JP2010075269A - Endoscope system and assisting tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To perform treatment comparable to that by an oral endoscope by a nasal endoscope as well without complicating operations. <P>SOLUTION: The assisting tool combined with a nasal endoscope which has an insertion section 16 to be inserted through one nostril is included. The assisting tool has an insertion section 112 to be inserted through the other nostril. On the distal end of the insertion section 16, magnetic bodies 105 and 107 are provided. On the distal end of the insertion section 112, electromagnets 118 and 119 are provided. For the assisting tool, the distal end of the insertion part 112 is arranged side by side with the distal end of the insertion section 16 of the endoscope and is connected by magnetizing the respective electromagnets 118 and 119 to the respective magnetic bodies 105 and 107. Thus, since the soft part 115 of the insertion section 112 is curved following the curve of a curve part 21 accompanying the curving operation of the endoscope, the operation is prevented from becoming complicated even when assisting the function of the endoscope using the assisting tool together. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an endoscope system that uses a combination of a nasal endoscope and an auxiliary tool that assists the function of the nasal endoscope.

  A so-called nasal endoscope is known in which an insertion portion formed in a flexible tubular shape is inserted from an outer nostril to inspect a body cavity of a subject (Patent Documents 1 and 2). Transnasal endoscopes enter the esophagus without touching the tongue base, so pharyngeal reflexes are less likely to occur than oral endoscopes where the insertion part is inserted through the mouth, and there is little nausea. The load on the person is low. Transnasal endoscopes also have the advantage that mouth breathing is possible, anesthetics are smaller than oral endoscopy, and conversation with the subject can be performed during the examination. Therefore, demand has increased in recent years.

A transnasal endoscope is configured in the same way as an oral endoscope. In the internal space of the insertion section, forceps conduits for inserting various treatment instruments, air and water are inserted into the distal end surface of the observation optical system. (Observation window), an air / water supply conduit for feeding into the body cavity, a light guide for guiding the light supplied from the light source device and irradiating it from the tip as illumination light, and the like are housed.
JP 2006-68030 A JP 2007-61377 A

  The transnasal endoscope passes through a narrow and winding insertion path from the outer nostril to the middle nasal passage (lower nasal passage), so the diameter of the insertion part of the oral endoscope is around 9 mm, whereas it is around 6 mm. And the diameter of the insertion part is thinner than the oral endoscope. For this reason, transnasal endoscopes have a narrower space for placing forceps ducts and the like provided in the insertion section than oral endoscopes, and these diameters can be reduced or any of them can be deleted. There is a problem of having to.

  If the diameter of the forceps conduit is reduced, the size of the treatment tool that can be used is limited, leading to a decrease in the amount of biopsy. The forceps conduit is also used as a suction conduit for sucking air, residue, body fluid, and the like accumulated in the body cavity. For this reason, when the diameter of the forceps conduit is reduced, the amount of suction is reduced and it takes time for suction. When the diameter of the air supply / water supply conduit is reduced, the flow rate per unit time of the air and water to be supplied decreases. For this reason, it takes time to expand the stomach to secure a visual field, and to wash away blood and mucus that disturb the observation. When the diameter of the light guide is reduced, the amount of illumination light is reduced and the background is darkened.

  As described above, the transnasal endoscope has an advantage that the load on the subject is low, but has a drawback that there are more functional restrictions than the oral endoscope. For this reason, in nasal endoscopy, when a lesion or the like that is difficult to treat with nasal endoscope is found, treatment must be performed by switching from nasal endoscope to oral endoscope. In some cases, there is a great demand for a transnasal endoscope that can perform the same level of treatment as an oral endoscope.

  As a proposal to meet these demands, a nasal endoscope is provided by using an auxiliary tool having a forceps conduit, a light guide, and the like, and having an insertion portion having the same diameter as that of a transnasal endoscope. It is conceivable to assist the function of the mirror. For example, if only the forceps conduit is provided in the insertion portion of the assisting device, the diameter of the forceps conduit is orally determined even if the diameter of the insertion portion is substantially the same as the insertion portion of the nasal endoscope. The diameter of the forceps conduit provided in the mirror can be made approximately the same. Therefore, the insertion part of the nasal endoscope is inserted from one outer nostril and the insertion part of the auxiliary tool is inserted from the other outer nostril. When performing the procedure, a biopsy amount equivalent to that of an oral endoscope can be obtained.

  Similarly, if an air supply / water supply conduit is provided at the insertion part of the auxiliary tool, the flow rate per unit time can be made the same level as that of an oral endoscope, and a light guide is provided at the insertion part of the auxiliary tool. If provided, the amount of illumination light can be made comparable to that of an oral endoscope.

  As described above, if a combination of auxiliary tools is used, a transnasal endoscope can perform the same level of treatment as an oral endoscope. However, in order to perform an examination using a nasal endoscope and an auxiliary tool, both insertion portions must be operated separately, which causes a problem that the operation becomes complicated.

  The present invention has been made in view of the above problems, and an object of the present invention is to enable a nasal endoscope to perform the same level of treatment as an oral endoscope without incurring complicated operations. To do.

  In order to achieve the above object, the present invention is used in combination with an endoscope having an insertion portion inserted into a body cavity from one outer nostril, and inserted into the body cavity from the other outer nostril. Thus, in an endoscope system comprising an auxiliary tool having an insertion part for assisting the function of the endoscope, the endoscope system is provided at one end of the insertion part of the endoscope and the insertion part of the auxiliary tool. A magnetic member provided at the other end of the insertion portion of the endoscope and the insertion portion of the auxiliary tool, and magnetically attached to the magnet to connect the distal ends of the insertion portions side by side. It is characterized by having.

  At least one of the magnet and the magnetic member is connected to the corresponding insertion portion so that the tip of each insertion portion can move in the axial direction while being connected by the magnet and the magnetic member. When the distal end is moved in the axial direction while being connected to the distal end of the insertion portion of the endoscope, the insertion portion of the auxiliary tool is inserted into the insertion portion of the endoscope. It is preferable to provide an engaging portion that engages with the provided engaged portion and mechanically fixes the distal ends of the insertion portions.

  When the engaging portion and the engaged portion are engaged with each other to fix the distal ends of the insertion portions, it is preferable that the distal ends of the insertion portions are aligned.

  The magnet is preferably an electromagnet. Further, it is more preferable to provide detection means for detecting that the insertion portions are connected.

  The endoscope includes an operation unit that is connected to a proximal end portion of the insertion portion and performs a bending operation of the insertion portion, and the auxiliary tool has a proximal end portion of the insertion portion that is the operation portion. It is preferable to have an attachment part for detachably attaching to.

  The auxiliary device includes a forceps conduit for inserting the treatment instrument into the body cavity, an illumination means for illuminating the interior of the body cavity by irradiating illumination light, an air supply conduit for feeding gas into the body cavity, and the body cavity It is preferable to have at least one of the water supply pipes for sending the liquid into.

  Further, the present invention is used in combination with an endoscope having an insertion portion that is inserted into a body cavity from one outer nostril, and has the function of the endoscope by being inserted into the body cavity from the other outer nostril. In the auxiliary tool having an insertion part to assist, a magnet is provided at one end of the insertion part of the endoscope and the insertion part of the auxiliary tool, and the insertion part of the endoscope and the insertion part of the auxiliary tool are provided. The other end is provided with a magnetic member that connects the ends of the insertion portions side by side by being magnetically attached to the magnet.

  According to the present invention, by using the auxiliary tool to assist the function of the endoscope, the transnasal endoscope can perform the same level of treatment as the oral endoscope. Since the distal ends of the insertion portions can be connected to each other by magnetic attachment between the magnet and the magnetic member, the insertion portion of the auxiliary tool can be made to follow the operation of the insertion portion of the endoscope. The operation can be prevented from becoming complicated even when the inspection is performed using the auxiliary tool.

  As shown in FIG. 1, an endoscope system 10 includes an endoscope 11 that captures an image of a body cavity of a subject, an auxiliary tool 12 that assists the function of the endoscope 11, and illumination in the body cavity. The light source device 13 that supplies the illumination light to the endoscope 11, the processor device 14 that generates the endoscope image, and the monitor 15 that displays the endoscope image generated by the processor device 14. .

  The endoscope 11 is connected to an insertion portion 16 to be inserted into a body cavity of a subject and a proximal operation portion 17 that is operated by a surgeon such as a doctor or a technician. And a universal cable 18 connected to the hand operation unit 17 for connecting the endoscope 11 to the light source device 13 and the processor device 14. Further, a forceps conduit 51 (see FIG. 2) for inserting various treatment tools such as forceps and snare from the hand operating section 17 to the distal end of the insertion section 16 is provided inside the endoscope 11. Is provided. The insertion portion 16 is formed in a tubular shape having an outer diameter of about 6 mm. The forceps conduit 51 is formed in a tubular shape having an inner diameter of about 2 mm.

  The auxiliary tool 12 includes an insertion portion 35 to be inserted into the body cavity of the subject, and an attachment portion 36 for attaching the proximal end portion of the insertion portion 35 to the hand operation portion 17 of the endoscope 11. Yes. The insertion portion 35 is formed in a tubular shape having an outer diameter that is substantially the same as or slightly thinner than the insertion portion 16 of the endoscope 11. A forceps conduit 64 (see FIG. 3) having a diameter larger than that of the forceps conduit 51 of the endoscope 11 is provided inside the auxiliary tool 12 from the attachment portion 36 to the distal end of the insertion portion 35. Yes.

  The endoscope 11 is a so-called transnasal endoscope that inserts the insertion portion 16 from the outer nostril. In the endoscope 11, the diameter of the insertion portion 16 is smaller than that of an oral endoscope in which the insertion portion is inserted from the mouth. Accordingly, the diameter of the forceps conduit 51 provided in the insertion portion 16 is naturally reduced. For this reason, in the endoscope 11, the size of the treatment tool that can be used is limited as compared with the oral endoscope.

  The endoscope system 10 inserts the insertion portion 16 of the endoscope 11 from one outer nostril, and inserts the insertion portion 35 of the auxiliary tool 12 from the other outer nostril where the insertion portion 16 of the endoscope 11 is not inserted. Are used in combination. Further, by assisting the function of the forceps conduit 51 of the endoscope 11 with the forceps conduit 64 of the assisting tool 12, even when performing an examination with the endoscope 11, which is a transnasal endoscope, oral endoscope is performed. Make it possible to use a treatment tool that is about the same size as a mirror. In addition, since the internal diameter of the forceps pipe line of a general oral endoscope is about 3.2 mm, it is preferable that the internal diameter of the forceps pipe line 64 of the auxiliary tool 12 is 3.2 mm or more.

  As is well known, the insertion portion 16 of the endoscope 11 includes a distal end hard portion 20, a bending portion 21, and a flexible portion 22. The distal end hard portion 20 incorporates an imaging element, an observation optical system, an illumination optical system, and the like inside a distal end main body formed of a hard metal material or the like.

  The bending portion 21 is configured to bend in four directions, up, down, left, and right in conjunction with operations of the up / down bending operation portion 23 and the left / right bending operation portion 24 provided in the hand operation portion 17. Thereby, the inside of the body cavity can be observed with the distal end surface of the distal end hard portion 20 directed in a desired direction. The soft part 22 is a part that connects the hand operating part 17 and the bending part 21, is formed in a thin and long tubular shape, and has flexibility.

  In addition to the bending operation sections 23 and 24, the hand operation section 17 includes a forceps inlet 25 for inserting the treatment instrument into the forceps conduit 51, and air supply / water supply for supplying air and water into the body cavity. Air supply / water supply button 26, suction button 27 for sucking air and residues accumulated in the body cavity, body fluid, and the like, and water jet port for jetting liquid such as washing water and chemical liquid toward the observation target ( WJ port) 28 and the like are provided. A syringe is detachably connected to the WJ port 28. Washing water, chemicals, and the like that are sprayed onto the observation target are supplied from this syringe. Note that the forceps inlet 25 and the WJ port 28 are usually closed by a detachable stopper.

  The universal cable 18 includes a light guide connector (LG connector) 30 for connecting to the light source device 13 and a video connector (electrical) for connecting to the processor device 14 at the end opposite to the hand operating unit 17. Connector) 31 is provided. The electrical connector 31 is connected to the LG connector 30 via a cord 32. The endoscope 11 is detachably connected to the devices 13 and 14 via these connectors 30 and 31.

  Further, the LG connector 30 is connected to a joint for connecting a water supply tank 33 for storing water for water supply and a joint for connecting a suction device 34 for supplying suction pressure for suction to the endoscope 11. And are provided. The LG connector 30 is connected to the water supply tank 33 via a water supply joint and a water supply tube 33a, and is connected to the suction device 34 via a suction joint and a suction tube 34a.

  The suction joint is connected to a suction pipe formed in the endoscope 11. The suction line is connected to the forceps line 51 in the hand operation unit 17 and is closed by a valve that is interlocked with the pressing operation of the suction button 27. When the suction button 27 is pressed, the suction line is opened, and the path from the forceps line 51 to the suction device 34 via the suction line and the suction tube 34a is connected. When this path is connected, suction is started by the suction pressure of the suction device 34, and air, body fluid, and the like accumulated in the body cavity are sucked from the distal end of the insertion portion 16. Further, when the suction device 34 sucks a liquid such as washing water or body fluid, the liquid is stored in the suction tank 34b. As described above, the forceps conduit 51 also functions as a suction conduit.

  The light source device 13 has a built-in light source lamp that emits illumination light. The light source lamp is disposed so as to face the light incident surface of the connected LG connector 30 and makes illumination light incident on the light incident surface. The illumination light incident on the LG connector 30 is guided to the illumination optical system in the distal end hard portion 20 by a light guide provided in the endoscope 11 and is irradiated from the distal end surface of the distal end hard portion 20.

  Further, the light source device 13 is provided with a pump for supplying air for air supply / water supply to the endoscope 11. The air supplied from the light source device 13 is sent to the air supply conduit formed in the endoscope 11 via the LG connector 30 and also to the water supply tube 33a.

  In the water supply tube 33a, air supplied from the light source device 13 is supplied to the water supply tank 33 to apply pressure to the water supply tank 33, and water in the water supply tank 33 pushed out by the applied pressure. And a conduit for water supply. The water supply conduit is connected to a water supply conduit formed in the endoscope 11 by the LG connector 30.

  The air supply conduit and the water supply conduit of the endoscope 11 are closed by a valve that is interlocked with the pressing operation of the air / water supply button 26. In the center of the air / water supply button 26, a hole for leaking air supplied from the light source device 13 is provided. The valve switches between closing and opening of each pipe line in accordance with the pressing operation of the air / water supply button 26. When the hole of the air / water supply button 26 is closed with a finger, the air supplied from the light source device 13 is sent to the air supply duct and discharged from the distal end of the insertion portion 16. When the air / water supply button 26 is pressed, the air supply line is closed, the water supply line is opened, and the water delivered from the water supply tank 33 is discharged from the distal end of the insertion portion 16.

  It should be noted that the air supply conduit and the water supply conduit of the endoscope 11 are combined into one as an air supply / water supply conduit 52 (see FIG. 2) at a portion downstream of the valve. In the insertion portion 16, the air from the light source device 13 and the water from the water supply tank 33 are sent to the tip of the insertion portion 16 through the same air / water supply conduit 52.

  The processor device 14 is provided with an image processing circuit that performs various kinds of image processing on an imaging signal output from an imaging element provided in the endoscope 11 to generate an endoscopic image. The image processing circuit encodes the endoscopic image into a composite signal or RGB component signal and outputs the encoded signal to the monitor 15. Thereby, an endoscopic image is displayed on the monitor 15.

  The insertion part 35 of the auxiliary tool 12 is composed of a tip part 37 and a flexible part 38. The distal end portion 37 is formed of a hard material such as metal, like the distal end hard portion 20 of the endoscope 11. The flexible portion 38 is also configured in the same manner as the flexible portion 22 of the endoscope 11, is formed in a thin and long tubular shape, has flexibility, and has a distal end portion 37 and an attachment portion 36. Connect between them.

  The attachment portion 36 is formed in a substantially T-shaped three-pronged tube, and is connected to the insertion portion 35 via a central conduit. One end portion of the attachment portion 36 is formed with an inner diameter substantially the same as the outer diameter of the forceps inlet 25 formed in a substantially cylindrical shape. The attachment portion 36 is detachably attached to the hand operation portion 17 by fitting this one end portion to the forceps inlet 25.

  The other end of the attachment portion 36 is a forceps inlet 40 for inserting a treatment tool into the forceps conduit 51 of the endoscope 11 and the forceps conduit 64 of the auxiliary tool 12. As described above, after the auxiliary tool 12 is attached to the forceps inlet 25 of the endoscope 11 by the attachment portion 36, the auxiliary tool 12 is endoscopically viewed through the forceps inlet 40 and the internal conduit of the attachment portion 36 formed in a three-pronged tubular shape. A treatment tool can be selectively inserted into the forceps conduit 51 of the mirror 11 and the forceps conduit 64 of the auxiliary tool 12. The forceps inlet 40 is formed in substantially the same shape as the forceps inlet 25 of the endoscope 11. Thereby, the forceps stopper used for the forceps inlet 25 of the endoscope 11 can be attached to the forceps inlet 40.

  As described above, the forceps conduit 51 of the endoscope 11 also has a function as a suction conduit. When the auxiliary tool 12 is attached to the forceps inlet 25 and the suction button 27 is pressed, the forceps pipe 51 of the endoscope 11 and the forceps pipe 64 of the auxiliary tool 12 are attached via the attachment part 36 formed in a trifurcated tube. Are connected to each other through the forceps conduits 51 and 64. Thereby, when suction is performed using the auxiliary tool 12 in combination, the amount of suction per unit time can be increased.

  In addition, as timing which attaches the attachment part 36 of the auxiliary tool 12 to the forceps inlet 25, before insertion of each insertion part 16 and 35 in a body cavity, and after insertion can be considered. In this case, in the latter case, it is desirable that the length of the insertion portion 35 of the auxiliary tool 12 be longer than that of the insertion portion 16 of the endoscope 11 because the operation is easy.

  As shown in FIG. 2, the flexible portion 22 of the endoscope 11 includes a screw tube 44 called a flex that protects the inside while maintaining flexibility in order from the inside, and the outer layer 46 that is covered on the screw tube 44. It is composed of a flexible tube 47 composed of three layers of a net 45 called a blade for holding a resin and an outer layer 46 on which the resin is deposited on the net 45.

  Inside the flexible tube 47, there are light guides 48 and 49, an angle wire 50, a forceps conduit 51, an air / water feed conduit 52, a multicore cable 53, and a water jet conduit (WJ conduit) 54. Etc. are provided. The light guides 48 and 49 guide the illumination light supplied from the light source device 13 to the illumination optical system of the distal end hard portion 20. The angle wire 50 is configured such that two angle wires for up and down and left and right are respectively wound around two pulleys interlocking with the operation of the bending operation parts 23 and 24 and their tips are inserted toward the bending part 21. Therefore, there are four inside the flexible tube 47, each of which is inserted into the close coiled pipe 50a.

  The forceps conduit 51 guides the treatment tool inserted from the forceps inlet 25 or the forceps inlet 40 to the distal end hard portion 20. The air / water supply pipeline 52 sends air or water supplied to the distal end hard portion 20 in response to the pressing operation of the air / water supply button 26. The multi-core cable 53 is a cable for mainly sending a signal for driving the imaging sensor from the video signal processing unit and sending an imaging signal obtained from the imaging sensor to the video signal processing unit. The cross-sectional shape is covered with a protective coating. The WJ pipe 54 sends a liquid such as water or a chemical supplied from the syringe connected to the WJ port 28 to the distal end hard portion 20.

  As shown in FIG. 3, the flexible portion 38 of the assisting tool 12 is covered with a flexible tube 63 composed of three layers of a screw tube 60, a net 61, and an outer layer 62, similarly to the flexible portion 22 of the endoscope 11. It has been broken. In the flexible tube 63, a forceps conduit 64 made of a synthetic resin flexible tube is provided. The screw tube 60 is provided around the forceps conduit 64 and protects the forceps conduit 64 while maintaining flexibility. The net 61 is covered on the screw tube 60 and holds the resin of the outer layer 62. The outer layer 62 is obtained by depositing a resin on the net 61.

  As shown in FIGS. 1 and 4, a fixing member 70 for fixing the distal end of the insertion portion 35 to the distal end of the insertion portion 16 of the endoscope 11 is attached to the distal end of the insertion portion 35 of the auxiliary tool 12. ing. The fixing member 70 has a shape that penetrates part of the side surface of the cylinder, and includes a main body portion 71 bent into a cylindrical surface shape and ring portions 72 and 73 provided at both ends of the main body portion 71. Have. The fixing member 70 is detachably attached to the insertion portion 35 by passing the ring portions 72 and 73 through the insertion portion 35.

  On the outer surface of the main body 71, an engagement protrusion (engagement portion) 74 and a magnetic body (magnetic member) 75 (a portion indicated by hatching in the figure) are provided. The engagement protrusion 74 is formed in a streak shape along the central axis direction of the fixing member 70 formed in a cylindrical shape. In addition, the engagement protrusion 74 is formed in a substantially cylindrical shape, and is formed in a taper shape in which the amount of protrusion from the outer surface of the main body portion 71 decreases from one ring portion 72 toward the other ring portion 73. Yes.

  The magnetic body 75 is formed in a streak shape along the central axis direction of the fixing member 70 similarly to the engagement protrusion 74, and is disposed adjacent to the engagement protrusion 74. This magnetic body 75 is a thin film of a magnetic material such as iron and has magnetism and flexibility. Further, portions of the fixing member 70 other than the magnetic body 75 are formed of a resin material having elasticity such as silicone rubber.

  A concave portion 66 corresponding to the shape of the fixing member 70 is provided on the outer surface of the flexible portion 38 of the insertion portion 35. The depth of the recess 66 is substantially the same as the thickness of the main body 71 of the fixing member 70 and the ring portions 72 and 73. Thus, when the fixing member 70 is attached to the insertion portion 35 via the ring portions 72, 72, the main body portion 71, the ring portions 72, 73, the tip portion 37, and the flexible portion 38 are substantially flush with each other, Only the engaging protrusion 74 protrudes, and the position of the fixing member 70 in the axial direction and the rotational direction is determined by the engagement with the recess 66.

  Moreover, the diameter of each ring part 72 and 73 is slightly smaller than the diameter of the part of the recessed part 66 corresponding to this. As a result, the fixing member 70 attached to the insertion portion 35 is in close contact with the recess 66 due to the elasticity of the ring portions 72 and 73.

  A forceps outlet 67 through which the distal end of the treatment instrument inserted into the forceps conduit 64 is led out is formed at the distal end surface 37 a of the distal end portion 37. On the other hand, on the distal end surface 20a of the distal end rigid portion 20 of the endoscope 11, as shown in FIG. 5, an observation window 80, a pair of illumination windows 81 and 82, a forceps outlet 83, an air / water supply nozzle 84, and water A jet nozzle (WJ nozzle) 85 and the like are provided. In the observation window 80, a part of the observation optical system for taking in image light from the observation object is arranged. The illumination windows 81 and 82 are provided on both sides of the observation window 80, and irradiate light from the light source device 13 supplied via the light guides 48 and 49 toward the observation target.

  The forceps outlet 83 guides the distal end of the treatment instrument inserted into the forceps conduit 51. The air / water supply nozzle 84 injects air or water sent from the air / water supply pipeline 52 in response to the pressing operation of the air / water supply button 26. At this time, the injection port of the air / water supply nozzle 84 is formed so that the air or water to be injected is directed toward the observation window 80. As a result, the observation window 80 is washed with air or water jetted from the air / water supply nozzle 84, and dirt and the like attached to the observation window 80 can be washed away. The WJ nozzle 83 ejects a liquid such as cleaning water or a chemical solution sent from the WJ pipe 54. The ejection port of the WJ nozzle 83 is formed in the direction of the optical axis of the observation window 80, and directly sprays the liquid to be ejected onto the observation target.

  Further, on the outer surface of the insertion portion 16 of the endoscope 11, an engagement groove (engaged portion) 86 that engages with the engagement protrusion 74 of the fixing member 70, and the engagement protrusion 74 and the engagement groove 86 are formed. A magnet 87 (portion indicated by hatching in the drawing) that is magnetically attached to the magnetic body 75 when engaged is provided. The engaging groove 86 has a shape corresponding to the engaging protrusion 74, is formed in a substantially cylindrical shape from the distal end surface 20 a to the curved portion 21, and from the outer surface toward the curved portion 21 from the distal end surface 20 a. It is formed in the taper shape from which the amount of dents decreases. The magnet 87 is adjacent to the engaging groove 86 so as to be magnetically attached to the magnetic body 75, and is disposed on the side surface of the distal end hard portion 20 while being brought close to the distal end surface 20 a. Further, the magnet 87 is substantially flush with the side surface of the distal end hard portion 20 so as not to be caught on the body wall or the like when inserted into the body cavity.

  When the distal end of the insertion portion 35 of the auxiliary tool 12 is fixed to the distal end of the insertion portion 16 of the endoscope 11, first, the insertion portions 16 and 35 are parallel so that the distal end surfaces 20a and 37a face the same direction. In addition, each is arranged so that the distal end surface 20a of the insertion portion 16 is located behind the fixing member 70 attached to the insertion portion 35.

  Thereafter, the insertion portion 16 is moved forward so that the distal end surface 20a of the insertion portion 16 approaches the distal end surface 37a of the insertion portion 35, and the direction of the rotation direction of each insertion portion 16, 35 is adjusted, and FIG. As shown in a), the magnet 87 is magnetically attached to the magnetic body 75 of the fixing member 70 by bringing the side surface of the distal end hard portion 20 of the insertion portion 16 into contact with the vicinity of the rear end of the fixing member 70.

  Thereby, the direction of the rotation direction of each insertion part 16 and 35 is determined, and the engagement protrusion 74 and the engagement groove 86 face each other. At this time, since the engagement protrusion 74 and the engagement groove 86 are formed in a tapered shape, in FIG. 6A, only a part of each other faces each other. Not done. In FIG. 6, illustrations of the built-in components of the insertion portions 16 and 35 are omitted for convenience.

  Then, after the magnet 87 is magnetically attached to the magnetic body 75 as described above, the insertion portion 16 is moved further forward so that the magnet 87 slides on the magnetic body 75 while being magnetized, and FIG. As shown to (b), each front end surface 20a, 37a is arrange | equalized. Thereby, the engagement protrusion 74 and the engagement groove 86 are engaged, and the distal end of the insertion portion 35 of the auxiliary tool 12 is fixed to the distal end of the insertion portion 16 of the endoscope 11.

  If the distal end of the insertion portion 35 is fixed to the distal end of the insertion portion 16 in this way, the flexible portion 38 of the insertion portion 35 bends following the bending of the bending portion 21 accompanying the bending operation of each bending operation portion 23, 24. The distal end surface 20a of the endoscope 11 and the distal end surface 37a of the auxiliary tool 12 are directed in the same direction. As a result, even when the endoscope 11 and the auxiliary tool 12 are used in combination, only the bending operation of the endoscope 11 is required, so that the operation can be prevented from becoming complicated.

  Further, since the engaging protrusion 74 and the engaging groove 86 are engaged when the insertion portion 16 is moved forward, the endoscope is used when fixing the insertion portions 16 and 35 in the body cavity. The insertion part 35 can be projected in the image. Thus, the positioning of the magnetic body 75 and the magnet 87 and the engagement of the engagement protrusion 74 and the engagement groove 86 can be performed while looking at the insertion portion 35 displayed in the endoscopic image. The operability when fixing the parts 16 and 35 can be improved.

  Furthermore, since each insertion part 16 and 35 is connected by the magnetic attachment of the magnetic body 75 and the magnet 87, each insertion part 16 and 35 is fixed by engaging the engagement protrusion 74 and the engagement groove 86. The operability during the process can be further improved.

  Next, the operation of the endoscope system 10 configured as described above will be described with reference to the flowchart shown in FIG. In the transnasal endoscopy, as a pretreatment, in order to insert the insertion part 16 of the endoscope 11, an anesthesia is performed from the nasal cavity of the nostril to the middle (lower) nasal passage and an insertion test is performed. The nasal cavity having an insertion path through which the unit 16 can be inserted is determined. The pretreatment is performed in the sitting position or the supine position, and thereafter, the insertion portion 16 is inserted into one outer nostril in the supine position or the left-side supine position. After being inserted from the outer nostril, the insertion unit 16 reaches the stomach or duodenum via the middle or lower nasal passage, the rear nostril (inner nostril), and the esophagus.

  When it is determined that treatment or treatment is not necessary by observing the duodenum or stomach, the insertion portion 16 of the endoscope 11 is pulled out from the body cavity and the examination is terminated. Further, when a lesion is found and treatment or treatment can be performed using the small-diameter forceps conduit 51 of the endoscope 11, a treatment such as a small snare or a biological forceps can be performed using the forceps conduit 51. A device is inserted for treatment or therapy.

  When it is determined that treatment or therapy cannot be performed in the forceps conduit 51 of the endoscope 11, the auxiliary tool 12 is used in combination. When the auxiliary tool 12 is used together with the endoscope 11, first, the insertion part 35 of the auxiliary tool 12 is inserted into the other nostril, so that the nasal cavity of the other nostril is anesthetized. Next, in order to fix the distal end of the insertion portion 35 of the auxiliary tool 12 to the distal end of the insertion portion 16 of the endoscope 11, the distal end surface 20 a is positioned in the range from the rear nostril to the esophagus. The insertion part 16 is pulled back. Then, the insertion part 35 of the auxiliary tool 12 is inserted from the other outer nostril, and the distal end surface 37a is positioned in the range from the rear nostril to the esophagus.

  After inserting the insertion portions 16 and 35, as described above, the alignment of the magnetic body 75 and the magnet 87, the engagement protrusion 74, and the engagement groove 86 while viewing the insertion portion 35 displayed in the endoscopic image. The distal end of the insertion portion 35 of the auxiliary tool 12 is fixed to the distal end of the insertion portion 16 of the endoscope 11. Thereafter, the attachment portion 36 of the auxiliary tool 12 is attached to the forceps inlet 25 of the endoscope 11 and insertion of the insertion portions 16 and 35 is started.

  When inserting the insertion sections 16 and 35, the bending operation sections 23 and 24 are operated while looking at the screen of the monitor 15, and insertion is performed while the bending section 21 of the endoscope 11 is bent. At this time, since the flexible portion 38 of the auxiliary tool 12 is in close contact with the bending portion 21 of the endoscope 11 by the engagement of the engaging protrusion 74 and the engaging groove 86, the bending portion 21 of the endoscope 11 is in contact with the bending portion 21 of the endoscope 11. They are bent together and inserted following the insertion of the insertion portion 16 of the endoscope 11. For this reason, the insertion part 35 of the auxiliary tool 12 is also inserted together by only inserting with the insertion part 16 of the endoscope 11.

  When each of the insertion parts 16 and 35 is inserted and an affected part that needs to be treated or treated is displayed on the screen of the monitor 15, a treatment tool such as a snare or biopsy forceps is inserted into a forceps inlet provided in the attachment part 36. 40 to the forceps conduit 64 of the auxiliary tool 12. Then, the distal treatment member of the treatment tool, for example, a pair of forceps cups or a loop for squeezing is led out from the forceps outlet 67 of the auxiliary tool 12 to perform treatment or treatment.

  A biopsy forceps described as an example of a treatment tool generally has an operation wire having a pair of forceps cups attached to the tip of the biopsy forceps so as to be freely opened and closed, and the rear end of the operation wire is positioned outside the forceps inlet. By moving forward and backward in the direction, the forceps cup is opened and closed in a hook shape by the link structure provided in the distal end portion of the flexible sheath. Biopsy forceps are mainly used for the purpose of tissue collection, and the inner diameter of a compatible forceps conduit often requires, for example, 2.8 mm or more.

  In addition, a snare is generally configured such that a squeezing loop formed by bending an elastic wire enters and exits the sheath tip by operation from the sheath side, and the squeezing loop is formed in the sheath. In the state of being pulled in, it is elastically deformed into a constricted state, and when it is pushed forward from within the sheath, it expands into a loop-like shape. When polypectomy is performed with a snare, the root portion of the polyp is properly tightened with a squeezing loop, and then a high-frequency current is applied to the squeezing loop to make contact with the squeezing loop. A part of living tissue is cauterized and cut and coagulated simultaneously. Many of these snares require an inner diameter of a compatible forceps conduit of, for example, 2.8 mm or more.

  Such a treatment tool such as a snare or a biopsy forceps is used, for example, tissue collection (biopsy) to remove the tissue, removal of a foreign substance, stop bleeding, removal of a tumor, gallstone Treatment and treatment such as crushing. Further, when it is desired to aspirate internal dirt or blood or other body fluids, when the suction button 27 of the hand operation unit 17 is pressed, the suction is performed not only from the forceps outlet 83 of the endoscope 11 but also from the forceps outlet 67 of the auxiliary tool 12. Therefore, rapid suction can be performed, and since suction from both forceps outlets 67 and 83 can be performed simultaneously, a large amount of living tissue can be collected.

  After the treatment or treatment is completed, the treatment tool is pulled out from the forceps inlet 40 of the auxiliary tool 12, and then both the insertion portions 16 and 35 are slowly pulled out. In the middle of this, for example, before passing through the range from the posterior nostril to the esophagus, the fixation of the distal ends of both insertion portions 16 and 35 is released. For example, only the insertion portion 16 of the endoscope 11 is pulled strongly, and the engagement between the engagement protrusion 74 and the engagement groove 86 and the magnetic attachment between the magnetic body 75 and the magnet 87 are released. Done. After the fixing of the insertion portions 16 and 35 is released, the insertion portions 16 and 35 are individually pulled out in the order of the auxiliary tool 12 and the endoscope 11. Finally, the attachment part 36 of the auxiliary tool 12 is removed from the forceps inlet 25 of the hand operation part 17.

  By the above, the test | inspection at the time of using the endoscope 11 and the auxiliary tool 12 in combination is complete | finished. If it is known from the beginning that treatment or therapy cannot be performed using the forceps conduit 51 of the endoscope 11, the assisting tool 12 may be used from the beginning.

  In the above embodiment, the engaging protrusion 74 and the magnetic body 75 are provided on the fixing member 70 that is detachable with respect to the insertion portion 35. However, the present invention is not limited to this, and these are integrally provided on the insertion portion 35. Alternatively, the fixing member 70 may be detachably attached to the insertion portion 16 of the endoscope 11. In the above embodiment, the engaging groove 86 is provided in the insertion portion 16 of the endoscope 11 and the engaging protrusion 74 is provided in the insertion portion 35 of the auxiliary tool 12. 16 may be provided with an engaging protrusion and the insertion portion 35 may be provided with an engaging groove. Furthermore, the present invention is not limited to the engagement protrusion and the engagement groove, and any other configuration may be used as long as the insertion portions 16 and 35 can be mechanically fixed by engagement.

  In the above-described embodiment, the magnet 87 is provided in the insertion portion 16 of the endoscope 11 and the magnetic body 75 is provided in the insertion portion 35 of the auxiliary tool 12. And a magnet may be provided in the insertion portion 35, or both may be magnets. The magnet 87 is not limited to a permanent magnet, and may be an electromagnet.

  Next, a second embodiment of the present invention will be described. The same functions and configurations as those of the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted. As shown in FIG. 8, in the endoscope 11 of the present embodiment, concave portions 100 and 102 are formed at both ends of the bending portion 21. Rubber bands 104 and 106 are attached to the recesses 100 and 102, respectively. The rubber bands 104 and 106 are provided with magnetic bodies 105 and 107 made of iron or the like.

  The rubber bands 104 and 106 are attached to the concave portions 100 and 102 so that the magnetic bodies 105 and 107 are aligned along the axial direction of the insertion portion 16. Each recess 100, 102 and each rubber band 104, 106 are provided with protrusions or grooves that engage with each other, and when each rubber band 104, 106 is attached to each recess 100, 102, these are engaged. By combining them, the positions of the magnetic bodies 105 and 107 may be uniquely determined.

  The thicknesses of the rubber bands 104 and 106 are substantially the same as the recesses of the recesses 100 and 102. Further, the diameters of the rubber bands 104 and 106 are slightly smaller than the diameters of the recesses 100 and 102. Thereby, when each rubber band 104 and 106 is attached to each recessed part 100 and 102, while adhering to each recessed part 100 and 102 by the elasticity, the side surface of parts other than each recessed part 100 and 102 of the insertion part 16 is provided. It becomes almost the same.

  As shown in FIG. 9, the auxiliary tool 110 according to this embodiment includes an insertion portion 112 that is inserted into a body cavity of a subject, and a base end portion of the insertion portion 112 that is attached to and detached from the forceps inlet 25 of the endoscope 11. It consists of a mounting part 113 for mounting freely.

  The insertion portion 112 is formed in a tubular shape having a diameter that is substantially the same as or thinner than the insertion portion 16 of the endoscope 11, and has a distal end portion 114 and a flexible portion 115 in order from the distal end. A forceps conduit 64 is provided inside the insertion portion 112 as in the first embodiment. A forceps outlet 116 is formed on the distal end surface 114 a of the distal end portion 114 to expose the distal end of the treatment instrument inserted into the forceps conduit 64. In addition, since the structure of the front-end | tip part 114 and the soft part 115 is the same as that of the said 1st Embodiment, detailed description is abbreviate | omitted.

  Two electromagnets 118 and 119 arranged at a predetermined interval are provided on the side surface of the flexible portion 115. Between these electromagnets 118 and 119, a pressure sensor (detection means) 120 is provided. The electromagnets 118 and 119 and the pressure sensor 120 are arranged on a straight line along the axial direction of the insertion portion 112. The electromagnets 118 and 119 and the pressure sensor 120 are substantially flush with the side surface of the flexible portion 115 so that the electromagnets 118 and 119 and the pressure sensor 120 are not caught on the body wall when inserted into the body cavity.

  As shown in FIG. 10A, each of the electromagnets 118 and 119 has a magnetic body attached to the insertion portion 16 when the insertion portions 16 and 112 are arranged in parallel with the distal end surfaces 20a and 114a aligned. It arrange | positions so that 105,107 may be faced. Thereby, as shown in FIG. 10B, the auxiliary tool 110 magnetically attaches the electromagnets 118 and 119 to the magnetic bodies 105 and 107, thereby inserting the insertion portion at the distal end of the insertion portion 16 of the endoscope 11. The tips of 112 are connected side by side.

  The pressure sensor 120 contacts the side surface of the bending portion 21 of the endoscope 11 when the insertion portions 16 and 112 are connected by magnetic adhesion between the magnetic bodies 105 and 107 and the electromagnets 118 and 119. And it detects that the front-end | tip of the insertion part 112 of the auxiliary tool 110 was connected to the front-end | tip of the insertion part 16 of the endoscope 11 by detecting the pressure change accompanying this contact.

  Returning to FIG. 9, the attachment portion 113 is formed in a substantially T-shaped three-pronged tube like the attachment portion 36 of the first embodiment, and the insertion portion 112 is connected to the insertion portion 112 via the central conduit. It is connected. One end of the attachment portion 113 is formed so as to be fitted to the forceps inlet 25, and the other end is inserted into the forceps conduit 51 of the endoscope 11 and the forceps conduit 64 of the auxiliary device 110. It is a forceps inlet 122 for doing this.

  The mounting portion 113 includes an electromagnet changeover switch 124 that switches ON / OFF of the electromagnets 118 and 119, an electromagnet lamp 125 that notifies the ON / OFF state of the electromagnets 118 and 119, and detection of the pressure sensor 120. A connection detection lamp 126 for notifying the result is provided.

  The electromagnet changeover switch 124 is a push button type switch, and each time the electromagnet changeover switch 124 is pressed, the electromagnets 118 and 119 are switched ON / OFF. The electromagnet lamp 125 is turned off when the electromagnets 118 and 119 are OFF, and is turned on when the electromagnets 118 and 119 are ON, thereby notifying the ON / OFF state. The connection detection lamp 126 is turned on when the pressure sensor 120 detects the connection of the insertion portions 16 and 112, and is turned off at other times to notify that the insertion portions 16 and 112 are connected. To do.

  The power used for each of the electromagnets 118 and 119, the pressure sensor 120, and each of the lamps 125 and 126 may be supplied from an external device such as the endoscope 11, or may be supplied by incorporating a battery or the like. May be.

  In the first embodiment, the magnetic body 75 and the magnet 87 are magnetized to connect the insertion portions 16 and 35, and then the engagement protrusion 74 and the engagement groove 86 are engaged to assist the tool 12. The distal end of the insertion portion 35 is mechanically fixed to the distal end of the insertion portion 16 of the endoscope 11. On the other hand, in this embodiment, each insertion part 16 and 112 was connected by the magnetic attachment of each magnetic body 105 and 107 and each electromagnet 118 and 119, and these were fixed only by magnetic force.

  As described above, even when the fixing is performed only by the magnetic force, the flexible portion 115 of the insertion portion 112 is bent following the bending of the bending portion 21 accompanying the bending operation of each of the bending operation portions 23 and 24, and the endoscope 11. Since each insertion part 16 and 112 can be inserted only by this bending operation, it can prevent that operation becomes complicated like the said 1st Embodiment. Further, when the fixation between the insertion portion 16 and the insertion portion 112 is released after the inspection is completed, in this embodiment, it is only necessary to press the electromagnet switch 124 to turn off the electromagnets 118 and 119. The operability when releasing the fixation can also be improved.

  In the second embodiment, the electromagnets 118 and 119 are provided in the insertion portion 112 of the auxiliary tool 110, and the magnetic bodies 105 and 107 are provided in the insertion portion 16 of the endoscope 11. However, the present invention is not limited thereto. Instead, a magnetic body may be provided in the insertion portion 112, an electromagnet may be provided in the insertion portion 16, or an electromagnet may be provided in both. In the second embodiment, the insertion portions 16 and 112 are fixed by the magnetic force of the electromagnets 118 and 119. However, the present invention is not limited to this, and the insertion portions are fixed by the magnetic force of the permanent magnet. May be.

  In the second embodiment, the pressure sensor 120 is shown as the detection unit. However, the detection unit is not limited to this, and for example, a mechanical switch such as a limit switch, an optical sensor, a magnetic sensor, or the like can be inserted. Any device can be used as long as it can detect contact between the units 16 and 112. In the first embodiment, the detection unit is not used. However, the detection unit may be provided in the configuration of the first embodiment.

  In the second embodiment, the insertion portion 16 is provided with the recesses 100 and 102, and the rubber bands 104 and 106 are attached to the recesses 100 and 102. For example, without providing the recesses 100 and 102, for example, In the nasal endoscope of the current model, each rubber band 104, 106 is provided at a location where the distal end side connection ring between the bending portion and the distal end hard portion and the rear end side connection ring between the bending portion and the flexible portion are provided. It may be attached. In the second embodiment, the magnetic bodies 105 and 107 are detachably attached to the insertion portion 16 via the rubber bands 104 and 106. However, the present invention is not limited thereto, and the magnetic bodies 105 and 107 are not limited thereto. It is good also as a structure which attaches to the insertion part 16 directly.

  In each of the embodiments described above, the forceps conduit 64 is provided in the auxiliary tool to assist the function of the forceps conduit 51 of the endoscope 11. However, the present invention is not limited to this. For example, a light guide is provided in the auxiliary tool. The function of each of the light guides 48 and 49 of the endoscope 11 may be assisted, or the auxiliary tool is provided with an air / water supply conduit, and the function of the air / water supply conduit 52 of the endoscope 11 is assisted. Alternatively, the auxiliary tool may be provided with a WJ pipe to assist the function of the WJ pipe 54 of the endoscope 11. Furthermore, a combination of these may be provided in the auxiliary tool to assist a plurality of functions of the endoscope 11.

  In the endoscope 11, which is a transnasal endoscope, the diameters of the light guides 48 and 49, the air / water supply conduit 52, and the like are narrower than those of the oral endoscope, like the forceps conduit 51. Many transnasal endoscopes do not include the WJ nozzle 85 and the WJ conduit 54. Reducing the diameter of each light guide 48, 49 causes a decrease in the amount of illumination light and the light distribution characteristics, and the distant view becomes dark. In addition, the reduction in the diameter of the air / water supply conduit 52 causes a decrease in the flow rate of air or water to be supplied per unit time, and it takes time to expand the stomach and clean blood and mucus. If the WJ pipe 54 is not provided, it is impossible to inject cleaning water or chemicals.

  Thus, if a light guide is provided in the auxiliary tool, the amount of illumination light can be improved, and inspection can be performed with the same brightness and light distribution characteristics as those of an oral endoscope. In addition, if an air supply / water supply conduit is provided in the auxiliary tool, the flow rate per unit time of the fluid to be fed can be set to the same level as that of the oral endoscope. Furthermore, if the auxiliary tool is provided with a WJ pipe, the amount of liquid ejected as a water jet can be made comparable to that of an oral endoscope.

  In each of the above embodiments, the proximal end portions of the insertion portions 35 and 112 are detachably attached to the hand operation portion 17 of the endoscope 11 via the attachment portions 36 and 113, but not limited thereto, It is good also as a structure which does not attach the base end part of an insertion part.

It is explanatory drawing which shows the structure of an endoscope system roughly. It is sectional drawing which shows schematically the structure in the soft part of an endoscope. It is sectional drawing which shows schematically the structure in the soft part of an auxiliary tool. It is explanatory drawing which shows schematically the structure of the front-end | tip of the insertion part of an auxiliary tool. It is explanatory drawing which shows roughly the structure of the front-end | tip of the insertion part of an endoscope. It is explanatory drawing which shows the state by which each insertion part was fixed. It is a flowchart which shows roughly the test | inspection procedure of an endoscope system. It is explanatory drawing which shows roughly the structure of the insertion part of an endoscope at the time of fixing each insertion part with magnetic force. It is explanatory drawing which shows roughly the structure of the auxiliary tool at the time of fixing each insertion part with magnetic force. It is explanatory drawing which shows the state by which each insertion part was fixed by the magnetic force.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Endoscope system 11 Endoscope 12 Auxiliary tool 16 Insertion part 17 Hand operation part (operation part)
35 Insertion part 36 Attachment part 74 Engagement protrusion (engagement part)
75 Magnetic body (magnetic member)
86 Engagement groove (engaged part)
87 Magnet 120 Pressure sensor (detection means)

Claims (8)

An endoscope having an insertion portion to be inserted into a body cavity from one nostril;
In an endoscope system comprising an auxiliary tool that is used in combination with the endoscope and has an insertion portion that assists the function of the endoscope by being inserted into a body cavity from the other nostril.
A magnet provided at one end of the insertion portion of the endoscope and the insertion portion of the auxiliary tool;
A magnetic member provided at the other distal end of the insertion portion of the endoscope and the insertion portion of the auxiliary tool, and magnetically attached to the magnet to connect the distal ends of the insertion portions side by side; A featured endoscope system. At least one of the magnet and the magnetic member is provided on the corresponding insertion portion so that the tip of each insertion portion can move in the axial direction while being connected by the magnet and the magnetic member. It is long in the axial direction,
An engagement portion provided in the insertion portion of the endoscope when the distal end is moved in the axial direction while being connected to the distal end of the insertion portion of the endoscope. The endoscope system according to claim 1, further comprising an engagement portion that mechanically fixes the distal ends of the insertion portions with each other.   3. The internal view according to claim 2, wherein the engaging portion and the engaged portion are aligned with each other so that the distal ends of the insertion portions are aligned when the distal ends of the insertion portions are fixed. Mirror system.   The endoscope system according to any one of claims 1 to 3, wherein the magnet is an electromagnet.   The endoscope system according to any one of claims 1 to 4, further comprising detection means for detecting that each of the insertion portions is connected. The endoscope has an operation unit that is connected to a proximal end portion of the insertion unit and performs a bending operation of the insertion unit,
6. The internal view according to claim 1, wherein the auxiliary tool has an attachment portion for detachably attaching a proximal end portion of the insertion portion to the operation portion. Mirror system.   The auxiliary device includes a forceps conduit for inserting the treatment instrument into the body cavity, an illumination means for illuminating the interior of the body cavity by irradiating illumination light, an air supply conduit for feeding gas into the body cavity, and the body cavity The endoscope system according to any one of claims 1 to 6, further comprising at least one of water supply pipes for feeding liquid into the tube. Used in combination with an endoscope having an insertion portion inserted into the body cavity from one outer nostril, and having an insertion portion that assists the function of the endoscope by being inserted into the body cavity from the other outer nostril In assistive devices,
A magnet is provided at one end of the insertion portion of the endoscope and the insertion portion of the auxiliary tool,
The other end of the insertion portion of the endoscope and the insertion portion of the auxiliary tool is provided with a magnetic member that connects the distal ends of the insertion portions side by side by being magnetically attached to the magnet. Auxiliary tool.

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