JP2006325744A - Endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscope that can be realized with a simple structure and can ensure good operability for endoscopic mucosal resection or the like.
SOLUTION: A distal end portion 15 of the insertion portion 7 is provided with a channel 25 that is formed along the longitudinal axis direction of the insertion portion 7 and through which a treatment instrument 24 can be inserted, and is adjacent to an upper portion of the channel 25. Then, an objective optical system 29 having an incident optical axis O that is a diagonally lower viewing direction is attached. The distal end side of the treatment tool 24 projecting from the channel 25 formed in the direction that is easy to treat is captured in the visual field range by the objective optical system 29 in the perspective direction so that the treatment is easy.
[Selection] Figure 2

Description

  The present invention relates to an endoscope suitable for performing treatment such as mucosal resection by inserting a treatment tool into a treatment tool channel.

In recent years, endoscopes have been widely used in the medical field and the industrial field. Particularly in the medical field, treatment such as biopsy, excision, and peeling can be performed by inserting the treatment tool into the treatment tool channel.
As a conventional endoscope equipped with a treatment instrument channel, it is a direct view type in which the visual field direction of the observation optical system (objective optical system) is the distal end side in the longitudinal direction of the insertion section, and the treatment instrument channel is also in the longitudinal direction of the insertion section. Some are formed in parallel.
In addition, there is a direct view type in which an elevator is provided near the distal end of the treatment instrument channel so that the direction of the treatment instrument protruding from the distal end of the treatment instrument channel can be inclined in the visual field direction.
Further, as disclosed in, for example, Japanese Patent Application Laid-Open No. 5-305051, there is an endoscope in which a perspective direction is a visual direction and a treatment instrument channel is also formed in a perspective direction.
JP-A-5-305051

When performing mucosal resection and the like endoscopically, a direct-view type endoscope is usually used, but in the case of a structure that tilts the treatment instrument channel or raises the elevator, the structure becomes complicated, It is convenient to have an endoscope with a simple structure and better operability for mucosal resection and the like.
Further, as described above, an endoscope in which the visual field direction is the longitudinal direction of the insertion portion and the treatment instrument channel is formed in parallel to the longitudinal direction of the insertion portion has a simple structure, but FIG. As shown in B), the conventional endoscope 2 ′ has a drawback that the distal end opening is easily obstructed by the body wall when the treatment instrument 24 is advanced and retracted from the distal end opening of the channel 25.
In FIG. 5B, the visual field range by the objective optical system 29 ′ at the tip of the insertion portion 7 ′ is indicated by W.

(Object of invention)
The present invention has been made in view of the above-described points, and an object thereof is to provide an endoscope that can be realized with a simple structure and can ensure good operability with respect to endoscopic mucosal resection or the like. .

According to the present invention, the distal end side of the treatment instrument channel opens along the longitudinal axis direction of the insertion portion, and the distal end side of the treatment instrument inserted into the treatment instrument channel can protrude along the longitudinal axis direction of the insertion portion. In an endoscope that
An incident optical axis in an objective optical system provided alongside the opening at the distal end of the insertion portion is formed to be inclined toward the treatment instrument channel side.
With the above configuration, when the distal end side of the treatment instrument is projected from the opening of the treatment instrument channel in order to perform a treatment using the treatment instrument like endoscopic mucosal resection, the direction in which the distal end side of the treatment instrument projects is changed. It can be set in the longitudinal axis direction of the insertion portion that is easy to treat, and the direction of the incident optical axis of the objective optical system is directed obliquely downward so that the direction in which the treatment tool protrudes can be easily captured within the visual field range. Therefore, when the observation target is captured in the visual field range, the distal end side of the treatment tool can also be captured on the central side of the visual field to perform the treatment, and good operability can be secured.

  According to the present invention, the distal end side of the treatment instrument can be protruded in the direction of the longitudinal axis of the insertion portion that is easy to treat, and the distal end side from which the treatment instrument protrudes is captured within the visual field range to perform the treatment. Easy to do.

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

1 to 9 relate to a first embodiment of the present invention, FIG. 1 shows a configuration of an endoscope apparatus including the first embodiment of the present invention, and FIG. 2 shows the vicinity of the distal end portion of the endoscope of the first embodiment. 3 shows a front view of the distal end portion, FIG. 4 shows a usage example of treatment using a treatment instrument according to the present embodiment, and FIG. A rough operation is shown by comparison with the conventional example of B).
6 shows a configuration near the distal end portion of the endoscope according to the first modification, FIG. 7 shows a front view thereof, and FIG. 8 shows a configuration near the distal end portion of the endoscope according to the second modification example. FIG. 9 shows a front view thereof.
As shown in FIG. 1, an endoscope apparatus 1 including Embodiment 1 of the present invention is inserted into a body cavity and the endoscope 2 of Embodiment 1 for performing an endoscopic examination, and the endoscope 2 performs signal processing on a light source / fluid control device 3 having a light source function for supplying illumination light to 2 and a fluid control function for performing fluid control such as air supply / water supply, and an image pickup device built in the endoscope 2 A video processor 4 and a monitor 5 that displays an endoscopic image captured by the image sensor when a video signal processed by the video processor 4 is input.

The endoscope 2 has an elongated insertion portion 7 to be inserted into a body cavity, an operation portion 8 provided at the rear end of the insertion portion 7, and a universal cable 9 extending from the operation portion 8. The connector 11 provided at the end of the universal cable 9 is detachably connected to the light source / fluid control device 3.
Further, the air / water supply tube 12 connected to the air / water supply cap in the connector 11 is connected to an air / water supply pump (not shown) of the light source / fluid control device 3 through a water supply tank 13. The insertion portion 7 includes a hard distal end portion 15, a bendable bending portion 16 provided at the rear end of the distal end portion 15, and a flexible portion extending from the rear end of the bending portion 16 to the front end of the operation portion 8. 17.

The bending portion 16 can be bent in a desired direction by operating, for example, a trackball 18 as a bending operation means provided in the operation portion 8. Note that a bending operation knob may be provided instead of the trackball 18 and the bending portion 16 may be driven to bend by a turning operation of the bending operation knob by the user.
A light guide (not shown) is inserted into the insertion portion 7, and the rear end of the light guide reaches the connector 11 at the rear end of the universal cable 9 extended from the operation portion 8. Then, the illumination light from the lamp in the light source / fluid control device 3 is transmitted by the light guide, and further from the front end surface of the light guide to the outside through the illumination lenses 19a and 19b attached to the illumination window as shown in FIG. The light is emitted and illuminates a subject such as an affected part in the body cavity.

As shown in FIG. 2, the tip portion 15 is formed of a tip member 21 whose main body is hard. A distal end of a curved portion outer skin 23 formed of an elastic member that covers the curved portion 16 is fixed to the rear outer peripheral surface of the distal end member 21.
The endoscope 2 is provided with a treatment instrument channel (hereinafter simply abbreviated as a channel) 25 through which a treatment instrument 24 such as an IT knife can be inserted along the longitudinal axis of the insertion portion 7. The rear end side is branched into two at the branch portion near the rear end of the insertion portion 7, and the one branched obliquely communicates with the treatment instrument insertion port 26. In addition, the pipe line branched to the rear side in the branch part communicates with the suction pipe line and is connected to the suction means in the light source / fluid control device 3.
As shown in FIG. 2, the channel 25 is formed by a hollow portion of the tube, and the distal end of the tube is connected to a base fixed to a through hole provided in the distal end member 21 (in the longitudinal axis direction of the insertion portion 7). ing.

Then, the user can perform a treatment such as excision at the protruding distal end portion by inserting the treatment instrument from the treatment instrument insertion port 26 and projecting the distal end side of the treatment instrument from the distal end opening of the channel 25. I am doing so.
Further, the distal end member 21 is inserted at a position adjacent to the through hole of the channel 25 so as to form a predetermined angle θ (in this embodiment, for example, about 5 to 10 degrees) with the direction of the longitudinal axis of the insertion portion 7. A through hole is formed in a direction inclined from the longitudinal axis of the portion 7, and the imaging unit 27 is attached.
The imaging unit 27 includes a lens frame 28 that is fixedly inserted into a through hole, an objective optical system 29 that is attached to the lens frame 28 and connects an optical image of an illuminated subject, and a connection between the objective optical system 29. For example, a charge coupled device (abbreviated as CCD) 30 is provided as a solid-state imaging device disposed at an image position.

On the back side of the CCD 30, a substrate 31 connected to the CCD 30 and mounted with circuit components such as a buffer amplifier is disposed. A tip of a signal cable 32 is connected to the substrate 31, and the signal cable 32 is connected to the video processor 4 via the connector 11.
The optical axis O of the objective optical system 29 constituting the imaging unit 27 is inclined with respect to the direction of the longitudinal axis of the insertion portion 7 by a predetermined angle θ.
Specifically, as shown in FIG. 2, the viewing direction along the optical axis O is a direction that is the front end side of the channel 25 provided adjacent to the lower side, that is, an inclined type that faces obliquely downward. The distal end side of the treatment tool protruding from the distal end opening of the channel 25 is easily captured in the field of view range of the objective optical system 29 (or the imaging range of the CCD 30).

When the image picked up by the CCD 30 in the state as shown in FIG. 2 is displayed on the monitor 5, the upper side in FIG. 2 is the upper side when displayed on the monitor 5, and the upward direction curves the bending portion 16. Coincides with the upper side in the case. That is, the objective optical system 29 is provided at a position above the channel 25 with respect to the observation field of view or the bending direction of the bending portion 16.
Further, the objective optical system 29 is set so that, for example, a portion protruding about 20 mm from the opening of the front end of the channel 25 is placed in the center of the visual field with the obliquely lower side as the visual field direction. As the image pickup unit 27 in this embodiment, a normal direct-view type image pickup unit can be used, and by attaching it to a through hole formed in the tip member 21 in an oblique direction, the longitudinal direction of the insertion portion 7 as described above. The distal end side of the treatment tool 24 that protrudes into the field of view is captured within the visual field range so that observation and treatment can be easily performed.
Therefore, it can be realized at a lower cost compared to an existing perspective type in which the objective optical system is attached so that the entire distal end surface of the distal end portion is flush with the inclined surface cut obliquely. Further, the objective optical system 29 used in this embodiment can reduce the manufacturing cost in that it can also be used as a normal direct-view type objective optical system. The imaging unit 27 has the same effect (merit).

In addition, the variation in the optical characteristics of the direct-view type objective optical system 29 can be reduced as compared with a normal perspective type, and the adjustment becomes easy.
Further, in the present embodiment, the distal end surface of the distal end member 21 is such that the lower surface Sa on which the channel 25 is formed is orthogonal to the longitudinal axis of the insertion portion 7 and is a surface near the center adjacent thereto. Sb is inclined so as to be flush with the front end surface of the inclined objective optical system 29 (from the direction of the longitudinal axis of the insertion portion 7), and the upper end side of the inclined surface Sb is also inclined to the opposite side of the surface Sb. Surface Sc. A bending piece 33 is provided at the rear end of the tip member 21, and a bending portion 16 that can be bent vertically and horizontally is formed.
FIG. 3 shows a front view of the tip member 21. Note that FIG. 2 shows a cross-sectional structure along a vertical section at the center position on the left and right in FIG.

As shown in FIG. 3, the channel 25 is disposed near the center in the left-right direction of the surface Sa on the lower end side, and the illumination lens 19a and the forward water supply nozzle 34 are disposed on both sides thereof. The front water supply nozzle 34 communicates with a front water supply pipe (not shown) inserted into the insertion portion 7, and the rear end side of the front water supply pipe is connected to the light source / fluid control device 3.
Further, the operation unit 8 is provided with a forward water supply switch 35, and the user operates the forward water supply switch 35 to turn it on, thereby configuring the fluid control means provided in the light source / fluid control device 3. The CPU (not shown) operates the water supply pump to supply water through the front water supply pipe so that the water supplied from the front water supply nozzle 34 can be supplied forward.

The objective optical system 29 is disposed at the center in the left-right direction on the surface Sb near the center, that is, above the channel 25, and the air / water supply nozzle 36 and the illumination lens 19b are disposed on both sides thereof.
Further, the operation unit 8 is provided with, for example, a two-stage air / water supply switch 37 adjacent to the front water supply switch 35, and the user performs an operation of pushing down the air / water supply switch 37 slightly. The CPU (not shown) constituting the fluid control means provided in the light source / fluid control device 3 is turned on by the air supply switch portion, and operates the air supply pump to supply air via the air supply / water supply pipeline. The gas sent from the water supply nozzle 36 toward the outer surface of the objective optical system 29 can be ejected.

Further, when the air supply / water supply switch 37 is pushed more strongly, the water supply switch portion is turned on, the water supply pump is operated to supply water through the air supply / water supply conduit, and the objective optical system 29 is supplied from the air supply / water supply nozzle 36. The water fed toward the outer surface of the can be ejected.
The illumination lens 19b provided on the inclined surface Sb on which the objective optical system 29 is disposed is set to be larger than the other illumination lens 19a so that the visual field direction by the objective optical system 29 can be reliably illuminated. I have to. The illumination lens 19b also has a distal end portion 15 such that the illumination optical axis is parallel to the visual field direction, for example, so that the illumination direction can illuminate the visual field direction (the direction of the incident optical axis O) by the objective optical system 29. Is attached.
Further, on this surface Sb, the air / water supply nozzle 36 is provided adjacent to the objective optical system 29 as described above so that the nozzle opening faces the objective optical system 29, and the outer surface of the objective optical system 29 is provided. However, even when a part of the visual field to be observed is obstructed due to attachment of body fluid or the like, a clean observation visual field can be secured by washing away the adhering matter by water supply or air supply.

  A scope switch 39 such as a freeze switch is provided on the top side of the operation unit 8 so that an instruction operation for displaying an image captured by the CCD 30 as a still image can be performed.

In the present embodiment having such a configuration, the channel 25 is formed in the longitudinal axis direction of the insertion portion 7, and the direction in which the distal end side of the treatment instrument 24 protrudes can be regulated in the longitudinal axis direction. The treatment is easy to perform. At the tip 15, the objective optical system 29 is adjacent to the upper portion of the channel 25, and the observation visual field direction or the incident-side optical axis O (also referred to as the incident optical axis) faces the tip of the channel 25. One of the features is that the distal end side of the treatment tool protruding from the distal end opening of the channel 25 is caught in the observation visual field to facilitate treatment.
Next, the operation of this embodiment will be described with reference to the usage example of FIG.
Endoscopic mucosal resection (EMR) in which the insertion portion 7 of the endoscope 2 is inserted into a body cavity, a lesion is formed in the mucosal tissue, and the lesion is excised with a treatment tool 24 such as an IT knife. Alternatively, there is Endoscopic Submucosal Dssection ESD.
In such a case, as shown in FIG. 4 (A), the surgeon makes the distal end portion 15 of the insertion portion 7 face a site 41 to be excised or incised and peeled in the in-vivo mucosa 40 to be treated such as a lesioned portion. Set to. Then, the distal end side of the treatment instrument 24 inserted into the channel 25 is projected. Since the channel 25 is provided on the lower side of the objective optical system 29, the distal end side of the treatment instrument 24 starts to enter the lower side in the visual field range by projecting the treatment instrument 24. For example, in a state where the portion 41 to be excised is captured near the approximate center of the visual field range, the distal end side of the treatment tool 24 is further protruded, and when the distal end reaches the approximate central area of the visual field range, the distal end is excised. Contact the region 41 to be.
As shown in FIG. 4A, when the distal end of the treatment instrument 24 is set near the center of the visual field range so as to contact the site 41 to be excised, the image displayed on the monitor 5 is as shown in FIG. It becomes like (B).
The distal end side of the treatment instrument 24 protrudes upward from the lower side of the screen, and the distal end thereof is displayed together with a portion 41 to be excised near the center of the screen.

In this embodiment, since the objective optical system 29 is provided on the upper side of the channel 25 so that the oblique lower side is the viewing direction, the treatment instrument 24 is inserted from the lower side thereof as shown in FIG. 7 also protrudes along the longitudinal axis direction of FIG. 7, and it is easy to perform an excision treatment by capturing it within the visual field range.
That is, when the treatment tool 24 protrudes, the protruding direction can be protruded in the direction of the longitudinal axis of the insertion portion 7, and the work in the case of excision or incision peeling almost parallel to the wall surface in the body can be easily performed. At the same time, the distal end of the treatment instrument 24 and the part 41 to be excised can be captured within the visual field range, so that the treatment work can be easily performed.
On the other hand, for example, when the same treatment is to be performed with a normal direct-view type endoscope, the longitudinal axis of the insertion portion 7 is set in an oblique direction (as in the visual field direction in FIG. 4A). Otherwise, it becomes difficult to capture the vicinity of the distal end of the treatment instrument within the visual field range.

Moreover, in the state set in the oblique direction as described above, the protruding direction of the treatment tool is also inclined, so that it takes time and effort to remove and incise and remove the treatment tool in parallel with the wall surface. In some cases it will take time. Further, if the treatment for excision is advanced in parallel, in the conventional example, the cut-opened portion becomes an obstacle when the treatment is further advanced, and the treatment for excision becomes difficult to proceed.
On the other hand, according to the present embodiment, the operation such as excision in parallel with the wall surface by the treatment tool 24 can be performed very easily, and the operation to be performed by capturing in the visual field range can be performed smoothly and in a short time. be able to. Further, the front end surface of the front end portion 15 can be embedded in the cut portion, and excision and the like can be smoothly performed over a wide range.
For this reason, according to the present Example, the lump excision of a lesion part can be performed in a short time and easily. That is, the operability during treatment can be improved. Further, it can be realized with a simple structure and low cost.

Further, an outline of the operation in comparison with the endoscope 2 'of the conventional example is as shown in FIG. That is, in this embodiment, the visual field direction (or the optical axis O direction) of the objective optical system 29 is the lower side from the axial direction of the insertion portion 7 to the tip side of the channel 25 (the channel 25 is the lower side of the objective optical system 29). It is formed so as to be inclined to the specified case).
Therefore, when compared with the condition of the same visual field range W as that of the endoscope 2 'of the conventional example shown in FIG. 5B, the direction of the insertion portion 7 of the endoscope 2 is laid down more than in the conventional example. The same visual field range W as the example can be secured. That is, the treatment instrument 24 can be advanced and retracted from the distal end opening of the channel 25 in a state of being laid down as compared with the conventional example. For this reason, it becomes possible to perform treatment so as not to hit the body wall (at a larger angle) than in the conventional example, and it is possible to improve the obstruction of the distal end opening of the channel 25 compared to the conventional example. Thus, the present embodiment can improve the operability in the case of treatment.
Further, according to the present embodiment, for example, as shown on the left side of FIG. 2, the angle θ formed by the visual field direction of the objective optical system 29 (or the direction of the optical axis O) and the axial direction of the insertion portion 7 is set to the tip member 21. When a treatment such as excision of the mucous membrane is performed with the treatment instrument 24 by setting α> θ as a relationship with the angle α at which the surface Sc formed at the upper end of the distal end of the distal end of the insertion portion 7 is in the axial direction, the distal end portion 15 Has the effect of easily sinking into the submucosa.

Next, a first modification of the present embodiment will be described with reference to FIGS.
6 shows a side view of the vicinity of the tip in the first modification, with a part cut away, and FIG. 7 shows a front view of the tip.
In this modification, the arrangement at the tip 15 in the first embodiment is modified. Specifically, the cross-sectional structure in this modification is almost the same as FIG. However, the surface Sc in FIG. 2 is rounded with a predetermined radius.
As shown in FIG. 7, in this modification, the air / water supply nozzle 36 provided on the surface Sb shown in the first embodiment of FIG. 3 is provided on the surface Sa.

In the first embodiment, the front water supply nozzle 34 provided on the surface Sa is provided on the surface Sb. Then, water can be fed in the visual field direction of the objective optical system 29.
Therefore, in this modification, the channel 25 is disposed at the center in the left-right direction on the surface Sa, and the air / water supply nozzle 36 and the illumination lens 19a are disposed on both sides thereof. The inclined surface Sb is provided with an objective optical system 29 at the center in the left-right direction, and an illumination lens 19b and a front water supply nozzle 34 on both sides thereof.
In this modification, when air is supplied or supplied from the air supply / water supply nozzle 36, the air or water supplied or supplied to the outer surface of the objective optical system 29 can be guided even when the nozzle portion has an angle smaller than 90 degrees. Thus, it is possible to easily remove the deposits attached to the outer surface of the objective optical system 29. The other effects are almost the same as those of the first embodiment.

Next, a second modification of the present embodiment will be described with reference to FIGS.
FIG. 8 shows a cross-sectional view of the vicinity of the tip in the second modification, and FIG. 9 shows a front view of the tip.
In this modification, the first modification is further modified. Specifically, the cross-sectional structure in this modification is similar to FIG. However, the lower end surface Sa in FIG. 2 is formed to be rounded with the curvature R1, and the upper end side surface Sc portion is rounded with a radius R2 larger than the radius R1 (the tip member 21 is ) It has a larger notch structure.
In this modification, as shown in FIG. 9, only the channel 25 is arranged on the surface Sa, and the objective optical system 29, the illumination lenses 19a and 19b, and the air / water supply nozzle 36 are arranged on the inclined surface Sb. . In this case, the illumination lenses 19 a and 19 b are arranged on the left and right sides of the objective optical system 29, and the air / water supply nozzle 36 is arranged on the upper part of the objective optical system 29.

Moreover, in this modification, the inclination angle of the inclined surface Sb is made larger than that in the first embodiment. That is, the angle θ formed by the optical axis O or the visual field direction of the objective optical system 29 and the longitudinal axis of the insertion portion 7 is set to a larger angle than in the first embodiment. Then, the distal end of the treatment instrument 24 is captured at the center of the visual field range in a state where the distance is set closer than in the case of the first embodiment, and the treatment is performed in a state where the distance is set closer than in the case of the first embodiment. Can be done smoothly. Further, as described above, in the present modification, when the notch on the upper end portion 15 is formed with a large curvature radius R2 and the treatment by EMR or ESD is performed, the tip portion 15 is cut into the inside of the excised portion. In this way, a structure that facilitates treatment by grasping a site to be excised more reliably in the field of view range.
The other effects are the same as those of the first embodiment.

Next, a second embodiment of the present invention will be described with reference to FIGS. FIG. 10 shows a configuration in the vicinity of the distal end portion of the endoscope according to the second embodiment of the present invention, and FIG. 11 shows a front view of the distal end portion.
The endoscope 2B includes an objective optical system 29B using the first wedge-shaped first lens 51, and the imaging unit 27B including the objective optical system 29B is parallel to the longitudinal axis of the insertion portion 7. It is installed in a through hole.
The first lens 51 employs a wedge-shaped lens in which the thickness on the lower side on the channel 25 side is large (thick) and the thickness on the upper side is small (thin). The optical system portion behind 51 is a short-axis optical system having a single optical axis O ″ parallel to the longitudinal axis direction of the insertion portion 7. The incident optical axis O ′ incident on the lens 51 or the visual field direction is set to the oblique direction which is obliquely below.

The first lens 51 causes the incident light to be refracted in the larger thickness and imaged on the CCD 30. As described above, in the present embodiment, the objective lens system 29B having the visual field direction obliquely below can be formed by the first lens 51 as the tip optical member provided at the forefront.
In the present embodiment, the tip surface of the tip member 21 is flush with the outer surface (tip surface) of the first lens 51 around the portion of the objective optical system 29B where the first lens 51 is attached. The inclined surface Sd.
In the first embodiment, a normal direct-view objective optical system 29 is attached to the distal end portion 15 at an angle, and a surface inclined to the distal end surface so that the distal end surface is flush with the outer surface of the objective optical system 29 at that time. Although Sb is provided, in this embodiment, the surface Sd is inclined in the direction opposite to the surface Sb.
In the present embodiment, a notch surface Se is formed by obliquely notching the upper side from the surface Sd. This notch surface Se is largely cut away from the direction of the insertion axis, for example α.

FIG. 11 shows a front view of the distal end portion 15 as viewed from the front. In the present embodiment, for example, the surfaces Sa and Sd are disposed on the surfaces Sa and Sd as in the case of the surfaces Sa and Sb in the first embodiment.
According to the present embodiment, it is possible to realize the endoscope 2B that can be easily treated with the treatment instrument 24 with a simple configuration as in the first embodiment.
Further, according to the present embodiment, as shown in FIG. 12, the distal end portion 15 is easily embedded inside the portion excised by the treatment instrument 24, and even in the case of a treatment such as a large excision or incision peeling, The treatment can be performed smoothly. That is, treatment can be performed with good operability.

  FIG. 13: shows the front view of the front-end | tip part in a 1st modification. In the present modification, for example, in Example 2, the flat portion 52 is formed by cutting out the bottom side of the tip portion 15 in a D-cut shape.

By providing the flat surface portion 52 in this way, the area where the distal end portion 15 comes into contact with the inner wall surface of the body can be increased, and treatment such as excision can be performed in a stable state with little fluctuation. In addition, it is possible to prevent slipping when an operation such as pressing is performed.
14A and 14B show the outer shape near the tip of the second modification, FIG. 14A shows a perspective view, and FIG. 14B shows a bottom view. In the present modification, the flat surface portion 52 in the first modification is an uneven flat surface portion 52B.
In this case, the concavo-convex shape is formed in the longitudinal axis direction of the insertion portion 7, it is easy to move in this longitudinal axis direction, and it is slippery in the left-right direction orthogonal to this direction. According to this modification, when a treatment such as excision is performed, it can be performed in a stable state and in a state in which there is little blurring over a wide range.

Next, Embodiment 3 of the present invention will be described with reference to FIGS. FIG. 15 shows a configuration near the distal end portion of the endoscope according to the third embodiment of the present invention, and FIG. 16 shows a front view of the distal end portion.
The endoscope 2 </ b> C according to the present embodiment includes an endoscope main body 61 and a hood 62 attached to the distal end portion 15 of the endoscope main body 61.
The imaging unit 27 of the first embodiment is attached to the distal end member 21 of the distal end portion 15 of the endoscope body 61 so that the optical axis O thereof is parallel to the longitudinal axis direction of the insertion portion 7. This configuration is the same as that of the existing endoscope main body 61.
In this embodiment, a removable hood 62 is attached to the distal end portion 15 of the existing endoscope main body 61. A wedge-shaped lens 63 is attached to the inside of the hood 62 via a support member 64 at a position facing the front end surface of the objective optical system 29 of the imaging unit 27.

Then, the optical axis O ″ by the objective optical system 29 is refracted downward by the wedge-shaped lens 63 as the tip optical member to realize the incident optical axis O ′ with the front lower side as the viewing direction. .
For example, as shown in FIG. 16, the support member 64 is provided so as to cover the upper half from the approximate center of the distal end surface. In addition, the part which opposes the air / water supply nozzle 36 is notched, and the opening is formed. Also, a wedge-shaped lens 65 is provided at the position of the illumination lens 19b so that the perspective direction by the objective optical system 29 and the wedge-shaped lens 63 can be illuminated.
According to the present embodiment, by attaching the hood 62 to the existing endoscope main body 61, the endoscope 2C that can be easily excised as described in the first embodiment or the like can be realized.
FIG. 17 shows an example of use of the distal end side of the endoscope of the first modification. An endoscope 2D according to this modification is configured such that, in the endoscope 2C according to the third embodiment, for example, a hood 62B in which a tapered portion 71 is provided at a distal end portion of the hood 62.

When the internal mucous membrane 40 such as a lesioned part is excised by making the taper shape in this way, the distal end side of the tapered part 71 is submerged inside the excised part so that the part 41 to be excised is within the field of view. Treatment can be performed.
In FIG. 15 or FIG. 17, the hood 62 or 61B to which the wedge-shaped lens 63 is attached is shown. However, for example, other embodiments or other modifications, for example, the endoscope shown in FIG. A hood 73 may be attached to the distal end portion 15 of 2B, as shown in FIG.
The hood 73 shown in FIG. 18 has a different shape from that shown in FIG. 17, but is also tapered.
Further, the hood 73 is made of titanium oxide (TiO 2), silica (SiO 2), etc. that are resistant to contamination and easy to remove on the inner peripheral surface and outer peripheral surface excluding the portion attached to the tip portion 15 by ultraviolet irradiation. A photocatalytic layer 75 having an antifouling function is formed by the photocatalytic reaction.

In this case, as shown in the enlarged view, a reaction barrier layer 76 is provided between the surface of the hood 73 and the photocatalyst layer 75.
According to this modification, in addition to the effect of the second embodiment, the antifouling effect is provided. That is, it is difficult for dirt to adhere. Further, it is possible to easily remove dirt due to body fluids and other attached substances attached by water supply and suction.
In addition, by including an ultraviolet irradiation device in the endoscope system using the endoscope 2B, the photocatalytic reaction can be advanced between inspections or during the inspection.
In addition, as a manufacturing method of the photocatalyst layer 75, vapor deposition, brushing, a dipping method, etc. can be utilized.

FIG. 19 shows an endoscope 2E of a second modification. This modification is configured, for example, by attaching a distal end cover 81 to the distal end of the distal end portion 15 of the endoscope main body 61 of FIG.
The tip cover 81 has a cylindrical portion 82 attached to the outer peripheral surface of the tip portion 15 and a disk-shaped portion 83 that covers the tip surface of the tip portion 15.
In the disk-shaped portion 83, a wedge-shaped lens 63 is provided at a portion facing the outer surface of the objective optical system 29 as in the case of FIG. Alternatively, the first lens may be shaped into a wedge shape.
In the present modification, the disc-shaped portion 83 is provided with a hollow transition portion 84 serving as a suction amount adjusting means for adjusting the suction amount at a portion facing the channel 25.
The transition portion 84 is provided with a taper portion 85 having a rear end opening equal to the inner diameter D of the channel 25, and the front end of the taper portion 85 is smaller than the inner diameter D of the channel 25 and is a non-circular, for example, rectangular opening 86. I have to.

The tip surface in this case is as shown in FIG. As shown in FIG. 20, the opening 86 at the front end of the transition portion 84 is, for example, rectangular. That is, as shown in FIG. 21A, the rear end of the transition portion 84 is a circle equal to the inner diameter D of the channel 25, and the opening 86 at the front end of the transition portion 84 has vertical and horizontal widths a = b, a = b <D. More specifically, for example, D = 3.2φ and a = 2.8φ.
Even when a treatment tool having a circular cross section with a diameter a as shown by a two-dot chain line is inserted, a gap is formed around the treatment tool so that the suction function can be maintained.
That is, the opening 86 at the front end (which has a smaller area than the rear end) in the transition portion 84 suppresses (regulates) the movable range in the axial direction of the treatment instrument inserted through the channel 25 to ensure good operability. In addition, the suction function is secured in the space of the non-circular portion.

A supplementary explanation of the suction amount adjusting means by such a transition part 84 will be given below. When EMR or ESD is performed with the treatment tool, bleeding is accompanied. Therefore, the affected part is washed with water and the liquid is sucked and removed. In this case, since suction is performed with the treatment instrument being passed through the channel 25, the space portion during suction is narrowed and the amount of suction is reduced.
On the other hand, if the inner diameter of the channel is increased, the position of the treatment tool in the axial direction is not determined when the treatment tool is passed, and the operability is degraded.
For this reason, it is desired that the operability by the treatment instrument can be secured and the suction function can be maintained, and the suction amount adjusting means by the transition portion 84 is formed as described above for the purpose of realizing this.
By adopting the configuration as described above, axial swaying by the treatment instrument is prevented to ensure good operability, and a space for suction is secured around the treatment instrument.

FIG. 21B shows the transition portion 84B in the case of the modification. In this case, the transition portion 84B is provided with an opening having a small diameter c except for four opening widths X in the circumferential direction. Then, by using a treatment instrument having a minimum diameter Y larger than the opening width X, the treatment tool can be used without causing rattling.
FIG. 22 shows a distal end portion of an endoscope according to a third modification. In the endoscope 2F, for example, in the existing endoscope main body 61 shown in FIG. 15, the first lens 51 in the objective optical system 29 is attached while being shifted downward from the optical axis O ″, and its optical axis is set to Oc. The lower side can be placed within the visual field range without shifting.
Even in this configuration, the lower visual field can be enlarged with a simple configuration.
It should be noted that embodiments configured by partially combining the above-described embodiments and modifications also belong to the present invention.

[Appendix]
1. 4. The objective optical system according to claim 3, wherein the objective optical system is provided on a hood member that is detachably attached to the tip portion.
2. In Claim 1, the tip part is provided with illumination means for emitting illumination light in the direction of the incident optical axis of the objective optical system.
3. In Claim 1, the said front-end | tip part is provided with the notch part by which the upper part side was notched larger than the lower part side.
4). The suction amount adjusting means for adjusting the suction amount is provided for the opening at the tip of the channel.
5. In Supplementary Note 4, the suction amount adjusting means includes an opening area changing member that changes the opening area of the channel with respect to the opening area.

6). In Supplementary Note 4, the suction amount adjusting means is formed by a detachable hood at the distal end portion.
7). In Supplementary Note 4, the suction amount adjusting means is disposed immediately before the opening of the front end of the channel, has a rear end opening having the same opening area as the opening area, and is formed on the front side of the rear end opening. It has a small area and a non-circular front end opening.
8). In Supplementary Note 6, a photocatalytic layer is provided on the surface of the hood.
9. An endoscope in which the distal end side of the treatment instrument channel opens along the longitudinal axis direction of the insertion portion, and the distal end side of the treatment instrument inserted into the treatment instrument channel can protrude along the longitudinal axis direction of the insertion portion. In
The optical axis of the most advanced lens in the objective optical system having the optical axis in the longitudinal axis direction is disposed at the distal end portion of the insertion portion so as to be shifted to the treatment instrument channel side. Features an endoscope.

  A channel that allows the treatment instrument to be inserted is provided in the longitudinal axis direction of the insertion portion, and the incident optical axis of the objective optical system is grasped at the distal end of the treatment instrument that protrudes from the distal end opening of the obliquely lower channel, so that the lower perspective view Since it is formed, it is easy to perform treatment by EMR or ESD.

FIG. 1 is an overall configuration diagram of an endoscope apparatus including Embodiment 1 of the present invention. FIG. 2 is a cross-sectional view showing an internal configuration in the vicinity of the distal end portion of the endoscope according to the first embodiment. FIG. 3 is a front view of the tip. FIG. 4 is a diagram showing a usage example in which treatment is performed using a treatment tool according to the present embodiment. The figure which shows the rough effect | action by a present Example by the comparison with a prior art example. FIG. 6 is a side view showing a configuration in the vicinity of a distal end portion of an endoscope according to a first modification. FIG. 7 is a front view of an endoscope according to a first modification. FIG. 8 is a side view showing a configuration in the vicinity of a distal end portion of an endoscope according to a second modification. FIG. 9 is a front view of an endoscope according to a second modification. FIG. 10 is a cross-sectional view showing the structure near the distal end portion of the endoscope according to the second embodiment of the present invention. FIG. 11 is a front view of the tip. FIG. 12 shows an example of use. FIG. 13 is a front view of the first modification. FIG. 14 is a front view and a bottom view of the second modification. FIG. 15 is a side view showing a portion near the distal end portion of the endoscope according to the third embodiment with a part cut away. FIG. 16 is a front view of the tip. FIG. 17 is a diagram showing a first modified example as a usage example. FIG. 18 is a diagram showing the distal end side in Example 2 with a hood attached. FIG. 19 is a side view illustrating a distal end side of an endoscope according to a second modified example with a part cut away. FIG. 20 is a front view showing the tip surface. FIG. 21 is an explanatory diagram showing, in an enlarged manner, the shape and the like of the transition portion and a modification. FIG. 22 is a cross-sectional view showing a configuration in the vicinity of the tip in a third modification.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Endoscope apparatus 2 ... Endoscope 3 ... Light source and fluid control apparatus 4 ... Video processor 5 ... Monitor 7 ... Insertion part 8 ... Operation part 15 ... Tip part 16 ... Curved part 19a, 19b ... Illumination lens 21 ... Tip Member 24 ... treatment tool 25 ... channel 26 ... treatment tool insertion port 27 ... imaging unit 28 ... lens frame 29 ... objective optical system 30 ... CCD
DESCRIPTION OF SYMBOLS 31 ... Board | substrate 32 ... Signal cable 34 ... Forward water supply nozzle 36 ... Air supply / water supply nozzle 40 ... Internal mucous membrane 41 ... Site to be excised

Claims (4)

An endoscope in which the distal end side of the treatment instrument channel opens along the longitudinal axis direction of the insertion portion, and the distal end side of the treatment instrument inserted into the treatment instrument channel can protrude along the longitudinal axis direction of the insertion portion. In
An endoscope characterized in that an incident optical axis in an objective optical system provided side by side with the opening is inclined at the distal end portion of the insertion portion toward the treatment instrument channel.   The endoscope according to claim 1, wherein the objective optical system is provided at a position above the treatment instrument channel with respect to an observation field of view by the objective optical system.   The objective optical system includes a direct-view type objective optical system having an optical axis parallel to the longitudinal axis direction of the insertion portion, and a front end of the objective optical system that is inclined toward the treatment instrument channel side. The endoscope according to claim 1, further comprising a tip optical member having an incident optical axis.   The objective optical system is formed by attaching a uniaxial optical system in which an optical system is disposed along one optical axis to the tip along the direction of the incident optical axis. The endoscope according to claim 1.

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