JPH1142207A - Parent and child type endoscope apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a parent and child type endoscope apparatus by which the operation until a child scope is inserted is easy and a good observational image can be obtd. by the child scope. SOLUTION: In this parent and child endoscope apparatus, an overcoat sheath 20 being freely inserted and removable in an inserting channel for a treating tool of a parent scope 10 and having a longer effective length than the whole length of the above described inserting channel for the treating tool, a contrast medium feeding tube 30 being freely inserted and removable in the overcoat sheath 20 and having a longer effective length than the whole length of the overcoat sheath 20 and a child scope being freely inserted and removable in the overcoat sheath 20 and having a longer effective length than the whole length of the overcoat sheath 20, are provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a parent-child type endoscope apparatus in which a contrast agent is injected into a bile duct or the like and a child scope is inserted so that the inside of the bile duct or the like can be observed.

[0002]

2. Description of the Related Art It is not easy to insert an endoscope into a bile duct or the like and observe the inside. Therefore, conventionally, the tip of the contrast agent injection tube inserted into the treatment instrument insertion channel of the parent scope is inserted into the bile duct from the duodenum side to inject the contrast agent into the tube, and then the tip of the guide wire passed through the contrast agent injection tube is inserted. The child scope was placed in the bile duct, the contrast medium injection tube was removed in that state, and instead, a guide wire was passed through the insertion channel of the child scope, and the child scope was guided into the bile duct along the guide wire.

[0003]

However, even if it is quite troublesome to just image the inside of the bile duct endoscopically, the distal end of the guide wire must first be placed in the bile duct. Since the insertion of the patient is only then, the operation is very complicated and time-consuming, and the doctor and the patient are often tired.

[0004] Further, since the insertion scope for passing the guide wire must be provided in the child scope in which the diameter of the insertion portion must be reduced to about 2 mm, the optical performance of the child scope is sacrificed and the inside of the bile duct is sacrificed. A good observation image could not be obtained.

SUMMARY OF THE INVENTION It is therefore an object of the present invention to provide a parent-child type endoscope apparatus in which an operation until a child scope is inserted is easy and a good observation image can be obtained by the child scope.

[0006]

In order to achieve the above-mentioned object, a parent-child type endoscope apparatus according to the present invention is capable of being inserted into and removed from a treatment instrument insertion channel of a parent scope and having an effective length longer than the entire length of the treatment instrument insertion channel. A sheath sheath having a length, a contrast agent injection tube which can be inserted into and removed from the outer sheath and has an effective length longer than the entire length of the outer sheath; and an effective tube which can be inserted into and removed from the outer sheath and longer than the entire length of the outer sheath. A child scope having a length is provided.

[0007] The child scope may not be provided with an insertion channel, and the distal end of the outer sheath may be formed in a tapered shape that gradually narrows toward the front.

It is preferable that a coupling mechanism is provided for coupling the proximal end portion of the outer sheath and the proximal end portion of the contrast medium injection tube in a detachable manner.

[0009]

Embodiments of the present invention will be described with reference to the drawings. FIG. 1 shows a bile duct 1 through a parent scope 10.
00, insert the tip of the contrast medium injection tube 30 into
A state where a contrast agent is injected into the bile duct 100 is shown.

The parent scope 10 is a so-called duodenal fiber scope of a side view type. A flexible tubular insertion part 12 is connected to an operation part 11, and the bending part is bendable by remote operation from the operation part 11. Reference numeral 13 is connected to the distal end of the insertion section 12, and a distal end body 14 having an objective optical system and the like is connected to the distal end of the bending section 13.

A treatment tool insertion channel for inserting treatment tools is disposed through the inside of the insertion portion 12 and the curved portion 13, and a treatment tool insertion port 15 is provided to project from a lower portion of the operation portion 11. The treatment tool outlet 16 is formed on the side surface of the distal end body 14 with an opening.

The contrast medium injection tube 30 is not directly passed through the treatment instrument insertion channel, but the flexible tube 31 of the contrast medium injection tube 30 is connected to the outer sheath 20.
Is passed through, and the base 32 provided at the base end of the contrast agent injection tube 30 is connected to the base 22 provided at the base end of the outer sheath 20, and the contrast agent injection tube 30 and the outer sheath 20 are connected to each other. Are used in an integrated state.

The effective length of the mantle sheath 20 (ie, the length of the flexible tube 21) is formed to be longer than the entire length of the treatment tool insertion channel. When the flexible tube 21 is fully inserted into the channel, the distal end portion 21a of the flexible tube 21 is formed to have a length protruding from the treatment instrument outlet 16 by, for example, about 5 to 10 cm.

However, in a state where the sheath 20 is used in combination with the contrast medium injection tube 30, the distal end portion of the flexible tube 31 of the contrast medium injection tube 30 projects from the treatment instrument outlet 16 into the bile duct 100. When in the inserted position, the flexible tube 21 of the outer sheath 20 and the contrast medium injection tube are so positioned that the distal end portion 21 a of the flexible tube 21 of the outer sheath 20 is located immediately before the root of the curved portion 13. The length difference between the flexible tube 31 and the flexible tube 31 is set.

In such a state, the contrast medium injection tube 30
The tip of the flexible tube 31 is inserted into the bile duct 100, and a contrast agent is injected from an injection mouth 33 protruding from a base mouth 32 of the contrast agent injection tube 30.
The contrast agent can be sent out into the bile duct 100 to obtain an X-ray contrast image of the bile duct 100.

After the injection of the contrast agent into the bile duct 100,
As shown in FIG.
The coupling between the contrast agent injection tube 30 and the base 32 is released, and only the outer sheath 20 is pushed into the treatment instrument insertion port 15 without moving the contrast agent injection tube 30.

Then, the distal end portion 21a of the flexible tube 21 of the mantle sheath 20 protrudes from the treatment instrument outlet 16, and
The flexible tube 31 is inserted into the bile duct 100 using the flexible tube 31 as a guide.

In this state, the contrast medium injection tube 30 is removed without moving the mantle sheath 20, and
As shown in FIG. 3, by inserting the insertion portion 42 of the child scope 40 into the mantle sheath 20, the distal end of the insertion portion 42 of the child scope 40 is inserted into the bile duct 100 by using the mantle sheath 20 as a guide. Bile duct 10 with scope 40
Inside 0 can be observed.

FIG. 4 is an external view showing a state in which the mantle sheath 20 and the contrast medium injection tube 30 are connected to both hand bases 22 and 32. Reference numeral 39 denotes an index formed on the outer peripheral surface near the distal end of the flexible tube 31 of the contrast medium injection tube 30.

FIG. 5 shows the mantle sheath 20 in the coupled state.
5 shows the structure of the bases 22 and 32 of the contrast agent injection tube 30. Flexible tube 2 of mantle sheath 20
Numeral 1 is formed of a fluororesin tube or the like having a small frictional resistance and is fixed to the base 22 by a tube holding member 24 screwed to the base 22.

The base 22 of the mantle sheath 20 is formed in a T-shape. The injection base 23 protruding from the side of the mantle sheath 20 allows the inside of the flexible tube 21 to be cleaned when the inside of the bile duct 100 needs to be cleaned. A lavage solution or the like can be injected into the bile duct 100 via the.

The flexible tube 31 of the contrast agent injection tube 30 is formed of a fluororesin tube or the like having a small frictional resistance and having a thickness detachable from the flexible tube 21 of the outer sheath 20. It is pressed and fixed to the base 32 by a tube holding member 34 screwed with the base 32.

The base 32 of the contrast medium injection tube 30 is formed in a T-shaped tube. A syringe or the like is connected to the injection base 33 protruding from the side of the tube, and the contrast medium is injected into the flexible tube 21. be able to.

A flexible tube 31 is provided to prevent the flexible tube 31 from buckling during the pushing operation.
A fixing knob 36 to which a base end portion of the metal core 35 is fixed is screwed and fixed to a protruding end side of the base die 32. 37 is an O-ring for sealing.

A nut 26 is screwed and fixed to the protruding end of the base 22 of the mantle sheath 20. A groove-shaped portion formed between the inner surface of the nut 26 and the protruding end of the base 22 has elasticity. A rubber O-ring 27 is loaded.

The tube holding member 34 of the contrast medium injection tube 30 has a tapered tapered outer surface at the front half, and that portion is formed inside the nut 26 from the hand base 2.
2 is inserted. A circumferential groove 38 with which the O-ring 27 is engaged is formed on the outer peripheral surface of the tube holding member 34 located inside the O-ring 27 when the O-ring 27 is fully inserted.

As a result, as shown in FIG. 5, when the contrast medium injection tube 30 is fully inserted into the outer sheath 20, the O-ring 27 engages with the circumferential groove 38, and the so-called click is performed. In this state, the contrast medium injection tube 30 and the sheath 20 are connected.

Since the engagement between the O-ring 27 and the circumferential groove 38 is elastic, the hand base 3 of the contrast medium injection tube 30 is
When a force is applied in a direction in which the outer ring 2 is strongly pulled out from the base 22 of the mantle sheath 20, the engagement between the O-ring 27 and the circumferential groove 38 is released, and as shown in FIG. The connection with 30 is released, and it becomes relatively movable in the axial direction.

Further, the contrast medium injection tube 3
If the hand cap 32 is pushed firmly into the hand cap 22 side of the mantle sheath 20, the O-ring 27 is engaged with the circumferential groove 38, and the contrast medium injection tube 30 and the mantle sheath 20 are connected in a clickable state. Can be done.

FIG. 7 shows the distal end portion 21a of the flexible tube 21 of the outer sheath 20. After the injection of the contrast agent by the contrast agent injection tube 30, the flexible tube 21 of the outer sheath 20 is pushed forward. The distal end portion 21a must be inserted into the bile duct 100.

The distal end portion 21a is formed in a tapered shape so that the flexible tube 21 of the mantle sheath 20 can be smoothly advanced without being caught. It is in close contact with the surface of the tube 31.

FIG. 8 shows a child scope 40 in which a base end of an insertion section 42 is connected to a lower end of an operation section 41. The diameter of the insertion portion 42 is, for example, about 2 mm, and the length (effective length) is formed to be longer than the entire length of the outer sheath 20. 43 is an eyepiece, and 44 is a light guide connector connected to a light source device (not shown).

FIG. 9 shows the distal end of the insertion section 42 of the child scope 40. The insertion section 42 is covered with a flexible tube 46 over the entire length, and a distal end main body 47 is connected to a distal end thereof.

As shown in FIG. 10, an observation window 48 and an illumination window 51 are disposed on the distal end surface of the distal end main body 47, and an objective optical system 49 disposed inside the observation window 48 is provided.
The incident end face of the image guide fiber bundle 50 is arranged at the image forming position of the subject by the above.

An emission end of a light guide fiber 52 made of plastic is arranged inside the illumination window 51.
A glass bead 53 for improving the light distribution of the illumination light emitted from the light guide fiber 52 and protecting the end face of the fiber is disposed on the front surface.

The child scope 40 of the present invention does not require the use of a guide wire for insertion into the bile duct 100.
As shown in FIG. 11 showing a cross section taken along the line XI-XI, the inside of the flexible tube 46 is not provided with any kind of channel for passing a guide wire, and only the image guide fiber bundle 50 and the light guide fiber 52 are provided. Has been passed.

[0037]

According to the present invention, first, the contrast medium is inserted into the treatment tool insertion channel of the parent scope while the contrast medium injection tube is passed through the sheath, and then the contrast medium injection tube is used as a guide. Push the mantle tube to the target part, remove the contrast medium injection tube, and pass the child scope through the mantle tube in place of the contrast medium injection tube to easily guide the child scope to the target site such as the bile duct Endoscope observation can be performed.

Accordingly, the child scope can be easily inserted into the target site without using a guide wire or the like, and it is not necessary to provide a channel for passing the guide wire in the child scope, and much of the internal space is used. Since it can be used for an optical system, optical performance can be improved and a good observation image can be obtained.

[Brief description of the drawings]

FIG. 1 is a schematic side view showing a first step of a procedure for using a parent-child type endoscope apparatus according to an embodiment of the present invention.

FIG. 2 is a schematic side view showing a second step of a procedure for using the parent-child type endoscope apparatus according to the embodiment of the present invention.

FIG. 3 is a schematic side view showing a third step of a procedure for using the parent-child type endoscope apparatus according to the embodiment of the present invention.

FIG. 4 is a side view showing a state in which a contrast agent injection tube is passed through the outer sheath according to the embodiment of the present invention.

FIG. 5 is a side cross-sectional view of a proximal portion of the outer sheath according to the embodiment of the present invention in a state where a contrast agent injection tube is passed through the sheath.

FIG. 6 is a side view showing a state in which a contrast medium injection tube is passed through the outer sheath according to the embodiment of the present invention.

FIG. 7 is a partially enlarged side sectional view showing a state in which a contrast medium injection tube is passed through the outer sheath according to the embodiment of the present invention.

FIG. 8 is a side view of the child scope according to the embodiment of the present invention.

FIG. 9 is an enlarged side sectional view of a distal end portion of the insertion section of the child scope according to the embodiment of the present invention.

FIG. 10 is an enlarged front view of the distal end portion of the insertion section of the child scope according to the embodiment of the present invention.

FIG. 11 shows an insertion portion of the child scope according to the embodiment of the present invention.
It is XI-XI sectional drawing.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Parent scope 15 Treatment tool insertion port 16 Treatment tool outlet 20 Outer sheath 21 Flexible tube 22 Hand mouthpiece 30 Contrast injection tube 31 Flexible tube 32 Hand mouthpiece 33 Injection mouthpiece

Claims (4)

[Claims] An outer sheath having an effective length longer than the entire length of the treatment instrument insertion channel, which can be inserted into and removed from the treatment instrument insertion channel of the parent scope; and longer than the entire length of the outer sheath, which can be inserted into and removed from the outer sheath. A parent-child type endoscope apparatus comprising: a contrast medium injection tube having an effective length; and a child scope which is detachably inserted into the outer sheath and has an effective length longer than the entire length of the outer sheath. 2. The parent-child type endoscope apparatus according to claim 1, wherein the child scope is not provided with an insertion channel. 3. The parent-child type endoscope apparatus according to claim 1, wherein a distal end portion of the outer sheath is formed in a tapered shape which gradually narrows toward a front side. 4. The parent-child system according to claim 1, further comprising a coupling mechanism for removably coupling a proximal end portion of the outer sheath and a proximal end portion of the contrast agent injection tube. Endoscope device.