Guide device for medical tool

Abstract

To provide a guide device for a medical tool capable of improving operability of the medical tool.SOLUTION: A guide tube 10 of an embodiment includes: a long tube body 50 inserted to a body; and a handle part 100 provided on a proximal end side of the tube body 50. The handle part 100 has: an inner cylinder 110 to which a proximal end portion of the tube body 50 is connected; and an outer cylinder 120 that is externally inserted to the inner cylinder 110. The inner cylinder 110 has a port part 112 for supplying and discharging fluid to and from the tube body 50.SELECTED DRAWING: Figure 5

Description

[Technical field]

[0001] The present invention relates to a medical instrument guide device for guiding a medical instrument, such as an endoscope insertion portion, into a body. [Background technology]

[0002] The insertion portion of an endoscope (hereinafter also referred to as the "endoscope insertion portion") is inserted along a winding and flexible insertion path, such as the upper digestive tract or the lower digestive tract, etc. Therefore, the endoscope insertion portion has flexibility that allows it to be inserted along the insertion path.

[0003] Incidentally, the intestine, which is an example of an insertion path, has some parts that are not fixed to the body (such as the sigmoid colon), and there is a problem that when the endoscope insertion part is inserted, the above parts are deformed along the way even if the insertion part is pushed in, making it difficult for the tip of the insertion part to move forward. Also, during endoscopic treatment, there are cases where a delicate operation is performed in which a treatment tool is led out from the tip of the insertion part to cut out the diseased part, but the deformation of the above parts can hinder this delicate operation.

[0004] Therefore, Patent Document 1 discloses a hardening device system that can eliminate unstable operation during insertion and treatment. The hardening device system of Patent Document 1 includes a hardening device having a wall with multiple layers including a braided layer, an outer layer, and an inner layer, and further includes a handle having a vacuum or pressure inlet for supplying vacuum or pressure to the hardening device. In addition, an operating element of the hardening device system is used to turn the vacuum or pressure on and off to transition the hardening device between the flexible and hardened configurations. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Special Publication No. 2021-531111 Summary of the Invention [Problem to be solved by the invention]

[0006] However, the curing device system (medical instrument guiding apparatus) of Patent Document 1 has a handle (handle portion) that has a complex shape, which makes it difficult for the surgeon to grip the handle portion, resulting in a problem that the operability of the medical instrument is affected.

[0007] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a medical instrument guide device capable of improving the operability of a medical instrument. [Means for solving the problem]

[0008] In order to solve the above-mentioned problems, the medical instrument guide device of the present invention is a medical instrument guide device having an insertion passage for guiding a medical instrument into the body, and comprises a long tube body to be inserted into the body, and a handle portion provided on the base end side of the tube body, the handle portion having an inner tube to which the base end of the tube body is connected, and an outer tube inserted onto the inner tube, and the inner tube has a port portion for supplying and discharging fluid to and from the tube body.

[0009] According to one aspect of the present invention, the tube body preferably has a hardness changing portion that is disposed along the longitudinal direction of the tube body and whose hardness changes depending on the fluid supplied or discharged from the port portion.

[0010] According to one aspect of the present invention, a stress relief ring is disposed so as to surround the outer periphery of the connection portion between the inner tube and the tube body in a loose fit state, and the inner tube and the outer tube are preferably connected and fixed to the stress relief ring.

[0011] According to one aspect of the present invention, a leak prevention valve for preventing leakage of liquid from the tube body is preferably disposed inside the handle portion.

[0012] According to one form of the present invention, it is preferable that the outer tube has a flange-shaped valve holding portion provided on the inner surface of the outer tube, and the anti-leak valve is sandwiched between the valve holding portion and the base end of the inner tube to regulate the axial position of the handle portion.

[0013] According to one form of the present invention, it is preferable that the outer tube has an engaging portion protruding from the outer peripheral surface of the inner tube, and the outer tube has a slit-shaped engaged portion that is open toward the tube body, and the outer tube is inserted onto the inner tube in a state prevented from rotating relative to the inner tube by engaging the engaged portion with the engaging portion.

[0014] According to one aspect of the present invention, the port portion is preferably provided in the engagement portion.

[0015] According to one form of the present invention, the tube body has a hardness changing section arranged along the longitudinal direction of the tube body and whose hardness changes depending on the fluid supplied or discharged from the port section, and it is preferable that the port section has a fluid port for supplying or discharging fluid to the tube body, and a liquid port for supplying liquid to the inner surface of the insertion passage.

[0016] According to one aspect of the present invention, the fluid port and the liquid port are preferably arranged side by side along the axial direction of the inner cylinder.

[0017] According to one aspect of the present invention, the liquid port is preferably disposed on the opposite side of the fluid port to the side to which the tube body of the inner cylinder is connected.

[0018] According to one form of the present invention, the device comprises a fluid tube connected to a fluid port and a liquid tube connected to a liquid port, and it is preferable that the direction in which the base end portion of the fluid tube is pulled out from the fluid port and the direction in which the base end portion of the liquid tube is pulled out from the liquid port are the same as each other.

[0019] According to one aspect of the present invention, it is preferable that the direction in which the base end portion of the fluid tube is pulled out from the fluid port and the direction in which the base end portion of the liquid tube is pulled out from the liquid port are perpendicular to the axial direction of the inner tube.

[0020] According to one embodiment of the present invention, it is preferable that the outer tube has a first tubular portion arranged on the side of the tube body, and a second tubular portion arranged on the opposite side of the tube body from the first tubular portion and having an outer diameter larger than that of the first tubular portion.

[0021] According to one embodiment of the present invention, it is preferable that the first cylindrical portion has a large diameter cylindrical portion arranged on the side of the tube body, and a small diameter cylindrical portion arranged on the opposite side of the tube body from the large diameter cylindrical portion and having an outer diameter smaller than that of the large diameter cylindrical portion.

[0022] According to one aspect of the present invention, the axial length of the cylindrical small diameter portion is preferably longer than the axial length of the second cylindrical portion.

[0023] According to one aspect of the present invention, the cylindrical small diameter portion is preferably disposed on the opposite side of the port portion from the tube main body.

[0024] According to one form of the present invention, the tube body has a hardness changing section arranged along the longitudinal direction of the tube body and whose hardness changes depending on the fluid supplied or discharged from the port section, the port section has a fluid port for supplying or discharging fluid to the tube body, and is equipped with a fluid tube connected to the fluid port, a switching section is provided midway through the fluid tube, and it is preferable that the switching section has a switching member capable of switching the supply or discharge of fluid to or from the fluid port.

[0025] According to one aspect of the present invention, the switching portion preferably has a fixing portion that is removably fixed to the medical device.

[0026] According to one aspect of the present invention, the medical instrument is an endoscope having an insertion portion to be inserted into the body, and the fixing portion preferably has a fitting portion that can be fitted into a treatment tool insertion portion of the endoscope.

[0027] According to one aspect of the present invention, the switching member is preferably disposed on the opposite side of the fixing portion to the fluid port side. Effect of the Invention

[0028] According to the present invention, it is possible to improve the operability of a medical instrument. [Brief description of the drawings]

[0029] [Figure 1] FIG. 2 is an external view of a guide tube according to the first embodiment. [Diagram 2] 4 is an enlarged cross-sectional view of a main portion showing the configuration of a guide tube. [Diagram 3] 2 is a schematic diagram showing the main configuration of a spiral tube. FIG. [Figure 4] FIG. 13 is an explanatory diagram showing a curved state of the helical tube. [Diagram 5] FIG. 4 is an assembled perspective view of the handle portion as viewed obliquely from the base end side of the shaft. [Figure 6] FIG. 2 is an assembled perspective view of the handle portion as viewed from an oblique direction on the tip side of the shaft. [Figure 7] FIG. 4 is a cross-sectional view showing the configuration of a handle portion. [Figure 8] FIG. 2 is a perspective view of a three-way stopcock provided midway through a fluid tube. [Figure 9] FIG. 2 is a perspective view of a main portion in which a three-way stopcock is detachably fixed to an endoscope by a hook. [Figure 10] 1A and 1B are explanatory diagrams showing an example of endoscopic treatment using a guide tube. [Figure 11] 4A to 4C are explanatory views of essential parts showing an example of operation of an endoscope using the guide tube of the first embodiment. [Figure 12] FIG. 11 is an external view showing a main part of a guide tube according to a second embodiment. [Figure 13] 13 is a perspective view of the outer cylinder of FIG. 12 as viewed obliquely from the base end side of the shaft. [Figure 14] 13 is a perspective view of the outer cylinder of FIG. 12 as viewed from an oblique direction on the tip side of the shaft. [Figure 15] 11 is a main part explanatory view showing an example of operation of an endoscope using a guide tube of the second embodiment. FIG. [Figure 16] FIG. 13 is a perspective view showing a modified example for disposing a three-way stopcock on an endoscope. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of a medical instrument guiding device according to the present invention will be described with reference to the accompanying drawings.

[0031] Fig. 1 is an external view of a medical instrument guide device (hereinafter referred to as a "guide tube") 10 according to a first embodiment of the present invention. In addition to the guide tube 10, Fig. 1 also illustrates an endoscope 12, and shows a usage form in which an insertion section 14 of the endoscope 12 is inserted into the guide tube 10.

[0032] First, a description will be given of the endoscope 12. As shown in Fig. 1, the endoscope 12 has an insertion section 14 and a proximal operation section 16, and the base end side of the insertion section 14 is connected to the proximal operation section 16. The endoscope 12 is an example of the medical instrument of the present invention that is guided into the body by a guide tube 10.

[0033] The insertion section 14 is configured by sequentially connecting a tip hard section 18, a bending section 20, and a flexible section 22 from the tip side to the base end side. In Fig. 1, the tip hard section 18, the bending section 20, and the tip side of the flexible section 22 are shown protruding outward from a tip opening 51 of a tube body 50 constituting the guide tube 10.

[0034] The distal end hard portion 18 has a pair of illumination windows 24 for illuminating the inside of the body on a distal end surface 18A of the distal end hard portion 18, an observation window 26 for acquiring an image of the inside of the body under illumination from the illumination windows 24, and a treatment tool outlet 28 for guiding a treatment tool such as forceps or a high-frequency treatment tool. A treatment tool insertion section 32 protrudes from the proximal operation section 16, and the treatment tool is inserted from an insertion port 30 provided in the treatment tool insertion section 32 toward the treatment tool outlet 28. Note that FIG. 1 shows a state in which the insertion port 30 is sealed with a cap 34.

[0035] The bending section 20 is bent in a desired direction by operating a pair of angle knobs 36 provided on the hand-held operation section 16. The flexible section 22 is made of a soft member having flexibility in the bending direction. Since the configuration of the endoscope 12 is conventionally well known, detailed illustration and description will be omitted here. The guide tube 10 according to the first embodiment will be described in detail below.

[0036] [First embodiment] Fig. 2 is an enlarged cross-sectional view of a main part of the guide tube 10 of the first embodiment, particularly showing the configuration of the tube main body 50. As shown in Fig. 2, the guide tube 10 includes a long tube main body 50 to be inserted into the body, and a handle portion 100 (see Fig. 1) to be gripped by an operator. The axes of the tube main body 50 and the handle portion 100 are arranged along the axis Ax direction of the guide tube 10. The configuration of the tube main body 50 will be described below with reference to Fig. 2. Note that Fig. 2 is a schematic diagram for easily explaining the configuration of each member, and therefore the scale of each member may differ from the actual scale.

[0037] 2, the tube main body 50 has a flexible outer tube 52, a flexible inner tube 54 disposed inside the outer tube 52, and a shape-changing body 58 disposed in an internal space 56 between the outer tube 52 and the inner tube 54. An insertion passage 60 for the insertion section 14 (see FIG. 1) is defined by the inner circumferential surface of the inner tube 54. A hydrophilic coating 62 is formed on the inner circumferential surface of the inner tube 54, thereby reducing frictional resistance between the inner tube 54 and the insertion section 14 (see FIG. 1).

[0038] The outer tube 52 and the inner tube 54 are each made of a soft resin material that can be bent along the curved portion of the intestinal tract. Examples of the soft resin material include, but are not limited to, urethane or polyester resin. The thickness of the outer tube 52 and the inner tube 54 is, for example, about 100 μm, and the thickness of the internal space 56 located between the outer tube 52 and the inner tube 54 is, for example, about 800 μm.

[0039] The internal space 56 is a space whose cross-sectional shape in a direction perpendicular to the axis Ax is formed in an annular shape so as to surround the outer periphery of the inner tube 54. The internal space 56 is sealed by a tubular cap 66 connected to the tip end 50A of the tube body 50 with an adhesive 64, and an inner cylinder 110 (described later) connected to the base end 50B of the tube body 50 with an adhesive 68. The tip opening 51 shown in FIG. 1 is provided in the cap 66 in FIG. 2.

[0040] The deformable body 58 is deformable to conform to the shapes of the outer tube 52 and the inner tube 54, and has, as an example, a helical tube 70 disposed along the axis Ax direction.

[0041] Fig. 3 is a schematic diagram showing the main configuration of the helical tube 70. As shown in Fig. 3, the helical tube 70 is formed by helically winding a strip-shaped member 72 and is provided on the outer circumferential side of the inner tube 54 (see Fig. 2). The strip-shaped member 72 is made of stainless steel (SUS: Steel Use Stainless) as an example, but is not limited to this. In addition, the thickness of the strip-shaped member 72 is preferably 300 µm or less when the thickness of the tube main body 50 is about 1 mm, for example.

[0042] The spiral tube 70 has a high-friction surface 74 on its outer circumferential surface. Examples of the high-friction surface 74 include a resin layer formed by coating the outer circumferential surface of the spiral tube 70 with a resin such as a urethane coat or a silica coat, a rough surface formed on the outer circumferential surface of the spiral tube 70, or a resin layer formed by coating the rough surface with a resin. As shown in FIG. 2, the spiral tube 70 has two turns on the base end side bonded to the base end side of the inner tube 54 with an adhesive 76, and two turns on the tip end side bonded to the tip end side of the inner tube 54 with an adhesive 78. This allows the spiral tube 70 to be firmly bonded to the inner tube 54. The spiral tube 70 has flexibility in the bending direction, and can be deformed into a curved shape, for example, as shown in FIG. 4.

[0043] Returning to FIG. 2, the shape-variable body 58 has a sheet material 80 that can come into contact with the high-friction surface 74 of the spiral tube 70. The sheet material 80 is formed in a cylindrical shape and arranged along the axis Ax direction. This causes the high-friction surface 74 of the spiral tube 70 to be covered by the sheet material 80. The sheet material 80 has flexibility that allows it to deform in accordance with the shape of the tube main body 50, and is made of a resin such as urethane as an example, but is not limited to this. The thickness of the sheet material 80 is preferably 300 μm or less when the thickness of the tube main body 50 is approximately 1 mm, for example.

[0044] The sheet material 80 has a high friction surface 82 on its inner circumferential surface that contacts the high friction surface 74 of the spiral tube 70. As a result, when the air in the internal space 56 is exhausted (sucked) by the vacuum pump 40 (see Figs. 1 and 2) and the internal space 56 is in a reduced pressure state (e.g., a vacuum state), the spiral tube 70 and the sheet material 80 are in close contact with each other via the high friction surfaces 74, 82 of the tube body 50 and are frictionally engaged. As a result, the shape of the spiral tube 70 is maintained in an undeformable state, and the hardness of the tube body 50 changes from a soft state to a hard state, and the shape retention of the tube body 50 is enhanced. In addition, by opening the internal space 56 to the atmosphere and supplying air to the internal space 56, the above-mentioned frictional engagement is released, and the hardness of the tube body 50 changes from a hard state to a soft state. The tube body 50 of this example is an example of the tube body of the present invention. Furthermore, the outer tube 52, the inner tube 54 and the shape-changing body 58 arranged along the longitudinal direction (axis Ax) of the tube body 50 are parts whose hardness changes as described above, and are an example of the hardness-changing portion of the present invention.

[0045] Next, the configuration of the handle portion 100 shown in Fig. 1 will be described in detail with reference to Fig. 5 to Fig. 7. Fig. 5 is an assembled perspective view of each member of the handle portion 100 as viewed obliquely from the base end side of the axis Ax (left side in Fig. 5), and Fig. 6 is an assembled perspective view of each member of the handle portion 100 as viewed obliquely from the tip end side of the axis Ax (right side in Fig. 6). Fig. 7 is a cross-sectional view of the handle portion 100 along the axis Ax.

[0046] 5 to 7, the handle portion 100 is provided on the base end side of the tube body 50, and has an inner tube 110 to which the base end portion 50B of the tube body 50 is connected, and an outer tube 120 that is fitted onto the inner tube 110. The inner tube 110 also has a port portion 112 for supplying and discharging a fluid to and from the tube body 50. The handle portion 100 is an example of a handle portion of the present invention. The inner tube 110 and the outer tube 120 are each arranged such that their axes are aligned along the axis Ax.

[0047] The inner tube 110 has an outer diameter that is approximately equal to the outer diameter of the tube body 50. In addition, an insertion passage 114 of the insertion part 14 (see FIG. 1) is defined by the inner peripheral surface of the inner tube 110. As a result, the insertion part 14 (see FIG. 1) is inserted into the insertion passages 114, 60 (see FIG. 2) defined by the inner peripheral surface of the inner tube 110 and the inner peripheral surface of the inner tube 54 (see FIG. 2) and guided into the body. Note that a hydrophilic coat 116 is formed on the inner peripheral surface of the inner tube 110 as well as on the inner tube 54, and frictional resistance between the inner tube 110 and the insertion part 14 is reduced. The inner tube 110 is an example of an inner tube of the present invention.

[0048] The outer cylinder 120 has an inner diameter larger than the outer diameter of the inner cylinder 110. This allows the outer cylinder 120 to be fitted onto the inner cylinder 110. The outer cylinder 120 is a member to be held by the fingers of an operator, and the outer diameter and length of the outer cylinder 120 in the axial direction Ax are configured to be large enough and long enough to be held by the fingers of an operator. As an example, the outer diameter of the outer cylinder 120 is 3 to 4 cm, and the length in the axial direction Ax is about 8 to 10 cm. The outer cylinder 120 is one example of an outer cylinder of the present invention. Other configurations of the outer cylinder 120 will be described later.

[0049] As shown in FIG. 7, a ring member 140 is disposed at a connection portion 118 between the inner tube 110 and the tube body 50, surrounding the outer periphery of the connection portion 118 in a loosely fitted state. The connection portion 118 is a portion on which stress is concentrated and loaded when the tube body 50 is bent, and includes the base end portion 50B of the tube body 50 and the application area of ​​the adhesive 68 (see FIG. 2), as well as a portion having a length of about 2 cm from the base end portion 50B of the tube body 50 toward the tip side in the axis Ax direction (hereinafter, also referred to as the "base end portion of the tube body 50"). When the tube body 50 is bent, the base end portion of the tube body 50 abuts against the inner circumferential surface of the ring member 140, thereby restricting excessive bending of the base end portion of the tube body 50. Thus, the ring member 140 has a function of relieving stress generated at the connection portion 118 when the tube body 50 is bent. The ring member 140 is an example of a stress relief ring of the present invention.

[0050] Here, the guide tube 10 of this example employs a configuration in which the inner tube 110 and the outer tube 120 are connected and fixed to a ring member 140. An example of a configuration for connecting and fixing the inner tube 110 and the outer tube 120 to the ring member 140 will be described below.

[0051] 5, the ring member 140 has a pair of arc-shaped projections 142 on a base end surface 140A of the ring member 140, and these projections 142 are provided to project from the base end surface 140A toward the base end side in the direction of the axis Ax. Moreover, these projections 142 are provided along a circumference centered on the axis of the ring member 140 (axis Ax after the above-mentioned fixed connection). The base end side opening 122 of the outer tube 120 is fitted onto these projections 142, whereby the outer tube 120 is connected and fixed to the ring member 140.

[0052] 5, the ring member 140 has three pins 144, 146, 148 on the base end surface 140A, and these pins 144, 146, 148 are provided to protrude from the base end surface 140A toward the base end side in the axis Ax direction. Among the pins 144, 146, 148, the pins 144 and 146 are provided adjacent to each other, and the pin 148 is provided at a position spaced approximately 180 degrees from the pins 144 and 146 in the circumferential direction. The three pins 144, 146, 148 are fitted into three holes 150, 152, 154 provided on the base end side of the inner tube 110 shown in FIG. 6. That is, the pin 144 is fitted into the hole 150, the pin 146 is fitted into the hole 152, and the pin 148 is fitted into the hole 154. In this manner, the three pins 144, 146, 148 are fitted into the three holes 150, 152, 154, whereby the inner tube 110 is fixedly connected to the ring member 140. As a result, the inner tube 110 and the outer tube 120 are fixedly connected to the ring member 140. The above is an example of a configuration for connecting and fixing the inner tube 110 and the outer tube 120 to the ring member 140. After the above connection and fixation, it is preferable that the outer tube 120 and the ring member 140 are fixed with an adhesive (not shown).

[0053] As shown in Fig. 7, a leak prevention valve 160 (see Figs. 5 and 6) is disposed inside the handle portion 100. The leak prevention valve 160 has a function of preventing leakage of liquid from the tube main body 50 by coming into close contact with the outer peripheral surface of the insertion portion 14 (see Fig. 1) when the insertion portion 14 is inserted into the handle portion 100. An example of a configuration for disposing the leak prevention valve 160 inside the handle portion 100 will be described below.

[0054] 7, the outer cylinder 120 has a flange-shaped valve holding portion 124 provided on the inner circumferential surface of the outer cylinder 120. The leak prevention valve 160 is sandwiched between the valve holding portion 124 and the base end portion 110B of the inner cylinder 110, and the position of the handle portion 100 in the axial Ax direction is regulated.

[0055] 5 to 7, the leak-proof valve 160 is configured in a substantially ring shape, and includes an annular valve body 162 and a tubular portion 164 protruding from the outer periphery of the valve body 162 toward the tip side in the axial Ax direction. The outer diameter of the tubular portion 164 is smaller than the inner diameter of the outer tube 120, and the inner diameter of the tubular portion 164 is larger than the outer diameter of the inner tube 110. The inner diameter of the valve body 162 is smaller than the inner diameter of the inner tube 110 and smaller than the outer diameter of the insertion portion 14 (see FIG. 1). The valve holding portion 124 is provided on the inner peripheral surface of the base end portion 120B of the outer tube 120, and the inner diameter of the valve holding portion 124 is larger than the inner diameter of the valve body 162 and smaller than the inner diameter of the inner tube 110. With such an arrangement of the leak prevention valve 160, the leak prevention valve 160 is arranged at the base end 120B of the outer cylinder 120 with the valve main body 162 sandwiched between the valve holding portion 124 and the base end 110B of the inner cylinder 110. The leak prevention valve 160 is an example of a leak prevention valve of the present invention, and the valve holding portion 124 is an example of a valve holding portion of the present invention.

[0056] In the above-mentioned arrangement, the valve holding portion 124 is provided at the base end 120B of the outer cylinder 120, but the present invention is not limited to this, and the valve holding portion 124 may be provided at a position away from the base end 120B toward the tip side in the axial Ax direction. However, from the viewpoint of stably restricting the position of the leak prevention valve 160 in the axial Ax direction, the above-mentioned arrangement in which the valve holding portion 124 is provided at the base end 120B of the outer cylinder 120 is preferable.

[0057] As shown in Figures 5 and 6, the inner tube 110 has a base portion 170 that protrudes from the outer circumferential surface of the inner tube 110. The outer tube 120 has a slit 180 that opens toward the tube body 50. As shown in Figure 7, the outer tube 120 is fitted onto the inner tube 110 in a state where it is prevented from rotating relative to the inner tube 110 by engaging the slit 180 with the base portion 170. An example of a configuration for engaging the base portion 170 with the slit 180 will be described below.

[0058] As shown in FIG. 5 and FIG. 6, the base portion 170 is configured as a substantially rectangular plate-like portion extending from the tip portion 110A side of the inner tube 110 toward the base end side in the axis Ax direction. The slit 180 is formed as a substantially rectangular cutout portion formed from the tip portion 120A of the outer tube 120 toward the base end side in the axis Ax direction, and has substantially the same length and width as the base portion 170 in the length in the axis Ax direction and the width in the circumferential direction around the axis Ax. With this configuration, the slit 180 and the base portion 170 are engaged with each other. As a result, the outer tube 120 is inserted onto the inner tube 110 in a state where it is prevented from rotating in the circumferential direction around the axis Ax with respect to the inner tube 110. The base portion 170 is exposed and disposed on the outer surface of the outer tube 120 (see FIG. 1). The base portion 170 is an example of an engaging portion of the present invention, and the slit 180 is an example of an engaged portion of the present invention. As shown in Fig. 6, holes 150, 152 into which pins 144, 146 (see Fig. 5) are fitted are provided on the tip side surface of base portion 170. Hole 154 into which pin 148 (see Fig. 5) is fitted is provided on the tip side surface of protrusion 172 protruding from the outer circumferential surface of inner tube 110. This protrusion 172 engages with notch 182 formed in tip portion 120A of outer tube 120 during the above-mentioned extrapolation.

[0059] As shown in Fig. 5 to Fig. 7, the port portion 112 is provided on the base portion 170. As shown in Fig. 7, the port portion 112 has a port 190 for supplying and discharging a fluid (e.g., air) to and from the tube main body 50, and a port 200 for supplying a liquid (e.g., water) to the inner peripheral surface of the insertion passage 114 (the inner peripheral surface of the inner tube 110). The port portion 112, the port 190, and the port 200 are examples of the port portion, the fluid port, and the liquid port of the present invention, respectively. The port 190 is connected to the internal space 56 (see Fig. 2) of the tube main body 50 via a flow path 191 formed in the inner tube 110, and the port 200 is connected to the inner peripheral surface of the inner tube 110 via a flow path 201 formed in the inner tube 110.

[0060] 5 to 7, the port 190 and the port 200 are arranged side by side along the axis Ax direction of the inner tube 110. That is, the port 190 and the port 200 are arranged side by side along the same axis line parallel to the axis Ax. Furthermore, the port 200 is arranged on the opposite side of the port 190 to the side to which the tube main body 50 of the inner tube 110 is connected. That is, the port 200 is arranged on the base end side of the port 190 in the axis Ax direction. A tube 192 is connected to the port 190, and a tube 202 is connected to the port 200.

[0061] 7, a pull-out direction B of the base end portion 193 of the tube 192 from the port 190 and a pull-out direction C of the base end portion 203 of the tube 202 from the port 200 are set to be the same direction. In the configuration of this example, both pull-out directions B and C are set to be perpendicular to the axial Ax direction of the inner cylinder 110. The base end portion 193 of the tube 192 includes an insertion portion that is inserted (fitted) into the port 190, which is a hole, and the base end portion 203 of the tube 202 includes an insertion portion that is inserted (fitted) into the port 200, which is a hole. The tube 192 is an example of a fluid tube of the present invention, and the tube 202 is an example of a liquid tube of the present invention. In addition, by configuring the hardness of the base end portions 193, 203 of the tubes 192, 202 to be higher than the hardness of the other portions excluding the base end portions 193, 203, the operation of connecting the base end portions 193, 203 to the ports 190, 200 becomes easier.

[0062] 8 is a perspective view of switching unit 208 provided midway through tube 192. Switching unit 208 is an example of the switching unit of the present invention. Switching unit 208 of this example has a three-way stopcock 210. The function of three-way stopcock 210 will be described below with reference to the schematic diagram of three-way stopcock 210 shown in FIG.

[0063] As shown in FIG. 2, the three-way stopcock 210 has a first port 210A connected to the tube 192A on the vacuum pump 40 side of the tube 192, a second port 210B connected to the tube 192B on the port 190 side, and a third port 210C for opening to the atmosphere. The three-way stopcock 210 also has a cock 212. The operator can rotate the cock 212 to selectively switch between an ON mode in which the first port 210A communicates with the second port 210B and an OFF mode in which the second port 210B communicates with the third port 210C. When the cock 212 is switched to the ON mode, the vacuum pump 40 and the internal space 56 of the tube body 50 communicate with each other via the tube 192 and the flow path 191. As a result, the air in the internal space 56 is exhausted (sucked) by the vacuum pump 40, the internal space 56 is in a reduced pressure state (for example, a vacuum state), and the hardness of the tube body 50 becomes a hard state. Furthermore, when the cock 212 is switched to the OFF mode, the internal space 56 and the outside air are communicated via the tube 192 and the flow path 191. As a result, air (outside air) is supplied from the tube 192 through the flow path 191 to the internal space 56, the internal space 56 becomes at atmospheric pressure, and the hardness of the tube body 50 becomes soft. In this manner, by operating the cock 212 of the three-way stopcock 210, it is possible to switch between supplying and discharging air to and from the internal space 56. The three-way stopcock 210 is an example of a switching member of the present invention.

[0064] Returning to Fig. 8, the switching unit 208 has a hook 214 that can be detachably fixed to the endoscope 12. The hook 214 has an opening 216 that can be fitted into the treatment tool insertion section 32 of the endoscope 12. As shown in Fig. 9, by fitting the opening 216 of the hook 214 into the treatment tool insertion section 32, the hook 214 is fixed to the treatment tool insertion section 32 and the switching unit 208 is disposed in the hand operation unit 16 (see Fig. 1). This allows the operator operating the hand operation unit 16 to operate the cock 212 of the three-way stopcock 210. The hook 214 is an example of a fixed portion of the present invention, and the opening 216 is an example of a fitting portion of the present invention.

[0065] 9, the cock 212 of the three-way stopcock 210 is disposed on the opposite side of the hook 214 from the port 190. In other words, the cock 212 of the three-way stopcock 210 is disposed on the vacuum pump 40 side of the hook 214. This allows the surgeon to operate the cock 212 with his / her right hand while holding the handheld operation unit 16 with his / her left hand.

[0066] It should be noted that tube 192 (including tube 192A and tube 192B) has a length (e.g., about 3 to 5 meters) required to connect port 190 and vacuum pump 40, but tube 192B only needs to have a length (e.g., about 1 meter) for disposing switching unit 208 on hand operation unit 16. In this case, switching unit 208 is provided at a midway position in tube 192, about 1 meter away from port 190. By providing switching unit 208 at such a midway position, the surgeon can operate cock 212 of three-way stopcock 210 without having to pull around tube 192B.

[0067] Returning to FIG. 1, a syringe 204 is connected to the tip 202A of the tube 202. The syringe 204 stores liquid (e.g., water) therein, and the surgeon can supply the liquid from the tube 202 to the inner circumferential surface of the inner cylinder 110 through the flow path 201 in FIG. 7 by operating the syringe. This allows the hydrophilic coat 116 formed on the inner circumferential surface of the inner cylinder 110 to be moistened with the liquid. Note that, in order to enable the surgeon to operate the syringe 204 together with the three-way stopcock 210, the tube 202 may have a length (e.g., about 1 meter) that is approximately equal to the length of the tube 192B, for example. This allows the surgeon to operate the syringe 204 without having to pull the tube 202 around.

[0068] Next, the configuration of the outer cylinder 120 will be described. As shown in Fig. 5 to Fig. 7, the outer cylinder 120 has a first cylindrical portion 126 and a second cylindrical portion 128. The first cylindrical portion 126 and the second cylindrical portion 128 are arranged along the axis Ax direction, with the first cylindrical portion 126 being arranged on the side of the tube main body 50 and the second cylindrical portion 128 being arranged on the opposite side of the first cylindrical portion 126 from the side of the tube main body 50. That is, the second cylindrical portion 128 is arranged on the base end side in the axis Ax direction with respect to the first cylindrical portion 126. Also, the second cylindrical portion 128 is configured to have an outer diameter larger than that of the first cylindrical portion 126.

[0069] The first cylindrical portion 126 is a portion forming the main body of the outer cylinder 120. In other words, the first cylindrical portion 126 is configured to be longer than the second cylindrical portion 128 in the direction of the axis Ax, and functions as a portion to be held by the fingers of the surgeon. The first cylindrical portion 126 is an example of the first cylindrical portion of the present invention.

[0070] The second cylindrical portion 128 is formed in a flange shape at the base end portion 120B of the outer cylinder 120. The second cylindrical portion 128 is provided mainly to form a step portion 130 between the second cylindrical portion 128 and the first cylindrical portion 126, and the surgeon can use the step portion 130 as a finger hook for hooking a finger. The second cylindrical portion 128 is an example of the second cylindrical portion of the present invention.

[0071] Next, an example of an operation for guiding the insertion portion 14 of the endoscope 12 to the large intestine 400 (see FIG. 10) using the guide tube 10 will be described.

[0072] First, the insertion portion 14 (see FIG. 1) is inserted through the insertion passages 114, 60 (see FIG. 7) of the guide tube 10 and then inserted along the large intestine 400 (see FIG. 10) together with the tube body 50. Since the insertion portion 14 and the tube body 50 are both flexible, they can be smoothly inserted along the curved shape of the large intestine 400.

[0073] Next, with the tube main body 50 aligned along the curved shape of the sigmoid colon 402, the cock 212 of the three-way stopcock 210 is operated to switch to the ON mode. Then, the vacuum pump 40 (see FIG. 1) exhausts (sucks) the air in the internal space 56, the sheet material 80 is pressed against the outer tube 52, and the spiral tube 70 is pressed against the inner tube 54. As a result, the high friction surface 74 of the spiral tube 70 and the high friction surface 82 of the sheet material 80 come into close contact with each other and frictionally engage. This causes the tube main body 50 to harden in a shape corresponding to the curved shape of the sigmoid colon 402 and maintain that shape, improving the insertability of the insertion portion 14 into the sigmoid colon 402.

[0074] Next, the curved portion 20 of the insertion portion 14 is projected forward from the tip opening 51 of the guide tube 10, and then a treatment tool (not shown) is led forward from the treatment tool lead-out port 28 (see FIG. 1) of the tip rigid portion 18 to start treatment of the lesion 406 of the transverse colon 404. At this time, because the insertability of the insertion portion 14 into the sigmoid colon 402 is improved by the guide tube 10, the tip rigid portion 18 can be positioned at an appropriate treatment position, and as a result, the lesion 406 can be treated appropriately.

[0075] During treatment with the endoscope 12, the surgeon generally holds the proximal operation section 16 with the left hand, and inserts the tube body 50 and the insertion section 14 of the guide tube 10 into the body while holding the handle section 100 and the insertion section 14 of the guide tube 10 with the right hand. When the hardness of the tube body 50 is to be changed, the cock 212 of the three-way stopcock 210 is operated with the right hand. Then, when treatment of the lesion 406 is completed, the surgeon holds the handle section 100 and the insertion section 14 with the right hand and pulls out the tube body 50 and the insertion section 14 from the body.

[0076] In the operation method described in FIG. 10, the tube body 50 (including the insertion part 14) in a flexible state is hardened while being aligned with the curved shape of the sigmoid colon 402, but the operation method is not limited to this. For example, an operation method may be adopted in which the sigmoid colon 402 is straightened by the tube body 50 (including the insertion part 14) in a flexible state, and then the tube body 50 is hardened. As an example of straightening the sigmoid colon 402, the tube body 50 (including the insertion part 14) in a flexible state is inserted along the curved shape of the sigmoid colon 402, and when the tip of the tube body 50 reaches the splenic bay (not shown), the tube body 50 is operated in the pull-out direction while rotating around the axis Ax. This operation makes it possible to straighten the sigmoid colon 402. In addition, an operation method may be adopted in which the intestine is straightened to a certain extent by the insertion part 14, the tube body 50 is inserted into the intestine, and then the tube body 50 is hardened.

[0077] The effects of the guide tube 10 of the first embodiment will be described below.

[0078] According to the guide tube 10, the handle section 100 has a simple configuration including an inner tube 110 to which the base end section 50B of the tube body 50 is connected and which has a port section 112 for supplying and discharging fluid to the tube body 50, and an outer tube 120 which is fitted onto the inner tube 110, making it easy for an operator operating the guide tube 10 to grip the handle section 100. As a result, according to the guide tube 10 of the first embodiment, it is possible to improve the operability of the endoscope 12 operated using the guide tube 10.

[0079] In addition, the guide tube 10 employs a configuration in which the ring member 140 is disposed to surround the outer periphery of the connection portion 118 between the inner tube 110 and the tube body 50 in a loosely fitted state, so that the ring member 140 can alleviate stress generated in the connection portion 118 when the tube body 50 is bent. That is, when the base end portion of the tube body 50 is bent during bending of the tube body 50, a part of the base end portion comes into contact with the inner periphery of the ring member 140, so that excessive bending of the base end portion of the tube body 50 is restricted by the ring member 140, so that the stress generated in the connection portion 118 can be alleviated and the connection portion 118 can be protected. In addition, the handle portion 100 is assembled by connecting and fixing the inner tube 110 and the outer tube 120 to the ring member 140, so that the handle portion 100 can be assembled more easily and robustly.

[0080] In addition, since the guide tube 10 employs a configuration in which the leak prevention valve 160 is disposed inside the handle portion 100, the leak prevention valve 160 can be disposed in the handle portion 100 with a simpler configuration than, for example, a configuration in which the leak prevention valve 160 is attached to the outside of the handle portion 100 using a cap. This improves the ease of assembly of the handle portion 100.

[0081] Furthermore, according to the above-mentioned guide tube 10, a configuration is adopted in which the position of the leak prevention valve 160 in the axial Ax direction is restricted by sandwiching the leak prevention valve 160 between the flange-shaped valve holding portion 124 provided on the inner circumferential surface of the outer tube 120 and the base end portion 110B of the inner tube 110, so that the positional deviation of the leak prevention valve 160 in the axial Ax direction can be restricted with a simple configuration. Furthermore, according to the configuration of this example, it is also possible to restrict the positional deviation of the leak prevention valve 160 in the direction perpendicular to the axis Ax. Therefore, according to the configuration of this example, the leakage of liquid can be effectively prevented.

[0082] In addition, the guide tube 10 employs a configuration in which the outer tube 120 is fitted onto the inner tube 110 in a state in which the outer tube 120 is prevented from rotating relative to the inner tube 110 by engaging the base portion 170 with the slit 180, so that the outer tube 120 can be prevented from rotating with a simple configuration. This improves the ease of assembly of the handle portion 100.

[0083] Furthermore, the guide tube 10 has a configuration in which the port portion 112 is provided on the base portion 170, i.e., the port portion 112 is provided on the base portion 170 that is exposed to the outside of the handle portion 100, which makes it easier to connect the tube 192 for supplying and discharging fluid to the port portion 112.

[0084] Furthermore, according to the above-mentioned guide tube 10, the port portion 112 has a configuration having a port 190 and a port 200, which makes it easier to connect the tube 192 to the port 190 and the tube 202 to the port 200.

[0085] Furthermore, according to the above-mentioned guide tube 10, a configuration is adopted in which the ports 190 and 200 are arranged side by side along the axis Ax direction of the inner tube 110, so that the surgeon can grip the handle portion 100 without the tubes 192 and 202 getting in the way. This improves the operability of the guide tube 10 and the endoscope 12. Note that, in the configuration of this example, if the ports 190 and 200 are arranged at positions offset from each other in the axis Ax direction, the tubes 192 and 202 may get in the way of the surgeon gripping the handle portion 100, but the configuration of this example can solve such a problem.

[0086] Furthermore, according to the above-mentioned guide tube 10, the port 200 is arranged on the opposite side of the port 190 from the side where the tube main body 50 of the inner tube 110 is connected, so that the flow path 191 from the port 190 to the tube main body 50 and the flow path 201 from the port 200 to the insertion passage 114 can be arranged without crossing each other. That is, as shown in FIG. 7, the above-mentioned flow path 201 may be arranged in a direction perpendicular to the axis Ax direction from the port 200 to the insertion passage 114, and the above-mentioned flow path 191 may be arranged in an L-shape from the port 190 to the tube main body 50, so that both the flow paths 191, 201 can be arranged without crossing each other. Therefore, by adopting the configuration of this example, the two flow paths 191, 201 can be arranged in the inner tube 110 with a simple configuration.

[0087] Furthermore, according to the above-mentioned guide tube 10, a configuration is adopted in which the pull-out direction B of the base end portion 193 of the tube 192 from the port 190 and the pull-out direction C of the base end portion 203 of the tube 202 from the port 200 are the same direction, so that the surgeon can grip the handle portion 100 without the tubes 192 and 202 getting in the way. This improves the operability of the guide tube 10 and the endoscope 12. Note that, in the configuration of this example, for example, when the pull-out directions B and C of both are different from each other (for example, when the pull-out direction B is directed toward the tip side in the direction of the axis Ax and the pull-out direction C is directed toward the base end side in the direction of the axis Ax), the tubes 192 and 202 may get in the way of the surgeon gripping the handle portion 100, but the configuration of this example can solve such a problem.

[0088] Furthermore, according to the above-mentioned guide tube 10, a configuration is adopted in which the above-mentioned withdrawal directions B and C are perpendicular to the axial direction Ax of the inner tube 110, so that an operator looking at the handle portion 100 can easily visually recognize the boundary between the handle area (the outer surface of the outer tube 120) that the operator grips and the tube area (the outer surface of the base portion 170) to which the tubes 192 and 202 are connected. This allows the operator to grip the handle area while avoiding the tube area at a glance. This improves the operability of the guide tube 10 and the endoscope 12.

[0089] In addition, according to the guide tube 10, the outer tube 120 has a configuration including a first tube portion 126 arranged on the tube main body 50 side and a second tube portion 128 arranged on the opposite side of the tube main body 50 side with respect to the first tube portion 126 and having a larger outer diameter than the first tube portion 126. As a result, as shown in FIG. 11, a step portion 130 formed between the first tube portion 126 and the second tube portion 128 can be used as a finger hook portion for hooking the operator's finger. This allows the operator to insert and remove the insertion portion 14 into and from the guide tube 10 and to pull out the guide tube 10 itself from the body while hooking his or her finger on the step portion 130 of the guide tube 10, thereby improving the operability of the guide tube 10 and the endoscope 12. Note that FIG. 11 shows an example of the operation of the endoscope 12 using the guide tube 10, but tubes 192 and 202 (see FIG. 7) are not shown.

[0090] In addition, the guide tube 10 employs a configuration in which the switching unit 208 is provided midway through the tube 192, so that the surgeon can operate the cock 212 of the three-way stopcock 210 without having to pull around the tube 192B. This improves the operability of the guide tube 10 and the endoscope 12.

[0091] Furthermore, according to the above-mentioned guide tube 10, the switching unit 208 employs a configuration having a hook 214 that can be detachably fixed to the endoscope 12, so that the switching unit 208 can be fixed to the endoscope 12 by utilizing the hook 214. This allows the surgeon to operate the cock 212 of the three-way stopcock 210 while operating the endoscope 12, improving the operability of the guide tube 10 and the endoscope 12.

[0092] Furthermore, according to the above-mentioned guide tube 10, the hook 214 is configured to have an opening 216 that can be fitted into the treatment tool insertion portion 32 of the endoscope 12, so that the switching portion 208 can be fixed to the endoscope 12 simply by fitting the opening 216 of the hook 214 into the treatment tool insertion portion 32.

[0093] Furthermore, according to the above-mentioned guide tube 10, when the switching section 208 is detachably fixed to the endoscope 12, a configuration is adopted in which the three-way stopcock 210 is disposed on the opposite side of the hook 214 from the port 190 side, so that the surgeon can operate the cock 212 of the three-way stopcock 210 with the left hand while, for example, holding the hand-held operation section 16 with the left hand and operating the endoscope 12 (for example, bending the bending section 20). This improves the operability of the guide tube 10 and the endoscope 12.

[0094] Second Embodiment Fig. 12 is an external view showing a main part of a guide tube 300 of the second embodiment. In explaining the guide tube 300 of the second embodiment, the same reference numerals will be used to denote the same or similar members as those of the guide tube 10 of the first embodiment shown in Figs. 1 to 11.

[0095] The difference between the configuration of the first embodiment and the second embodiment is that the first cylindrical portion 126 of the outer cylinder 120 (see Figs. 5 to 7) of the first embodiment is configured to have the same outer diameter over the entirety in the axial Ax direction, whereas the first cylindrical portion 304 of the outer cylinder 302 of the second embodiment has a cylindrical large diameter portion 306 and a cylindrical small diameter portion 308 whose outer diameters differ from each other in the axial Ax direction. Since the other configurations are the same, the outer cylinder 302 of the second embodiment will be described here.

[0096] Figure 13 is an oblique view of the outer tube 302 seen from an oblique direction of the base end side of the axis Ax (left side of Figure 13), and Figure 14 is an oblique view of the outer tube 302 seen from an oblique direction of the tip side of the axis Ax (right side of Figure 14).

[0097] As shown in Figs. 12 to 14, the first cylindrical portion 304 has a large diameter cylindrical portion 306 disposed on the side of the tube main body 50, and a small diameter cylindrical portion 308 disposed on the opposite side of the tube main body 50 with respect to the large diameter cylindrical portion 306. That is, the small diameter cylindrical portion 308 is disposed on the base end side in the axial direction Ax with respect to the large diameter cylindrical portion 306. The small diameter cylindrical portion 308 is configured to have an outer diameter smaller than that of the large diameter cylindrical portion 306 and the second cylindrical portion 128, and is disposed on the tip side in the axial direction Ax with respect to the second cylindrical portion 128. The small diameter cylindrical portion 308 is configured such that the length in the axial direction Ax of the small diameter cylindrical portion 308 is longer than the axial length of the second cylindrical portion 128. The small diameter cylindrical portion 308 is disposed on the opposite side of the tube main body 50 with respect to the port portion 112. That is, the cylindrical small diameter portion 308 is disposed on the base end side of the port portion 112 in the direction of the axis Ax.

[0098] In the outer tube 302 of this example, the first tube portion 304 has a large-diameter tube portion 306 arranged on the tube main body 50 side and a small-diameter tube portion 308 arranged on the opposite side of the tube main body 50 side with respect to the large-diameter tube portion 306, so that the small-diameter tube portion 308 formed between the large-diameter tube portion 306 and the second tube portion 128 can be used as a finger insertion portion into which the operator's finger is inserted, as shown in Fig. 15. This allows the operator to insert, for example, the index finger and middle finger into the small-diameter tube portion 308 of the guide tube 300, and perform the operation of inserting and removing the insertion portion 14 into and from the guide tube 300 while pinching the small-diameter tube portion 308 with the index finger and middle finger, or removing the guide tube 300 itself from the body. This allows the guide tube 300 of the second embodiment to improve the operability of the endoscope 12. FIG. 15 shows an example of operation of the endoscope 12 using the guide tube 300, but the tubes 192, 202 (see FIG. 7) are not shown.

[0099] 15 shows an example in which the index finger and middle finger are used to pinch the cylindrical small diameter portion 308, but the present invention is not limited to this. For example, the operator may insert and remove the guide tube 300 while holding the index finger along the outer circumferential surface of the cylindrical small diameter portion 308.

[0100] In addition, in the outer tube 302 of this example, the length of the small diameter cylinder portion 308 in the axial direction Ax is longer than the axial length of the second cylinder portion 128, so that the small diameter cylinder portion 308 can be effectively used as a portion for the surgeon to pinch or grip. This makes it possible to effectively transmit the force for inserting and extracting the guide tube 300 to the guide tube 300. Note that since the second cylinder portion 128 only needs to be formed as a cylinder portion for forming the step portion 130 for hanging a finger, even if the length of the second cylinder portion 128 in the axial direction Ax is shorter than the length of the small diameter cylinder portion 308 in the axial direction Ax, the function of the guide tube 300 is not impaired.

[0101] In addition, as shown in FIG. 12, in the outer tube 302 of this example, the small diameter cylindrical portion 308 is positioned on the opposite side of the port portion 112 from the tube main body 50, so that the small diameter cylindrical portion 308 can be pinched or gripped with the surgeon's fingers without being hindered by the port portion 112.

[0102] Several variations of the present invention will now be described.

[0103] [First Modification] 16 shows a modified example of a switching unit 310 having a three-way stopcock 210. The switching unit 310 is one example of the switching unit of the present invention.

[0104] The switching section 310 has a hook 312 curved into a C-shape by an elastic plate material. The hook 312 can be attached with one touch to the cylindrical section 35 located between the treatment tool insertion section 32 and the break prevention section 33 of the hand operation section 16. This allows the switching section 310 to be fixed to the hand operation section 16 by using the hook 312. The hook 312 is an example of a fixing section of the present invention. In the switching section 310 of this example, the three-way stopcock 210 is also disposed on the opposite side of the port 190 with respect to the hook 312, so that the operability of the cock 212 of the three-way stopcock 210 is improved.

[0105] [Second Modification] In the above first and second embodiments, the tube body 50 having the hardness changing portion is exemplified as the tube body applied to the medical instrument guiding device of the present invention, but the present invention is not limited to this. For example, an overtube for an endoscope having a balloon at the tip and a flow path for supplying and discharging a fluid to the balloon may be applied.

[0106] [Third Modification] In the above first and second embodiments, the endoscope 12 having the insertion portion 14 is exemplified as a medical instrument guided by the medical instrument guiding device of the present invention, but the present invention is not limited to this. For example, the present invention can be applied to medical instruments such as manipulators.

[0107] <Additional Notes> As will be understood from the detailed description of the embodiments above, this specification includes disclosure of various technical ideas including the inventions described below.

[0108] (Invention 1) A medical instrument guiding device having an insertion passage for guiding a medical instrument into a body, A long tube body to be inserted into the body; A handle portion provided on a base end side of the tube body; Equipped with The handle portion has an inner tube to which the base end of the tube body is connected, and an outer tube to be fitted onto the inner tube. The inner cylinder has a port portion for supplying and discharging a fluid to and from the tube body. Medical instrument guidance device.

[0109] (Invention 2) The tube body has a hardness changing portion disposed along the longitudinal direction of the tube body, the hardness of which changes depending on the fluid supplied or discharged from the port portion. A medical instrument guiding device as described in Invention 1.

[0110] (Invention 3) A stress relief ring is disposed around the outer periphery of the connection between the inner tube and the tube body in a loose fit state; The inner cylinder and the outer cylinder are connected and fixed to a stress relief ring. 3. A medical instrument guiding device according to claim 1 or 2.

[0111] (Invention 4) A leak-proof valve is disposed inside the handle portion to prevent liquid from leaking from the tube body. A medical instrument guiding device according to any one of claims 1 to 3.

[0112] (Invention 5) The outer cylinder has a flange-shaped valve holding portion provided on an inner peripheral surface of the outer cylinder, The leak prevention valve is sandwiched between the valve holding portion and the base end portion of the inner cylinder to regulate the axial position of the handle portion. A medical instrument guiding device according to claim 4.

[0113] (Invention 6) The inner cylinder has an engagement portion protruding from an outer circumferential surface thereof, The outer cylinder has a slit-shaped engaged portion that is open toward the tube body, The outer cylinder is fitted onto the inner cylinder in a state where it is prevented from rotating relative to the inner cylinder by the engaged portion and the engaging portion being engaged with each other. 6. A medical instrument guiding device according to any one of claims 1 to 5.

[0114] (Invention 7) The port portion is provided in the engagement portion. A medical instrument guiding device according to claim 6.

[0115] (Invention 8) the tube body has a hardness changing portion disposed along a longitudinal direction of the tube body and having a hardness changing portion whose hardness changes depending on a fluid supplied or discharged from the port portion; The port section is A fluid port for supplying and discharging a fluid to and from the tube body; a liquid port for supplying liquid to an inner circumferential surface of the insertion passage; having A medical instrument guiding device according to invention 7.

[0116] (Invention 9) The fluid port and the liquid port are arranged in parallel along the axial direction of the inner cylinder. A medical instrument guiding device according to claim 8.

[0117] (Invention 10) The liquid port is disposed on the opposite side of the fluid port to the side to which the tube body of the inner cylinder is connected. A medical instrument guiding device as described in claim 9.

[0118] (Invention 11) A fluid tube connected to the fluid port; A liquid tube connected to the liquid port; Equipped with the direction in which the base end portion of the fluid tube is pulled out from the fluid port and the direction in which the base end portion of the liquid tube is pulled out from the liquid port are the same; A medical instrument guiding device according to any one of claims 8 to 10.

[0119] (Invention 12) a direction in which the base end portion of the fluid tube is pulled out from the fluid port and a direction in which the base end portion of the liquid tube is pulled out from the liquid port are perpendicular to the axial direction of the inner tube; 12. A medical instrument guiding device according to claim 11.

[0120] (Invention 13) The outer cylinder is A first cylindrical portion disposed on the side of the tube body; a second cylindrical portion disposed on the opposite side of the first cylindrical portion from the tube body and having an outer diameter larger than that of the first cylindrical portion; having 13. A medical instrument guiding device according to any one of claims 1 to 12.

[0121] (Invention 14) The first cylindrical part is A large diameter cylindrical portion disposed on the side of the tube main body; a cylindrical small diameter portion that is disposed on the opposite side of the tube main body with respect to the cylindrical large diameter portion and has an outer diameter smaller than that of the cylindrical large diameter portion; having 14. A medical instrument guiding device according to claim 13.

[0122] (Invention 15) The axial length of the small diameter cylindrical portion is longer than the axial length of the second cylindrical portion. 15. A medical instrument guiding device according to claim 14.

[0123] (Invention 16) The small diameter cylindrical portion is disposed on the opposite side of the port portion from the tube main body. 16. A medical instrument guiding device according to claim 14 or 15.

[0124] (Invention 17) the tube body has a hardness changing portion disposed along a longitudinal direction of the tube body and having a hardness changing portion whose hardness changes depending on a fluid supplied or discharged from the port portion; The port portion has a fluid port for supplying and discharging a fluid to and from the tube main body, A fluid tube connected to a fluid port, A switching section is provided midway through the fluid tube, The switching unit has a switching member capable of switching between supplying and discharging fluid to and from the fluid port. 17. A medical instrument guiding device according to any one of claims 1 to 16.

[0125] (Invention 18) The switching unit has a fixing portion that can be removably fixed to the medical instrument. 18. A medical instrument guiding device according to claim 17.

[0126] (Invention 19) The medical instrument is an endoscope having an insertion portion to be inserted into a body, The fixing portion has a fitting portion that can be fitted into a treatment tool insertion portion of an endoscope. 19. A medical instrument guiding device according to claim 18.

[0127] (Invention 20) The switching member is disposed on the opposite side of the fixed portion from the fluid port side. 20. A medical instrument guiding device according to claim 18 or 19.

[0128] Although the examples of the medical instrument guiding device according to the present invention have been described above, the present invention may be improved or modified in several ways without departing from the gist of the present invention. [Explanation of symbols]

[0129] 10 Guide tube 12 Endoscopy 14 Insertion section 16 Handheld operation unit 18 Hard tip 18A Tip surface 20 Curved section 22 Soft part 24 Lighting window 26 Observation window 28 Treatment tool outlet 30 Insertion port 32 Treatment tool insertion part 33 Anti-break part 34 Cap 35 Cylindrical section 36 Angle knob 40 Vacuum Pump 50 Tube body 50A Tip 50B Base end 51 Tip opening 52 Outer tube 54 Inner tube 56 Interior Space 58 Variable Shape 60 Passage 62 Hydrophilic Coating 64 Adhesive 66 Cap 68 Adhesive 70 Spiral tube 72 Belt-shaped member 74 High friction surface 76 Adhesive 78 Adhesive 80 Sheet material 82 High friction surface 100 Handle 110 Inner cylinder 110A tip 110B Base end 112 Port section 114 Passage 116 Hydrophilic Coating 118 Connection 120 Outer cylinder 120A Tip 120B Base end 122 Proximal opening 124 Valve holder 126 First cylinder part 128 Second tube part 130 Multilayered section 140 Ring member 140A proximal surface 142 Protrusion 144 pin 146 pins 148 pins 150 holes 152 holes 154 holes 160 Leak prevention valve 162 Valve body 164 Tubular part 170 Base 172 Protrusion 180 Slit 182 Notch 190 Port 191 Flow Path 192 tubes 192A Tube 192B Tube 193 Proximal part 200 Port 201 Flow Path 202 Tube 202A Tip 203 Proximal part 204 Syringe 208 Switching section 210 Three-way stopcock 210A 1st port 210B 2nd port 210C 3rd port 212 Cook 214 Hook 216 Opening 300 Guide tube 302 Outer cylinder 304 First cylinder part 306 Cylindrical body large diameter part 308 Small diameter part of cylinder 310 Switching section 312 Hook 400 Large intestine 402 Sigmoid colon 404 Transverse colon 406 Lesions

Claims

1. A medical instrument guiding device having an insertion passage for guiding a medical instrument into a body, A long tube body to be inserted into the body; A handle portion provided on a base end side of the tube body; Equipped with The handle portion has an inner tube to which a base end of the tube body is connected, and an outer tube to be fitted onto the inner tube, The inner cylinder has a port portion for supplying and discharging a fluid to and from the tube body. Medical instrument guidance device.

2. The tube body has a hardness changing portion that is arranged along a longitudinal direction of the tube body and has a hardness changing portion whose hardness changes depending on the fluid supplied or discharged from the port portion.

10. The medical instrument guide device of claim 1.

3. a stress relief ring is disposed around the outer periphery of the connection portion between the inner tube and the tube body in a loose fit state; The inner cylinder and the outer cylinder are connected and fixed to the stress relief ring.

3. A medical instrument guide device according to claim 1 or 2.

4. A leak prevention valve is disposed inside the handle portion to prevent leakage of liquid from the tube body.

3. A medical instrument guide device according to claim 1 or 2.

5. The outer cylinder has a flange-shaped valve holding portion provided on an inner circumferential surface of the outer cylinder, The leak prevention valve is sandwiched between the valve holding portion and the base end portion of the inner cylinder to regulate the axial position of the handle portion.

5. The medical instrument guide device of claim 4.

6. The inner cylinder has an engagement portion protruding from an outer circumferential surface thereof, The outer cylinder has a slit-shaped engaged portion that is open toward the tube body, The outer cylinder is fitted onto the inner cylinder in a state where it is prevented from rotating relative to the inner cylinder by the engaged portion and the engaging portion being engaged with each other.

3. A medical instrument guide device according to claim 1 or 2.

7. The port portion is provided in the engagement portion.

7. The medical instrument guide device of claim 6.

8. the tube body has a hardness changing portion that is disposed along a longitudinal direction of the tube body and has a hardness changing portion that changes depending on the fluid supplied or discharged from the port portion, The port portion is a fluid port for supplying and discharging the fluid to and from the tube body; a liquid port for supplying liquid to an inner circumferential surface of the insertion passage; having 8. The medical instrument guide device of claim 7.

9. The fluid port and the liquid port are arranged side by side along the axial direction of the inner cylinder.

9. The medical instrument guide device of claim 8.

10. the liquid port is disposed on an opposite side of the inner cylinder to a side to which the tube body is connected with respect to the fluid port; 10. The medical instrument guide device of claim 9.

11. a fluid tube connected to the fluid port; A liquid tube connected to the liquid port; Equipped with a direction in which the base end portion of the fluid tube is pulled out from the fluid port and a direction in which the base end portion of the liquid tube is pulled out from the liquid port are the same as each other; 11. The medical instrument guide device of claim 10.

12. a direction in which the base end portion of the fluid tube is pulled out from the fluid port and a direction in which the base end portion of the liquid tube is pulled out from the liquid port are perpendicular to an axial direction of the inner tube.

12. The medical instrument guide device of claim 11.

13. The outer cylinder is A first cylindrical portion disposed on the side of the tube main body; a second cylindrical portion disposed on an opposite side of the first cylindrical portion from the tube body and having an outer diameter larger than that of the first cylindrical portion; having 3. A medical instrument guide device according to claim 1 or 2.

14. The first cylindrical portion is A large diameter cylindrical portion disposed on the side of the tube main body; a cylindrical small diameter portion that is disposed on the opposite side of the tube main body with respect to the cylindrical large diameter portion and has an outer diameter smaller than that of the cylindrical large diameter portion; having 14. The medical instrument guide device of claim 13.

15. The axial length of the cylindrical small diameter portion is longer than the axial length of the second cylindrical portion.

15. The medical instrument guide device of claim 14.

16. The cylindrical small diameter portion is disposed on the opposite side of the port portion from the tube main body.

15. The medical instrument guide device of claim 14.

17. the tube body has a hardness changing portion that is disposed along a longitudinal direction of the tube body and has a hardness changing portion that changes depending on the fluid supplied or discharged from the port portion, the port portion has a fluid port for supplying and discharging the fluid to and from the tube main body, a fluid tube connected to the fluid port; A switching section is provided midway through the fluid tube, The switching unit has a switching member capable of switching between supply and discharge of the fluid to and from the fluid port.

3. A medical instrument guide device according to claim 1 or 2.

18. The switching unit has a fixing unit that can be removably fixed to the medical instrument.

20. The medical instrument guide device of claim 17.

19. the medical instrument is an endoscope having an insertion portion to be inserted into a body, The fixing portion has a fitting portion that can be fitted into a treatment tool insertion portion of the endoscope.

20. The medical instrument guide device of claim 18.

20. The switching member is disposed on the opposite side of the fixing portion to the fluid port.

20. The medical instrument guide device of claim 18.

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