JP6697301B2 - Medical equipment - Google Patents

Description

  The present invention relates to a medical device, and more particularly to a medical device used when performing an operation on an affected part in a body cavity.

  As a surgery for removing stones formed in the bile duct and in the pancreatic duct, for example, using a treatment tool projected from the distal end of an endoscope placed in the duodenum, a stone formed in the common bile duct ( Conventionally, surgery is performed to remove gallstones while appropriately crushing them.

  On the other hand, for example, in Patent Document 1, it is possible to prevent air and dirt accumulated in a body cavity during surgery or the like from leaking back through a forceps insertion channel (hereinafter also referred to as a forceps channel) of the endoscope. Techniques for doing so have been disclosed. Specifically, in Patent Document 1, in a forceps plug that can be attached to a forceps port that is an opening on the proximal side of a forceps insertion channel of an endoscope, the forceps is more suitable than the valve body provided in the forceps plug body. A configuration is disclosed in which a conduit branch member is arranged at a position close to the mouth, and dirt and the like is sucked through the forceps insertion channel and a suction tube branched from the conduit branch member.

  By the way, in the operation for removing the calculi in the common bile duct using the endoscope as described above, in order to prevent fluid such as bile from leaking to the outside unintentionally by flowing back the forceps channel, It is desirable that the operation of sucking the fluid existing in the forceps channel is always performed.

  On the other hand, according to the configuration disclosed in Patent Document 1, when the filth or the like existing in the forceps insertion channel is sucked, regardless of whether the suction tube is used or not, it is provided in the distal end hard portion of the endoscope. It is necessary to inhale from the outlet of the forceps mouth. Therefore, according to the configuration disclosed in Patent Document 1, it may be difficult to maintain the observation visual field during the operation when the dirt and the like existing in the forceps insertion channel is continuously sucked.

  Further, Patent Document 1 does not particularly mention a method or the like capable of solving the above-mentioned problems. Therefore, according to the configuration disclosed in Patent Document 1, it is difficult to prevent the fluid from unintentionally leaking to the outside while maintaining the observation field of view when performing surgery on the affected part in the body cavity. Is.

  The present invention has been made in view of the above-mentioned circumstances, and it is possible to prevent unintended leakage of fluid to the outside as much as possible while maintaining an observation visual field when performing surgery on an affected part in a body cavity. Intended to provide medical equipment.

A medical device according to one aspect of the present invention includes an insertion portion that can be inserted into a body cavity of a subject and a first opening provided inside the insertion portion and communicating with the outside of the insertion portion on a distal end side. And a first pipe line whose proximal end side is connected to a suction device for sucking fluid from the first opening, and a first pipe line that is branched from the middle of the first pipe line. A second conduit formed having a second opening communicating with the outside of the insertion portion and a fluid passage extending from the second opening to the base end side of the first conduit are formed. Along with the flow path forming member configured to be able to take in the outside air around the second opening, and a position in the middle of the first pipeline that is greater than the position where the second pipeline branches. A first flow path that is provided on the end side and allows the fluid sucked from the first opening to flow directly through the flow path when the suction device sucks the fluid to the base end side of the first pipeline. A switching valve that switches to either the flow path or a second flow path that allows the fluid sucked from the second opening to flow to the proximal end side of the first conduit via the flow path forming member; , I have a,
The flow path forming member is capable of inserting a treatment tool that is inserted into the first conduit through the second opening and the second conduit, and regardless of whether or not the treatment tool is inserted. Further having a hole around the second opening for taking in outside air,
The hole is formed so that when the treatment tool is not inserted and when the treatment tool having a diameter smaller than a predetermined outer diameter is inserted, a gap is formed in contact with the outside air around the second opening. It is formed by combining a round hole and a slit hole formed so as to form a gap in contact with the outside air around the second opening when the treatment tool having the predetermined outer diameter or more is inserted. medical equipment that characterized the child is.

  According to the medical device of the present invention, it is possible to prevent unintended leakage of fluid to the outside as much as possible while maintaining an observation visual field when performing an operation on an affected part in a body cavity.

The figure which shows the structure of the principal part of the endoscope system containing the suction adapter which concerns on an Example. Sectional drawing for demonstrating an example of a structure of the part which belongs to the forceps plug side among the suction adapters which concerns on an Example. The top view for demonstrating an example of a structure of the part which belongs to the forceps plug side among the suction adapters which concerns on an Example. Sectional drawing for demonstrating an example of a structure of the part which belongs to the suction switch side among the suction adapters which concerns on an Example. The figure which shows an example of the treatment tool used with the suction adapter which concerns on an Example. VI-VI sectional view taken on the line of FIG. VII-VII sectional view taken on the line of FIG. The figure which shows an example at the time of inserting the proximal end side of the treatment tool shown in FIG. The figure which shows an example at the time of inserting the proximal end side of the treatment tool shown in FIG. The figure which shows an example in case the part which belongs to the suction switch side of the suction adapter which concerns on an Example is pressed.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings.

  1 to 10 relate to an embodiment of the present invention.

  As shown in FIG. 1, the endoscope system 101 is configured to be insertable into a body cavity of a subject and to image a subject such as a biological tissue in the body cavity and output an image pickup signal. A light source device 3 configured to supply illumination light used for observing the subject through a side-view endoscope 2 and a light guide (not shown) that is inserted and arranged inside the endoscope 2. A video processor 4 configured to generate and output a video signal or the like corresponding to the image pickup signal output from the endoscope 2, and an observation image or the like corresponding to the video signal output from the video processor 4. It has a display device 5 configured to display and a suction device 6. FIG. 1 is a diagram illustrating a configuration of a main part of an endoscope system according to an embodiment.

  The endoscope 2 has an elongated insertion portion 21 that can be inserted into the body cavity of the subject, and an operation portion 22 provided on the proximal end side of the insertion portion 21. Further, the endoscope 2 has a configuration that can be attached to and detached from each of the light source device 3, the video processor 4, and the suction device 6 via a universal cable 28 extending from the operation unit 22.

  Specifically, as shown in FIG. 1, the endoscope 2 is configured to be attachable to and detachable from the light source device 3 via a universal connector 29 at the end of the universal cable 28, for example. Further, the endoscope 2 is configured to be attachable to and detachable from the video processor 4 via a connector 29C at an end portion of a signal cable 29B extending from the universal connector 29, as shown in FIG. 1, for example. .. Further, the endoscope 2 is connected to the suction device 6 via a suction mouthpiece 29A provided on the universal connector 29 and a suction tube 6A connected to the suction mouthpiece 29A, as shown in FIG. 1, for example. It is configured to be removable.

  At the distal end portion 23 of the insertion portion 21, a subject existing on the side of the distal end portion 23 (direction orthogonal to the longitudinal axis direction of the insertion portion 21) is emitted through the light guide of the endoscope 2. An illumination window (not shown) including a lens or the like for illuminating the illumination light is provided. Further, the distal end portion 23 of the insertion portion 21 is provided with an observation window (not shown) including a lens and the like for obtaining an optical image of a subject illuminated by the illumination light from the illumination window. Further, at the distal end portion 23 of the insertion portion 21, an imaging signal is generated by capturing an optical image of a subject obtained through the observation window, and a signal line (not shown) built in the endoscope 2 is used. An image sensor (not shown) such as a CCD configured to output the generated image pickup signal to the video processor 4 is provided.

  A forceps channel 25 formed in a shape through which an elongated treatment instrument 71 can be inserted is provided in a portion from the distal end portion 23 to the universal connector 29 inside the endoscope 2.

  The forceps channel 25 has a function as a suction port for sucking a foreign substance existing on the side of the distal end portion 23, and a treatment instrument 71 inserted through a treatment instrument insertion channel 26 described later to the side of the distal end portion 23. The distal end side opening 25A having the function of the treatment tool projecting port for projecting is also formed. That is, the forceps channel 25 is formed by including the tip end side opening 25A communicating with the tip end portion 23 of the insertion portion 21 to the outside at the tip end side end portion. The proximal end of the forceps channel 25 is connected to the suction device 6. In addition, inside the forceps channel 25 in the vicinity of the distal end side opening 25A, the treatment tool 71 can be raised to be projected to the side of the distal end portion 23, and a raising lever ( A forceps raising base 25B configured to change the protruding direction of the treatment tool 71 according to an operation (not shown) is provided.

  The forceps channel 25 is formed with a treatment instrument insertion channel 26 branched from a predetermined position on the proximal end side of the insertion portion 21.

  The treatment instrument insertion channel 26 includes a treatment instrument insertion port 26A which is an opening formed in a shape to which the forceps plug 27 can be attached and detached, and the treatment instrument 71 inserted into the inside through the treatment instrument insertion port 26A is inserted into the forceps channel 25. It is configured so that it can be inserted into the tip side opening 25A side. That is, the treatment instrument insertion channel 26 is provided so as to be branched from the middle of the forceps channel 25, and is provided with a treatment instrument insertion port 26A communicating with the outside of the insertion portion 21.

  For example, as shown in FIG. 2, the forceps plug 27 is attachable to and detachable from a plug body 27A that is formed into a substantially cylindrical shape that is attachable to and detachable from the mouthpiece 26B of the treatment instrument insertion port 26A, and the top portion of the plug body 27A. And a lid 27B formed in a substantially cylindrical shape.

  The plug 27A is made of, for example, an elastic material such as silicone rubber. Further, the stopper 27A is provided with a mounting portion 271 formed on the bottom portion so that it can be attached to the mouthpiece 26B by elastically deforming according to the shape of the mouthpiece 26B. Further, as shown in FIG. 2, a small hole 272 which is a circular hole is provided in the center of the inside of the plug 27A.

  The lid 27B is made of, for example, an elastic material such as silicone rubber. Further, as shown in FIG. 2, a slit 273 arranged at a position facing the small hole 272 when the lid 27B is mounted on the top of the plug 27A is formed in the central portion inside the lid 27B. ing.

  That is, the forceps plug 27 is configured to have a valve portion formed by the small hole 272 and the slit 273 that elastically deform according to the thickness of the treatment instrument 71 inserted from the top.

  On the other hand, on the top of the forceps plug 27, as shown in FIGS. 1 and 2, a lid-shaped member 31A which is one of two lid-shaped members communicating with each other via the suction tube 31C of the suction adapter 31 is provided. It is installed. FIG. 2 is a cross-sectional view for explaining an example of the configuration of the portion of the suction adapter according to the embodiment that belongs to the forceps plug side.

  The lid-shaped member 31A is formed, for example, in a substantially concave shape having a bottom surface portion 314 and is made of an elastic material such as silicone rubber. Further, the lid-shaped member 31A is formed, for example, as shown in FIG. 2, by providing a mounting portion 311 having a shape attachable / detachable with respect to the top of the lid 27B attached to the plug 27A on the inner peripheral surface. Has been done. Further, as shown in FIG. 2, the side portion of the lid-shaped member 31A communicates with a suction tube 31C which is a hollow tubular body. Further, the lid-shaped member 31A is configured to form a flow path of a fluid from the slit 273 to the suction tube 31C while substantially covering the outer surface of the top portion of the lid body 27B when the attachment portion 311 is attached. Has been done. Further, the central portion of the bottom surface portion 314 of the lid-shaped member 31A is provided with a shape capable of inserting the treatment instrument 71 that is inserted into the forceps channel 25 through the treatment instrument insertion opening 26A and the treatment instrument insertion channel 26, and has a lid. A hole 310 is formed at a position facing the slit 273 when the lid-shaped member 31A is attached to the top of the lid 27B.

  As shown in FIGS. 2 and 3, the hole 310 is a combination of a circular hole 312, which is a circular hole, and a slit hole 313, which is a linear hole extending from the circumference of the circular hole 312. Is formed. FIG. 3 is a plan view for explaining an example of the configuration of the portion of the suction adapter according to the embodiment that belongs to the forceps plug side.

  That is, according to the configuration as described above, the treatment instrument 71 is inserted into the treatment instrument insertion channel 26 from the hole 310 of the bottom surface portion 314 with the lid-shaped member 31A attached to the top portion of the forceps plug 27. can do. Further, according to the configuration described above, for example, when the treatment tool 71 is not inserted into the hole 310 and when the treatment tool 71 having a smaller outer diameter is inserted into the hole 310, While the slit hole 313 is substantially closed, a gap is formed in the round hole 312 in contact with the outside air around the treatment instrument insertion opening 26A. Further, according to the configuration described above, for example, when the treatment tool 71 having a predetermined outer diameter or more is inserted into the hole 310, the round hole 312 is substantially closed while the treatment tool insertion is performed. A gap is formed in the slit hole 313 in contact with the outside air around the mouth 26A. Therefore, the lid-shaped member 31A can take in outside air around the treatment instrument insertion opening 26A from the hole 310 (at least one of the round hole 312 and the slit hole 313) regardless of whether or not the treatment instrument 71 is inserted. It is configured to be able to.

  The operation unit 22 is configured to have a shape that can be held and operated by a user such as an operator. Further, the operation unit 22 is provided with a scope switch (not shown) including one or more switches capable of giving an instruction to the video processor 4 according to an input operation of the user. There is. Further, the operation unit 22 is provided with a suction switch 22A formed as a push button switch capable of switching a flow path when the suction device 6 sucks a foreign substance including a fluid, in accordance with a pressing operation by a user. .. That is, the suction switch 22A is provided in the middle of the forceps channel 25, closer to the base end side than the position where the treatment instrument insertion channel 26 branches.

  The suction switch 22A is a first flow that causes the fluid sucked from the distal end side opening 25A to directly flow to the proximal end side of the forceps channel 25 through the flow path when the suction device 6 sucks the fluid according to the pressing operation of the user. Function as a switching valve that can be switched to either the passage or the second flow path that allows the fluid sucked from the treatment instrument insertion port 26A to flow to the proximal end side of the forceps channel 25 via the suction adapter 31. It is equipped and configured. Further, as shown in FIG. 4, the suction switch 22A is extended from the center of the pressing member 221 having the pressing surface 221a pressed by the user and the bottom surface 221b which is the surface opposite to the pressing surface 221a. The columnar support member 222, the coil spring 223 wound so as to substantially cover the side surface of the support member 222, the support member 222 and the coil spring 223 are housed inside, and at a position facing the bottom surface 221b. And an enclosure member 224 formed in a thick-walled cylindrical shape having an opening 224a and an opening edge portion 224b. FIG. 4 is a cross-sectional view for explaining an example of the configuration of the portion of the suction adapter according to the embodiment that belongs to the suction switch side.

  The pressing member 221 is biased in advance in a direction in which the pressing surface 221a is separated from the enclosing member 224 by the biasing force of the coil spring 223 attached to the bottom surface 221b.

  A communication pipe C1 which is a substantially T-shaped pipe line is provided at the bottom of the support member 222.

  The communication pipe C1 is formed by providing an intake port IN for admitting the fluid flowing from the suction tube 31C through the opening 224a to the inside at a position adjacent to the bottom of the support member 222. Further, the communication pipe C1 has a side surface of the support member 222 when the pressing surface 221a of the pressing member 221 is not pressed, that is, when an external force exceeding the biasing force of the coil spring 223 is not applied to the pressing surface 221a. While the space formed by the inner peripheral surface of the enclosing member 224 is communicated with the portion of the forceps channel 25 that belongs to the proximal end side (the universal cable 28 side), the forceps channel 25 moves toward the distal end side (the insertion portion 21 side). The belonging portion is configured not to communicate with the portion belonging to the base end side. The communication pipe C1 has a side surface of the support member 222 when the pressing surface 221a of the pressing member 221 is pressed, that is, when an external force exceeding the urging force of the coil spring 223 is applied to the pressing surface 221a. And the space formed by the inner peripheral surface of the enclosing member 224 is prevented from communicating with the portion of the forceps channel 25 on the proximal side, while the portion of the forceps channel 25 on the distal side communicates with the portion on the proximal side. Is configured to let.

  On the other hand, as shown in FIGS. 1 and 4, the suction switch 22A is provided with a lid-shaped member 31B that is one of two lid-shaped members that communicate with each other via the suction tube 31C of the suction adapter 31. ing.

  The lid-shaped member 31B is formed, for example, in a substantially concave shape having a bottom surface portion 324, and is made of an elastic material such as silicone rubber. Further, for example, as shown in FIG. 4, the lid-shaped member 31B has an inner peripheral surface having a mounting portion 321 having a shape attachable to and detachable from a groove portion CS having a substantially concave shape formed on the outer surface of the enclosing member 224. It is provided and formed. Further, as shown in FIG. 4, the side portion of the lid-shaped member 31B communicates with a suction tube 31C which is a hollow tubular body. In addition, the lid-shaped member 31B covers the outer surface of the pressing member 221 when the mounting portion 321 is mounted in the groove CS of the enclosing member 224, and at the same time, the flow of the fluid from the suction tube 31C through the opening 224a to the communication pipe C1. Is configured to form a passage.

  That is, according to the configuration as described above, the suction adapter 31 forms a fluid flow path from the treatment instrument insertion port 26A to the proximal end side of the forceps channel 25, and surrounds the treatment instrument insertion port 26A. It is configured as a flow path forming member capable of constantly taking in outside air. Specifically, the suction adapter 31 includes a hole 310 and a lid-like member 31A that forms a fluid flow path in a state of being attached to the forceps plug 27 on the treatment instrument insertion port 26A side, and the suction switch 22A side. And a suction tube 31C formed as a communication tube for communicating the lid-shaped members 31A and 31B with each other. There is.

  Further, according to the above-described configuration, the suction switch 22A does not close the first flow path when the bottom surface portion 324 of the lid-shaped member 31B attached to the enclosing member 224 is not pressed. It is configured so that the second flow path described above can be brought into a communicating state while being in a communicating state. In addition, the suction switch 22A keeps the above-mentioned first flow path in a communicating state and presses the above-mentioned second flow path when the bottom surface portion 324 of the lid-shaped member 31B attached to the support member 222 is pressed. Is configured to be in a non-communication state.

  The light source device 3 includes, for example, a white light source, and is configured to be able to supply white light emitted from the white light source as illumination light.

  The video processor 4 is configured to generate and output a drive signal for driving the image pickup device of the endoscope 2 when the connector 29C is connected. Further, the video processor 4 performs signal processing such as noise removal, white balance and gamma correction on an image pickup signal output from the image pickup device of the endoscope 2 when the connector 29C is connected. Is configured to generate a video signal and output the generated video signal to the display device 5.

  The suction device 6 is provided outside the endoscope 2 and includes a suction pump and the like. Further, the suction device 6 is configured to perform a suction operation for sucking a foreign substance containing a fluid from the distal end side opening 25A of the endoscope 2 connected via the suction mouthpiece 29A and the suction tube 6A. ..

  Next, the operation of the endoscope system 101 according to this embodiment will be described. In the following description, it is assumed that the suction operation by the suction device 6 is always performed. Further, in the following, a case of performing a surgery for removing a calculus in the common bile duct while using a catheter 72 having a monorail type structure as shown in FIG. 5 as a treatment tool 71 will be described as an example. .. FIG. 5: is a figure which shows an example of the treatment tool used with the suction adapter which concerns on an Example.

  First, the structure of the catheter 72 will be described below.

  As shown in FIG. 5, the catheter 72 is inserted into the elongated treatment instrument body 73 from the distal end side of the treatment instrument body 73, and is exposed to the outside through an opening 73A provided in the middle of the treatment instrument body 73. And a guide wire 74 which is arranged in a closed state.

  As shown in FIGS. 5 to 7, the treatment tool main body 73 has a guide wire insertion conduit 73B that is a conduit through which the guide wire 74 can be inserted, and a conduit for performing a predetermined treatment. Is configured. The above-mentioned pipeline is, for example, an air supply pipeline 73C that is a pipeline through which a gas such as air supplied from the base end side can be circulated to expand a balloon arranged on the distal end side, And a liquid delivery conduit 73D which is a conduit through which a liquid such as a contrast agent supplied from the end side can be circulated and discharged from the front end side. FIG. 6 is a sectional view taken along line VI-VI of FIG. FIG. 7 is a sectional view taken along line VII-VII in FIG.

  That is, according to the catheter 72 having the above-described structure, for example, the distal end side of the guide wire 74 inserted through the treatment instrument insertion channel 26 and the forceps channel 25 is protruded from the distal end side opening 25A and the body cavity is opened. By inserting the proximal end side of the guide wire 74 into the guide wire insertion conduit 73B while inserting the catheter 72 along the guide wire 74 while leaving the catheter 72 indwelled at a desired site inside the treatment tool main body 73. The tip side can be arranged at the desired site.

  The treatment tool main body 73 illustrated in FIGS. 5 to 7 is mainly used when performing a treatment of administering a contrast agent into the common bile duct for confirming the position of the stone and the presence or absence of stenosis due to the stone. Is. Therefore, when removing a calculus in the common bile duct using the catheter 72 having the structure described above, for example, the distal end side of the guide wire 74 protruding from the distal end side opening 25A is placed in the common bile duct. With the indwelling operation, an operation is performed to replace the treatment tool main body 73 (which is different from the one illustrated in FIGS. 5 to 7) according to the treatment such as expansion of the teat and quarrying.

  Next, the operation of the endoscope system 101 in the case of performing an operation for removing a stone in the common bile duct using the catheter 72 will be described.

  The user inserts the insertion part 21 into the deep part of the body cavity of the subject while checking the observation image displayed on the display device 5 after connecting the respective parts of the endoscope system 101 and turning on the power. Thus, the distal end portion 23 is arranged at a position where the papilla communicating with the common bile duct in the body cavity can be visually recognized. After that, the user inserts the guide wire 74 into the forceps plug 27, the treatment instrument insertion channel 26, and the forceps channel 25 from the hole 310 of the lid-shaped member 31A attached to the top of the forceps plug 27, and The tip side is projected from the tip side opening 25A. Then, the user inserts the proximal end side of the guide wire 74 into the guide wire insertion conduit 73B while inserting the distal end side of the guide wire 74 into the common bile duct from the papilla and leaving the guide wire 74 along the guide wire 74. After inserting the catheter 72 and arranging the distal end side of the treatment instrument main body 73 in the common bile duct, a treatment of administering a contrast agent into the common bile duct via the liquid feeding conduit 73D is performed.

  Here, a state in which the pressure inside the body cavity exceeds the pressure outside the endoscope 2 is highly likely to occur due to an air supply operation performed in the endoscope 2. In addition, in the procedure of administering the contrast agent into the common bile duct via the liquid delivery conduit 73D of the treatment instrument main body 73, that is, in the procedure using the monorail type catheter 72, the guide wire on the proximal end side of the catheter 72 is used. Since 74 is inserted into the forceps plug 27 in a state where it is exposed to the outside of the treatment instrument main body 73 (a state as shown in FIG. 7), a gap is formed in both the small hole 272 and the slit 273 that form the valve portion of the forceps plug 27. Occurs (see FIGS. 8 and 9). Therefore, during the treatment of administering the contrast agent into the common bile duct from the liquid delivery conduit 73D of the treatment instrument main body 73, the fluid such as bile accumulated in the common bile duct flows backward through the forceps channel 25 and the forceps. It is considered that the plug 27 easily leaks to the outside unintentionally. 8 and 9 are views showing an example of a case where the proximal end side of the treatment tool shown in FIG. 5 is inserted into the forceps plug.

  On the other hand, in the present embodiment, even if the suction switch 22A is not pressed by the user, the fluid (gas and liquid) leaking from the forceps plug 27 to the outside is passed through the suction adapter 31 through the flow path. Can be aspirated. Specifically, in the present embodiment, even when the suction switch 22A is not pressed by the user, the fluid leaking from the forceps plug 27 to the outside is sucked into the suction adapter 31 and the opening 224a of the suction switch 22A. A fluid such as bile can be sucked in the flow path passing through (the intake port IN of) the communication pipe C1 and each part of

  On the other hand, when the user visually recognizes a foreign substance existing on the side of the distal end portion 23 in the observation image displayed on the display device 5, for example, as shown in FIG. 10, the lid-shaped member attached to the support member 222 is used. The operation of pressing the pressing surface of the pressing member 221 from the outside of the bottom surface portion 324 of 31B is performed. FIG. 10: is a figure which shows an example when the part which belongs to the suction switch side of the suction adapter which concerns on an Example is pressed.

  Then, the communication pipe C1 (and the intake port IN) is pushed down in response to the pressing operation of the pressing member 221 by the user, so that the intake port IN of the communication pipe C1 and the forceps channel 25 communicate with each other, so that the distal end side opening is formed. The part of the forceps channel 25 that communicates with the distal end side of the forceps channel 25 and the part of the forceps channel 25 that belongs to the proximal end side of the forceps channel 25 are in communication with each other. Further, in this embodiment, as illustrated in FIG. 10, the bottom surface 221b is pushed down in response to the pressing operation of the pressing member 221 by the user, so that the outer edge portion of the pressing member 221 (bottom surface 221b) is the opening edge portion 224b. Since it enters inside (the inside of the enclosure member 224), the opening 224a is substantially closed. That is, in the state described above, the fluid sucked by the suction device 6 flows from the distal end side of the forceps channel 25 to the proximal end side of the forceps channel 25 via the communication pipe C1, while the fluid of the support member 222 Since it does not substantially flow into the space formed by the side surface and the inner peripheral surface of the enclosure member 224, the fluid flow path from the suction tube 31C to the communication pipe C1 is in a non-communication state. Therefore, when the user performs a pressing operation on the pressing member 221, the flow path for suctioning the foreign matter including the fluid is changed from the flow path passing through the suction adapter 31 to the distal opening 25A and the communication pipe. The flow path is switched to via C1.

  As described above, according to this embodiment, even when the suction switch 22A is not pressed by the user, the treatment tool is used instead of the gas existing around the distal end side opening 25A inserted into the body cavity. While sucking the outside air around the insertion opening 26A, the fluid can be sucked through the flow path passing through the treatment tool insertion opening 26A and the suction adapter 31. Therefore, according to the present embodiment, it is possible to prevent the unintended leakage of fluid such as bile to the outside as much as possible while maintaining the observation visual field when performing surgery on the affected part in the body cavity.

  In the present embodiment, for example, in order to prevent the fluid sucked in the flow path passing through the treatment instrument insertion opening 26A and the suction adapter 31 from flowing back into the treatment instrument insertion channel 26, for example, a suction tube. A check valve may be provided inside 31C.

  Further, in the present embodiment, the lid-shaped member 31A and the forceps plug 27 are not limited to being formed separately, and the lid-shaped member 31A and the forceps plug 27 may be integrally formed. Specifically, for example, the slit 273 of the lid 27B may be replaced with the hole 310, and the bottom side of the lid 27B with respect to the hole 310 may be communicated with the suction tube 31C.

  The present invention is not limited to the embodiments described above, and it goes without saying that various modifications and applications are possible without departing from the spirit of the invention.

2 endoscope 3 light source device 4 video processor 5 display device 6 suction device 21 insertion part 22 operation part 22A suction switch 23 tip part 25 forceps channel 25A tip side opening 26 treatment instrument insertion channel 26A treatment instrument insertion port 27 forceps plug 31 suction Adapter 101 endoscope system

JP-A-7-184847

Claims (1)

An insertion part that can be inserted into the body cavity of the subject,
The suction device for suctioning fluid from the first opening is provided with a first opening provided inside the insertion portion and communicating with the outside of the insertion portion on the distal end side, A connected first line,
A second pipeline formed by branching from the middle of the first pipeline and having a second opening communicating with the outside of the insertion portion;
A flow path forming member configured to form a flow path of a fluid from the second opening to the base end side of the first pipeline and to take in outside air around the second opening. When,
In the middle of the first pipeline, the second pipeline is provided on the proximal side of the branched position, and the flow path when the suction device sucks fluid is defined by the first pipeline. The first flow path that allows the fluid sucked from the opening to directly flow to the base end side of the first conduit, or the fluid sucked from the second opening via the flow path forming member A switching valve that switches to any of the second flow paths that are circulated to the proximal end side of the pipeline of
Have
The flow path forming member is capable of inserting a treatment tool that is inserted into the first conduit through the second opening and the second conduit, and regardless of whether or not the treatment tool is inserted. Further having a hole around the second opening for taking in outside air,
The hole is formed so that when the treatment tool is not inserted and when the treatment tool having a diameter smaller than a predetermined outer diameter is inserted, a gap is formed in contact with the outside air around the second opening. It is formed by combining a round hole and a slit hole formed so as to form a gap in contact with the outside air around the second opening when the treatment tool having the predetermined outer diameter or more is inserted. medical equipment that characterized the child is.

Images