JP2013172780A - Instrument guide device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an instrument guide device suitable for having an operator recognize from which position of a device distal end a medical instrument inserted to a channel is projected.SOLUTION: An instrument guide device includes a plurality of channel parts having a proximal end side opening into which a tubular instrument is to be inserted, a channel communicated with the proximal end side opening and a distal end side opening through which the tubular instrument guided inside the channel is taken in and out of the channel. Each of the plurality of channel parts has a channel identification part which is visible by an instrument for observation inserted to the channel, and is distinguishable for each channel at a position from the proximal end side opening to the distal end side opening.

Description

  The present invention relates to an instrument guide device capable of guiding a plurality of tubular instruments toward a target site.

  An instrument guide device capable of guiding a medical instrument to a target site in a body cavity is known. A specific configuration of this type of apparatus is described in Patent Document 1, for example. The instrument guide apparatus described in Patent Literature 1 includes an overtube, and the overtube is inserted toward a target site in a body cavity through an incision portion of the abdomen. A channel with a large inner diameter is formed in the overtube, and a plurality of medical instruments can be inserted. Therefore, a plurality of medical instruments such as an endoscope and a retractor are inserted into the channel and guided to the target site as needed during surgery.

Special table 2009-537225 JP 2006-102177 A

  As an example, consider a case in which an endoscope is inserted above the proximal end (insertion side) opening of the channel of such an instrument guide device and a retractor is inserted below the proximal end opening. . In this case, the endoscope protrudes from the upper side of the opening on the distal end side of the channel and the retractor protrudes from the lower side of the opening on the distal side, so that the positional relationship between the endoscope and the retractor at the proximal end of the instrument guide device It seems that the positional relationship between the endoscope and the retractor at the tip of the instrument guide device matches. However, since endoscopes and retractors are generally flexible and long tubular instruments, they may twist or cross each other in the channel during insertion or use. The endoscope may protrude from the lower side and the retractor may protrude from the right side in the distal end side opening. That is, since the positional relationship of each medical instrument at the proximal end of the instrument guide device may not match the positional relationship of each medical instrument at the distal end of the instrument guide device, the medical instrument inserted into the channel is A problem is pointed out that it is difficult for the surgeon to grasp from which position of the tip of the guide device it protrudes.

  Patent Document 2 describes a system that can detect the position of the endoscope tip by incorporating a magnetic sensor at the tip of the endoscope and picking up the signal of the magnetic sensor using a magnetic field generator. Has been. By adopting such a system, it is considered that the surgeon can grasp the position of each medical instrument in the opening on the distal end side of the channel of the instrument guide device. However, in this case, it is necessary to prepare a dedicated medical instrument with a built-in magnetic sensor, and a magnetic generator and a dedicated control unit are required separately. Therefore, it is easy to adopt such a system. I can't.

  The present invention has been made in view of the above circumstances, and the object of the present invention is suitable for allowing the operator to grasp from which position of the apparatus tip the medical instrument inserted into the channel protrudes. It is to provide an instrument guide device.

  An instrument guide device according to an aspect of the present invention is an apparatus capable of guiding a plurality of tubular instruments toward a target site, and includes a proximal end opening into which the tubular instrument is inserted, a proximal end opening, A plurality of channel portions each having a communicating channel and a distal end side opening through which a tubular instrument guided in the channel is taken in and out of the channel are provided. Each of the plurality of channel portions has a channel identification portion that can be discriminated for each channel at a position between the proximal end side opening and the distal end side opening that can be visually recognized by an observation instrument inserted into the channel. ing.

  In the instrument guide device according to one aspect of the present invention, since a plurality of channels into which the tubular instrument is inserted are provided independently, the instrument guide device is not twisted and entangled with each other in the instrument guide apparatus. The relative insertion position of each medical instrument on the insertion side of the device is not different from the relative protrusion position of each medical instrument on the protruding side of the instrument guide device, and the operator repeats the instrument guide device. By using it, it becomes possible to associate and grasp the protruding position of the observation instrument from the channel identification unit visually recognized by the observation instrument inserted into the channel.

  The tip side openings of the plurality of channel portions may be arranged side by side at the tip of the instrument guide device, for example, and the channel identification part may be a mark indicating the position of each tip side opening at the tip of the instrument guide device. In this case, the surgeon can visually recognize the channel identification unit and more directly grasp the protruding position of the observation instrument.

  The channel identification unit may have a notch formed at a different angular position of the distal end side opening in each channel unit.

  The channel identification unit may have a ring body installed in the channel. The ring body is made of, for example, a material that allows the inside of the ring body to be visible, and two types of fluids having different specific gravities that are distinguishable from each other are sealed inside the ring body.

  Moreover, the instrument guide apparatus which concerns on one form of this invention is good also as a structure provided with the tubular insertion part inserted in a body cavity, and the main-body part connected with the base end of an insertion part. In this configuration, the openings on the distal end side of the plurality of channel portions are arranged in an arc shape on the distal end surface of the insertion portion, for example. The channel extends from the opening on the distal end side in the insertion portion along the longitudinal direction of the insertion portion and reaches the inside of the main body, and then extends spirally around a predetermined axis along the longitudinal direction in the main body. It communicates with the base end side opening arranged on the base end face of the. Further, the base end side openings of the plurality of channel portions are arranged in an arc shape on the base end surface of the main body portion. The angular position of the arc formed by the plurality of distal end openings at the distal end surface of the insertion portion is different from the angular position of the arc formed by the plurality of proximal end openings at the proximal end surface of the main body.

  According to one aspect of the present invention, there is provided an instrument guide apparatus suitable for allowing an operator to grasp from which position of the apparatus tip a medical instrument inserted into a channel protrudes.

It is a figure which shows the external appearance of the instrument guide apparatus of embodiment of this invention. It is a perspective view which shows the internal structure of the main-body part with which the instrument guide apparatus of embodiment of this invention is equipped. It is a figure which expands and shows the front end surface of the insertion part with which the instrument guide apparatus of embodiment of this invention is equipped. It is a figure which expands and shows the front end side opening vicinity formed in the front end surface of the insertion part with which the modification of the instrument guide apparatus of embodiment of this invention is equipped. It is a figure which expands and shows the front end surface of the insertion part with which the instrument guide apparatus of another modification of embodiment of this invention is equipped.

  Hereinafter, with reference to drawings, the instrument guide device concerning the embodiment of the present invention is explained.

  FIG. 1 is a diagram illustrating an appearance of the instrument guide device 1 according to the present embodiment. 1A to 1E show a plan view, a side view, a bottom view, a front view, and a rear view of the instrument guide device 1, respectively. As shown in FIG. 1, the instrument guide device 1 includes a main body 10 and an insertion portion 20, and the insertion portion 20 is inserted toward a target site in a body cavity through, for example, an abdominal incision. The instrument guide device 1 includes a plurality of channels C1 to C10 (FIG. 2), and various medical instruments such as an observation instrument such as an endoscope and a treatment instrument such as forceps are inserted into each channel. can do. That is, when the instrument guide apparatus 1 is used, a maximum of ten medical instruments can be guided to the target site.

  The distal end portion (curved portion 22) of the insertion portion 20 is configured to be bendable by remote operation by the hand operation portion 12 provided in the main body portion 10. This bending mechanism is the same as a known mechanism incorporated in, for example, a general endoscope, and is bent by pulling an operation wire in conjunction with the rotation operation of the bending operation knobs 12a and 12b of the hand operation unit 12. The portion 22 is configured to bend in, for example, up, down, left, and right directions. In addition, the rear end portion (connecting portion 24) of the insertion portion 20 that connects the bending portion 22 and the main body portion 10 may be flexibly deformable along, for example, its own weight or a wall portion in the body cavity. The hard part which does not substantially deform may be used.

  2A and 2B are perspective views showing the internal structure of the main body 10. As shown in FIG. 2, a body-side through passage 32 extending along the longitudinal direction of the instrument guide device 1 is formed in the exterior housing 30 of the body portion 10, and the inside of the insertion portion 20 extends along the longitudinal direction. It communicates with the insertion side through passage 26 that extends. The insertion-side through passage 26 and the main body-side through passage 32 have a substantially circular cross section in a direction orthogonal to the longitudinal direction, and the insertion-side through passage 26 and the main body-side through passage 32 communicate with each other. Through-holes for channel insertion are formed over the entire length of 1. That is, the instrument guide device 1 is formed with a through passage that linearly penetrates the instrument guide device 1 from the distal end surface 20a of the insertion portion 20 to the proximal end surface 10b of the main body portion 10, and has a large-diameter channel C1 (for example, The channel tube) is inserted and fixed over the entire length of the through path. The distal end face 20a and the proximal end face 10b are respectively provided with a distal end side opening OP1a communicating with the large diameter channel C1 (insertion side through passage 26) and a proximal end opening OP1b communicating with the large diameter channel C1 (main body side passageway 32). Is formed.

  The large-diameter channel C1 is, for example, a fluororesin (PRFE, PFA, FEP, etc.) tube having a low frictional force in order to ensure smooth insertion of the medical instrument into the channel. In addition, when there is substantially no step at the connecting portion between the inner wall surface of the insertion-side through passage 26 and the inner wall surface of the main body-side through passage 32 and the frictional force of these inner wall surfaces is low, the channel tube is used instead. These through paths themselves may be the large-diameter channel C1. A medical instrument having a relatively large outer diameter can be inserted into the large-diameter channel C1.

  On the distal end surface 20a of the insertion portion 20, distal end side openings OP2a to OP10a are arranged in an arc around the distal end side opening OP1a. Inside the insertion portion 20, small-diameter through passages 28 </ b> C <b> 2 to 28 </ b> C <b> 10 having a substantially circular cross section in a direction orthogonal to the longitudinal direction and communicating with the distal end side openings OP <b> 2 a to OP <b> 10 a are formed. Inside the insertion portion 20, the small-diameter through passages 28 </ b> C <b> 2 to 28 </ b> C <b> 10 are arranged side by side at an annular position around the insertion-side through passage 26. In FIG. 2A, only the small-diameter through passage 28C6 among the small-diameter through passages 28C2 to 28C10 is indicated by a broken line for the sake of simplicity.

  A plurality of partition walls 36 that spirally surround the outer peripheral surface of the cylindrical body 34 that defines the main body side through passage 32 are formed in the exterior housing 30 of the main body 10. By the plurality of partition walls 36, the internal space of the exterior housing 30 that covers the outer peripheral surface of the cylindrical body 34 is substantially partitioned into at least nine spiral paths 36 </ b> C <b> 2 to 36 </ b> C <b> 10 that spirally extend around the axis of the cylindrical body 34. Further, on the base end surface 10b of the main body 10, base end side openings OP2b to OP10b communicating with the internal space of the exterior housing 30 are arranged in a circular arc around the base end side opening OP1b.

  Small-diameter channels C2 to C10 (for example, channel tubes) are inserted and fixed in the instrument guide device 1. Here, the small-diameter channel C6 (mainly a broken line in FIGS. 1 and 2) among the small-diameter channels C2 to C10 will be described as a representative. When the small-diameter channel C6 is inserted into the small-diameter through passage 28C6 through the distal end opening OP6a of the distal end surface 20a of the insertion portion 20, protrudes from the proximal end of the small-diameter through passage 28C6, and reaches the internal space of the exterior housing 30, then It is inserted into the spiral path 36C6 and pushed around the axis of the cylindrical body 34 in the spiral direction along the spiral path 36C6, and the end (the end that becomes the leading end when inserted) is the base end of the base end face 10b of the main body 10 It is fixed at the position that has reached the side opening OP6b. Further, the end portion of the small-diameter channel C6 (the end portion serving as the base end during insertion) is fixed at a position in the vicinity of the distal end side opening OP6a. As a result, the channel tube constituting the small-diameter channel C <b> 6 extends linearly within the insertion portion 20 and spirally extends within the main body portion 10.

  The small-diameter channel C6 is a resin tube made of the same material as the large-diameter channel C1, for example, in order to ensure a smooth insertion property of the medical instrument into the channel. In addition, a guide member for assisting smooth insertion of the medical instrument or a guide wall is formed between the small-diameter through path 28C6 and the spiral path 36C6 and between the spiral path 36C6 and the proximal end opening OP6b. In this case, instead of the channel tube, the small diameter through path 28C6, the spiral path 36C6, and the guide path itself including the guide member may be used as the small diameter channel C6.

  In the above description, for the sake of convenience, an example in which the small-diameter channel C6 is inserted from the distal end side opening OP6a toward the proximal end side opening OP6b has been described. There is no problem even if the small-diameter channel C6 is inserted toward the center.

  Thus, since the small diameter channels C2 to C10 of the present embodiment are supported at the separated positions in the instrument guide apparatus 1, they do not mechanically interfere with each other. Therefore, there is no possibility that the small diameter channels C <b> 2 to C <b> 10 and the medical instrument inserted through the small diameter channels C <b> 2 to C <b> 10 are tangled or rubbed with each other in the instrument guide device 1. Therefore, the small diameter channels C2 to C10 and the medical instrument are entangled, the bending range of the bending portion 22 is reduced, the flexibility of the connecting portion 24 is lowered, and the small diameter channels C2 to C10 and the medical instrument are damaged by rubbing each other. Etc. can be prevented. Further, since the small-diameter channels C2 to C10 and the medical instrument do not twist or cross within the instrument guide device 1, the relative insertion position relationship of each medical instrument on the proximal end surface 10b of the main body 10 and the insertion part 20 The relative protruding position relationship of each medical instrument on the distal end surface 20a is not changed. Therefore, the surgeon can easily grasp the relative protruding position relationship of each medical device on the distal end surface 20a.

  Moreover, since the insertion part 20 is a structure provided with many channels, it is thick compared with the general endoscope with a channel. Therefore, the channel length in the bending portion 22 required when the bending portion 22 is bent is greatly different between the small diameter channel closest to the center of curvature of the bent shape and the farthest small diameter channel. Specifically, the closer to the center of curvature of the bent shape, the shorter the required channel length in the curved portion 22, so that the channel portion in the insertion portion 20 is pushed into the exterior housing 30 of the main body portion 10. On the other hand, since the necessary channel length in the curved portion 22 becomes longer as it is farther from the center of curvature of the bent shape, the channel portion in the outer casing 30 is drawn into the insertion portion 20. Since the small-diameter channel is a resin tube that is substantially non-stretchable, the short-diameter channel cannot follow the bending operation of the bending portion 22 when the pull-in length into the insertion portion 20 is insufficient. The bending range is limited.

  Therefore, the channel lengths of the small-diameter channels C <b> 2 to C <b> 10 in the exterior housing 30 are intentionally designed to be long so as to satisfy a necessary pull-in length into the insertion portion 20 when the bending portion 22 is bent. Therefore, the small-diameter channels C2 to C10 gently wave in the height direction (radial direction of the cylindrical body 34 while being along the spiral direction) in a state in which the small diameter channels C2 to C10 are slackened in the spiral paths 36C2 to 36C10. In a relaxed state). The channel portion in the spiral paths 36C2 to 36C10 follows a bending operation of the bending portion 22 and becomes a tension state or a more slack state. The “tensioned state” here is a relative expression with respect to the initial state where the bending portion 22 is not bent, and the amplitude of the wavy shape (slack shape) may be smaller than the initial state. Thus, the channel length in the spiral paths 36C2 to 36C10 is shortened. In addition, the “sagging state” refers to a state in which the amplitude of the corrugated shape increases with respect to the initial state, and the channel length in the spiral paths 36C2 to 36C10 increases.

  By arranging the small-diameter channels C2 to C10 in a spiral shape in the outer casing 30, the pull-in length of the small-diameter channels C2 to C10 into the insertion portion 20 is ensured while the overall length of the outer casing 30 is designed to be short. be able to. However, as a compensation for adopting such a spiral arrangement, the angular position of the arc formed by the distal end openings OP2a to OP10a at the distal end surface 20a of the insertion portion 20 and the proximal end opening OP2b at the proximal end surface 10b of the main body portion 10 are used. The angular position of the arc formed by ~ OP10b may not match as in the present embodiment (see FIGS. 1D and 1E). Therefore, even if the surgeon can sensuously grasp the relative protruding position relationship of each medical device on the distal end surface 20a, from which position in the distal end surface 20a the medical device protrudes ( It is difficult to grasp the absolute protruding position sensuously. Therefore, the surgeon performs a procedure while considering from which position in the distal end surface 20a the medical instrument inserted into the small diameter channel through the proximal end opening of the proximal end surface 10b. This leads to prolonged operation time, which not only burdens the operator but also burdens the patient. Therefore, the instrument guide device 1 according to the present embodiment includes a configuration described below.

  FIG. 3 is an enlarged view of the distal end surface 20 a of the insertion portion 20. As shown in FIG. 3, notched shapes CT2a to CT10a (not shown in FIGS. 1 and 2 for the sake of convenience) are formed in part of the edge portions of the distal end openings OP2a to OP10a disposed on the distal end surface 20a. Yes. The operator can visually recognize the notch shape formed at the edge of the distal end opening through the observation instrument by inserting an observation instrument such as an endoscope into the small diameter channel and approaching the distal end opening. it can.

  The cutout shapes CT2a to CT10a are formed at different angular positions with respect to the centers of the distal end side openings OP2a to OP10a. Specifically, the cutout shapes CT2a to CT10a include the angular positions of the cutout shapes CT2a to CT10a with respect to the centers of the distal end openings OP2a to OP10a and the angles of the distal end openings OP2a to OP10a with respect to the center of the distal end surface 20a. It is formed at a position that matches the position.

  Here, it is assumed that the instrument guide device 1 is used with the hand operating unit 12 facing upward. In this case, the distal end side opening OP6a is located directly above (90 ° angular position) with respect to the center of the distal end surface 20a, and the notch shape CT6a is also directly above the distal end side opening OP6a (90 ° angular position). To position. Further, the cutout shapes (CT2a to CT5a) are located at an angle on the right side with respect to the center of the front end side opening, as the front end side openings (OP2a to OP5a) are positioned in the right angle direction in FIG. The cutout shapes (CT7a to CT10a) are also located with respect to the center of the front end side opening as the front end side openings (OP7a to OP10a) are positioned in the direction and positioned in the angular direction on the left side in FIG. Located in the left angle direction. That is, the cutout shapes CT2a to CT10a can be defined as position identification marks that indicate the positions of the distal end side openings OP2a to OP10a themselves in the distal end surface 20a. The surgeon visually recognizes the cutout shapes CT2a to CT10a formed at different angular positions in the distal end side openings OP2a to OP10a, so that the observation instrument inserted into the small diameter channel protrudes from any position in the distal end surface 20a. It is possible to grasp sensuously.

  The form of the position identification mark is not limited to the notch shapes CT2a to CT10a. The position identification mark may be, for example, characters indicating position information carved on the walls of the small diameter channels C2 to C10 (for example, “up” in the case of the distal end side opening OP6a). Further, the position identification mark is not limited to the position described in the present embodiment, and can be visually recognized by an observation instrument inserted in the small-diameter channels C2 to C10 to the proximal end openings OP2b to OP10b to the distal end openings OP2a to OP10a. It may be provided at other positions up to. A plurality of position identification marks may be provided for one small-diameter channel. For example, when a plurality of position identification marks are provided at regular intervals in each of the small-diameter channels C2 to C10, it is difficult for the operator to overlook the position identification marks.

  Up to this point, it is assumed that the connecting portion 24 is not substantially deformed by its own weight or the like, but the connecting portion 24 is also assumed to be deformed and twisted during use of the instrument guide device 1. In this case, for example, the distal end side opening OP6a may be positioned on the right (for example, an angular position of 0 °) with respect to the center of the distal end surface 20a. That is, since the positions of the distal end openings OP2b to OP10b in the distal end surface 20a are not uniquely determined, only the notch shapes CT2a to CT10a provide the absolute protruding position of the medical instrument in the distal end surface 20a of the insertion portion 20. Difficult to grasp. Therefore, a modified example of the instrument guide device 1 according to the present embodiment includes a configuration described below.

  4 (a) and 4 (b) are enlarged views showing the vicinity of the distal end side opening OP6a formed on the distal end surface 20a of the insertion portion 20 of the instrument guide device of the present modification. In addition, in the instrument guide apparatus of this modification, the same or similar components as those in the instrument guide apparatus 1 of the above embodiment are denoted by the same or similar reference numerals, and the description thereof is simplified or omitted.

  As shown in FIG. 4, the instrument guide device of this modification includes a ring body 40 and a ring cylinder 46. The ring body 40 is a hollow torus, and a colored liquid 44 is sealed inside the ring body 40 leaving a bubble 42. The ring cylinder 46 is a cylindrical resin member. Both the ring body 40 and the ring cylinder 46 are made of a material that is transparent to visible light. As shown in the cross-sectional view of FIG. 4B, a convex portion 48 is formed in the vicinity of the tip of the small-diameter through passage 28C6. The ring cylinder 46 is inserted and fixed into the small-diameter through passage 28C6 from the distal end side opening OP6a, and is bonded and fixed at a position where it abuts against the convex portion 48. The ring body 40 is also inserted into the small-diameter through passage 28C6 from the front end side opening OP6a, and is bonded and fixed at a position where it abuts against the ring cylinder 46. The small-diameter channel C6 is inserted from the proximal end side in the small-diameter through passage 28C6 and is fixedly bonded at a position where the small-diameter channel C6 comes into contact with the convex portion 48. The ring body 40, the ring cylindrical body 46, the small diameter channel C6, and the projection 48 have the same inner diameter so that the observation instrument inserted into the small diameter channel C6 can smoothly protrude from the distal end side opening OP6a without being caught. Designed. Therefore, a part of the ring body 40 can be viewed directly or through the ring cylinder 46 from the base end side opening OP6b side. FIG. 4A illustrates an image in the vicinity of the distal end side opening OP6a visually recognized by the observation instrument inserted in the small-diameter channel C6. At this time, the notch shape CT6a is visually recognized through the ring cylinder 46 (not shown for convenience in FIG. 4A). Here, the small-diameter through passage 28C6 is described as a representative, but the same ring body 40 is bonded and fixed to the other small-diameter through passages. In FIG. 4A, the bubble 42 having a specific gravity smaller than that of the liquid 44 is located on the upper side in the figure because the lower side in the figure is the ground.

  In FIG. 4A, the notch shape CT6a is located to the right (0 ° angular position) with respect to the center of the distal end side opening OP6a. In this case, for example, the connecting portion 24 is twisted by 90 ° around the major axis, and the distal end side opening OP6a is positioned on the right side with respect to the center of the distal end surface 20a (when the distal end surface 20a is viewed from the outside from the outside, Located on the left side). However, it is difficult for the surgeon to determine that the position of the distal end opening OP6a in the distal end surface 20a is on the right side (left side in a front view) only by the notch shape CT6a. Therefore, the surgeon visually recognizes the position of the bubble 42 in the ring body 40 to grasp the position above the distal end surface 20a, and then visually recognizes the position of the notch shape CT6a. Thereby, the surgeon grasps that the absolute protrusion position in the distal end surface 20a of the observation instrument inserted into the small-diameter channel C6 is the position on the right side (left side in front view) in the distal end surface 20a. Can do. The medium in the ring body 40 is not limited to the combination of the bubble 42 and the liquid 44, and may be any of two types of fluids having different specific gravities, for example, as long as they can be distinguished from each other by color or the like.

  The above is the description of the exemplary embodiments of the present invention. Embodiments of the present invention are not limited to those described above, and various modifications are possible within the scope of the technical idea of the present invention. For example, the embodiment of the present application also includes contents appropriately combined with examples and modifications explicitly shown in the specification or obvious examples and modifications.

  Although the instrument guide apparatus 1 of the present embodiment includes ten channels C1 to C10, the number of channels is not limited thereto. FIG. 5 is an enlarged view of the distal end surface 20az of the insertion portion 20 of the instrument guide device according to another modification of the present embodiment. Another variation of the instrument guide device is provided with four channels. Therefore, as shown in FIG. 5, the distal end side openings OP1a ′ to OP4a ′ are arranged on the distal end surface 20az side by side at intervals of 90 ° in the circumferential direction. Cutout shapes CT1 'to CT4' are formed in the front end openings OP1a 'to OP4a', respectively.

  The distal end side opening OP1a 'is located directly above (90 ° angular position) with respect to the center of the distal end surface 20a. The cutout shape CT1 ′ is located immediately above the distal end side opening OP1a ′ (at an angular position of 90 °) so as to function as a position identification mark indicating the position of the distal end side opening OP1a ′ in the distal end surface 20az. ing. The same applies to the other front end openings OP2a 'to OP4a' and the cutout shapes CT2 'to CT4'.

  In another variation, all four channels have the same diameter, so the types of medical instruments that can be inserted in each channel are the same. Therefore, the surgeon can quickly insert the medical instrument into the channel without checking whether the channel diameter is small or large.

  In another modification, the number of channels is not limited to four, and may be another number such as three.

DESCRIPTION OF SYMBOLS 1 Instrument guide apparatus 10 Main-body part 10b Base end surface 12 Hand operation part 12a, 12b Bending operation knob 20 Insertion part 20a Tip surface 22 Bending part 24 Connection part 26 Insertion side penetration path 28C2-28C10 Small diameter penetration path 30 Outer housing 32 Main body side Through passage 34 Cylindrical body 36 Partition wall 36C2 to 36C10 Spiral path 40 Ring body 42 Bubble 44 Liquid 46 Ring cylinder 48 Convex part C1 Large diameter channel C2 to C10 Small diameter channel CT2a to CT10a Notch shape OP1a to OP10a Tip side opening OP1b to OP10b Base end opening

Claims (5)

In an instrument guide device capable of guiding a plurality of tubular instruments toward a target site,
A proximal opening into which the tubular instrument is inserted;
A channel communicating with the proximal opening;
A distal opening through which a tubular instrument guided in the channel is withdrawn and withdrawn from the channel;
A plurality of channel portions having
Each of the plurality of channel portions is
It has a channel identification part that can be discriminated for each channel at a position between the proximal end opening and the distal end opening that can be visually recognized by the observation instrument inserted in the channel. An instrument guide device. The tip side openings of the plurality of channel portions are
It is arranged side by side at the tip of the instrument guide device,
The channel identification unit
The instrument guide device according to claim 1, wherein the instrument guide device is a mark that indicates a position of each of the tip side openings at a tip of the instrument guide device. The channel identification unit
The instrument guide device according to claim 1, wherein each of the channel portions has a notch formed at a different angular position of the distal end side opening. The channel identification unit
A ring body installed in the channel,
The ring body is
The inside of the ring body is made of a material that is visible,
The instrument guide device according to claim 2 or 3, wherein two types of fluids having different specific gravities that are distinguishable from each other are sealed in the ring body. A tubular insertion section to be inserted into the body cavity;
A main body connected to the proximal end of the insertion part;
With
The tip side openings of the plurality of channel portions are
Arranged in a circular arc shape at the distal end surface of the insertion portion,
The channel is
After extending from the distal end side opening in the insertion portion along the longitudinal direction of the insertion portion and reaching the main body portion, the main body portion extends spirally around a predetermined axis along the longitudinal direction, Communicating with the base end side opening disposed on the base end surface of the main body,
The proximal-side openings of the plurality of channel portions are
Arranged in an arc shape on the base end surface,
The angular position of an arc formed by the plurality of distal end side openings on the distal end surface is different from the angular position of an arc formed by the plurality of proximal end openings on the proximal end surface. The instrument guide device according to claim 4.

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