Over tube and endoscope system

Abstract

To provide an over tube and an endoscope system which can improve usability while reducing a burden applied to a user.SOLUTION: In an over tube 50, an effective length L2 of an outer tube 200 is 1200 mm or more to 1700 mm or less, an effective length of an inner tube 100 is 1400 mm or more to 2000 mm or less, a first maximum projection length A of the endoscope mirror insertion part 12 from the tip end of the inner tube 100 is 100 mm or more to 550 mm or less, and a second maximum projection length B of the inner tube 100 from the tip end of the outer tube 200 is 200 mm or more to 700 mm or less. A total maximum projection length S is the sum of the first maximum projection length A and the second maximum projection length B, and is 300 mm or more to 800 mm or less. A maximum projection length ratio is the ratio of the first maximum projection length A with respect to the second maximum projection length B, and is 0.15 or more to 1.0 or less.SELECTED DRAWING: Figure 9

Description

[Technical Field]

[0001] The present disclosure relates to an overtube that is inserted into a body together with an insertion section of an endoscope, and an endoscope system. [Background technology]

[0002] In the medical field, a conventional procedure involves inserting the insertion portion of an endoscope into the intestinal tract (large or small intestine) to observe, diagnose, and treat the inner wall surface of the intestinal tract. The intestinal tract is complexly curved, and simply pushing the insertion portion of the endoscope through the intestine makes it difficult to transmit force to the tip of the insertion portion, making it difficult to insert the endoscope deep into the intestine.

[0003] To address this issue, a so-called double-balloon endoscopic device is known, in which an inflatable and deflated balloon is provided on the insertion section of the endoscope and on the distal end of an overtube (also called an insertion aid) that covers the insertion section (see, for example, Patent Document 1). With this endoscopic device, the inflation and deflation of each balloon can be individually controlled by supplying and suctioning air into the interior of each balloon from a balloon control device. This allows the insertion section to be inserted deep into the complexly curved intestinal tract by alternately inserting the insertion section of the endoscope and the overtube while temporarily fixing each balloon individually and at a predetermined timing. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] International Publication No. 2019 / 073886 Summary of the Invention [Problem to be solved by the invention]

[0005] In a double-balloon endoscopic device, an insertion operation is performed in which the insertion portion of the endoscope and the overtube are alternately inserted, and a retraction operation is performed in which the insertion portion of the endoscope and the overtube are retracted toward the operator. In this case, the operations must be shared, with the surgeon operating the insertion portion of the endoscope and the assistant operating the overtube. This requires coordination between the two, which places a significant burden on the user and is not necessarily user-friendly.

[0006] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an overtube and an endoscope system that can reduce the burden on the user and improve usability. [Means for solving the problem]

[0007] The present disclosure includes the following inventions.

[0008] The overtube according to the first aspect is a long, flexible overtube, comprising an inner tube having a first insertion passage through which an endoscope insertion portion can be inserted, an outer tube having a second insertion passage through which the inner tube can be inserted, a first balloon provided at a distal end of the inner tube, and a second balloon provided at a distal end of the outer tube, wherein the effective length of the outer tube is 1200 mm or more and 1700 mm or less, and the effective length of the inner tube is 1400 mm or more and 2000 mm or less, and when the endoscope insertion portion is inserted into the first insertion passage and the inner tube is inserted into the second insertion passage, a first maximum protrusion length of the endoscope insertion portion from the distal end of the inner tube and a second maximum protrusion length of the endoscope insertion portion from the distal end of the outer tube are 1200 mm or more and 1700 mm or less. The total maximum protrusion length, which is the sum of the first maximum protrusion length and the second maximum protrusion length of the inner tube, is 300 mm or more and 800 mm or less, the first maximum protrusion length is 100 mm or more and 550 mm or less, the second maximum protrusion length is 200 mm or more and 700 mm or less, and the maximum protrusion length ratio, which is the ratio of the first maximum protrusion length to the second maximum protrusion length, is 0.15 or more and 1.0 or less.

[0009] In the overtube according to the second aspect, in the first aspect, at least one of the first balloon and the second balloon has an axial length of 50 mm or more.

[0010] In the overtube according to a third aspect, in the second aspect, the balloon has a bulging portion that can expand and contract, and the bulging portion has an axial length of 30 mm or more.

[0011] The overtube of the fourth aspect is any of the first to third aspects, and comprises an inner tube gripping portion provided at the base end of the inner tube and an outer tube gripping portion provided at the base end of the outer tube, and the axial lengths of the inner tube gripping portion and the outer tube gripping portion are each 15 mm or more and 200 mm or less.

[0012] The overtube according to the fifth aspect is any of the first to fourth aspects, wherein the inner tube has an inner tube stopper portion in an inner tube protruding region that protrudes from the tip of the outer tube, and the inner tube stopper portion has an inner tube stopper surface that abuts against the tip of the outer tube to restrict movement of the inner tube toward the base end in the axial direction relative to the outer tube.

[0013] An overtube according to a sixth aspect is the overtube of the fifth aspect, wherein the inner tube stopper portion is a large diameter portion having an outer diameter larger than the inner diameter of the second insertion passage.

[0014] The overtube of the seventh aspect is the same as that of the fifth or sixth aspect, wherein the stopper portion for the inner tube is located closer to the base end than the first balloon and within 100 mm from the tip of the inner tube toward the base end.

[0015] An overtube according to an eighth aspect is the overtube of any one of the fifth to seventh aspects, wherein the inner tube stopper portion is detachable from the inner tube.

[0016] The overtube according to a ninth aspect is the overtube of any of the first to eighth aspects, wherein the inner tube has a lubricant supply part that supplies lubricant, and the lubricant supply part has an inner supply port that opens to the inner surface of the inner tube and an outer supply port that opens to the outer surface of the inner tube.

[0017] An overtube according to a tenth aspect is the overtube of the ninth aspect, wherein the inner tube has an inlet for injecting a lubricant, and the inlet communicates with the inner supply port and the outer supply port.

[0018] An overtube according to an eleventh aspect is the overtube of any one of the first to tenth aspects, wherein the inner tube has an index indicating its relative position in the axial direction with respect to the outer tube.

[0019] The overtube according to the twelfth aspect is the overtube according to any one of the first to eleventh aspects, and includes an inner tube gripping portion provided at the base end of the inner tube and an outer tube gripping portion provided at the base end of the outer tube.

[0020] The overtube of the 13th aspect is the same as that of the 12th aspect, in which the inner tube gripping portion has a first finger hook portion on which the operator can hook their finger, and the outer tube gripping portion has a second finger hook portion on which the operator can hook a finger other than the first finger.

[0021] The overtube according to a fourteenth aspect is the overtube of the twelfth or thirteenth aspect, wherein the inner tube gripping portion is detachable from the inner tube.

[0022] The overtube according to a fifteenth aspect is the overtube of any one of the first to fourteenth aspects, further comprising a relative movement detector that detects relative axial movement between the outer tube and the inner tube.

[0023] A sixteenth aspect of the present invention provides an overtube according to the fifteenth aspect, wherein the relative movement detection unit includes a proximity sensor or a position sensor.

[0024] The overtube according to a seventeenth aspect is the overtube of any one of the first to sixteenth aspects, further comprising a movement direction detector that detects the movement direction of the inner tube in the axial direction.

[0025] An overtube according to an eighteenth aspect is the overtube of the seventeenth aspect, wherein the movement direction detection unit includes a direction sensor or an angular velocity sensor.

[0026] An overtube according to a 19th aspect is any of the first to 18th aspects, wherein at least one of the inner tube and the outer tube comprises a common conduit connected at one end to one of the first and second balloons provided on the tube, an air supply conduit and a suction conduit branching off from the other end of the common conduit, an air supply source conduit connected to an air supply source, a suction source conduit connected to a suction source, a conduit switching unit that selectively switches between an air supply state in which the air supply conduit and the air supply source conduit are connected and the suction conduit and suction source conduit are blocked, and a suction state in which the air supply conduit and the air supply source conduit are blocked and the suction conduit and suction source conduit are connected, a first communication passage connecting the air supply source conduit to a space on the outer circumferential surface side or the inner circumferential surface side of the tube, and a second communication passage connecting the suction source conduit to a space on the outer circumferential surface side or the inner circumferential surface side of the tube.

[0027] An endoscopic system according to a twentieth aspect includes an overtube according to any one of the first to nineteenth aspects, and a balloon control device that controls air supply and suction to the first balloon and the second balloon. The overtube has a relative movement detection unit that detects relative axial movement between the outer tube and the inner tube, and a movement direction detection unit that detects the axial movement direction of the inner tube. The balloon control device has at least one processor, and the processor starts suction to the second balloon when the relative movement detection unit detects movement between the tip of the outer tube and the tip of the inner tube in the direction away from each other, starts air supply to the second balloon when the relative movement detection unit detects movement between the tip of the outer tube and the tip of the inner tube in the direction approaching each other, starts air supply to the first balloon when the movement direction detection unit detects movement of the inner tube toward the tip end in the axial direction, and starts suction to the first balloon when the movement direction detection unit detects movement of the inner tube toward the base end in the axial direction.

[0028] The endoscopic system of the 21st aspect is the 20th aspect, and includes a remote controller connected to the balloon control device, and the detection results of the relative movement detection unit and the movement direction detection unit are notified to the balloon control device via the remote controller.

[0029] An endoscopic system according to a 22nd aspect includes an overtube according to any one of the first to 19th aspects and an endoscope having an endoscope insertion portion, wherein the endoscope insertion portion has a stopper portion for the endoscope insertion portion in an endoscope insertion portion protruding area that protrudes from the tip of the inner tube, and the stopper portion for the endoscope insertion portion has a stopper surface for the endoscope insertion portion that abuts against the tip of the inner tube to restrict movement of the endoscope insertion portion relative to the inner tube toward the base end in the axial direction.

[0030] A twenty-third aspect of the present invention is directed to the twenty-second aspect of the endoscope system, wherein the stopper portion for the endoscope insertion portion is a large-diameter portion having an outer diameter larger than the inner diameter of the first insertion passage.

[0031] A twenty-fourth aspect of the present invention is an endoscope system according to the twenty-second or twenty-third aspect, wherein the endoscope insertion portion stopper portion is detachable from the endoscope insertion portion.

[0032] An endoscopic system according to a 25th aspect includes an endoscope having an overtube according to any one of the first to 19th aspects, an endoscope insertion section, and an operation section connected to the base end of the endoscope insertion section, and a holding member that is detachably attached to the operation section and holds at least one of a first tube for supplying air to and suctioning from a first balloon and a second tube for supplying air to and suctioning from a second balloon.

[0033] An endoscope system according to a 26th aspect includes the overtube according to any one of the first to 19th aspects and an endoscope having an endoscope insertion portion, and the effective length of the endoscope insertion portion is 2000 mm.

[0034] An endoscopic system according to a 27th aspect includes an overtube according to any one of the first to 19th aspects and an endoscope having an endoscope insertion portion, and has a third balloon at the tip of the endoscope insertion portion.

[0035] The endoscopic system of the 28th aspect is, in the 20th or 21st aspect, provided with an endoscope having an endoscope insertion portion, the endoscope insertion portion having a stopper portion for the endoscope insertion portion in an endoscope insertion portion protruding area that protrudes from the tip of the inner tube, and the stopper portion for the endoscope insertion portion having a stopper surface for the endoscope insertion portion that abuts against the tip of the inner tube to restrict movement of the endoscope insertion portion toward the base end in the axial direction relative to the inner tube.

[0036] A twenty-ninth aspect of the present invention provides an endoscope system according to the twenty-eighth aspect, wherein the stopper portion for the endoscope insertion portion is a large-diameter portion having an outer diameter larger than the inner diameter of the first insertion passage.

[0037] A thirtieth aspect of the present invention is an endoscope system according to the twenty-eighth or twenty-ninth aspect, wherein the stopper portion for the endoscope insertion portion is detachable from the endoscope insertion portion.

[0038] The endoscopic system of the 31st aspect is any of the 20th, 21st, and 28th to 30th aspects, and comprises an endoscope having an endoscope insertion section and an operating section connected to the base end of the endoscope insertion section, and a holding member that is detachably attached to the operating section and holds at least one of a first tube for supplying air to and suctioning from the first balloon and a second tube for supplying air to and suctioning from the second balloon.

[0039] The endoscopic system according to the 32nd aspect is an endoscope system according to any one of the 20th, 21st, and 28th to 31st aspects, which includes an endoscope having an endoscope insertion portion, and the effective length of the endoscope insertion portion is 2000 mm.

[0040] The endoscopic system according to the 33rd aspect is any one of the 20th, 21st, and 28th to 32nd aspects, and includes an endoscope having an endoscope insertion portion, and a third balloon at the tip of the endoscope insertion portion.

[0041] A method for operating an overtube according to a 34th aspect is the method for operating an overtube according to any one of the 1st to 19th aspects, wherein the overtube and the endoscope insertion portion are inserted into the intestinal tract, and a part of the inner tube is exposed from the tip of the outer tube. and a method for operating an overtube in a state in which the inner tube is inserted into the second insertion passage as shown in FIG. 1 and the endoscope insertion portion is inserted into the first insertion passage so that a portion of the endoscope insertion portion is exposed from the tip of the inner tube, the method including: an inner tube pushing step of pushing the inner tube so that the first balloon is separated from the second balloon within a range in which the tip of the inner tube is closer to the base end than the tip of the endoscope insertion portion while the first balloon is deflated; a first balloon expanding step of inflating the first balloon; an outer tube pushing step of pushing the outer tube so that the second balloon approaches the first balloon while the second balloon is deflated; a second balloon expanding step of inflating the second balloon; and a retracting step of retracting the inner tube and outer tube while the first balloon and the second balloon are inflated and close to each other, thereby pulling in the intestinal tract.

[0042] A thirty-fifth aspect of the overtube operating method is the thirty-fourth aspect, in which the second balloon inflation step and the retraction step are performed in parallel.

[0043] A thirty-sixth aspect of the method for operating an overtube is the thirty-fourth or thirty-fifth aspect, in which the inner tube and the outer tube are operated by a second operator different from the first operator who operates the endoscope insertion portion.

[0044] The method of operating an overtube according to the 37th aspect is the same as in the 34th to 36th aspects, in which the inner tube has an inner tube stopper portion in an inner tube protruding region protruding from the tip of the outer tube, and the inner tube stopper portion has an inner tube stopper surface that abuts against the tip of the outer tube to restrict movement of the inner tube toward the base end in the axial direction relative to the outer tube, and the retracting step retracts the inner tube and the outer tube together by retracting the inner tube while the inner tube stopper surface abuts against the tip of the outer tube.

[0045] A thirty-eighth aspect of the invention provides a method of operating an overtube in the thirty-seventh aspect, wherein the inner tube is operated by a second operator who is different from the first operator who operates the endoscope insertion portion.

[0046] The method for inserting an endoscope insertion portion according to the 39th aspect is a method for inserting an endoscope insertion portion that includes the method for operating an overtube according to any one of the 34th to 38th aspects, and includes an endoscope insertion portion pushing step of pushing the endoscope insertion portion so that the tip of the endoscope insertion portion is separated from the tip of the inner tube while leaving a part of the endoscope insertion portion exposed from the tip of the inner tube.

[0047] The method for inserting an endoscope insertion portion according to the 40th aspect includes a repeating step of performing the overtube operation at least once or more, in the case where the overtube operation in the 39th aspect includes an operation including an inner tube pushing step, a first balloon inflation step, an outer tube pushing step, a second balloon inflation step, and a pulling step, and the endoscope insertion portion pushing step is performed independently of the repeating step.

[0048] The method for inserting an endoscope insertion portion according to a 41st aspect is the 40th aspect, in which the endoscope insertion portion pushing step is performed when the intestinal tract pulled toward the base end side of the second balloon by the repeating step is accumulated.

[0049] The method of inserting an endoscope insertion portion according to the 42nd aspect is the 40th aspect, in which, when the intestinal tract pulled toward the base end of the second balloon by the repeating step accumulates, an endoscope insertion portion pushing step is performed, and then a repeating step is performed. [Effects of the Invention]

[0050] According to the present invention, it is possible to reduce the burden on the user and improve usability. [Brief explanation of the drawings]

[0051] [Figure 1]FIG. 1 is a configuration diagram of an endoscope system according to the first embodiment. [Figure 2] FIG. 2 is an exploded view of the overtube. [Figure 3] FIG. 3 is a cross-sectional view of the overtube with the endoscope insertion portion inserted through the overtube. [Figure 4] FIG. 4 is an enlarged cross-sectional view showing the distal end portion of the overtube. [Figure 5] FIG. 5 is a functional block diagram showing the balloon control device. [Figure 6] FIG. 6 is a flowchart showing an example of a method for inserting an endoscope insertion portion using an overtube. [Figure 7] FIG. 7 is an explanatory diagram for explaining an example of a method for inserting an endoscope insertion portion using an overtube. [Figure 8] FIG. 8 is an explanatory diagram for explaining an example of a method for inserting an endoscope insertion portion using an overtube. [Figure 9] FIG. 9 is an explanatory diagram for explaining preferable dimensions of the overtube. [Figure 10] FIG. 10 is a table showing an example of dimensions of each part of the overtube. [Figure 11] FIG. 11 is an explanatory diagram for explaining the second embodiment. [Figure 12] FIG. 12 is an explanatory diagram for explaining the third embodiment. [Figure 13] FIG. 13 is a block diagram of a balloon control device according to the third embodiment. [Figure 14] FIG. 14 is a block diagram of another example of the balloon control device in the third embodiment. [Figure 15] FIG. 15 is an explanatory diagram for explaining the fourth embodiment. [Figure 16] FIG. 16 is an explanatory diagram for explaining the fifth embodiment. [Figure 17] FIG. 17 is an explanatory diagram for explaining the sixth embodiment. [Figure 18]FIG. 18 is an explanatory diagram for explaining the sixth embodiment. [Figure 19] FIG. 19 is an explanatory diagram for explaining the seventh embodiment. [Figure 20] FIG. 20 is an explanatory diagram for explaining the eighth embodiment. [Figure 21] FIG. 21 is an explanatory diagram for explaining the eighth embodiment. [Figure 22] FIG. 22 is an explanatory diagram for explaining the ninth embodiment. DETAILED DESCRIPTION OF THE INVENTION

[0052] Hereinafter, an embodiment of the present invention will be described with reference to the accompanying drawings.

[0053] [First embodiment] 1 is a configuration diagram of an endoscope system 1 according to a first embodiment. As shown in FIG. 1, the endoscope system 1 includes an endoscope 10, an overtube 50, and a balloon control device 300.

[0054] [Endoscope] The endoscope 10 includes an insertion section 12 (hereinafter referred to as the "endoscope insertion section 12") that is inserted into the body of a subject, and an operation section 14 that is connected to the base end of the endoscope insertion section 12.

[0055] One end of a universal cable 16 is connected to the operation unit 14. Although not shown, a connector is provided at the other end of the universal cable 16, and the endoscope 10 is connected to a light source device using the connector. The light source device is also connected to a processor device, and the endoscope 10 is connected to the processor device via the light source device.

[0056] The operation unit 14 includes an air / water supply button 30, a suction button 32, and a pair of angle knobs 34. , 34. The operation section 14 is also provided with a treatment tool introduction port 36 through which a treatment tool is inserted.

[0057] The endoscope insertion section 12 extends from the tip of the operation section 14 and is formed in a thin, elongated shape overall. The endoscope insertion section 12 is composed of a tip section 20, a bending section 22, and a flexible section 24, in that order from the tip side to the base end side.

[0058] Although not shown, the distal end surface 38 of the distal end portion 20 is provided with an observation window for observing the inside of the body, a pair of illumination windows for illuminating the inside of the body, an air and water supply nozzle for cleaning the observation window, and a forceps port for leading out treatment tools.

[0059] An imaging element (not shown) is provided behind the observation window in the tip portion 20. An observation image is formed on this imaging element and photoelectrically converted. A signal cable (not shown) is connected to the imaging element, and this signal cable is connected to a processor device via the endoscope insertion portion 12, the operation unit 14, the universal cable 16, etc. Therefore, an electrical signal representing the observation image photoelectrically converted by the imaging element is output to the processor device, where it is subjected to appropriate signal processing and then output to a monitor. As a result, the observation image is displayed on the monitor.

[0060] The exit ends of light guides (not shown) are disposed behind the pair of illumination windows within the distal end 20. The incident ends of the light guides are connected to a light source device. As a result, illumination light supplied from the light source device to the incident ends of the light guides is irradiated onto the region to be observed through the pair of illumination windows.

[0061] The bending section 22 is bent in a desired direction by operating a pair of angle knobs 34, 34 provided on the operation section 14. The length of the bending section 22 in the longitudinal direction of the endoscope insertion section 12 is, for example, 70 mm or more and 150 mm or less. The flexible section 24 occupies the majority of the endoscope insertion section 12 and is made of a flexible material. Note that mm stands for millimeter (the same applies below).

[0062] [Overtube] The overtube 50 is used when inserting the endoscope insertion portion 12 into the body of a subject. The overtube 50 is a long, flexible member. As will be described in detail later, the overtube 50 has a double structure in which two tubes (an inner tube 100 and an outer tube 200) are stacked one on top of the other, and the distance between the balloons (a first balloon 120 and a second balloon 220) provided on each tube can be changed by moving each tube back and forth relative to each other.

[0063] 1, the overtube 50 is a flexible, long, tubular member, and is provided along the central axis K of the overtube 50. In the following description, one side (the right side in FIG. 1) in the direction along the central axis K will be referred to as the distal end side, and the other side facing the opposite direction will be referred to as the proximal end side.

[0064] An endoscope insertion passage 52 formed along the central axis K is provided inside the overtube 50, through which the endoscope insertion portion 12 can be inserted. The endoscope insertion passage 52 opens at each end face on the distal and proximal sides in the direction of the central axis K, and communicates between the distal opening (distal opening) and the proximal opening (proximal opening). The inner diameter of the endoscope insertion passage 52 is formed larger than the outer diameter of the endoscope insertion portion 12. This allows the endoscope insertion portion 12 to be inserted from the proximal opening of the overtube 50 into the endoscope insertion passage 52, and a portion of the endoscope insertion portion 12 to be exposed from the distal opening of the overtube 50.

[0065] Fig. 2 is an exploded view of the overtube 50. Fig. 3 is a cross-sectional view of the overtube 50 in a state in which the endoscope insertion portion 12 is inserted through the overtube 50. Fig. 4 is an enlarged cross-sectional view showing the distal end portion of the overtube 50. Note that in Fig. 2, the first balloon air supply tube 130, the second balloon air supply tube 230, the first liquid supply tube 134, and the second liquid supply tube 234 are omitted for convenience. The same applies to other figures (Figs. 9, 12, etc.) described later.

[0066] 2 to 4, the overtube 50 includes an inner tube 100 and an outer tube 200. The overtube 50 has a double structure in which the inner tube 100 and the outer tube 200 are overlapped with each other, with the inner tube 100 being inserted into the outer tube 200.

[0067] The inner tube 100 has an inner tube main body 102. The inner tube main body 102 is formed into a cylindrical shape from various flexible materials, etc. The outer shape of the inner tube main body 102 has a substantially constant size along the central axis K direction.

[0068] An inner tube gripping portion 104 is detachably provided on the base end side of the inner tube main body 102. The inner tube gripping portion 104 is the portion that is gripped by the operator (caregiver) of the overtube 50, and is preferably configured with a length in the direction of the central axis K (axial length) of 15 mm or more and 200 mm or less. This inner tube gripping portion 104 is configured in a cylindrical shape from various hard materials. A mating portion (not shown) is provided on the tip side of the inner tube gripping portion 104, and the inner tube main body 102 is mated and fixed to this mating portion.

[0069] The inner tube gripping portion 104 is provided with a small diameter portion 104a whose outer diameter is smaller than the surrounding area (see FIG. 2). The small diameter portion 104a is a portion that is narrowed inward (toward the central axis K) from the base end and tip end portions in the direction of the central axis K in a side view, and the operator can easily grip the inner tube gripping portion 104 by hooking their fingers on the small diameter portion 104a. In addition, the small diameter portion 104a makes it easy for the operator's fingers to catch on, and also functions as a non-slip surface when gripping the inner tube gripping portion 104.

[0070] A first insertion passage 106 is provided inside the inner tube 100 along the direction of the central axis K. The first insertion passage 106 is provided from the inner tube gripping portion 104 to the inner tube main body 102. The first insertion passage 106 is a conduit through which the endoscope insertion portion 12 can be inserted (corresponding to the endoscope insertion passage 52 described above), and its inner diameter is slightly larger than the outer diameter of the endoscope insertion portion 12. The inner peripheral surface of the first insertion passage 106 is coated with a hydrophilic coating material (lubricating coating material) such as polyvinylpyrrolidone.

[0071] The inner tube 100 has a base end opening 108 provided at the base end of the inner tube 100 (the base end of the inner tube gripping portion 104) and a tip end opening 110 provided at the tip end of the inner tube 100 (the tip end of the inner tube main body 102), and a first insertion passage 106 communicates between the base end opening 108 and the tip end opening 110. As a result, as shown in Fig. 3, the endoscope insertion portion 12 is inserted from the base end opening 108 of the inner tube 100 into the first insertion passage 106 and can advance and retreat along the direction of the central axis K, and a partial region of the endoscope insertion portion 12 (a region including at least the tip end portion 20) can be exposed from the tip end opening 110.

[0072] As shown in Fig. 4, a first balloon 120 made of various elastic materials is attached to the outer peripheral surface of the distal end of the inner tube body 102. The first balloon 120 is attached so that the inner tube body 102 penetrates through it, and is composed of a central bulging portion 120c and attachment portions 120a and 120b on both ends. The attachment portion 120a on the distal end side is attached to the bulging portion 120c. The attachment portion 120a is folded back inside the first balloon 120, and a thread 121 is wound around the folded back attachment portion 120a. The attachment portion 120b on the base end side is disposed outside the first balloon 120, and is fixed to the inner tube main body 102 with the thread 121 wound around it.

[0073] The length P1 of the first balloon 120 in the direction of the central axis K (axial length) is preferably 50 mm or more. Furthermore, the length Q1 of the bulging portion 120c in the direction of the central axis K (axial length) is preferably 30 mm or more. With a first balloon 120 having such a length, when the bulging portion 120c of the first balloon 120 is inflated, it is engaged with the inner wall surface of the intestinal tract without shifting position, and the distal end of the inner tube 100 can be stably fixed within the intestinal tract.

[0074] In the first balloon 120 configured in this manner, the bulging portion 120c expands into an approximately spherical shape when air is blown out from the first air supply suction port 126 described below, and the bulging portion 120c contracts when air is sucked in from the first air supply suction port 126.

[0075] A first air supply / discharge pipe 122 and a first liquid pipe 124 are formed along the central axis K in the outer peripheral wall (wall between the outer peripheral surface and the inner peripheral surface) of the inner tube 100 (the inner tube main body 102 and the inner tube gripping portion 104) (see FIGS. 3 and 4). The first air supply / discharge pipe 122 opens as a first air supply / suction port 126 for the first balloon 120 on the outer peripheral surface located inside the first balloon 120. The first liquid pipe 124 opens as a first liquid supply port 128 on the inner peripheral surface of the first insertion passage 106 (the inner peripheral surface of the inner tube main body 102 or the inner tube gripping portion 104).

[0076] A first balloon air supply tube 130 communicating with the first air supply / exhaust pipe 122 is provided on the outer peripheral surface of the inner tube gripping portion 104. As shown in FIG. 1, a first air supply port 132 is provided at one end of the first balloon air supply tube 130. The first air supply port 132 is connected to the balloon control device 300 via a first connection tube 302. When air is supplied from the balloon control device 300 to the first air supply port 132, the air is blown out from the first air supply / suction port 126 via the first balloon air supply / exhaust pipe 122, thereby inflating the first balloon 120. When air is sucked by the balloon control device 300, the air inside the first balloon 120 is sucked from the first air supply / suction port 126 via the first air supply / exhaust pipe 122, thereby deflating the first balloon 120.

[0077] A first liquid supply pipe 134 is provided on the outer peripheral surface of the inner tube gripping portion 104 to supply a lubricant such as water to the first insertion passage 106. A first inlet 136, which serves as an inlet for injecting the lubricant, is provided at one end of the first liquid supply pipe 134 (see FIG. 1). A lubricant supply means (not shown), such as a syringe, is connected to the first inlet 136. The lubricant supplied from the first liquid supply pipe 134 through the first inlet 136 is supplied from the first liquid supply port 128 via the first liquid conduit 124 to the inner peripheral surface of the first insertion passage 106, thereby reducing friction between the lubricant and the outer peripheral surface of the endoscope insertion portion 12 inserted through the first insertion passage 106. The first liquid conduit 124 and the first liquid supply port 128 constitute a lubricant supply unit that supplies the lubricant.

[0078] The outer tube 200 has an outer tube main body 202. The outer tube main body 202 is formed into a cylindrical shape from various flexible materials, etc. The outer shape of the outer tube main body 202 has a substantially constant size along the central axis K direction.

[0079] An outer tube gripping portion 204 is detachably provided on the base end side of the outer tube main body 202. The outer tube gripping portion 204 is a portion that is gripped by the operator (caregiver) of the overtube 50, and is preferably configured to have a length in the direction of the central axis K (axial length) of 15 mm to 200 mm. The outer tube gripping portion 204 can be made of various hard materials. The outer tube gripping portion 204 is formed into a cylindrical shape using a material. A mating portion (not shown) is provided on the tip side of the outer tube gripping portion 204, and the outer tube main body 202 is mated and fixed to this mating portion.

[0080] The outer tube gripping portion 204 is provided with a small diameter portion 204a that has a smaller outer diameter than the surrounding area (see FIG. 2). The small diameter portion 204a is a portion that is narrowed inward (toward the central axis K) from the base end and tip end in the direction of the central axis K in a side view, and the operator can easily grip the outer tube gripping portion 204 by hooking their fingers on the small diameter portion 204a. In addition, the small diameter portion 204a makes it easy for the operator's fingers to catch on, and also functions as a non-slip surface when gripping the outer tube gripping portion 204.

[0081] A second insertion passage 206 is provided inside the outer tube 200 along the direction of the central axis K. The second insertion passage 206 is provided from the outer tube gripping portion 204 to the outer tube main body 202. The second insertion passage 206 is a conduit through which the inner tube main body 102 of the inner tube 100 can be inserted, and its inner diameter is slightly larger than the outer diameter of the inner tube main body 102. The inner circumferential surface of the second insertion passage 206 is coated with a hydrophilic coating material (lubricating coating material) such as polyvinylpyrrolidone.

[0082] The outer tube 200 has a base end opening 208 provided at the base end of the outer tube 200 (the base end of the outer tube gripping portion 204) and a tip end opening 210 provided at the tip end of the outer tube 200 (the tip end of the outer tube main body 202), and a second insertion passage 206 communicates between the base end opening 208 and the tip end opening 210. As a result, as shown in Fig. 3 , the inner tube main body 102 of the inner tube 100 is inserted from the base end opening 208 of the outer tube 200 into the second insertion passage 206 and can move forward and backward along the direction of the central axis K, and a partial region of the inner tube 100 (inner tube main body 102) (a region including at least the first balloon 120) can be exposed from the tip end opening 210.

[0083] As shown in Fig. 4, a second balloon 220 made of various elastic materials is attached to the outer peripheral surface of the distal end side of the outer tube main body 202. The second balloon 220 is attached so that the outer tube main body 202 passes through it, and is composed of a central bulging portion 220c and attachment portions 220a, 220b on both ends. The attachment portion 220a on the distal end side is folded back inside the bulging portion 220c, and a thread 221 is wound around the folded attachment portion 220a. The attachment portion 220b on the proximal end side is disposed outside the second balloon 220, and is fixed to the outer tube main body 202 with the thread 221 wound around it.

[0084] The length P2 of the second balloon 220 in the direction of the central axis K (axial length) is preferably 50 mm or more. Furthermore, the length Q2 of the expansion portion 220c in the direction of the central axis K (axial length) is preferably 30 mm or more. With the second balloon 220 having such a length, when the expansion portion 220c of the second balloon 220 is expanded, it is engaged with the inner wall surface of the intestinal tract without shifting position, and the distal end of the outer tube 200 can be stably fixed within the intestinal tract.

[0085] In the second balloon 220 configured in this manner, the bulging portion 220c expands into an approximately spherical shape when air is blown out from the second air supply suction port 226 described below, and the bulging portion 220c contracts when air is sucked in from the second air supply suction port 226.

[0086] A second air supply / exhaust pipe 222 and a second liquid pipe 224 are formed along the central axis K in the outer wall (wall between the outer peripheral surface and the inner peripheral surface) of the outer tube 200 (outer tube body 202 and outer tube gripping portion 204) (see FIG. 3). The second air supply / exhaust pipe 222 is formed on the outer peripheral surface located inside the second balloon 220, and is connected to the second balloon 220 via the second air supply / exhaust pipe 222. The second liquid conduit 224 opens as a second liquid supply port 228 on the inner circumferential surface of the second insertion passage 206 (the inner circumferential surface of the outer tube main body 202 or the outer tube gripping portion 204).

[0087] A second balloon air supply pipe 230 communicating with the second air supply / exhaust pipe 222 is provided on the outer peripheral surface of the outer tube gripping portion 204. As shown in FIG. 1 , a second air supply port 232 is provided at one end of the second balloon air supply pipe 230. The second air supply port 232 is connected to the balloon control device 300 via a second connection tube 304. When air is supplied from the balloon control device 300 to the second air supply port 232, the air is blown out from the second air supply / suction port 226 via the second balloon air supply pipe 230 and the second air supply / exhaust pipe 222, thereby inflating the second balloon 220. When air is sucked by the balloon control device 300, the air inside the second balloon 220 is sucked from the second air supply / suction port 226 via the second air supply / exhaust pipe 222, thereby deflating the second balloon 220.

[0088] A second liquid supply pipe 234 is provided on the outer peripheral surface of the outer tube gripping portion 204 to supply a lubricant such as water to the second insertion passage 206. A second injection port 236, which serves as an injection port for the lubricant, is provided at one end of the second liquid supply pipe 234 (see FIG. 1). A lubricant supply means (not shown), such as a syringe, is connected to the second injection port 236. The lubricant supplied from the second liquid supply pipe 234 through the second injection port 236 is supplied to the inner peripheral surface of the second insertion passage 206 from the second liquid supply port 228 via the second liquid pipeline 224, reducing friction with the outer peripheral surface of the inner tube 100 (inner tube main body 102) inserted into the second insertion passage 206.

[0089] 3, the overtube 50 is formed by inserting the inner tube main body 102 of the inner tube 100 through the second insertion passage 206 from the proximal end opening 208 of the outer tube 200, and exposing a partial area of ​​the distal end side of the inner tube main body 102 (an area including at least the first balloon 120) from the distal end opening 210 of the outer tube 200, thereby assembling the inner tube 100 and the outer tube 200 together. At this time, the inner tube gripping portion 104 is not inserted through the second insertion passage 206 of the outer tube 200, but is positioned closer to the proximal end than the proximal end opening 208 of the outer tube 200 (outside the second insertion passage 206). This makes it possible to grip both the inner tube gripping portion 104 and the outer tube gripping portion 204, allowing a single operator to move the inner tube 100 and the outer tube 200 back and forth.

[0090] Furthermore, because the inner tube gripping portion 104 is configured to be detachable from the inner tube body 102, when assembling the overtube 50, the inner tube body 102 may be inserted from the distal opening 210 of the outer tube 200 into the second insertion passage 206, with a portion of the proximal end of the inner tube body 102 exposed from the proximal opening 208 of the outer tube 200, and then the inner tube body 102 may be mated with the mating portion of the inner tube gripping portion 104. This eliminates the need to insert the first balloon 120 into the second insertion passage 206, thereby preventing damage to the first balloon 120.

[0091] [Balloon control device] 1, the balloon control device 300 is connected to the first air supply port 132 of the inner tube 100 via a first connecting tube 302, and is also connected to the second air supply port 232 of the outer tube 200 via a second connecting tube 304. A remote controller 306 is also connected to the balloon control device 300. In response to control signals from the remote controller 306, the balloon control device 300 supplies air to each of the balloons 120, 220 and sucks air from each of the balloons 120, 220. This causes each of the balloons 120, 220 to inflate and deflate individually.

[0092] Although not shown, the front panel of the balloon control device 300 is provided with a power switch, a stop switch, a pressure display unit for the first balloon 120, and a pressure display unit for the second balloon 220. Also attached to the front panel of the balloon control device 300 are a first connecting tube 302 that supplies air to and suctions the first balloon 120, and a second connecting tube 304 that supplies air to and suctions the second balloon 220.

[0093] The remote controller 306 is connected to the balloon control device 300 by wire or wirelessly. The remote controller 306 is provided with a stop switch similar to the stop switch on the balloon control device 300, an ON / OFF switch for supporting pressurization / depressurization of the first balloon 120, a pause switch for maintaining the pressure of the first balloon 120, an ON / OFF switch for supporting pressurization / depressurization of the second balloon 220, and a pause switch for maintaining the pressure of the second balloon 220, and is configured to be able to send and receive various signals, including signals corresponding to each switch, to and from the balloon control device 300.

[0094] Fig. 5 is a functional block diagram showing the balloon control device 300. As shown in Fig. 5, the balloon control device 300 is provided with a control system for the first balloon 120, which includes a pressurizing pump 310, a depressurizing pump 312, a solenoid valve 314, and a pressure sensor 336, a control system for the second balloon 220, which includes a pressurizing pump 316, a depressurizing pump 318, a solenoid valve 320, and a pressure sensor 338, and a controller 322 that controls these pumps and solenoid valves.

[0095] The pressurizing pump 310 and the decompression pump 312 are connected to a solenoid valve 314 via tubes 324 and 326, respectively. The solenoid valve 314 is connected to the first balloon 120 via a tube 328. Therefore, by controlling the solenoid valve 314, one of the pressurizing pump 310 and the decompression pump 312 can be connected to the first balloon 120. A pressure sensor 336 is connected to the tube 328, and this pressure sensor 336 measures the internal pressure of the first balloon 120. The measurement value of the pressure sensor 336 is displayed on a pressure display unit (not shown), and an electrical signal indicating the measurement value is output to the controller 322.

[0096] Similarly, the pressurizing pump 316 and the decompression pump 318 are connected to a solenoid valve 320 via tubes 330 and 332, respectively. The solenoid valve 320 is connected to the second balloon 220 via a tube 334. Therefore, by controlling the solenoid valve 320, one of the pressurizing pump 316 and the decompression pump 318 can be connected to the second balloon 220. A pressure sensor 338 is connected to the tube 334, and measures the internal pressure of the second balloon 22. The measurement value of the pressure sensor 338 is displayed on a pressure display unit (not shown), and an electrical signal indicating the measurement value is output to the controller 322.

[0097] The controller 322 includes at least one processor, which will be described later, and functions as a control unit that executes various controls. The controller 322 controls the solenoid valve 314 based on the measurement value of the pressure sensor 336, connects one of the pressurizing pump 310 and the decompression pump 312 to the first balloon 120, and drives the connected pressurizing pump 310 or decompression pump 312. The controller 322 also controls the solenoid valve 320 based on the measurement value of the pressure sensor 338, connects one of the pressurizing pump 316 and the decompression pump 318 to the second balloon 220, and drives the pressurizing pump 316 or decompression pump 318. This allows the first balloon 120 and the second balloon 220 to be inflated by supplying air thereto, or to be deflated by sucking air therefrom. In addition, by controlling the solenoid valves 314, 320, both the pressure pumps 310, 316 and the pressure pumps 312, 318 can be disconnected from the first balloon 120 and the second balloon 220, thereby maintaining the first balloon 120 and the second balloon 220 in an inflated or deflated state.

[0098] [Method of inserting the endoscope insertion part] Next, an example of a method for inserting the endoscope insertion portion 12 using the overtube 50 (including a method for operating the overtube) will be described. FIG. 6 is a flowchart showing an example of a method for inserting the endoscope insertion portion 12 using the overtube 50. FIGS. 7 and 8 are explanatory diagrams for explaining an example of a method for inserting the endoscope insertion portion 12 using the overtube 50. In the following description, unless otherwise specified, it is assumed that the endoscope insertion portion 12 is operated by a first operator (surgeon) and the overtube 50 (inner tube 100 and outer tube 200) is operated by a second operator (caregiver). It is also assumed that the balloon control device 300 is operated by the second operator (or a third operator).

[0099] First, as shown in VIIA of Fig. 7, with the overtube 50 placed over the endoscope insertion portion 12 (i.e., with the endoscope insertion portion 12 inserted into the first insertion passage 106 of the inner tube 100), the endoscope insertion portion 12 and the overtube 50 are inserted into the intestinal tract 350 from the anus or mouth (step S10: initial insertion step). At this time, the first balloon 120 and the second balloon 220 are both in a deflated state. In addition, the distal end portion 20 of the endoscope insertion portion 12 is exposed from the distal end opening 110 of the inner tube 100.

[0100] 7 VIIB, air is supplied from the balloon control device 300 to the second balloon 220 to inflate the second balloon 220 (step S12: second balloon inflation step). As a result, the second balloon 220 is engaged with the inner wall surface of the intestinal tract 350, and the distal end of the outer tube 200 (outer tube main body 202) is fixed to the intestinal tract 350.

[0101] 7, VIIC, while maintaining the state of the endoscope insertion portion 12 and the outer tube 200, the inner tube 100 is pushed deep into the intestinal tract 350 so that the first balloon 120 is separated from the second balloon 220, and is inserted along the endoscope insertion portion 12 (step S14: inner tube pushing step). At this time, the inner tube 100 is pushed within a range where the tip of the inner tube 100 is closer to the base end than the tip of the endoscope insertion portion 12.

[0102] 7, air is supplied from the balloon control device 300 to the first balloon 120 to inflate the first balloon 120 (step S16: first balloon inflation step). As a result, the first balloon 120 is engaged with the inner wall surface of the intestinal tract 350, and the distal end of the inner tube 100 is fixed to the intestinal tract 350.

[0103] Next, as shown in VIID of FIG. 7, the balloon control device 300 sucks air from the second balloon 220 to deflate the second balloon 220 (step S18: second balloon deflation step).

[0104] 8A, while maintaining the state of the endoscope insertion portion 12 and the inner tube 100, the outer tube 200 is pushed in so that the second balloon 220 approaches the first balloon 120, and is inserted along the inner tube 100 (step S20: outer tube pushing step). At this time, the inner tube 100 is pushed in until the tip of the outer tube 200 does not exceed the base end of the first balloon 120 of the inner tube 100.

[0105] Then, after the tip of the outer tube 200 is inserted up to the vicinity of the first balloon 120, air is supplied from the balloon control device 300 to the second balloon 220 to inflate the second balloon 220 (step S22: second balloon inflation step), as shown in VIIIB of Fig. 8. As a result, the second balloon 220 is engaged with the inner wall surface of the intestinal tract 350, and the tip of the outer tube 200 is fixed to the intestinal tract 350.

[0106] Next, as shown in VIIIC of Figure 8, with the first balloon 120 and the second balloon 220 inflated and close to each other, the inner tube 100 and the outer tube 200 are pulled together toward the proximal side, and the intestinal tract 350 is pulled toward the proximal side (step S24: pulling step).

[0107] Next, it is determined whether the retraction of the intestinal tract 350 has been completed (Step S26: Retraction Completion Determination Step). This determination is made by the second operator operating the overtube 50 (or the first operator operating the endoscope insertion section 12). Note that, when it is determined that the retracted intestinal tract 350 has accumulated on the proximal end side of the second balloon 220, it is determined that the retraction of the intestinal tract 350 has been completed. When it is determined that the retraction of the intestinal tract 350 has not been completed (No in Step S26), the balloon control device 300 suctions air from the first balloon 120 to deflate the first balloon 120 (Step S28: First Balloon Deflation Step), and then the processes of Steps S14 to S26 are repeated. That is, the overtube operation including the inner tube pushing step, the first balloon inflation step, the second balloon deflation step, the outer tube pushing step, the second balloon inflation step, the retraction step, and the retraction completion determination step are repeatedly performed.

[0108] On the other hand, if it is determined that the pulling in of the intestinal tract 350 is complete (Yes in step S26), the endoscope insertion portion 12 is pushed deeper into the intestinal tract 350 with the first balloon 120 and the second balloon 220 inflated (the state shown in VIIIC of FIG. 8) (step S30: endoscope insertion portion pushing step). That is, with a part of the endoscope insertion portion 12 exposed from the tip of the inner tube 100, the endoscope insertion portion 12 is pushed so that the tip of the endoscope insertion portion 12 is separated from the tip of the inner tube 100. This allows the tip portion 20 of the endoscope insertion portion 12 to be inserted deeper into the intestinal tract 350.

[0109] Next, it is determined whether the tip of the endoscope insertion portion 12 has reached the target position in the intestinal tract 350 (step S32: target position arrival determination step). This determination is made by the first operator operating the endoscope insertion portion 12. If it is determined that the tip of the endoscope insertion portion 12 has not reached the target position in the intestinal tract 350 (No in step S32), the balloon control device 300 suctions air from the first balloon 120 to deflate the first balloon 120 (step S28: first balloon deflation step), and then the processes of steps S14 to S32 are repeated.

[0110] On the other hand, if it is determined that the tip of the endoscope insertion portion 12 has reached the target position in the intestinal tract 350 (Yes in step S32), this flowchart ends.

[0111] In this way, by repeatedly performing the advancement and retreat operation of the inner tube 100 and the outer tube 200, it becomes possible to insert the endoscope insertion portion 12 deep into the intestinal tract 350.

[0112] The operation of pushing the endoscope insertion portion 12 deeper into the intestinal tract 350 may be performed independently of the operation of advancing and retracting the inner tube 100 and the outer tube 200 (the overtube operation described above). For example, when the operation of advancing and retracting the inner tube 100 and the outer tube 200 is repeatedly performed, the endoscope insertion portion 12 may be pushed deeper into the intestinal tract 350 in a state where only the first balloon 120 of the first balloon 120 and the second balloon 220 is inflated (the state shown in VIID of FIG. 7). Furthermore, the endoscope insertion portion 12 may be pushed deeper into the intestinal tract 350 in a state where only the second balloon 220 of the first balloon 120 and the second balloon 220 is inflated (the state shown in VIIB or VIIC of FIG. 7). However, since the endoscope insertion section 12 is inserted through the inner tube 100, it is preferable to perform the operation of pushing the endoscope insertion section 12 deep into the intestinal tract 350 with at least the first balloon 120 inflated and the tip of the inner tube 100 fixed to the intestinal tract 350.

[0113] As described above, the overtube 50 of this embodiment is configured with a double structure in which the inner tube 100 and the outer tube 200 are stacked on top of each other, and a first balloon 120 and a second balloon 220 are provided at the tip ends of the inner tube 100 and the outer tube 200, respectively, so that the operations required to pull in the intestinal tract can be performed by a single operator.

[0114] Furthermore, according to the overtube 50 of this embodiment, the intestinal tract can be efficiently drawn toward the proximal side by repeatedly performing the advancement and retraction operation of the inner tube 100 and the outer tube 200 with short strokes.

[0115] Furthermore, according to the overtube 50 of this embodiment, the insertion operation of the endoscope insertion portion 12 can be performed independently of the advancement and retreat operations of the inner tube 100 and the outer tube 200. Therefore, an operator (first operator) other than the operator (second operator) of the overtube 50 can operate the endoscope insertion portion 12. Therefore, the burden when coordinating the operation of the endoscope insertion portion 12 and the operation of the overtube 50 can be significantly reduced, and the usability of the overtube 50 can be improved.

[0116] [Overtube dimensions] Next, the preferred dimensions of the overtube 50 will be described with reference to Fig. 9. Fig. 9 is an explanatory diagram for explaining the preferred dimensions of the overtube 50.

[0117] The dimensions of the inner tube 100 and outer tube 200 that constitute the overtube 50 are preferably determined based on the relationship between the ease of operation when a single operator moves the inner tube 100 and the outer tube 200 forward and backward in the above-described method of inserting the endoscope insertion portion 12, and the length of the intestinal tract into which the overtube 50 is inserted (the maximum length from the insertion opening (mouth or anus) of the subject to the depth of the intestinal tract). Note that the following description will be given assuming that the effective length L of the endoscope insertion portion 12 is 2000 mm.

[0118] 9, the effective length of the outer tube 200 is L2, and the effective length of the inner tube 100 is L1. When the endoscope insertion portion 12 is inserted into the first insertion passage 106 of the inner tube 100 and the inner tube 100 is inserted into the second insertion passage 206 of the outer tube 200, the maximum protrusion length of the endoscope insertion portion 12 from the tip of the inner tube 100 (hereinafter referred to as the "first maximum protrusion length") is A, the maximum protrusion length of the inner tube 100 from the tip of the outer tube 200 (hereinafter referred to as the "second maximum protrusion length") is B, and the total maximum protrusion length, which is the sum of the first maximum protrusion length A and the second maximum protrusion length B, is S (= A + B). Furthermore, the maximum protrusion length ratio, which is the ratio of the first maximum protrusion length A to the second maximum protrusion length B, is R (= A / B).

[0119] The effective length L2 of the outer tube 200 is the maximum length of the outer tube 200 that can be inserted into the intestinal tract from the insertion opening (mouth or anus) of the subject, and corresponds to the length of the outer tube 200 in the direction of the central axis K of the outer tube main body 202 excluding the outer tube gripping portion 204. The effective length L1 of the inner tube 100 is the maximum length of the inner tube 100 that can be inserted into the intestinal tract from the insertion opening of the subject. In other words, the effective length L1 of the inner tube 100 is the maximum length of the inner tube 100 that can be inserted into the intestinal tract from the insertion opening of the subject. 4 and the inner tube gripping portion 104 are closest to each other), the base end position of the outer tube main body 202 (the tip end position of the outer tube gripping portion 204), which is the reference position for the length of the outer tube 200.

[0120] It is preferable that the dimensions of each part of the overtube 50 of this embodiment satisfy the following conditions M1 to M6. (M1) The effective length L2 of the outer tube 200 is 1300 mm or more and 1600 mm or less. (M2) The effective length L1 of the inner tube 100 is 1500 mm or more and 1900 mm or less. (M3) The total maximum protrusion length S is 400 mm or more and 700 mm or less. (M4) The first maximum protrusion length A is 100 mm or more and 350 mm or less. (M5) The second maximum protrusion length B is 200 mm or more and 600 mm or less. (M6) The maximum protrusion length ratio R is 0.15 or more and 1.0 or less.

[0121] These conditions M1 to M6 are derived as follows.

[0122] In the overtube 50 of this embodiment, when the inner tube 100 and the outer tube 200 are advanced and retracted, the total maximum protrusion length S is a standard for determining the stroke amount (advance and retraction amount) of the inner tube 100 and the outer tube 200 required to pull in the intestinal tract, and must be approximately 400 mm or more and 700 mm or less. Within this range, the minimum value of 400 mm is the minimum length required to pull in the intestinal tract. The maximum value of 700 mm is determined from the difference between the effective length L (2000 mm) of the endoscope insertion portion 12 and the length (1300 mm) required for the outer tube 200 to exceed the length of the large intestine.

[0123] Within the above condition for the total maximum protrusion length S (400 mm or more and 700 mm or less), it is preferable that the first maximum protrusion length A be less than the second maximum protrusion length B. If the first maximum protrusion length A is greater than the second maximum protrusion length B, the outer tube 200 will be more likely to move when the inner tube 100 is pushed in, compared to the case where the relationship is reversed. Therefore, from the perspective of stably performing the forward and backward operation of the inner tube 100 and the outer tube 200, it is desirable that the first maximum protrusion length A be the same as or smaller than the second maximum protrusion length B.

[0124] (1) When the total maximum protrusion length S is the minimum value First, consider the effective length L1 of the inner tube 100 and the effective length L2 of the outer tube 200 required when the total maximum projection length S is the minimum value of 400 mm. Based on the condition that the first maximum projection length A is equal to or less than the second maximum projection length B, when the total maximum projection length S is 400 mm, for example, when the first maximum projection length A is 100 mm and 200 mm, the second maximum projection length B will be 300 mm and 200 mm, respectively. That is, the first maximum projection length A and the second maximum projection length B are determined so as to satisfy the condition that the total maximum projection length S is 400 mm within the range of the first maximum projection length A being equal to or greater than 100 mm and the second maximum projection length B being equal to or greater than 200 mm and 300 mm. From the viewpoint of operability of the endoscope insertion portion 12 exposed from the tip of the inner tube 100, the first maximum projection length A needs to be at least 100 mm.

[0125] When the first maximum protrusion length A and the second maximum protrusion length B are determined as described above when the total maximum protrusion length S is 400 mm, the effective length L2 of the outer tube 200 is 1600 mm, which is the value obtained by subtracting the total maximum protrusion length S from the effective length L (2000 mm) of the endoscope insertion portion 12. Also, the effective length L1 of the inner tube 100 is 1600 mm, which is the value obtained by subtracting the first maximum protrusion length A (100 mm or more and 200 mm or less) from the effective length L (2000 mm) of the endoscope insertion portion 12. The effective length L1 of the inner tube 100 is equal to the value obtained by adding the second maximum protruding length B to the effective length L2 (1600 mm) of the outer tube 200.

[0126] When the first maximum protrusion length A is 100 mm and the second maximum protrusion length B is 300 mm, the maximum protrusion length ratio R is 0.3 (= 100 / 300). When the first maximum protrusion length A is 200 mm and the second maximum protrusion length B is 200 mm, the maximum protrusion length ratio R is 1.0 (= 200 / 200). Therefore, when the total maximum protrusion length S is 400 mm, the maximum protrusion length ratio R is a value in the range of 0.3 to 1.0.

[0127] (2) When the total maximum protrusion length S is the maximum value Next, consider the effective length L1 of the inner tube 100 and the effective length L2 of the outer tube 200 required when the total maximum projection length S is the maximum value of 700 mm. Based on the condition that the first maximum projection length A is equal to or less than the second maximum projection length B, when the total maximum projection length S is 700 mm, for example, when the first maximum projection length A is 100 mm, 200 mm, or 350 mm, the second maximum projection length B will be 600 mm, 500 mm, and 350 mm, respectively. In other words, the first maximum projection length A and the second maximum projection length B are determined so as to satisfy the condition that the total maximum projection length S is 700 mm within the range where the first maximum projection length A is equal to or greater than 100 mm and equal to or less than 350 mm, and the second maximum projection length B is equal to or greater than 350 mm and equal to or less than 600 mm.

[0128] When the first maximum projection length A and the second maximum projection length B are determined as described above when the total maximum projection length S is 700 mm, the effective length L2 of the outer tube 200 is 1300 mm, which is the value obtained by subtracting the total maximum projection length S from the effective length L (2000 mm) of the endoscope insertion portion 12. The effective length L1 of the inner tube 100 is 1650 mm or more and 1900 mm or less, which is the value obtained by subtracting the first maximum projection length A (100 mm or more and 350 mm or less) from the effective length L (2000 mm) of the endoscope insertion portion 12. The effective length L1 of the inner tube 100 is equal to the value obtained by adding the second maximum projection length B to the effective length L2 (1300 mm) of the outer tube 200.

[0129] When the first maximum protrusion length A is 100 mm and the second maximum protrusion length B is 600 mm, the maximum protrusion length ratio R is 0.167 (= 100 / 600). When the first maximum protrusion length A is 200 mm and the second maximum protrusion length B is 500 mm, the maximum protrusion length ratio R is 0.4 (= 200 / 500). When the first maximum protrusion length A is 350 mm and the second maximum protrusion length B is 350 mm, the maximum protrusion length ratio R is 1.0 (= 350 / 350). Therefore, when the total maximum protrusion length S is 700 mm, the maximum protrusion length ratio R is a value in the range of 0.167 to 1.0.

[0130] (3) When the total maximum protrusion length S is the minimum value and the effective length L2 of the outer tube 200 is the minimum value If the total maximum protrusion length S is a minimum of 400 mm and the effective length L2 of the outer tube 200 is a minimum of 1300 mm, the first maximum protrusion length A is 200 mm, and the second maximum protrusion length B is 200 mm, the effective length L1 of the inner tube 100 will be the minimum value. In this case, the effective length L1 of the inner tube 100 is 1500 mm, which is the sum of the effective length L2 of the outer tube 200 and the second maximum protrusion length B (200 mm).

[0131] In this way, by selecting a range that satisfies at least one of the ranges determined in (1) to (3) above, the above-mentioned conditions M1 to M6 can be derived.

[0132] Fig. 10 is a table showing an example of the dimensions of each part of the overtube 50. In Fig. 10, values ​​outside the ranges defined by conditions M1 to M6 are shown in bold and shaded. Each example was evaluated according to the following criteria. ++ Meets all requirements (excellent). + Some conditions are slightly outside the specified range (but still practical). - Some conditions are significantly outside the specified range (not practical).

[0133] 10, Examples 1 to 10 satisfy all of Conditions M1 to M6. In this case, the length required to insert the overtube 50 (particularly the outer tube 200) into the intestinal tract can be ensured relative to the effective length L of the endoscope insertion portion 12. Also, it becomes possible to stably perform the advance / retract operation of the inner tube 100 and the outer tube 200 while ensuring the stroke amount (advance / retraction amount) of the inner tube 100 and the outer tube 200 required to pull in the intestinal tract.

[0134] Examples 11 to 14 are slightly outside the range defined by one of conditions M1 to M6, and are somewhat inferior to Examples 1 to 10, but are sufficient for practical use and provide effects roughly equivalent to those of Examples 1 to 10.

[0135] In Examples 15 and 16, the maximum protrusion length ratio R exceeds 2.0, which is significantly outside the range defined by condition M6. In such cases, as described above, the outer tube 200 tends to move when the inner tube 100 is pushed in, which can lead to instability in the forward and backward movement of the inner tube 100 and the outer tube 200. In Example 16, the effective length L2 of the outer tube 200 and the effective length L1 of the inner tube 100 are also slightly outside the ranges defined by conditions M1 and M2, respectively.

[0136] In this way, by having the dimensions of each part of the overtube 50 satisfy all of conditions M1 to M6, it is possible to obtain the length required to insert the overtube 50 into the intestinal tract while also obtaining the stroke amount required for moving the inner tube 100 and the outer tube 200 back and forth. Furthermore, by setting the maximum projection length ratio R within the range defined by condition M6, the first maximum projection length A becomes shorter than the second maximum projection length B, and it becomes possible to stably move the inner tube 100 and the outer tube 200 back and forth.

[0137] The above-mentioned conditions M1 to M6 indicate preferable ranges in this embodiment, but the values ​​are not necessarily limited to these ranges. For example, it is possible to obtain substantially the same effect as this embodiment even within the ranges indicated by the following conditions N1 to N6. (N1) The effective length L2 of the outer tube 200 is 1200 mm or more and 1700 mm or less. (N2) The effective length L1 of the inner tube 100 is 1400 mm or more and 2000 mm or less. (N3) The total maximum protrusion length S is 300 mm or more and 800 mm or less. (N4) The first maximum protrusion length A is 100 mm or more and 550 mm or less. (N5) The second maximum protrusion length B is 200 mm or more and 700 mm or less. (N6) The maximum protrusion length ratio R is 0.15 or more and 1.0 or less.

[0138] Furthermore, the above-mentioned conditions M1 to M6 (as well as conditions N1 to N6) were explained assuming that the effective length L of the endoscope insertion portion 12 is 2000 mm, but this is not limited to this and can also be applied to an endoscope insertion portion 12 whose effective length L is, for example, 1500 mm or more and 2500 mm or less.

[0139] [Second embodiment] 11 is an explanatory diagram for explaining the second embodiment. The overtube 50 of the second embodiment is similar to that of the first embodiment except for the difference in the configuration of the lubricant supply unit provided in the inner tube 100. The differences from the first embodiment will be described below.

[0140] 11, in the second embodiment, the inner tube 100 includes, as components of the lubricant supply section, an inner supply port 140 that opens to the inner circumferential surface (first insertion passage 106) of the inner tube 100, and an outer supply port 142 that opens to the outer circumferential surface of the inner tube 100. The position of the outer supply port 142 in the direction of the central axis K is located inside the outer tube 200.

[0141] One end of the first liquid conduit 124 branches into two at the outer peripheral wall portion of the inner tube 100, with one branch conduit 124a communicating with the inner supply port 140 and the other branch conduit 124b communicating with the outer supply port 142. The other end of the first liquid conduit 124 communicates with the first liquid supply pipe 134. As described above, one end of the first liquid supply pipe 134 is provided with the first injection port 136, which serves as an injection port for the lubricant (see FIG. 1). Therefore, the first injection port 136 communicates with the inner supply port 140 and the outer supply port 142 via the first liquid supply pipe 134 and the first liquid conduit 124.

[0142] According to the second embodiment, the lubricant supplied from the first injection port 136 through the first liquid supply pipe 134 can be supplied from the inner supply port 140 and the outer supply port 142 to both the inner circumferential surface of the first insertion passage 106 (endoscope insertion passage 52) of the inner tube 100 and the inner circumferential surface of the second insertion passage 206 of the outer tube 200. Therefore, as shown in Fig. 11, the outer tube 200 in the second embodiment does not need to be provided with a conduit for supplying the lubricant (the second liquid conduit 224 and the second liquid supply pipe 234 in the first embodiment, see Fig. 3), and the structure of the outer tube 200 can be simplified.

[0143] [Third embodiment] 12 is an explanatory diagram for explaining the third embodiment. The overtube 50 of the third embodiment is similar to that of the first embodiment except that a sensor is provided on each of the inner tube 100 and the outer tube 200. Differences from the first embodiment will be described below.

[0144] As shown in FIG. 12, the overtube 50 of the third embodiment includes a first sensor 150 provided on the inner tube 100 and a second sensor 250 provided on the outer tube 200. The first sensor 150 is provided on the inner tube 100, and the second sensor 250 is provided on the outer tube 200. As shown in FIG.

[0145] The first sensor 150 functions as a movement direction detection unit that detects the direction of axial movement of the inner tube 100 (movement in the direction of the central axis K; the same applies below), and is configured by, for example, a direction sensor or an angular velocity sensor. The first sensor 150 is provided at any position on the inner tube 100. For example, the first sensor 150 may be provided on the inner tube gripping portion 104, or on the inner tube main body 102. From the viewpoint of practicality, it is desirable to provide the first sensor 150 at the base end of the inner tube gripping portion 104, which is a position where the direction of axial movement of the inner tube 100 can be easily detected.

[0146] The second sensor 250 functions as a relative movement detection unit that detects relative axial movement between the outer tube 200 and the inner tube 100, and is configured by, for example, a proximity sensor or a position sensor. The second sensor 250 is provided at any position on the outer tube 200. For example, the second sensor 250 may be provided on the outer tube gripping portion 204, or on the outer tube main body 202. Note that the second sensor 250 is preferably provided at the base end of the outer tube gripping portion 204, which is a position where relative axial movement between the outer tube 200 and the inner tube 100 can be easily detected. Furthermore, the second sensor 250 is not limited to being provided on the outer tube 200, and may also be provided on the inner tube 100.

[0147] 13 is a block diagram of a balloon control device 300 according to the third embodiment. As shown in FIG. 13, a first sensor 150 and a second sensor 250 are connected to the balloon control device 300, and signals indicating the detection results of these sensors are output to a controller 322.

[0148] The controller 322 controls the solenoid valve 314 based on the detection result of the first sensor 150. Specifically, when the first sensor 150 detects movement of the inner tube 100 toward the distal end in the axial direction, the controller 322 controls the solenoid valve 314 to connect the pressurizing pump 310 and the first balloon 120, and starts supplying air to the first balloon 120. On the other hand, when the first sensor 150 detects movement of the inner tube 100 toward the proximal end in the axial direction, the controller 322 controls the solenoid valve 314 to connect the decompression pump 312 and the first balloon 120, and starts suction to the first balloon 120.

[0149] Furthermore, the controller 322 controls the solenoid valve 320 based on the detection result of the second sensor 250. Specifically, when the second sensor 250 detects movement of the tip of the outer tube 200 and the tip of the inner tube 100 in a direction separating them from each other, the controller 322 controls the solenoid valve 320 to connect the decompression pump 318 to the second balloon 220, and starts suctioning the second balloon 220. On the other hand, when the second sensor 250 detects movement of the tip of the outer tube 200 and the tip of the inner tube 100 in a direction approaching each other, the controller 322 controls the solenoid valve 320 to connect the pressurization pump 316 to the second balloon 220, and starts supplying air to the second balloon 220.

[0150] The method of inserting the endoscope insertion portion 12 in the third embodiment is basically the same as that in the first embodiment described above, but differs in the following respects.

[0151] First, in the first embodiment, as shown in VIIB to VIIC of Fig. 7, after the inner tube 100 is pushed in with the first balloon 120 deflated, it is necessary to operate the balloon control device 300 to inflate the first balloon 120. Also, as shown in VIIIB to VIIIC of Fig. 8, after the inner tube 100 is retracted together with the outer tube 200, if the inner tube 100 and the outer tube 200 are repeatedly moved forward and backward, it is necessary to operate the balloon control device 300 to deflate the first balloon 120.

[0152] In contrast, the third embodiment is provided with a first sensor 150 that functions as a movement direction detector that detects the axial movement direction of the inner tube 100, making it possible for the first sensor 150 to detect the pushing of the inner tube 100. Therefore, when the pushing of the inner tube 100 begins (see FIG. 7B), the first sensor 150 detects the movement of the inner tube 100 toward the axial tip, and the balloon control device 300 automatically starts inflating the first balloon 120. Then, in parallel with the pushing of the inner tube 100, the first balloon 120 gradually inflates, and upon completion of the pushing of the inner tube 100, the first balloon 120 is engaged with the inner wall surface of the intestinal tract 350, and the tip of the inner tube 100 is fixed to the intestinal tract 350 (see FIG. 7C-VII).

[0153] Furthermore, in the third embodiment, by providing the first sensor 150, the retraction of the inner tube 100 can also be detected by the first sensor 150. Therefore, when the retraction of the inner tube 100 starts together with the outer tube 200 (see VIIIB in FIG. 8), the first sensor 150 detects the movement of the inner tube 100 toward the axial base end, and the balloon control device 300 automatically starts to deflate the first balloon 120. Then, in parallel with the retraction of the inner tube 100, the first balloon 120 gradually contracts. As the retraction of the inner tube 100 is completed, the first balloon 120 moves away from the inner wall surface of the intestinal tract 350, after which the inner tube 100 can be immediately pushed in.

[0154] Second, in the first embodiment, as shown in VIIC to VIID of Fig. 7 and VIIIA of Fig. 8, when pushing in the outer tube 200, it is necessary to operate the balloon control device 300 to deflate the second balloon 220 beforehand. Also, as shown in VIIIA to VIIIC of Fig. 8, when retracting the outer tube 200 together with the inner tube 100, it is necessary to operate the balloon control device 300 to inflate the second balloon 220 beforehand.

[0155] In contrast, the third embodiment is provided with a second sensor 250 that functions as a relative movement detector that detects relative axial movement between the outer tube 200 and the inner tube 100, making it possible for the second sensor 250 to detect the pushing of the inner tube 100. Therefore, when the pushing of the inner tube 100 begins (see VIIB to VIIC in FIG. 7), the second sensor 250 detects the movement of the tip of the inner tube 100 and the tip of the outer tube 200 in the direction away from each other, and the balloon control device 300 automatically starts to deflate the second balloon 220. Then, the second balloon 220 gradually deflates in parallel with the pushing of the inner tube 100, and when the pushing of the inner tube 100 is completed, the second balloon 220 moves away from the inner wall surface of the intestinal tract 350, after which the pushing operation of the outer tube 200 can be immediately performed (see VIID in FIG. 7).

[0156] Furthermore, in the third embodiment, the provision of the second sensor 250 enables the second sensor 250 to detect the pushing of the outer tube 200. Therefore, when the pushing of the outer tube 200 starts (see VIID in FIG. 7), the second sensor 250 detects the movement of the tip of the inner tube 100 and the tip of the outer tube 200 toward each other, and the balloon control device 300 automatically starts to inflate the second balloon 220. Then, in parallel with the pushing of the outer tube 200, the second balloon 220 gradually inflates, and upon completion of the pushing of the outer tube 200, the second balloon 220 is engaged with the inner wall surface of the intestinal tract 350, and the tip of the outer tube 200 is fixed to the intestinal tract 350 (see VIIIB in FIG. 8).

[0157] As described above, according to the third embodiment, by providing the first sensor 150 and the second sensor 250, the balloon control device 300 automatically controls the inflation and deflation of the first balloon 120 and the second balloon 220 in accordance with the advancement and retreat of the inner tube 100 and the outer tube 200. Therefore, it is not necessary to individually operate the inflation and deflation of the first balloon 120 and the second balloon 220, which significantly reduces the burden on the operator and makes it possible to improve the efficiency of operation of the overtube 50.

[0158] Furthermore, in the third embodiment, as an example, a configuration was shown in which signals indicating the detection results of the first sensor 150 and the second sensor 250 were output to the balloon control device 300, but this is not limiting, and for example, as shown in Fig. 14, the detection results of the first sensor 150 and the second sensor 250 may be output to a controller 322 of the balloon control device 300 via a remote controller 306. In this case, by placing the remote controller 306 in a position close to the first sensor 150 and the second sensor 250, wiring connecting the first sensor 150 and the second sensor 250 to the balloon control device 300 is not necessary, and the degree of freedom in the placement of the balloon control device 300 can be improved.

[0159] In the third embodiment, as an example, the outer tube 200 and the inner tube 1 Although the case has been shown in which the relative movement detection unit that detects relative axial movement with respect to 00 is configured with the second sensor 250 (proximity sensor or position sensor), it is not limited to this and may be configured with, for example, a magnetic switch or an electric switch.

[0160] [Fourth embodiment] 15 is an explanatory diagram for explaining the fourth embodiment. The overtube 50 of the fourth embodiment is similar to that of the first embodiment except that an index is provided on each of the inner tube 100 and the endoscope insertion portion 12. Differences from the first embodiment will be described below.

[0161] 15, the inner tube 100 is provided with an indicator 152 that indicates its relative position in the direction of the central axis K with respect to the outer tube 200. The indicator 152 is provided on the outer peripheral surface of the inner tube body 102 and is composed of letters, figures, or a combination of letters and figures. The indicator 152 includes information regarding the length of the inner tube 100 that protrudes from the tip of the outer tube 200. The indicator 152 may also include information indicating the position at which the inner tube 100 can be pushed into the outer tube 200 to the maximum.

[0162] The endoscope insertion portion 12 is provided with an index 40 that indicates its relative position in the direction of the central axis K with respect to the inner tube 100. The index 40 is provided on the outer peripheral surface of the endoscope insertion portion 12 and is composed of letters, figures, or a combination of letters and figures. The index 40 includes information regarding the protruding length of the endoscope insertion portion 12 that protrudes from the tip of the inner tube 100.

[0163] According to the fourth embodiment, by performing the forward and backward operation of the inner tube 100 and the outer tube 200 while checking the indicator 152 on the inner tube 100, it is possible to grasp the protruding length of the inner tube 100 relative to the outer tube 200, thereby improving the efficiency of operation of the overtube 50.

[0164] Furthermore, according to the fourth embodiment, by checking the indicator 40 of the endoscope insertion portion 12 while pushing the endoscope insertion portion 12, it is possible to grasp the protruding length of the endoscope insertion portion 12 relative to the inner tube 100, thereby improving the efficiency of operating the endoscope insertion portion 12.

[0165] In the fourth embodiment, as an example, a case is shown in which indicators 152 and 40 are provided on the inner tube 100 and the endoscope insertion portion 12, respectively, but this is not limited to this, and indicators may be provided on only one of the inner tube 100 and the endoscope insertion portion 12.

[0166] [Fifth embodiment] 16 is an explanatory diagram for explaining the fifth embodiment. The overtube 50 of the fifth embodiment is similar to that of the first embodiment except for the different shapes of the inner tube gripping portion 104 and the outer tube gripping portion 204. The differences from the first embodiment will be described below.

[0167] As shown in FIG. 16, the inner tube gripping portion 104 and the outer tube gripping portion 204 each have a cylindrical outer circumferential surface, and are not provided with small diameter portions 104a, 204a as in the first embodiment.

[0168] In the fifth embodiment, the inner tube gripping portion 104 is provided with a ring-shaped first finger hook 154 on which the operator's first finger (thumb) can be hooked. The outer tube gripping portion 204 can be hooked with the operator's second finger (index finger) and third finger (middle finger), respectively. The second finger hooks 254A and 254B are arranged on the outer circumferential surface of the outer tube gripping portion 204 at positions that face each other at 180 degrees.

[0169] According to the fifth embodiment, the operator can easily move the inner tube 100 and the outer tube 200 back and forth with one hand by placing the thumb on the first finger rest 154 and the index finger and middle finger on the second finger rests 254A and 254B, respectively. This makes it possible to further improve the ease of use of the overtube 50.

[0170] [Sixth embodiment] 17 and 18 are explanatory diagrams for explaining a sixth embodiment. The overtube 50 of the sixth embodiment is similar to that of the first embodiment, except that it has a configuration in which the conduits communicating with the first balloon 120 and the second balloon 220 can be selectively switched between an air supply state and a suction state. Differences from the first embodiment will be described below. For simplicity of explanation, the following description will be given of the configuration in which the conduits communicating with the first balloon 120 can be selectively switched between an air supply state and a suction state, representing the first balloon 120 and the second balloon 220. However, a similar configuration is also applicable to the second balloon 220. Also, in FIGS. 17 and 18, a portion of the configuration of the inner tube 100 is shown in a simplified form.

[0171] 17 and 18, a common conduit 160 is provided on the outer peripheral wall of the inner tube 100 to which the first balloon 120 is attached, the common conduit 160 having one end connected to the first balloon 120. The other end of the common conduit 160 branches into two conduits at a branching point 160a. One of the two conduits is an air supply conduit 162, and the other is a suction conduit 164. In other words, the air supply conduit 162 and the suction conduit 164 are branched and connected to the other end of the common conduit 160.

[0172] An air supply source conduit 166 communicating with an air supply source (pressurizing pump) and a suction source conduit 168 communicating with a suction source (decompressing pump) are provided on the outer peripheral wall of the inner tube 100. Air is constantly supplied from the air supply source to the air supply source conduit 166. A first communication passage 182 that communicates with the outer peripheral surface of the inner tube 100 is provided midway along the air supply source conduit 166. The first communication passage 182 is a relief hole that releases part of the positive pressure generated in the suction source conduit 168 when the air supply source conduit 166 and the air supply conduit 162 are not in communication with each other, and is configured to be smaller than the cross-sectional area of ​​the air supply source conduit 166. It is sufficient that the first communication passage 182 communicates with either the outer peripheral surface or the inner peripheral surface of the inner tube 100.

[0173] Air is constantly sucked into the suction source conduit 168 by the suction source. A second communication passage 184 that communicates with the inner circumferential surface of the inner tube 100 is provided midway through the suction source conduit 168. The second communication passage 184 is a relief hole that releases part of the negative pressure generated in the suction source conduit 168 when the suction source conduit 168 and the suction conduit 164 are not in communication with each other, and is configured to be smaller than the cross-sectional area of ​​the suction source conduit 168. It is sufficient that the second communication passage 184 communicates with either the outer circumferential surface or the inner circumferential surface of the inner tube 100.

[0174] Inner tube 100 is provided with a valve housing portion 170. Valve housing portion 170 is configured as a hole that penetrates the outer peripheral wall portion of inner tube 100 from the outer peripheral surface to the inner peripheral surface. A communication space 172 is provided inside valve housing portion 170. Communication space 172 is connected to air supply conduit 162, suction conduit 164, air supply source conduit 166, and suction source conduit 168 at predetermined positions.

[0175] A conduit switching valve 174 is provided in the valve housing portion 170. The conduit switching valve 174 includes a valve main body portion 176, a sealing member 178, and a spring member 180. The conduit switching valve 174 is an example of a conduit switching portion.

[0176] The valve main body 176 is composed of a cylindrical shaft 176a, a head 176b provided at one end of the shaft 176a, and a pair of flanges 176c, 176c spaced apart on the other end of the shaft 176a. The sealing member 178 has a cylindrical shape and is provided between the pair of flanges 176c, 176c, coaxially with the shaft 176a. The spring member 180 is interposed between the head 176b and the outer peripheral surface of the inner tube 100. The spring member 180 biases the valve main body 176 toward the outside of the valve accommodating portion 170 (i.e., in the direction in which the head 176b moves away from the outer peripheral surface of the inner tube 100).

[0177] According to this configuration, when valve main body 176 is not pressed down by the operator (i.e., in a non-operated state), valve main body 176 is biased to the first position shown in Fig. 17 by the biasing force of spring member 180. In this case, sealing member 178 is located between air supply conduit 162 and air supply source conduit 166 in communication space 172. Therefore, air supply conduit 162 and air supply source conduit 166 are not in communication with each other, and suction conduit 164 and suction source conduit 168 are in communication with each other.

[0178] On the other hand, when valve main body 176 is pressed down by the operator (i.e., in the operating state), valve main body 176 is positioned in the second position shown in Fig. 18 against the biasing force of spring member 180. In this case, sealing member 178 is positioned between suction conduit 164 and suction source conduit 168 in communication space 172. Therefore, air supply conduit 162 and air supply source conduit 166 are in a communication state, and suction conduit 164 and suction source conduit 168 are in a non-communication state.

[0179] Therefore, according to the sixth embodiment, depending on whether or not the conduit switching valve 174 (valve main body 176) is operated, it is possible to selectively switch between an air supply state in which the air supply conduit 162 and the air supply source conduit 166 are connected and the suction conduit 164 and the suction source conduit 168 are blocked, and a suction state in which the air supply conduit 162 and the air supply source conduit 166 are blocked and the suction conduit 164 and the suction source conduit 168 are connected.

[0180] Furthermore, according to the sixth embodiment, first and second communication passages 182, 184 are provided midway through air supply source conduit 166 and suction source conduit 168, respectively, as relief holes for preventing an increase in pressure (positive or negative pressure). This allows air to be constantly supplied from the air supply source to air supply source conduit 166, while air can be constantly drawn into suction source conduit 168 by the suction source. This eliminates the need for a solenoid valve in balloon control device 300 for selectively switching between the air supply source (pressurizing pump) and the suction source (decompressing pump), thereby simplifying the structure of balloon control device 300 and reducing costs.

[0181] In the sixth embodiment, from the viewpoint of practicality, it is preferable that the conduit switching valve 174 be disposed in the inner tube gripping portion 104. However, as long as the conduit switching valve 174 is located in a position where an operator can operate it, the conduit switching valve 174 may be disposed in the inner tube main body 102, not limited to the inner tube gripping portion 104. The same applies to the case where the conduit switching valve 174 is provided for the outer tube 200.

[0182] [Seventh embodiment] 19 is an explanatory diagram for explaining the seventh embodiment. The seventh embodiment is similar to the first embodiment except that the inner tube 100 and the endoscope insertion portion 12 are each provided with a stopper portion for restricting movement toward the base end in the axial direction. The following points are different from the first embodiment. This explains the points.

[0183] 19, the inner tube 100 has an inner tube stopper portion 186. The inner tube stopper portion 186 is provided in an inner tube protruding region (region on the distal end side of the inner tube main body 102) that protrudes from the distal end of the outer tube 200 (outer tube main body 202). Specifically, the inner tube stopper portion 186 is provided on the proximal side of the first balloon 120, and at a position within 100 mm from the distal end of the inner tube 100 (inner tube main body 102) toward the proximal end.

[0184] The inner tube stopper portion 186 is configured as a ring-shaped large-diameter portion (e.g., a rubber band) having an outer diameter larger than the inner diameter of the second insertion passage 206 of the outer tube 200, and is configured to be detachable from the inner tube 100 (inner tube main body 102). The inner tube stopper portion 186 has an inner tube stopper surface 186a on its base end side end surface.

[0185] The inner tube stopper surface 186a comes into contact with the tip (end surface on the tip side) of the outer tube 200, thereby restricting movement of the inner tube 100 toward the base end in the axial direction relative to the outer tube 200. Looking at this from another perspective, it can also be said that the inner tube stopper surface 186a restricts movement of the outer tube 200 toward the tip end in the axial direction relative to the inner tube 100.

[0186] 19, the endoscope insertion portion 12 is provided with an endoscope insertion portion stopper portion 42. The endoscope insertion portion stopper portion 42 is provided in an endoscope insertion portion protruding region that protrudes from the tip of the inner tube 100 (inner tube main body 102).

[0187] The endoscope insertion portion stopper portion 42 is configured as a ring-shaped large-diameter portion (e.g., a rubber band) having an outer diameter larger than the inner diameter of the first insertion passage 106 of the inner tube 100, and is configured to be detachable from the endoscope insertion portion 12. The endoscope insertion portion stopper portion 42 has an endoscope insertion portion stopper surface 42a on its proximal end side end surface.

[0188] The endoscope insertion portion stopper surface 42a comes into contact with the tip (end surface on the tip side) of the inner tube 100, thereby restricting movement of the endoscope insertion portion 12 toward the base end in the axial direction relative to the inner tube 100. From another perspective, the endoscope insertion portion stopper surface 42a can also be said to restrict movement of the inner tube 100 toward the tip end in the axial direction relative to the endoscope insertion portion 12.

[0189] The method of inserting the endoscope insertion portion 12 in the seventh embodiment is basically the same as that in the first embodiment described above, but differs in the following respects.

[0190] In the first embodiment, as shown in VIIIB to VIIIC of Figure 8, when retracting the inner tube 100 and the outer tube 200 together, the operator (second operator) of the overtube 50 needs to retract the inner tube 100 and the outer tube 200 together while holding the inner tube holding portion 104 and the outer tube holding portion 204.

[0191] In contrast to this, in the seventh embodiment, the inner tube 100 is provided with the inner tube stopper portion 186, so that by pulling in the inner tube 100 with the inner tube stopper surface 186a abutting against the tip of the outer tube 200, the outer tube 200 can be pulled in at the same time as the inner tube 100 is pulled in. Therefore, the operator of the overtube 50 does not need to grip the outer tube gripping portion 204, which reduces the operational burden and improves operational efficiency.

[0192] According to the seventh embodiment, when the inner tube 100 and the outer tube 200 are moved back and forth, the inner tube stopper portion 186 provided on the inner tube 100 can prevent the first balloon 120 of the inner tube 100 from entering the inside of the outer tube 200.

[0193] Furthermore, according to the seventh embodiment, when the endoscope insertion portion 12 is advanced or retracted independently of or in conjunction with the advancement and retraction of the inner tube 100 and the outer tube 200, the endoscope insertion portion stopper portion 42 provided on the endoscope insertion portion 12 can prevent the tip portion 20 of the endoscope insertion portion 12 from entering the inside of the inner tube 100. This makes it possible to keep the tip portion 20 of the endoscope insertion portion 12 always exposed from the tip of the inner tube 100 regardless of the advancement and retraction of the inner tube 100 and the outer tube 200, thereby improving operability of the endoscope insertion portion 12.

[0194] Furthermore, according to the seventh embodiment, by pulling in the inner tube 100 while gripping the inner tube gripping portion 104 without gripping the outer tube gripping portion 204, the outer tube 200 can be pulled in at the same time as the inner tube 100 is pulled in. This reduces the operational burden and improves operational efficiency.

[0195] Furthermore, in the seventh embodiment, as an example, the case where the stopper portion 186 for the inner tube and the stopper portion 42 for the endoscope insertion portion are each configured by a ring-shaped large diameter portion has been shown, but this is not limited thereto, and for example, these stopper portions may have a C-shape with a portion of the circumference cut out, or may have a shape in which only a portion of the circumference protrudes radially.

[0196] In addition, in the seventh embodiment, a case where a stopper portion is provided on both the inner tube 100 and the endoscope insertion portion 12 is shown, but this is not limited to this, and a stopper portion may be provided on only one of the inner tube 100 and the endoscope insertion portion 12.

[0197] [Eighth embodiment] 20 and 21 are explanatory diagrams for explaining the eighth embodiment. The eighth embodiment is similar to the first embodiment except that it includes a holding member that holds the tubes (first connecting tube 302 and second connecting tube 304) that connect the inner tube 100 and outer tube 200 to the balloon control device 300 on the operation section 14 of the endoscope 10. Differences from the first embodiment will be described below.

[0198] As shown in FIG. 20 , the eighth embodiment includes a flexible, belt-like band member 360 as an example of a holding member. The band member 360 has a length that allows it to be wound around the operation unit 14 of the endoscope 10. One end of the band member 360 is configured to be detachably attached to the other end of the band member 360 by a hook-and-loop fastener. That is, a hook-and-loop fastener hook surface 364 is provided on the outer surface of one end of the band member 360, and a hook-and-loop fastener loop surface 366 is provided on the inner surface of the other end, and these surfaces come into contact with each other and are detachably coupled. Note that the hook surface 364 and the loop surface 366 may be reversed. Also, as long as the ends of the band member 360 can be detachably coupled to each other, various known configurations other than the hook-and-loop fastener may be applied. For example, a protruding engagement member may be provided on one of the inner surface of one end of the band member 360 and the outer surface of the other end of the band member 360, and one or more engagement holes may be provided on the other. The engaging member may be engaged with the engaging hole to detachably connect the two.

[0199] A tube holding portion 362 is provided on the outer surface of the band member 360. The tube holding portion 362 is made of a strip-like member that is narrower than the band member 360. One end of the band member 360 is fixed to the band member 360, and the other end is configured to be detachable from the outer surface of the band member 360 by a hook-and-loop fastener. The configuration of the hook-and-loop fastener is the same as that of the band member 360, so a description thereof will be omitted. Note that various known configurations can be applied as long as the other end of the band member 360 can be detachably connected to the outer surface of the band member 360.

[0200] When the first connection tube 302 and the second connection tube 304 are to be held by the tube holding portion 362, the other end of the tube holding portion 362 is detached from the outer surface of the band member 360. Then, the first connection tube 302 and the second connection tube 304 are arranged between the tube holding portion 362 and the outer surface of the band member 360, and the other end of the tube holding portion 362 and the outer surface of the band member 360 are brought into contact with each other and joined together, thereby closing the other end of the tube holding portion 362. This results in the first connection tube 302 and the second connection tube 304 being held between the tube holding portion 362 and the outer surface of the band member 360. The first connection tube 302 and the second connection tube 304 are examples of the first tube and the second tube, respectively, of the present invention.

[0201] 21 , by wrapping the band member 360 around the outer periphery of the operation section 14 of the endoscope 10 and joining the ends of the band member 360 together with a hook-and-loop fastener, the band member 360 can be detachably attached to the operation section 14 while adjusting its length. Then, the first connection tube 302 and the second connection tube 304 are held by the tube holding section 362. This makes it possible to position the first connection tube 302 and the second connection tube 304 along the operation section 14 of the endoscope 10. Note that the band member 360 may be attached to the operation section 14 of the endoscope 10 after the first connection tube 302 and the second connection tube 304 are held by the tube holding section 362.

[0202] According to the eighth embodiment, the first connecting tube 302 and the second connecting tube 304 are held by the operating section 14 of the endoscope 10 via the band member 360, so that these tubes do not get in the way when operating the endoscope 10, making the procedure easier.

[0203] Furthermore, in the eighth embodiment, as an example, the case where the tube holding portion 362 of the band member 360 holds two tubes (the first connection tube 302 and the second connection tube 304) has been described, but the present invention is not limited to this, and the tube holding portion 362 may hold only one tube. In this case, a plurality of different band members 360 may be provided, one for each tube. Furthermore, the tube holding portion 326 of the band member 360 may hold three or more tubes.

[0204] Furthermore, in the eighth embodiment, as an example, a configuration was shown in which the other end of the tube holding portion 362 is detachable from the outer surface of the band member 360, but this is not limited to this, and for example, the tube holding portion 362 may have a loop shape and both ends thereof may be fixed to the outer surface of the band member 360.

[0205] In the eighth embodiment, as an example, the first connecting tube 302 and the second connecting tube 304 are held by the tube holding portion 362 of the band member 360. However, any tube other than the first connecting tube 302 and the second connecting tube 304 may be used as long as it is a tube for supplying air to and suctioning from the first balloon 120 or the second balloon 220. For example, it may be an extension tube that connects between the first connecting tube 302 and the first air supply port 132 (or between the second connecting tube 304 and the second air supply port 232).

[0206] Furthermore, in the eighth embodiment, as an example, the holding member is shown to be configured as a band member 360, but this is not limited thereto, and the band member 360 may be configured as, for example, a string-like member as long as it can be fixed to the operating section 14 of the endoscope 10.

[0207] [Ninth embodiment] 22 is an explanatory diagram for explaining the ninth embodiment. The ninth embodiment is similar to the first embodiment except for the difference in the configuration of the tip portion of the endoscope insertion portion 12. The following describes the differences from the first embodiment.

[0208] 22, a third balloon 44 formed of various elastic materials is provided on the outer peripheral surface on the distal end side of the endoscope insertion portion 12. The third balloon 44 has basically the same configuration as the first balloon 120 and the second balloon 220 described above, and therefore a detailed description thereof will be omitted here.

[0209] Although not shown, the balloon control device 300 is provided with a control system for the first balloon 120 and a control system for the second balloon 220, as well as a control system for the third balloon 44, which includes a pressure pump, a pressure reduction pump, an electromagnetic valve, and a pressure sensor, and these pumps and electromagnetic valves are controlled by a controller 322 (see FIG. 5). As a result, the third balloon 44 is inflated and deflated by the supply and suction of air by the balloon control device 300.

[0210] The method of inserting the endoscope insertion portion 12 in the ninth embodiment is basically the same as that in the first embodiment described above, but differs in the following respects.

[0211] In the first embodiment, when the inner tube 100 and the outer tube 200 are repeatedly advanced and retreated, the tip portion of the endoscope insertion portion 12 is not fixed to the intestinal tract, and the tip side is in a so-called cantilever state where it is free.

[0212] In contrast to this, in the ninth embodiment, the third balloon 44 is attached to the tip portion of the endoscope insertion portion 12, and therefore, when the inner tube 100 and the outer tube 200 are repeatedly advanced and retreated, the tip portion of the endoscope insertion portion 12 can be fixed to the intestinal tract by inflating the third balloon 44 and engaging it with the inner wall surface of the intestinal tract. Therefore, even if the protruding region of the endoscope insertion portion 12 protruding from the inner tube 100 is long, fixing the tip portion of the endoscope insertion portion 12 to the intestinal tract makes it possible to stably advance and retreat the inner tube 100 and the outer tube 200.

[0213] [others] The hardware structure that executes various controls of the balloon control device 300 of each of the above embodiments is the following various processors. The various processors include a CPU (Central Processing Unit), which is a general-purpose processor that executes software (programs) and functions as various control units, a programmable logic device (PLD), such as an FPGA (Field Programmable Gate Array), whose circuit configuration can be changed after manufacturing, and an ASIC (Application Specific Integrated Circuit). This includes dedicated electrical circuits, such as processors with circuitry designed specifically to perform specific processing, such as a PLC (Programmable Circuit).

[0214] A processing unit may be configured with one of these various processors, or with two or more processors of the same or different types (for example, multiple FPGAs, or a CPU and an FPGA). A combination of the above-mentioned control units. Also, the multiple control units may be configured by a single processor. As an example of configuring multiple control units by a single processor, first, there is a form in which one processor is configured by a combination of one or more CPUs and software, as typified by computers such as client and server, and this processor functions as multiple control units. Second, there is a form in which a processor is used to realize the functions of the entire system including multiple control units by a single IC (Integrated Circuit) chip, as typified by System On Chip (SoC). In this way, the various control units are configured by using one or more of the above-mentioned various processors as a hardware structure.

[0215] Of course, any of the above embodiments may be combined.

[0216] Although the embodiments of the present invention have been described above, the present invention is not limited to the above examples, and various improvements and modifications may be made without departing from the spirit of the present invention. [Explanation of symbols]

[0217] 1. Endoscopy system 10 Endoscopy 12 Endoscope insertion part 14 Control section 16 Universal Code 20 Tip 22 Curved section 24 Soft part 30 Air and water supply button 32 Suction button 34 Angle knob 36 Treatment tool inlet 38 Tip surface 40 indicators 42 Stopper part for endoscope insertion part 42a Endoscope insertion part stopper surface 44 Third Balloon 50 Overtube 52 Endoscope insertion passage 100 inner tube 102 Inner tube body 104 Inner tube grip 104a Small diameter section 106 First Passage 108 Proximal opening 110 Tip opening 120 First Balloon 120a Mounting part 120b Mounting part 120c bulge 121 Thread 122 First air supply and exhaust line 124 First liquid line 124a Branch Pipe 124b Branch pipeline 126 First air supply suction port 128 First liquid supply port 130 First balloon air supply pipe 132 First air outlet 134 1st liquid supply pipe 136 1st injection port 140 Inner supply port 142 Outside supply port 150 First Sensor 152 indicators 154 1st finger rest 160 Common pipeline 160a Branch 162 Air line 164 Suction line 166 Air supply pipe line 168 Suction source pipeline 170 Valve housing 172 Communication space 174 Pipe switching valve 176 Valve body 176a Shaft 176b Head 176c flange 178 Sealing member 180 Spring material 182 1st communication passage 184 2nd communication passage 186 Inner tube stopper 186a Inner tube stopper surface 200 outer tube 202 outer tube body 204 Outer tube grip 204a Small diameter section 206 Second Passage 208 Proximal opening 210 Tip opening 220 Second Balloon 220a Mounting part 220b Mounting part 220c bulge 221 Thread 222 Second air supply and exhaust line 224 Second liquid line 226 Second air supply suction port 228 Second liquid supply port 230 Second balloon air supply pipe 232 Second air outlet 234 2nd liquid supply pipe 236 2nd inlet 250 Second Sensor 254A 2nd finger rest 254B 2nd finger rest 300 Balloon control device 302 First connecting tube 304 Second connecting tube 306 Remote Controller 310 Pressure Pump 312 Pressure reducing pump 314 Solenoid valve 316 Pressure Pump 318 Pressure reducing pump 320 Solenoid valve 322 Controller 324 tubes 326 tubes 328 tubes 330 tubes 332 tubes 334 tube 336 Pressure Sensor 338 Pressure Sensor 350 Intestinal Tract 360 Band material 362 Tube holding part 364 Hook surface 366 Loop Surface K center axis

Claims

1. A long, flexible overtube, an inner tube having a first insertion passage through which an endoscope insertion portion can be inserted; an outer tube having a second insertion passage through which the inner tube can be inserted; A first balloon provided at a tip portion of the inner tube; A second balloon provided at a tip portion of the outer tube; Equipped with The effective length of the outer tube is 1200 mm or more and 1700 mm or less, The effective length of the inner tube is 1400 mm or more and 2000 mm or less, when the endoscope insertion portion is inserted into the first insertion passage and the inner tube is inserted into the second insertion passage, a total maximum protrusion length which is a sum of a first maximum protrusion length of the endoscope insertion portion from a tip of the inner tube and a second maximum protrusion length of the inner tube from a tip of the outer tube is 300 mm or more and 800 mm or less, The first maximum protruding length is 100 mm or more and 550 mm or less, The second maximum protrusion length is 200 mm or more and 700 mm or less, a maximum protrusion length ratio, which is a ratio of the first maximum protrusion length to the second maximum protrusion length, is 0.15 or more and 1.0 or less; Overtube.

2. The axial length of at least one of the first balloon and the second balloon is 50 mm or more. The overtube according to claim 1 .

3. The balloon has a bulge portion that can be expanded and contracted, The bulge portion has an axial length of 30 mm or more. The overtube according to claim 2 .

4. an inner tube gripping portion provided at a base end of the inner tube; an outer tube gripping portion provided at a base end portion of the outer tube; Equipped with The axial length of each of the inner tube gripping portion and the outer tube gripping portion is 15 mm or more and 200 mm or less. The overtube according to claim 1 .

5. the inner tube has an inner tube stopper portion in an inner tube protruding region protruding from a tip end of the outer tube, the inner tube stopper portion has an inner tube stopper surface that abuts against a tip end of the outer tube to restrict movement of the inner tube toward a base end side in an axial direction relative to the outer tube, The overtube according to claim 1 .

6. The inner tube stopper portion is a large diameter portion having an outer diameter larger than an inner diameter of the second insertion passage. The overtube according to claim 5 .

7. the inner tube stopper portion is provided at a position closer to the base end than the first balloon and within 100 mm from the tip of the inner tube toward the base end. The overtube according to claim 5 .

8. The inner tube stopper portion is detachably attached to the inner tube. The overtube according to claim 5 .

9. The inner tube has a lubricant supply portion for supplying a lubricant, The lubricant supply unit has an inner supply port that opens to an inner circumferential surface of the inner tube and an outer supply port that opens to an outer circumferential surface of the inner tube. The overtube according to claim 1 .

10. the inner tube has an inlet for the lubricant, The inlet is in communication with the inner supply port and the outer supply port. The overtube according to claim 9 .

11. The inner tube has an index indicating a relative axial position with respect to the outer tube. The overtube according to claim 1 .

12. an inner tube gripping portion provided at a base end of the inner tube; an outer tube gripping portion provided at a base end portion of the outer tube; The overtube of claim 1 .

13. the inner tube gripping portion has a first finger hook portion on which an operator can hook a finger, The outer tube gripping portion has a second finger hook portion on which the operator can hook a finger other than the first finger. The overtube according to claim 12.

14. The inner tube gripping portion is detachably attached to the inner tube. The overtube according to claim 12.

15. a relative movement detection unit that detects a relative axial movement between the outer tube and the inner tube, The overtube according to claim 1 .

16. The relative movement detection unit includes a proximity sensor or a position sensor. The overtube according to claim 15.

17. A movement direction detection unit is provided to detect the axial movement direction of the inner tube. The overtube according to claim 1 .

18. The movement direction detection unit includes an orientation sensor or an angular velocity sensor. The overtube according to claim 17.

19. At least one of the inner tube and the outer tube is a common pipe having one end connected to one of the first balloon and the second balloon that is provided on the tube; an air supply pipe line and a suction pipe line branched and connected to the other end of the common pipe line; an air supply source line communicating with an air supply source; a suction source line communicating with a suction source; an air supply state in which the air supply conduit and the air supply source conduit are in communication with each other and the suction conduit and the suction source conduit are blocked; a suction state in which the suction pipe is in communication with the suction pipe; a first communication passage that communicates the air supply source pipe with a space on an outer circumferential surface side or an inner circumferential surface side of the tube; a second communication passage that communicates the suction source conduit with a space on an outer circumferential surface side or an inner circumferential surface side of the tube; The overtube of claim 1 .

20. An overtube according to any one of claims 1 to 19; a balloon control device that controls air supply and suction to the first balloon and the second balloon; Equipped with the overtube includes a relative movement detection unit that detects a relative axial movement between the outer tube and the inner tube; a movement direction detection unit that detects an axial movement direction of the inner tube; having The balloon controller includes at least one processor; The processor, when the relative movement detection unit detects a movement of the tip of the outer tube and the tip of the inner tube in a direction away from each other, the suction of the second balloon is started; when the relative movement detection unit detects a movement of the tip of the outer tube and the tip of the inner tube in a direction toward each other, the relative movement detection unit starts supplying air to the second balloon; When the movement direction detection unit detects the movement of the inner tube toward the axial tip side, air supply to the first balloon is started. When the movement direction detection unit detects the movement of the inner tube toward the base end side in the axial direction, suction to the first balloon is started. Endoscopy system.

21. A remote controller connected to the balloon control device, The detection results of the relative movement detection unit and the movement direction detection unit are notified to the balloon control device via the remote controller. The endoscope system of claim 20.

22. An overtube according to any one of claims 1 to 19; an endoscope having the endoscope insertion portion; Equipped with the endoscope insertion portion has an endoscope insertion portion stopper portion in an endoscope insertion portion protruding region protruding from a tip of the inner tube, the stopper portion for the endoscope insertion portion has a stopper surface for the endoscope insertion portion that restricts movement of the endoscope insertion portion toward the base end side in the axial direction relative to the inner tube by abutting against a tip end of the inner tube, Endoscopy system.

23. The endoscope insertion portion stopper portion is a large diameter portion having an outer diameter larger than an inner diameter of the first insertion passage. The endoscopic system of claim 22.

24. The endoscope insertion portion stopper portion is detachable from the endoscope insertion portion. The endoscopic system of claim 22.

25. An overtube according to any one of claims 1 to 19; an endoscope having the endoscope insertion portion and an operation portion connected to a base end side of the endoscope insertion portion; a holding member that is detachably provided on the operation unit and holds at least one of a first tube for supplying air to and suctioning the first balloon and a second tube for supplying air to and suctioning the second balloon; An endoscope system comprising:

26. An overtube according to any one of claims 1 to 19; an endoscope having the endoscope insertion portion; Equipped with The effective length of the endoscope insertion portion is 2000 mm. Endoscopy system.

27. An overtube according to any one of claims 1 to 19; an endoscope having the endoscope insertion portion; Equipped with A third balloon is provided at the tip of the endoscope insertion portion. Endoscopy system.

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