Endoscope

Abstract

Provided is an endoscope enabling efficient treatment. This endoscope (100) is characterized by comprising: a distal end surface (120) that has a treatment tool hole through which a first treatment tool can be inserted, and an observation part; a distal end part (110) that has a curved part that supports the distal end surface in a freely bendable manner; and an opening part (130), which is provided on a side surface (110a) of the distal end part, and is capable of absorbing water, and through which a second treatment tool can be inserted.

Description

Endoscopy

[0001] The present invention relates to an endoscope, and more particularly to a therapeutic endoscope for the digestive tract.

[0002] Endoscopes are used to treat diseases such as those of the digestive system by inserting them into a patient's internal cavity. The forceps holes provided on such endoscopes are used to insert treatment instruments and to suction intraluminal gas, digestive fluid, blood, etc., and are located at the tip of the endoscope. In conventional endoscopes, even those with two-channel forceps holes have both forceps holes located at the tip of the endoscope. This creates problems when suctioning digestive fluid or blood, aspirated digestive fluid, etc., flows toward the tip of the endoscope, obstructing the field of view, and when ejected irrigation fluid returns, obstructing the field of view. Furthermore, in treatment endoscopes, when grasping forceps or the like are inserted through one of the two-channel forceps holes to grasp tissue and an endoscopic knife or the like inserted through the other forceps hole to incise the tissue, the grasping forceps and the knife move parallel to each other in synchronization with the movement of the tip of the endoscope, making it difficult to efficiently perform procedures such as dissection (see, for example, Patent Documents 1 to 4).

[0003] Japanese Patent Application Laid-Open No. 2000-37390 Japanese Patent Application Laid-Open No. 2003-210389 Japanese Patent No. 5498794 Japanese Patent Application Laid-Open No. 2002-125921

[0004] In view of the above-described conventional techniques, an object of the present invention is to provide an endoscope that can perform treatment efficiently.

[0005] In order to solve the above problems, the present invention provides an endoscope comprising: a tip surface having a tip opening through which a first treatment tool can be inserted and an observation section; a tip portion having a bending section that supports the tip surface so that it can be bent freely; and a side opening provided on the side of the tip portion, which is capable of absorbing water and through which a second treatment tool can be inserted.

[0006] With this, when the side opening is used for absorbing water, a good field of view can be ensured by sucking up the liquid that obstructs the view of the observation area from the side opening, and when a second treatment tool is inserted into the side opening, it can be made independent of the first treatment tool that is inserted into the tip opening, allowing endoscopic treatment to be carried out efficiently.

[0007] In the present invention, the side opening may be provided at a position within a range of ±60° in the circumferential direction, including the direction directly above, with respect to the center of the field of view of the observation unit.

[0008] This allows the side opening to be directed toward the lumen of the organ when the endoscope is bent and inserted directly upward, improving the efficiency of the treatment.

[0009] In the present invention, the side opening may be provided at a position within a range of ±60° in a circumferential direction including a direction in which the curved portion is curved.

[0010] This allows the side opening to be directed toward the lumen of the organ when the endoscope is curved and inserted, improving the efficiency of the treatment.

[0011] In the present invention, the side opening may be provided behind the curved portion.

[0012] In the present invention, the side opening may be provided within the field of view of the observation unit provided on the distal end surface supported by the distal end portion in which the curved portion is bent toward the base end side.

[0013] According to this, if a problem such as clogging of the side opening occurs, the state of the opening can be confirmed by the observation section.

[0014] In the present invention, the channel connected to the side opening and extending toward the base end may have an end on the side opening side that forms an angle of 0° to 45° with respect to the axial direction of the tip end portion.

[0015] This allows the second treatment tool inserted through the side opening to have a desired range of motion independent of the first treatment tool inserted through the tip opening, thereby allowing treatment to be performed efficiently.

[0016] According to the present invention, an endoscope capable of efficiently performing treatment can be provided.

[0017] Fig. 1 is a perspective view of the tip of an endoscope according to an embodiment. Fig. 2 is a view of the endoscope according to the embodiment as seen from the tip surface. Fig. 3 is a view explaining the relationship between a side opening and the field of view of the endoscope according to the embodiment. Fig. 4(A) is a side view of the tip of the endoscope according to the embodiment, and Fig. 4(B) is an enlarged view of the periphery of the side opening in Fig. 4(A). Fig. 5 is a view showing a state in which the angle section of the endoscope according to the embodiment is inverted. Fig. 6 is a view showing an example of use of the endoscope according to the embodiment. Fig. 7 is a side view of an endoscope according to a modified example.

[0018] Hereinafter, specific embodiments of the present invention will be described with reference to the drawings.

[0019] Example 1 An example of an embodiment of the present invention will be described below. However, unless otherwise specified, the dimensions, materials, shapes, relative positions, etc. of the components described in this example are not intended to limit the scope of the present invention to only those.

[0020] FIG. 1 is a perspective view showing a distal end portion 110 of an endoscope 100 according to a first embodiment. FIG. 2 is a view of the endoscope 100 as viewed from the distal end surface 120 side. The distal end surface 120 of the endoscope 100 is provided with an objective lens 121, light guides 122 and 123, an air and water nozzle 124, an auxiliary water nozzle 125, and a forceps hole 126. The light guides 122 and 123 are disposed on both sides of the objective lens 121. The air and water nozzle 124 is disposed facing the objective lens 121 so that cleaning water, air, etc., sprayed from the air and water nozzle 124 are directly sprayed onto the objective lens 121. The auxiliary water nozzle 125 sprays auxiliary water, such as a cleaning solution for removing contaminants within the field of view or a staining solution for staining a desired position. A treatment tool, such as grasping forceps, is insertably and removably inserted into the forceps hole 126. The configuration of the distal end surface 120 is not limited to this. Here, the endoscope 100, the tip section 110, and the tip surface 120 correspond to the endoscope, tip section, and tip surface of the present invention, respectively. The objective lens 121 and the forceps hole 126 correspond to the observation section and tip opening of the present invention. The treatment tool inserted through the forceps hole 126 corresponds to the first treatment tool of the present invention.

[0021] The main body of the endoscope 100 houses an observation optical system, an illumination optical system, and a channel conduit (not shown). A handheld control unit (not shown) is provided at the proximal end of the endoscope 100 in the extension direction. The indirect optical system connects an objective lens 121 provided on the distal end surface 120 to a video processor or the like via a cord extending from the handheld control unit. The illumination optical system connects light guides 122 and 123 provided on the distal end surface 120 to a light source device via a cord also extending from the handheld control unit. The forceps hole 126 is connected to a channel conduit opening into the handheld control unit. The air / water supply nozzle 124 is connected via a conduit to a tube connector provided on the handheld control unit. One end of a tube connected to an air supply device or a water supply device is connected to the tube connector. The auxiliary water supply nozzle 125 is similarly connected via a conduit to a tube connector provided on the handheld control unit, and one end of a tube connected to a water supply device for auxiliary water supply is connected to this tube connector.

[0022] In the endoscope 100 according to this embodiment, a side opening 130 is provided on the side surface 110a of the tip portion 110 at a position a predetermined distance from the distal end surface 120 toward the proximal end. This side opening 130 is connected to the proximal operation unit by a sub-channel duct 131 that is built into the main body of the endoscope 100 together with the above-mentioned channel ducts and the like. That is, the sub-channel duct 131 having the side opening 130 is integrally provided on the main body of the endoscope 100. As will be described later, when the side opening 130 is used as a suction port, the sub-channel duct 131 is connected to a suction device via a tube in the proximal operation unit. Here, the side opening 130 and the sub-channel duct 131 correspond to the side opening and the channel, respectively, of the present invention.

[0023] The field of view V obtained by the objective lens 121 is shown in Figure 3. When the direction of arrow U, which is the up-angle direction relative to the field of view V obtained by the objective lens 121, is set to the 12 o'clock direction clockwise, the side opening 130 is preferably positioned around the center of the field of view V in a range from the 10 o'clock direction counterclockwise along arrow D1 to the 2 o'clock direction clockwise along arrow D2 (a range of ±60° from the direction of arrow U), and more preferably, the side opening 130 is positioned in the up direction indicated by arrow U. Here, the field of view V corresponds to the field of view of the observation unit in this invention, and the direction of arrow U corresponds to the direction directly above the center of the field of view in this invention.

[0024] When the angle section 140 is bent in an up-angle direction and the endoscope 100 is inserted into the gastrointestinal tract, the underside of the endoscope 100 (the 6 o'clock direction in the above example) is often in contact with the wall of the gastrointestinal tract. In contrast, in the above example, the 12 o'clock direction is often facing the lumen of the gastrointestinal tract, and by providing the side opening 130 in the above position, it is possible to prevent the side opening 130 from sucking the wall of the gastrointestinal tract when performing suction, thereby preventing a decrease in suction efficiency. It can also be said that the position of the side opening 130 in the circumferential direction of the distal end section 110 of the endoscope 100 is within a range of ±60° based on the direction in which the angle section 140 is bent.

[0025] Fig. 4(A) is a diagram showing the distal end portion 110 of the endoscope 100 as viewed from the right side of Fig. 2. As shown in Fig. 4(A), the side opening 130 is provided in a flexible soft section 150 connected to the proximal end of a bendable angle section 140 provided at the distal end of the endoscope 100. The angle section 140 has a bendable configuration that allows it to be bent in a desired direction and angle by operating a knob or the like on a hand-operated control unit to which an internal wire is connected. In this example, the side opening 130 is provided at a position rearward of the angle section 140. Here, "rearward of the angle section 140" refers to the proximal end side of the angle section 140. When using the side opening 130 positioned in this way as a suction port, the angle portion 140 of the endoscope 100 can be bent and inverted in an up-angle direction (the direction of arrow U in FIG. 2 ) as shown in FIG. 5 . Therefore, even if a blood clot or other obstruction blocks the side opening 130 and prevents suction during suction for bleeding or other reasons, the condition of the side opening 130 can be easily confirmed using the objective lens 121 on the distal end surface 120. Furthermore, if necessary, a treatment tool inserted through the forceps hole 126 can be used to remove the blood clot or other obstruction, thereby resolving the problem. It is sufficient for the side opening 130 to be positioned so that its condition can be visually confirmed by manipulating the angle portion 140. Alternatively, the side opening 130 may be provided on the angle portion 140, and the distal end portion of the angle portion 140 may be inverted to enable visual confirmation of the side opening 130. Here, the angle portion 140 corresponds to the bending portion of the present invention.

[0026] By using the side opening 130 as a suction port, waste liquid generated by water supply from the forceps hole 126 or auxiliary water supply nozzle 125 located on the tip surface 120 of the endoscope 100 and blood due to bleeding can be sucked out from the side opening 130, creating a structure in which liquid circulates, allowing the field of view of the endoscope 100 to be maintained at all times in a good condition and improving the efficiency of treatment.

[0027] This is particularly effective during procedures such as endoscopic submucosal dissection (ESD), which are prone to bleeding. Even if bleeding occurs, hemostasis can be performed while maintaining a good field of view by continuing irrigation through the auxiliary water supply port. This effect is particularly pronounced when a transparent hood is attached to the distal end of the endoscope 100 and the side opening 130 is located proximal to the hood. That is, the hood is constantly filled with clear, clean water by the air / water supply nozzle 124 or the auxiliary water supply nozzle 125, and obstruction of the field of view due to blood or turbid waste fluid returning to the distal end of the endoscope 100 can be avoided by suction through the side opening 130. This effect is also particularly effective during hemostasis procedures using a viscous viewing-enhancing liquid (Viscoclear®), allowing suction through the side opening 130 without obstructing the field of view, even when the viewing-enhancing liquid is continuously dispensed from the distal end of the endoscope 100 to maintain the field of view.

[0028] 4(B) is an enlarged view of the side opening 130 of FIG. 4(A). As shown in FIG. 4(B), the sub-channel duct 131 opening into the side opening 130 can be formed at the opening-side end 131a in a direction that forms an angle α with the axis Ax of the endoscope 100. This angle α is defined as the angle between the center line L1 of the sub-channel duct 131, which is parallel to the axis Ax of the endoscope 100, and the center line L2 of the opening-side end 131a of the sub-channel duct 131. The angle α is preferably in the range of 0° to 45°, and more preferably in the range of 5° to 25° (15°±10°). An angle α of 0° means that the sub-channel duct 131 is formed parallel to the axis Ax of the endoscope 100 and reaches the side opening 130. As will be described later, when the side opening 130 is used as a second forceps channel through which a treatment tool such as grasping forceps 160 is inserted, the efficiency of endoscopic treatment can be improved by appropriately setting the angle α that the opening side end 131a makes with the axis Ax of the endoscope 100 in accordance with the range of motion of the treatment tool. Here, the axis Ax corresponds to the axis of the tip portion in the present invention, and the opening side end 131a corresponds to the end on the side opening side in the present invention.

[0029] The side opening 130 according to this embodiment can also be used as a second forceps hole for inserting a treatment tool such as grasping forceps 160. In this case, the treatment tool inserted through the side opening 130 is connected to a proximal operation unit disposed on the proximal operation unit side of the endoscope 100 via a sub-channel duct 131. FIG. 6 shows an example in which the grasping forceps 160 is inserted through the side opening 130 and used as a second forceps hole. In this example, a treatment tool such as the grasping forceps 160 corresponds to the second treatment tool of the present invention. Grasping and traction of the dissected mucosa during ESD enables the expansion of the surgical field, significantly improving the efficiency of the procedure. Various traction methods have been devised to achieve this, but with grasping forceps inserted through the forceps hole of a conventional two-channel endoscope, as described in the prior art, the grasping forceps also move in synchronization with the movement of the tip of the endoscope, making it difficult to efficiently expand the field of view. The grasping forceps 160 inserted through the side opening 130 according to this embodiment does not follow the angled section 140 of the endoscope 100, and therefore can maintain a grasping state with independent movement that is not affected by the movement of the knife inserted through the forceps hole 126 located on the distal end surface 120 of the endoscope 100. This makes it easier to obtain an effective field of view, improving the treatment efficiency of endoscopic treatment.

[0030] The endoscope 100 according to this embodiment is suitable as a thin and long endoscope for use in the digestive system, but can also be used suitably for treating diseases of the urinary system, bronchial tubes, and gynecological diseases.

[0031] (Modification) FIG. 7 shows an endoscope 100 according to a modification. Since the endoscope 101 has the same configuration as the endoscope 100 except for the position of the side opening 130A, only the differences will be described. In the endoscope 101 shown in FIG. 7, the side opening 130A is located closer to the distal end face 120 along the axial direction of the endoscope 101. When the side opening 130 located closer to the distal end face 120 is used as a suction port, liquid that obstructs the field of view of the objective lens 121 can be aspirated closer to the objective lens 121 located on the distal end face 120, thereby making the field of view of the objective lens 121 clearer. Furthermore, when the side opening 130A is used as a second forceps channel, positioning the side opening 130A closer to the distal end face 120 facilitates treatment. Furthermore, both the side opening 130 according to the embodiment and the side opening 130A according to the modification may be provided. The side opening 130 and the side opening 130A may each have an independent sub-channel. Alternatively, the side opening 130 and the side opening 130A may have a common sub-channel duct, and a mechanism for switching between using the side opening 130 and the side opening 130A may be provided. In the endoscope 100 according to the illustrated first embodiment and the modified example, the outer diameters of the distal end and proximal end of the side opening 130 and the side opening 130A are different, but the distal end and proximal end of the side opening 130A may have the same outer diameter.

[0032] REFERENCE SIGNS LIST 100: endoscope 110: tip portion 120: tip surface 122: objective lens 126: forceps hole 130: side opening

Claims

1. An endoscope comprising: a distal end surface having a distal end opening through which a first treatment tool can be inserted and an observation section; a distal end portion having a bending section that supports the distal end surface so that it can be bent freely; and a side opening provided on the side of the distal end, which is capable of absorbing water and through which a second treatment tool can be inserted.

2. An endoscope according to claim 1, characterized in that the side opening is provided at a position within a range of ±60° in the circumferential direction, including the direction directly above, relative to the center of the field of view of the observation section.

3. The endoscope according to claim 1, wherein the side opening is provided at a position within a range of ±60° in the circumferential direction including the direction in which the bending portion is bent.

4. The endoscope according to claim 1, wherein the side opening is provided behind the bending portion.

5. An endoscope as claimed in any one of claims 1 to 4, characterized in that the side opening is located within the field of view of the observation section provided on the tip surface supported by the tip section in which the bending section is bent towards the base end.

6. An endoscope as claimed in any one of claims 1 to 4, characterized in that the channel connected to the side opening and extending towards the base end forms an angle of 0° to 45° with respect to the axial direction of the tip end at the end on the side opening side.

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