Endoscopic treatment tool and endoscope system

Abstract

An endoscopic treatment tool (20) comprises: a catheter shaft (21) having a first channel (23) into which an endoscope (10) is inserted and a second channel (24) for use in a prescribed treatment; and a handle (22) attached to the base end of the catheter shaft (21). At the leading end of the catheter shaft (21), a leading end marker (32) for confirming the top-bottom direction of the endoscope (10) is provided to a portion of the inner circumferential surface of the first channel (23).

Description

Endoscopic treatment tool and endoscope system

[0001] The present invention relates to an endoscopic treatment tool and an endoscopic system.

[0002]

[0003] Conventionally, endoscopic systems for performing a predetermined procedure while observing the inside of a body have been known. For example, Patent Document 1 discloses an endoscopic treatment tool including a guide pipe through which an endoscope is inserted and a guide sheath attached to the distal end of the pipe, and an endoscopic system using the treatment tool. Patent Document 1 describes that mucosal tissue from the paranasal sinuses can be collected by passing forceps, a brush, or the like through the guide sheath.

[0003] Patent No. 6082169

[0004] In endoscopic treatment instruments and endoscopic systems, ease of operation and ease of use are important issues. The endoscopic system of Patent Document 1 has a simple structure and improved operability, but there is a need to further improve usability to reduce the burden on the doctor who uses it.

[0005] One aspect of the present invention is an endoscopic treatment tool comprising a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a predetermined treatment, and a handle attached to the base end of the catheter shaft, and characterized in that a tip marker is provided on part of the inner surface of the first channel at the tip end of the catheter shaft to allow the user to check the up-and-down orientation of the endoscope.

[0006] According to the above configuration, the tip marker can be used to easily confirm the upside-down orientation of the endoscope inserted into the first channel of the catheter shaft. It can sometimes be difficult to determine the upside-down orientation of the endoscope once the catheter shaft is inserted into the body. In this case, if a tip marker is provided, it becomes possible to confirm the upside-down orientation of the endoscope at the tip of the catheter shaft. In other words, according to the above configuration, when it becomes difficult to determine the upside-down orientation of the endoscope, there is no need to pull the endoscope out of the first channel, confirm the upside-down orientation, and then reinsert it, greatly improving the ease of use of the treatment tool. Furthermore, the tip marker can be used to confirm the upside-down orientation of the endoscope even during initial setup when inserting the endoscope into the first channel.

[0007] Another aspect of the present invention is an endoscopic treatment tool comprising a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a predetermined treatment, a handle attached to the base end of the catheter shaft, and a first tube constituting the first channel and extending from the base end side of the handle, the first tube being characterized by having a locking portion provided on the first tube for fixing the relative movement of the endoscope with respect to the catheter shaft.

[0008] The above configuration prevents the endoscope from rotating within the first channel when the endoscope system is in use. That is, the function of the locking section more reliably maintains the state in which the endoscope is inserted and set in the first channel. If the endoscope rotates within the first channel while the catheter shaft is inserted into the body, it may become difficult to determine the up-and-down orientation of the endoscope. The above configuration solves this problem and significantly improves the usability of the treatment tool.

[0009] Another aspect of the present invention is an endoscopic treatment tool comprising a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a predetermined treatment, a handle attached to the base end of the catheter shaft, and a first tube constituting the first channel and extending from the base end side of the handle, the first tube being characterized by having a branch port for irrigation for supplying a cleaning solution to the tip of the endoscope via the first channel of the catheter shaft.

[0010] According to the above configuration, the cleaning liquid is supplied to the first channel through which the endoscope is inserted, thereby enabling the tip of the endoscope to be effectively cleaned. The tip of the endoscope can become soiled with body fluids and the like, making it difficult to obtain clear images. However, according to the above configuration, the cleaning liquid is supplied to the tip of the endoscope more reliably and efficiently than, for example, when the cleaning liquid is supplied from a separate channel. This makes it easier to irrigate the tip of the endoscope, greatly improving the usability of the treatment tool.

[0011] The handle is preferably provided with a rotation control part for bending the distal end of the catheter shaft, and is also preferably provided with a hand marker.

[0012] With the above configuration, the distal end of the catheter shaft can be bent using the rotating control part of the handle, improving the operability of the treatment tool and making it easier to observe and treat the target area inside the body. The hand marker on the handle can serve as a mark for indicating the position of the rotating control part and can also be used to confirm the up-down direction of the endoscope.

[0013] An endoscope system according to one aspect of the present invention includes the above-described endoscopic treatment tool and an endoscope inserted into the first channel.

[0014] The endoscopic treatment tool and the endoscopic system according to the present invention are simple to operate and easy to use, and can reduce the burden on the doctor who uses them.

[0015] 7 is a diagram showing the overall configuration of an endoscopic system that is an example of an embodiment; FIG. 8 is a perspective view of an endoscopic treatment tool that is an example of an embodiment; FIG. 9 is a diagram showing the distal end surface of a catheter shaft of the endoscopic treatment tool; FIG. 10 is a diagram showing a base end side portion of the endoscopic treatment tool; FIG. 11 is an exploded perspective view of a handle of the endoscopic treatment tool; FIG. 12 is a diagram showing an endoscope that is an example of an embodiment; FIG. 13 is a cross-sectional view of a portion of the endoscope that has a protective tube cut in the length direction; FIG. 14 is a cross-sectional view taken along line AA in FIG. 11; FIG. 15 is a diagram showing an example of use of the endoscopic system that is an example of an embodiment.

[0016] Hereinafter, an example of an embodiment of an endoscopic treatment tool and an endoscopic system according to the present invention will be described in detail with reference to the drawings. The embodiment described below is merely an example, and the present invention is not limited to the following embodiment. Furthermore, the present invention includes forms obtained by selectively combining multiple embodiments and modified examples described below.

[0017] Fig. 1 is a perspective view showing the overall configuration of an endoscopic system 1, which is an example of an embodiment. As shown in Fig. 1, the endoscopic system 1 includes an endoscope 10 and an endoscopic treatment tool 20, and is configured so that the endoscope 10 can be inserted into a first tube 25 of the endoscopic treatment tool 20. The endoscope 10 is a flexible endoscope having a flexible and bendable insertion section 11. The first tube 25 extends to the tip of a catheter shaft 21 and forms a first channel 23 (see Fig. 3 described below) through which the insertion section 11 of the endoscope 10 passes. The endoscopic system 1 is usually used in a state in which the tip of the insertion section 11 is inserted all the way into the tip of the catheter shaft 21 of the endoscopic treatment tool 20.

[0018] The endoscope system 1 can be applied to various endoscopic procedures, such as arthroscopes, laryngoscopes, oral endoscopes, transnasal endoscopes, biliary endoscopes, colonoscopes, and coeloscopic endoscopes. In this embodiment, the use of the endoscope system 1 in lactose catheterization is described as an example. The lactose catheterization is a treatment for chronic lower back pain caused by conditions such as spinal canal stenosis and herniated discs, in which a catheter is inserted close to the painful area to remove adhesions around nerves. Details of how the endoscope system 1 is used will be described later.

[0019] The endoscope system 1 includes a console for controlling the endoscope 10 and a monitor for displaying images acquired by the endoscope 10 (neither is shown). The console generates images by receiving electrical signals from, for example, the imaging unit 16 of the endoscope 10 (see FIG. 3 described below). The generated images are displayed on the monitor, allowing a doctor to perform a predetermined procedure while observing the inside of the body. The console also includes a light source for illumination. The console and the monitor may be integrated. The illumination device is not limited to being built into the console, and may be a device separate from the console.

[0020] The endoscope 10 constituting the endoscopic system 1 includes an insertion section 11 and a base section 2. The insertion section 11 is a section that is inserted into the body, and is inserted into the body while being inserted into a catheter shaft 21 of an endoscopic treatment tool 20. Normally, the endoscope 10 is inserted into the endoscopic treatment tool 20 so that the tip of the insertion section 11 and the tip of the catheter shaft 21 are approximately aligned. The base section 2 is a section disposed adjacent to the proximal end side of the insertion section 11, and includes a connector section 12 and a protective tube 13.

[0021] The connector portion 12 of the endoscope 10 is a portion to which a cable leading to a console is connected. A cable extending from the base end of the insertion portion 11 is connected to the connector portion 12. The cable is housed in an outer tube 15 (see FIGS. 7 and 8 described below) in the insertion portion 11 that is inserted into the endoscopic treatment tool 20, and a portion of the cable extends from the base end of the outer tube 15 and is connected to the connector portion 12. The endoscope 10 is provided with a protective tube 13 that covers the cable exposed from the outer tube 15.

[0022] The endoscopic treatment tool 20 constituting the endoscopic system 1 includes a catheter shaft 21 and a handle 22. As will be described in detail below, the catheter shaft 21 is a long, thin tube having a first channel 23 through which the endoscope 10 is inserted and a second channel 24 used for a predetermined treatment. The second channel 24 can be used to pass a medicinal solution and to insert instruments such as forceps and a brush. It is also possible to aspirate bodily fluids through the second channel 24. At least the tip portion of the catheter shaft 21 is made of a flexible material that allows it to bend.

[0023] The handle 22 of the endoscopic treatment tool 20 is the part that is gripped during use and is attached to the proximal end of the catheter shaft 21. The handle 22 is thicker than the catheter shaft 21 and has a shape that is easy to grip, and is made of, for example, a hard resin material. The handle 22 is provided with a rotation operation unit 27 for bending the distal end of the catheter shaft 21. The handle 22 also has a hand marker 33. As will be described in more detail below, the hand marker 33 serves as a mark that indicates, for example, the position of the rotation operation unit 27.

[0024] The endoscopic treatment tool 20 further includes two tubes (a first tube 25 and a second tube 26) extending from the proximal end of the handle 22. The first tube 25 constitutes the first channel 23 and is a tube into which the endoscope 10 is inserted. The second tube 26 constitutes the second channel 24 and is a tube into which instruments such as forceps and a brush are inserted. The two tubes are integrated within the handle 22 to form a single catheter shaft 21. The first tube 25 is provided with a locking portion 30 that secures the endoscope 10 and a branch port 31 for irrigation. A connector 29 is provided at the proximal end of the second tube 26.

[0025] The configuration of the endoscopic system 1, particularly the configuration of the endoscopic treatment tool 20, will be described in detail below with reference to Figures 2 to 5. Figure 2 is a perspective view of the endoscopic treatment tool 20, Figure 3 is a diagram showing the distal end surface of the catheter shaft 21, and Figure 4 is an enlarged view of the proximal end portion of the endoscopic treatment tool 20. Figure 5 is a perspective view showing a state in which a part of the handle 22 is disassembled.

[0026] 2 to 5, the endoscopic treatment tool 20 has a structure in which a catheter shaft 21 extends from the distal end of a handle 22, and two tubes extend from the proximal end of the handle 22. The catheter shaft 21 is preferably longer than the handle 22. When the endoscopic treatment tool 20 is applied to lactose catheterization, an example of a suitable length for the catheter shaft 21 is 300 mm to 400 mm. The length of the handle 22 is, for example, 60% or less of the length of the catheter shaft 21. A first tube 25 and a second tube 26 extend from the proximal end of the handle 22 by lengths shorter than the length of the handle 22.

[0027] An imaging unit 16 including an imaging element is built into the distal end of the insertion section 11 of the endoscope 10, which is inserted into the catheter shaft 21. The imaging unit 16 may include a lens, a filter, a cover glass, etc. The imaging unit 16 has, for example, a substantially square light-receiving surface, and is provided so that the light-receiving surface is located on the distal end surface of the insertion section 11. The imaging element is an element in which a large number of photodiodes that convert light into electrical signals are arranged on a substrate, and is also called a solid-state imaging element or an image sensor.

[0028] A suitable example of the imaging element is a CCD image sensor or a CMOS image sensor. Light incident on the imaging element is converted into an electrical signal, and the acquired image data is transmitted to the console. An optical fiber 18 is also disposed at the distal end surface of the insertion section 11. The optical fiber 18 is a light guide for guiding light from an illumination light source to the distal end surface of the insertion section 11. In the endoscope 10, light emitted from the optical fiber 18 is irradiated onto and reflected from a target region to be observed, and the reflected light is incident on the imaging element, thereby acquiring image data of the target region.

[0029] The catheter shaft 21 is a thin tube with a substantially constant outer diameter along its entire length. Because the catheter shaft 21 is inserted into the body, it is preferable that the outer diameter be small. The outer diameter of the catheter shaft 21 is, for example, 2.0 mm to 3.5 mm, or 2.3 mm to 3.0 mm.

[0030] As described above, the catheter shaft 21 is made of a flexible material. While the material of the catheter shaft 21 is not particularly limited, a suitable example is a polyamide-based thermoplastic elastomer (e.g., polyamidepolyamine epichlorohydrin (PAE)) that has good biocompatibility. The catheter shaft 21 may contain an X-ray contrast agent such as barium sulfate. The catheter shaft 21 may also contain various pigments to be colored.

[0031] The catheter shaft 21 may have different hardnesses at its tip portion and other portions. In this embodiment, the hardness of the tip portion of the catheter shaft 21 is lower than that of other portions, and the tip portion is configured to be bendable by operating the rotation operation unit 27. The hardness of the tip portion may be 60% or less of the hardness of the other portions. The length of the tip portion, which has a lower hardness than the other portions, is, for example, 5% to 20% of the total length of the catheter shaft 21. Making the catheter shaft 21 bendable within a predetermined length from the tip makes it easier to observe and treat the target area inside the body.

[0032] As described above, the catheter shaft 21 has a first channel 23 through which the endoscope 10 is inserted and a second channel 24 used for a predetermined treatment (see FIG. 3). The first channel 23 has a diameter that allows the endoscope 10 to be inserted therethrough and is formed over the entire length of the catheter shaft 21. The second channel 24 has a diameter that allows instruments such as forceps or a brush to be inserted therethrough and is formed parallel to the first channel 23 over the entire length of the catheter shaft 21. The catheter shaft 21 may have three or more channels, but in this embodiment, it has a double-lumen structure including two channels. The diameters of the two channels may be the same, and are, for example, 1.0 mm to 1.5 mm.

[0033] Two wires 28 are introduced into the catheter shaft 21 up to its distal end for bending the distal end by operating the rotation control unit 27 (see FIGS. 3 and 5 ). The catheter shaft 21 is manufactured by integrating two tubes that form two channels with the two wires 28, for example, by extrusion molding using a polyamide-based thermoplastic elastomer. The two tubes are a first tube 25 and a second tube 26 that extend from the proximal end of the handle 22. The proximal end of the catheter shaft 21 is located within the handle 22. That is, the two tubes and the two wires 28 are integrated within the handle 22.

[0034] At the distal end of the catheter shaft 21, a tip marker 32 is provided on part of the inner circumferential surface of the first channel 23 into which the endoscope 10 is inserted, for confirming the up-and-down orientation of the endoscope 10 (see FIG. 3 ). The endoscope 10 is inserted into the first channel 23 with its up-and-down orientation specified, and is set in the endoscopic treatment tool 20 so that the tips of the insertion section 11 and the catheter shaft 21 are aligned. However, there are cases in which it is difficult to determine the up-and-down orientation of the endoscope 10 during use. If the tip marker 32 is provided, the up-and-down orientation of the endoscope 10 can be easily confirmed in such cases. Details of how to use the tip marker 32 will be described later.

[0035] The tip marker 32 is preferably provided on the inner circumferential surface of the first channel 23 over an area that is equal to or less than half the inner circumferential length, and may be of any size that can be confirmed in images acquired by the endoscope 10. The tip marker 32 is, for example, a mark indicating the top (top) of the endoscope 10, and is provided on the upper half of the inner circumferential surface of the first channel 23. The tip marker 32 may be provided on the inner circumferential surface of the first channel 23, but in this embodiment, the tip marker 32 is provided from the inner circumferential surface of the first channel 23 to the outer circumferential surface of the catheter shaft 21 that is close to the inner circumferential surface. In this case, the position of the tip marker 32 can be easily confirmed from the outside of the catheter shaft 21.

[0036] The tip marker 32 may be provided near the tip of the catheter shaft 21 at a position away from the tip, but is preferably provided within a predetermined length range from the tip of the catheter shaft 21. The length of the tip marker 32 along the longitudinal direction of the catheter shaft 21, i.e., the above-mentioned predetermined length, is not particularly limited, but is preferably set to 0.5 mm or more because if the tip marker 32 is too small, it will be difficult to identify the marker. The length of the tip marker 32 is more preferably 1 mm or more, and is, for example, 1 mm to 5 mm or 2 mm to 4 mm. The tip marker 32 is provided, for example, only in the tip portion of the catheter shaft 21, where the hardness is reduced.

[0037] The tip marker 32 can be provided by adding a predetermined coloring material to the resin that constitutes the catheter shaft 21. The predetermined coloring material may be any material that has a color different from the pigment that colors the entire catheter shaft 21, other additives such as barium sulfate, and may be a common pigment, or resin particles, inorganic particles, or metal particles that are not commonly used as pigments. When a metal such as a platinum-iridium alloy is used as the coloring material, the position of the tip marker 32 can be easily detected under X-ray fluoroscopy. On the other hand, when a metal is used, the catheter shaft 21 tends to become hard, so it is preferable to make the size of the tip marker 32 small.

[0038] The tip marker 32 is arranged in the same direction as the upper surface of the handle 22, which will be described later, with respect to the endoscope 10 inserted into the first channel 23. In this embodiment, the endoscopic treatment tool 20 is used with the upper surface of the handle 22 facing vertically upward, and at this time, the tip marker 32, which indicates the top of the endoscope 10, also faces vertically upward. In this case, as long as the insertion section 11 of the endoscope 10 does not rotate within the first channel 23, the top and bottom of the endoscope 10 can be identified from the orientation of the upper surface of the handle 22.

[0039] The tip marker 32 can be confirmed in an image acquired by the endoscope 10. During initial setup when the endoscope 10 is inserted into the first channel 23, the top-bottom orientation of the endoscope 10 can be confirmed by the tip marker 32. Note that since the endoscope 10 is set in the endoscopic treatment tool 20 so that the tip of the insertion section 11 coincides with the tip of the catheter shaft 21, if the top-bottom orientation of the endoscope 10 becomes unclear, the endoscope 10 is moved several millimeters toward the proximal end to capture an image of the tip marker 32.

[0040] According to the endoscopic treatment tool 20, the function of the tip marker 32 makes it possible to confirm the upside-down direction of the endoscope 10 by simply moving the insertion section 11 of the endoscope 10 slightly. For example, if the tip marker 32 is located on the left side of the image displayed on the monitor, it can be seen that the top of the endoscope 10 is tilted to the left. In this case, the upside-down direction of the endoscope 10 can be readjusted by rotating the endoscope 10 so that the tip marker 32 is located on the upper side of the monitor screen. In other words, the tip marker 32 is a guide for confirming the upside-down direction of the image acquired by the endoscope 10. Note that if the tip marker 32 were not present, it would be necessary to completely withdraw the endoscope 10 from the endoscopic treatment tool 20, confirm the upside-down direction, and then reinsert it.

[0041] The handle 22 has a thickness that allows for easy gripping and is formed into a flat, cylindrical shape that is long in the direction of extension of the catheter shaft 21. The housing that constitutes the handle 22 has a rounded shape with no corners to allow for easy gripping, and the sides of the housing are gently curved so that they convex inward. In this embodiment, the up and down directions of the handle 22 are specified; for example, the side that displays the manufacturer's name, manufacturer logo, product name, etc. is the top surface of the handle 22, and the endoscopic treatment tool 20 is used with the top surface of the handle 22 facing vertically upward. As shown in Figure 5, the housing of the handle 22 includes an upper case 22a and a lower case 22b and is configured to be disassembled.

[0042] The handle 22 has a maximum thickness (maximum vertical length) of, for example, 20 mm to 30 mm, with the thickness being greatest at the portion where the rotation operation unit 27 is provided. The handle 22 is formed in a tapered shape that gradually narrows from the rotation operation unit 27 toward the distal and proximal ends of the handle 22. The rotation operation unit 27 is positioned so that its center is, for example, 70 mm to 90 mm from the distal end of the handle 22 and 80 mm to 100 mm from the proximal end. The handle 22 is easy to hold and provides good operability.

[0043] As described above, the handle 22 has a rotation control unit 27 located distally of the center in the longitudinal direction. The rotation control unit 27 is a generally disk-shaped control unit with a portion of its outer periphery protruding left and right and distally of the handle 22. A physician can bend the distal end of the catheter shaft 21 left and right by rotating the rotation control unit 27 left and right. Two wires 28 extending to the distal end of the catheter shaft 21 are fixed to the rotation control unit 27. Rotating the rotation control unit 27 left and right pulls one of the wires 28, bending the distal end of the catheter shaft 21 in the direction in which the rotation control unit 27 is rotated.

[0044] The convex portion 27a of the rotation operation unit 27 that protrudes in the left and right directions of the handle 22 makes it easier for fingers to hook onto it, improving operability. In addition, the convex portion 27b that protrudes toward the tip of the handle 22 serves as a marker that indicates the position of the rotation operation unit 27. When the convex portion 27b points straight toward the tip, the rotation operation unit 27 is in a neutral position, and the tip of the catheter shaft 21 is in a straight state. When the convex portion 27b points to the left or right of the handle 22, the tip of the catheter shaft 21 is bent in the direction in which the convex portion 27b points. The shape of the rotation operation unit 27 when viewed from both the top and bottom of the handle 22 is the same, and the convex portions 27b are formed on the top and bottom of the handle 22.

[0045] The rotation operation unit 27 is preferably configured to be able to maintain the orientation of the operation unit (the orientation of the convex portion 27b) even when the hand is released. In this case, the tip of the catheter shaft 21 can maintain its bent state to the left or right even when the hand is released from the rotation operation unit 27, improving operability. On the other hand, the torque of the rotation operation unit 27 is preferably set to such an extent that when the rotation operation unit 27 is turned with a finger hooked on the convex portion 27a, the rotation operation unit 27 rotates smoothly without applying excessive force.

[0046] The handle 22 has a hand marker 33 provided closer to the tip than the rotation operation unit 27. The hand marker 33 is used as a mark indicating the neutral position of the rotation operation unit 27. For example, one hand marker 33 is provided on each of the upper case 22a and the lower case 22b at a position facing each of the protrusions 27b of the rotation operation unit 27 in the neutral position. By providing the hand markers 33 on the upper and lower surfaces of the handle 22, the position of the rotation operation unit 27 can be easily confirmed even when the handle 22 is rotated. The shape and size of the hand marker 33 are not particularly limited. The hand marker 33 is, for example, a perfect circle marker with a diameter of 0.5 mm to 5 mm.

[0047] A first tube 25 extending from the proximal end of the handle 22 is provided with a locking section 30 that fixes relative movement of the endoscope 10 with respect to the catheter shaft 21. The first tube 25 is a thin tube into which the insertion section 11 of the endoscope 10 is inserted, and is connected to the catheter shaft 21 inside the handle 22 to form a first channel 23. The locking section 30 tightens and fixes the insertion section 11, preventing relative rotation of the insertion section 11 with respect to the catheter shaft 21. The locking section 30 also prevents movement of the insertion section 11 along the length of the catheter shaft 21.

[0048] The locking unit 30 is provided at or near the proximal end of the first tube 25. Because the length of the first tube 25 extending from the proximal end of the handle 22 is, for example, 100 mm or less, the locking unit 30 is located close to the proximal end of the handle 22. This allows the locking unit 30 to be easily operated. After aligning the top of the endoscope 10 with the tip marker 32, the surgeon can maintain the initial setting by fixing the insertion section 11 with the locking unit 30. Note that if the locking unit 30 is not fixed properly or the insertion section 11 is rotated with a force that exceeds the tightening torque of the locking unit 30, making it difficult to determine the top and bottom of the endoscope 10, the top and bottom orientation can be easily readjusted using the tip marker 32.

[0049] The locking unit 30 may be attached to the first tube 25 and may have any structure as long as it can fix the insertion section 11 of the endoscope 10. The locking unit 30 may be, for example, a member having a generally cylindrical shape overall, including a passage through which the insertion section 11 can be inserted, a rubber valve that opens and closes the passage, and an operating unit provided on the outer circumferential surface, and is configured to open and close the rubber valve by rotating the operating unit. The rubber valve comes into contact with the outer circumferential surface of the insertion section 11, thereby fixing the relative movement of the insertion section 11 with respect to the catheter shaft 21.

[0050] In this embodiment, since the first tube 25 is provided with a branch port 31 for irrigation, it is preferable that the locking unit 30 be provided closer to the proximal end of the first tube 25 than the branch port 31. In this case, irrigation of the endoscope 10 can be performed while the locking unit 30 maintains the state in which it tightens and fixes the insertion section 11. The locking unit 30 is disposed adjacent to the proximal end of the branch port 31, for example.

[0051] As described above, the branch port 31 is a branch path for irrigation for supplying cleaning liquid to the tip of the endoscope 10 via the first channel 23, and is attached to the first tube 25. The branch port 31 is provided between the handle 22 and the locking section 30, and forms a cleaning liquid supply port in the first channel 23 that is separate from the inlet through which the insertion section 11 of the endoscope 10 is inserted. In other words, by branching the first tube 25, cleaning liquid can be supplied via the first channel 23 with the insertion section 11 inserted into the first tube 25 and fixed by the locking section 30. The cleaning liquid is, for example, physiological saline.

[0052] The branch port 31 is formed so that the cleaning solution flows from the opening of the port toward the connecting part with the first tube 25 and gradually moves toward the distal end of the catheter shaft 21. As shown in Figure 4, the branch port 31 is preferably configured to be connectable to a needleless syringe 51 filled with cleaning solution. The cleaning solution introduced from the syringe 51 connected to the branch port 31 flows through the gap between the inner circumferential surface of the first channel 23 and the outer circumferential surface of the insertion section 11 and is supplied to the distal end surface of the insertion section 11.

[0053] The branch port 31 may be provided by attaching a member having a first path into which the insertion section 11 is inserted and a second path branched from the first path to the first tube 25. The first path forms a part of the first tube 25, and the second path becomes the branch port 31. The member that forms the branch port 31 may be fixed to the handle 22 or may be integrated with the locking section 30.

[0054] The configuration of the endoscope 10 will be described in further detail below with reference to Figures 6 to 8. Figure 6 is a plan view of the endoscope 10. Figure 7 is a longitudinal cross-sectional view of a portion of the endoscope 10 to which the protective tube 13 is attached, and Figure 8 is a cross-sectional view taken along line AA in Figure 7.

[0055] 6 to 8, the endoscope 10 has an insertion section 11 and a base section 2 including a connector section 12 and a protective tube 13, with the protective tube 13 extending from the connector section 12 to the proximal end of the insertion section 11. A cable leading to a console is connected to the connector section 12, and a cable extending from the proximal end of the insertion section 11 is also connected to the connector section 12. The cable includes an electric wire 17 that transmits an electric signal from the imaging unit 16 and an optical fiber 18 that transmits light for illumination.

[0056] The insertion section 11 has an outer tube 15 that houses electric wires 17 and optical fibers 18, and is flexible and bendable. The outer tube 15 is made of, for example, the same material as the catheter shaft 21. The electric wires 17 and optical fibers 18 are housed in the outer tube 15 in the insertion section 11 that is inserted into the endoscopic treatment tool 20, but a portion of them extends from the proximal end of the outer tube 15 and is connected to the connector section 12. The protective tube 13 covers and protects the cables extending from the outer tube 15 so that they are not exposed.

[0057] The connector portion 12 and the protective tube 13 may be grasped by the physician who is the user when inserting and setting the endoscope 10 into the endoscopic treatment tool 20, and also when using the endoscopic system 1. For example, the physician may grasp and attempt to rotate the protective tube 13 in order to change the orientation of the endoscope 10. At this time, if the locking unit 30 is not sufficiently fixed or if the endoscope 10 is rotated with a force that exceeds the tightening torque of the locking unit 30, it is conceivable that the insertion section 11 will rotate within the first channel 23, causing the top and bottom of the endoscope 10 to become unclear.

[0058] To address the above-mentioned problems, the endoscope 10 is configured such that the protective tube 13 is not fixed to the insertion section 11 or the cable, but is slidable relative to the insertion section 11. Generally, the protective tube is fixed to the insertion section using an adhesive or the like, but in this case, when a force that rotates the protective tube is applied, the insertion section 11 rotates following the protective tube. In contrast, in the endoscope 10, the protective tube 13 rotates freely, and the insertion section 11 does not rotate following the protective tube 13. As a result, the occurrence of the above-mentioned problems is effectively suppressed.

[0059] The protective tube 13 has a tip that extends to a position overlapping the insertion section 11 so as to prevent the cable from being exposed. The protective tube 13 may be longer than the insertion section 11. The insertion section 11 has a length that exceeds the length of the endoscopic treatment tool 20. The protective tube 13 may be made of, for example, an elastomer, but any material may be used as long as it can protect the cable and has good slip properties. The protective tube 13 may be adhesively fixed to the tip of the connector section 12.

[0060] Preferably, the base portion 2 of the endoscope 10 further includes an inner tube 14, which is a second protective tube. The inner tube 14 houses the base end of the insertion portion 11, the electric wires 17, and the optical fiber 18, and is disposed within the protective tube 13. The protective tube 13 is not fixed to the inner tube 14, but is configured to be slidable relative to the inner tube 14. That is, the protective tube 13 is configured to be slidable relative to the insertion portion 11 via the inner tube 14. This effectively prevents the insertion portion 11 from rotating in accordance with the protective tube 13.

[0061] The inner tube 14 is provided from the tip of the connector portion 12 to the base end of the insertion portion 11, and covers the entire length of the cable extending from the outer tube 15. Protecting the cable with two tubes ensures more reliable protection. The inner tube 14 is preferably made of an elastomer like the protective tube 13, and has excellent sliding properties relative to the protective tube 13. The length of the inner tube 14 may be substantially the same as the length of the protective tube 13.

[0062] The gap between the insertion portion 11 and the inner tube 14 is preferably sealed with adhesive 19. The adhesive 19 is filled to fill the gap and prevents water and the like from entering the insertion portion 11 and the inner tube 14. A resin with excellent water resistance is used for the adhesive 19, which can strongly bond the insertion portion 11 and the inner tube 14 together. For example, the adhesive 19 is filled from the tip of the inner tube 14 beyond the area that overlaps with the insertion portion 11. On the other hand, because the two protective tubes are not fixed with adhesive, the effect of suppressing rotation of the insertion portion 11 can be ensured.

[0063] The mechanism of the endoscope system 1 having the above configuration will be further explained below with reference to the usage mode shown in Fig. 9. Fig. 9 is a schematic diagram showing how the endoscope system 1 is used for lactose catheterization.

[0064] 9, the endoscope system 1 is used by inserting a catheter shaft 21 of an endoscopic treatment tool 20 into the body. The insertion section 11 of the endoscope 10 is inserted into a first channel 23 of the catheter shaft 21, and the insertion section 11 is fixed by a locking section 30 so as not to rotate relative to the catheter shaft 21. In the lactose catheter method, the catheter shaft 21 equipped with a sheath 50 is inserted into the body from the sacrum, and while viewing an image from the endoscope 10, the catheter shaft 21 extending from the sheath 50 is advanced along the lumbar vertebrae 70 to near the painful area.

[0065] The lactu-catheter method has attracted attention as a treatment for chronic lower back pain caused by spinal canal stenosis, herniated discs, etc., and is a method in which a catheter shaft 21 is inserted close to the painful area to remove adhesions that exist around the nerve root 71. One cause of lower back pain is inflammation of the nerve root 71, and minute adhesions exist around the inflamed nerve root 71. By removing these adhesions from around the nerve root 71, the inflammation of the nerve root 71 can be suppressed, and pain can be alleviated.

[0066] Adhesion around the nerve root 71 can be dissected and removed, for example, by supplying a medicinal solution through the second channel 24 of the catheter shaft 21. Alternatively, adhesions can be removed by inserting instruments such as forceps or a brush through the second channel 24. In either case, the prescribed procedure is performed while viewing the image from the endoscope 10. For example, the physician holds the handle 22 with his left hand to operate the catheter shaft 21, while operating instruments such as forceps or a brush with his right hand. Furthermore, as shown in FIG. 9 , the distal end of the catheter shaft 21 can be bent by turning the rotation control unit 27.

[0067] According to the endoscopic system 1, when inserting the insertion section 11 of the endoscope 10 into the first channel 23, the doctor can confirm the top-to-bottom orientation of the endoscope 10 using the tip marker 32. The doctor aligns the top of the endoscope 10 with the position of the tip marker 32 and inserts the insertion section 11 until the tip of the insertion section 11 is substantially aligned with the tip of the catheter shaft 21. The doctor then operates the locking section 30 to fix the insertion section 11.

[0068] According to the endoscope system 1, the locking unit 30 can fix the endoscope 10 in a specified up-down direction, but if the locking unit 30 is not fixed properly, for example, the insertion section 11 may rotate within the first channel 23, making it impossible to determine the up-down direction of the endoscope 10. Alternatively, a similar problem may occur if the insertion section 11 or the protective tube 13 is rotated with a force that exceeds the tightening torque of the locking unit 30.

[0069] However, in such a case, the top-bottom orientation of the endoscope 10 inserted into the first channel 23 can be easily confirmed by using the tip marker 32. If it becomes difficult to determine the top-bottom orientation of the endoscope 10, the tip marker 32 can be confirmed by moving the endoscope 10 toward the proximal end by about a few millimeters, so there is no need to pull out the insertion section 11 from the first channel 23 to confirm the top-bottom orientation, and the top-bottom orientation can be easily readjusted.

[0070] Furthermore, in the endoscope system 1, the protective tube 13 of the endoscope 10 is configured to be slidable relative to the insertion section 11, so the insertion section 11 does not rotate in accordance with the protective tube 13. A doctor may pinch and twist the protective tube 13 to change the orientation of the endoscope 10, but even when such an operation is performed, the rotation of the insertion section 11 can be effectively suppressed, and the initial setting can be maintained.

[0071] According to the endoscope system 1, when the tip of the endoscope 10 becomes soiled with body fluids or the like, cleaning liquid can be supplied to the tip of the endoscope 10 from the branch port 31 via the first channel 23. In this case, cleaning liquid is more reliably and efficiently supplied to the tip of the endoscope 10. Furthermore, because the branch port 31 is provided closer to the tip of the processing tool than the locking unit 30, irrigation can be easily performed while the endoscope 10 is fixed.

[0072] As described above, the endoscope system 1 having the above configuration is simple to operate and easy to use, and can greatly reduce the burden on the doctor who uses it.

[0073] The above embodiment can be modified as needed without impairing the object of the present invention. For example, the above embodiment illustrates an endoscopic treatment tool 20 including a locking section 30, a branch port 31, and a tip marker 32, but it is also possible to selectively adopt at least one of these configurations. Furthermore, a conventionally known endoscope can be used instead of the endoscope 10. However, as described above, the endoscope system 1 including these configurations has excellent functionality.

[0074] In the above embodiment, the optical fiber 18 is built into the insertion section 11 of the endoscope 10, but a light source such as an LED may be arranged on the distal end surface of the insertion section 11. Also, although an endoscope equipped with an imaging element such as a CMOS image sensor has been exemplified, it is possible to use an image fiber instead of the imaging element. In the above embodiment, an imaging element (CMOS image sensor) is used as the image acquisition means and an optical fiber is used as the illumination means, but for example, the following configurations are possible. Example 1: Image acquisition means: image fiber, illumination means: optical fiber Example 2: Image acquisition means: CMOS image sensor, illumination means: LED Example 3: Image acquisition means: image fiber, illumination means: LED

[0075] 1 Endoscope system, 2 Base part, 10 Endoscope, 11 Insertion part, 12 Connector part, 13 Protective tube, 14 Inner tube, 15 Outer tube, 16 Imaging unit, 17 Electric wire, 18 Optical fiber, 19 Adhesive, 20 Endoscopic treatment tool, 21 Catheter shaft, 22 Handle, 22a Upper case, 22b Lower case, 23 First channel, 24 Second channel, 25 First tube, 26 Second tube, 27 Rotation operation part, 27a, 27b Convex part, 28 Wire, 29 Connector, 30 Lock part, 31 Branch port, 32 Tip marker, 33 Hand marker, 50 Sheath, 51 Syringe, 70 Lumbar vertebrae, 71 Nerve root

Claims

1. An endoscopic treatment tool comprising: a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a specified treatment; and a handle attached to the base end of the catheter shaft, wherein the tip of the catheter shaft is provided with a tip marker on part of the inner surface of the first channel for checking the up-down orientation of the endoscope.

2. An endoscopic treatment tool comprising: a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a specified treatment; a handle attached to the base end of the catheter shaft; and a first tube constituting the first channel and extending from the base end side of the handle, wherein the first tube is provided with a locking portion for fixing the relative movement of the endoscope with respect to the catheter shaft.

3. An endoscopic treatment tool comprising: a catheter shaft having a first channel through which an endoscope is inserted and a second channel used for a specified treatment; a handle attached to the base end of the catheter shaft; and a first tube constituting the first channel and extending from the base end side of the handle, wherein the first tube is provided with a branch port for irrigation for supplying a cleaning liquid to the tip of the endoscope via the first channel of the catheter shaft.

4. An endoscopic treatment tool as claimed in any one of claims 1 to 3, wherein the handle is provided with a rotation operating portion for bending the tip of the catheter shaft.

5. An endoscopic treatment tool as claimed in any one of claims 1 to 4, wherein the handle is provided with a hand marker.

6. An endoscopic treatment tool according to any one of claims 1 to 4, wherein the handle has a maximum thickness of 20 mm to 30 mm, and the center of the rotation operation part is located in a range of 70 mm to 90 mm from the tip and 80 mm to 100 mm from the base end of the handle.

7. An endoscope system comprising: an endoscopic treatment tool according to any one of claims 1 to 6; and an endoscope inserted into the first channel.

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