JP2018175225A - Endoscope system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope system in which a flexible insertion part of a ureteroscope can be inserted in a urinary tract easily and quickly with less equipment, a burden to a patient is reduced and it contributes to a spread of an inspection and treatment of the urinary tract.SOLUTION: An endoscope system 100 comprises: a long insertion part 2 having a curved part 7; a flexible sheath 40 having a tip opening and having a tube-like insertion part 2 capable of being freely inserted and extracted; and a support 51 being removably inserted to the flexible sheath 40, having a surface coming in contact with an outer circumferential part of the insertion part 2 extending from the tip opening, and provided with a rigid portion for supporting to regulate a curve in a direction opposite to a curvature direction at least at a tip portion.SELECTED DRAWING: Figure 1

Description

  The present invention particularly relates to an endoscope system that inserts a flexible insertion portion into the ureteral tube from the ureteral opening in the bladder.

  The endoscope has an insertion portion which is formed in an elongated tubular shape and inserted into a lumen in accordance with an observation target in order to correspond to various observation targets. In such an endoscope, various techniques have been proposed in which the insertion portion is inserted into and guided to a cover sheath as an insertion aid to insert it to a target site in order to improve the insertion into the subject.

  As an endoscope system provided with such an insertion aid, for example, an endoscope as disclosed in Patent Document 1 and a cover type endoscope having a cover sheath as a guide sheath are well known. This patent document 1 discloses a technique of a cover type endoscope which prevents a conduit tube provided inside the cover sheath from being broken when the bending portion of the insertion portion is bent.

Unexamined-Japanese-Patent No. 8-191790

  By the way, when inserting the flexible insertion portion of the ureteroscope into the ureter, conventionally, a procedure in which the guide wire and the guide sheath are first inserted into the ureter by using a cystoscope having a rigid insertion portion as an insertion aid. Is done.

  Specifically, a cystoscope is inserted into the bladder, and a guide wire is inserted from the ureteral opening into the ureter via the cystoscope. Then, only the cystoscope is removed, and the guide sheath is inserted into the ureter along the guide wire. The procedure is as follows: the inner core of the guide sheath is removed and the soft insertion portion of the ureteroscope is inserted into the ureter via the guide sheath.

  As described above, conventionally, when inserting the soft insertion portion into the ureter, the soft insertion portion is inserted into the ureter by a large number of tools for insertion assistance and complicated operations. There is a problem that it takes time and effort to insert a part. Therefore, not only burdening patients but also spreading and developing ureteral examinations and treatments are difficult and improvements are required.

  Therefore, the present invention has been made in view of the above-mentioned circumstances, and the soft insertion portion of the ureteroscope can be inserted easily into the ureter in a short time with a small number of tools, thereby reducing the burden on the patient and urine. It is an object of the present invention to provide an endoscope system that contributes to the spread of tube examination and treatment.

  The endoscope system according to one aspect of the present invention includes a long insertion part having a bending part, and a distal end opening, and the insertion part can be inserted into and removed from the flexible sheath in the form of a tube. A support having at least a rigid portion disposed on the distal end portion, the rigid portion having a surface which is inserted and contacts the outer peripheral portion of the insertion portion extending from the distal end opening and restricts bending in the opposite direction to the bending direction. Have a body.

  The present invention is an endoscope system that can easily insert the flexible insertion portion of the ureteroscope into the ureter in a short time with a small number of tools, reduce the burden on the patient, and contribute to the spread of examination and treatment of the ureter Can be provided.

The perspective view showing the composition of the endoscope system of one mode Similarly, a perspective view showing a distal end portion of the guide sheath unit in a state in which the insertion portion is extended Similarly, a front view showing the configuration of the guide sheath unit Similarly, a front view showing a state in which the insertion portion is inserted into the guide sheath unit Similarly, a schematic view showing the guide sheath unit being inserted into the bladder via the urethra Similarly, a cross-sectional view showing the guide sheath unit being inserted into the bladder via the urethra Similarly, a cross-sectional view showing a guide sheath unit inserted into the bladder and showing a state in which the support is extended from the guide tube Similarly, a guide sheath unit inserted into the bladder is shown, and a sectional view showing a state in which the insertion portion of the endoscope is curved toward the ureteral opening Similarly, a cross-sectional view showing a guide sheath unit inserted into the bladder and showing a state in which the insertion portion of the endoscope is inserted into the ureteral tube The front view which shows the structure of the guide sheath unit of a 1st modification of the same. Similarly, a front view showing a state in which the insertion portion is inserted into the guide sheath unit of the first modified example The front view which shows the structure of the guide sheath unit of a 2nd modification of the same. The front view which shows the state by which the insertion part was inserted in the guide sheath unit of a 2nd modification similarly. Sectional drawing which shows the structure of the guide sheath unit of a 3rd modification similarly. Sectional drawing which shows the state in which the insertion part was inserted in the guide-sheath unit of a 3rd modification similarly. The front view which shows the state in which the insertion part was inserted in the guide sheath unit of a 4th modification of the same. The front view which shows the structure of the guide-sheath unit of a 5th modification of the same. In the same manner, a side view showing a state in which the support and the insertion portion are led out from the tip end opening of the guide tube of the fifth modification and diameter-expanded Sectional drawing which shows the structure of the support body which penetrates the guide tube of a 6th modification of the same. Sectional drawing which shows the structure of the support body which penetrates the guide tube of a 7th modification of the same.

  Hereinafter, preferred embodiments of the present invention will be described with reference to the drawings. In the drawings used in the following description, the scale of each component is different in order to make each component have a size that can be recognized in the drawings, and the present invention is not limited to these drawings. The present invention is not limited only to the number of components described in the above, the shape of the components, the ratio of the size of the components, and the relative positional relationship of the respective components. Further, in the following description, the upper and lower directions viewed in the plane of the drawing may be described as the upper part and the lower part of the component.

First, one aspect of the present invention will be described below based on the drawings.
FIG. 1 is a perspective view showing the configuration of an endoscope system, FIG. 2 is a perspective view showing a tip portion of a guide sheath unit in a state in which the insertion portion is extended, FIG. 3 is a front view showing the configuration of the guide sheath unit FIG. 4 is a front view showing a state in which the insertion portion is inserted into the guide sheath unit, FIG. 5 is a schematic view showing a state in which the guide sheath unit is inserted into the bladder via the urethra, and FIG. 7 is a cross-sectional view showing a guide sheath unit inserted in the bladder, and FIG. 8 is a cross-sectional view showing a state in which the support is extended from the guide tube. FIG. 9 is a cross-sectional view showing a guide sheath unit in which the insertion portion of the endoscope is curved toward the ureteral opening, FIG. 9 shows the guide sheath unit inserted in the bladder, and the insertion portion of the endoscope is Inserted in the ureter It is a sectional view showing a state.

  As shown in FIG. 1, an endoscope system 100 of the present embodiment is an electronic endoscope (hereinafter simply referred to as an endoscope) 1 and a guide sheath unit 30 which are a ureteroscope (a pelvic ureteroscope). Is configured.

  First, the endoscope 1 of the present embodiment includes an insertion portion 2 formed in an elongated tubular shape, an operation portion 3 continuously provided at a proximal end of the insertion portion 2, and an inner portion extended from the operation portion 3. It is mainly comprised by the universal cord 4 which is an endoscope cable, and the light source connector 5a and the electrical connector 5b which are arranged at the tip of this universal cord 4.

  The insertion portion 2 is a flexible tubular member formed by connecting the tip portion 6, the bending portion 7 as the endoscope bending portion of the present embodiment, and the flexible tube portion 8 sequentially from the tip side. It is. Among them, the tip end portion 6 accommodates and arranges an imaging unit which is an imaging device (not shown) having an imaging means inside and a lighting means (not shown).

  The endoscope 1 is not limited to an electronic endoscope, and may be a fiberscope in which an image guide fiber not including an imaging unit is disposed in the insertion portion 2.

  The bending portion 7 incorporates a bending tube structure to be described later, and actively operates in two directions (UP-DOWN) in the upper and lower directions by the turning operation of a bending lever 13 to be described later among the operation members of the operation portion 3. It is a mechanical part configured to be capable of being bent.

  In addition, the bending portion 7 is not limited to this type, and four directions including the left and right direction in addition to the up and down direction (all circumferential directions around the axis by the up, down, left, and right operations, UP-DOWN / RIGHT -LEFT) or may be of a type that can be curved only in the upward direction (UP direction).

  The flexible tube portion 8 is a tubular member formed to be flexible so as to be passively flexible. In addition to the treatment instrument insertion channel 18 (see FIGS. 2 and 4), the flexible tube 8 extends from the imaging unit incorporated in the distal end portion 6 and further from the operation unit 3 to the inside of the universal cord 4 A variety of signal lines, which will be described later, extend, and a light guide, which will be described later, for guiding illumination light from the light source device and emitting the light from the tip portion 6 (all not shown).

  An observation window 16 for the imaging light to enter the imaging unit and an illumination window 17 for emitting the illumination light are provided on the tip surface of the tip portion 6 (see FIGS. 2 and 4).

  The operation unit 3 is provided on the distal end side, covers the proximal end of the flexible tube 8 and covers the fold-away unit 9 connected to the flexible tube 8 and the fold-away unit 9 so that the user can view It comprises the grasping part 10 grasped by hand when using the mirror 1, the operation means for operating various endoscope functions provided on the outer surface of the grasping part 10, the treatment instrument insertion part 11, the suction valve 15, etc. Be done.

  As the operation means provided in the operation unit 3, for example, a plurality of operations for performing corresponding operations such as a bending lever 13 which performs bending operation of the bending portion 7, air / water / water operation or suction operation, imaging means, illumination means There is a member 14 or the like.

  The treatment instrument insertion portion 11 has a treatment instrument insertion port for inserting various treatment instruments (not shown), and the treatment instrument insertion channel 18 (see FIGS. 2 and 4) via the branch member inside the operation portion 3 Component that communicates with the

  A forceps plug 12 which is a cover member for opening and closing the treatment instrument insertion opening and is configured to be detachable (replaceable) with respect to the treatment instrument insertion unit 11 is disposed in the treatment instrument insertion unit 11 ing.

  The universal cord 4 penetrates the inside of the insertion portion 2 from the distal end portion 6 of the insertion portion 2 to reach the operation portion 3 and further penetrates various signal lines and the like extending from the operation portion 3 It is a composite cable in which a light guide (not shown) is inserted.

  The light source connector 5a is connected to a light source device (not shown) of the external device, and the electrical connector 5b is connected to a video processor (not shown) of the external device. A monitor (not shown) is connected to the video processor, and an endoscopic image of the endoscope 1 is displayed on the monitor.

Next, the guide sheath unit 30 will be described below based on FIGS. 1 to 3.
The guide sheath unit 30 of the present embodiment is configured to have a guide sheath 40 which is a flexible sheath and an insertion portion support member 50 as a rigid member which can be inserted into and removed from the guide sheath 40.

  The guide sheath 40 is configured to have a guide tube 41 formed of a soft resin or the like, and a tube side grip portion 42 provided at the proximal end of the guide tube 41. The insertion portion 2 of the endoscope 1 is inserted into the guide sheath 40.

  The insertion portion support member 50 is configured to have a support 51 which is a long hard rod and a support-side grip portion 52 provided at the base end of the support 51. The support 51 has a semicircular cross section (see FIGS. 2 and 3) having an outer peripheral surface 53 and a flat surface 54 having substantially the same curvature as the inner peripheral surface of the guide tube 41 of the guide sheath 40. It is a rod-like member formed.

  In the guide sheath unit 30 configured as described above, the length L1 of the guide tube 41 of the guide sheath 40 is set to about 350 mm to 400 mm, and the length L2 of the support 51 of the insertion portion support member 50 is the guide tube 41 The length is set to about 500 mm to 700 mm, which is longer than the length L1.

  Then, the support 51 is inserted into the guide tube 41, and is operated to be able to advance and retract with respect to the guide tube 41 by the operation at hand of the user. The distal end portion of the support 51 is operated to project and retract from the distal end opening of the guide tube 41.

  The endoscope system 100 configured as described above further includes the endoscope 1 of the endoscope 1 in the guide tube 41 of the guide sheath 40 in which the support 51 of the insertion portion support member 50 in the guide sheath unit 30 is inserted in advance. The insertion portion 2 is to be inserted.

  Then, as shown in FIG. 4, a clearance 20 is formed between the guide tube 41 into which the insertion portion 2 is inserted and the outer peripheral surface of the insertion portion 2. The field of view of the endoscope 1 can be secured by the circulation of the fluid by liquid feeding and suction by the clearance 20 and the treatment instrument insertion channel 18 of the insertion portion 2 of the endoscope 1.

Here, a procedure for inserting the insertion portion 2 of the endoscope 1 from the bladder 201 into the ureter 202 will be described below.
First, as shown in FIGS. 5 and 6, the guide tube 41 of the guide sheath 40 with the support 51 of the insertion portion support member 50 inserted is inserted into the bladder 201 via the urethra. Then, the insertion portion 2 of the endoscope 1 is inserted into the guide tube 41.

  The user may insert the guide tube 41 into the bladder 201 via the urethra in a state where the support 51 and the insertion portion 2 of the endoscope 1 are inserted in advance.

  Next, as shown in FIG. 7, the support 51 of the insertion portion support member 50 of the guide sheath unit 30 is pushed in, and the distal end portion of the support 51 is extended into the bladder 201 from the distal end opening of the guide tube 41. .

  Then, as shown in FIG. 8, the insertion portion 2 of the endoscope 1 is pushed in and the distal end portion of the insertion portion 2 is extended into the bladder 201, and the insertion portion toward the ureteral opening 203 in the bladder 201. The bending portion 7 of 2 is operated to bend. After the insertion portion 2 of the endoscope 1 is inserted into the ureter 202 via the ureteral opening 203 as shown in FIG. 9, the support 51 of the insertion portion support member 50 is removed from the guide sheath 40 .

  When the insertion portion 2 of the endoscope 1 is inserted into the ureter 202, the position of the support 51 protruding from the guide tube 41 is adjusted in a direction to be away from the ureteral opening 203 than the insertion portion 2. That is, the insertion portion 2 is inserted into the ureter 202 in a state in which the support 51 is positioned on the curved outer side where the insertion portion 2 is curved so as to face the ureteral opening 203.

  As a result, even if the bending portion 7 is bent, the insertion portion 2 of the endoscope 1 is prevented from being broken so as to be held in contact with the support 51. That is, when the outer peripheral portion of the insertion portion 2 contacts the flat surface 54 of the support 51, bending in the direction opposite to the bending direction to the ureteral opening 203 is restricted.

  Therefore, when inserting the insertion portion 2 of the endoscope 1 into the ureteral opening 203 which is closed by somatic reflection when stimulation is applied from the bladder 201 side, the insertion unit 2 is in the opposite direction to the direction to the ureteral opening 203 Extreme bending and breaking into is prevented. Then, the insertion portion 2 is prevented from being crushed by the support body 51, and it is possible to reduce the transmission loss of the insertion force amount for passing to the ureteral opening 203 which is closed by somatic reflection.

  From the above description, the endoscope system 100 according to the present embodiment is a flexible insertion portion of the endoscope 1 which can not be conventionally performed using the guide sheath unit 30 without using a cystoscope, a guide wire or the like. 2 can be inserted into the ureter 202 alone.

  Therefore, the endoscope system 100 can insert the flexible insertion portion 2 into the ureter 202 without performing complicated operations with a large number of instruments as in the prior art, thereby reducing time and labor. it can. Therefore, the burden on the patient is also reduced, which facilitates the spread and deployment of examination and treatment of the ureter 202.

  As described above, the endoscope system 100 can easily insert the flexible insertion portion 2 of the endoscope 1 into the ureter 202 in a short time simply by the guide sheath unit 30 alone, thereby reducing the burden on the patient and the ureter It can be configured to contribute to the spread of 202 examinations and treatments.

  Furthermore, when inserting the insertion portion 2 of the endoscope 1 into the ureteral tube 202, there is no need for various auxiliary tools, and the guide sheath unit 30 consisting of the tubular guide sheath 40 and the rigid rod-like insertion portion support member 50 is inexpensive. Can lead to cost reduction.

(First modification)
FIG. 10 is a front view showing the configuration of the guide sheath unit of the first modification, and FIG. 11 is a front view showing a state in which the insertion portion is inserted into the guide sheath unit of the first modification.

  As shown in FIGS. 10 and 11, the support 51 of the insertion portion support member 50 provided in the guide sheath unit 30 has a circle similar to the outer peripheral shape of the insertion portion 2 at the portion where the insertion portion 2 of the endoscope 1 contacts. It may have an arc-shaped recess 55.

  With such a configuration, in the endoscope system 100 of the present modification, the insertion portion 2 of the endoscope 1 is guided along the recess 55 formed in the support 51, and the guide tube of the guide sheath 40 The insertion property is improved without the longitudinal axis of the insertion portion 2 being displaced at the time of the insertion into the housing 41.

  Furthermore, when the insertion portion 2 of the endoscope 1 is extended into the bladder 201 and the bending portion 7 is bent toward the ureteral opening 203, the insertion portion 2 becomes difficult to remove from the support 51, and the outer peripheral portion is a support The recessed portions 55 of 51 can ensure contact. This becomes a structure which can perform bending control of insertion part 2 more certainly.

(Second modification)
FIG. 12 is a front view showing the configuration of a guide sheath unit of a second modification, and FIG. 13 is a front view showing a state in which the insertion portion is inserted into the guide sheath unit of the second modification.

  As shown in FIGS. 12 and 13, the guide tube 41 of the guide sheath 40 provided in the guide sheath unit 30 has two projections from the inner circumferential surface for guiding the advancing and retracting position of the support 51 of the insertion portion support member 50. You may have two rail parts 56 as a guide part made to project in the left-right symmetric position.

  With such a configuration, in the endoscope system 100 of the present modification, the position of the support 51 in the guide tube 41 is defined, and the advancing and retreating movement in the longitudinal axis direction can be smoothly performed. In addition, although the support body 51 here has illustrated the structure which has the recessed part 55 of a 1st modification, it is good also as a substantially semicircular structure which has the plane 54 of the said embodiment.

(Third modification)
FIG. 14 is a cross-sectional view showing the configuration of a guide sheath unit of a third modification, and FIG. 15 is a cross-sectional view showing a state in which the insertion portion is inserted into the guide sheath unit of the third modification.

  As shown in FIGS. 14 and 15, the guide tube 41 of the guide sheath 40 provided in the guide sheath unit 30 causes a projection for guiding the advancing and retreating position of the insertion portion 2 of the endoscope 1 from the inner circumferential surface. The insertion portion 2 may be provided with a groove portion 19 which is a guide groove engaged with the rail portion 57 as a guide portion.

  With this configuration, in the endoscope system 100 of the present modification, the insertion position of the guide sheath 40 of the insertion portion 2 of the endoscope 1 into the guide tube 41 is positioned. As a result, the position of the treatment instrument insertion channel 18 of the insertion portion 2 is also determined, and the liquid to be fed and sucked is recirculated at a fixed position by the clearance 20 formed in the treatment instrument insertion channel 18 and the guide tube 41. The cleaning property of the observation window 16 of the endoscope 1 is improved.

  Furthermore, when the bending portion 7 of the insertion portion 2 is bent in the guide tube 41, the bending of the bending portion 7 can be easily transmitted to the guide tube 41, and the observation of the target portion and the insertability of the guide sheath unit 30 are improved. It can also be done. Although the support body 51 also exemplifies the configuration having the concave portion 55 of the first modified example here, it may of course have a substantially semi-circular configuration having the flat surface 54 of the above embodiment.

(The 4th modification)
FIG. 16 is a front view showing a state in which the insertion portion is inserted into the guide sheath unit of the fourth modified example.
As shown in FIG. 16, the insertion portion 2 of the endoscope 1 may be elliptical so that the bending vertical direction of the bending portion 7 becomes thin. Reference numerals 21 and 22 denote bending operation wires for bending the bending portion 7 in the vertical direction.

  With such a configuration, in the endoscope system 100 of the present modified example, the bending direction of the bending portion 7 provided in the insertion portion 2 of the endoscope 1 becomes thin, so it is easy to bend. Furthermore, by reducing the vertical direction of the insertion portion 2, the outer diameter of the insertion portion 2 can be further reduced and the diameter can be reduced. The configuration of this modification may be a combination of the above-described modifications.

(Fifth modification)
FIG. 17 is a front view showing the configuration of a guide sheath unit of a fifth modification, and FIG. 18 shows a state in which the support and the insertion portion are drawn out from the distal end opening of the guide tube of the fifth modification and diameter is increased. It is a side view.

  As shown in FIGS. 17 and 18, the distal end portion of the guide tube 41 of the guide sheath 40 is tapered, and a plurality of V-shaped grooves 45 are provided at the distal end portion, here four places in the upper, lower, left, and right directions. It is good also as composition which can be elastically deformed from a diameter state to a diameter expansion state.

  That is, in a state in which the support body 51 and the insertion portion 2 are accommodated in the guide tube 41, the diameter of the distal end portion of the guide tube 41 is reduced, and the support body 51 and the insertion portion 2 are At the time of lead-out, the tip end portion of the guide tube 41 which has been contracted is expanded in diameter.

  In addition, the peripheral edge portion of the distal end opening of the guide tube 41 of this modification has a predetermined thickness and has a convex portion shaped edge having a predetermined thickness and a circular arc shape in the outer peripheral portion so as to be less invasive. 46 are provided.

  With such a configuration, in the endoscope system 100 of this modification, the insertability of the tapered guide tube 41 into the urethra and the bladder 201 is improved. Furthermore, the guide tube 41 itself can be inserted into the ureter 202, and the insertability of the insertion portion 2 of the endoscope 1 into the ureter 202 can be further improved. The configuration of this modification may be a combination of the above-described modifications.

(Sixth modification)
FIG. 19 is a cross-sectional view showing the configuration of a support inserted into the guide tube of the sixth modification.
As shown in FIG. 19, the support 51 is a hard support portion 51a whose component is provided at the tip portion to prevent backlash of the curved portion 7 only at the tip portion, and the base end side of the hard support portion 51a is flexible. It is good also as composition which connected flexible part 51b which has the flexibility.

  The hard support portion 51a has a predetermined length L3 that can sufficiently support the bending of the bending portion 7 in the bladder 201 and a predetermined length L3 that is accommodated in the guide tube 41. A total length L5 having a length L4 is set.

(Seventh modified example)
FIG. 20 is a cross-sectional view showing the configuration of a support inserted into the guide tube of the seventh modification.
As shown in FIG. 20, the support 51 may be configured such that the wire 51c is connected to the rigid support portion 51a of the sixth modification and the flexible portion 51b at the base end of the rigid support portion 51a. .

  In the present modification, the guide tube 41 is inserted into the bladder 201 from the urethra in a state where the rigid support portion 51 a is inserted in advance to the distal end side of the guide tube 41.

  Next, the insertion portion 2 of the endoscope 1 is inserted into the guide tube 41, and the user pushes the proximal end portion of the hard support portion 51a with the distal end portion 6 of the insertion portion 2 while watching the observation image The hard support portion 51a is made to project therefrom.

  Then, the user inserts the insertion portion 2 into the space between the guide tube 41 and the rigid support portion 51 a while viewing the observation image. When the hard support portion 51a is removed, the wire 51c is pulled to the hand side and the hard support portion 51a is pulled out.

  The invention described in each of the above-described embodiments is not limited to the embodiments and the modifications, and various modifications can be made without departing from the scope of the invention in the implementation stage. Furthermore, the above-described embodiments include inventions of various stages, and various inventions can be extracted by appropriate combinations of a plurality of disclosed configuration requirements.

  For example, even if some of the configuration requirements are removed from all the configuration requirements shown in the respective embodiments, the configuration requirements can be eliminated if the problems described can be solved and the described advantages can be obtained. The configuration as described above can be extracted as the invention.

1 ... Ureteroscope (Kenoureteroscope)
DESCRIPTION OF SYMBOLS 2 ... Insertion part 3 ... Operation part 4 ... Universal code 5a ... Light source connector 5b ... Electric connector 6 Tip part 7 ... Curved part 8 ... Flexible tube part 9 ... Breaking part 10 ... Grip part 11 ... Treatment tool insertion part 12 ... Forceps plug 13 ... Curved lever 14 ... Operation member 15 ... Suction valve 16 ... Observation window 17 ... Illumination window 18 ... Treatment tool insertion channel 19 ... Grooved portion 20 ... Clearance 30 ... Guide sheath unit 40 ... Guide sheath 41 ... Guide tube 42 ... Tube side grip portion 50: Insertion portion support member 51: Support body 52: Support body side grip portion 53: Outer peripheral surface 54: Flat surface 100: Endoscope system 201: Bladder 202: Urinary duct 203: Ureteral opening

Claims (7)

An elongated insertion portion having a curved portion,
A tube-like flexible sheath having a distal end opening, the insertion portion being insertable and removable;
A rigid portion is inserted through the flexible sheath so as to be insertable and removable, has a surface in contact with the outer peripheral portion of the insertion portion extending from the distal end opening, and supports a rigid portion supporting at least the distal end to restrict bending in the opposite direction to the bending direction. A support disposed on the part,
An endoscope system comprising:   The endoscope system according to claim 1, wherein the bending portion is bendable in at least two directions.   The endoscope system according to claim 1, wherein the insertion portion has a channel.   The endoscope system according to claim 1, wherein the surface of the rigid portion is an arc-shaped concave portion similar to the outer peripheral shape of the insertion portion.   The endoscope system according to claim 1, wherein the flexible sheath is provided with a guide portion which positions the insertion position of the support and guides the support longitudinally. A guide portion provided on the flexible sheath to position the insertion position of the insertion portion and to guide the insertion portion in the longitudinal axis direction;
A groove portion provided in the insertion portion and engaged with the guide portion;
The endoscope system according to claim 1, comprising:   The endoscope system according to claim 1, wherein the flexible sheath has a distal end portion formed to have a diameter reduction, and the distal end portion is provided with a plurality of grooves so as to be able to expand in diameter by elastic deformation.

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