Endoscopy

Abstract

Provided is an endoscope (10) whereby both the insertability and standing ability of a treatment instrument (13) in a distal end part of the endoscope are improved.　The endoscope (10) is provided with: an insertion part (14) that is inserted into a subject; a distal end part body (31); a treatment instrument contact part (38); and a raising stand (39). The distal end part body (31) has a raising stand accommodation space (37) in communication with a treatment instrument outlet (35). The treatment instrument contact part (38) is provided in the raising stand accommodation space (37), and is brought into contact with the treatment instrument (13) to control the direction of advance of the treatment instrument (13). The raising stand (39) is provided in the raising stand accommodation space (37), and raises the treatment instrument (13) the advance direction of which is controlled by the treatment instrument contact part (38).

Description

[Technical Field]

[0001] The present invention relates to an endoscope having a treatment tool stand at the distal end of an insertion section. [Background technology]

[0002] In recent years, diagnosis or treatment using endoscopes has become increasingly common in the medical field. An endoscope comprises an insertion section that is inserted into a subject and an operation section that is connected to the proximal end of the insertion section. The operation section is provided with a treatment tool introduction port (forceps port) through which various treatment tools are introduced. The introduced treatment tool is led out of a treatment tool outlet that opens at the distal end of the insertion section and protrudes outside the distal end, where it is used to treat the object being observed. In a side-viewing endoscope, the distal end is provided with a treatment tool outlet through which the treatment tool protrudes in a direction perpendicular to the axial direction of the insertion section, and the distal end is provided with a stand that comes into contact with the treatment tool to raise it up and lock it in place.

[0003] The operating unit is provided with an operation input unit such as a standing operation lever or a bending operation knob. By operating the standing operation lever, the position of the stand provided at the distal end is controlled to lie down or stand up. As a result, the treatment tool is supported by the stand and raised toward the treatment tool outlet, or the erected treatment tool is held in place by being clamped between the distal end main body forming the treatment tool outlet and the stand.

[0004] Various shapes of elevators have been disclosed. For example, a elevator that can hold a treatment tool without damaging the treatment tool or compressing the catheter has been disclosed (Patent Document 1). This elevator has a gripping tip made of a polymer material. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2008-536579 Summary of the Invention [Problem to be solved by the invention]

[0006] When the treatment tool is raised by the raising stand, the treatment tool is led out from the treatment tool outlet and the raising stand is operated from the reclined position to the raised position. This operation causes the treatment tool to be supported by the raising stand and to rise as the raising stand rises. When the treatment tool is raised by this operation, the treatment tool is bent near the treatment tool outlet, and the contact point between the treatment tool and the upper part of the treatment tool outlet provided on the distal end main body becomes the fulcrum, and the contact point between the treatment tool and the raising stand becomes the force point, causing the treatment tool to be raised.

[0007] 16, when the treatment tool insertion channel 61 is formed in a state nearly horizontal to the axial direction Ax of the insertion portion at the treatment tool outlet 62 provided in the distal end main body 67, the distance D1 between the fulcrum 65 and the force point 66 can be made relatively long, so that less force is required to operate the erector 63 to erect the treatment tool 64. This also makes it easier to control the outlet direction of the treatment tool 64. Therefore, in this case, it can be said that the erector force of the erector 63 is high.

[0008] In this case, however, there is a possibility that the tip of the treatment tool 64 coming out of the treatment tool outlet 62 will come into contact with the stand 63 at an angle close to perpendicular, which may hinder the advancement of the treatment tool 64 and make it difficult for the treatment tool 64 to protrude outside the tip portion. To avoid this, it is necessary to lower the stand 63 more than necessary (to the collapsed position). Therefore, there is a possibility that a problem will occur with the insertion of the treatment tool.

[0009] 17, in order to improve the ease of insertion of the treatment tool, for example, if the treatment tool insertion channel 61 is formed with an inclination near the treatment tool outlet 62 in the direction in which the treatment tool 64 protrudes outward, the tip of the treatment tool 64 emerging from the treatment tool outlet 62 of the distal end main body 67 comes into contact with the raising table 63 at an inclination, thereby improving the ease of insertion of the treatment tool 64. However, when the raising table 63 is used to raise the treatment tool 64 emerging from the treatment tool outlet 62, the distance D2 between the fulcrum 65 and the force point 66 described above becomes shorter than the distance D1, which may require more force to operate the raising table 63 to raise the treatment tool 64 and may also make it difficult to operate the raising table 63 to control the outlet direction of the treatment tool 64. Therefore, in this case, the raising force may be reduced.

[0010] An object of the present invention is to provide an endoscope that can improve both the insertability of a treatment tool and the erection force at the distal end of the endoscope. [Means for solving the problem]

[0011] The present invention provides an endoscope, comprising: an insertion section to be inserted into a subject; a distal end section body located at the distal end of the insertion section, having a distal end surface with a treatment tool outlet and forming a stand accommodating space communicating with the treatment tool outlet; It is a member , The treatment instrument exited Treatment tools Tip By contacting Treatment tools and a stand provided in the stand accommodating space and configured to stand up the treatment tool whose direction of travel is controlled by the treatment tool contact part.

[0012] It is preferable that one end of the elevator is rotatably supported by the elevator support portion relative to the distal end portion main body, and the treatment tool contact portion is provided in the vicinity of the elevator support portion.

[0013] The treatment tool contact portion is preferably provided in a half region of the elevator support portion side in the longitudinal direction of the elevator.

[0014] It is preferable that the distal end portion body is provided with a cap that is attached to the distal end portion body and covers at least a part of the elevator housing space, and the treatment tool contact portion is provided on the cap.

[0015] The treatment tool contact portion is preferably provided on the distal end portion main body.

[0016] The treatment tool contact portion is preferably a protrusion.

[0017] The treatment tool contact portion preferably has a triangular prism shape.

[0018] It is preferable to provide a plurality of treatment tool contact portions.

[0019] The elevator preferably has a tip projection in a half area on the side opposite to the elevator support part in the longitudinal direction.

[0020] It is preferable that the treatment tool contact portion controls the direction of travel of the treatment tool in the direction of the tip protrusion when the stand is in the collapsed position, and that the stand has a tip protrusion at a position where the treatment tool comes into contact when the stand is in the upright position.

[0021] It is preferable that some or all of the components are disposable. [Effects of the Invention]

[0022] According to the present invention, in an endoscope equipped with a standing table, it is possible to improve both the insertability of a treatment tool and the standing force. [Brief explanation of the drawings]

[0023] [Figure 1] FIG. 1 is a perspective view showing an outline of an endoscope system. [Figure 2] FIG. 1 is a perspective view of a tip cap and a tip body. [Figure 3] FIG. 1 is a perspective view of a tip portion consisting of a tip cap and a tip portion body. [Figure 4] FIG. [Figure 5]FIG. 2 is a plan view of the tip body. [Figure 6] FIG. 10 is a perspective view of a stand having a treatment tool contact portion. [Figure 7] FIG. 10 is a perspective view of a distal end cap having a treatment tool contact portion. [Figure 8] 8A and 8B are perspective views of a distal end main body having a treatment tool contact portion, with Fig. 8A being a perspective view seen from one side, and Fig. 8B being a perspective view seen from another side different from (A). [Figure 9] FIG. 10 is a perspective view of a stand having a treatment tool contact portion with an adjusted inclination. [Figure 10] FIG. 10 is a perspective view of a stand having a treatment tool contact portion in the shape of a triangular prism. [Figure 11] FIG. 10 is a perspective view of a stand having a plurality of treatment tool contact portions. [Figure 12] FIG. 10 is a perspective view of a stand having a treatment tool contact portion and a distal end protrusion. [Figure 13] 10 is a cross-sectional view of a main part of the distal end portion showing an example of the relationship between the treatment tool and a stand having a treatment tool contact portion and a distal end protrusion. FIG. [Figure 14] 10 is a cross-sectional view of the essential part of the distal end portion showing another example of the relationship between the treatment tool and the raising base including the treatment tool contact portion and the distal end protrusion. FIG. [Figure 15] FIG. 10 is a flow diagram of a process for performing treatment with a treatment tool using an endoscope. [Figure 16] FIG. 10 is a cross-sectional view of the essential parts of the distal end showing an example of the relationship between a conventional treatment instrument channel, a treatment instrument, and an erection table. [Figure 17] FIG. 10 is a cross-sectional view of the essential parts of the distal end showing another example of the relationship between a conventional treatment instrument channel, a treatment instrument, and an erection table. DETAILED DESCRIPTION OF THE INVENTION

[0024] 1, the endoscope system 2 includes an endoscope 10, a processor device 11, a light source device 12, a treatment tool 13, and a display 21. The endoscope 10 has an insertion section 14 that is inserted into the body of a subject, an operation section 15 that is connected to the base end portion of the insertion section 14, and a universal cord 16 that is connected to the processor device 11 and the light source device 12. A connector 17 is attached to the tip of the universal cord 16. The endoscope 10 is communicably connected to the processor device 11 via the light source device 12 that is connected to the connector 17.

[0025] The insertion section 14 is divided into a distal section 14a, a bending section 14b, and a flexible tube section 14c, in that order from the distal end. The bending section 14b is connected to the proximal end side of the distal section 14a and is formed by connecting multiple bending pieces. The flexible tube section 14c is flexible and extends from the proximal end side of the bending section 14b to the connecting section of the operation section 15.

[0026] The endoscope 10 is a side-viewing endoscope primarily used as a duodenoscope. This type of endoscope has an insertion section 14 inserted into a subject's mouth, through the esophagus, stomach, and into the duodenum. In a side-viewing endoscope, a treatment tool 13 is inserted from the bile duct of the duodenum into the common bile duct or the like to perform a predetermined examination, treatment, or other procedure. Specific examples of the treatment tool 13 include biopsy forceps having a cup at the distal end 13a of the treatment tool 13 that can collect biological tissue, an EST (Endoscopic Sphincterotomy) knife, an imaging tube, and the like. In this specification, the treatment tool 13 refers to a treatment tool such as a biopsy forceps or a knife, as well as a wire or the like connected to the treatment tool for operating the treatment tool.

[0027] 2 and 3, the tip portion 14a includes a tip portion body 31 and a tip portion cap 32 that is detachably fitted onto the tip portion body 31. The tip portion cap 32 is attached to the tip portion body 31 when performing treatment using the endoscope 10. The tip portion cap 32 and the tip portion body 31 form a treatment tool outlet 33 from which the treatment tool 13 protrudes on the side surface of the tip portion 14a. After treatment is completed, the tip cap is removed from the tip portion body 31 and discarded. Therefore, the tip portion cap 32 is a disposable item.

[0028] The tip portion body 31 is located at the tip of the insertion section 14 and is made of a corrosion-resistant metal material, plastic material, or the like. The tip portion body 31 has a tip surface 36, and the tip surface 36 has a treatment tool outlet 35. A pair of partitions consisting of partitions 34a and 34b are provided on the tip surface 36 so as to face each other across the treatment tool outlet 35.

[0029] The distal end body 31, together with the partition wall 34a, the partition wall 34b, and the distal end surface 36, forms a stand-up table accommodating space 37 that communicates with the treatment tool outlet 35. The distal end cap 32 covers at least a portion of the stand-up table accommodating space 37. A treatment tool contact portion 38 that contacts the treatment tool 13 led out from the treatment tool outlet 35 and controls the direction of travel of the treatment tool 13 is provided in the stand-up table accommodating space 37. In this embodiment, the treatment tool contact portion 38 is provided on a stand-up table 39. The stand-up table 39 is provided in the stand-up table accommodating space 37. The stand-up table 39 stands up the treatment tool 13 whose direction of travel is controlled by the treatment tool contact portion 38.

[0030] Therefore, the treatment tool 13 led out from the treatment tool lead-out port 35 comes into contact with the treatment tool contact portion 38 of the stand 39, and the direction of travel is controlled by the treatment tool contact portion 38. By further advancing the treatment tool 13 and raising the stand 39, the treatment tool 13 guided by the stand 39 protrudes from the treatment tool lead-out port 33 to the outside of the tip end portion 14a.

[0031] The raising base 39 has one end rotatably supported by the raising base support part 40 with respect to the distal end portion main body 31, for example. As shown in FIG. 4 , the raising base support part 40 is an axis in this embodiment. Therefore, the raising base 39 can freely stand up and lie down around the raising base support part 40. The raising base 39, whose standing and lying positions are controlled, guides the treatment tool 13, thereby controlling the protruding direction of the treatment tool 13 and fixing the treatment tool 13 by sandwiching it between the raising base 39 and the distal end portion main body 31. The configurations and functions of the treatment tool contact part 38 and the raising base 39 will be described in detail later.

[0032] A flat portion 41 is formed on the upper part of the outer peripheral surface of the tip portion main body 31. Because a portion of the outer peripheral surface is formed by a partition wall, the flat portion 41 is provided on the upper part of the partition wall 34b. An illumination unit 42 and an observation unit 43 are provided on the flat portion 41 as observation means. The illumination unit 42 and the observation unit 43 are arranged side by side in the axial direction Ax of the insertion portion 14. Because the treatment tool 13 is led out from the treatment tool lead-out port 35 to the outside in the axial direction Ax of the insertion portion 14, the alignment of the illumination unit 42 and the observation unit 43 is parallel to the lead-out direction of the treatment tool 13, and the distance between the illumination unit 42 and the observation unit 43 and the treatment tool 13 is within a certain range. Therefore, regardless of the protruding direction of the treatment tool 13 depending on the standing state of the treatment tool 13, illumination and observation by the illumination unit 42 and the observation unit 43 can be performed without any problems.

[0033] In the flat portion 41, the endoscope 10 of the observation unit 43 Controls An air and water nozzle 44 is provided on the observation unit 43 side. An opening 45 of the air and water nozzle 44, through which a gas such as air or a liquid such as water is discharged, is arranged facing the observation unit 43. Therefore, by spraying gas and liquid from the air and water nozzle 44, dirt and the like adhering mainly to the observation unit 43 is washed away.

[0034] The illumination unit 42 has an optical system housing chamber inside the partition 34b, and an illumination section and an imaging section are housed inside the optical system housing chamber. The interior of the partition 34b is not shown. The illumination section has an illumination lens arranged on the optical system housing chamber side of the illumination unit 42, and a light guide arranged so that its emission end faces the illumination lens. The light guide is disposed on a universal cord 16 from the insertion section 14 of the endoscope 10 (see FIG. 1) via the operation section 15, and its proximal end is connected to the connector 17. As a result, when the connector 17 is connected to the light source device 12, illumination light from the light source device 12 is irradiated from the illumination unit 42 via the light guide onto the field of view of the endoscope 10.

[0035] The observation unit 43 is provided with a side-viewing observation optical system for observing the side-viewing direction of the insertion section 14, and an image sensor such as a CMOS (complementary metal oxide semiconductor) or a CCD (charge coupled device) is disposed at the imaging position of this side-viewing observation optical system. A signal cable is connected to the image sensor, and the signal cable is disposed in a universal cord 16 from the insertion section 14 of the endoscope 10 (see FIG. 1) via the operation section 15, and its base end is connected to a connector 17. Thus, when the connector 17 is connected to the processor device 11, an imaging signal of the subject image obtained by the observation unit 43 is transmitted to the processor device 11 via the signal cable.

[0036] The operation section 15 (see FIG. 1) is provided with a treatment tool inlet 18, a bending operation knob 19, and an upright operation lever 20. The treatment tool 13 is introduced from the treatment tool inlet 18 with the treatment tool tip 13a at the front, inserted into a treatment tool channel provided inside the insertion section 14, and led out of the tip section 14a from a treatment tool lead-out port 35 provided in the tip section main body 31.

[0037] When the bending operation knob 19 is operated, the angle wire inserted in the insertion section 14 is pushed and pulled, causing the bending section 14b to bend up, down, left, and right, thereby directing the tip section 14a in a desired direction inside the body.

[0038] The standing operation lever 20 is provided so as to be freely rotatable. When the standing operation lever 20 is rotated, a standing table wire (not shown) inserted in the insertion section 14 is pushed or pulled in conjunction with the rotation of the standing operation lever 20. By operating the standing table wire in this manner, the position of the standing table 39 connected to the tip end of the standing table wire is changed between a lying position and an erect position.

[0039] The operation unit 15 is also provided with an air / water supply button 46 and a suction button 47. When the air / water supply button 46 is operated, air and water, for example, are supplied to an air / water supply tube (not shown), and the air and water can be ejected from the air / water supply nozzle 44 provided on the tip portion main body 31. The air / water supply button 46 is a multi-stage push button; for example, air is supplied to the air / water supply tube by operating it in one stage, and water is supplied to the air / water supply tube by operating it in two stages. When the suction button 47 is operated, bodily fluids such as blood can be suctioned through the treatment tool channel from the suction port that also serves as the treatment tool outlet 35.

[0040] The processor device 11 (see FIG. 1) receives an image signal output from a CCD or the like via a signal cable and performs various image processing to generate image data. The image data generated by the processor device 11 is displayed as an observation image on a display 21 connected to the processor device 11.

[0041] Next, the configurations and functions of the treatment tool contact portion 38 and the stand 39 will be described in detail. The treatment tool contact portion 38 is provided to control the direction of travel of the treatment tool 13 by contacting it with the treatment tool 13 emerging from the treatment tool outlet 35. The treatment tool 13 advances in the axial direction Ax in the treatment tool channel, but after emerging from the treatment tool outlet 35, contact with the treatment tool contact portion 38 allows the treatment tool 13 to appropriately change its direction of travel while improving the insertability of the treatment tool 13. The treatment tool 13, whose direction of travel has been appropriately changed, smoothly protrudes from the treatment tool outlet 33. The treatment tool contact portion 38 is provided on the path of the treatment tool 13 in the stand accommodating space 37.

[0042] Furthermore, it is preferable that the first member that the treatment tool 13 comes into contact with after emerging from the treatment tool outlet 35 is the treatment tool contact portion 38. "First contact" means that when the stand 39 is in the collapsed position, the treatment tool 13, emerging from the treatment tool outlet 35, first comes into contact with the treatment tool contact portion 38 without coming into contact with any other member. When the treatment tool 13 comes into contact with a member other than the treatment tool contact portion 38, such as the stand 39, depending on the angle of contact and other circumstances, the path of the treatment tool 13 may be obstructed, preventing the treatment tool 13 from advancing any further, or the direction of travel of the treatment tool 13 may be changed to a direction other than the treatment tool outlet 33.

[0043] Furthermore, when the protruding direction of the treatment tool 13 is controlled by the raising base 39, the treatment tool 13 is bent toward the treatment tool outlet 33 by bringing the raising base 39, which comes into contact with the treatment tool 13 and raises it, into the raised position. Generally, in this case, the point of contact between the treatment tool 13 and the upper part of the treatment tool outlet 35 becomes the fulcrum (65), and the point of contact between the treatment tool 13 and the raising base 39 becomes the force point (66) (see FIG. 16 ). By increasing the distance (D1) between this fulcrum and the force point, the raising force of the raising base 39, which is the force for raising the treatment tool 13 when the raising base 39 is in the raised position, can be further improved.

[0044] Therefore, it is preferable to install the raising table 39 in a position and shape such that the treatment tool contact portion 38 serves as a fulcrum when the treatment tool 13 is bent toward the treatment tool outlet 33 by setting the raising table 39 in the upright position, and to install the raising table 39 in a position and shape such that the force point is at a position farther away from the fulcrum. This reduces the force required to operate the raising table 39 to raise the treatment tool 13. This also makes it easier to control the lead-out direction of the treatment tool 13. Therefore, the raising force of the raising table 39 can be improved.

[0045] As shown in FIG. 5 , the treatment tool contact portion 38 is preferably provided in the vicinity 40a of the stand support portion 40. The vicinity 40a of the stand support portion 40 is a position where, if the treatment tool contact portion 38 is provided at this position, the treatment tool 13 emerging from the treatment tool outlet 35 will first come into contact with the treatment tool contact portion 38. The vicinity 40a of the stand support portion 40 may also be the portion on the stand support portion 40 side when the stand accommodation space 37 is divided into two in the axial direction Ax. By providing the treatment tool contact portion 38 in the vicinity 40a of the stand support portion 40, the treatment tool 13 emerging from the treatment tool outlet 35 will first come into contact with the treatment tool contact portion 38, and there is no risk of the treatment tool 13 coming into contact with other components or the like and being prevented from being led out. This allows the treatment tool contact portion 38 to function effectively, improving the ease of insertion of the treatment tool 13.

[0046] When the treatment tool contact portion 38 is provided, specific examples include providing the treatment tool contact portion 38 on the stand 39 as shown in Fig. 6, providing the treatment tool contact portion 38 on the tip cap 32 as shown in Fig. 7, or providing the treatment tool contact portion 38 on the tip body 31 as shown in Figs. 8(A) and 8(B). In any case, when the treatment tool 13 exiting the treatment tool outlet 35 advances through the stand accommodation space 37, it comes into contact with the treatment tool contact portion 38, thereby appropriately changing the traveling direction of the treatment tool 13 to the treatment tool outlet 33. The choice of which method to use can be determined depending on the type and shape of the treatment tool 13, the purpose of the treatment, etc.

[0047] In this embodiment, a treatment tool contact portion 38 is provided on the stand 39 (see FIG. 6). When the treatment tool contact portion 38 is provided on the stand 39, it can be preferably used for all treatment tools 13 regardless of the type of treatment tool 13.

[0048] Furthermore, when the treatment tool contact portion 38 is provided on the stand 39, it is preferable to provide it in an area within half of the stand 39 on the stand support portion 40 side in the longitudinal direction. standing platformIt is preferable that the treatment tool contact portion 38 be provided in an area within 1 / 4 of the length of the treatment tool outlet 35 on the side of the stand support portion 40 in the longitudinal direction of the treatment tool 13. By providing the treatment tool contact portion 38 in the above area, the treatment tool 13 coming out of the treatment tool outlet 35 can contact the treatment tool contact portion 38 without contacting other components, etc., and therefore the direction of travel of the treatment tool 13 can be appropriately controlled.

[0049] The distal end cap 32 may be provided with a treatment tool contact portion 38 (see FIG. 7). When the distal end cap 32 is provided with the treatment tool contact portion 38, it is preferable to provide it at a position where the treatment tool 13 coming out of the treatment tool outlet 35 can contact the treatment tool contact portion 38 without contacting other components, etc. Furthermore, after the treatment tool 13 comes into contact with the treatment tool contact portion 38 and its direction of travel is changed, it contacts the stand 39 in accordance with the movement of the stand 39, thereby controlling the position, etc. of the treatment tool 13. Therefore, it is preferable to provide the treatment tool contact portion 38 at a position that does not interfere with the movement of the stand 39. In FIG. 7, the distal end cap 32 has two treatment tool contact portions 38, but it may have one or three or more.

[0050] Furthermore, since the tip cap 32 is attached to the tip portion body 31, it is possible to change the installation position of the treatment tool contact portion 38, or to prepare a plurality of tip caps 32 with different shapes, numbers, or positions of the treatment tool contact portions 38, and select an appropriate tip cap 32 according to the shape or type of the treatment tool 13, for example, and attach it to the tip portion body 31. Therefore, by simply selecting a tip cap 32 and attaching it to the tip portion body 31, it is possible to provide treatment tool contact portions 38 appropriate for a plurality of types of treatment tools 13.

[0051] The distal end body 31 may be provided with a treatment tool contact portion 38 (see FIGS. 8A and 8B). When the treatment tool contact portion 38 is provided on the distal end body 31, it is preferable that the treatment tool contact portion 38 be provided at a position where the treatment tool 13 coming out of the treatment tool outlet 35 can contact the treatment tool contact portion 38 without contacting other components, as in the case of providing the treatment tool contact portion 38 on the distal end cap 32. It is also preferable that the treatment tool contact portion 38 be provided at a position where it does not interfere with the movement of the treatment tool 13. As shown in FIGS. 8A and 8B, the distal end body 31 has two treatment tool contact portions 38. Specifically, one treatment tool contact portion 38 is provided on the distal end body 31 in contact with the partition wall 34a, and the other treatment tool contact portion 38 is provided in contact with the partition wall 34b. As shown in FIGS. 8A and 8B, these treatment tool contact portions 38 may also function as the stand support portion 40. The distal end body 31 may be provided with one or three or more treatment tool contact portions 38.

[0052] In addition, when the distal end cap 32 or the distal end body 31 is provided with the treatment tool contact portion 38, the stand 39 is in the collapsed position. stand up Therefore, the treatment tool contact portion 38 does not move in conjunction with the rotational movement that moves the raising table 39 between the above positions. Therefore, there is no risk that the treatment tool contact portion 38 will get in the way when the raising table 39 is raised or the like, which is preferable.

[0053] The treatment tool contact portion 38 is preferably a protrusion. The protrusion refers to a portion that protrudes from the surroundings, and the surroundings refers to the periphery of the location where the treatment tool contact portion 38 is provided. Specifically, the surroundings refers to the installation surface of the treatment tool contact portion 38, such as the stand 39, the tip cap 32, or the tip body 31.

[0054] The shape of the treatment tool contact portion 38 is preferably such that when the treatment tool 13 coming out of the treatment tool outlet 35 first comes into contact with the treatment tool contact portion 38, the treatment tool 13 does not hinder its advancement and the direction of advancement can be appropriately controlled. For example, the shape of the treatment tool contact portion 38 is preferably such that the portion close to the treatment tool outlet 35 is gentle, and the height or angle of the protrusion is adjusted so that the protrusion gradually moves in the desired direction of advancement. As shown in FIG. 9, in this embodiment, the treatment tool contact portion 38 is provided as a gently sloping protrusion in a position close to the stand support portion 40 of the stand 39, and the angle is adjusted to a sudden The angle of the mountain-shaped protrusion in the treatment tool contact portion 38 is set to allow smooth and easy advancement of the treatment tool 13 depending on the type of treatment tool 13 or the position or shape of the treatment tool 13 and the treatment tool channel. Also, as shown in Fig. 10, the treatment tool contact portion 38 may be in the shape of a triangular prism.

[0055] The shape or installation position of the treatment tool contact portion 38 is preferably such that the distance between the fulcrum and the force point described above is long when the stand 39 is in the upright position. Therefore, the shape of the treatment tool contact portion 38 is preferably such that the angle of the portion close to the treatment tool outlet 35 is gentle, this portion guides the progress of the treatment tool 13, and the highest position of the treatment tool contact portion 38 compared to its surroundings, i.e., the position that serves as the force point, is farther from the treatment tool outlet 35. Therefore, when the stand support portion 40 of the stand 39 is the axis, it is preferable that the treatment tool contact portion 38 has the shape of a triangular prism that is installed so that the contact surface of the treatment tool 13 forms the widest side of the triangular prism when viewed from the axial direction (see FIG. 10 ). This is because the highest ridge of the triangular prism farthest from the stand support portion 40 can be used as the force point.

[0056] A plurality of treatment tool contact portions 38 may be provided. The number of treatment tool contact portions 38 can be determined depending on the type, shape, size or thickness, function, etc. of the treatment tool 13. For example, as shown in Fig. 11, in order to guide a relatively thick treatment tool 13, two triangular prism-shaped protrusions can be provided on both ends of the stand 39 in the width direction at positions near the stand support portion 40 of the stand 39.

[0057] When multiple treatment tool contact portions 38 are provided, they can be used for thick treatment tools 13. Because thick treatment tools 13 tend to have high rigidity, if there are no treatment tool contact portions 38, the treatment tool 13 will get caught on the longitudinal central region of the stand 39 as the treatment tool 13 advances, and the advancement of the treatment tool 13 will likely be hindered. Therefore, by providing multiple treatment tool contact portions 38, even for treatment tools 13 that have problems with insertability, such as thick treatment tools 13, the insertability can be improved without affecting anything else.

[0058] Furthermore, when a plurality of treatment tool contact portions 38 are provided, it is possible to set the position, shape, etc. of the plurality of treatment tool contact portions 38 in detail in accordance with the shape, etc. of the treatment tool 13. For example, depending on the shape, etc. of the treatment tool 13, it is possible to provide a plurality of treatment tool contact portions 38 asymmetrically on the stand 39, or to provide each of the plurality of treatment tool contact portions 38 with a different shape, thereby providing a high degree of freedom in installation and allowing the optimum one to be installed in accordance with the treatment tool 13.

[0059] In this embodiment, the treatment tool contact portion 38 is provided on the stand 39. However, the shape, type, installation position, etc. of the treatment tool contact portion 38 can also be applied to a case where the treatment tool contact portion 38 is provided on the distal end cap 32 or the distal end body 31 (see FIG. 7 or FIG. 8). Therefore, even when the treatment tool contact portion 38 is provided on the distal end cap 32 or the distal end body 31, treatment tool contact portions 38 of various shapes can be provided, and multiple treatment tool contact portions 38 can be provided in different locations. Furthermore, when multiple treatment tool contact portions 38 are provided, the treatment tool contact portions 38 may be provided on different members. For example, when multiple treatment tool contact portions 38 are provided, some of the treatment tool contact portions 38 may be provided on the distal end cap 32 and some may be provided on the distal end body 31.

[0060] The elevator 39 may be provided with a tip protrusion in a half region opposite the elevator support unit 40 side in the longitudinal direction of the elevator 39. The half region opposite the elevator support unit 40 side refers to the region on the opposite side of the elevator support unit 40 side when the elevator 39 is positioned halfway in the longitudinal direction Lx. This region is the region at the tip of the elevator 39, and when the elevator 39 is in the upright position, this region comes into contact with the wire or the like of the treatment tool 13 protruding from the treatment tool outlet 33, and the contacted part serves as the above-mentioned point of force, causing the treatment tool 13 to stand up and being clamped and fixed together with the tip body 31. The protrusion provided in this region is called the tip protrusion, and by providing the tip protrusion, the treatment tool 13 protruding outside the tip can be more firmly fixed by the tip body 31 and the tip protrusion. Furthermore, even if the treatment tool 13 is thin and therefore difficult to fix, the treatment tool 13 can be fixed more reliably.

[0061] As shown in FIG. 12 , the distal protrusion 51 is provided in a half of the region of the stand 39 opposite the stand support portion 40 in the longitudinal direction Lx. The shape or installation position of the distal protrusion 51 is preferably such that it does not hinder the advancement of the treatment tool 13 when the treatment tool 13 is introduced. If the distal protrusion 51 is provided without the treatment tool contact portion 38, there is a risk that the distal protrusion 51 will hinder the advancement of the treatment tool 13 when the treatment tool 13 is introduced. However, if the treatment tool contact portion 38 is provided and then the distal protrusion 51 is provided, the shape or installation position of the distal protrusion 51 can be set with a relatively high degree of freedom, and there is little risk of the distal protrusion 51 hindering the advancement of the treatment tool 13 when the treatment tool 13 is introduced. This is because the treatment tool contact portion 38 controls the advancement direction of the treatment tool 13 in advance. Therefore, it is preferable that both the treatment tool contact portion 38 and the distal protrusion 51 are provided on the stand 39.

[0062] Furthermore, it is preferable that the raising table 39 has a tip protrusion 51 at a position where the treatment tool 13 comes into contact when the raising table 39 is in the raised position, and that the treatment tool contact portion 38 controls the traveling direction of the treatment tool 13 so that it comes into contact with the tip protrusion 51 when the raising table 39 is in the reclined position. In the raising table 39 having the tip protrusion 51, the treatment tool tip 13a protruding from the treatment tool outlet 35 may or may not come into contact with the tip protrusion 51. However, as will be described below, in either case, when the raising table 39 moves to the raised position, the tip protrusion 51 of the raising table 39 comes into contact with the treatment tool 13, and this contact point becomes a force point, so that the treatment tool 13 can be easily raised by the tip protrusion 51.

[0063] After the treatment tool 13 comes into contact with the treatment tool contact portion 38, when it is further advanced and the raising base 39 raises the treatment tool 13, it is preferable that the raising base 39 and the treatment tool 13 contact only at the tip protrusion 51. In particular, when the angle at which force is required to raise the treatment tool 13, that is, when the raising base 39 is in a position close to a lying state, it is preferable that the raising base 39 and the treatment tool 13 contact only at the tip protrusion 51. This is because the tip protrusion 51 becomes a force point away from the above-mentioned fulcrum, and the treatment tool 13 can be raised with less force.

[0064] 13 , specifically, when the tip of the treatment tool 13 led out from the treatment tool outlet 35 comes into contact with the treatment tool contact portion 38, is further led out to the treatment tool outlet 33, and also comes into contact with the tip protrusion 51, by raising the stand 39 in this state, for example, to about one-third of the maximum raised position, the treatment tool 13 moves away from the treatment tool contact portion 38. Furthermore, as the stand 39 rises, the point where the treatment tool 13 contacts the tip main body 31 becomes a fulcrum 52, and the point where the treatment tool 13 contacts the tip protrusion 51 becomes a force point 53. In other words, the stand 39 and the treatment tool 13 contact only at the force point 53. Therefore, the stand 39 comes into contact with the treatment tool 13 at a point away from the fulcrum 52 to raise the treatment tool 13, and the treatment tool 13 can be raised with less force.

[0065] 14, when the tip of the treatment tool 13 led out from the treatment tool outlet 35 comes into contact with the treatment tool contact portion 38 and is further led out to the treatment tool outlet 33 without coming into contact with the tip projection 51, by raising the stand 39 in this state, for example, to about one-third of the maximum raised position, the tip projection 51 comes into contact with the treatment tool 13, and the treatment tool 13 moves away from the treatment tool contact portion 38. As in the case of FIG. 13, as the stand 39 rises, the stand 39 and the treatment tool 13 come into contact only at the force point 53, and the stand 39 comes into contact with the treatment tool 13 at a point away from the fulcrum 52 to raise the treatment tool 13, so that the treatment tool 13 can be raised with less force.

[0066] In this way, the stand 39 is in the standing position. WhenIn order to provide the distal end protrusion 51 at the position where the treatment tool 13 comes into contact, the shape or position of the treatment tool contact portion 38 or the distal end protrusion 51 can be adjusted. In this case, the treatment tool contact portion 38 may be provided on the stand 39 as in this embodiment, or on the distal end cap 32 or the distal end body 31.

[0067] Furthermore, it is preferable that the endoscope 10 is partially or entirely disposable. In particular, it is preferable that parts that may be susceptible to infection if reused are disposable. Therefore, it is preferable that the distal end portion 14a be disposable, and in particular, the distal end body 31, the stand 39, the distal end cap 32, and the treatment tool contact portion 38 are disposable. This eliminates the need to consider cleaning uneven portions, even for the stand 39, the distal end body 31, or the distal end cap 32 that includes the treatment tool contact portion 38, or the stand 39 that includes the distal end protrusion 51. This allows for a high degree of freedom in the design and placement of the treatment tool contact portion 38 or the distal end protrusion 51. Therefore, the endoscope 10 can be effectively used when it is disposable.

[0068] The entire insertion section 14 except for the tip section 14a may be disposable, or the entire endoscope 10 may be disposable. In these cases, parts that are not likely to cause infection when reused, such as part or all of the illumination unit 42 provided inside the partition wall 34b or part or all of the observation unit 43, may be reused.

[0069] When part or all of the endoscope 10 is disposable, the endoscope 10 is preferably a side-viewing endoscope. A side-viewing endoscope is used as a duodenoscope for endoscopic retrograde cholangiopancreatography (ERCP), in which the endoscope 10 is inserted into a subject, a thin catheter is inserted directly into the bile duct or pancreatic duct in the duodenum, a contrast agent is injected, and an X-ray is taken. In this case, if the endoscope is a reusable product, the transmission of multidrug-resistant bacteria becomes a problem. Therefore, when the endoscope 10 is disposable, both the insertability and erection force are improved, allowing the treatment tool 13 used in ERCP to be properly introduced, and there is no risk of infection, making it suitable for use as a duodenoscope.

[0070] Next, the operation of the endoscope 10 will be described with reference to the flowchart in FIG. 15. When performing a treatment using the endoscope 10, the endoscope 10 is inserted into the subject (step ST110), and the distal end 14a is advanced to the treatment site while checking the image of the endoscope 10 displayed on the display 21 (step ST120). The treatment tool 13 appropriate for the treatment is inserted through the treatment tool inlet 18 (step ST130). The treatment tool 13 exits the treatment tool outlet 35 and contacts the treatment tool contact portion 38 (step ST140), and control is performed to change the direction of travel of the treatment tool 13 from the axial direction Ax to the direction of the treatment tool outlet 33. By the treatment tool 13 contacting the treatment tool contact portion 38, the direction of travel of the treatment tool 13 can be easily changed without impeding its advancement. Note that when the treatment tool 13 is introduced, the stand 39 is placed in a reclined position beforehand.

[0071] After the treatment tool 13 contacts the treatment tool contact portion 38, the treatment tool 13 is further advanced, and the raising base wire is operated to raise the raising base 39 (step ST150). As a result, the raising base 39 changes from the collapsed position to the standing position, and the treatment tool 13 supported by the raising base 39 also rises in accordance with the change in the position of the raising base 39. When the treatment tool 13 is raised, the treatment tool contact portion 38 facilitates the operation of the raising base 39 using the raising base wire by separating the fulcrum and the point of force, thereby using the principle of leverage. The protruding direction and length of the treatment tool 13 are adjusted, and the raising base 39 is further raised, and the wire portion of the treatment tool 13 is clamped and fixed between the raising base 39 and the distal end main body 31 (step ST160). Treatment is performed using the treatment tool 13 that is fixed in a stable position (step ST170). When the treatment is completed, the raising base 39 is collapsed. In position The treatment tool 13 is then returned and the endoscope 10 is removed (step ST190). With the above, the treatment using the treatment tool 13 and the endoscope 10 is completed.

[0072] The endoscope 10 is configured as described above, and the treatment tool contact portion 38 is provided at the distal end portion 14a of the endoscope 10. Therefore, when the treatment tool 13 is protruded by the stand 39 at the distal end portion 14a of the endoscope 10, Progression The treatment tool 13 can be easily erected without interfering with the insertion of the treatment tool 13. Therefore, the endoscope 10 is excellent in both the insertion ability and the erection force of the treatment tool 13. The endoscope 10 is excellent in both the insertion ability and the erection force of the treatment tool, and is suitable as a duodenoscope, which is a side-viewing endoscope. In particular, by making the endoscope 10 or the tip portion 14a disposable, it becomes a duodenoscope that is free from the risk of infection, and is therefore particularly suitable.

[0073] The endoscope 10 provided with the treatment tool contact portion 38 of the present invention is an endoscope 10 used for observing or treating the inside of a subject, but can also be suitably used in various devices such as other endoscopes that use treatment tools 13. [Explanation of symbols]

[0074] 2 Endoscopy System 10 Endoscopy 11 Processor unit 12 Light source device 13, 64 Treatment tools 13a Treatment tool tip 14 Insertion section 14a Tip 14b Curved section 14c Flexible tube section 15 Control section 16 Universal Code 17 Connectors 18 Treatment tool entrance 19. Curvature control knob 20 Operating lever 21 Display 31, 67 Tip body 32 Tip cap 33 Treatment tool outlet 34a, 34b bulkhead 35, 62 Treatment tool outlet 36 Tip surface 37 Standing platform storage space 38 Treatment tool contact part 39, 63 Standing platform 40 Standing platform support part Near 40a 41 Flat area 42 Lighting Unit 43 Observation Unit 44 Air and water supply nozzle 45 Aperture 46 Air and water supply button 47 Suction button 51 Tip protrusion 52, 65 fulcrum 53, 66 Emphasis 61 Treatment tool insertion channel Ax axis direction Lx Longitudinal direction D1, D2 distance ST110~ST190 Steps

Claims

1. an insertion section to be inserted into a subject; a distal end portion body that is located at the distal end of the insertion portion, has a distal end surface with a treatment tool outlet, and forms an elevator housing space that communicates with the treatment tool outlet; a treatment tool contact portion that is a member provided in the stand accommodation space and that controls a direction of travel of the treatment tool by contacting a distal end of the treatment tool that has come out of the treatment tool outlet; a stand provided in the stand accommodation space and configured to stand up the treatment tool whose traveling direction is controlled by the treatment tool contact portion, The position of the stand can be changed between a lying position and an erect position, The treatment tool contact portion has a shape in which the height or angle is adjusted according to the direction of travel of the treatment tool on the stand, and when the stand is in a collapsed position, it contacts the tip of the treatment tool and controls the direction of travel of the treatment tool.

2. The stand is supported at one end by a stand support part so as to be rotatable relative to the tip portion main body, The endoscope according to claim 1 , wherein the treatment tool contact portion is provided in the vicinity of the elevator support portion.

3. The endoscope according to claim 2, wherein the treatment tool contact portion is provided in a longitudinal half of the elevator support portion side of the elevator.

4. a cap attached to the tip body and covering at least a portion of the stand accommodation space; The endoscope according to claim 1 , wherein the treatment tool contact portion is provided on the cap.

5. 5. The endoscope according to claim 1, wherein the treatment tool contact portion is provided on the distal end body.

6. The endoscope according to claim 1 , wherein the treatment tool contact portion is a protrusion.

7. The endoscope according to claim 1 , wherein the treatment tool contact portion has a triangular prism shape.

8. The endoscope according to claim 1 , wherein a plurality of the treatment tool contact portions are provided.

9. 9. The endoscope according to claim 2, wherein the elevator has a distal end protrusion in a half region on the opposite side of the elevator support portion in the longitudinal direction.

10. the treatment tool contact portion controls the direction of travel of the treatment tool in the direction of the distal end protrusion when the erection table is in the laid-down position; The endoscope according to claim 9, wherein the stand includes the distal end protrusion at a position where the stand comes into contact with the treatment tool when the stand is in the upright position.

11. 11. The endoscope according to claim 1, wherein a part or all of the endoscope is disposable.

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