JPH0345644B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an endoscope guide tube used to guide an insertion section of an endoscope inserted into a body cavity.

[Prior art] Conventionally, this type of guide pipe was
The one disclosed in the above publication is well known.

This kind of guide tube is a flexible tube through which the insertion section of the endoscope can be inserted, in order to secure an insertion path for the endoscope when observing or treating a lesion in a body cavity with an endoscope. It is made up of a cylindrical body with properties.

In addition, in conventional endoscopy, when treating raised lesions such as polyps and varicose veins in a body cavity using a processing tool such as forceps, the endoscope's forceps insertion channel is usually Insert the treatment instrument into the
Currently, treatment is performed by bending the treatment instrument itself or using a forceps erecting device.

[Problems to be Solved by the Invention] However, in the above-mentioned treatment means using the conventional treatment instrument, since the treatment instrument is inserted through the forceps insertion channel of the endoscope, the distal end insertion portion of the treatment instrument is inserted into the body cavity. It protrudes inward and therefore tends to move due to peristalsis within the body cavity, making it difficult to catch the raised lesion to be treated, and the raised lesion also moves, so careful manipulation is required. There was a problem that required a high degree of skill to handle.

The present invention has been made in view of the above-mentioned problems.The purpose of the present invention is to prevent the treatment tool from moving when treating raised lesions such as polyps and varicose veins, and to easily remove the lesions. Another object of the present invention is to provide a guide tube for an endoscope that can be guided so as to be able to securely catch the endoscope.

[Means for Solving the Problems] In order to solve the above problems, the present invention provides an internal body for inserting and guiding the insertion portion of an endoscope into a flexible cylindrical body inserted into a body cavity. In the endoscopic guide tube, an insertion passage for a treatment instrument is formed along the inner wall of the cylindrical body, and an opening is provided near the distal end of the cylindrical body corresponding to the distal end exit side of the insertion passage; An opening is provided near the rear end of the cylindrical body corresponding to the rear end entrance side of the insertion passage.

[Operation] That is, the present invention has the above-described configuration, so that the treatment instrument insertion passage 5 formed in the cylindrical body 21 through which the insertion portion 201 of the endoscope 200 is inserted.
Since the treatment instrument 300 can be inserted through the treatment instrument 300, the distal end insertion portion of the treatment instrument 300 is not affected by peristaltic movement within the body cavity, and the distal end of the cylindrical body 21, which the distal end insertion portion of the treatment instrument faces, Since the opening 3 is formed in the vicinity of 21a, by pressing this opening 3 against the raised lesion 102 such as a polyp or varicose vein in the body cavity, the raised lesion to be treated can be removed. 102 can be reliably caught and fixed, and processing can be performed easily. In addition, an opening 4 near the rear end of the cylindrical body 21
Since the treatment instrument 300 is inserted through the opening 4
The treatment instrument 300 is held in a bent state at the edge portion.

[Example] Hereinafter, the present invention will be described based on each illustrated example.

1 to 3 show a first embodiment of the guide tube for an endoscope according to the present invention. In the figures, 1 is a gripping part, 2 is an insertion part, and this insertion part 2 is made of polyurethane resin as a whole. It is formed of a transparent cylindrical body 21 having flexibility. In the vicinity of the tip 21a of this cylindrical body 21, a first opening window 3 having a substantially rectangular shape with a long side of about 30 mm and a short side of about 7 mm along the longitudinal direction is opened with rounded corners. On the other hand, a second opening window 4 is opened on the rear end portion 21b side. Then, on the inner wall surface connecting the first and second opening windows 3 and 4 of the cylindrical body 21, a treatment instrument insertion passage 5 is integrally formed along the longitudinal direction by extrusion molding. A treatment instrument such as forceps, which will be described later, is inserted into the passage 5 from the first opening window 4 to the second opening window 3, and both openings 5a and 5b on the entrance/exit side are The opening windows 3 and 4 are located corresponding to each of the opening windows 3 and 4 mentioned above. Further, the gripping portion 1 is formed of an outer presser 11 and an inner presser 12, and both of these pressers 1
1 and 12, the rear end 21b of the cylindrical body 21 is clamped and fixed.

In this way, the guide tube has a communication section between the gripping part 1 and the cylindrical body 21 constituting the insertion part 2 as the endoscope insertion passage 20, and the first part of the inner wall surface of the cylindrical body 21 A treatment instrument is specifically inserted into the insertion passage 5 formed between the second opening windows 3 and 4, and an example of its use is shown in FIG. That is, when a protruding lesion, for example, varicose veins 102, occurs in the esophagus portion 101 in the body cavity of the patient 100,
When treating this with endoscopy, first,
Insert the insertion portion 2 of the guide tube into the esophagus portion 101 of the patient 100.
Insert up to Next, the guide tube insertion passage 20
Insert the insertion section 201 of the endoscope 200, locate the position of the varicose vein 102 while operating the operation section 202, and in this state operate the grip section 1 of the guide tube to remove the cylindrical body 21. Varicose veins 1 within the first opening window 3
Press and capture 01. Then, the cylindrical body 21
A treatment tool 300 such as a hypodermic needle is inserted through the second opening window 4 of the
Insert the endoscope 200 to the vicinity of the first opening window 3.
The treatment is performed by pushing the treatment tool 200 through the varicose vein 102 of the lesion caught in the first opening window 3, puncturing it, injecting a sclerosing agent, and performing sclerotherapy.

Further, FIGS. 5 to 7 show a second embodiment of the guide tube for an endoscope according to the present invention, in which the structure of the first embodiment is improved, and the cylindrical body 21
The first opening window 3 formed in the vicinity of the distal end insertion portion 21a is made into a notch, while the treatment instrument insertion passage 5
is separately adhered or welded using a thin flexible tube, and the rear end 51 is pulled out from the second opening window 4, and the cylindrical body 21 is made of a transparent flexible material. It has a configuration in which an index a indicating the insertion distance from the first opening window 3 is attached to the outer periphery of the opening window 3. With such a configuration, when the guide tube is used for emergency hemostasis, for example, the bleeding site can be found from inside the guide tube because the whole is transparent, and the cylindrical body 21 When the position of the lesion at the pre-examination stage is known by the index a attached to the outer periphery of the
The insertion depth can be easily determined, the lesion can be searched for in a short time, the examination time can be shortened, and the pain caused to the patient can also be shortened.

Furthermore, FIGS. 8 to 10 show a third embodiment of the guide tube for an endoscope according to the present invention, in which the outlet side opening of the treatment instrument insertion passage 5 formed on the inner wall surface of the cylindrical body 21 is shown. The lower side 52 on the 5a side is extended, and one end of the wire 6 is connected to the extended end 52,
The other end of the wire 6 is pulled out from the second opening window 4 and the finger ring 7 is attached, and by pulling the finger ring 7 as indicated by the solid arrow, the extending end 52 is raised upward. Then, the distal end of the treatment instrument 300 to be inserted is guided so as to protrude outside from the first opening window 3, and the direction of the distal end of the treatment instrument 300 is varied to selectively and easily position the lesion. It has a structure that allows it to be changed to

Furthermore, FIG. 11 shows a fourth embodiment of the guide tube for an endoscope according to the present invention, and shows a treatment instrument insertion passage 5.
The outlet side opening 5a of the cylindrical body 21 is inserted into the tip insertion portion 2.
1a, and has a tapered upright surface 8a on the opening 5a side thereof, and connects one end 9a of a wire 9 to the slider 8, and connects the wire 9 to the grip portion 1 side. Pull it out and attach the rear end 9b to the operating screw 10 screwed into the gripping part 1, and by rotating the operating screw 10 forward and backward as indicated by the solid arrow, the wire 9 is reciprocated in the longitudinal direction of the cylindrical body 21. By moving the slider 8 and thereby causing the tapered upright surface 8a of the slider 8 to approach and separate from the first opening window 3, the same state as in the third embodiment is achieved in the close state. It is structured to obtain action and effect.

12 and 13 show fifth and sixth embodiments according to the present invention. In the fifth embodiment shown in FIG. 12, the first treatment instrument insertion passage 50a and the second On the other hand, in the sixth embodiment shown in FIG. The first opening window 3 provided near the side is opened at a different angle from that of the first treatment instrument insertion passage 50a, and the treatment instrument is configured to protrude in a different direction. With such a configuration, two treatment instruments can be used at the same time, and if one is used for fixation and the other for treatment, the treatment of the lesion can be performed more reliably. Moreover, with the configuration of the sixth embodiment shown in FIG. Even a small lesion caught within the opening window 3 can be easily treated.

It should be noted that the present invention is not limited to the above embodiments in any way, and it goes without saying that various modifications can be made without departing from the gist of the present invention.

[Effects of the Invention] As explained above, according to the present invention, if the opening on the distal end side of the cylindrical body is pressed in the direction of the lesion, the lesion can be taken into the opening and removed. You can definitely catch it.

Further, since the treatment instrument insertion passage faces the position corresponding to the opening for taking in the lesion, the lesion can be easily and reliably treated with the treatment instrument.

Furthermore, since the treatment instrument is inserted through the opening in the vicinity of the rear end of the cylindrical body, the treatment instrument is used in a bent state depending on the running direction of the treatment instrument insertion passage. Although the treatment instrument is flexible, it has a certain degree of strength, so the treatment instrument contacts the tip edge and rear edge of the rear opening, and its elasticity allows it to straighten. Since it is energized so that it is in the state of
The treatment instrument can be appropriately held at the two contact points.

Therefore, when puncturing a varicose vein or the like, there is no need to take the trouble to support and fix the treatment instrument by hand so that it does not move in the axial direction of the guide tube.

Since the operator only needs to pay attention to the amount of movement of the treatment instrument, the burden on the operator is reduced, and the treatment is easy and safe.

[Brief explanation of drawings]

1 is a schematic longitudinal sectional side view showing a first embodiment of the guide tube for an endoscope according to the present invention, FIG. 2 is a plan view thereof, and FIG. 3 is a sectional view taken along the line shown in FIG.
FIG. 4 is a schematic explanatory diagram showing how the guide tube is used;
FIG. 5 is a schematic longitudinal sectional side view showing a second embodiment of the present invention, FIG. 6 is a plan view thereof, and FIG.
8 is a schematic vertical sectional side view showing the third embodiment of the present invention, FIG. 9 is a plan view as well, FIG. 10 is a sectional view taken along the line 9, and FIG. The figure is a schematic vertical side view showing a fourth embodiment according to the present invention, FIG. 12 is a plan view of main parts showing a fifth embodiment according to the present invention, and FIG. 13 is a schematic longitudinal side view showing a fourth embodiment according to the present invention. FIG. DESCRIPTION OF SYMBOLS 1... Grip part, 2... Insertion part, 20... Endoscope insertion passage, 21... Cylindrical body, 21a... Tip insertion part, 3... First opening window, 5... Treatment insertion passage, 5a...exit side opening, 200...endoscope,
201... Insertion section, 300... Treatment instrument.

Claims (1)

[Scope of Claims] 1. In an endoscope guide tube for inserting and guiding an insertion portion of an endoscope into a flexible cylindrical body inserted into a body cavity, the inner wall of the cylindrical body An insertion passage for a treatment instrument is formed along the insertion passage, an opening is provided near the distal end of the cylindrical body corresponding to the distal end exit side of the insertion passage, and an opening is provided in the vicinity of the distal end of the cylindrical body corresponding to the rear end inlet side of the insertion passage. A guide tube for an endoscope, characterized in that an opening is provided near the rear end of the body.