Removal parts, operating mechanisms and endoscopes

Abstract

The present invention discloses a sheathing member, an operating mechanism, and an endoscope, relating to the field of medical device technology. The sheathing member of the present invention is integrated into the endoscope and includes a sheathing rope, with a loop formed at the distal end of the sheathing rope. The sheathing rope has at least a first state, a second state, and a third state. When the sheathing rope is in the first state, the sheathing rope is housed within the insertion portion of the endoscope, and the distal end of the sheathing rope is located in the distal region of the insertion portion. When the sheathing rope is in the second state, the sheathing rope extends through the end face of the insertion portion, releasing the loop and locating it at the distal end of the insertion portion. When the sheathing rope is in the third state, the loop engages with the target object, and the size of the loop in the third state is smaller than the size of the sheathing rope in the second state. When the sheathing member of the present invention is used to remove the target object, the sheathing member of the present invention can improve the efficiency of target object removal by simplifying the insertion process and reducing the sheathing rope travel.

Description

Technical Field

[0001] The present invention relates to the technical field of medical instruments, and in particular to a sheath removal piece, an operating mechanism and an endoscope. Background Art

[0002] Patients with stones and ureteral stenosis need to have a ureteral stent placed during surgery. One end of the ureteral stent extends into the renal pelvis, and the other end extends into the bladder cavity. The ureteral stent can drain urine and dilate the ureter. The ureteral stent cannot be left in the human body for a long time. Once the ureteral stent is placed in the human body, it needs to be removed from the bladder 2 to 4 weeks later. The traditional method of removing a ureteral stent is to use a foreign body forceps to clamp the ureteral stent in the bladder, and then retract the foreign body forceps to remove the ureteral stent from the body.

[0003] However, the inventors discovered that traditional ureteral stent removal methods are complex and inefficient. Therefore, providing an operating assembly that simplifies the ureteral stent removal process and improves its efficiency is a pressing technical challenge for those skilled in the art. Summary of the Invention

[0004] The invention discloses a sheath removal piece, an operating mechanism and an endoscope, which are used to solve the technical problems in the related art of using foreign body forceps to remove a ureteral stent, which have complicated tube removal process and low efficiency.

[0005] In order to solve the above problems, the present invention adopts the following technical solutions:

[0006] A first aspect of the present invention provides a collection piece.

[0007] The retrieval device of the present invention is integrated into an endoscope, and includes a lanyard, a loop formed at the distal end of the lanyard, and the lanyard has at least a first state, a second state, and a third state. When the lanyard is in the first state, the lanyard is accommodated in the insertion portion of the endoscope, and the distal end of the lanyard is located in the distal region of the insertion portion; when the lanyard is in the second state, the lanyard extends through the end surface of the insertion portion, and the loop is released and located at the distal end of the insertion portion; when the lanyard is in the third state, the loop is engaged with a target object, and the size of the loop in the third state is smaller than the size of the lanyard in the second state.

[0008] A second aspect of the present invention provides an operating mechanism.

[0009] The operating mechanism of the present invention includes a driving member and an operating member, wherein the driving member is connected to the operating member, and the driving member is further connected to a collecting member, and the collecting member is the collecting member described in any technical solution of the present invention. The operating member is controlled to move so that the driving member drives the collecting member to have a first moving state and a second moving state in sequence. When the collecting member is in the first moving state, the collection rope moves toward the distal end and is placed in the second state; when the collection member is in the second moving state, the collection rope moves in a direction close to the target object and is placed in the third state.

[0010] A third aspect of the present invention provides an endoscope.

[0011] The endoscope of the present invention comprises an insertion portion and a handle, and further comprises a sheathing member and an operating mechanism, wherein the sheathing member is the sheathing member described in any one of the technical solutions of the present invention, and the operating mechanism is the operating mechanism described in any one of the technical solutions of the present invention, the sheathing member is arranged in the insertion portion, the operating mechanism is arranged on the handle, and the operating mechanism is connected to the proximal end of the sheathing member.

[0012] The technical solution adopted by the present invention can achieve the following beneficial effects:

[0013] The extraction member of the present invention includes a loop, a distal end of the loop forming a loop, and the loop has at least a first state, a second state, and a third state. When the loop is in the first state, the loop is accommodated in the insertion portion of the endoscope, facilitating the insertion of the insertion portion into the cavity; when the loop is in the second state, the loop extends through the end face of the insertion portion, and the loop is released and located at the distal end of the insertion portion. At this time, the loop can be approached to the target object and the loop is sleeved on the target object; when the loop is in the third state, the loop is sleeved on the target object. The size of the loop in the third state is smaller than the size of the loop in the second state. At this time, the sleeve area of ​​the loop is reduced, so that the loop can be firmly sleeved on the target object, so that the target object can be removed from the body through the loop.

[0014] It can be seen that the sheath of the present invention, since the sheath is integrated into the endoscope, only one insertion and removal process of the endoscope is required to achieve the removal of the target object. In addition, when the sheath is in the storage state, the distal end of the sheath is located in the distal area of ​​the insertion portion, so that the travel of the sheath out of the insertion portion is relatively small. Compared with the traditional method of using two instruments, the sheath of the present invention not only simplifies the instrument insertion process, but also allows the sheath to quickly enter the cavity. Therefore, the sheath of the present invention can improve the efficiency of removing the target object from two aspects: simplifying the insertion process and reducing the travel of the sheath.

[0015] On the other hand, by integrating the sheathing component of the present invention into an endoscope, only one operating instrument, the endoscope, is needed to complete the operation of removing the target object. Compared with the traditional method of using two instruments, the surgical cost can be reduced for the patient; for the operator, the operation process and difficulty of the operator can be simplified. Specifically, the operator only needs to insert one instrument, the endoscope, and during the operation, only needs to control the operating mechanism on the endoscope to achieve the sheathing of the target object.

[0016] That is, the sheath removal component of the present invention is integrated into a cystoscope, which can solve the technical problems in the related art of using foreign body forceps to remove the ureteral stent, such as the complicated removal process and low efficiency. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying any creative work.

[0018] Figure 1 is a schematic diagram of an endoscope according to an embodiment of the present application;

[0019] Figure 2 is a partial schematic diagram of an endoscope according to an embodiment of the present application;

[0020] Figure 3 yes Figure 2 Enlarged view of part A;

[0021] Figure 4 It is a schematic diagram of the sleeve removal member according to an embodiment of the present application;

[0022] Figure 5 This is a first schematic diagram of the cooperation between the sheathing member and the distal end of the insertion portion according to an embodiment of the present application;

[0023] Figure 6 This is a second schematic diagram of the embodiment of the present application showing the engagement of the sheathing member with the distal end of the insertion portion;

[0024] Figure 7 This is a third schematic diagram of the embodiment of the present application showing the cooperation between the sheathing member and the distal end of the insertion portion;

[0025] Figure 8 This is a first schematic diagram of another embodiment of the present application showing the engagement of the sheathing member with the distal end of the insertion portion;

[0026] Figure 9 This is a second schematic diagram of another embodiment of the present application showing the engagement of the sheathing member with the distal end of the insertion portion;

[0027] Figure 10This is a third schematic diagram of another embodiment of the present application showing the engagement of the sheathing member with the distal end of the insertion portion;

[0028] Figure 11 is a schematic diagram of a connector according to an embodiment of the present application;

[0029] Figure 12 This is an overall schematic diagram of the driving member of an embodiment of the present application;

[0030] Figure 13 is a partial schematic diagram of the driving member in the first state according to the embodiment of the present application;

[0031] Figure 14 is a partial schematic diagram of the driving member in the second state according to the embodiment of the present application;

[0032] Figure 15 is a partial schematic diagram of the driving member in the third state according to the embodiment of the present application;

[0033] Figure 16 is a partial schematic diagram of the driving member in the fourth state according to the embodiment of the present application;

[0034] Figure 17 is a partial schematic diagram of the driving member in the fifth state according to the embodiment of the present application;

[0035] Figure 18 It is a schematic diagram of a push block according to an embodiment of the present application;

[0036] Figure 19 is a schematic diagram of the first moving block of an embodiment of the present application;

[0037] Figure 20 is a schematic diagram of the second moving block of an embodiment of the present application;

[0038] Figure 21 It is a schematic diagram of the shell of an embodiment of the present application.

[0039] In the figure: 11, insertion portion; 11a, camera module; 12, first channel; 13, front end seat; 14, instrument channel; 14a, slit; 15, handle; 16, connector; 16a, first cavity; 16b, second cavity; 100, rope; 110, collar; 200, sleeve; 300, drive member; 310, push block; 311, first push surface; 312, second push surface; 313, fourth push surface; 314, fifth push surface; 320, first moving block; 321, first gap; 322, second gap; 323, third push surface; 330, second moving block Block; 331, third gap; 332, sixth pushing surface; 340, shell; 341, inner cavity; 342, seventh pushing surface; 351, first limiting groove; 352, first limiting block; 3521, third end face; 3522, fourth end face; 361, second limiting groove; 362, third limiting groove; 363, second limiting block; 3631, first end face; 3632, second end face; 364, connecting channel; 370, first locking knob; 380, second locking knob; 390, second tooth structure; 400, operating member; 410, knob; 420, first tooth structure. DETAILED DESCRIPTION

[0040] To make the objectives, technical solutions, and advantages of the present invention more apparent, the technical solutions of the present invention will be described in detail below. Obviously, the embodiments described are only some of the embodiments of the present invention, not all of them. Based on the embodiments of the present invention, all other implementations obtained by those of ordinary skill in the art without inventive effort are within the scope of protection of the present invention.

[0041] The terms "first," "second," and the like in the specification and claims of this application are used to distinguish similar objects, and are not used to describe a specific order or precedence. It should be understood that the terms used in this manner are interchangeable where appropriate, so that the embodiments of this application can be implemented in an order other than that illustrated or described herein, and that the objects distinguished by "first," "second," and the like are generally of the same type, and do not limit the number of objects; for example, the first object can be one or more. In addition, the term "and / or" in the specification and claims refers to at least one of the connected objects, and the character " / " generally indicates that the objects connected are in an "or" relationship.

[0042] In each embodiment of the present application, "proximal end" and "distal end" refer to the position of each component relative to the user in the use environment, wherein the end closer to the user is designated as the "proximal end" and the end farther from the user is designated as the "distal end".

[0043] In the related art, the use of foreign body forceps to remove a ureteral stent includes at least the following process: inserting a cystoscope into the bladder, then inserting a foreign body forceps into the instrument channel of the cystoscope, then using the foreign body forceps to remove the ureteral stent, and finally removing the cystoscope. The above-mentioned process of removing the ureteral stent requires two insertion processes and two removal processes, which makes the removal process complicated and inefficient. The longer removal time will undoubtedly cause greater pain to the patient. On the other hand, the above-mentioned process of removing the ureteral stent requires the use of at least two instruments, a cystoscope and a foreign body forceps, which will undoubtedly increase the patient's surgical costs; and for the operator, it will undoubtedly increase the difficulty of the operator's operation.

[0044] To this end, the present application provides a sheath that is integrated into an endoscope and can be inserted and removed by inserting and removing the endoscope. Furthermore, the sheath includes a loop that engages with the target object to remove the target object from the body. Using this sheath with an endoscope can simplify the ureteral stent removal process and improve removal efficiency. Furthermore, the procedure requires only one operating instrument, the endoscope, making the entire surgical procedure simple and economical, while also simplifying the operator's operating process and reducing the difficulty of the procedure.

[0045] The following is combined with Figures 1 to 21 , the collection piece, operating mechanism and endoscope provided in the embodiment of the present application are described in detail through specific embodiments and their application scenarios.

[0046] An embodiment of the present application provides a collection piece.

[0047] The sheath of this embodiment is integrated into the endoscope. The endoscope of this embodiment can be a disposable endoscope, a limited-time reuse endoscope, or an unlimited-time reuse endoscope. The endoscope of this embodiment can be a bronchoscope, a pyeloscope, an esophagoscope, a gastroscope, a colonoscope, an otoscope, a rhinoscope, a stomatoscope, a laryngoscope, a colposcope, a laparoscope, an arthroscope, etc. This embodiment does not impose any specific restrictions on the type of endoscope. Figure 1 and Figure 2 FIG. 1 is a schematic diagram showing the sheath removal member of this embodiment integrated into the insertion portion 11 of the cystoscope.

[0048] The sheath of this embodiment is integrated into an endoscope and can be used to remove a target object. For example, the target object is an implanted device, such as a ureteral stent, which can be removed from the body using the sheath. For example, the target object is tissue to be sampled, such as a polyp or tumor, which can be separated from the tissue using the sheath and then removed from the body.

[0049] The sleeve removal member of this embodiment includes a sleeve rope 100, and a sleeve loop 110 is formed at the distal end of the sleeve rope 100. Figure 4As shown. For example, the materials used for the lanyard 100 and the loop 110 can be the same or different. The lanyard 100 and the loop 110 can be a one-piece structure; or the loop 110 can be integrated into the end of the lanyard 100. For example, the hardness of the lanyard 100 is greater than the hardness of the loop 110. For example, the loop 110 can be made of a memory alloy material, so that the loop 110 can expand into a pre-defined shape after release, such as a ring, circle, or ellipse.

[0050] In some embodiments, the diameter of the material used for the collar 110 is relatively small, so that the collar 110 is easily deformed, thereby facilitating the collar 110 to be received in the insertion portion 11 and facilitating the adjustment of the collar area of ​​the collar 110 .

[0051] In some embodiments, the lanyard 100 has at least a first state, a second state, and a third state. When the lanyard 100 is in the first state, the lanyard 100 is received in the insertion portion 11 of the endoscope. Figure 5 or Figure 8 When the lanyard 100 is in the second state, the lanyard 100 extends through the end surface of the insertion portion 11, and the loop 110 is released and located at the distal end of the insertion portion 11, as shown in FIG. Figure 6 or Figure 9 When the lanyard 100 is in the third state, the loop 110 is engaged with the target object, and the size of the loop 110 in the third state is smaller than the size of the lanyard 100 in the second state.

[0052] The collar 110 is prefabricated into an annular structure using a memory alloy material. After the collar 110 extends from the end surface of the inserting portion 11, the collar 110 can be restored to an annular structure. Figure 6 or Figure 9 In some embodiments, after the collar 110 returns to the annular structure, the collar 110 can continue to move away from the end surface of the insertion portion 11, so that there is a larger distance between the collar 110 and the end surface of the insertion portion 11, as shown. Figure 7 or Figure 10 In this way, there is enough clearance between the collar 110 and the end surface of the inserting portion 11 to accommodate the target object, so that the collar 110 can be sleeved on the target object.

[0053] In some embodiments, when the lanyard 100 is received in the insertion portion 11 of the endoscope, the distal end of the lanyard 100 is located at the distal end region of the insertion portion 11, such as Figure 5 or Figure 8 Preferably, the distal region of the insertion portion 11 refers to the portion of the insertion portion 11 located distal to the passive bending section, such as the active bending section or the front seat 13 of the insertion portion 11. Without limitation, the distal region of the insertion portion 11 may also include part of the passive bending section of the insertion portion 11.

[0054] The sleeve removal member of this embodiment includes a sleeve rope 100, and a loop 110 is formed at the distal end of the sleeve rope 100. The sleeve rope 100 has at least a first state, a second state and a third state. When the sleeve rope 100 is in the first state, the sleeve rope 100 is received in the insertion portion 11 of the endoscope, which facilitates the insertion of the insertion portion 11 into the cavity; when the sleeve rope 100 is in the second state, the sleeve rope 100 extends through the end surface of the insertion portion 11, and the loop 110 is released and located at the distal end of the insertion portion 11. At this time, the loop 110 can be moved to the distal end of the insertion portion 11. The target object is brought closer (the loop 110 can be moved closer to the target object by moving the lanyard 100 or moving the endoscope), and the loop 110 is sleeved on the target object; when the lanyard 100 is in the third state, the loop 110 is sleeved on the target object, and the size of the loop 110 in the third state is smaller than the size of the lanyard 100 in the second state. At this time, the sleeve area of ​​the loop 110 is reduced, so that the loop 110 can be firmly sleeved on the target object, so that the target object can be removed from the body through the loop 110.

[0055] It can be seen that the sheath of the present embodiment is integrated into the endoscope, so the target object can be removed by inserting and removing the endoscope once. In addition, when the sheath 100 is in the stored state, the distal end of the sheath 100 is located in the distal area of ​​the insertion portion 11, so that the travel of the sheath 100 extending out of the insertion portion 11 is relatively small. Compared with the traditional method of using two instruments, the sheath of the present embodiment can not only simplify the instrument insertion process, but also allow the sheath to quickly enter the cavity. Therefore, the sheath of the present embodiment can improve the efficiency of removing the target object from two aspects: simplifying the insertion process and reducing the travel of the sheath.

[0056] On the other hand, the extraction piece of this embodiment is integrated into the endoscope. During the operation to remove the target object, only one operating instrument, the endoscope, is needed to complete the operation. Compared with the traditional method of using two instruments, the surgical cost can be reduced for the patient. For the operator, the operation process and difficulty of the operator can be simplified. Specifically, the operator only needs to insert one instrument, the endoscope, and during the operation, only the operating mechanism on the endoscope needs to be controlled to achieve the extraction of the target object.

[0057] That is, the sheath removal component of this embodiment is integrated into the cystoscope, which can solve the technical problems in the related art of using foreign body forceps to remove the ureteral stent, such as the complicated removal process and low efficiency.

[0058] In some embodiments, the inserting portion 11 is provided with a first channel 12, such as Figures 5 to 7 The distal end of the first channel 12 is flush with the distal end surface of the insertion portion 11, as shown. Figures 5 to 7 When the lanyard 100 is in the first state, the lanyard 100 is stored in the first channel 12. When the lanyard 100 is in the second state, the lanyard 100 is extended through the first channel 12. Figures 5 to 7For example, when the lanyard 100 is received in the first channel 12, the distal end of the lanyard 100 can be flush with the distal end surface of the insertion portion 11, so that when the lanyard 100 extends out of the insertion portion 11, the movement displacement of the lanyard 100 is small, as shown in FIG. Figure 5 shown.

[0059] In some embodiments, a first channel 12 is provided in the insertion portion 11. The distal end of the first channel 12 is located at the proximal end of the front end seat 13 of the endoscope, such as Figure 9 When the lanyard 100 is in the first state, the lanyard 100 is received in the first channel 12. When the lanyard 100 is received in the first channel 12, the distal end of the lanyard 100 does not exceed the distal end of the first channel 12. When the lanyard 100 is in the second state, the lanyard 100 extends through the instrument channel 14 of the endoscope, as shown in FIG. Figure 9 As shown. Figures 8 to 10 As shown, the first channel 12 and the instrument channel 14 are two independent channels. In some embodiments, the first channel 12 can be disposed within the instrument channel 14, so that the lanyard 100 can move along the first channel 12 and extend through the instrument channel 14. In some embodiments, the first channel 12 is disposed outside the instrument channel 14, so that the first channel 12 does not occupy the space of the instrument channel 14, such as Figures 8 to 10 shown.

[0060] The inventors discovered during their research that the size of the insertion portion 11 is usually small. If the first channel 12 is set inside the instrument channel 14, it will inevitably occupy the space of the instrument channel 14. In order to ensure that the instrument channel 14 is not affected, the size of the insertion portion 11 needs to be increased. Even if the first channel 12 is set outside the instrument channel 14, if the distal end of the first channel 12 extends to the distal end face of the insertion portion 11, this approach will also cause the size of the insertion portion 11 to increase. Specifically, the size of the insertion portion 11 is small, and the distal end of the insertion portion 11 is provided with a camera module 11a, the distal end of the insertion portion 11 is also provided with an outlet for the instrument channel 14, and may even be provided with an outlet for the spray channel, an outlet for the suction channel, and other structures. As a result, there is almost no space on the distal end face of the insertion portion 11 to set the first channel 12. If the distal end of the first channel 12 is extended to the distal end face of the insertion portion 11, the distal end size of the insertion portion 11 will inevitably increase.

[0061] In the sleeve removal device of this embodiment, when the sleeve rope 100 is in the first state, the sleeve rope 100 is stored in the first channel 12 located at the proximal end of the front end seat 13, and when the sleeve rope 100 is in the second state, the sleeve rope 100 extends out through the instrument channel 14. In this arrangement, since there is a certain gap at the proximal end of the front end seat 13, arranging the first channel 12 at the proximal end of the front end seat 13 will not occupy the space in the instrument channel 14, and can also avoid the problem of the first channel 12 extending to the distal end face of the insertion portion 11, resulting in an increase in the distal size of the insertion portion 11.

[0062] In some embodiments, the first channel 12 and the instrument channel 14 may be connected via a tee, so that the lanyard 100 may pass from the first channel 12 into the instrument channel 14 .

[0063] In some embodiments, when the lanyard 100 is extended through the instrument channel 14 of the endoscope, a slit 14a is provided on the wall of the instrument channel 14. The slit 14a is located at the distal end of the first channel 12. Figure 9 As shown, for example, the slit 14a passes through the wall of the instrument channel 14, so that the instrument channel 14 can communicate with the outside of the instrument channel 14 through the slit 14a.

[0064] Since the instrument channel 14 is provided with a slit 14a, when the distal end of the loop rope 100 extends out of the first channel 12, the loop rope 100 can squeeze the wall surface at the slit 14a, and the gap of the slit 14a becomes larger. The distal end of the loop rope 100 can enter the instrument channel 14 through the slit 14a, thereby allowing the loop rope 100 to extend through the instrument channel 14 without the need to set up a separate extension channel for the loop rope 100.

[0065] Before the lanyard 100 enters the instrument channel 14, the walls of the instrument channel 14 remain unchanged, thus not affecting the original function of the instrument channel 14. Alternatively, when the lanyard 100 is withdrawn from the instrument channel 14 and returned to the first channel 12, the deformed walls of the instrument channel 14 recover, thereby maintaining the original function of the instrument channel 14. For example, by providing a slit 14a in the instrument channel 14, during procedures such as stone removal, the smaller slit 14a prevents foreign matter such as stones from passing through the slit 14a, allowing stones and other foreign matter to be discharged directly through the instrument channel 14.

[0066] In some embodiments, the instrument channel 14 is connected to the first channel 12 via a connector 16, such as Figures 8 to 10 As shown. Figure 11 As shown, the connecting member 16 has a first cavity 16a and a second cavity 16b for mounting the instrument channel 14 and the first channel 12 respectively, and the first cavity 16a and the second cavity 16b are communicated with each other.

[0067] In some embodiments, the sleeve further comprises a sleeve 200, such as Figure 7 and Figure 10 As shown, the sleeve 200 can be slidably mounted on the outside of the lanyard 100, and the distance between the sleeve 200 and the lanyard 100 satisfies the following relationship: L1>L2. L1 is the distance between the distal end of the sleeve 200 and the distal end of the lanyard 100 when the lanyard 100 is in the second state; L2 is the distance between the distal end of the sleeve 200 and the distal end of the lanyard 100 when the lanyard 100 is in the third state.

[0068] For example, after the lanyard 100 extends to the distal end of the insertion portion 11, the lanyard 100 and cannula 200 are moved toward the target object. The cannula 200 strengthens the portion of the lanyard 100 located outside the insertion portion 11, making it easier for the loop 110 to be attached to the target object. Furthermore, by positioning the cannula 200 outside the lanyard 100, the distance between the distal ends of the cannula 200 and the lanyard 100 can be changed by moving the lanyard 100 and / or the cannula 200. This means that the cannula 200 can also adjust the size of the loop 110, thereby changing the area within which the loop 110 can be removed. For example, after the loop 110 is attached to the target object, the size of the loop 110 can be reduced, allowing the loop 110 to be securely attached to the target object, thereby facilitating removal of the target object from the body through the loop 110.

[0069] Some embodiments of the present application also provide an operating mechanism.

[0070] The operating mechanism of this embodiment includes a driving member 300 and an operating member 400. Figure 2 and Figure 3 As shown. The driving member 300 is connected to the operating member 400, which is also connected to the extraction member. The extraction member is the extraction member of any technical solution in this embodiment. For example, the driving member 300 is disposed within the handle 15, and the operating member 400 is disposed on the outer shell of the handle 15 to facilitate operation by the operator.

[0071] In some embodiments, the control operating member 400 is actuated to cause the driving member 300 to drive the sleeve removal member to sequentially have a first movement state and a second movement state. When the sleeve removal member is in the first movement state, the sleeve lanyard 100 switches from the first state to the second state. When the sleeve removal member is in the second movement state, the sleeve lanyard 100 switches from the second state to the third movement state.

[0072] The operating mechanism of this embodiment is used to control the movement of the extraction member of any technical solution in this embodiment. Specifically, by controlling the movement of the operating member 400, the driving member 300 can drive the rope 100 to switch from the first state to the second state, and from the second state to the third moving state, thereby achieving the purpose of using the extraction member to extract the target object and remove the target object from the cavity.

[0073] For example, for the scheme in which the lanyard 100 extends through the instrument channel 14 of the endoscope, the lanyard 100 includes at least the following movement processes: the lanyard 100 moves from the first state to the process of entering the instrument channel 14, the lanyard 100 moves from the state in the instrument channel 14 to the process of the loop 110 being released at the distal end of the insertion portion 11 (e.g., Figure 9 As shown), the process in which the lanyard 100 moves from the state in which the loop 110 is at the distal end of the insertion portion 11 to the state in which the loop 110 is engaged with the target object (as shown Figure 10 As shown), the rope 100 or the sleeve 200 moves to the process of reducing the size of the ring 110.

[0074] For example, for the solution in which the lanyard 100 extends through the first channel 12, the lanyard 100 includes at least the following movement process: the lanyard 100 moves from the state in the instrument channel 14 to the process in which the loop 110 is released at the distal end of the insertion portion 11 (e.g., Figure 5 and Figure 6 As shown), the process in which the lanyard 100 moves from the state in which the loop 110 is at the distal end of the insertion portion 11 to the state in which the loop 110 is engaged with the target object (as shown Figure 7 As shown), the rope 100 or the sleeve 200 moves to the process of reducing the size of the ring 110.

[0075] In some embodiments, the driving member 300 includes a push block 310, a first moving block 320 and a second moving block 330. Figures 13 to 17 The push block 310 is connected to the operating member 400, and the push block 310 is also connected to the first moving block 320 and the second moving block 330, as shown. Figure 3 、 Figures 13 to 17 As shown, the first movable block 320 is fixedly connected to the lanyard 100, and the second movable block 330 is fixedly connected to the sleeve 200. As can be seen, by controlling the operation member 400, the push block 310 can be controlled to move, thereby driving the first movable block 320 and / or the second movable block 330 to move, and further driving the lanyard 100 and / or the sleeve 200 to move, thereby enabling the sleeve removal member to have a first movable state or a second movable state.

[0076] In some embodiments, the driving member 300 includes a first locking knob 370, which is disposed at the proximal end of the push block 310. The first locking knob 370 can be used to lock and secure the lanyard 100. Figure 12 As shown. For example, the driving member 300 includes a second locking knob 380, which is provided at the distal end of the housing 340. The first channel 12 can be locked and fixed by the second locking knob 380. Figure 12 Taking the second locking knob 380 as an example, the locking knob includes a plurality of locking blocks distributed at intervals, a locking sleeve is placed over the plurality of locking blocks, and the locking sleeve is tightened, so that the plurality of locking blocks can clamp and fix the first channel 12, as shown in FIG. Figure 21 shown.

[0077] Taking the scenario of extending the tether 100 through the instrument channel 14 of an endoscope as an example, the operating member 400 is controlled to operate, causing the driving member 300 to sequentially enter a first sliding state, a second sliding state, a third sliding state, and a fourth sliding state. When the driving member 300 is in the first sliding state, the first and second moving blocks 320, 330 move synchronously distally, thereby allowing the tether 100 and cannula 200 to move synchronously distally into the instrument channel 14. When the driving member 300 is in the second sliding state, the first moving block 320 moves distally while the second moving block 330 remains stationary, allowing the tether 100 to move distally until the loop 110 is released at the distal end of the insertion portion 11. When the driving member 300 is in the third sliding state, the first and second moving blocks 320, 330 move synchronously distally, thereby allowing the tether 100 and cannula 200 to move synchronously distally to a position close to the target site. When the driving member 300 is in the fourth sliding state, the first moving block 320 moves toward the proximal end and the second moving block 330 remains fixed, so that the lanyard 100 can move toward the proximal end to a state where the size of the loop 110 is reduced.

[0078] It can be seen that, for the solution in which the lanyard 100 extends through the first channel 12 , the driving member 300 only needs to have the second sliding state, the third sliding state and the fourth sliding state, but does not need the first sliding state.

[0079] The operating mechanism of this embodiment requires only a single movement of the operating member 400 to achieve the engagement of the collar 110 with the target object, simplifying the operation process and reducing the difficulty of the operation. Furthermore, the operating mechanism of this embodiment reduces the size of the collar 110 by proximally moving the first movable block 320, thereby reducing the stroke of the driver 300 and thereby reducing the space occupied by the driver 300 within the handle 15.

[0080] In some embodiments, the driving member 300 further includes a housing 340, such as Figures 12 to 17 The housing 340 is fixed to the handle 15 and has an inner cavity 341. The push block 310, the first moving block 320 and the second moving block 330 are slidably arranged in the inner cavity 341 of the housing 340. Figures 12 to 17 The housing 340 not only provides a mounting base for the push block 310 , the first moving block 320 and the second moving block 330 , but also provides a guide rail for the sliding of the push block 310 , the first moving block 320 and the second moving block 330 .

[0081] In some embodiments, a first limiting assembly is provided on the housing 340 and the first movable block 320 to limit the movement of the first movable block 320. When the lanyard is in the first state, the first limiting assembly limits the movement of the first movable block 320, thereby preventing the first movable block 320 from sliding, which could cause the lanyard 100 to slide.

[0082] In some embodiments, a second limiting assembly is provided on the housing 340 and the second movable block 330, and the second limiting assembly is used to limit the movement position of the second movable block 330. The second limiting assembly can limit the movement displacement of the second movable block 330, so that when only the first movable block 320 needs to move, the second movable block 330 can remain fixed.

[0083] The following describes the specific structures of the first and second position-limiting assemblies using the example of extending the lanyard 100 through the instrument channel 14 of an endoscope. Based on this, the specific structures of the first and second position-limiting assemblies for extending the lanyard 100 through the first channel 12 can be obtained, and will not be further described here.

[0084] In some embodiments, the first limiting assembly includes a first limiting groove 351 and a first limiting block 352, such as Figures 13 to 17 The first limiting groove 351 is provided on one of the first moving block 320 and the housing 340 , and the first limiting block 352 is elastically provided on the other of the first moving block 320 and the housing 340 . The first limiting block 352 is engaged with the first limiting groove 351 for limiting position. Figure 19 and Figure 21 Schematic diagram showing that the first limiting groove 351 is provided on the housing 340 and the first limiting block 352 is elastically provided on the first moving block 320 .

[0085] like Figure 13 As shown, before the control operating member 400 is actuated, the first limit block 352 is engaged with the first limit groove 351 to limit the position, so that only when force is applied to the first movable block 320 can the first limit block 352 be driven to disengage from the first limit groove 351, so as to drive the first movable block 320 to move toward the far end.

[0086] In some embodiments, at least one of the contact surfaces of the first limiting groove 351 and the first limiting block 352 is an inclined structure, so that when the first moving block 320 is subjected to force, the first limiting block 352 is easily separated from the first limiting groove 351. Figures 13 to 17 A schematic diagram showing that the wall surface of the first limiting groove 351 is an inclined surface.

[0087] In some embodiments, the first limit block 352 is elastically provided on the first movable block 320 or the housing 340, and before the control operating member 400 is actuated, the first limit block 352 is in a partially compressed state. For example, a first gap 321 is provided on the first movable block 320, and the first gap 321 extends at least to the first limit block 352, so that the first limit block 352 has elasticity, such as Figure 19 shown.

[0088] In some embodiments, the distal end or proximal end of the first limit block 352 further has a second gap 322, so that the distal end or proximal end of the first limit block 352 is formed as a free end, which can further improve the elasticity of the first limit block 352 and avoid the problem that the first limit block 352 is easily damaged during the compression process. Figure 19 shown.

[0089] The first limit block 352 is in a partially compressed state, which means that the first limit block 352 is in a partially deformed state. In the operating mechanism of this embodiment, before the control operating member 400 is actuated, the first limit block 352 is in a partially compressed state, so that when the first movable block 320 is subjected to force, the first limit block 352 can easily be disengaged from the first limit slot 351.

[0090] In some embodiments, the first limiting block 352 has at least a third end surface 3521 and a fourth end surface 3522, the height of the third end surface 3521 is less than the height of the fourth end surface 3522, the width of the first limiting groove 351 is less than the sum of the width of the third end surface 3521 and the width of the fourth end surface 3522, and the width of the first limiting groove 351 is greater than or equal to the width of the fourth end surface 3522. Figure 19 shown.

[0091] When the first limiting block 352 is located in the first limiting groove 351, since the width of the first limiting groove 351 is less than the sum of the width of the third end surface 3521 and the width of the fourth end surface 3522, the first limiting groove 351 cannot completely accommodate the first limiting block 352; and since the width of the first limiting groove 351 is greater than or equal to the width of the fourth end surface 3522, the first limiting groove 351 can accommodate the portion corresponding to the fourth end surface 3522, and the portion corresponding to the third end surface 3521 with a smaller height is squeezed by the first limiting block 352, so that the first limiting block 352 is in a partially compressed state, as shown in FIG. Figure 13 shown.

[0092] In some embodiments, the second limiting assembly includes a second limiting groove 361, a third limiting groove 362 and a second limiting block 363, such as Figures 13 to 17The second limiting groove 361 and the third limiting groove 362 are provided on one of the second moving block 330 and the housing 340, and the second limiting block 363 is elastically provided on the other of the second moving block 330 and the housing 340. The second limiting block 363 engages with the second limiting groove 361 or the third limiting groove 362 for limiting. Figure 20 and Figure 21 Schematic diagram showing that the second limiting groove 361 and the third limiting groove 362 are provided on the housing 340 , and the second limiting block 363 is elastically provided on the second moving block 330 .

[0093] For example, before the control operating member 400 is actuated, the second limiting block 363 is not engaged with the second limiting groove 361 and the third limiting groove 362, so that the second moving block 330 can move along with the movement of the push block 310. Figure 13 Exemplarily, the second limiting block 363 is located near the second limiting groove 361 and the third limiting groove 362, so that after the second moving block 330 moves a certain distance, the second limiting block 363 can be engaged with the second limiting groove 361 or the third limiting groove 362.

[0094] In some embodiments, at least one of the surfaces of the second limiting block 363 in contact with the second limiting groove 361 is an inclined structure, so that when the second moving block 330 is subjected to force, the second limiting block 363 is easily disengaged from the third limiting groove 362, such as Figures 13 to 17 、 Figure 20 As shown. Figures 13 to 17 As shown, the distal side of the second limit block 363 is a slope and the proximal side is a plane, so that when the second limit block 363 is engaged with the second limit groove 361, the second limit block 363 can be easily disengaged from the third limit groove 362; at the same time, when the second limit block 363 is engaged with the third limit groove 362, the second limit block 363 is not easy to be disengaged from the third limit groove 362.

[0095] In some embodiments, the second limit block 363 is elastically provided on the second movable block 330 or the housing 340, and before the control operating member 400 is actuated, the second limit block 363 is in a partially compressed state. For example, a third gap 331 is provided between the second limit block 363 and the second movable block 330, so that the second limit block 363 has elasticity, such as Figure 20 The proximal end of the exemplary second limiting block 363 is a free end, which can further provide the elasticity of the second limiting block 363 and avoid the problem that the second limiting block 363 is easily damaged during the compression process. Figure 20 shown.

[0096] In some embodiments, a communication channel 364 is provided between the second limiting groove 361 and the third limiting groove 362, and the communication channel 364 connects the second limiting groove 361 and the third limiting groove 362. Figure 12 and Figure 21 By providing the communicating channel 364 , the second limiting block 363 can be easily moved from the second limiting groove 361 to the third limiting groove 362 .

[0097] In some embodiments, the second limiting block 363 has a first end surface 3631, at least one side of the first end surface 3631 has a second end surface 3632, and the height of the first end surface 3631 is greater than the height of the second end surface 3632. Figure 20 As shown, second end surfaces 3632 are provided on both sides of the first end surface 3631 .

[0098] In some embodiments, the width of the second limiting groove 361 and the third limiting groove 362 is greater than or equal to the sum of the width of the first end face 3631 and the width of the second end face 3632, so that when the second limiting block 363 is located in the second limiting groove 361 or the third limiting groove 362, the second limiting block 363 can be in a natural state.

[0099] In some embodiments, the width of the communication channel 364 is smaller than the sum of the widths of the first end surface 3631 and the second end surface 3632, and the width of the communication channel 364 is larger than the width of the first end surface 3631. By setting the width of the communication channel 364 to be smaller, when the first movable block 320 moves toward the proximal end, the second limiting block 363 can be ensured to be located in the third limiting groove 362 and will not move with the movement of the first movable block 320.

[0100] In some embodiments, the push block 310 is engaged with the first movable block 320. For example, before the control operating member 400 is actuated, the push block 310 is in contact with the first movable block 320, so that the push block 310 can drive the first movable block 320 to move when it starts to move.

[0101] Exemplarily, the push block 310 has a first push surface 311. When the first limit block 352 is in a partially compressed state, the proximal end surface of the first limit block 352 abuts against the first push surface 311. Figure 13 and Figure 18 As shown. During the movement of the push block 310 toward the distal end, the proximal end surface of the first limit block 352 abuts against the first abutting surface 311, thereby pushing the first moving block 320 toward the distal end through the movement of the push block 310 toward the distal end. Figures 14 to 16 shown.

[0102] In some embodiments, the push block 310 further has a second push surface 312, and the first movable block 320 has a third push surface 323. When the push block 310 moves toward the proximal end, the second push surface 312 abuts against the third push surface 323, so that the first movable block 320 can be pushed toward the proximal end by the movement of the push block 310 toward the proximal end. Figures 13 to 18shown.

[0103] In some embodiments, the push block 310 is also engaged with the second movable block 330. For example, before the control operating member 400 is actuated, the push block 310 abuts against the second movable block 330, so that the push block 310 can drive the second movable block 330 to move when it first starts to move. For example, the push block 310 has a fourth abutting surface 313. When the second limit block 363 is in a partially compressed state, the proximal end surface of the second limit block 363 abuts against the fourth abutting surface 313, as shown in FIG. Figure 13 and Figure 18 shown.

[0104] When the second limiting block 363 returns to its natural state in the second limiting groove 361 or the third limiting groove 362, the proximal end surface of the second limiting block 363 is separated from the fourth pushing surface 313, and the proximal end surface of the second limiting block 363 is located above the fourth pushing surface 313, so that when the pushing block 310 moves, the second moving block 330 can remain fixed. Figure 14 and Figure 15 shown.

[0105] In some embodiments, the push block 310 further has a fifth push surface 314, the second moving block 330 has a sixth push surface 332, and the housing 340 has a seventh push surface 342. Figures 13 to 18 、 Figure 20 When the second limiting block 363 is engaged in the second limiting groove 361, the abutment between the fifth abutting surface 314 and the sixth abutting surface 332 can drive the second movable block 330 to move distally, thereby allowing the second limiting block 363 to move from the second limiting groove 361 to the third limiting groove 362 for engagement. At this time, the seventh abutting surface 342 abuts against the distal end of the second movable block 330, thereby restricting the second movable block 330 from further distal movement. Figure 13 、 Figure 14 and Figure 17 FIG. 3 shows a schematic diagram when the fifth pushing surface 314 and the sixth pushing surface 332 are not in contact with each other. Figure 15 and Figure 16 FIG. 3 is a schematic diagram showing the fifth pushing surface 314 and the sixth pushing surface 332 abutting against each other.

[0106] like Figure 17 As shown, during the process of the pushing block 310 moving toward the proximal end, the fifth pushing surface 314 and the sixth pushing surface 332 are separated.

[0107] See also Figures 13 to 17 , Figure 13 shows a schematic diagram of the driving member 300 in an initial state; Figure 14A schematic diagram showing the first moving block 320 and the second moving block 330 moving toward the distal end is shown, at which point the lanyard 100 and the cannula 200 can be synchronously pushed into the instrument channel 14; Figure 15 A schematic diagram is shown in which the first moving block 320 moves distally and the second moving block 330 remains stationary, at which point the lanyard 100 can be pushed out of the instrument channel 14 and the loop 110 is released into a ring-shaped structure; Figure 16 A schematic diagram showing the first moving block 320 and the second moving block 330 moving toward the distal end is shown, at which point the lanyard 100 and the sleeve 200 can be synchronously pushed to a position close to the target object; Figure 17 The diagram shows that the first movable block 320 moves toward the proximal end and the second movable block 330 remains fixed. At this time, the rope 100 can be moved toward the proximal end and the sleeve 200 remains fixed, so that the size of the loop 110 can be reduced to firmly fit the loop 110 on the target object.

[0108] In some embodiments, the operating member 400 includes a knob 410 and a first tooth structure 420, and the knob 410 is fixedly connected to the first tooth structure 420, such as Figure 2 and Figure 3 The driving member 300 is provided with a second tooth structure 390, and the first tooth structure 420 is engaged with the second tooth structure 390, as shown in FIG. Figure 2 、 Figure 3 and Figure 12 As shown. Exemplarily, the second tooth structure 390 is fixedly connected to the push block 310. Exemplarily, the first tooth structure 420 is a gear, and the second tooth structure 390 is a rack, as shown. Figure 3 and Figure 12 shown.

[0109] The operating mechanism of this embodiment, through the engagement of the first tooth structure 420 with the second tooth structure 390, can drive the push block 310 to move distally when the knob 410 is rotated. In addition, in the operating mechanism of this embodiment, the operating member 400 is configured as a knob 410, and the push block 310 can be driven to move distally by rotating the knob 410. This structure can achieve a large displacement of the push block 310 by simply rotating the knob 410, which helps to reduce the space occupied by the operating member 400 in the endoscope.

[0110] Some embodiments of the present application also provide an endoscope.

[0111] The endoscope of this embodiment includes an insertion portion 11 and a handle 15. The endoscope also includes a sheath and an operating mechanism. The sheath is provided in the insertion portion 11, and the operating mechanism is provided on the handle 15. The operating mechanism is connected to the proximal end of the sheath, as shown in FIG. Figure 1 and Figure 2In some embodiments, the collecting member is the collecting member of any technical solution in this embodiment, and the operating mechanism is the operating mechanism of any technical solution in this embodiment.

[0112] In some embodiments, the operating mechanism is fixedly connected to the handle 15 .

[0113] In some embodiments, the operating mechanism and the handle 15 are detachably connected.

[0114] The endoscope of this embodiment has the advantages of simple process and high removal efficiency when used to remove the ureteral stent; at the same time, the endoscope of this embodiment can also make the surgical process of removing the ureteral stent simple and economical, simplify the operator's operation process and reduce the operator's operation difficulty.

[0115] It should be noted that, in this article, the terms "comprise", "include" or any other variants thereof are intended to cover non-exclusive inclusion, so that a process, method, article or device comprising a series of elements includes not only those elements, but also other elements not explicitly listed, or also includes elements inherent to such process, method, article or device. In the absence of further restrictions, an element defined by the sentence "comprises a ..." does not exclude the presence of other identical elements in the process, method, article or device comprising the element. In addition, it should be noted that the scope of the methods and devices in the embodiments of the present application is not limited to performing functions in the order shown or discussed, and may also include performing functions in a substantially simultaneous manner or in the opposite order according to the functions involved. For example, the described method may be performed in an order different from that described, and various steps may also be added, omitted, or combined. In addition, the features described with reference to certain examples may be combined in other examples.

[0116] The above description is only a specific embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Any technician familiar with this technical field can easily think of changes or replacements within the technical scope disclosed by the present invention, which should be covered by the scope of protection of the present invention.

Claims

1. A sleeve removal device, characterized in that: The invention is integrated on an endoscope, wherein a first channel (12) is provided in an insertion portion (11) of the endoscope, the sleeve extractor comprises a sleeve rope (100), a distal end of the sleeve rope (100) forms a sleeve ring (110), the sleeve rope (100) and the sleeve ring (110) are an integrated structure, and the sleeve rope (100) has at least a first state, a second state and a third state, wherein: When the lanyard (100) is in the first state, the lanyard (100) is received in the first channel (12), and the distal end of the lanyard (100) is located in the distal region of the insertion portion (11); When the loop (100) is in the second state, the loop (100) extends through the end surface of the insertion portion (11), and the loop (110) is released and located at the distal end of the insertion portion (11); When the loop (110) is in the third state, the loop (110) is engaged with the target object, and the size of the loop (110) in the third state is smaller than the size of the loop (100) in the second state.

2. The sleeve according to claim 1, characterized in that: The distal end of the first channel (12) is located at the proximal end of the front end seat (13) of the endoscope, and when the lanyard (100) is in the second state, the lanyard (100) extends through the instrument channel (14) of the endoscope; or The distal end of the first channel (12) is flush with the distal end surface of the insertion portion (11); when the loop rope (100) is in the second state, the loop rope (100) extends through the first channel (12).

3. The sleeve removal piece according to claim 2, characterized in that: When the loop rope (100) is extended through the instrument channel (14) of the endoscope, a slit (14a) is provided on the wall surface of the instrument channel (14), and the slit (14a) is located at the distal end of the first channel (12).

4. The sleeve removal piece according to claim 2 or 3, characterized in that: It also includes a sleeve (200), the sleeve (200) can be slidably sleeved outside the sleeve rope (100), and the distance between the sleeve (200) and the sleeve rope (100) satisfies: L1>L2, wherein, L1 is the distance between the distal end of the sleeve (200) and the distal end of the rope (100) when the rope (100) is in the second state; L2 is the distance between the distal end of the sleeve (200) and the distal end of the rope (100) when the rope (100) is in the third state.

5. An operating mechanism, characterized in that: The invention comprises a driving member (300) and an operating member (400), wherein the driving member (300) is connected to the operating member (400), and the driving member (300) is further connected to a sleeve removing member, wherein the sleeve removing member is the sleeve removing member according to any one of claims 1 to 4. The operating member (400) is controlled to move so that the driving member (300) drives the sleeve taking member to sequentially have a first moving state and a second moving state, and when the sleeve taking member is in the first moving state, the sleeve rope (100) switches from the first state to the second state, and when the sleeve taking member is in the second moving state, the sleeve rope (100) switches from the second state to the third state.

6. The operating mechanism according to claim 5, characterized in that: The driving member (300) comprises a push block (310), a first moving block (320) and a second moving block (330), wherein: The push block (310) is connected to the operating member (400), and the push block (310) is also connected to the first moving block (320) and the second moving block (330). The first moving block (320) is fixedly connected to the rope (100), and the second moving block (330) is fixedly connected to the sleeve (200). The operating member (400) is controlled to move, and the driving member (300) drives at least one of the sleeve rope (100) and the sleeve (200) to move, and enables the sleeve taking member to have a first moving state or a second moving state.

7. The operating mechanism according to claim 6, characterized in that: The driving member (300) further includes a housing (340), wherein the push block (310), the first moving block (320) and the second moving block (330) are slidably disposed in the housing (340), and A first limiting assembly is provided on the housing (340) and the first moving block (320), and the first limiting assembly is used to limit the moving position of the first moving block (320). A second position-limiting assembly is provided on the housing (340) and the second moving block (330), and the second position-limiting assembly is used to limit the moving position of the second moving block (330).

8. The operating mechanism according to claim 7, characterized in that: The first limiting assembly comprises a first limiting groove (351) and a first limiting block (352), wherein the first limiting groove (351) is provided on one of the first moving block (320) and the shell (340), the first limiting block (352) is elastically provided on the other of the first moving block (320) and the shell (340), and the first limiting block (352) is engaged with the first limiting groove (351) for limiting. The second limiting assembly includes a second limiting groove (361), a third limiting groove (362) and a second limiting block (363), wherein the second limiting groove (361) and the third limiting groove (362) are provided on one of the second moving block (330) and the shell (340), the second limiting block (363) is elastically provided on the other of the second moving block (330) and the shell (340), and the second limiting block (363) is engaged with the second limiting groove (361) or the third limiting groove (362) for limiting.

9. The operating mechanism according to claim 8, characterized in that: A communication channel (364) is provided between the second limiting groove (361) and the third limiting groove (362), and the communication channel (364) connects the second limiting groove (361) and the third limiting groove (362); The second limiting block (363) has a first end surface (3631), at least one side of the first end surface (3631) has a second end surface (3632), the height of the first end surface (3631) is greater than the height of the second end surface (3632), and The width of the second limiting groove (361) and the third limiting groove (362) is greater than or equal to the sum of the width of the first end surface (3631) and the width of the second end surface (3632). The width of the communicating channel (364) is smaller than the sum of the width of the first end surface (3631) and the width of the second end surface (3632), and the width of the communicating channel (364) is larger than the width of the first end surface (3631).

10. An endoscope, characterized in that: The endoscope comprises an insertion portion (11) and a handle (15), and further comprises a sheath removal member and an operating mechanism, wherein: The sleeve is any one of claims 1 to 4. The operating mechanism is an operating mechanism according to any one of claims 5 to 9, The sheathing member is arranged in the insertion portion (11), the operating mechanism is arranged on the handle (15), and the operating mechanism is connected to the proximal end of the sheathing member.

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