extension 8B ... second opening extension tool 8a ... connecting part 8b ... extended opening 8c ... holding unit 81 ... Channel tube for extending the first opening 82 ... Channel tube for extending the second opening

Claims (3)

[Claims] 1. A treatment instrument insertion channel disposed inside an insertion portion of an endoscope, and two treatment instrument insertion channels provided below a grip portion of an operation portion of the endoscope. At the proximal side, the treatment instrument rocking bases respectively arranged at the tip openings of the two treatment instrument insertion channels or near the tip openings, and provided on the upper side of the grip portion in the operation section, It has two swing operation members that can independently operate the tool swing base and a channel inside, and the opening of the distal end is detachably attached to the proximal side opening of the treatment tool insertion channel. An opening extension body formed such that a base end portion thereof is positioned in the vicinity of the swing operation member when the distal end portion is attached to the proximal side opening portion, and an endoscope. apparatus. 2. The treatment instrument insertion channel, wherein the opening extension is provided with a swing base operated by at least a swing operation member on a side far from the grip of the two proximal openings. The endoscope apparatus according to claim 1, wherein the endoscope apparatus is detachably attached to the proximal opening of the. 3. The two treatment tool insertion channels provided in the insertion part of the endoscope, and the two treatment tool insertion channels provided below the grip portion of the operation part of the endoscope. A hand side opening in each, a treatment instrument rocking table respectively disposed in the tip opening of the two treatment instrument insertion channels or in the vicinity of the tip opening, and provided on the upper side of the grip portion in the operation portion, A first swing operation member that swings one of the treatment tool swing bases when operated by the operator's left hand, and a first swing operation member provided on the upper side of the grip portion of the operation unit and operated by the operator's right hand. A second swing operation member for swinging the other of the treatment instrument swing bases by being performed, and the grip portion is on the upper side, and the insertion portion is on the lower side. When the front opening is viewed from the front, the first swing operation described above is performed. A treatment instrument swinging table swung by the second swinging operation member is provided on the right side of the proximal side opening of the treatment instrument insertion channel provided with the treatment instrument swinging table. The endoscope apparatus according to claim 1, wherein the treatment instrument insertion channel is arranged so that a proximal opening portion is located on the left side.