JP5442079B2 - Plug and endoscope - Google Patents

Description

  The present invention relates to a non-reusable plug attached to an endoscope, and an endoscope including the plug.

  Conventionally, in the medical field, endoscopy for observing the inside of a body has been performed. In this endoscopy, an insertion portion of an endoscope is inserted into a patient's body, and the inside of the patient is observed with a monitor on the hand side. When a lesion is found during observation, various treatments are performed on the lesion. Specifically, various treatment tools such as forceps and an incision tool are inserted from a treatment tool introduction port provided in the operation unit of the endoscope. The inserted treatment tool passes through the treatment tool channel in the insertion portion and protrudes from the distal end of the insertion portion. Various treatments such as excision and collection of a lesioned part are performed by the protruding treatment tool.

  Due to changes in the internal pressure of the body, bodily fluids, dirt, physiological saline for body washing, etc. may leak through the treatment instrument channel to the outside. In order to prevent this, a treatment tool stopper is attached to the base. The treatment instrument plug has a valve through which the treatment instrument can be inserted, and this valve is closed when the treatment instrument plug is not inserted. As such a treatment tool stopper, body fluid or the like adheres due to use, and therefore it is necessary to replace it with a new one for each use from the viewpoint of preventing infection. Therefore, a disposable type that cannot be reused is generally used.

  Patent Document 1 describes that when a treatment instrument plug is removed from the base and cannot be reused, the treatment instrument plug is destroyed using a destruction jig. In this case, the breaking jig is connected to a breaking ring provided on the side of the plug body of the treatment instrument plug. Then, by applying a force to the breaking ring using the breaking jig, the plug body breaking portion formed on the plug body is broken.

JP 2006-346197 A

  However, in Patent Document 1, in addition to the step of connecting the breaking jig to the breaking ring, it is necessary to perform a step of breaking the plug body breaking portion by applying a force to the breaking ring with the breaking jig. Is bad. Further, since the body fluid or the like is attached to the plug body, the body fluid or the like is scattered together with the fragments when the plug body breaking portion is broken, which causes a hygiene problem.

  The present invention has been made to solve the above problems, and an object thereof is to provide a plug body that can be easily removed and cannot be reused, and an endoscope including the same.

To achieve the above object, an endoscope plug body according to the present invention is an endoscope plug body that is detachably attached to an mouth portion of an endoscope via an engaging portion, and has a hole. A cylindrical plug body, and a displacement between an attachment position that is arranged inside the plug body, engages with the engaging portion and attaches the plug body to the mouth portion, and an attachment release position where the attachment is released. In the state that the removal tool is inserted from the inside of the plug body, the plug mounting hook that is pushed by the removal tool and displaced to the mounting release position, and the removal tool that is provided inside the plug body and inserted into the plug body A stopper locking portion that locks and makes the removal tool unremovable from the stopper main body.

A pushing part that is inserted into the hole of the plug body and pushes the plug mounting hook to displace it from the mounting position to the mounting release position. It is preferable to provide the removal tool which has the tool locking part locked to the stopper locking part after making it stop. Further, the stopper locking portion is a locking claw that protrudes obliquely inward with respect to the insertion direction of the removal tool, and the tool locking portion is diagonally outward with respect to the direction opposite to the insertion direction of the removal tool. It is preferable that it is the latching claw which protrudes.

  The plug mounting hook is preferably biased toward the mounting position. Moreover, it is preferable that a plurality of plug mounting hooks are provided apart from each other in the circumferential direction of the plug body.

The stopper locking portion is preferably formed integrally with the stopper body. The hole is an insertion hole through which the treatment tool is inserted, and the insertion hole is preferably closed by the removal tool. It is preferable that a slit valve having a slit through which the treatment tool is inserted is disposed in the insertion hole.

  The endoscope according to the present invention includes an insertion portion to be inserted into a body, an operation portion to which a proximal end of the insertion portion is connected, a mouth portion provided in the operation portion, and the endoscope attached to the mouth portion. And a plug for use. The mouth portion is preferably a base connected to a treatment instrument channel through which the treatment instrument is inserted.

  According to the present invention, when the removal tool is inserted into the hole of the plug body, the plug mounting hook in the plug body is displaced to the mounting release position. Thereby, the plug for endoscope can be removed from the mouth, and the plug can be easily removed from the mouth. Also, the inserted removal tool cannot be separated from the plug body by locking with the plug body by the plug locking portion. Therefore, it becomes impossible to newly attach to the mouth. In addition, since the treatment tool cannot be inserted, reuse of the plug is prevented.

  By pushing the tip of the removal tool, the plug mounting hook is brought into the mounting release position and the plug main body is removed from the mouth portion. Therefore, the plug main body can be easily removed without damage. Therefore, there is no scattering of bodily fluids due to an impact at the time of breakage of the plug body, so that it is hygienic and infection is suppressed.

It is a perspective view of an endoscope. It is a perspective view which shows a nozzle | cap | die fixing | fixed part and a treatment tool stopper. It is a disassembled perspective view which decomposes | disassembles and shows a nozzle | cap | die, a stopper attachment hook, and a stopper main body. It is a perspective sectional view showing the state where the treatment implement stopper is attached to the base. It is a disassembled perspective sectional view which decomposes | disassembles and shows a nozzle | cap | die, a stopper attachment hook, and a stopper main body. It is sectional drawing which shows the upper stage part of a hook recessed part. It is sectional drawing which shows the state which attached the treatment tool stopper to the nozzle | cap | die. It is sectional drawing which shows the state before attaching a treatment tool stopper to a nozzle | cap | die. It is sectional drawing which shows the state which penetrated the treatment tool through the treatment tool stopper. It is sectional drawing which shows the state which inserted the removal tool in the penetration hole of the treatment tool stopper, and canceled the latching by a stopper attachment hook. It is sectional drawing which shows the state which removed the treatment tool stopper from the nozzle | cap | die.

  As shown in FIG. 1, the endoscope 10 includes an insertion unit 11, an operation unit 12, and a universal cord 13, and is used as, for example, a bronchoscope that is inserted into a trachea. The insertion part 11 is inserted into the trachea. The operation unit 12 is connected to the proximal end of the insertion unit 11. The universal cord 13 is connected to a processor device, a light source device, etc. (not shown) through a composite type connector 13a.

  The insertion portion 11 is divided into a distal end rigid portion 11a, a bendable bending portion 11b, and a flexible flexible tube portion 11c in order from the distal end side to the proximal end side. In addition to the treatment instrument outlet 15 which is the outlet of the treatment instrument 14 such as forceps, an observation window and an illumination window are provided on the distal end surface of the distal rigid portion 11a, although not shown. An image sensor (not shown) or the like is arranged behind the observation window, and an optical fiber cable (not shown) is arranged behind the illumination window. A signal line and an optical fiber cable of the image sensor are connected to the processor device and the light source device through the insertion portion 11, the universal cord 13, and the connector 13a, respectively.

  A treatment instrument channel 16 for inserting the treatment instrument 14 is disposed in the insertion portion 11. One end of the treatment instrument channel 16 is connected to the treatment instrument outlet 15, and the other end is connected to a base fixing part 20 provided in the operation section 12. The treatment instrument channel 16 is also used as a path for sucking body fluid such as blood and solid matter such as filth from the treatment instrument outlet 15. A suction channel (not shown) branched from the treatment instrument channel 16 is disposed in the operation unit 12. This suction channel is connected to a suction button 19 provided on the operation unit 12.

  The suction button 19 is connected to a negative pressure source (not shown) outside the operation unit 12. The suction button 19 switches between communication and blocking of the suction passage and the negative pressure source by pressing operation or releasing the pressing operation.

  As shown in FIG. 2, a base fixing portion 20 is formed in the operation portion 12. A base 17 (see FIG. 7) is fixed to the base fixing portion 20. As shown in FIGS. 3 and 4, a treatment instrument stopper 21 is attached to the base 17. When the treatment instrument plug 21 is treated by the treatment instrument 14 (see FIG. 1), body fluid, filth, and physiological saline for washing the body pass through the treatment instrument channel 16 (see FIG. 1). Prevent leakage from 17 to the outside.

  As shown in FIG. 3, a treatment instrument introduction port 18 is provided at the upper end of the base 17. As shown in FIGS. 4 and 5, the base 17 is formed in a substantially cylindrical shape. Inside the base 17, an internal pipe line (insertion hole) 22 having one end connected to the treatment instrument introduction port 18 and the other end connected to the treatment instrument channel 16 is formed. As shown in FIG. 7, a packing housing groove 17 a is formed on the outer peripheral surface of the base 17. A packing 24 is stored in the packing storage groove 17a. The packing 24 prevents leakage of body fluid or the like from a gap between the inner peripheral surface of the base fixing portion 20 and the outer peripheral surface of the base 17.

  As shown in FIG. 5, a base engaging portion 25 and a receiving portion 26 are formed at the upper end portion of the base 17. The base engaging portion 25 is formed at the upper end of the base 17 and is constituted by an engaging flange. The treatment instrument stopper 21 is engaged with the base engaging portion 25 and is detachably attached. The receiving part 26 is composed of a disc provided separately below the base engaging part 25. The receiving portion 26 receives the lower surface of the treatment instrument stopper 21.

  As shown in FIG. 3, the treatment instrument plug 21 includes a substantially cylindrical plug body 30 and plug mounting hooks 31 to 34. The plug body 30 is made of an elastic material such as synthetic resin. The stopper body 30 is formed with an insertion hole 30a through which the treatment instrument 14 is inserted. As shown in FIGS. 3 to 5, hook recesses 30b, 30c, 30d, and 30e, a locking claw 30f as a plug locking portion, and a slit valve mounting groove 30g are formed in the insertion hole 30a in this order from the bottom. ing. Plug attachment hooks 31-34 are accommodated in the hook recesses 30b-30e.

  As shown in FIG. 6, four hook recesses 30b to 30e are formed at a 90 ° pitch in the circumferential direction. As shown in FIG. 6, the hook recesses 30 b to 30 e are formed in a sector shape whose width gradually decreases from the outside toward the cylinder core when viewed from the cylinder core direction. Further, as shown in FIG. 5, the hook recesses 30 b to 30 e are formed in a two-stepped shape in the cylinder core direction, and the stepped surface 35 is used to form the flange portions 31 c to 31 c of the plug mounting hooks 31 to 34. 34c is received.

  The plug attachment hooks 31 to 34 are arranged in the hook recesses 30b to 30e. The plug attachment hooks 31 to 34 have shapes corresponding to the hook recesses 30b to 30e when viewed from the cylinder core direction. Specifically, it has a fan shape in which the lateral width decreases from the outer surface toward the inner surface as viewed from the cylinder core direction.

  As shown in FIG. 3, the plug mounting hooks 31 to 34 include engaging claws 31 a to 34 a, clamping parts 31 b to 34 b, flange parts 31 c to 34 c, passive parts 31 d to 34 d, and main body parts 31 e to 34 e. Have. The main body portions 31e to 34e are arcuate plate-like members arranged along the cylinder core direction, and sandwiching portions 31b to 34b and passive portions 31d to 34d are disposed on the inner side (plug main body). It projects toward the cylinder core side 30). Moreover, the collar parts 31c-34c protrude toward the outer side in the approximate center of the up-down direction of the main-body parts 31e-34e. Further, engaging claws 31a to 34a protrude inward from the lower inner side of the main body portions 31e to 34e.

  As shown in FIG. 4, the engaging claw 31 a is locked to the lower surface 25 a of the base engaging portion 25 of the base 17. The sandwiching portion 31 b is locked to the upper surface 25 b of the base engaging portion 25. The base engaging portion 25 of the base 17 is sandwiched from above and below by the engaging claws 31 a and the sandwiching portion 31 b, whereby the plug body 30 is attached to the base 17. The other engaging claws 32 a to 34 a and the sandwiching portions 32 b to 32 d are similarly locked to the base engaging portion 25. As shown in FIG. 3, passive portions 31 d to 34 d protrude inward toward the cylindrical core on the upper side of the sandwiching portions 31 b to 34 b.

  As shown in FIG. 6, the collar portions 31 c to 34 c are held on both side surfaces (extending in the radial direction of the plug body 30) of the hook recesses 30 b to 30 e when viewed from above, and the collar The portions 31c to 34c have the same shape as the hook recesses 30b to 30e, and are fitted to the hook recesses 30b to 30e. For this reason, since the collar parts 31c-34c are hold | maintained at the both sides, they cannot rotate up and down. On the other hand, the engaging claws 31a to 34a, the clamping portions 31b to 34b, the passive portions 31d to 34d, and the main body portions 31e to 34e are more than the hook recesses 30b to 30e so that gaps are formed on both side surfaces of the hook recesses 30b to 30e. The width is slightly narrow.

  Accordingly, with respect to the flange portions 31c to 34c, the main body portions 31e to 34e, the engaging claws 31a to 34a, the sandwiching portions 31b to 34b, The passive portions 31d to 34d can be swung. Accordingly, the plug attachment hooks 31 to 34 are engaged with the base engaging portion 25 to attach the treatment instrument stopper 21 to the base 17 (see FIGS. 4 and 7) and an attachment release position for releasing this attachment ( (See FIG. 10). Moreover, the plug mounting hooks 31 to 34 are held at the mounting positions by the flanges 31c to 34c held by the hook recesses 30b to 30e. When the base 17 of the treatment instrument stopper 21 is attached, the base engaging portion 25 is urged so as to return to the attachment position by the restoring force of the stopper attachment hooks 31 to 34 after getting over the engaging claws 31a to 34a. Is done.

  In addition, the number of the plug attachment hooks 31-34 can be changed suitably, and should just be one or more. Moreover, in FIG. 7 to FIG. 11, the illustration of the plug attachment hook 32 on the back side is omitted.

  The locking claw 30f is formed in an annular shape over the entire circumference of the insertion hole 30a and protrudes inwardly in the insertion direction of the treatment instrument. A tool locking claw 40b of the removal tool 40 is locked to the locking claw 30f. In addition, the latching claw 30f does not necessarily have an annular shape, and may be divided in the circumferential direction.

  The slit valve mounting groove 30g is a circumferential groove formed over the entire circumference of the insertion hole 30a. The slit valve 36 is accommodated in the mounting groove 30g. The slit valve 36 is bonded to the mounting groove 30g as necessary. The slit valve 36 is made of rubber, and a slit 36a made of a cut is formed at the center. In the normal state, the contact surfaces of the slits 36a are brought into close contact by elasticity, and function as a shut-off valve. This prevents body fluid from leaking from the plug body 30. Further, when the treatment instrument 14 is inserted, the contact surface of the slit 36a comes into close contact with the peripheral surface of the treatment instrument 14, so that leakage of body fluids and the like is prevented in the same manner. The slit valve 36 is drawn with its thickness emphasized so that it can be clearly seen.

  As shown in FIG. 7, the removal tool 40 is configured by projecting a pushing portion 40a on a disk-shaped tool body 40c. The pushing portion 40a is formed in a cylindrical shape and has a diameter that can be inserted into the insertion hole 30a. A locking claw 40b is formed on the outer peripheral surface of the pushing portion 40a. The locking claw 40b is formed so as to protrude obliquely outward toward the direction opposite to the direction in which the removal tool 40 is inserted.

  The distal end portion of the pushing portion 40a is tapered. The pushing portion 40a is formed to have a length that reaches the passive portions 31d to 34d of the plug attachment hooks 31 to 34 when inserted into the insertion hole 30a of the treatment instrument plug 21. When the distal end of the pushing portion 40a abuts against the passive portions 31d to 34d and is pushed downward, as shown in FIG. 10, the engaging claws 31a to 34a including the main body portions 31e to 34e of the plug mounting hooks 31 to 34e. The clamping portions 31b to 34b and the passive portions 31d to 34d are rotationally displaced with respect to the flange portions 31c to 34c, and the engagement between the engaging claws 31a to 34a and the base engaging portion 25 is released, and the attachment is released. become.

  Further, when the removal tool 40 is pushed into the treatment instrument plug 21 until the attachment is released, the locking claw 40b gets over the locking claw 30f of the plug main body 30, and the both are locked. At this time, since the slit valve 36 is made of rubber, the slit valve 36 is easily expanded and deformed and is brought into close contact with the peripheral surface of the pushing portion 40a. It should be noted that the slit valve 36 is formed as thin as possible so that the thickness of the slit valve 36 does not hinder the locking between the removal tool 40 and the pushing portion 40a. In addition to forming the slit valve 36 thin, a slit valve housing groove 40d indicated by a two-dot chain line may be formed on the peripheral surface of the pushing portion 40a. Furthermore, although illustration is omitted, a gap may be provided between the peripheral surface of the insertion hole 30a and the outer peripheral surface of the pushing portion 40a.

  As shown in FIG. 8, in use, the treatment instrument stopper 21 is attached to the mouthpiece 17 so that the mouthpiece engaging portion 25 of the mouthpiece 17 enters the insertion hole 30 a of the treatment instrument stopper 21. As shown in FIG. 7, when the treatment instrument stopper 21 is attached to the base 17, the engaging claws 31a to 34a are locked to the lower surface 25a of the base engaging portion 25, and the holding portions 31b to 34b are locked to the upper surface 25b. To do. In this state, the upper end surfaces of the plug mounting hooks 31 to 34 are pressed by the hook recesses 30b to 30e, and the plug mounting hooks 31 to 34 are not displaced, and the locked state to the base 17 is maintained.

  Next, the operation of the above embodiment will be described. First, as shown in FIG. 8, the base engaging portion 25 of the base 17 is inserted into the insertion hole 30a from below. Each of the plug attachment hooks 31 to 34 is pressed by the base engaging portion 25 inserted into the insertion hole 30a and rotated to the attachment release position, and then returns to the attachment position. As shown in FIG. 31 a to 34 a are engaged with the base engaging portion 25. By this engagement, the treatment instrument stopper 21 is attached to the base 17.

  The operator turns on the power of the processor device, the light source device, etc. to prepare for the examination, and after the preparation for the examination is completed, the insertion portion 11 of the endoscope 10 is inserted into the trachea of the patient. The light from the light source device irradiates the inside of the trachea through the optical fiber cable in the insertion portion 11 and the illumination window of the distal end rigid portion 11a. The image sensor built in the distal end rigid portion 11a captures the inside of the trachea and outputs an imaging signal. This imaging signal is input to the processor device via the signal output cable in the insertion section 11 and the universal cord 13, and is displayed on a monitor (not shown). The operator observes the inside of the trachea through a monitor. At this time, body fluid or the like enters the internal conduit 22 of the base 17 through the treatment instrument channel 16, but since the slit 36a of the slit valve 36 is closed by the elastic force of the slit valve 36, leakage of body fluid or the like is prevented. Is prevented.

  When a lesion is found during observation in the trachea, as shown in FIG. 9, the treatment instrument 14 is inserted through the insertion hole 30a, and the slit 36a, the internal conduit 22, and the treatment instrument channel 16 are inserted in this order. And projecting from the treatment instrument outlet 15. The lesioned part is treated by the treatment tool 14 protruding from the treatment tool outlet 15. In the state where the treatment instrument 14 is inserted, the slit 36a is in a state where the inner peripheral surface of the slit is in close contact with the outer peripheral surface of the treatment instrument 14 due to the elastic force of the slit valve 36, and leakage of body fluid and the like is prevented.

  After the lesion is processed with the treatment tool 14, the treatment tool 14 is extracted from the endoscope 10. After extracting the treatment tool 14, the insertion part 11 of the endoscope 10 is extracted from the trachea. In this state, the treatment instrument stopper 21 remains attached to the base. Since body fluid or the like is attached to the treatment instrument stopper 21, it is necessary to remove the treatment instrument stopper 21 from the base 17 from the viewpoint of preventing infection.

  When removing the treatment instrument plug 21 from the endoscope 10, first, as shown in FIG. 10, the removal tool 40 is inserted into the insertion hole 30 a of the treatment instrument plug 21. When the removal tool 40 is inserted, each of the plug attachment hooks 31 to 34 is pushed by the pushing portion 40a and rotated to the attachment release position, and the engagement between the treatment instrument stopper 21 and the base 17 is released. At the same time, the tool locking claw 40 b of the removal tool 40 gets over the locking claw 30 f of the treatment tool plug 21, and the removal tool 40 is locked to the treatment tool plug 21.

  Next, as shown in FIG. 11, the treatment instrument stopper 21 is extracted from the base 17 and removed. In this state, the tool locking claw 40b is locked by the locking claw 30f, and the removal tool 40 is locked to the treatment tool plug 21 so as not to be removed. Thereby, even if it is going to reuse the treatment tool stopper 21, since the penetration hole 30a is in the state closed with the removal tool 40, it cannot be used. In addition, the engagement claw 33a can be unlocked by the removal tool 40, and can be easily removed from the base 17 without damaging the treatment instrument stopper 21. Therefore, since the treatment instrument plug 21 is not removed excessively like the removal of the treatment instrument plug 21 accompanied by a destruction operation, scattering of body fluids and the like due to breakage is prevented.

  The treatment instrument plug 21 removed from the base 17 is discarded together with the removal tool 40. Body fluid or the like adheres to the removal tool 40 when the treatment tool stopper 21 is removed. However, since it is discarded together with the treatment tool stopper 21, it is not reused and is hygienic.

  In addition, in the said embodiment, although the plug attachment hooks 31-33 are provided rotatably, you may provide it so that a slide to a horizontal direction etc., and may attach and release attachment of a treatment tool plug by a slide.

  Moreover, in the said embodiment, although the removal tool 40 is locked so that it cannot be removed by locking the tool locking claw 40b of the removal tool 40 by the locking claw 30f of the treatment tool stopper 21, the removal tool 40 is locked. The stopper locking portion for locking can be changed as appropriate. For example, a recess may be formed on one of the treatment instrument stopper 21 and the removal tool 40, and a protrusion engaging the recess may be formed on the other, and both may be locked by press-fitting.

  In the above embodiment, the removal tool 40 covers almost the entire range of the entrance of the insertion hole 30a. However, the removal tool 40 may be closed so that at least the treatment tool 14 cannot be inserted.

  In the above embodiment, the treatment instrument plug 21 attached to the base 17 leading to the treatment instrument channel 16 is described as an example. However, for example, the inside of an endoscope such as a suction channel or an air / water supply channel is described. The present invention can be applied to plugs attached to various channels and mouths connected to pipes.

  Furthermore, in each of the above-described embodiments, description has been made by taking an endoscope inserted into the trachea as an example. However, various medical endoscopes such as a colonoscope inserted into the large intestine, industrial use, etc. The present invention can also be applied to endoscopes used for other purposes.

DESCRIPTION OF SYMBOLS 10 Endoscope 16 Treatment tool channel 17 Base 21 Treatment tool stopper 30 Plug body 30a Insertion hole 30f Locking claw 31-34 Plug attachment hook 36 Slit valve 40 Removal tool

Claims (10)

In the endoscope plug body detachably attached to the mouth portion of the endoscope via the engaging portion,
A cylindrical plug body with holes formed therein;
It is arranged inside the plug body and is displaceable between an attachment position for engaging the engagement portion to attach the plug body to the mouth portion and an attachment release position for releasing the attachment. In a state where the removal tool is inserted into the plug mounting hook, the stopper mounting hook that is pushed by the removal tool and is displaced to the mounting release position;
A stopper for an endoscope, comprising: a stopper locking portion provided inside the stopper body, locked to a removal tool inserted into the stopper body, and made impossible to remove the removal tool from the stopper body. body. A pushing portion that is inserted into the hole of the plug main body and pushes the plug mounting hook to displace the mounting position from the mounting position;
A detaching tool having a tool locking part for locking to the plug locking part after the pressing part pushes the plug mounting hook to displace it from the mounting position to the mounting release position; The endoscope plug body according to claim 1, characterized in that: The stopper locking portion is a locking claw that protrudes obliquely inward with respect to the insertion direction of the removal tool, and the tool locking portion is diagonally outward with respect to a direction opposite to the insertion direction of the removal tool. 3. The endoscope plug body according to claim 2, wherein the locking claw protrudes. The plug for an endoscope according to any one of claims 1 to 3 , wherein the plug mounting hook is biased toward the mounting position . The endoscope plug body according to any one of claims 1 to 4 , wherein a plurality of the plug attachment hooks are provided apart from each other in a circumferential direction of the plug body.   The plug member for an endoscope according to any one of claims 1 to 5, wherein the plug locking portion is formed integrally with the plug main body.   The endoscope hole according to any one of claims 1 to 6, wherein the hole is an insertion hole through which a treatment tool is inserted, and the insertion hole is closed by the removal tool.   The endoscope plug body according to any one of claims 1 to 7, wherein a slit valve having a slit through which a treatment tool is inserted is disposed in the insertion hole.   The insertion part inserted in a body, the operation part to which the base end of this insertion part is connected, the opening part provided in the said operation part, The any one of Claims 1-8 attached to the said opening part An endoscope comprising: an endoscope plug body.   The endoscope according to claim 9, wherein the mouth portion is a base connected to a treatment instrument channel through which a treatment instrument is inserted.

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