JP2005080866A

Movatterモバイル変換

Info

Publication number: JP2005080866A
Application number: JP2003316130A
Authority: JP
Inventors: Takayuki Ogino; 隆之荻野
Original assignee: Pentax Corp
Current assignee: Pentax Corp
Priority date: 2003-09-09
Filing date: 2003-09-09
Publication date: 2005-03-31
Anticipated expiration: 2023-09-09
Also published as: JP4349870B2

Abstract

【課題】高周波スネアの先端ループ電極部分を先端フード内で大きく広げて切除範囲を十分に確保することができ、しかも目標部位に対する高周波スネアの狙撃性をよくすることができる内視鏡の先端フードを提供すること。
【解決手段】観察窓２と処置具突出口３とが並んで配置されている内視鏡挿入部の先端部本体１の先端面１ａから前方に略円筒状に突出する状態に、先端部本体１に着脱自在に取り付けられる内視鏡の先端フードにおいて、処置具突出口３内に前方から嵌め込まれて処置具突出口３から突出される処置具５０を観察窓２から遠ざかる方向に偏角させるように案内する処置具案内部１２が一体的に形成されている。
【選択図】図１A distal end hood of an endoscope which can widen the distal end loop electrode portion of the high frequency snare greatly in the distal end hood to ensure a sufficient excision range and improve the snipability of the high frequency snare to the target site. To provide.
A distal end body in a state of projecting in a substantially cylindrical shape forward from a distal end surface of a distal end body of an endoscope insertion portion in which an observation window and a treatment instrument projecting port are arranged side by side. In the distal end hood of the endoscope that is detachably attached to 1, the treatment instrument 50 that is fitted from the front into the treatment instrument protrusion 3 and protrudes from the treatment instrument protrusion 3 is declinated in a direction away from the observation window 2. In this way, the treatment instrument guide portion 12 is integrally formed.
[Selection] Figure 1

Description

Translated fromJapanese

この発明は内視鏡の挿入部先端に取り付けられる先端フードに関する。 The present invention relates to a tip hood attached to the tip of an insertion portion of an endoscope.

内視鏡の先端フードは一般に、観察窓と処置具突出口とが並んで配置されている内視鏡挿入部の先端部本体の先端面から前方に略円筒状に突出する状態に着脱自在に取り付けられるように構成されている（例えば、特許文献１、特許文献２）。
実用新案登録第２５８５９１２号公報特開平８−１３１３９７号公報Endoscope hood of endoscope is generally detachable so that it protrudes forward in a generally cylindrical shape from the distal end surface of the distal end body of the endoscope insertion part where the observation window and the treatment instrument projection port are arranged side by side It is comprised so that it can be attached (for example,patent document 1, patent document 2).
Utility Model Registration No. 2558512 Japanese Patent Laid-Open No. 8-131397

経内視鏡的粘膜切除術の一つとして、内視鏡挿入部の先端部本体の先端面から前方に略円筒状に突出する先端フード内に患部粘膜を吸引してポリープ状にし、先端ループ電極部分が側方に折り曲げられた高周波スネア等で患部粘膜の基部を切断する処置が行われており、そのような処置の際には、高周波スネアの先端ループ電極が先端フード内で広げられて粘膜に対し輪投げ状に引っ掛けられる。 As one example of transendoscopic mucosal resection, the affected mucosa is sucked into a polyp shape by sucking the affected mucosa into a tip hood that protrudes in a substantially cylindrical shape from the tip surface of the tip body of the endoscope insertion portion to the tip loop. A treatment is performed to cut the base of the affected mucous membrane with a high-frequency snare or the like where the electrode portion is bent sideways. During such a treatment, the tip loop electrode of the high-frequency snare is spread in the tip hood. It is hooked on the mucous membrane like a ring.

しかし、処置具突出口はその奥に連通する処置具挿通チャンネルのレイアウト上の制約等から、先端部本体の先端面の外縁ぎりぎり付近には配置されず、ある程度中央寄りの位置に配置される。 However, the treatment instrument protrusion port is not arranged near the outer edge of the distal end surface of the distal end portion body, but is located at a position near the center to some extent due to restrictions on the layout of the treatment instrument insertion channel communicating with the interior thereof.

そのため、例えば図４に示されるように、折り曲げられている高周波スネア５０の先端ループ電極５１を先端フード１０内で大きく広げることができず、切除範囲が小さくなってしまう。また、処置具突出口３内で高周波スネア５０の可撓性シース５２が大きくガタついて患部粘膜１００に対する狙撃性を損ねる場合が少なくない。 Therefore, for example, as shown in FIG. 4, thetip loop electrode 51 of the bent high-frequency snare 50 cannot be greatly expanded in thetip hood 10, and the excision range becomes small. In many cases, theflexible sheath 52 of the high-frequency snare 50 is largely rattled in the treatmentinstrument projection port 3 and impairs the sniping ability with respect to the affectedmucous membrane 100.

そこで本発明は、高周波スネアの先端ループ電極部分を先端フード内で大きく広げて切除範囲を十分に確保することができ、しかも目標部位に対する高周波スネアの狙撃性をよくすることができる内視鏡の先端フードを提供することを目的とする。 Accordingly, the present invention provides an endoscope that can widen the tip loop electrode portion of the high-frequency snare within the tip hood to ensure a sufficient excision range, and can improve the snipability of the high-frequency snare with respect to the target site. The object is to provide a tip hood.

上記の目的を達成するため、本発明の内視鏡の先端フードは、観察窓と処置具突出口とが並んで配置されている内視鏡挿入部の先端部本体の先端面から前方に略円筒状に突出する状態に、先端部本体に着脱自在に取り付けられる内視鏡の先端フードにおいて、処置具突出口内に前方から嵌め込まれて処置具突出口から突出される処置具を観察窓から遠ざかる方向に偏角させるように案内する処置具案内部が一体的に形成されているものである。 To achieve the above object, the distal end hood of the endoscope of the present invention is generally forward from the distal end surface of the distal end main body of the endoscope insertion portion in which the observation window and the treatment instrument protruding port are arranged side by side. In a distal end hood of an endoscope that is detachably attached to the distal end main body so as to project in a cylindrical shape, the treatment instrument that is fitted from the front into the treatment instrument projection port and protrudes from the treatment instrument projection port is moved away from the observation window. A treatment instrument guide portion for guiding the guide so as to deviate in the direction is integrally formed.

なお、処置具案内部が、処置具突出口内に嵌め込まれる部分と略円筒状の突出部との間を先端部本体の先端面に沿う位置で連結する連結部を有していて、処置具突出口の径より細い径の処置具案内孔が処置具突出口内に嵌め込まれる部分と連結部とにまたがって形成されていると狙撃性がよくなる。 The treatment instrument guide portion has a connecting portion that connects a portion fitted in the treatment instrument projection opening and the substantially cylindrical projection portion at a position along the distal end surface of the distal end portion body, and the treatment instrument projection If the treatment instrument guide hole having a diameter smaller than the diameter of the mouth is formed across the portion fitted into the treatment instrument projection opening and the connecting portion, the sniper performance is improved.

また、連結部が観察窓からの観察視野範囲外にあると、内視鏡観察の妨げにならず、略円筒状の突出部が透明部材によって形成されていると、周辺観察上都合がよい。 Further, when the connecting portion is outside the observation visual field range from the observation window, the endoscope observation is not hindered, and it is convenient for peripheral observation if the substantially cylindrical protrusion is formed of the transparent member.

本発明によれば、処置具突出口から突出される高周波スネア等の処置具が、先端フードに一体的に形成された処置具案内部によって観察窓から遠ざかる方向に偏角されて突出するので、高周波スネアの先端ループ電極部分を先端フード内で大きく広げて切除範囲を十分に確保することができ、処置具案内部に処置具突出口の径より細い径の処置具案内孔を形成することにより、目標部位に対する高周波スネアの狙撃性をよくすることができる。 According to the present invention, a treatment instrument such as a high-frequency snare projecting from the treatment instrument projecting port is protruded by being deflected in a direction away from the observation window by the treatment instrument guide unit formed integrally with the tip hood. By expanding the tip loop electrode part of the high-frequency snare greatly in the tip hood, a sufficient excision range can be secured, and by forming a treatment instrument guide hole with a diameter smaller than the diameter of the treatment instrument protrusion at the treatment instrument guide part The sniper property of the high-frequency snare with respect to the target part can be improved.

観察窓と処置具突出口とが並んで配置されている内視鏡挿入部の先端部本体の先端面から前方に略円筒状に突出する状態に、先端部本体に着脱自在に取り付けられる内視鏡の先端フードに、処置具突出口内に前方から嵌め込まれて処置具突出口から突出される処置具を観察窓から遠ざかる方向に偏角させるように案内する処置具案内部が一体的に形成され、処置具案内部には処置具突出口の径より細い径の処置具案内孔が形成されている。 An endoscope that is detachably attached to the distal end body so as to protrude forward in a substantially cylindrical shape from the distal end surface of the distal end body of the endoscope insertion portion in which the observation window and the treatment instrument projection opening are arranged side by side. A treatment instrument guide portion is integrally formed on the front end hood of the mirror so as to guide the treatment instrument, which is fitted from the front into the treatment instrument projection opening and is protruded from the treatment instrument projection opening, in a direction away from the observation window. The treatment instrument guide portion is formed with a treatment instrument guide hole having a diameter smaller than the diameter of the treatment instrument protrusion.

図面を参照して本発明の実施例を説明する。
図２は内視鏡の挿入部の先端部分の正面図であり、図１は、観察窓２の中心と処置具突出口３の中心とを含む内視鏡の挿入部の先端部分の側面断面図である。Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 is a front view of the distal end portion of the insertion portion of the endoscope, and FIG. 1 is a side cross-sectional view of the distal end portion of the insertion portion of the endoscope including the center of theobservation window 2 and the center of thetreatment instrument protrusion 3. FIG.

挿入部の最先端部材である略円柱状の先端部本体１の先端面１ａには、先端部本体１の前方を観察するための観察窓２と処置具類を突出させるための処置具突出口３とが並んで配置され、その他にも、照明窓４等が配置されている。 Anobservation window 2 for observing the front of the distal endmain body 1 and a treatment instrument projecting opening for projecting treatment instruments are provided on thedistal end surface 1a of the substantially cylindrical distal endmain body 1 which is the most advanced member of the insertion portion. 3 are arranged side by side, and an illumination window 4 and the like are also arranged.

そして、観察窓２の奥には対物光学系５が配置され、その対物光学系５による被写体の投影位置に固体撮像素子６が配置されている。また、処置具突出口３の奥には、挿入部内に全長にわたって挿通配置されている処置具挿通チャンネル７の先端開口が連通配置されている。 An objectiveoptical system 5 is disposed in the back of theobservation window 2, and a solid-state image sensor 6 is disposed at a subject projection position by the objectiveoptical system 5. In addition, a distal end opening of the treatmentinstrument insertion channel 7 that is inserted and disposed throughout the entire length in the insertion portion is communicated and disposed behind thetreatment instrument protrusion 3.

例えば透明なアクリル樹脂やポリカーボネート樹脂等のような透明樹脂によって先端部本体１の外径と略同程度の径の略円筒状に形成された先端フード１０の基端側には、弾力性のあるゴム材等によって内径寸法が先端部本体１の外径寸法より小さな円筒状に形成された弾力環１１が溶着等によって一体に連結されている。 For example, the proximal end side of thedistal end hood 10 formed into a substantially cylindrical shape having a diameter substantially the same as the outer diameter of the distal endmain body 1 by a transparent resin such as a transparent acrylic resin or polycarbonate resin is elastic. Aresilient ring 11 formed in a cylindrical shape whose inner diameter is smaller than the outer diameter of the distal endmain body 1 by a rubber material or the like is integrally connected by welding or the like.

弾力環１１は弾性変形させることによって先端部本体１に対して被脱自在であり、弾力環１１で先端部本体１の外周面を締め付ける状態にすることにより先端フード１０が先端部本体１に取り付けられ、弾力環１１を先端部本体１から取り外せばそれと共に先端フード１０も外される。ただし、先端部本体１に対する先端フード１０の着脱は、係合突起と溝等各種の構造を採用することができる。 Theelastic ring 11 is detachable from the distal endmain body 1 by being elastically deformed, and thedistal end hood 10 is attached to the distal endmain body 1 by tightening the outer peripheral surface of the distal endmain body 1 with theelastic ring 11. If theelastic ring 11 is removed from thetip body 1, thetip hood 10 is also removed. However, various structures, such as an engagement protrusion and a groove | channel, can be employ | adopted for attachment or detachment of the front-end |tip hood 10 with respect to the front-end | tip partmain body 1. FIG.

先端フード１０には、処置具突出口３内に前方から嵌め込まれて、処置具突出口３から突出される処置具を観察窓２から遠ざかる方向に偏角させるように案内する処置具案内孔１３が形成された処置具案内部１２が、一体成形されている。 A treatmentinstrument guide hole 13 that is fitted into thedistal hood 10 from the front into thetreatment instrument protrusion 3 and guides the treatment instrument that protrudes from thetreatment instrument protrusion 3 to deviate in a direction away from theobservation window 2. The treatmentinstrument guide portion 12 in which is formed is integrally formed.

処置具案内部１２には、処置具突出口３内に嵌め込まれる部分１２ａと先端フード１０（即ち、略円筒状の突出部）との間を先端部本体１の先端面１ａに沿う位置で連結する連結部１２ｂが形成されており、連結部１２ｂは観察窓２からの観察視野範囲ＶＦ外に位置している。 The treatmentinstrument guide portion 12 is connected at a position along thedistal end surface 1a of the distal end portionmain body 1 between aportion 12a fitted into the treatmentinstrument projection port 3 and the distal end hood 10 (that is, a substantially cylindrical projection portion). The connectingportion 12b is formed, and the connectingportion 12b is located outside the observation visual field range VF from theobservation window 2.

そして処置具案内孔１３は、処置具案内部１２の処置具突出口３内に嵌め込まれる部分１２ａと連結部１２ｂとにまたがって、前方へ行くほど観察窓２の観察光軸から遠ざかる方向に偏角して形成されている。 The treatmentinstrument guide hole 13 extends across theportion 12a and the connectingportion 12b that are fitted in the treatmentinstrument projection port 3 of the treatmentinstrument guide portion 12, and moves in a direction away from the observation optical axis of theobservation window 2 as it goes forward. The corner is formed.

そのような処置具案内孔１３は、処置具突出口３の径より細い径に形成されて処置具突出口３の観察窓２から最も遠い稜線位置Ａで処置具突出口３と滑らかにつながっており、処置具突出口３の内周面に対して段差ができないよう、処置具突出口３内に位置する処置具案内孔１３の稜線部分は全て滑らかにテーパ面取りされている。 Such a treatmentinstrument guide hole 13 is formed with a diameter smaller than the diameter of thetreatment instrument protrusion 3 and is smoothly connected to thetreatment instrument protrusion 3 at the ridge line position A farthest from theobservation window 2 of thetreatment instrument protrusion 3. In addition, the ridge line portion of the treatmentinstrument guide hole 13 positioned in thetreatment instrument protrusion 3 is smoothly tapered and chamfered so that a step cannot be formed with respect to the inner peripheral surface of thetreatment instrument protrusion 3.

図３は、本実施例の先端フード１０が取り付けられた内視鏡を用いて経内視鏡的粘膜切除術を施行している状態を示しており、先端フード１０の内側に位置する患部粘膜１００が観察窓２を通して観察され、先端フード１０の周囲の状態も透明な先端フード１０を通して観察される。 FIG. 3 shows a state in which transendoscopic mucosal resection is performed using an endoscope to which thedistal end hood 10 of this embodiment is attached, and the affected mucosa located inside thedistal end hood 10. 100 is observed through theobservation window 2, and the state around thetip hood 10 is also observed through thetransparent tip hood 10.

そして、処置具挿チャンネル７を通過した高周波スネア５０は、先端フード１０の処置具案内孔１３内を通過することによって観察窓２から遠ざかる方向に偏角して、先端フード１０の最先端部分では先端フード１０の外縁部に近づく。 Then, the high-frequency snare 50 that has passed through the treatmentinstrument insertion channel 7 is deviated in a direction away from theobservation window 2 by passing through the treatmentinstrument guide hole 13 of thedistal hood 10, and at the most distal portion of thedistal hood 10. The outer edge of thetip hood 10 is approached.

その結果、高周波スネア５０の先端から側方に折れ曲がった状態に突出する先端ループ電極５１を、先端フード１０の内部空間いっぱいに大きく広げて患部粘膜１００に引っ掛け、先端ループ電極５１に高周波電流を通電して患部粘膜１００を広い範囲で切除することができる。 As a result, thetip loop electrode 51 protruding in a state bent sideward from the tip of thehigh frequency snare 50 is greatly spread over the inner space of thetip hood 10 and hooked on the affectedmucous membrane 100, and a high frequency current is applied to thetip loop electrode 51. Thus, the affectedmucous membrane 100 can be excised in a wide range.

また、処置具案内孔１３の径が処置具突出口３の径より小さく形成されていることにより、そこを通過する可撓性シース５２のガタつきが小さいので、所望の患部粘膜１００を確実にねらって誘導し、先端ループ電極５１で容易に切除処置することができる。 In addition, since the diameter of the treatmentinstrument guide hole 13 is smaller than the diameter of thetreatment instrument protrusion 3, the backlash of theflexible sheath 52 passing therethrough is small. It can be guided to aim and can be easily excised with thetip loop electrode 51.

本発明の実施例の内視鏡の挿入部の先端部分の側面断面図である。It is side surface sectional drawing of the front-end | tip part of the insertion part of the endoscope of the Example of this invention.本発明の実施例の内視鏡の挿入部の先端部分の正面図である。It is a front view of the front-end | tip part of the insertion part of the endoscope of the Example of this invention.本発明の実施例の内視鏡の使用状態の挿入部の先端部分の側面断面図である。It is side surface sectional drawing of the front-end | tip part of the insertion part of the use condition of the endoscope of the Example of this invention.従来の内視鏡の使用状態の挿入部の先端部分の側面断面図である。It is side surface sectional drawing of the front-end | tip part of the insertion part of the use condition of the conventional endoscope.

符号の説明Explanation of symbols

１先端部本体
１ａ先端面
２観察窓
３処置具突出口
１０先端フード
１２処置具案内部
１２ａ処置具突出口内に嵌め込まれる部分
１２ｂ連結部
１３処置具案内孔
５０高周波スネア（処置具）
５１先端ループ電極
５２可撓性シースDESCRIPTION OFSYMBOLS 1 Tip partmain body1a Tip surface 2Observation window 3Treatment tool protrusion 10Tip hood 12 Treatmenttool guide part 12a The part inserted in thetreatment tool protrusion12b Connection part 13 Treatmenttool guide hole 50 High frequency snare (treatment tool)
51 Tip Loop Electrode 52 Flexible Sheath

Claims

Translated fromJapanese

観察窓と処置具突出口とが並んで配置されている内視鏡挿入部の先端部本体の先端面から前方に略円筒状に突出する状態に、上記先端部本体に着脱自在に取り付けられる内視鏡の先端フードにおいて、
上記処置具突出口内に前方から嵌め込まれて上記処置具突出口から突出される処置具を上記観察窓から遠ざかる方向に偏角させるように案内する処置具案内部が一体的に形成されていることを特徴とする内視鏡の先端フード。An inner part that is detachably attached to the distal end body so as to project forward in a substantially cylindrical shape from the distal end surface of the distal end body of the endoscope insertion portion in which the observation window and the treatment instrument projection opening are arranged side by side. In the tip hood of the endoscope,
A treatment instrument guide portion that is fitted from the front into the treatment instrument projection opening and guides the treatment instrument projected from the treatment instrument projection opening so as to deviate in a direction away from the observation window is integrally formed. Endoscope hood characterized by

上記処置具案内部が、上記処置具突出口内に嵌め込まれる部分と上記略円筒状の突出部との間を上記先端部本体の先端面に沿う位置で連結する連結部を有していて、上記処置具突出口の径より細い径の処置具案内孔が上記処置具突出口内に嵌め込まれる部分と上記連結部とにまたがって形成されている請求項１記載の内視鏡の先端フード。The treatment instrument guide has a connecting portion that connects a portion fitted into the treatment instrument protrusion and the substantially cylindrical protrusion at a position along the distal end surface of the distal end main body, and The endoscope distal end hood according to claim 1, wherein a treatment instrument guide hole having a diameter smaller than a diameter of the treatment instrument protrusion is formed across a portion into which the treatment instrument protrusion is fitted and the connecting portion.

上記連結部が上記観察窓からの観察視野範囲外にある請求項２記載の内視鏡の先端フード。The endoscope front end hood according to claim 2, wherein the connecting portion is outside an observation visual field range from the observation window.

上記略円筒状の突出部が透明部材によって形成されている請求項１、２又は３記載の内視鏡の先端フード。The distal end hood of an endoscope according to claim 1, 2 or 3, wherein the substantially cylindrical protrusion is formed of a transparent member.