Endoscopic instrument insertion assistance device

Abstract

To provide an endoscopic instrument insertion assistance device that allows an endoscope to be held and supported in a stable posture and enables medical instrument advancement and retraction operations.SOLUTION: An endoscopic instrument insertion assistance device is used by being attached to an endoscope in which an endoscope gripping section 107 is held by hand and a treatment instrument reaches an affected portion or the like through the endoscope. There is provided a finger-operated section 168 at a position that can be pinched with the fingers while an area near the little finger is kept in contact with a palm contact portion 199 of the endoscope in a state where the assistance device is attached to the endoscope. An instrument linear motion operation section 103 which includes the finger-operated section converts the operation of the finger-operated section into the advancement and retraction operations of linearly moving the inserted instrument. With this configuration, the endoscope can be supported at a total of four points even during operation, this allows a user to perform the advancement and retraction operations of the medical instrument by himself / herself while stably supporting the endoscope. In addition, shortening a channel through which the medical instrument passes reduces frictional resistance, and further improves operability.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to an endoscopic instrument insertion assist device (hereinafter referred to simply as "this assist device") that is attached to an endoscope through which a medical instrument is introduced to an affected area, etc., and that enables the advancement and retreat of the medical instrument.

[0002] More specifically, this relates to an endoscopic instrument insertion assistance device that is held in the hand and attached to an endoscope that delivers a therapeutic instrument to an affected area, etc., through an internal channel; the positional relationship between the operating part that moves the therapeutic instrument forward and backward and the endoscope main body is within a range that fits in one hand, allowing the endoscope to be held stably while also making it easy to operate.

[0003] In this specification, the subject to which this auxiliary device is attached will be mainly described as a bladder endoscope (hereinafter simply referred to as a "cystoscope"); however, the subject matter is not limited to this and can be broadly applied to industrial endoscopes as well. [Background technology]

[0004] 1. Context of the Invention In recent years, endoscopes used in medical care have become smaller due to improvements in overall technical standards, such as high-precision fibers. In addition, endoscopes can no longer simply be used to view images of narrow areas, but can also be used in conjunction with various medical instruments to perform necessary medical procedures while viewing the images.

[0005] With such devices, medical procedures such as tissue resection and lithotripsy can be performed by passing the operating part of a medical instrument such as forceps through a hollow tube called a channel inside the endoscope from near an operating position near the hand to the treatment position, allowing the instrument to be operated at hand.

[0006] For example, when focusing on biopsy or lithotripsy using a cystoscope, the movement of the heart and blood causes the affected area and targets such as stones to move or float in the water. The practitioner must be very careful to avoid prolonging the treatment time or damaging the healthy wall.

[0007] In view of this background, medical treatment tools are required to make it as easy as possible to manipulate the part that acts on the affected area, etc., and the distance between the affected area, etc.

[0008] (3. Background Art of the Invention) In situations such as those described above, the surgeon must be able to operate both the endoscope itself and the medical instruments, and conventional technological developments have also sought to make medical instruments easier and simpler to operate, as well as more sophisticated.

[0009] For example, Patent Document 1 discloses that a biopsy forceps with a rigid sheath is passed through an endoscope to reach the affected area, and the operation stability of the medical instrument is improved. However, because a rigid sheath is used, the operation point of the biopsy forceps is located away from the endoscope (see

[0044] ,

[0047] , and Figure 27 in the document).

[0010] Also, Patent Document 2 discloses an endoscope body in which the entrance opening of the guidewire lumen can be fixed near the operator's hand, thereby enabling the operator to quickly replace a treatment part such as a catheter by himself.

[0011] Furthermore, the invention of Patent Document 3 discloses that the treatment tool is adjusted to move forward and backward by a slider, and that the slider is provided on a guide unit body fixed to the endoscope body, thereby achieving stable operability of the slider that controls the advancement and retreat of the treatment tool. [Prior art documents] [Patent documents]

[0012] [Patent Document 1] Japanese Patent Application Publication No. 9-322880 [Patent Document 2] JP 2005-58749 A [Patent Document 3] JP 2017-121367 A Summary of the Invention [Problem to be solved by the invention]

[0013] According to Patent Document 1, the above-mentioned effect can certainly be expected.

[0014] However, let us now imagine a situation in which, when using an endoscope, one hand begins to move a treatment instrument forward or backward. In this situation, the endoscope body is held with one hand. For the sake of convenience, let's assume that the hand holding the endoscope is the "left hand," and then the other hand, that is, the right hand, touches the operating part that is distant from the part being held. Even if the hand is carefully brought close to this operating point, when this right hand hits the endoscope, it will deliver a corresponding shock. Then, when the right hand hits the endoscope with the left hand as a fulcrum, a large moment of force is applied because of the long distance.

[0015] For this reason, in order to continue operating stably, the surgeon must operate with great care, and because the operating part is located away from the main body, the surgeon is forced to move his or her line of sight, making it difficult to move the right hand to the operating part, which may cause a considerable amount of stress to the surgeon.

[0016] According to Patent Document 2, the advancement and retreat of the treatment instrument is performed by a treatment tool operation section, and this treatment tool operation section is fixed to the endoscope adaptor.

[0017] However, when trying to operate the treatment tool operation unit with the fingers, it is necessary to determine the hand posture in a way that avoids the adapter that holds it in place. And since the endoscope adapter is in hand, the hand posture becomes more restrictive.

[0018] Next, according to Patent Document 3, a treatment tool insertion tool and a slider serving as an operation section are installed on the endoscope body.

[0019] However, since the channel that has exited the endoscope body is looped about halfway around before the treatment instrument insertion tool is installed in the endoscope body, the operating site is located considerably away from the site where the endoscope is grasped.

[0020] For this reason, as with the technique disclosed in Patent Document 1, the position of the hand holding the endoscope body and the hand operating the operation part must be far apart. When the hand moves to touch the operation part, a large moment of force is applied to the endoscope itself. For this reason, extremely careful operation is required to continue stable operation.

[0021] Under the circumstances described above, there is a demand for improved operability of treatment tools that does not restrict the freedom of movement of the hand as much as possible and that does not significantly affect the holding position of the endoscope body even when the user performs relatively rough operations.

[0022] That is, (1) It allows the surgeon to operate the endoscope alone, (2) To easily enable fine adjustment of the movement of treatment instruments; (3) At the same time, it must be possible to hold the endoscope in a stable state. Prioritizing one of these two requirements would make it difficult to achieve the other, but it can be said that there is a need to make improvements to the endoscope as a whole, including auxiliary devices, to achieve both. [Means for solving the problem]

[0023] The means for solving this problem will be explained according to the following table of contents. --- table of contents --- (1.Text definition) (2. Explanation of the means for solving the problem) (3. Sorting out the relationships between claims and the matters specifying the invention in each claim) (3.1. Relationship between claims) (3.2. Clarification of matters specifying the invention in each claim) --- Main text ---

[0024] The present invention has been made in view of such circumstances, and aims to further improve the stability of holding the endoscope main body and the operability of the instruments.

[0025] (1. Word definition) Before describing the means for solving the problems, for the sake of convenience, the terms used in this specification are defined as follows.

[0026] The "central cavity" of the inner cylinder is the space formed inside the inner cylinder, regardless of whether the top and bottom are sealed.

[0027] An "instrument" refers to a device or tool that exerts a physical effect on a point of action within the field of view observed by the endoscope. The mechanism that connects the point of action to the point of action is one that can pass through a channel inside the endoscope. Here, the mechanism that connects the point of action to the point of action can be any transmission means, such as electrical, mechanical, or fluid, or a combination of these.

[0028] "Instrument action point" or "instrument action point" refers to the position of an instrument that can perform some physical action on an object. In the narrowest sense, it refers to the position of the instrument action part in the vicinity of the object within the field of view observed by the endoscope, focusing on the part that exerts the physical action. In the broadest sense, it can refer to the position of the entire instrument when the instrument action part is attached to the instrument action point in the narrow sense.

[0029] "Hand posture" refers to the position of the hand, including the direction of the fingers and palm.

[0030] (2. Explanation of the means for solving the problem) The present invention aims to meet the demands for endoscopes as a whole, including the above-mentioned auxiliary device, by devising an endoscopic instrument insertion auxiliary device that is used in conjunction with the use of an endoscope and for operating medical instruments.

[0031] Here, the present auxiliary device according to the present invention is premised on being attached to an endoscope as follows. Here, the main body of the endoscope to which the present auxiliary device is attached is: 1. A handle for holding the endoscope body with one's hand; 2. A channel inside the endoscope body for guiding instruments; 3. A channel connector in the vicinity of a channel outlet where the channel leads out to the outside; It is equipped with the following:

[0032] Since the channel connector is fixed to the outer wall of the endoscope body, the mating connection member fixed to this connector is capable of fixing the connection member itself to the endoscope body.

[0033] (2.1. Description of the Means Relating to Claim 1) The endoscopic instrument insertion auxiliary device according to claim 1 comprises a connection portion, an inner cylinder member, and an instrument linear motion operation portion.

[0034] The connection portion is adapted to be connected to a channel connector provided on the endoscope to fix the entire endoscopic instrument insertion assistance device.

[0035] The inner tube member is positioned by being mechanically fixed to the connecting portion, so that the inner tube member is fixed to the endoscope body. The central lumen of the inner tube member is also connected to a channel provided inside the endoscope, so that an instrument can be introduced into the endoscope auxiliary device through the endoscope body channel.

[0036] The instrument linear motion operation section is designed to linearly move an instrument that has passed through the channel in the longitudinal axis direction of the inner tube member when the instrument is pinched with the fingertips of the operator's hand, while the operator maintains a hand position in which any part of the operator's hand from the wrist to the fingertips is touching the endoscope body.

[0037] In addition, the instrument linear motion operation unit is positioned relative to the inner tube member and its positional relationship is fixed. That is, the inner tube member is fixed to the endoscope body by the connection unit, and the instrument linear motion operation unit is further fixed in position relative to the inner tube member, so that the instrument linear motion operation unit is fixed in position relative to the endoscope body. This makes it possible to maintain a substantially constant distance between the fingertip operating at the operation point and the endoscope body.

[0038] (2.2. Description of the means according to claim 2) The endoscopic instrument insertion assistance device of claim 2 is the endoscopic instrument insertion assistance device of claim 1 comprising a connection portion, an inner tube member, and an instrument linear motion operation portion, and in addition, the instrument linear motion operation portion comprises an operation ring and a rotation-to-linear motion conversion portion.

[0039] The operation ring is an annular member provided so as to surround a part of the outer periphery of the inner tube member, and is provided so as to be rotatable coaxially with the inner tube member at a position where the operator can pinch it with their fingers while touching the endoscope body with any part of the operator's body from the wrist to the fingertips when the assist device is attached to the endoscope body.

[0040] The rotary-linear motion conversion portion converts the motion of an instrument inserted in the channel into linear motion in the coaxial direction when the operating ring rotates.

[0041] (2.3. Description of the means according to claim 3) The endoscopic instrument insertion assistance device according to claim 3 is the endoscopic instrument insertion assistance device according to claim 2 which comprises a connection portion, an inner tube member, and an instrument linear motion operation portion, and in which operation of the instrument linear motion operation portion is performed by a sliding stem.

[0042] The inner tube member is provided with a slide pin or a guide groove. This slide pin or guide groove engages with a guide groove or slide pin of the slide culm, which will be described later. This prevents the slide culm from accidentally rotating during operation, and allows it to be restricted so that it moves linearly back and forth in the coaxial direction of the inner tube member.

[0043] The operation ring has a female thread on at least a part of its inner circumference. Note that "at least a part" here does not mean to exclude the case where the entire inner circumference surface is male threaded.

[0044] The tool linear motion operation unit is provided with a sliding stem, which is a cylindrical member at least a part of which is inserted between the outer periphery of the inner tube member and the inner periphery of the operation ring and is axially slidable relative to the inner tube member.

[0045] In addition, this slide culm has the following features: 1) A male screw is provided on at least a portion of its circumference. 2) When the inner cylindrical member is provided with a slide pin, a guide groove for guiding the movement of the slide pin is provided. When the inner cylindrical member is provided with a guide groove, a slide pin whose movement is guided by the guide groove is provided. 3) Further, an instrument holding portion for gripping and holding a treatment instrument, It is designed to be prepared.

[0046] Here, the male screw 1) is adapted to be screwed into the female screw of the operation ring, so that when the operation ring is rotated, a force is applied to move the slide rod forward and backward.

[0047] Furthermore, the guide groove or slide pin of 2) engages with the slide pin or guide groove provided at a fixed position relative to the main body to regulate its own path, so that the forward and backward movement of the slide culm is made to follow the groove shape of the guide groove. In other words, it acts to prevent the slide culm and the inner tube from rotating inadvertently relative to each other.

[0048] The instrument holding portion 3) grasps the treatment instrument and therefore acts to move the treatment instrument back and forth in accordance with the forward and backward movement of the slide culm itself.

[0049] (2.4. Description of the means according to claim 4) The endoscopic instrument insertion assist device according to claim 4 is the endoscopic instrument insertion assist device according to claim 2 which comprises a connection portion, an inner tube member, and an instrument linear motion operation portion, and in which the operation of the instrument linear motion operation portion is performed by a cam mechanism.

[0050] The endoscope instrument insertion assist device according to claim 3 uses a screw mechanism to move the slide shaft back and forth, whereas the endoscope instrument insertion assist device according to this claim differs in that it uses a cam mechanism. The cam pins and the corresponding cam grooves are provided on the inner tube member and the operation ring. That is, if the cam pins are provided on the inner tube member, the cam grooves will be provided on the operation ring, and if the cam pins are provided on the operation ring, the cam grooves will be provided on the inner tube member.

[0051] The inner tube member is provided with a slide pin or a guide groove. When the inner tube member is provided with a slide pin, this slide pin engages with a guide groove provided in the slide culm, which will be described later. When the inner tube member is provided with a slide groove, this slide groove engages with a slide pin provided in the slide culm, which will be described later. In either case, this allows the slide culm to move linearly back and forth in the coaxial direction of the inner tube member along the guide groove provided in either of them, without accidental rotation.

[0052] The operation ring is an annular member provided to surround a part of the outer periphery of the inner cylinder member, and is also provided with a cam pin or a cam groove. Whether the operation ring has a cam pin or a cam groove depends on whether the slide culm, which will be described later, has a cam pin or a cam groove, and these correspond to each other. In other words, if the slide culm has a cam groove, the operation ring will have a cam pin, and if the slide culm has a cam pin, the operation ring will have a cam groove.

[0053] In the case where the operation ring is provided with a cam groove, at least a portion of the inner circumference is provided with a spiral cam groove. Again, "at least a portion" does not mean to exclude the entire inner circumference being male threaded.

[0054] The tool linear motion operation unit is provided with a sliding stem, which is a cylindrical member at least partly inserted between the outer periphery of the inner tube member and the inner periphery of the operation ring, and is axially slidable relative to the inner tube member.

[0055] In addition, this slide culm is 1) A cam pin or cam groove is formed on the outer circumference. 2) When the inner cylindrical member is provided with a slide pin, a guide groove is provided to guide the movement of the slide pin. When the inner cylindrical member is provided with a guide groove, a slide pin whose movement is guided by the guide groove is provided. 3) Further, an instrument holding portion for gripping and holding a treatment instrument, Prepare.

[0056] Here, 1) means that if the operation ring has a cam pin, it has a spiral cam groove on the outer periphery, and if the operation ring has a cam groove, it has a cam pin on the outer periphery. This allows the slide to move forward and backward when the operation ring is rotated.

[0057] Furthermore, the guide groove or slide pin of 2) engages with the slide pin or guide groove of the inner tube member that is provided at a fixed position relative to the main body, and thus restricts its own path, so that it acts to restrict the forward and backward movement of the slide culm along the groove shape of the guide groove. In other words, it acts to prevent the slide culm and the inner tube from rotating inadvertently relative to each other.

[0058] The instrument holding portion grasps the treatment instrument, and therefore acts to move the treatment instrument back and forth in accordance with the forward and backward movement of the slide culm itself.

[0059] (2.5. Description of the means according to claim 5) An endoscopic instrument insertion assistance device according to claim 5 is the endoscopic instrument insertion assistance device according to claim 1 comprising a connection portion, an inner tube member, and an instrument linear motion operation portion, and in addition, the instrument linear motion operation portion comprises an operation knob and an instrument linear motion portion.

[0060] The operation knob is provided at a position where the operator can pinch it with his / her fingers while touching the endoscope body with any part of the operator from the wrist to the fingertips. The operation knob is located on the outer circumferential side of the inner tube member.

[0061] The instrument linear motion portion is configured to advance and retreat a treatment instrument inserted into the channel in the coaxial direction when the operation knob is advanced and retreated.

[0062] (2.6. Description of the means according to claim 6) The endoscopic instrument insertion assistance device according to claim 6 comprises: 1) a connection portion; 2) an inner cylindrical member; 3) an instrument direct-acting operation unit having an operation knob and a treatment instrument direct-acting unit; In addition to the endoscope instrument insertion assist device according to claim 5, 4) An outer peripheral member is provided, 5) The direct-acting operating part of the device has a sliding culm, The present invention is an endoscopic instrument insertion assistance device equipped with the above.

[0063] The outer circumferential member is a cylindrical member having an elongated hole extending in the axial direction in a portion thereof, and is held so as to cover the periphery of the inner tubular member.

[0064] The tool linear motion operation section includes a slide culm. The slide culm includes a tool holding section for holding the tool. The slide culm is adapted to have a portion thereof inserted into the gap between the inner and outer cylindrical members.

[0065] The sliding culm is axially slidable relative to the inner tube member. An operating knob is fixed to the sliding culm. The operating knob is exposed to the outside of the outer circumferential member through a long hole in the outer circumferential member. This restricts the operating range of the operating knob by the long hole in the outer circumferential member.

[0066] In addition, the operation knob can be touched by the surgeon's fingers, and when operated to move it forward or backward, it acts to move the sliding stem to which the operation knob is fixed forward or backward in the longitudinal axial direction of the auxiliary device.

[0067] Since the instrument holding portion is provided on the sliding culm, by operating the operating knob to move forward and backward, the instrument held by the instrument holding portion can be moved forward and backward.

[0068] (2.7. Description of the means according to claim 7) The endoscopic instrument insertion assistance device according to claim 7 is an endoscopic instrument insertion assistance device comprising a connection part, an inner tube member, and an instrument linear motion operation part, and further comprising a perfusion port part in the inner tube member and a roll fixing part in the connection part.

[0069] The perfusion port is formed so as to communicate with a branched central lumen formed within the inner cylindrical member.

[0070] The roll fixing portion is designed so that, when connecting and fixing the connection portion and the channel connector, the inner tube member can be fixed at any roll position relative to its longitudinal axis, i.e., at a roll angle desired by the operator.

[0071] (3. Sorting out the relationships between claims and the matters specifying the invention in each claim) (3.1. Subordinate relationship of each claim) As described above, in order to make it easier to understand the relationships between the inventions related to each claim, a table showing the relationships between the claims is provided below. [Table 1]

[0072] (3.2. Categorization of matters specifying the invention in each claim) The invention-specifying matters in the [Claims] attached to this application have a somewhat cross-subordinate relationship, so in this section, in order to facilitate understanding of the invention-specifying matters, we have organized and presented them in a format that does not cite the preceding claims, i.e., in a format similar to an independent claim. Only the names of elements will be listed. Also, the level of indentation indicates that the item is additional to the invention-specifying matter at the higher indentation. Also, an asterisk (*) after the element name indicates that the item is an invention-specifying matter added in the claim to the higher claim.

[0073] (3.2.1. List of elements specifying the invention in claim 1) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material Direct-acting instrument operation unit

[0074] (3.2.2. List of elements specifying the invention in claim 2) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material Direct-acting instrument operation unit ··Pinch position with fingers(*) ··Operation ring(*) Rotary-linear converter (*)

[0075] (3.2.3. List of elements specifying the invention in claim 3) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material ··Slide pin or guide groove(*) Direct-acting instrument operation unit ··Operation ring ···Female thread(*) Rotational-linear conversion unit ··Slide culm(*) ···Male screw(*) ···Guide groove or slide pin(*) ...Instrument holding part (*)

[0076] (3.2.4. List of elements specifying the invention in claim 4) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material ··Slide pin or guide groove(*) Direct-acting instrument operation unit ··Operation ring Cam groove(*) Rotational-linear conversion unit ··Slide culm(*) Cam pin (*) ···Guide groove or slide pin(*)

[0077] (3.2.5. List of elements specifying the invention in claim 5) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material Direct-acting instrument operation unit ··Operation knob(*) ··Linear motion part of treatment instrument(*)

[0078] (3.2.6. List of elements specifying the invention in claim 6) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Inner cylinder material Direct-acting instrument operation unit ··Operation knob ··Linear motion part of treatment instrument ··Slide culm(*) ...Treatment grip -Outer material(*)

[0079] (3.2.7. List of elements specifying the invention in claim 7) Endoscopic instrument insertion assistance device -Applicable endoscope ··handle ··channel ··Channel Connector Connections Roll fixing part (*) Inner cylinder material ·Irrigation port (*) Direct-acting instrument operation unit Effect of the Invention

[0080] [Effects of the invention according to claim 1] According to the endoscope instrument insertion assist device of the invention described in claim 1, the proximal linear operation part that moves the treatment instrument forward and backward can be operated by pinching it with fingers, and in the position of the hand performing the operation, other parts of the same hand are touching the endoscope body. At this time, the endoscope has at least The part of the surgeon's hand that holds the endoscope, The part of the fingers that grips the linear motion operating part of the endoscopic instrument insertion assistance device, The part that touches the endoscope body when the instrument direct-acting control unit is pinched, Your posture will be determined by these three points.

[0081] Furthermore, pinching the operating point with the fingers means grabbing it with two or three points, for example, the thumb and index finger, the thumb and middle finger, or the thumb and middle finger and index finger. The part of the surgeon's hand that holds the endoscope, The thumb gripping the linear motion control part of the endoscopic instrument insertion assistance device, - the index finger and middle finger of the same hand, The part that touches the endoscope body when the instrument direct-acting control unit is pinched, The posture is held at these four points. Therefore, the surgeon can stabilize the posture even while moving the treatment instrument forward and backward.

[0082] In addition, since the channel leading from the endoscope body to the outside is only as long as the longitudinal length of the endoscopic instrument insertion assistance device, unnecessary resistance between the instrument and the channel wall can be minimized, allowing for smooth advancement and retreat of the therapeutic instrument.

[0083] [Effects of the invention according to claim 2] According to the endoscopic instrument insertion assist device of the invention described in claim 2, the treatment instrument can be advanced and retreated by just moving the fingertips, without moving the hand significantly. Also, since the treatment instrument is advanced and retreated by simply rotating the operation ring, the hand does not move significantly during operation, which reduces the inconvenience of the endoscope losing its posture significantly during operation.

[0084] [Effects of the invention according to claim 3] According to the endoscope instrument insertion assist device of the invention described in claim 3, the rotation of the operation ring is converted into the advancement and retreat of the treatment instrument by the screw mechanism, so that the finger movement is converted into a minute advancement and retreat distance. Therefore, it is possible to provide an endoscope instrument insertion assist device that can precisely adjust the distance between the affected area and the working end of the treatment instrument.

[0085] [Effects of the invention according to claim 4] According to the endoscope instrument insertion assist device of the invention described in claim 4, the rotation of the operation ring is converted into the advancement and retreat of the medical instrument by the cam mechanism, so that even monotonous finger movements can be converted into a desired instrument advancement and retreat speed by arbitrarily selecting the shape of the cam groove. Therefore, it is possible to provide an endoscope instrument insertion assist device that can advance and retreat the medical instrument at a speed that cannot be achieved by a screw mechanism, and that can change the advancement and retreat speed depending on the position of the instrument.

[0086] [Effects of the invention according to claim 5] According to the endoscopic instrument insertion assist device of the invention described in claim 5, the treatment instrument is advanced or retreated by operating the operation knob that is slidable in the longitudinal direction. This makes it easier to intuitively grasp the relationship between the movement of the treatment instrument's point of action and the movement of the fingertips while keeping the posture of the endoscope body stable, thereby improving operability.

[0087] [Effects of the invention according to claim 6] According to the endoscopic instrument insertion assist device of the invention described in claim 6, it is possible to realize, with a simple configuration, the advancement and retraction of the treatment instrument by operating the operation knob that is slidable in the longitudinal direction and in accordance with the sliding operation. In addition, since the outer peripheral member has a long hole, the operation knob is stopped with a firm feeling at both ends of the advancement and retraction operation, so that it is possible to reliably know by the touch of the fingers whether the knob will not advance any further during the operation under silent vision, which contributes to an intuitive operation feeling.

[0088] [Effects of the invention according to claim 7] According to the endoscopic instrument insertion assist device of the invention described in claim 7, it is possible to add an additional irrigation channel. On the other hand, although there is a risk that the operation of the treatment instrument may be hindered depending on the routing of the irrigation tube, since the roll angle can be adjusted and fixed by the roll fixing part, it is possible to provide an endoscopic instrument insertion assist device in which the operability is not reduced as much as possible. [Brief description of the drawings]

[0089] [Figure 1]FIG. 1 is a schematic explanatory diagram of the present auxiliary device, showing the general configuration of the device and its operating status. [Diagram 2] FIG. 2 is an explanatory diagram showing a state in which the auxiliary device is attached to the endoscope body. [Diagram 3] FIG. 3 is a schematic diagram showing an example of the shape of the main parts according to the first embodiment. [Figure 4] FIG. 4 is a structural example diagram of an endoscopic instrument insertion assist device showing an assembled structural example according to the first embodiment. [Diagram 5] FIG. 5 is a schematic diagram of a modified main component configuration showing an example of the shape of the main components according to the modified example (1) of the first embodiment. [Figure 6] FIG. 6 is a schematic diagram showing an example of the shape of main parts according to the second embodiment. [Figure 7] FIG. 7 is a structural example diagram of an endoscopic instrument insertion assist device according to the second embodiment, showing a structure after assembly. [Figure 8] FIG. 8 is a schematic diagram of a main component configuration showing an example of the shape of main components according to a modification (1) of the second embodiment. [Figure 9] FIG. 9 is a schematic diagram of a modified main component configuration showing an example of the shape of the main components according to the modified example (2) of the second embodiment. [Figure 10] FIG. 10 is a schematic diagram of a modified main component configuration showing an example of the shape of the main components according to the modified example (3) of the second embodiment. [Figure 11] FIG. 11 is a schematic diagram showing an example of the shape of main parts according to the third embodiment. [Figure 12] FIG. 12 is a structural diagram of an endoscopic instrument insertion assist device showing an assembled structural example according to the third embodiment. [Figure 13] FIG. 13 is a schematic diagram of a modification of the main components showing a modification (1) in which the outer cylinder is screwed and fixed to the inner cylinder according to the third embodiment. [Figure 14] FIG. 14 is a schematic diagram of a modification of the main components showing a modification (2) in which the rotation of the outer cylinder is restricted through a sliding stem whose rotation is fixed, according to the third embodiment. [Figure 15] FIG. 15 is a structural diagram of an endoscopic instrument insertion assist device showing an assembled structural example according to the fourth embodiment. [Figure 16] FIG. 16 is a diagram showing an example of the external appearance of the endoscopic instrument insertion assist device after assembly according to the fourth embodiment. [Figure 17] FIG. 17 is a diagram illustrating a configuration example of a connection unit in each embodiment. [Figure 18] FIG. 18 is a schematic view of a flange shutter ring when the flange shutter ring is used in a connection portion. [Figure 19] FIG. 19 is a diagram illustrating another configuration example of the connection portion in each embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0090] The embodiments of the present invention will be described according to the following table of contents. -------------[table of contents]------------- (1. Matters common to all embodiments of the present invention) (1.1. Terminology and notation) (1.2. Common Appearance Features) (1.2.1. Attaching the endoscope body and the endoscopic instrument insertion assistance device) (1.2.2. Hand posture when using an endoscopic instrument insertion assist device) (1.2.3. Holding posture of endoscope with endoscopic instrument insertion assistance device attached) (2. First embodiment) (2.1. Configuration according to the first embodiment) (2.1.1. Overview of configuration and characteristic effects of the first embodiment) (2.1.2. Component configuration according to the first embodiment) (2.1.3. Configuration of the First Embodiment (Explanation of Functionality After Assembly)) (2.1.4. Assembly of the first embodiment) (2.2. Operation of the First Embodiment) (2.2.1. Actions when attaching this auxiliary device to an endoscope) (2.2.2. Instrument advance / retract operation) (2.2.2.1. Instrument Insertion Action) (2.2.2.2. Prevention of contamination by sewage) (2.2.2.3. Instrument advancement / retraction movement) (2.3. Design aspects of the first embodiment) (2.4. Effective Features of the First Embodiment) (2.5. Modification (1) of the First Embodiment) (2.6. Modification (2) of the First Embodiment) (3. Second embodiment) (3.1. Configuration according to the second embodiment) (3.1.1. Overview of configuration and characteristic effects of the second embodiment) (3.1.2. Configuration according to the second embodiment) (3.2. Operation of the Second Embodiment) (3.3. Effective Features of the Second Embodiment) (3.4. Modification (1) of the second embodiment) (3.5. Modification (2) of the second embodiment) (3.6. Modification (3) of the second embodiment) (4. Third embodiment) (4.1. Configuration according to the third embodiment) (4.1.1. Overview of configuration and characteristic effects of the third embodiment) (4.1.2. Configuration according to the third embodiment) (4.2. Operation of the Third Embodiment) (4.2.1. Tool forward / backward movement) (4.2.2. Fixing the roll angle of the control knob) (4.3. Effective Features of the Third Embodiment) (4.4. Supplementary matters related to the third embodiment) (4.4.1. Adjusting the angle) (4.4.1.1. Technique for adjusting roll angle at joint) (4.4.1.2. Technique for adjusting the roll angle of the outer cylinder) (4.4.2. Position of the control knob) (4.5. Modification (1) of the third embodiment) (4.5.1. Technique for curving the operation knob guide hole itself) (4.5.2. Technique to allow the outer cylinder to rotate freely without engaging with the inner cylinder) (4.6. Modification (2) of the third embodiment) (4.7. Modification (3) of the third embodiment) (4.8. Modification (4) of the third embodiment) (4.9. Modification (5) of the third embodiment) (5. Fourth embodiment) (5.1. Configuration according to the fourth embodiment) (5.1.1. Overview of configuration and characteristic effects of the fourth embodiment) (5.1.2. Configuration according to the fourth embodiment) (5.2. Operation of the Fourth Embodiment) (5.3. Variation (1) of the Fourth Embodiment) (5.4. Modification (2) of the fourth embodiment) (6. Connections) (6.1. Example using fastening screws) (6.2. Example using flange shutter ring) (6.2.1 Overview of an example using a flange shutter ring) (6.2.2 Example configuration using flange shutter ring) (6.2.3 Example operation using flange shutter ring) (6.3. Example using a ball plunger) (6.3.1. Overview of configuration using ball plunger) (6.3.2. Example configuration using ball plunger) (6.3.2. Mounting operation using ball plunger) (6.4. Example of a part of the connection part being integrally molded with the inner tube) (7. Others) (7.1. Modifications Related to Luer Connectors) (8. Correspondence between the above-mentioned embodiments and matters specifying the invention) (8.1. Corresponding relationship in claim 1) (8.2. Corresponding relationship in claim 2) (8.3. Corresponding relationship in claim 3) (8.4. Corresponding relationship in claim 4) (8.5. Corresponding relationship in claim 5) (8.6. Corresponding relationship in claim 6) (8.7. Corresponding relationship in claim 7) -------------[Main text]-------------

[0091] (1. Matters common to all embodiments of the present invention) First, matters common to each embodiment of the present invention will be mentioned. For ease of understanding, the following description will be given mainly of a cystoscope as an example of an endoscope that is particularly suitable for implementing the present invention. A cystoscope is relatively small among endoscopes, and is suitable for implementing the present invention. Another characteristic is that the subject to be imaged and the subject instruments to be operated are submerged in water, and the present invention is also suitable for implementing such situations.

[0092] However, the connection target of the present auxiliary device according to the present invention is not limited to cystoscopes, but can also be widely applied to industrial endoscopes, etc. Therefore, when connecting to an endoscope other than a cystoscope, it is not necessary to implement the implementation portion that was implemented for the purpose of preventing contamination from water ingress, for example.

[0093] (1.1. Terminology and notation) Terms used in describing this Detailed Description of the Invention shall be subject to the following definitions.

[0094] The term "endoscope side" refers to the side closer to the endoscope in the longitudinal direction when the auxiliary device is attached to the endoscope.

[0095] "The side opposite the endoscope" refers to the side opposite the endoscope when this auxiliary device is attached to the endoscope, i.e., the side farther from the endoscope in the longitudinal direction.

[0096] When there is a statement in parentheses at the beginning of each paragraph, such as "[~]", that paragraph is an explanation of "~".

[0097] When a paragraph begins with "[A:B]," it means that the paragraph explains "B" and that B is an element of A. For example, a paragraph beginning with [Inner tube: Connection fixing flange] means that the paragraph explains the "Connection fixing flange," and that the "Connection fixing flange" is a part or element of the "Inner tube."

[0098] (1.2. Common Appearance Features) In this section, the hand and finger posture when the endoscopic instrument insertion assist device is attached to the endoscope body and operated will be described with reference to Fig. 1. Also, the situation when the endoscopic instrument insertion assist device is attached to the endoscope body will be described with reference to Fig. 2.

[0099] (1.2.1. Attaching the endoscope body and the endoscopic instrument insertion assistance device) The auxiliary device (102) mainly comprises a connection part (106) and an instrument direct-acting operation part (103).

[0100] [Connection] The connector has the function of connecting the present auxiliary device to an endoscope side connector provided on the endoscope main body (101).

[0101] As shown in Fig. 2, the endoscope side connection part (210) has a channel opening (290) that leads to an instrument insertion passage provided inside the endoscope body, called a channel, and is capable of guiding an instrument that has passed through the instrument insertion passage to the outside of the endoscope body. This also applies to what is generally called a "Luer Connector" (a connector with a Luer taper that is used in syringes and needles and is a common standard. The same applies below.), which is a connector that prevents water leakage, falls into this category.

[0102] Generally, a flange-like locking mechanism is provided at the end of the endoscope side connection part (210). For example, in some endoscopes, this luer flange (263) is shaped like a disk with a portion of it missing, like a wing spread out. In this case, a female screw can be engaged here to attach parts, etc. In other words, the object to be attached here is provided with a mechanism to engage with this flange, so that once attached, it is difficult to unintentionally remove it. The connection part (206) engages with this flange to prevent the auxiliary device from being removed from the endoscope body, and also fits tightly with the channel opening (290) of the endoscope side connection part (210), so that it communicates with the channel inside the auxiliary device without compromising the waterproof effect.

[0103] The connection section (206) also functions to position the part of the instrument linear operation section (203) to be described later that is to be touched by the fingers, so that when the present auxiliary device is attached to the endoscope, the positional relationship between the endoscope body (101) and the part of the instrument linear operation section (203) that is to be touched by the fingers is fixed.

[0104] [Instrument direct operation unit] The instrument linear motion operation section (203) receives manipulation by the fingers and converts the instrument, which has passed through the channel guided by the endoscope body via the connection section, into movement in the longitudinal direction of the channel.

[0105] For example, in the first and second embodiments, when the assisting device is operated in a twisting direction with the fingers, the instrument passed through the channel can be advanced or retreated.

[0106] Since it is sufficient that the operating point can be pinched, it is also possible to operate it with an operating knob or the like, without using an operating ring. An example in which an operating knob is used is the third embodiment.

[0107] In the third embodiment, when the operating knob is slid by a finger in the longitudinal direction of the assisting device, an instrument passed through the channel can be advanced or retreated.

[0108] The instrument linear operation unit (203) also has an instrument holding portion (205) near the opposite end to the connection portion (206) of the auxiliary device. The instrument holding portion (205) holds the instrument inserted into the channel and acts to prevent the instrument from moving forward or backward unexpectedly due to slippage. For this reason, the instrument can be moved forward or backward only by operating the operating point of the instrument linear operation unit (203), such as the operating ring or operating knob.

[0109] Since the instrument linear motion operation unit (203) is positioned by the above-mentioned connection unit, when this auxiliary device is attached to the endoscope body, the positional relationship of the instrument linear motion operation unit (203) with the endoscope body is also determined. Then, when this positional relationship is determined, if any part of the operator from the wrist to the fingertips is in a position to touch the endoscope body, it is guaranteed that the operation point of the instrument linear motion operation unit is located at a position where the instrument linear motion operation unit (203) can be pinched with the fingers of the same hand.

[0110] (1.2.2. Hand posture when using an endoscopic instrument insertion assist device) Next, the hand and finger posture when the endoscopic instrument insertion assist device is attached will be described mainly with reference to FIG.

[0111] In the case of the illustrated endoscope main body (101), the endoscope is held by gripping the endoscope gripping portion (107) with the left hand. Also, although not shown in the figure, the endoscope operation portion is provided at a position where it can be operated with the index finger or thumb of the left hand.

[0112] Meanwhile, the auxiliary device (102) is connected to an endoscope side connection part provided on the side of the endoscope main body (101) by the action of a connection part (106). In the drawing, the endoscope side connection part is provided near the area hidden by the middle finger and ring finger of the right hand. The connection part is part of the auxiliary device (102) and is mechanically integrated with the endoscope to which it is connected.

[0113] Since the present auxiliary device (102) is provided with an instrument direct-acting operation section (103), an instrument passing through the channel can be advanced or retreated by operation from the fingertip applied to the finger operation section (168).

[0114] Due to the positioning action of the connection part, the operator can grasp the instrument linear motion operation part (103) with the thumb and index finger to middle finger as shown in Fig. 1. This is because, when operating this assist device, the operator can hold down the position of the device itself with these fingers, and the position of the entire device integrated with the endoscope via the connection part can be stably maintained. This is because, in addition to the endoscope grip part (107) being able to roughly hold the position of the endoscope, by grasping the instrument linear motion operation part, which is part of the endoscopic instrument insertion assist device integrated with the endoscope, it is possible to further suppress fluctuations in the roll angle relative to the longitudinal direction of the endoscope.

[0115] (1.2.3. Holding posture of endoscope with endoscopic instrument insertion assistance device attached) The holding posture in which the endoscopic instrument insertion assist device and the endoscope are integrally held when the above-mentioned hand posture is adopted will now be described in further detail.

[0116] As described above, by grasping the endoscope gripper and the instrument linear motion operation unit, the general orientation of the endoscope is maintained and the roll angle relative to the longitudinal axis of the endoscope is fixed. In addition, by bringing the little finger of the right hand into contact with the palm contact area (199) of the endoscope body, fluctuations in the yaw and pitch angles relative to the longitudinal axis of the endoscope can also be suppressed.

[0117] This is the right hand 1) The side of the little finger touches the palm contact area (199). 2) The thumb is in contact with the finger operation point (108); 3) The index finger is in contact with the finger operation point (108); And the left hand, 4) The endoscope is held by the endoscope holding portion (107); This is because it is held down at at least four points, making it possible to stably maintain not only the position of the endoscope but also its posture.

[0118] (2. First embodiment) Next, the first embodiment will be described with reference to FIGS.

[0119] (2.1. Configuration according to the first embodiment) (2.1.1. Overview of configuration and characteristic effects of the first embodiment) The first embodiment is The operation ring (304) is used as the part of the instrument direct-acting operation unit (303) that is operated by the fingers. By rotating this operation ring, the instrument can be moved forward and backward. As a mechanism for moving the instrument forward and backward, a female screw is provided in the operating ring, and a slide stalk is provided with a male screw that screws into the female screw. This is the most basic, stable, and simplest embodiment for carrying out the present invention.

[0120] When high accuracy is required for the advancement and retreat of the instrument, it is desirable to implement an operation ring (304) as a finger operation unit as in this embodiment, and advance and retreat of the instrument by rotating the ring. This is because the instrument is moved linearly by rotating the operation ring with the fingers, but even a large angle of rotation can be converted into a short-distance advancement and retreat of the instrument. In other words, it is easy to realize a mechanism that converts the rotation angle into a small advancement and retreat of the instrument, and the rotation angle can be easily adjusted even at a small angle when the fingers are in the position shown in Figure 2.

[0121] (2.1.2. Component configuration according to the first embodiment) In describing the configuration of this embodiment, first, a configuration from the viewpoint of components will be described with reference to FIG. 3, and then a configuration from the viewpoint of functions will be described with reference to FIG.

[0122] [Inner cylinder] The inner cylinder (313) is a generally cylindrical member, and has a channel (309) formed in the longitudinal direction near the inner center core from the endoscope side end to the end opposite the endoscope.

[0123] Furthermore, a connection part (306) is provided on the endoscope side of the inner tube (313) after assembly. When the present auxiliary device is attached to the endoscope, the connection part acts to fix the present auxiliary device, including the roll angle, and the internal channel (309) is connected to a channel opening (290) provided on the endoscope side connection part (210).

[0124] [Inner cylinder: flange for fixing connection part] It is advantageous to provide a flange (323) for fixing the connection part on the endoscope side on the outer surface of the inner tube (313). If the inner tube has a flange, the contact surface with the connection part (306) that contacts it can be made wider, and the two can be securely fixed together by, for example, screwing them together.

[0125] The inner cylinder 313 and the connecting portion 306 may be formed by combining separate members or may be integrally molded. If they are integrally molded, the flange 323 for fixing the connecting portion is not necessary.

[0126] [Inner tube: Male locking screw on inner tube side, locking screw] The inner tube side male set screw (318) is a screw element that is provided on a part of the outer surface of the inner tube (313) between the endoscope side and the opposite side of the endoscope, and screws into the set screw (317). Together with the set screw (317), it acts to keep the operation ring (304), which will be described later, rotatable and to prevent the operation ring from falling off.

[0127] [Inner cylinder: slide pin fixing hole] The slide pin fixing hole (342) is a hole into which the slide pin (311) is inserted and fixed when assembling this auxiliary device. In this example, a female screw is formed on the inner wall surface of the hole, and the male screw at the tip of the slide pin can be screwed into the hole to fix the slide pin.

[0128] [Slide pin] The slide pin (311) that screws into the slide pin fixing hole is located in a guide groove (312) provided in a slide stalk (316) described later, and acts to allow the slide stalk to advance and retreat in the longitudinal direction of the inner tube (313).

[0129] It is desirable that the shape of the slide pin (311) be such that, as shown in the figure, a male thread is formed on the fixing hole side and a smooth surface is formed on the opposite side so that the surface that abuts against the guide groove (312) with which it engages after assembly will not be worn or damaged.

[0130] [Inner tube: Watertight O-ring] The watertight O-ring (314) is an elastic O-ring that can be fitted into an O-ring mounting groove (315) provided on the inner tube (313) on the side opposite the endoscope, substantially near the tip.

[0131] [Slide culm] The slide culm (316) is a part having a substantially cylindrical shape. It is provided with an instrument holding portion (305) on the side opposite the endoscope, and is provided with a slide culm-side male screw (319) on the endoscope side. In addition, because it is cylindrical, a space is provided inside, and the side opposite the endoscope of the inner tube (313) is accommodated in this space.

[0132] [Slide culm: guide groove] The guide groove (312) is a long hole provided at a portion of the slide stem (316) that abuts against the cylindrical side surface of the slide stem (316). The slide pin (311) is adapted to engage with this long hole.

[0133] [Operation ring] The operation ring (304) is a hollow cylindrical part located at the outermost periphery of the assisting device. The outer surface is designed to be rotated by the operator's fingers. The outer surface, especially the part that the fingers touch, may be given a matte finish to prevent slipping.

[0134] It is preferable to provide a slide pin insertion hole (341) on the cylindrical side of the operation ring (304). When assembling this auxiliary device, the slide pin (311) is passed through this slide pin insertion hole (341), and then through the guide groove (312) of the slide stem (316) so that it can be attached to the slide pin fixing hole (342) of the inner tube (313).

[0135] The operation ring (304) is provided with a thick operation ring portion (459) in which the thickness is increased on the endoscope side to narrow the inner diameter of the cavity. The axial movement of this thick operation ring portion is restricted by the connection portion fixing flange (323) on the endoscope side and by a set screw corresponding flange (422) described below on the opposite side of the endoscope. In other words, the operation ring thick portion (459) is sandwiched between the connection portion fixing flange (323) and the set screw (317) provided on the inner tube after assembly. This prevents the operation ring from falling off the inner tube.

[0136] Because of the above configuration, near the endoscope side of the sliding culm of this auxiliary device, there is a part where the inner tube, sliding culm, and operating ring are overlapped in this order from the inside.

[0137] (2.1.3. Configuration of the First Embodiment (Explanation of Functionality After Assembly)) The endoscopic instrument insertion assist device according to the first embodiment is assembled using the above-mentioned parts. Next, the configuration will be further described from the viewpoint of the function and arrangement of each part with reference to FIG. 4, which is a cross-sectional view of the assist device after assembly.

[0138] In the first embodiment, the inner tube (413) is surrounded by a sliding stem (416) on the opposite side of the endoscope and a connection part (406) on the endoscope side. A control ring (404) is attached to surround a part of the inner tube (413) on the endoscope side and a part of the sliding stem (416). In addition, where the control ring (404) surrounds a part of the inner tube (413) on the endoscope side, the inner surface of the control ring and the outer surface of the inner tube are in contact with each other, but a gap is provided that allows the control ring to rotate about the longitudinal axis.

[0139] [Operation ring: Thick part of operation ring] The purpose of the thick-walled portion (459) of the operation ring (404) is to provide a flange that abuts against the set screw (317) on the opposite side of the endoscope to prevent it from falling off, and to facilitate smooth rotation. Therefore, it is not required that the entire portion from the end of the operation ring to the portion that abuts against the set screw (317) be thick.

[0140] [Operation ring: Female screw on operation ring side] An operating ring side female screw (420, 320) is provided on the inside of the operating ring (404) on the side opposite the endoscope.

[0141] The female screw (420, 320) on the operating ring side is screwed into a male screw (419) on the slide stalk side, which will be described later.

[0142] [Set screw] As described above, the locking screw (417, 317) is a member for preventing the operating ring (404) from falling off, and remains within the locking screw space (421) provided at the end of the operating ring thick portion (459) opposite the endoscope.

[0143] [Slide culm] As described above, the slide culm (416, 316) is a cylindrical member that moves forward and backward in the longitudinal direction relative to the inner tube.

[0144] [Slide culm: Slide culm side male screw] The slide culm is formed with a slide culm-side male screw (419) near its end on the endoscope side. The slide culm-side male screw is screwed into the operation ring-side female screw (420, 320) so that when the operation ring is rotated, a force is applied to the slide culm through the slide culm-side male screw that is screwed into it.

[0145] [Slide culm: instrument holding part] The sliding culm (416) also has an instrument holding portion (405). The instrument holding portion (405) is adapted to hold an instrument inserted inside. With this configuration, when the sliding culm itself moves forward or backward, the instrument held by the instrument holding portion moves forward or backward.

[0146] If the instrument needs to be used underwater, such as in a cystoscope, it is desirable to provide the instrument holding portion (405) with a water-stop function to stop the water flowing up the channel and to prevent water from flowing further to the opposite side of the endoscope. To provide such a function, the instrument holding portion (405) may be provided with an instrument gripper / water-stop valve (425) made of an elastic material.

[0147] [Slide culm: instrument holder and water stop valve] The instrument gripper / water stop valve (425) has, for example, a cone-shaped membrane with the endoscope side at the center and a flange around the periphery. The cone has a small hole at the tip to allow the instrument to pass through. If the flange is pressed into the instrument holding part (405) by the water stop valve screw (426) as shown in the figure, the water stop function can be maintained in the instrument holding part (405) and the valve can be fixedly mounted.

[0148] [Slide culm: Watertight O-ring] The watertight O-ring (414) is fitted tightly into a watertight O-ring mounting groove (415) provided near the end of the inner tube (413) opposite the endoscope. This arrangement allows the watertight O-ring to contact the inner wall of the opposing slide stem. This blocks the water flow from the opposite side of the endoscope to the endoscope side inside the slide stem, preventing water from leaking out of the auxiliary device, in combination with the action of the instrument gripper and watertight valve.

[0149] [Inner cylinder: slide pin] The slide pin (311) is fitted into a guide groove (412) provided in the slide culm (416) and is fixed to the inner tube. Since the inner tube (413) is fixed to the endoscope, it is possible to prevent the slide culm from rotating due to the friction between the female screw (420) on the operation ring side and the male screw (419) on the slide culm side when the operation ring (404) is rotated, which is an undesirable result. As a result, when the operation ring is rotated around the longitudinal axis, the slide culm can be converted into a forward and backward movement in the longitudinal axis direction without rotating, except for slight rotation due to play.

[0150] [Connection] The connecting part (406) uses a cylindrical part for its main part, and has a female screw formed on the inside. It is fixed to the connecting part fixing flange (423) provided on the endoscope side of the inner tube by using a connecting part fixing screw (424). The female screw part is designed to be screwed into the flange of the endoscope side connecting part (210).

[0151] [Connection: Channel opening connecting protrusion] In this embodiment, the endoscope-side tip of the inner tube (413) also constitutes one element of the connection part. That is, the endoscope-side tip of the inner tube (413) is provided with a channel opening communication protrusion (460) for communication between a channel in the endoscope-side connection part and a channel penetrating inside the auxiliary device.

[0152] The channel opening connecting protrusion (460) is inserted into the channel opening (290) of the endoscope side connection part (210) with which it is connected, and connects the channel led to the channel opening inside the endoscope to the channel (409) inside the inner tube (413), thereby extending the channel itself.

[0153] For example, when this auxiliary device is used in a cystoscope, the working end of the instrument is submerged, and moisture in the bladder may rise up the channel. In order to seal this and prevent water from leaking to the outside, it is desirable to provide the channel opening communicating protrusion (460) with a taper that gradually expands in diameter from the endoscope side toward the opposite side of the endoscope. Of course, a water-tight sealant such as an O-ring may be provided in the space with the female screw provided inside the connection part (406).

[0154] (2.1.4. Assembly of the first embodiment) The assembly procedure when the parts configuration and structure described above are used will be briefly described below.

[0155] (1) First, prepare the inner tube and connection part. (2) The connection part is fastened to the connection part fixing flange (423) on the endoscope side of the inner tube with the connection part fixing screw (424). (3) Insert the inner cylinder (413) into the operating ring (404) until it contacts the connection portion fixing flange (423). (4) Insert the set screw (417) between the inner tube and the operating ring, and screw it into the inner tube side set screw (318) of the inner tube and tighten it. (5) The slide culm (416) is screwed in. At this time, it is screwed in to the point where the guide groove (312) in the slide culm is located when viewed from the slide pin insertion hole (441) in the operation ring (404). (6) While keeping the relationship between the slide stem (416) and the operating ring (404) the same, rotate the inner cylinder until the slide pin fixing hole (442) in the inner cylinder can be seen through the slide pin insertion hole (441) and the guide groove (312). (7) Insert the slide pin (411) through the slide pin insertion hole (441) and the guide groove (312) and screw it into place. (8) After inserting the instrument gripper / stop valve (425) into the inner cavity of the instrument holding portion, screw in the stop valve locking screw (426).

[0156] This completes the assembly process.

[0157] (2.2. Operation of the First Embodiment) Next, the operation of the present assisting device assembled as described above will be described with reference to FIGS.

[0158] (2.2.1. Actions when attaching this auxiliary device to an endoscope) First, the operation for mounting this auxiliary device on an endoscope will be described.

[0159] When attaching this auxiliary device, the connection part is placed so that the channel opening communicating protrusion (460) on the inside of this auxiliary device fits into the channel opening (290) of the endoscope side connection part (210). Then, the auxiliary device is pushed in as it is and screwed in. This completes the attachment of this auxiliary device to the endoscope body.

[0160] (2.2.2. Instrument advance / retract operation) Next, the operation and movement of this assisting device will be explained with reference to FIGS.

[0161] (2.2.2.1. Instrument Insertion Action) First, hold the endoscope gripper (107) of the endoscope body in one hand, and insert an instrument into the opening of the instrument holder with the other hand. The instrument passes through the instrument gripper and water stop valve (425), the channel in the auxiliary device, and the channel in the endoscope, and finally reaches the point of application.

[0162] (2.2.2.2. Prevention of contamination by sewage) In this case, if the channel is connected to a part immersed in sewage, such as a cystoscope, water may rise through the channel and overflow from the opening on the opposite side of the endoscope of the inner tube (413). However, the instrument gripper and water stop valve (425) tightly grips the instrument and prevents it from leaking out. Even if water leaks into the gap between the slide stem and the inner tube, it is stopped by the water stop O-ring (414), so it does not go any further. This reduces the risk of the rising sewage contaminating the outside.

[0163] (2.2.2.3. Instrument advancement / retraction movement) Next, the operation of advancing and retracting the instrument inserted in the channel will be described, starting from the state immediately before the instrument is advanced and retracted, as described above in (2.2.2.1. Instrument Insertion Operation). 1) The slide culm (416) is the furthest from the endoscope, and 2) The instrument is roughly reaching the point of application. The following explanation is based on the above premise.

[0164] In this state, while holding the endoscope gripper (107) with the left hand, place the right hand next to the endoscope in the position shown in Fig. 1. Then, grasp the operating ring (104) with the thumb and index finger of the right hand. Since this auxiliary device is already attached to the endoscope by the connection part and is physically integrated, the endoscope is supported by the left and right hands at the endoscope gripper (107), the front and side of the little finger at the palm contact part (199), and the right thumb and index finger at the finger operating point (108). As a result, the roll angle, yaw angle, and pitch angle in the longitudinal direction of the endoscope are all determined, and the endoscope is in a stable position.

[0165] Here, the instrument is advanced and retracted while observing the object to be treated with the endoscope, and the operating ring (104) held by the thumb and index finger is rotated. When the operating ring is rotated, a force is applied to the male screw (419) of the sliding culm that is screwed into the female screw (420) of the operating ring on the inside. However, the sliding pin (411) is fitted in the guide groove (412) of the sliding culm, which prevents the sliding culm from rotating. Therefore, the force received by the male screw (419) of the sliding culm from the female screw (420) of the operating ring is converted into a resultant force that moves the sliding culm in the longitudinal direction. The instrument gripper and water stop valve (425) advances and retracts together with the sliding culm, and as a result, the instrument is advanced and retracted in the longitudinal direction.

[0166] By the above operations, the operator can achieve the tool advancement and retraction desired.

[0167] (2.3. Design aspects of the first embodiment)

[0168] As described above, the endoscope integrated with this auxiliary device is supported at multiple points to stabilize its posture, and in order to advance and retreat the instrument, the operating ring can be rotated with the thumb and index finger. Therefore, the position of the operating ring in the longitudinal direction should be such that it can be grasped and rotated with the thumb and index finger while the ring is placed in the palm of the hand near the little finger.

[0169] In this regard, if a normal adult were to operate it, the distance from the palm contact point near the little finger to the point where it is grasped with the thumb and index finger would be about 7 to 10 cm. If this part is rotatable, the extent to which the operating ring should be extended toward the endoscope and its width can be determined based on design considerations, including aesthetic appearance.

[0170] (2.4. Effective Features of the First Embodiment) As described above, according to this embodiment, the endoscope can be held extremely stably while the instrument can be advanced and retreated at the same time. In addition, the female screw (420) on the operating ring side and the male screw (419) on the slide culm side form a reduction mechanism, so that even if the instrument is advanced and retreated by a large rotation, it is converted into a small movement, and it is possible to achieve extremely accurate instrument advancement and retreat operation.

[0171] (2.5. Modification (1) of the First Embodiment) Next, a modified example of the first embodiment will be briefly described with reference to Fig. 5. In this modified example, the slide pin and the guide groove are simply arranged in reverse, but there are some points to note, which will be mentioned below.

[0172] In the first embodiment, the slide pin (411) and the guide groove (412) were provided on the inner tube (413) and the slide culm (416), respectively, but these were intended to prevent the slide culm from rotating when the operating ring was rotated. In contrast, in this modified example (1), the locations where these are provided are changed, and the slide pin (511) and the guide groove (512) are mounted on the slide culm and the inner tube, respectively. The rest is as described above.

[0173] In this case, it is desirable that the male thread portion of the slide pin (511) is attached only to the slide culm side, and the portion that abuts against the guide groove is left smooth.

[0174] By doing so, in the process of attaching the slide pin, it becomes easier to find the slide pin fixing hole (542), making assembly easier. However, if the guide groove were made into a through hole leading to the channel, the rising sewage would overflow from there. For this reason, the guide groove needs to be a shallow groove that does not reach the channel. If this is not permissible, a solution can be found by positioning the watertight O-ring closer to the endoscope than the guide groove.

[0175] (2.6. Modification (2) of the First Embodiment) Next, as another modification of the first embodiment, a screw mechanism for linearly moving the slide culm using a double-thread or multiple-thread screw will be described. Specifically, the slide culm side male screw (419) and the operation ring side female screw (420) are double-thread or multiple-thread screws.

[0176] By making the male screw (419) on the sliding culm side and the female screw (420) on the operating ring side double-start or multiple-start threads, the linear movement distance of the sliding culm per a given angle of the operating ring can be increased. For example, when using a medical endoscope, the inner wall surface of an organ may move in accordance with the heartbeat. In such a case, the instrument may need to be moved in accordance with the heartbeat, and depending on the organ, a single-start thread as in the first embodiment cannot follow the movement of the inner wall surface.

[0177] In such a case, by adopting a multiple thread structure as in this modified example, it becomes possible to provide an assist device that can be adapted to a larger number of organs while maintaining high positioning accuracy.

[0178] (3. Second embodiment) Next, a second embodiment will be described with reference to FIGS.

[0179] (3.1. Configuration according to the second embodiment) (3.1.1. Overview of configuration and characteristic effects of the second embodiment)

[0180] The present embodiment is generally similar in structure to the first embodiment, however, whereas the first embodiment achieves rotational-linear conversion by using a screw structure between the operating ring and the sliding stem, the present embodiment differs in structure and operation in that a cam is used.

[0181] Other parts, such as the inner tube (613), the set screw, the tool holding portion provided on the sliding stem, and the connecting portion (606) are the same as those in the first embodiment.

[0182] (3.1.2. Configuration according to the second embodiment) The main components of this embodiment are as shown in Figure 6. In this embodiment, a cam pin (627) is provided on the operation ring (604) and a cam groove (628) is formed on the slide stalk (616), thereby realizing rotational / linear conversion.

[0183] For this purpose, the operation ring (604) is provided with a cam pin fixing hole (629) in which the cam pin can be screwed in. Also, in the first embodiment, there is no male screw on the slide culm side provided on the endoscope side of the slide culm, and no female screw on the operation ring side on the inside of the operation ring.

[0184] In this embodiment, the slide pin and guide groove for preventing unnecessary rotation of the sliding culm during its forward and backward movement are provided on the inner tube and the sliding culm, respectively, as in the first embodiment.

[0185] It is also preferable to provide a slide pin insertion hole (not shown) in the operation ring (604) for use during assembly. However, if the diameter of the cam pin (627) can be made large, the cam pin fixing hole (629) may be used instead of the slide pin insertion hole.

[0186] When these are assembled, they are positioned as shown in Figure 7. The cam pin (727) is screwed into the operating ring and is guided by the cam groove (728). The cam groove is provided in the sliding culm and may be a through hole or a shallow groove as shown in the figure. Also, to ensure stable forward and backward movement of the sliding culm, it is desirable to provide two or more cams. When providing two cam pins, they should be located in positions that are linearly symmetrical about the longitudinal axis, and when providing three or more cam pins, they should be located in positions that are equiangularly spaced about the longitudinal axis.

[0187] (3.2. Operation of the Second Embodiment) The operation of this embodiment, including the operation of inserting the appliance and the operation of preventing contamination by dirty water, is the same as that of the first embodiment.

[0188] The instrument advancement / retraction operation is also generally similar to that of the first embodiment. That is, when the operation ring is rotated, the roll angle of the cam pin with respect to the longitudinal axis direction also changes.

[0189] On the other hand, the sliding culm is pulled along by a slide pin guide groove (not shown) that is installed between the inner tube and the sliding culm, which prevents it from rotating, and as a result, it is forced to move in the forward and backward direction, which is converted into a forward and backward movement.

[0190] (3.3. Effective Features of the Second Embodiment) As described above, according to this embodiment, the advance / retract distance relative to the rotation angle of the operation ring can be changed by changing the angle of the cam. For example, irregular instrument advance / retraction can be realized by changing the ratio of the rotation angle and the instrument advance / retract distance depending on the instrument position. This embodiment does not require the same level of precision as the screw mechanism, but can be used when it is desired to move the instrument quickly.

[0191] (3.4. Modification (1) of the second embodiment) In the second embodiment, the slide pin is provided on the inner tube and the guide groove is provided on the slide culm. However, as shown in FIG. 8, it is also possible to provide the slide pin (811) on the slide culm (816) and the guide groove (812) on the inner tube (813). This is a modification similar to the modification (1) in the first embodiment. Therefore, the points to note are the same as those in the modification (1) in the first embodiment, such as the shape of the guide groove and avoiding a long hole when the purpose is to see inside in sewage. The modification using a long hole will be mentioned in the next section (3.5. Modification (2) of the second embodiment).

[0192] The advantage of adopting this configuration is the ease of manufacture, just like the advantage of the modified example (1) in the first embodiment. However, if it is necessary to avoid making it a long hole, the guide groove (812) must be shallow. For this reason, it is worth considering adopting it for relatively large industrial endoscopes, except for endoscopes such as cystoscopes that are small and difficult to make thick for the inner tube.

[0193] (3.5. Modification (2) of the second embodiment) In the modified example (1) of the second embodiment described above, when endoscopy in dirty water is required, it is necessary to avoid making the guide groove a long hole. However, as shown in FIG. 9, by providing an O-ring mounting groove (915) on the endoscope side of the guide groove (912) and changing the position at which the watertight O-ring (914) is provided, it is possible to make the guide groove (912) penetrate through the channel.

[0194] According to this modification (2), it is possible to prevent water leakage while maintaining ease of manufacture.

[0195] However, if the cam groove (928) is an elongated hole that penetrates the sliding culm, the water-stopping O-ring (914) must be kept out of the cam groove (928) over the entire range of movement of the sliding culm, otherwise water will leak through the cam groove and overflow. For this reason, the cam groove (928) and the slide pin fixing hole (942) must be spaced apart by more than the entire range of movement of the sliding culm.

[0196] However, if the thickness of the slide culm near the cam groove (928) can be made large and the cam groove is made shallow so that it does not penetrate through, this will not be a problem and design freedom can be maintained.

[0197] Points other than these are as described above.

[0198] (3.6. Modification (3) of the second embodiment) In the second embodiment, the cam pin is provided on the operation ring and the cam groove is provided on the slide culm, but it is also possible to provide the cam pin (1027) on the slide culm and the cam groove (1028) on the operation ring (1004) as shown in Fig. 10. In this case, a cam pin fixing hole (1029) is provided on the slide culm and the cam pin is fixed therein.

[0199] According to this modification (3), the shape of the cam groove can be visually checked. Therefore, when preparing many variations of the present auxiliary device with various rotation and forward / backward ratios, it becomes possible to know at a glance which present auxiliary device to select, and the work of replacing the variations becomes easy.

[0200] However, the cam grooves come into contact with the fingers, so the feel is sacrificed, and the processing precision must be increased to prevent the openings of the cam grooves and the cam pins from damaging the thin gloves worn to prevent contamination.

[0201] The remaining points are as explained above.

[0202] (4. Third embodiment) Next, a third embodiment will be described with reference to FIGS.

[0203] (4.1. Configuration according to the third embodiment) (4.1.1. Overview of configuration and characteristic effects of the third embodiment) This embodiment differs in configuration and operation from the first and second embodiments in that a lever is used to advance and retract the sliding culm, instead of using an operating ring.

[0204] (4.1.2. Configuration according to the third embodiment) First, the configuration according to the third embodiment will be described with reference to FIG.

[0205] [Inner cylinder] The inner cylinder (1113) is a cylindrical member. As in the first embodiment, a channel is formed in the longitudinal direction on the inside from the endoscope side end to the end opposite the endoscope.

[0206] The connection part provided on the inner tube and the action of the connection part are also the same as those in the first embodiment. However, the slide pin and guide groove provided to prevent the rotation of the slide culm, which were essential in the first embodiment, are not necessary in principle. An example of implementing the slide pin and guide groove will be described later in (4.6. Modification (2) of the third embodiment).

[0207] [Outer cylinder] The outer cylinder (1132) is a cylindrical member that covers the inside of the auxiliary device from the outside. An operation knob guide hole (1131) is provided in a part of the outer cylinder (1132), which will be described later. In addition, an outer cylinder fixing screw (1134) can be inserted to prevent unnecessary rotation as necessary.

[0208] [Operation knob] The operation knob (1130) is a handle that can be grasped with two fingers or pushed and pulled with one finger to move it back and forth in the longitudinal direction of the auxiliary device. A male screw is formed on one end, which can be screwed into the operation knob fixing hole (1133) and fixed to the slide stalk (1116). This allows the slide stalk (1116) to be moved back and forth by moving the operation knob back and forth in the longitudinal direction of the auxiliary device.

[0209] The operating knob has a large diameter portion which serves as a handle, a male screw portion which screws into the slide stem, and a smooth portion which connects the two and comes into contact with the operating knob guide hole.

[0210] If the two fingers holding the knob are the index finger and the middle finger, a relatively wide range of forward and backward movement is possible. If it is assumed that the knob will be pushed and pulled with one finger, a recess or a through hole may be provided on the knob so that the finger can be hooked.

[0211] [Operation knob guide hole] The operation knob guide hole (1131) is an elongated hole provided in the outer cylinder (1132). The central axis of the operation knob (1130) passes through the operation knob guide hole (1131) and defines the operating range of the operation knob (1130).

[0212] The operation knob guide hole regulates the movement of the operation knob, so that if the roll angle of the outer tube with respect to the longitudinal axis is fixed with respect to the inner tube, the slide stem will not rotate unnecessarily.

[0213] [Structure after assembly] When the above main parts are assembled, they are arranged as shown in Fig. 12. The characteristic parts of this embodiment are as described above.

[0214] As for the remaining part, The inner tube has a channel (1209) located near the center of the inner tube in the longitudinal direction. The connection part (1206) is fixed to the connection part fixing flange (1223) of the inner cylinder by the connection part fixing screw (1224); The outer cylinder (1232) surrounds the thick part of the inner cylinder. The inner and outer cylinders are secured to each other by a set screw (1217) to prevent them from falling off. The slide culm (1216) is provided with an instrument holding portion (1205); The fixture holder (1205) contains a fixture holder / water stop valve (1225), The water stop valve (1225) is secured in the water stop valve retaining portion (1205) by a water stop valve retaining screw (1126). The water-stopping O-ring (1214) is fitted into the water-stopping O-ring fitting groove (1215) to prevent water flow between the inner tube and the slide stem. etc. are similar to those described in the first embodiment, and therefore will not be described here.

[0215] (4.2. Operation of the Third Embodiment) Regarding the operation of this embodiment, the operation of inserting the tool and the operation of preventing contamination by dirty water are the same as those of the first and second embodiments.

[0216] (4.2.1. Tool forward / backward movement) The feature of the endoscopic instrument insertion assist device according to this embodiment is that the instrument advances and retreats when the operating knob is moved in the longitudinal direction of the assist device. That is, since the operating knob is directly fixed to the sliding culm, moving the operating knob in the longitudinal direction of the assist device appears as a movement of the sliding culm in the longitudinal direction. The sliding culm is equipped with an instrument holding part (1205), which moves. And since the instrument gripping part grasps the instrument, it causes the instrument itself to advance and retreat.

[0217] (4.2.2. Fixing the roll angle of the control knob) The roll angle position of the operation knob on this auxiliary device is fixed by the connection part and the outer cylinder fixing screw (1134).

[0218] That is, the roll angle of the inner tube itself relative to the longitudinal axis direction is fixed by the action of the connecting part. If twisting between the inner tube and the outer tube can be suppressed here, the roll angle of the outer tube will also be fixed. The outer tube fixing screw (1134) acts to suppress twisting between the inner tube and the outer tube. The operation knob is regulated by the operation knob guide hole provided in the outer tube, and as a result, the roll angle of the operation knob does not easily change.

[0219] (4.3. Effective Features of the Third Embodiment) As described above, according to this embodiment, the tool advance / retract distance coincides with the lever movement distance, which not only allows for quick tool advance / retract operation but also provides an intuitive operational feel. Therefore, this embodiment is particularly suitable for use in industrial endoscopes.

[0220] (4.4. Supplementary matters related to the third embodiment) (4.4.1. Adjusting the angle) In this embodiment, since the operation knob is shaped to protrude outside the auxiliary device, it is desirable that the protruding portion faces a direction that is easy for the operator to operate (roll angle with respect to the longitudinal direction of the auxiliary device). However, it is expected that the ease of operation for each operator will vary greatly depending on the size of the operator's hand and the range of movement of the fingers. Therefore, it is desirable to make it possible to adjust the direction that is easy for each operator to operate. The following two methods can be used for this adjustment. Which of the two methods is to be used can be determined by comprehensively considering the size of the auxiliary device, the type and size of the endoscope to be attached, the ease of handling of the instrument to be inserted, and the like.

[0221] (4.4.1.1. Technique for adjusting roll angle at joint) As mentioned in the following chapter (6. Connection), the roll angle of the inner tube in the longitudinal axis direction can be set arbitrarily by devising the connection. Therefore, the configuration of the connection allows the roll angle of the outer tube fixed to it to be adjusted, and this allows the roll angle position of the operation knob to be adjusted to a position that is easy for each individual operator to operate.

[0222] (4.4.1.2. Technique for adjusting the roll angle of the outer cylinder) By semi-fixing the outer tube (1232) to the inner tube, it is also possible to select a design option that allows the roll angle to be corrected after the auxiliary device is attached to the endoscope via the connection part.

[0223] (4.4.2. Position of the control knob) In the endoscopic instrument insertion assist device according to this embodiment, when the control knob is closest to the endoscope, it is the position where the instrument is inserted to the back. This vicinity is where the most delicate operation is required. Therefore, it is sufficient to pinch the control knob with the fingers in this vicinity, and there is no need to require a high degree of stability in the gripping position of the endoscope when the control knob reaches the opposite side of the endoscope.

[0224] Therefore, when the control knob reaches the opposite side of the endoscope, it is not necessary for part of the operating hand to come into contact with the endoscope, but it is necessary that part of the operating hand come into contact with the endoscope near the endoscope side where delicate operation of the control knob is required. In other words, the design item of the operating range of the control knob can be freely designed in areas away from the endoscope.

[0225] Even if you do this, you will end up pinching the knob with your fingers at positions that require delicate operation, and as with the first embodiment, 1) The side of the little finger touches the palm contact area (199), 2) The thumb touches the finger operation point (108), 3) The index finger touches the finger operation point (108), 4) and the left hand holds the endoscope with the endoscope holding portion (107), This makes it possible to grasp the endoscope in a stable position.

[0226] In addition, even if the control knob is located far away on the opposite side of the endoscope, where delicate operation is not required, 1) The thumb touches the finger operation point (108), 2) The index finger touches the finger operation point (108), 3) and the left hand holds the endoscope with the endoscope holding portion (107), Therefore, at least three points of support are provided, and although not as stable as four points of support, the necessary stability can be maintained. In particular, when the inner and outer tubes are engaged with the outer tube fixing screw (1134) as per the principle, even if the three points are maintained, the roll angle in the longitudinal axis direction can be reliably held by pinching with the thumb and index finger, so that even if the side of the little finger does not come into contact with the palm contact part (199), there is little problem in maintaining the endoscope posture at this position where accuracy is required, i.e., at a position away from the treatment object. This is because, if the operation knob is already being held to adjust the instrument forward and backward, it is rare for a large moment force to be applied by newly touching the endoscope or this auxiliary device with a finger.

[0227] (4.5. Modification (1) of the third embodiment) In the third embodiment, in order to facilitate stable operation by the operator, the roll angle of the operation knob with respect to the longitudinal axis of the auxiliary device is made not to change easily. Specifically, an outer tube fixing screw (1134) is provided so as to span from the outer tube to the inner tube. However, since the movable range of the operation knob is the maximum distance the instrument can move forward and backward, when moving forward and backward by a large distance, the linear operation knob guide hole (1131) as shown in the figure may not be able to be reached by the fingers.

[0228] In such a case, if you grab the control knob or extend your fingertips in the opposite direction from the endoscope and then curve your fingers, you can operate the control knob over a wide range as expected. There are two techniques that can be used to operate the control knob over a wide range.

[0229] (4.5.1. Technique for curving the operation knob guide hole itself) When the finger is extended, the path of the fingertip curves. The operation knob guide hole (1131) is a straight hole in the longitudinal direction, but if the guide hole shape is a deformed hole that curves in the same way as the path of the fingertip, stability can be maintained. This technique can be easily implemented without requiring any other parts, by simply engaging the outer tube and inner tube with the outer tube fixing screw (1134).

[0230] (4.5.2. Technique to allow the outer cylinder to rotate freely without engaging with the inner cylinder) If the outer tube is allowed to rotate freely without engaging with the inner tube, the operation knob will curve and follow the path of the fingertip as it is extended. To achieve this state, the outer tube and inner tube should not be engaged with each other using the outer tube fixing screw (1134).

[0231] Although some stability is sacrificed, this allows the operator greater freedom in operation. This is a technique worth considering when such instrument operation is required. This selection is made easy because the function of moving the tool forward and backward is integrated into this auxiliary device, and it is significant that the same endoscope can be used for different purposes simply by replacing this device.

[0232] Regardless of which of the above techniques is adopted, it is desirable to provide the operation knob with a recess on the side or a finger ring so that the index finger can be placed thereon.

[0233] (4.6. Modification (2) of the third embodiment) Instead of fixing the outer tube to the inner tube with the outer tube fixing screw (1134), the outer tube can be semi-fixed by applying grease with appropriate viscosity near the contact surface between the outer tube and the inner tube.

[0234] This allows a large range of motion to be secured, as described above (4.5.2. Technique for allowing the outer cylinder to rotate freely without engaging with the inner cylinder), and also ensures stability of posture, although it cannot be said to be sufficient. By selecting the viscosity of the grease, it becomes possible to strike a balance between stability of posture and ease of operation within the range of motion.

[0235] There is a risk of grease leakage when the device is used multiple times with cleaning, but this modified example is a suitable design option when a single use is assumed, or when cleaning is not required even after multiple use, such as when the device is used as an auxiliary device for a cystoscope or an auxiliary device for an industrial endoscope.

[0236] (4.7. Modification (3) of the third embodiment) Regarding the engagement means between the outer tube and the inner tube, instead of the outer tube fixing screw (1134), a butterfly screw that is easy for the operator to operate can be used so that the tip of the butterfly screw presses the inner tube. In this case, the operator can loosen and adjust the butterfly screw himself, and then tighten it again to fix it at the appropriate roll angle.

[0237] This makes it possible to easily adjust the roll angle of the assist device to suit the operator's hand size, finger shape, ROM (Range Of Motion), etc.

[0238] (4.8. Modification (4) of the third embodiment) In order to prevent the outer tube and the inner tube from easily rotating, in the basic type of the third embodiment, the two are engaged using an outer tube fixing screw, but as shown in FIG. 13, it is also possible to provide an outer tube fixing male screw (1335) on the endoscope side of the outer tube and an outer tube fixing female screw (1336) on the endoscope side inside the outer tube (1332), and engage the outer tube and inner tube by screwing them together. In this case, the roll angle position of the outer tube is determined only by the cutting of these screws. Therefore, if a function for adjusting the roll angle of this auxiliary device is implemented, one that allows the angle position to be freely adjusted will be adopted from among the variations of the connection part described later.

[0239] This modification has the advantage in terms of manufacturing since it requires fewer parts.

[0240] (4.9. Modification (5) of the third embodiment) In the past, the outer tube and the inner tube were engaged with each other using a screw for fixing the outer tube to prevent them from easily rotating. However, as shown in FIG. 14, a slide pin fixing hole (1442) can be provided in the inner tube (1413) and a guide groove (1412) can be provided in the sliding culm (1416), and unnecessary rotation of the sliding culm can be suppressed by using a slide pin guided by this guide groove.

[0241] This modified example is advantageous when commercializing a product lineup that includes the first embodiment, as it allows for the standardization of parts and enhances the product lineup while reducing part costs.

[0242] (5. Fourth embodiment) Next, a fourth embodiment will be described with reference to FIGS.

[0243] (5.1. Configuration according to the fourth embodiment) (5.1.1. Overview of configuration and characteristic effects of the fourth embodiment) This embodiment is generally similar in structure to the first embodiment, but differs in that a channel branch is provided near the endoscope side of the inner tube. This allows the addition of other instruments or the use of the channel as a perfusion channel even in a small endoscope with a small number of channels without using a switching valve.

[0244] For example, if the endoscope body is a cystoscope, it becomes possible to pass irrigation water through the branched channel opening without using a separate branch stop. The following description will be given on the assumption that the endoscope to which this auxiliary device is attached is a cystoscope.

[0245] (5.1.2. Configuration according to the fourth embodiment) This embodiment will be described primarily with reference to FIG. 15, which shows the configuration after assembly. This embodiment has a configuration similar to that of the first embodiment. In other words, by comparing with FIG. 3, the operation ring (304), the slide pin insertion hole (341) on the side of the operation ring, and the components on the opposite side of the endoscope from the flange (323) for fixing the connection part of the inner tube (313), i.e., the watertight O-ring (314), the O-ring mounting groove (315), the male screw (318) on the inner tube side, the slide pin fixing hole (342), the slide culm (316), the guide groove (312) on the slide culm, the instrument holding part (305), the slide pin (311), and the set screw (317) are as described above in (2. First embodiment), and therefore will not be described again here. Moreover, each portion except for the channel branch portion may be embodied with the other structures explained in (3. Second embodiment) and (4. Third embodiment).

[0246] [Channel branch] The channel branching section (1537) is a section that branches the channel (1509) of this auxiliary device and branches the channel that has passed through the endoscope into two channels. The channel branching section is provided on the inner tube, toward the opposite side of the endoscope, near the connection section on the endoscope side. As mentioned in (2.3. Design aspects of the first embodiment), this position is a dead space, considering the distance from the palm contact area near the little finger of an adult to the position where the thumb and index finger hold the device, and is a characteristic section with relatively large space that does not interfere with operation or connection. Therefore, even if a channel branching mechanism is provided in this section, no inconvenience will occur.

[0247] [Irrigation port] The perfusion port (1539) is a channel opening at the point where the channel branched at the channel branching section leads to the outside of this auxiliary device. Medical instruments used for perfusion can be attached here. Although the illustrated perfusion port is a single port, multiple ports may be provided.

[0248] [Perfusion device attachment adapter] The perfusion device attachment adapter (1561) is provided on the endoscope side near the perfusion port to ensure a reliable connection between the branched channel and the perfusion device. When no perfusion device is attached, a water stop valve can be attached instead of the perfusion device attachment adapter.

[0249] [Water-stopping O-ring for irrigation port] The irrigation port water-stopping O-ring (1540) is an O-ring provided near the irrigation port, and is inserted between the irrigation device mounting adapter (1561) and the wall surface of the channel branched off from the channel branching part (1537) and is adapted to abut against both. In other words, the irrigation port water-stopping O-ring is adapted to seal the gap between the wall surface of the channel branched off from the channel branching part (1537) and the medical instrument used for irrigation. This makes it possible to prevent leakage of wastewater or irrigation water from the irrigation port.

[0250] [Connection] Next, the connecting portion will be described. In the first embodiment, the connecting portion is fixed with a female screw element so that it can be easily screwed onto a luer connector.

[0251] However, in this embodiment, since the irrigation port is configured to protrude outward from the side of the assist device, it is easily conceivable that if a female screw element were simply used as is, this would get in the way of operation.

[0252] In order to prevent the perfusion port and the subsequent perfusion device from interfering with the operation, it is desirable to allow the operator to freely adjust the roll angle of the present auxiliary device. 1) The roll angle of the device relative to the longitudinal axis can be adjusted at any angle when the device is worn. 2) Since there is an increased possibility that unexpected force may be applied from the medical equipment attached for perfusion, it is necessary to ensure a connection with the main body that can resist such force. It is necessary to satisfy these two requirements. In this embodiment, the connection that is considered to be the simplest among them is adopted.

[0253] In this embodiment, the connection part is constructed as an integrated member that includes a connector (1543) and a connection part tightening screw (1538). Each part will be explained below, but the appearance of such a connection part is shown in Figure 16 and Figure 17(A).

[0254] [Connection: Connector] The connectors (1543, 1643, 1743) in the connection sections (1506, 1606, 1706) are cylindrical members with an elliptical or similar opening on the endoscope side. A female screw is cut on the side opposite the endoscope. There is a roll angle at which the lure connector of the endoscope-side connection section passes through the opening, and when the connector is turned 90 degrees from this angle, the flange portion of the lure connector is engaged, making it difficult to come off. In other words, the long diameter of the endoscope-side opening of the connector is larger than the flange diameter of the lure connector, and the short diameter is smaller.

[0255] [Connection: Connection tightening screw] The connection part tightening screw (1538, 1638, 1738) is also a cylindrical member, and has a male screw on the outside on the endoscope side so that it can be screwed into the female screw part of the connection tool. Also, the inner space is designed to fit into the inner cylinder while remaining rotatable.

[0256] [Connection: Stop ring] The stop ring (1562) is a member known as a C-ring or E-ring, and is adapted to fit into a groove provided at the approximate end of the inner tube on the endoscope side at a position that fits inside the female thread of the connector. The end of the connection part fastening screw (1538) on the endoscope side abuts against the surface on the opposite side of the endoscope. This prevents the connection part fastening screw from coming off the inner tube.

[0257] (5.2. Operation of the Fourth Embodiment) The auxiliary device according to this embodiment having the above-mentioned structure is attached and fixed to the endoscope in the following procedure. 1) The connection tightening screw (1538) is first inserted into the inner tube from the endoscope side, and then a locking ring (1562) is used to prevent it from falling off. 2) The flange of the lure connector of the endoscope side connection part is passed through the opening of the connector. At this time, since the endoscope side opening of the connector is not a perfect circle, such as an ellipse, depending on the roll angle, it can be passed through without hanging on the flange of the lure connector that constitutes the endoscope side connection part. Next, rotate the connector 90 degrees so that the flange part of the lure connector is hung. 3) Next, place this auxiliary device against the connection part on the endoscope side, and screw the connection part tightening screw (1538) into the connection tool (1543) to press down the front and back of the flange part of the luer connector, thereby fixing this auxiliary device at the desired roll angle.

[0258] With the above-described configuration and operation, this assist device can be adjusted to any roll angle.

[0259] (5.3. Variation (1) of the Fourth Embodiment) In the above (5.1.2. Configuration of the fourth embodiment), the perfusion device mounting adapter can be formed integrally with the inner cylinder member. In this case, the perfusion port water stop O-ring is not required, which has the advantage of reducing the number of parts, but the water stop valve used when the perfusion port is not required must have a shape similar to that of the mounting part on the perfusion device to which it is to be attached.

[0260] (5.4. Modification (2) of the fourth embodiment) In the above (5.1.2. Configuration of the Fourth Embodiment), an example was shown in which a part of the connection part and the channel branch part (1537) were integrally molded on the inner cylinder, but these may be separated as separate parts. That is, All connections, channel branches and inner cylinders are molded as one unit. The connection and channel branch are molded as a single piece, and the inner tube is a separate part. The connection, channel branch and inner cylinder are all separate parts. By making either of these separate parts, it becomes possible to make the components from the inner tube to the opposite side of the endoscope into common parts when offering a variation of products, such as products with and without irrigation ports.

[0261] In addition, the channel branch and the inner cylinder may be molded as a single unit, with the connection part being a separate part. This makes it easy to provide a variety of options to meet the needs of, for example, connecting various perfusion devices and requiring a more mechanically stable connection part.

[0262] (6. Connections) Up to this point, in the explanation of each embodiment, the embodiment with the easiest-to-implement connection structure has been explained, but depending on the application of the endoscope, the type of instrument, and how they are used, there may be situations where the connection between the main body and the auxiliary device is not sufficient. In such situations, a more reliable connection is required. In this chapter, four typical examples of the configuration of the connection part for a more reliable connection will be explained.

[0263] (6.1. Example using fastening screws) First, an example using a tightening screw is shown in Fig. 17(A). This has already been explained in the section on [Connection] in (5.1.2. Configuration of the Fourth Embodiment), so the details will be given in the same description.

[0264] In the fourth embodiment, this connection portion realizes adjustment of the roll angle and a stronger connection. Such a requirement may be required not only in the fourth embodiment but also in other embodiments depending on the purpose of the endoscope and the type and size of the instruments to be used. This may be substituted when implementing these other embodiments.

[0265] (6.2. Example using flange shutter ring) Next, an example of a connection portion including a flange shutter ring as a component will be described mainly with reference to FIG. 18 and supplementarily with FIG. 17(B).

[0266] (6.2.1 Overview of an example using a flange shutter ring) In this example, the luer flange (263) at the end of the endoscope side connection part (210) shown in Fig. 2 is sandwiched between the luer flange insertion grooves (1847-1, 1847-2) provided at the end of the inner tube of this auxiliary device and the flange shutter ring (1845) to make it difficult for the endoscope side connection part and this auxiliary device to come off. In this example, an elastic body is normally used to bias the flange shutter ring to close, so that a strong connection is achieved by attaching this auxiliary device.

[0267] (6.2.2 Example configuration using flange shutter ring) Below, the outline of this example will be explained element by element.

[0268] [Inner cylinder] A spring housing groove (1864) and a luer insertion groove (1848) are provided at the end of the inner tube (1813) on the endoscope side, and two rotation limiting pins (1858-1, 1858-2) and a rotation guide protrusion (1854) are also provided. Furthermore, a flange shutter ring (1845) is adapted to rotatably contact the end of the endoscope side.

[0269] [Inner cylinder: spring storage groove] The spring storage groove (1864) is a groove provided in an arc shape on a part of the outer circumference centered on the channel hole at the end of the endoscope, and stores an elastic shutter ring pressure spring (1855) therein. The shutter ring pressure spring is preferably a spiral spring, and biases the flange shutter ring (described later) in a direction to rotate clockwise. For this purpose, the inner tube side spring hook pin (1856) fixed to the inner tube (described later) and the shutter side spring hook pin (1857) fixed to the flange shutter ring (1845) are also configured so that their protruding portions are accommodated in the space within this spring storage groove (1864). Note that, although the flange shutter ring is shown here to rotate clockwise, it may be rotated counterclockwise.

[0270] [Inner cylinder: inner cylinder side spring hook pin] The inner tube side spring hook pin (1856) is located in the spring storage groove (1864) and is a cylindrical pin fixed to the inner tube side, on which one end of the shutter ring pressure spring (1855) is hooked.

[0271] Regarding the inner cylinder side spring hook pin, in order to facilitate ease of assembly and ensure operational stability, it is desirable to provide a groove (not shown) on the cylindrical side of the cylindrical pin so that the shutter ring pressure spring can be securely hooked onto it.

[0272] [Inner cylinder: rotation limit pin] The rotation limiting pins (1858-1, 1858-2) are pins that engage with the rotation guide hole 1 (1850) of the flange shutter ring (1845) described below, and act in cooperation with it to limit the rotation angle of the flange shutter ring. Since the flange shutter ring (1845) is normally biased in the clockwise direction, the end point of the rotation limiting pin (1858-2) normally abuts against the rotation guide hole 1 (1850) and is prevented from rotating any further.

[0273] In addition, when the flange shutter ring (1845) is continuously rotated counterclockwise by hand to attach this auxiliary device, the end point of the rotation limiting pin (1858-1) abuts against the rotation guide hole 1 (1850), restricting further rotation.

[0274] It is also preferable that the rotation limiting pin also have a cover member screw hole (1866) for use in screwing the cover member (1746) in order to secure the cover member.

[0275] [Inner tube: Lure insertion groove] The luer insertion groove (1848) is a hole into which the tip of the luer connector of the endoscope side connection part is inserted, and furthermore, the space formed here also includes a luer flange insertion groove (1847-1).

[0276] [Inner tube: Luer flange insertion groove] The lure flange insertion groove (1847-1) is a space for inserting the lure flange attached to the tip of the lure connector of the endoscope side connection part and storing it when the auxiliary device is used. The lure flange is stored in this space. For this reason, the depth of the groove is approximately equal to or greater than the thickness of the lure flange.

[0277] [Inner cylinder: rotating protrusion] The rotation guide protrusion (1854) is a protrusion provided on the end of the inner tube on the endoscope side, and engages with a rotation guide hole 2 (1851) provided on a flange shutter ring (1845) described later, and acts to rotate the flange shutter ring (1845) by rolling it in the longitudinal axial direction of the auxiliary device together with the rotation limiting pins (1858-1, 1858-2) passing through the rotation guide hole 1 (1850). That is, the inner tube is fixed to the endoscope by the action of the connecting part, and as a result, the rotation of the flange shutter ring depends on the shape of the rotation guide hole 2 and the shape of the rotation guide hole 1. In this way, the rotation guide protrusion (1854) and the rotation limiting pins (1858-1, 1858-2) define the rotation center of the flange shutter ring (1845), and therefore, in order to ensure smooth rotation, it is desirable to arrange them equiangularly from the rotation center that roughly coincides with the channel center position.

[0278] [Flange shutter ring] The flange shutter ring (1845) is a ring-shaped member that is rotatable around a channel that passes through the inner cylinder and abuts against the surface of the endoscope side end of the inner cylinder (1813).

[0279] The flange shutter ring (1845) is provided with a luer flange shutter (1849) and a shutter side spring hook pin (1857), as well as three openings: a rotation guide hole 1 (1850), a rotation guide hole 2 (1851), and a luer passage hole (1865) in the center.

[0280] The flange shutter ring (1845) should have a larger outer diameter than the cover member and the inner cylinder it contacts, so that the operator can turn it directly with his or her fingers. Of course, it is not necessary to make the diameter of the entire outer circumference large. Tabs (projections) may be provided on some of the periphery to make it easier for the operating finger to catch on.

[0281] [Flange shutter ring: Lure passage hole] The luer passage hole (1865) is a nearly circular opening located near the center of the flange shutter ring (1845), and its maximum diameter must be such that the luer used in the endoscope side connection part, excluding the tab portion which is the luer flange shutter (1849) described below, can pass through the luer flange shutter ring, including the luer flange, and reach the luer insertion groove in the inner tube part.

[0282] [Flange shutter ring: Lure flange shutter] The luer flange shutter (1849) provided on the luer flange shutter ring is a tab protruding toward the inside of the luer passage hole (1865), and a pair is provided at opposing positions on the inside of the luer passage hole (1865). The luer flange shutter is designed to abut against the flange of the endoscope-side luer connector on the back side of the drawing (i.e., the side opposite the endoscope). Therefore, if the shape of the connector flange is different, the luer flange shutter can be arranged accordingly.

[0283] The luer flange shutter may have any shape as long as the luer flange can pass through the luer passage hole when the luer flange is inserted into the auxiliary device by turning the flange shutter ring.

[0284] [Flange shutter ring: Rotation guide hole 1] As described above, the rotation guide hole 1 (1850) engages with the rotation limiting pins (1858-1, 1858-2) on the inner tube side and acts to restrict the total rotation angle of the flange shutter ring. Therefore, the length (phase angle) of this guide hole can be determined by adding the phase angle of the arranged rotation control pins (1858-1, 1858-2) to the rotational angle. The rotational angle can be set to an extent that the luer flange shutter (1849) does not interfere with the insertion and removal of the luer flange on the endoscope side when rotated to the maximum angle.

[0285] [Flange shutter ring: Rotation guide hole 2] The rotation guide hole 2 (1851) is an opening provided in the flange shutter ring (1845), which engages with the rotation guide protrusion (1854) provided on the inner cylinder and guides it according to the shape of the guide hole. For details, please refer to the explanation of [Inner cylinder: rotation protrusion] above.

[0286] [Flange shutter ring: shutter side spring hook pin] The shutter side spring hook pin (1857) is a cylindrical pin provided on the flange shutter ring (1845) and is adapted to hook one end of the shutter ring pressure spring (1855). After assembly, it enters the spring housing groove (1864) and biases the shutter side spring hook pin, on which the shutter ring pressure spring (1855) is hooked, and the inner cylinder side spring hook pin (1856) in the direction of attracting each other.

[0287] As with the inner cylinder side spring hook pin (1856), in order to ensure ease of assembly and stability of operation, it is desirable to provide a groove (not shown) on the cylindrical side of the shutter side pin so that the shutter ring pressure spring can be securely hooked onto it.

[0288] [Cover parts] The lid member (1746) is a cover that is disposed on the endoscope side of the flange shutter ring (1745) after assembly, and is screwed in place using the lid member screw holes (1866) provided in the heads of the rotation limiting pins (1858-1, 1858-2). This sandwiches the flange shutter ring (1845) between the inner tube and the endoscope side end, and acts to maintain the flange shutter ring in a rotatable state.

[0289] The cover member has an opening in the center, through which the luer flange located at the tip of the endoscope side connection part can pass. For this reason, the shape of this opening needs to be equal to or larger than the maximum diameter of the flange shutter ring. It is preferable to have a shape in which the luer passing hole (1865) is missing the luer flange shutter (1849) part. However, since the function of the cover member is to keep the flange shutter ring in a rotatable state as described above, it is acceptable to have a simple circular ring shape as long as the flange shutter ring does not come off and rotation is not hindered.

[0290] (6.2.3 Example operation using flange shutter ring) With the above-mentioned configuration, the auxiliary device can be attached to an endoscope by following the procedure below. (1) Take this auxiliary device in your hand and turn the flange shutter ring so that the Luer flange insertion groove at the end of the inner tube on the endoscope side can be seen from the outside. (2) With your hands still on the flange shutter ring, attach this auxiliary device to the endoscope side connector. The lure flange of the endoscope side connector will then fit into the lure flange insertion groove. (3) Release the flange shutter ring. The luer flange shutter closes due to the action of the shutter ring pressure spring (1855).

[0291] As a result of the above, the luer flange of the endoscope side connection part is pinched between the luer flange shutter (1849) and the inner tube (1813), so that the auxiliary device cannot be removed unless the flange shutter ring is turned again.

[0292] (6.3. Example using a ball plunger) Next, an example of a connection portion including a ball plunger as a component will be described with reference to FIG.

[0293] (6.3.1. Overview of configuration using ball plunger) The connection part in this example can be constructed by an inner tube and a ball plunger, and is characterized in that no special connection tool is required. Specifically, a thick part is provided at the end of the inner tube on the endoscope side, which serves as a plunger housing (1767), and necessary components such as a ball plunger are incorporated. When this auxiliary device is attached, the ball plunger presses the flange in the endoscope side connection part from the back side, thereby crimping the inner tube to the endoscope side joint and connecting the internal channels. Of course, the connection part may be connected to the inner tube as an independent component.

[0294] (6.3.2. Example configuration using ball plunger)

[0295] [Ball plunger] A ball plunger (1744) is a mechanical part in which an elastic body is incorporated into a cylindrical housing, a sphere is placed at the end of the cylinder, and when the sphere is pressed against the housing, it generates a repulsive force, but is also machined so that the sphere does not pass over the end and escape. The ball plunger in this example uses a cylindrical housing with the outer wall machined as a male screw.

[0296] [Plunger housing] The plunger housing (1767) is a part of the inner tube, and is located at the end of the endoscope. It is a cylindrical part with a sufficient thickness to accommodate the ball plunger (1744) that presses the ball at the tip from the outer surface side toward the inside. In this example, a ball plunger with a screw structure can be inserted while being screwed from the outside of the plunger housing (1767). A luer taper or the like can be further arranged in the inner cavity to connect the channel of the endoscope connection part to a channel provided near the center of the inner tube.

[0297] The ball plunger is inserted and screwed from the outside, with the spherical portion protruding from the inner wall of the hollow portion inside the plunger housing. When a part of the endoscope side connection part is pushed into the plunger housing and the sphere of this ball plunger comes into contact with it, the sphere is pushed outward and retreats, and when it is pushed further in, the sphere acts to return to its original position.

[0298] The diameter of the hollow part inside the plunger housing (1767) is determined taking into consideration the maximum diameter that passes through this opening end. That is, what passes through the opening end is the endoscope side connection part, and in the case of a cystoscope, it is often a luer connector. Of course, the plunger housing may be constructed as a member independent of the inner tube, and this may be connected to the inner tube.

[0299] (6.3.2. Mounting operation using ball plunger) With the above-mentioned configuration, the auxiliary device can be attached to an endoscope by following the procedure below. (1) Take this auxiliary device in your hand, place the open end of the plunger housing against the connection part on the endoscope side, and push it in. (2) As the auxiliary device is pushed in and the endoscope connection portion is inserted into the plunger housing, the Luer flange, which is part of the endoscope connection portion, presses down on the sphere of the ball plunger. (3) When the auxiliary device is further pushed in and the luer flange moves further away from the ball plunger sphere toward the opposite side of the endoscope, the ball plunger sphere returns to its original position. This means that to release the device again, a force equal to that applied when pushing in and from the opposite direction is required, allowing the connection to be held firmly in place.

[0300] (6.4. Example of a part of the connection part being integrally molded with the inner tube) Next, an example in which a part of the connection portion is integrally molded with the inner cylinder will be described with reference to FIG.

[0301] In this example, the endoscope side end of the inner tube (1913) is provided with an inner tube integral connector tightening male screw (1969). In other words, the male screw that constitutes the connector is molded integrally with the inner tube. The connector tightening female screw (1970) that screws into this is provided on the connector (1943) side.

[0302] The connection part is made up of the endoscope side end of the inner tube and the connector, which reduces the total number of parts compared to the example described in (6.1. Example using a tightening screw). However, because the endoscope side connection part is in direct contact with the inner tube, if you try to adjust the inner tube roll angle while the connector is in the process of tightening the endoscope integrated connection part tightening screw, there is a risk that mechanical discontinuity will appear compared to the example described in (6.1. Example using a tightening screw), making it difficult to obtain the desired roll angle.

[0303] To avoid this, the procedure for attaching this auxiliary device involves determining the roll angle of the inner tube before screwing in the connector, and then tightening the connector while keeping the positional relationship between the endoscope and this auxiliary device fixed by hand.

[0304] (7. Others) Below, we will briefly touch on points that have not been fully explained in the above embodiments, as well as modified examples that are common to each embodiment.

[0305] (7.1. Modifications Related to Luer Connectors) Luer connectors come in male and female versions, and these are combined to prevent water leakage, but if the endoscope is designed to connect with a female screw, the connection part of this auxiliary device can also be made with a male screw.

[0306] (8. Correspondence between the above-mentioned embodiments and matters specifying the invention) Here, we will touch upon the correspondence between the wording used in the claims of this application and the wording used in the embodiments. When the wording used in the claims and the embodiments are the same, they are usually explained as they are. However, it goes without saying that the matters described in the claims are not intended to be limited by the [Mode for carrying out the invention] described so far.

[0307] (8.1. Corresponding relationship in claim 1) The invention described in claim 1 corresponds to each of the auxiliary devices described in the first, second, third, and fourth embodiments. The wording used in claim 1 is explained as follows:

[0308] The "channel connector" of the "endoscope" corresponds to the "endoscope side connection portion (210)" in each embodiment.

[0309] The "connection portion" typically refers to either the connection portion (206, 306, 406, 606, 1006, 1206, 1506, 1606, 1706), the ensemble of the cover member (1746), the flange shutter ring (1745, 1845), and the endoscope side end of the inner tube (1813), or the plunger housing (1767).

[0310] The "inner cylinder member" corresponds to the inner cylinder (313, 413, 613, 813, 1013, 1113, 1413, 1813).

[0311] The "instrument direct-acting operating unit" corresponds to either the entirety of the instrument direct-acting operating unit (203, 303), the operating ring (304, 404, 1504), the sliding culm (316, 416, 616, 716, 816, 1016) and the instrument holding unit (205, 305, 405), or the entirety of the outer tube (1132, 1232), the sliding culm (1116, 1216, 1416) and the instrument holding unit.

[0312] (8.2. Corresponding relationship in claim 2) The invention described in claim 2 corresponds to each of the embodiments except the third embodiment, that is, each of the auxiliary devices described as the first embodiment, the second embodiment, and the fourth embodiment. The wording used in claim 2 is explained as follows.

[0313] The "operation ring" corresponds to the operation ring (304, 404, 1504).

[0314] The "rotational-linear motion conversion unit" corresponds as follows.

[0315] In the first embodiment, (A) The female screw (320) on the operating ring, the male screw (319) on the slide culm (316), the guide groove (312) on the slide culm, the slide pin (311), and the slide pin fixing hole (342) on the inner tube (313) together form a (B) In the case of the modified example (1), the female screw on the operation ring side of the operation ring, the male screw on the slide culm side of the slide culm, the slide pin (511) on the slide culm, the slide pin fixing hole (542) on the slide culm, and the guide groove (512) on the inner cylinder are, as a whole, To correspond to this.

[0316] In the second embodiment, (A) The cam pins (627, 727) of the operating ring (604), the cam pin fixing holes (629, 729), the cam grooves (628, 728) of the slide culms (616, 716), the guide grooves of the slide culms, the slide pins, and the slide pin fixing holes of the inner cylinder are combined together to form a (B) In the case of the modified example (1), the cam pin (827) on the operation ring, the cam pin fixing hole, the cam groove (828) on the slide culm, the slide pin (811) on the slide culm, and the guide groove (812) on the inner cylinder are, as a whole, (C) In the case of the modified example (2), the cam pin of the operation ring, the cam groove (928) of the slide culm, the slide pin (911) of the slide culm, and the guide groove (912) of the inner cylinder are combined together to form a (D) In ​​the case of the modified example (3), the cam groove (1028) on the operation ring, the cam pin (1027) on the slide culm, the cam pin fixing hole (1029) on the slide culm, the guide groove on the slide culm, and the slide pin on the inner cylinder are combined together to form a To correspond to this.

[0317] In the fourth embodiment, the combination of the female screw on the operating ring (1504), the male screw on the slide culm, the guide groove on the slide culm, the slide pin, and the slide pin fixing hole on the inner tube corresponds to this.

[0318] (8.3. Corresponding relationship in claim 3) The invention described in claim 3 corresponds to the auxiliary devices described as the first embodiment and the fourth embodiment. The wording used in claim 3 corresponds to the following:

[0319] Regarding the "slide pin or guide groove" provided in the inner cylindrical member, the inner cylindrical member is provided with: (A) In the case of a slide pin as in the first embodiment, the slide pin (311, 411) is (B) In the case of a guide groove as in the modified example (1) of the first embodiment, the guide groove (512) is To correspond to this.

[0320] The "slide culm" provided in the tool linear motion operation unit corresponds to the slide culm (316, 416).

[0321] The "guide groove" or "slide pin" on the slide culm is (A) When the inner cylindrical member is provided with a slide pin as in the first embodiment, the guide groove (312, 412) that engages with the slide pin is (B) In the case where the inner cylindrical member is provided with a guide groove as in the modified example (1) of the first embodiment, the slide pin (511) To correspond to this.

[0322] The "female screw" provided on the operation ring corresponds to the female screw (320, 420) on the operation ring side.

[0323] The "male screw" on the slide culm corresponds to the male screw on the slide culm side (319, 419), etc.

[0324] The "instrument holding part" provided on the slide culm corresponds to the instrument holding part (305, 405) etc.

[0325] (8.4. Corresponding relationship in claim 4) The invention described in claim 4 corresponds to the auxiliary device described as the second embodiment. The wording used in claim 4 corresponds to the following:

[0326] Regarding the "slide pin or guide groove" provided on the inner cylindrical member, (A) In the case of a slide pin as in the second embodiment or the modified example (3), the slide pin is (B) In the case of a guide groove as in the modified example (1) or modified example (2) of the second embodiment, the guide groove (812, 912) is To correspond to this.

[0327] The "slide culm" provided in the instrument direct-acting operation unit corresponds to the slide culm (616, 716, 816, 1016).

[0328] The "guide groove" or "slide pin" on the slide culm is (A) In the case of a slide pin as in the second embodiment or the modified example (3), the guide groove is (B) In the case of a guide groove as in the modified example (1) or (2) of the second embodiment, the slide pin (811, 911) is To correspond to this.

[0329] The "cam pin" or "cam groove" on the operation ring is provided on the operation ring. (A) In the case of a cam pin as in the second embodiment, the modified example (1), or the modified example (2), the cam pin (627, 727) is (B) In the case of a cam groove as in the modified example (3) of the second embodiment, the cam groove (1028) is To correspond to this.

[0330] The "cam pin" or "cam groove" on the slide culm is the same as that on the operating ring. (A) In the case of a cam pin as in the second embodiment, the modified example (1), or the modified example (2), the cam groove (628, 728, 928) is (B) In the case of a cam groove (1028) as in the modified example (3) of the second embodiment, the cam pin (1027) is To correspond to this.

[0331] The "instrument holding part" provided on the slide culm corresponds to this.

[0332] (8.5. Corresponding relationship in claim 5) The invention described in claim 5 corresponds to the auxiliary device described as the third embodiment. The wording used in claim 5 corresponds to the following:

[0333] "Operation knob" corresponds to the operation knobs (1130, 1230, 1430).

[0334] The "treatment instrument linear motion part" corresponds to the instrument holding part (1205) and the slide stem (1116).

[0335] (8.6. Corresponding relationship in claim 6) The invention recited in claim 6 corresponds to the auxiliary device described as the third embodiment together with each of the modified examples.

[0336] (8.7. Corresponding relationship in claim 7) The invention recited in claim 6 corresponds to the auxiliary device described as the fourth embodiment, including each of the modified examples. [Industrial Applicability]

[0337] The present invention can be used in the manufacturing industry that manufactures endoscopic instrument insertion assistance devices, and can also be used in the manufacturing process of products that involve processing the inside of a pouch-like narrow portion using various endoscopes. [Explanation of symbols]

[0338] The first digit of each reference number in the drawings indicates the drawing number. In addition, the numbers are arranged so that those with the same last two digits in different drawings have roughly the same functional meaning.

[0339] 101 Endoscope body 102 This auxiliary device 103, 203, 303 Direct-acting instrument operation unit 104, 304, 404, 604, 1004, 1504 Operation Ring 106, 206, 306, 406, 606, 1006, 1206, 1506, 1606, 1706, 1906 Connections 107 Endoscope gripping part 108 Finger Operation Points 168 Hand operation section 199 Palm contact area 205, 305, 405, 1205 Instrument holding part 210 Endoscope side connection part 263 Luer flange 290 Channel Opening 309, 409, 1209, 1509 channels 311, 411, 511, 811, 911 Slide pin 312, 412, 512, 812, 912, 1412 Guide groove 313, 413, 613, 813, 1013, 1113, 1413, 1813, 1913 Inner cylinder 314, 414, 914, 1214 Watertight O-rings 315, 915 O-ring mounting groove 316, 416, 616, 716, 816, 1016, 1116, 1216, 1416 Slide culm 317, 417, 1217 Set screw 318 Inner tube side locking screw 319, 419 Slide culm side male screw 320, 420 Operation ring side female screw 323, 423, 1223 Connection fixing flange 341, 441 Slide pin insertion hole 342, 442, 542, 942, 1442 Slide pin fixing hole 415, 1215 Watertight O-ring mounting groove 421 Set screw space 422 Set screw compatible flange 424, 1224 Connection fixing screw 425 Instrument gripper and water stop valve 426, 1126 Water stop valve screw 459 Operation ring thick part 460 Channel opening connecting protrusion 627, 727, 827, 1027 Campin 628, 728, 828, 928, 1028 Cam groove 629, 729, 1029 Cam pin fixing hole 1130, 1230, 1430 Operation knob 1131 Operation knob guide hole 1132, 1232, 1332 Outer cylinder 1133 Operation knob fixing hole 1134 Screw for fixing the outer cylinder 1225 Fixture holding and water stop valve 1335 Male screw for fixing outer tube 1336 Female screw for fixing outer cylinder 1537 Channel Branch 1538, 1638, 1738 Connection tightening screw 1539 Irrigation port 1540 Irrigation port water stop O-ring 1543, 1643, 1743, 1943 Connectors 1561, 1661 Perfusion device attachment adapter 1562 Retaining ring 1744 Ball Plunger 1745, 1845 flange shutter ring 1746 Cover parts 1767 Plunger Housing 1847-1 Luer flange insertion groove 1848 Lure insertion groove 1849 Luer flange shutter 1850 Rotation guide hole 1 1851 Rotation guide hole 2 1854 Rotating guide protrusion 1855 Shutter ring pressure spring 1856 Inner cylinder spring hook pin 1857 Shutter side spring pin 1858-1, 1858-2 Rotation limit pin 1864 Spring storage groove 1865 Lure passage hole 1866 Cover screw hole 1969 Inner tube integrated connection tightening male screw 1970 Connection tightening female screw

Claims

1. An endoscope instrument insertion assist device is provided which is attached to an endoscope and adjusts the advancement and retreat of an instrument, the endoscope comprising: a handle to be held by hand; a channel for guiding an instrument inside; and a channel connector located near a channel outlet where the channel leads to the outside, the endoscope instrument insertion assist device comprising: a connection portion that is connected to and fixed to the channel connector; an inner tubular member positioned by the connecting portion and having a central lumen communicating with the channel; an instrument direct-acting operation unit that is positioned by the inner cylindrical member and that, in response to an operation of an operator pinching the instrument with the fingertips while maintaining a hand position in which any part from the wrist to the fingertips touches the endoscope body, directs an instrument inserted in the channel in the coaxial direction relative to the inner cylindrical member; An endoscopic instrument insertion assist device comprising:

2. The instrument linear motion operation unit includes: an operation ring provided on the outer periphery of the inner tube member at a position where the operator can pinch the operation ring with the operator's fingers while the operator is touching the endoscope body with any part of the operator's body from the wrist to the fingertips, and which is rotatable coaxially with the inner tube member; a rotation-to-linear motion conversion unit that converts the instrument inserted in the channel into a linear motion in the coaxial direction when the operation ring is rotated; 2. The endoscopic instrument insertion assist device according to claim 1, further comprising:

3. The inner cylindrical member is provided with a slide pin or a guide groove, The operation ring has a female screw on at least a part of its inner circumference, The instrument direct operation unit includes: A cylindrical member at least partly inserted between an outer periphery of the inner cylinder member and an inner periphery of the operation ring, a male screw on at least a part of an outer periphery thereof which is screwed into the female screw of the operation ring; a guide groove provided in the inner cylindrical member for guiding the movement of the slide pin, or a slide pin engaging with the guide groove provided in the inner cylindrical member; A slide culm having an instrument holding portion for holding the instrument and axially slidable relative to the inner cylindrical member; 3. The endoscopic instrument insertion assist device according to claim 2, further comprising:

4. The inner cylindrical member is provided with a slide pin or a guide groove, The operation ring is provided with a cam pin or a spiral cam groove on at least a part of its inner circumference, The instrument direct operation unit includes: A cylindrical member at least partly inserted between an outer periphery of the inner cylinder member and an inner periphery of the operation ring, a spiral cam groove on an outer periphery thereof which engages with the cam of the operation ring or a cam pin which is guided by the cam groove of the operation ring; a guide groove provided in the inner cylindrical member for guiding the movement of the slide pin, or a slide pin engaging with the guide groove provided in the inner cylindrical member; An instrument holding portion that holds the instrument, A slide stem that is axially slidable relative to the inner cylindrical member; 3. The endoscopic instrument insertion assist device according to claim 2, further comprising:

5. The instrument linear motion operation unit includes: an operation knob provided on the outer periphery of the inner tube member at a position where the operator can pinch it with his / her fingers while touching the endoscope body with any part of the operator from the wrist to the fingertips; an instrument linear motion unit that causes an instrument inserted in the channel to advance and retreat in the same axial direction when the operation knob is linearly moved forward and backward; 2. The endoscopic instrument insertion assist device according to claim 1, further comprising:

6. The inner cylindrical member has an elongated hole extending in the axial direction in a part of the outer cylindrical member and is fixed to the periphery of the inner cylindrical member. The instrument direct operation unit includes: The slide pin is a cylindrical member having a part inserted between the outer periphery of the inner tube member and the outer periphery of the outer tube member, and is provided with an instrument holding portion for holding the instrument, and is axially slidable relative to the inner tube member; Equipped with The operation knob is fixed to the slide stem and reaches the outside of the outer peripheral member through the long hole; 6. An endoscopic instrument insertion assist device according to claim 5,

7. Furthermore, the central lumen is branched in the inner tube member, and the branched lumen has a perfusion port provided on the outer periphery, The connecting portion includes a roll fixing portion that fixes the inner tube member at a freely adjustable roll angle relative to a central axis of the inner tube member, 7. An endoscopic instrument insertion assist device according to claim 1, further comprising:

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