JP2005334475A - Endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope, even if sucking a balloon via an air sending conduit for deflating it, preventing the balloon from closing an opening communicated with the air sending conduit and appropriately inflating/deflating the balloon. <P>SOLUTION: This endoscope having the balloon 11 for the endoscope at the distal end of the insertion tube 2 is provided with the air sending conduit 13 in the insertion tube 2, and an opening part 14 communicated with the air sending conduit 13 and opened into the balloon 11 for the endoscope, and a recessed part 16 as a step adjacent to the opening part 14. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an endoscope which is inserted into a body cavity orally or transanally and observed inside the body cavity.

  For example, as a procedure for inserting a small intestine endoscope into a small intestine in a body cavity, there are a case where it is inserted orally and a case where it is inserted transanally. In any case, since the intestinal tract is bent flexibly, even if the insertion part of the endoscope is pushed out of the body cavity, it is difficult to transmit the force to the distal end of the insertion part, and it is difficult to insert it deeply. is there.

  Therefore, an endoscope tube is provided at the distal end portion of the endoscope so that the insertion portion of the endoscope can be smoothly inserted into a complicatedly bent intestine, and an overtube (externally inserted into the endoscope insertion portion) Sly dig tube) double-balloon endoscope system in which a balloon overtube distal end has been known (e.g., see Patent Document 1.).

  This is because after inserting the overtube that serves as a guide when inserting the endoscope insertion portion into the deep part to the deep part of the intestinal tract, the overtube balloon is inflated to fix the overtube balloon to the intestinal tract. state, by retracting the overtube is adapted to insert the endoscope insertion portion into a deeper portion taking the deflection of the intestinal tract.

Also, when the overtube balloon is inflated and the overtube is fixed to the intestinal tract, the balloon is made of a soft material like latex so that the intestinal tract is not burdened, and the internal pressure of the balloon is measured. Thus, there is also known one capable of controlling the pressure (see, for example, Patent Documents 2 and 3).
JP 11-290263 discloses JP 2001-340462 A JP 2002-301019 A

  In each of Patent Documents 1 to 3, an endoscope balloon is fixed to the distal end portion of the insertion portion of the endoscope, and the pump device is inflated and contracted by supplying air to or sucking the endoscope balloon. can do.

  However, the air supply conduit for supplying air to the endoscope balloon is provided in the axial direction of the insertion portion of the endoscope, and the opening of the air supply conduit is provided on the side wall of the insertion portion. Opened inside the balloon. The endoscopic balloon is inflated and deflated via the air supply conduit. When the balloon is deflated, the inner surface of the balloon is adsorbed in a state where the opening of the air supply conduit is blocked. In other words, the endoscope balloon may not be deflated even if suction is performed via the air supply conduit.

  The present invention has been made paying attention to the above circumstances, and its purpose is to open an opening through which the balloon communicates with the air supply conduit even if suction is performed through the air supply conduit in order to deflate the balloon. It is an object of the present invention to provide an endoscope capable of accurately inflating and deflating a balloon without blocking.

  In order to achieve the above object, according to a first aspect of the present invention, in an endoscope in which a balloon is provided at a distal end portion of an insertion portion, an air supply conduit is provided in the insertion portion and communicated with the air supply conduit. An opening that opens in the balloon is provided, and a step is provided in the vicinity of the opening.

  A second aspect of the present invention is characterized in that the step of the first aspect is a concave groove provided in the axial direction of the insertion portion where the balloon is disposed.

  A third aspect of the present invention is characterized in that the step of the first aspect is a concave groove provided in a circumferential direction of the insertion portion where the balloon is disposed.

  A fourth aspect is characterized in that a hole is provided in the step of the first aspect in parallel with the axial direction of the insertion portion.

  In an endoscope in which a balloon is provided at the distal end portion of the insertion portion, an air supply conduit is provided in the insertion portion, and an opening that opens into the balloon is provided in communication with the air supply conduit. A convex portion is provided on the balloon facing the opening.

  A sixth aspect of the present invention is characterized in that the convex portion of the fifth aspect is provided over the outer periphery of the balloon.

  According to the present invention, the balloon can be appropriately inflated and deflated, and the observation and treatment time can be shortened.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 and 2 show a first embodiment, FIG. 1 is an overall configuration diagram of an endoscope, and FIG. 2 is a longitudinal side view of the endoscope.

  1 and 2 show an endoscope 1, which has an elongated soft insertion portion 2, and a distal end (tip side) of the insertion portion 2 is provided with a bending portion 3. The tip structure portion 4 is provided. The proximal end of the insertion portion 2 (the base end side) is operating section 6 having a grip portion 5 is provided, a universal cord 8 having a connector 7 at the distal end is connected to the operating section 6 .

  Treatment channel in the insertion portion 2, the illumination optical system in the distal end construction part 4, the solid-state image pickup element or the like of the observation optical system, treatment channel and communicating with a forceps opening, for supplying water to the air and the observation lens into the body cavity nozzle (both not shown) are provided, treatment channel is in communication with the treatment instrument insertion opening 9 of the operation portion 6. The operation section 6 is provided with an angle operation knob 10 for bending the bending section 3, and the bending section 3 can be bent by pushing and pulling an angle wire (not shown).

  An endoscopic balloon 11 made of an elastic material such as rubber is provided across the bending portion 3 and the distal end constituting portion 4 of the insertion portion 2. The endoscope balloon 11 is a cylindrical body fitted to the outside of the insertion portion 2, and one end thereof is fitted and fixed in an annular groove 12 formed on the outer peripheral surface of the distal end constituting portion 4, and the other end portion. Is fitted and fixed to the outer peripheral surface of the bending portion 3.

  An air supply line 13 is provided in the insertion portion 2 along the axial direction thereof. One end of the air supply conduit 13 communicates with the lumen of the endoscope balloon 11 through an opening 14 that opens to the outer periphery of the distal end component 4. The other end of the air supply conduit 13 is connected to the air supply base 15 of the connector 7 via the operation unit 6 of the endoscope 1 and the universal cord 8. The air supply base 15 is connected to a balloon control device (not shown).

  The opening 14 that opens to the outer peripheral portion of the tip component 4 penetrates in the radial direction of the tip component 4 and opens to the outer peripheral surface, and a recess as a step is formed on the opening edge of the opening 14. A portion 16 is provided. That is, the opening edge of the opening 14 is formed one step lower than the outer peripheral surface of the tip component 4 by the recessed portion 16.

  Next, the operation of the endoscope configured as described above will be described.

  When the endoscope 1 is orally inserted into the small intestine and the inner wall of the intestinal tract is observed, first, when the suction is performed by the balloon control device, the endoscopic balloon 11 is negatively pressured via the air supply conduit 13 and the opening 14. Thus, the endoscope balloon 11 is contracted to be in close contact with the outer peripheral surfaces of the bending portion 3 and the tip constituting portion 4.

  In this state, the esophagus, stomach, and duodenum are inserted in this order from the distal end component 4 side of the insertion section 2 of the endoscope 1. When inserting into the small intestine from the duodenum, the insertion resistance increases due to the curvature of the small intestine. Therefore, when the air is supplied by the balloon control device, the air is supplied to the endoscope balloon 11 through the air supply conduit 13 and the opening 14, and the endoscope balloon 11 is inflated so that the outer peripheral portion thereof is the lumen of the small intestine. Close contact with.

  Therefore, the distal end constituting portion 4 of the endoscope 1 is fixed to the lumen of the small intestine, and in this state, treatment such as observation of the lumen of the small intestine and collection of tissue can be performed. Further, when the distal end constituting portion 4 of the insertion portion 2 is pushed deeper into the small intestine, if the suction is again performed by the balloon control device, the endoscopic balloon 11 becomes negative pressure via the air supply passage 13 and the opening 14. Thus, the endoscope balloon 11 is deflated, and the distal end constituting portion 4 can be pushed deeper into the small intestine.

  In this way, when the endoscope 1 is inserted into the lumen of the body cavity, the action of inflating and deflating the endoscope balloon 11 is repeated. When the endoscope balloon 11 is deflated, the endoscope balloon 11 is in close contact with the outer peripheral surface of the distal end constituting portion 4. However, since the opening edge of the opening portion 14 communicating with the air supply duct 13 is formed one step lower than the outer peripheral surface of the tip constituting portion 4 by the recessed portion 16, the endoscope balloon 11 is shown in FIG. As shown in FIG. 3, the opening 14 is not completely closed, and a part of the opening 14 is opened. When the endoscope balloon 11 is deflated, the endoscope balloon 11 can be reliably deflated. it can.

  FIG. 3 shows a second embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 3 is a longitudinal side view of the distal end portion of the endoscope and the overtube. As shown in FIG. 3, the distal end configuration portion 4 of the endoscope 1 includes a direct-view observation optical system 17 and a side-view observation optical system 18. The direct viewing observation optical system 17 and the side viewing observation optical system 18 include an objective lens 19, a relay lens 20, a solid-state imaging device 21 such as a CCD, and a signal line 22, respectively.

  An inflatable / shrinkable endoscope balloon 11 made of an elastic material such as rubber is fitted over the bending portion 3 and the distal end constituting portion 4 of the insertion portion 2. An overtube 23 is externally inserted in the insertion portion 2 of the endoscope 1. A distal end of the overtube 23 is provided with an overtube balloon 24 made of an elastic material such as rubber, which can be expanded and contracted. An air supply line 25 is attached to a part of the outer peripheral surface of the overtube 23. One end of the air supply conduit 25 is in communication with the overtube balloon 24.

  The air supply conduit 13 inserted into the insertion portion 2 of the endoscope 1 communicates with the endoscope balloon 11 through an opening 14 provided penetrating in the radial direction of the distal end constituting portion 4. A portion of the endoscope balloon 11 that faces the opening 14 is provided with a convex portion 11a. Even if the lumen of the endoscope balloon 11 is forcibly sucked and contracted by the convex portion 11a, The mirror balloon 11 does not completely close the opening 14 and ensures a partially opened state. Therefore, when the endoscope balloon 11 is deflated, the endoscope balloon 11 can be reliably deflated.

  A receiving surface 11 b that receives a pressing force of the pressing surface 23 a at the front end of the overtube 23 is provided at the rear end of the endoscope balloon 11. Furthermore, the proximal end (hand side) of the insertion portion 2 of the endoscope 1 has a push-down limit position (the pressing surface 23a of the overtube 23 and the receiving surface 11b of the endoscope balloon 11) to the front of the overtube 23. An index (not shown) indicating a position where the contact is made.

  Accordingly, when the overtube 23 that has been externally inserted into the insertion portion 2 of the endoscope 1 moves forward, the limit of pushing the overtube 23 forward can be determined by the index provided on the insertion portion 2. Further, when only the endoscope is replaced while leaving the overtube 23 in the body cavity, if the overtube 23 is pushed forward, the pressing surface 23a of the overtube 23 contacts the receiving surface 11b of the endoscope balloon 11. The endoscope balloon 11 can be removed from the insertion portion 2 of the endoscope 1 by pressing the overtube 23. Accordingly, the endoscope can be easily replaced while minimizing the outer diameter of the overtube 23.

  Since the endoscope has a variable field-of-view endoscope that can be switched between direct view and side view, when the digestive tract, which is a luminal organ, is inserted, direct view that can capture the entire lumen in the field of view is When doing this, it is possible to properly use the side view that can be approached.

  In addition, the overtube balloon 24 is inflated and the outer periphery thereof is brought into close contact with the intestinal wall and fixed, thereby facilitating the replacement work of the endoscope 1. It can be applied to an endoscope system using a dedicated large-channel endoscope, and can achieve both insertability and treatment. Furthermore, if a treatment instrument having an electromagnet function is inserted into the channel of the large channel endoscope or the lumen of the overtube with balloon, the capsule endoscope in the body cavity can be easily collected.

  FIG. 4 shows a third embodiment, and is a cross-sectional view of an overtube 26 that is externally inserted into the insertion portion 2 of the endoscope 1. The overtube 26 is a multi-lumen tube, and a plurality of channel holes 27 are provided in the axial direction. Therefore, it can be used as a treatment instrument channel for inserting a treatment instrument into the channel hole 27 and a channel for air supply / water supply / suction. In addition, since it can be used as a treatment instrument channel and an arbitrary duct can be selected when performing necessary treatment such as washing of affected area or hemostasis on a lesion or observation site, an appropriate and reliable treatment can be performed.

  FIG. 5 shows a fourth embodiment, and the same components as those of the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 5 is a side view of the distal end portion of the endoscope, in which the endoscope balloon is omitted. An annular groove 28 is provided over the outer peripheral surface of the distal end constituting portion 4 of the insertion portion 2 of the present embodiment, and an opening 14 communicating with the air supply conduit 13 is provided in a part of the annular groove 28. .

  According to this embodiment, when the endoscope balloon 11 is deflated, a part of the inner peripheral surface of the endoscope balloon 11 has an opening 14 that communicates with the air supply conduit 13. Since it is provided in the annular groove 28 that is one step lower than the outer peripheral surface, the endoscope balloon 11 does not completely close the opening 14, and an endoscope balloon is secured to secure a suction passage composed of a gap. When deflating 11, the endoscope balloon 11 can be reliably deflated.

  FIG. 6 shows a fifth embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 6 is a side view of the distal end portion of the endoscope, in which the endoscope balloon is omitted. A concave groove 30 is provided along the axial direction on the outer peripheral surface of the distal end constituting portion 4 of the insertion portion 2 of the present embodiment, and an opening 14 communicating with the air supply conduit 13 is provided in a part of the concave groove 30. It has been.

  According to this embodiment, when the endoscope balloon 11 is deflated, a part of the inner peripheral surface of the endoscope balloon 11 has an opening 14 that communicates with the air supply conduit 13. Since it is provided in the concave groove 30 that is one step lower than the outer peripheral surface, the endoscope balloon 11 does not completely close the opening 14 and secures a suction passage composed of a gap. When deflating 11, the endoscope balloon 11 can be reliably deflated.

  FIG. 7 shows a sixth embodiment, and the same components as those of the first embodiment are denoted by the same reference numerals and description thereof is omitted. FIG. 7A is a longitudinal side view of the distal end portion of the endoscope, and FIG. 7B is a front view, in which the endoscope balloon is omitted. A convex portion 31 protruding from the outer peripheral surface is provided on the distal end constituting portion 4 of the insertion portion 2 of the present embodiment, and the convex portion 31 is provided with an opening 14 communicating with the air supply conduit 13. Further, a concave groove 32 communicating with the opening 14 is provided on the side of the convex portion 31 on the distal end side of the distal end component portion 4.

  According to the present embodiment, when the endoscope balloon 11 is deflated, a part of the inner peripheral surface of the endoscope balloon 11 is in close contact with the convex portion 31 of the distal end constituting portion 4 and the convex portion 31. Since the concave groove 32 communicating with the opening 14 is provided in the endoscope 14, the endoscope balloon 11 does not completely close the opening 14, and the concave groove 32 secures a suction passage. When the medical balloon 11 is deflated, the endoscope balloon 11 can be reliably deflated.

  FIG. 8 shows an example of disclosure, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. 8A and 8B are vertical side views of the distal end portion of the endoscope. The insertion section 2 of the endoscope 1 is provided with an air supply conduit 33 and a treatment instrument channel 34. The tip constituent part 4 is provided with an axial opening 35 that communicates with the air supply conduit 33 and opens at the front end surface of the tip constituent part 4. Further, a radial opening 36 that opens from the middle of the axial opening 35 to the outer peripheral surface of the tip component 4 is branched.

  FIG. 8A shows a state in which the balloon-equipped hood 37 is attached to the tip constituting portion 4, and the hood 38 of the balloon-equipped hood 37 made of an elastic body is fitted to the front end portion of the tip constituting portion 4. The axial opening 35 is closed and the radial opening 36 is opened. Therefore, when air is supplied from the air supply duct 33, air is supplied to the lumen of the balloon 39 through the radial opening 36, and the balloon 39 can be inflated.

  FIG. 8B shows a state in which a hood 40 made of an elastic body is attached to the tip constituent portion 4. The hood 40 is fitted to the outer peripheral portion of the tip constituent portion 4, and the radial opening 36 is blocked by a part of the hood 40. Thus, the axial opening 35 is opened. Therefore, when air is supplied from the air supply conduit 33, air can be supplied from the axial opening 35 to a lumen such as the small intestine, and when water is supplied, forward water supply such as washing of the affected area can be performed.

  Therefore, the endoscope 1 can be selectively used by selectively attaching the hood 37 with balloon and the hood 40 to the distal end constituting portion 4 according to the purpose of use.

  It should be noted that the lesion site in the body cavity is marked at the time of endoscopy, but by using a clip made of a phosphorescent substance as a marking means, the treatment position can be easily moved from outside the gastrointestinal tract during surgical operation. There is an effect that can be confirmed.

  Furthermore, as a method for treating obesity, absorption dysfunction drugs such as lipase inhibitors (inhibiting degradation of ingested fat in the small intestine and reducing ingested energy) via the small intestinal endoscope channel are directly applied to the small intestine. Applicable to the treatment to be applied. That is, since the drug can be directly administered to a necessary site in the small intestine rather than the oral administration, the therapeutic effect is high.

  In addition, when the distal end constituent portion 4 of the endoscope 1 is colored white, an effect of preventing burning when a treatment using thermal ablation or the like is performed is obtained.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. Moreover, various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment. For example, some components may be deleted from all the components shown in the embodiment. Furthermore, you may combine suitably the component covering different embodiment.

1 is an overall configuration diagram of an endoscope showing a first embodiment of the present invention. FIG. The longitudinal side view of the front-end | tip part of the endoscope of the embodiment. The 2nd Embodiment of this invention is shown, The longitudinal side view of the front-end | tip part of an endoscope and an overtube. The 3rd Embodiment of this invention is shown, and a cross-sectional view of an overtube. The side view of the front-end | tip part of an endoscope which shows 4th Embodiment of this invention. The side view of the front-end | tip part of an endoscope which shows 5th Embodiment of this invention. The 6th Embodiment of this invention is shown, (a) is a vertical side view of the front-end | tip part of an endoscope, (b) is a front view. The disclosure example is shown, and (a) and (b) are longitudinal side views of the distal end portion of the endoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Insertion part, 3 ... Bending part, 4 ... Tip structure part, 11 ... Endoscope balloon, 13 ... Air supply line, 14 ... Opening part, 16 ... Recessed part (step)

Claims (6)

In an endoscope provided with a balloon at the distal end of the insertion part,
An endoscope characterized in that an air supply conduit is provided in the insertion portion, an opening is formed in the balloon in communication with the air supply conduit, and a step is provided in the vicinity of the opening.   The endoscope according to claim 1, wherein the step is a concave groove provided in an axial direction of the insertion portion in which the balloon is disposed.   The endoscope according to claim 1, wherein the step is a concave groove provided in a circumferential direction of the insertion portion in which the balloon is disposed.   The endoscope according to claim 1, wherein a hole is provided in the step in parallel to the axial direction of the insertion portion. In an endoscope provided with a balloon at the distal end of the insertion part,
An air supply conduit is provided in the insertion portion, an opening is formed in the balloon in communication with the air supply conduit, and a convex portion is provided in the balloon opposite to the opening. Endoscope.   The endoscope according to claim 5, wherein the convex portion is provided over an outer periphery of the balloon.

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