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WO2016017264A1 - Coiffe d'endoscope - Google Patents

Coiffe d'endoscope Download PDF

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Publication number
WO2016017264A1
WO2016017264A1 PCT/JP2015/065768 JP2015065768W WO2016017264A1 WO 2016017264 A1 WO2016017264 A1 WO 2016017264A1 JP 2015065768 W JP2015065768 W JP 2015065768W WO 2016017264 A1 WO2016017264 A1 WO 2016017264A1
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WO
WIPO (PCT)
Prior art keywords
cap
pressing
endoscope
pressing region
pair
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2015/065768
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English (en)
Japanese (ja)
Inventor
淳一 小木曽
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to JP2016526249A priority Critical patent/JPWO2016017264A1/ja
Publication of WO2016017264A1 publication Critical patent/WO2016017264A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor

Definitions

  • the present invention relates to an endoscope cap attached to the distal end portion of an endoscope.
  • This application claims priority based on Japanese Patent Application No. 2014-155275 for which it applied to Japan on July 30, 2014, and uses the content here.
  • the endoscope When performing treatment using a treatment instrument while observing the surgical site with an endoscope, in order to secure a field of view for the endoscope and a space for performing treatment, the endoscope is inserted at the distal end of the insertion portion of the endoscope.
  • a mirror cap may be attached.
  • Patent Document 1 discloses an endoscope hood that has a substantially cylindrical cap portion and that has a proximal end of the cap portion attached to a distal end portion of an insertion portion of the endoscope.
  • the opening at the distal end of the cap portion of the endoscope hood is pressed against the mucous membrane and sucked with a suction device, so that the pressure inside the endoscope hood is negative and the mucosa is pulled into the cap portion.
  • a procedure is disclosed.
  • the endoscope hood disclosed in Patent Document 1 has a hardness that does not cause a large deformation when pressed against the mucous membrane or when sucked.
  • ESD endoscopic submucosal dissection
  • the endoscope hood disclosed in Patent Document 1 can be inserted between the incised submucosa and muscle layer. difficult.
  • a hood attached to the insertion portion of the endoscope, a substantially cylindrical cap fixed to the hood, and an outer periphery of the cap are provided.
  • a treatment in which a mucosa is incised by a high-frequency knife arranged in a cap while the treatment tool is provided and the mucous membrane is gripped by the treatment tool.
  • the endoscope treatment tool disclosed in Patent Document 2 grips the mucous membrane in front of the cap with the treatment tool and pulls up the mucosa so as to cover the opening on the distal end side of the cap, so that the distal end portion of the endoscope is incised. It is possible to easily enter between the submucosa layer and the muscle layer. However, there is a high need for a simpler configuration that can be easily operated.
  • An endoscope cap includes a cap body having a cylindrical shape that has a distal end and a proximal end that are open and communicates from the distal end to the proximal end, and the proximal end of the cap body is disposed inside.
  • Non-pressing The cap main body is elastically deformed so that the pair of first deforming portions are separated from each other as the external force is applied to the pressing area, and the pressing area and the non-pressing area
  • the cap body is elastically deformed so that the opening area at the tip of the cap body is narrowed close to the region.
  • the cap body has different rigidity between the pressing region and the non-pressing region with the pair of first deforming portions as a boundary.
  • the pressing area may be formed of a material having higher rigidity than the non-pressing area.
  • the cap body has a thickness in which the pressing area and the non-pressing area are different from each other with the pair of first deforming portions as a boundary.
  • the thickness of the pressing area may be greater than the thickness of the non-pressing area.
  • the pair of first deforming portions of the cap body is formed with a recess so as to be thin. Also good.
  • At least the distal end portion of the cap main body of the pair of first deformable portions is not the cap main body. It may be formed of a material having a lower rigidity than the region.
  • the cap main body includes the pair of first deformation portions, and the distal end of the cap main body is the base end.
  • a notch that is recessed in the direction may be formed.
  • the cap body is elastically deformed so that the pair of first deformable portions are separated from each other.
  • the distal end of the cap body may be restored to the initial shape opened along the shape of the proximal end.
  • the distal end of the endoscope apparatus can be easily inserted between the submucosa and the muscle layer and the submucosa can be raised by a simple operation.
  • FIG. 1 is a perspective view showing an endoscope cap 1 according to the present embodiment.
  • the endoscope cap 1 has a proximal end opening 31 (mounting portion), a cap body 2, and a distal end opening 61, and is formed in a substantially cylindrical shape that communicates from the distal end 6 to the proximal end 3. .
  • the proximal end opening 31 is formed at the proximal end 3 of the cap body 2.
  • the endoscope cap 1 according to this embodiment is attached to a distal end portion of an endoscope insertion portion 100 of an endoscope (not shown).
  • the proximal end opening 31 is attached to the distal end portion of the endoscope insertion portion 100 by a known method.
  • the distal end opening 61 protrudes in the distal direction relative to the endoscope insertion portion 100.
  • the cap body 2 is made of an elastically deformable material. In the natural state, the cap body 2 maintains a substantially cylindrical shape in which the tip opening 61 is circular as shown in FIG. On the other hand, the cap body 2 can be elastically deformed by applying an external force so that the distance between the pressing region 4 and the non-pressing region 5 is reduced and the opening area of the tip opening 61 is reduced. Furthermore, when the applied external force is released, the cap body 2 is restored to the substantially cylindrical initial shape again. Details of the mode in which the endoscope cap 1 is elastically deformed will be described later.
  • FIG. 2 is a front view of the endoscope cap shown in FIG. 1 as viewed from the distal end side.
  • a pressing area 4 In the circumferential direction of the cap body 2, a pressing area 4, a pair of first deformable portions 8, and a non-pressing area 5 are formed.
  • the pair of first deformable portions 8 are provided at positions sandwiching the pressing region 4 in the circumferential direction of the distal end portion 9 (see FIG. 1) of the cap body 2.
  • the pair of first deformable portions 8 are located on a straight line L ⁇ b> 2 that includes the central axis L ⁇ b> 1 of the cap body 2 and extends in the radial direction of the cap body 2.
  • the pair of first deformable portions 8 are regions including a point P on the straight line L2 (hereinafter sometimes referred to as “first elastic deformation point P”).
  • the first elastic deformation point P is a position serving as a reference point for elastically deforming the cap body 2 outward in the radial direction.
  • the pressing area 4 is a partial area in the circumferential direction of the cap body 2 in the tip opening 61 of the cap body 2.
  • the pressing area 4 is located between the pair of first deformable portions 8 in the circumferential direction of the cap body 2.
  • the non-pressing region 5 is located on the opposite side of the pressing region 4 with the pair of first deformable portions 8 interposed therebetween in the circumferential direction of the cap body 2.
  • the non-pressing area 5 is formed of a material having lower rigidity than the pressing area 4.
  • the material constituting the cap body 2 is, for example, an acrylic elastomer.
  • the cap body 2 of the present embodiment performs a known crosslinking process to crosslink the acrylic elastomer so that the non-pressing area 5 has lower rigidity than the pressing area 4.
  • the portion that becomes the non-pressing region 5 is cross-linked by adding relatively less cross-linking agent than the portion that becomes the pressing region 4 and irradiating with ionizing radiation.
  • the addition amount of the crosslinking agent at the tip of the cap body 2 uniform and reducing the dose of ionizing radiation applied to the non-pressing region 5 as compared with the pressing region 4, the rigidity of the non-pressing region 5 is reduced to the pressing region. 4 so as to be lower than the rigidity of 4.
  • the cap body 2 of the present embodiment has a substantially circular cross-sectional shape perpendicular to the central axis L ⁇ b> 1 of the tip opening 61. Located in. That is, in the circumferential direction of the cap body 2, one of the regions divided by the pair of first deformable portions 8 as a boundary is the pressing region 4, and the other is the non-pressing region 5.
  • an endoscope (not shown) provided with the endoscope cap 1 at the distal end portion of the endoscope insertion portion 100 is used to perform submucosal layer 200 in ESD. Is described with an example of performing a treatment of cutting with a high-frequency knife (not shown).
  • the normal mucous membrane around the region including the lesioned part 202 formed in the digestive tract is incised all around, and then the lesioned part 202 inside is excised.
  • the endoscope insertion portion 100 of the endoscope to which the endoscope cap 1 is attached is advanced between the incised normal mucosa submucosal layer 200 and the muscle layer 201 to be used for the endoscope.
  • the incision is advanced so as to separate the submucosal layer 200 from the muscle layer 201 using a treatment tool such as a high-frequency knife.
  • the tip 6 of the endoscope cap 1 is disposed in the vicinity of the end 200a of the entire circumferential incision portion of the normal mucous membrane incised from the outer peripheral side of the entire circumferential incision portion.
  • the incision area of the incised submucosa 200 after the entire circumference incision is small. Therefore, it is difficult to insert the endoscope cap 1 between the incised end portion 200 a of the normal mucous membrane and the muscle layer 201.
  • the distal end portion 9 of the cap body 2 can be elastically deformed so that the distance between the pressing region 4 and the non-pressing region 5 becomes small. Therefore, the endoscope cap 1 can be easily inserted between the submucosa 200 and the muscle layer 201.
  • FIG. 4 is a schematic diagram for explaining the action of elastically deforming the endoscope cap.
  • the endoscope cap 1 according to the present embodiment has a distal end opening 61 that opens in a substantially circular shape in a natural state.
  • the endoscope insertion portion 100 is moved and the tip 6 of the endoscope cap 1 is pressed toward the living tissue side in a state where the pressing region 4 is in contact with the living tissue (such as the submucosa 200), an external force is applied to the pressing region 4. (Reaction force from the living tissue side) is added.
  • the pressing region 4 of the endoscope cap 1 has higher rigidity than the non-pressing region 5 with the pair of first deforming portions 8 (first elastic deformation points P) as a boundary. Therefore, in the circumferential direction of the distal end portion 9 of the cap body 2, the first deformable portion 8 becomes a stiffness change point. Therefore, when the pressing area 4 receives an external force, first, the pair of first deformable portions 8 having rigidity smaller than that of the pressing area 4 is elastically deformed.
  • the first deformable portion 8 is formed on the first elastic deformation point P, and the cap body 2 has a pressing region 4, a non-pressing region 5, and a pair of first deforming portions 8 located therebetween.
  • the first deforming portion 8 is elastically deformed so that the radius of curvature decreases toward the radially outer side of the cap body 2 (the direction of the arrow B shown in FIG. 4). That is, when the pressing region 4 receives an external force, the pair of first deformable portions 8 are elastically deformed in a direction away from each other. Accordingly, the pressing area 4 and the non-pressing area 5 are elastically deformed so that the respective radii of curvature become large. In this state, when the endoscope insertion portion 100 is further pushed toward the living tissue side, the pressing area 4 and the non-pressing area 5 approach each other, and the width in the direction of the arrow C shown in FIG.
  • the pressing area 4 is formed to have higher rigidity than the pair of first deformable portions 8 and the non-pressing area 5.
  • the tip 9 of the cap body 2 is easily elastically deformed into a desired shape. That is, when an external force is applied to the pressing region 4, the pair of first deformable portions 8 are separated from each other, and the pair of first deformable portions 8 are elastically deformed so that the radius of curvature decreases toward the radially outer side.
  • the non-pressing region 5 since the non-pressing region 5 has lower rigidity than the pressing region 4 with the pair of first deforming portions 8 as a boundary, the non-pressing region 5 also follows the elastic deformation in which the pair of first deforming portions 8 are separated.
  • the endoscope insertion portion 100 When the endoscope insertion portion 100 is advanced in a state where the shape of the distal end portion 9 of the endoscope cap 1 is elastically deformed, the endoscope is inserted between the submucosa 200 and the muscle layer 201 as shown in FIG.
  • the mirror insertion part 100 can be entered.
  • the tip 6 of the endoscope cap 1 is advanced to a position where the submucosal layer 200 should be incised, the pressing of the endoscope insertion portion 100 toward the living tissue is released. As a result, no external force is applied to the pressing region 4. Since the cap body 2 is configured to be elastically deformable when an external force is applied and to be restored to a predetermined curved shape when the external force is released, as shown in FIG. Restore the initial shape. Further, the non-pressing region 5 has such a rigidity that it can maintain a certain shape even when the cut mucosal layer 200 contacts.
  • the submucosal layer 200 is a very soft tissue, even when the submucosal layer 200 contacts the non-pressing region 5 in the state illustrated in FIG. 6, the non-pressing region 5 is not elastically deformed by an external force.
  • the endoscope cap 1 secures an observation field of view by the endoscope, and prevents the treatment by the incised submucosal layer 200 when the treatment target site is treated by the treatment tool such as a high-frequency knife. This can be prevented and treatment can be performed smoothly.
  • a treatment tool such as a high-frequency knife is protruded from the distal end of the endoscope insertion portion 100 to incise the submucosal layer 200.
  • the distal end portion 9 of the endoscope cap 1 is not pressed against the pressing region 4 by a simple operation of pressing the endoscope insertion portion 100 toward the living tissue side. It can be elastically deformed so as to be close to the region 5.
  • the endoscope cap 1 elastically deformed so that the pressing region 4 and the non-pressing region 5 are close to each other is disposed between the submucosal layer and the muscle layer, the living body of the endoscope insertion unit 100 When the pressure on the tissue side is released, the submucosa can be lifted easily.
  • the configuration of the cap body 2 in which the rigidity of the non-pressing area 5 is lower than the rigidity of the pressing area 4 with the pair of first deformable portions 8 as a boundary is a material whose rigidity is lower than the material forming the pressing area 4 as in the above embodiment.
  • FIG. 7 and 8 show a first modification of the endoscope cap 1 according to the present embodiment.
  • FIG. 7 is a front view showing an endoscope cap 1a of a first modification.
  • FIG. 8 is a perspective view showing an endoscope cap 1a according to a first modification.
  • the configuration for making the rigidity of the non-pressing region 5 lower than the rigidity of the pressing region 4 with the pair of first deforming portions 8 as a boundary is different from that of the first embodiment.
  • the endoscope cap 1 a in the present modified example has a pressing region such that the thickness of the pressing region 4 is greater than the thickness of the non-pressing region 5 with the pair of first deforming portions 8 as a boundary. 4 and a non-pressing area 5 are formed. As a result, the rigidity of the non-pressing area 5 is lower than the rigidity of the pressing area 4.
  • the present modification is different from the first embodiment. As shown in FIG. 8, in the cap body 2, the non-pressing area 5 is formed thinner than the pressing area 4 from the distal end opening 61 to the vicinity of the proximal end opening 31.
  • a step is formed at the position of the pair of first elastic deformation points P on the inner peripheral surface of the cap body 2.
  • the pressing region 4, the non-pressing region 5, and the pair of first deformable portions are made of the same material, and the thickness of the pressing region 4 is made thicker than the thickness of the non-pressing region 5. Is lower than the rigidity of the pressing region 4.
  • the endoscope cap 1a according to the present modification can obtain the same effects as those of the first embodiment.
  • region 4 was shown so that a level
  • the pressing region 4 may have a configuration in which the thickness increases on the outer peripheral surface side of the cap body 2 or a configuration in which the pressing region 4 increases in thickness on the inner surface and the outer surface of the cap body 2.
  • FIG. 9 shows a second modification of the endoscope cap 1 according to this embodiment.
  • the thickness of the pressing area 4 is made thicker than the non-pressing area 5 only at the tip 9 of the cap body 2. That is, this is an example in which the pressing region 4 having higher rigidity than the other regions is formed only at the tip 9 of the cap body 2.
  • the cap body 2 of this modification is made of the same material as that of the first modification.
  • the endoscope cap 1b of the present modified example since the pressing area 4 having high rigidity is formed only at the distal end portion 9 of the cap body 2, when an external force is applied to the pressing area 4, other than the pressing area 4 This area is easily elastically deformed. Therefore, the opening area of the distal end opening 61 of the endoscope cap 1a can be easily changed, and the operability is excellent. Further, the endoscope cap 1b according to the present modification can obtain the same effects as those of the first embodiment.
  • FIG. 1 A third modification of the endoscope cap 1 according to this embodiment is shown in FIG.
  • the present modification only the tip 9 of the cap body 2 in the pressing area 4 is formed using a material having higher rigidity than the other areas of the cap body 2. That is, this is an example in which a region having higher rigidity than the non-pressing region 5 is formed only in the pressing region 4 of the distal end portion 9 of the cap body 2.
  • the cap main body 2 of this modification is formed so that the pressing area 4 of the distal end portion 9 is higher than the rigidity of the non-pressing area 5 by the same bridging process as in the first embodiment.
  • the endoscope cap 1c of the present modification a region having high rigidity is formed only in the distal end portion 9 of the cap body 2 in the pressing region 4, so that when an external force is applied to the pressing region 4, Areas other than the pressing area 4 are easily elastically deformed. Therefore, the opening area of the distal end opening 61 of the endoscope cap 1c can be easily changed, and the operability is excellent. Further, the endoscope cap 1c according to the present modification can obtain the same effects as those of the first embodiment.
  • FIG. 11 is a perspective view showing an endoscope cap 11 according to the second embodiment.
  • 12 is a front view of the endoscope cap 11 shown in FIG. 11 as viewed from the distal end side.
  • the pair of first deformable portions 8 are formed with recesses 81 that are recessed in the radial direction of the cap body 2 on the inner peripheral surface of the cap body 20.
  • the recess 81 is formed from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1).
  • the concave portion 81 is formed in the pair of first deformable portions 8
  • the cap body 20 is thin in the concave portion 81, and the pair of first deformable portions 8.
  • the rigidity is lower than the rigidity of the pressing area 4.
  • the pair of first deformable portions 8 are elastically deformed so as to be separated from each other toward the radially outer side of the cap body 20 (in the direction of arrow A shown in FIG. 12) along with the elastic deformation of the pressing region 4.
  • the endoscope cap 11 has a distal end opening 61 that opens in a substantially circular shape in a natural state.
  • an external force from the living tissue side is applied to the pressing region 4. Reaction force).
  • the pair of first deformable portions 8 are formed with concave portions 81 that are recessed in the radial direction of the cap body 2 on the inner peripheral surface of the cap body 2. That is, the recess 81 has the lowest rigidity in the circumferential direction of the cap body 2. Therefore, when the pressing region 4 receives an external force, first, the pair of first deformable portions 8 are elastically deformed so that the radius of curvature decreases toward the radially outer side of the cap body 2 (in the direction of arrow B shown in FIG. 4). . That is, the pair of first deformable portions 8 is elastically deformed in a direction away from each other.
  • the pressing area 4 and the non-pressing area 5 are each pulled toward the pair of first deformable portions 8 and elastically deformed so that the respective radii of curvature become large.
  • the pressing area 4 and the non-pressing area 5 approach each other, and the width in the direction of the arrow C shown in FIG. (Opening width of the tip opening 61 in the direction of arrow C) is reduced.
  • the distal end portion 9 of the cap body 20 can be easily embedded between the submucosa 200 and the muscle layer 201, and the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle.
  • the cap body 20 is configured such that the rigidity of the non-pressing area 5 is smaller than the rigidity of the pressing area 4 with the pair of first deformable portions 8 as a boundary.
  • This embodiment is different from the first embodiment in that the rigidity of the pair of first deformable portions 8 is configured to be smaller than the rigidity of the pressing region 4.
  • the endoscope cap 11 according to the present embodiment sets the pair of first deformable portions 8 to the cap body by setting the rigidity of at least the pair of first deformable portions 8 to be smaller than the rigidity of the pressing region 4. It has the structure which is easy to be elastically deformed in the direction which mutually space
  • the tip portion 9 of the endoscope cap 11 is elastically deformed so that the pressing area 4 and the non-pressing area 5 are close to each other by a simple operation of pressing the endoscope insertion section 100 toward the living tissue. Can be made.
  • the endoscope cap 11 according to the present embodiment can obtain the same effects as those of the first embodiment.
  • the pair of first deformable portions 8 are configured to bend and form a concave portion 81 extending from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1).
  • the main body 20 should just be the structure which has the press area
  • the base end 3 side is configured not to be elastically deformed, it can be easily restored to the initial shape after the external force applied to the endoscope cap 11 is released.
  • the recesses 81 of the pair of first deformable portions 8 may be configured to be formed on the outer peripheral surface of the cap body 20 in addition to the example formed on the inner peripheral surface of the cap body 20 as in the present embodiment. .
  • the concave portion 81 is formed on the outer peripheral surface of the cap main body 20, the first deformable portion 8 is easily bent radially outward of the cap main body 2, and the concave portion 81 can be easily formed when the endoscope cap 1 is manufactured. It is.
  • the concave portion 81 is formed from the distal end to the proximal end in the longitudinal direction of the cap body 20, but the concave portion 81 only needs to be formed at least at the distal end portion 9.
  • FIG. 13 shows a first modification of the endoscope cap 11 according to this embodiment.
  • the endoscope cap 11a of the present modification is different in configuration from the pair of first deformable portions 8 in the second embodiment.
  • it comprised so that the rigidity of a pair of 1st deformation
  • the concave portion 81 is not formed, and the first deformation portion 8a is formed of a material having lower rigidity than the material forming the pressing region 4.
  • the pair of first deformable portions 8a includes a pair of regions including the first elastic deformation point P in the cap body 20 and extending from the distal end 6 to the proximal end 3 in the length direction of the cap body 20 (in the direction of the central axis L1). , Formed of a material having lower rigidity than the other regions (the pressing region 4 and the non-pressing region 5). Other configurations are the same as those of the endoscope cap 11 according to the second embodiment. The endoscope cap 11a according to this modification can obtain the same effects as those of the second embodiment.
  • the pair of first deformable portions 8a only need to be formed at least on the distal end portion 9 side.
  • tip opening part 61 may be comprised from a material whose rigidity is lower than another area
  • FIG. 14 shows a second modification of the endoscope cap 11 according to this embodiment.
  • the cutout portion 10 is formed in the distal end opening 61 of the cap body 2 in the first deformable portion 8b. Is formed.
  • the notch 10 is formed only at the tip 9.
  • the notch 10 has a circumferential position of the cap body 20 including the first elastic deformation point P, and extends from the distal end 6 toward the proximal end 3 in the direction of the central axis L1 of the cap body 20.
  • a tip opening 61 is formed by cutting out.
  • the notch 10 has a curved surface formed from the distal end opening 61 toward the deepest portion (proximal end portion) of the notch 10 when the endoscope cap 11b is viewed from the side. .
  • the distal end portion of the cap body 20 is increased by increasing the inclination of the endoscope cap 11 with respect to the living tissue (the inclination of the endoscope insertion portion 100 with respect to the living tissue). 9 is curved.
  • the notch 10 at the tip 6 of the cap body 20 has lower rigidity in the direction of the external force applied to the cap body 20 than other regions. For this reason, the first deformable portion 8b has a structure that is easily bent.
  • the endoscope cap 11b according to this modification can obtain the same effects as those of the second embodiment.
  • the region of the first deformable portion 8 is changed to another region as in the first modified example. You may combine the structure used as material with low rigidity compared with.
  • the configuration of the second modification example in which the region of the pair of first deformation portions 8 is made of a material having lower rigidity than the other regions may be combined.
  • FIG. 15 is a perspective view showing an outline of the endoscope cap 12 according to the present embodiment.
  • the present embodiment is different from the first and second embodiments in that a pressing region side protrusion is provided at the tip of the pressing region, and a non-pressing region side protrusion is further provided at the tip of the non-pressing region.
  • the same reference numerals are given to the same components and the like as those in the first and second embodiments, and redundant description is omitted.
  • the endoscope cap 12 includes a proximal end opening 31 (mounting portion), a cap body 21, a distal end opening 61, a pressing region side protruding portion 71, and a non-pressing region side protruding portion 72. And have.
  • the endoscope cap 12 according to the present embodiment is formed in a substantially cylindrical shape that communicates from the distal end 6 to the proximal end 3.
  • the distal end opening 61 is provided so as to protrude from the proximal end opening 31 in the distal direction relative to the endoscope insertion portion 100.
  • the pressing region side protrusion 71 is provided to extend from the pressing region 4 in the tip opening 61 in the distal direction of the cap body 21 (the direction of arrow E shown in FIG. 15).
  • the non-pressing area side protrusion 72 is provided to extend from the non-pressing area 5 in the tip opening 61 in the distal direction of the cap body 21 (in the direction of arrow E shown in FIG. 15).
  • the pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 each have a shape curved in an arc shape along the cylindrical shape of the cap body 21.
  • the pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 are provided at positions facing each other.
  • the endoscope cap 12 according to the present embodiment is further provided at the distal end of the endoscope caps 1 and 11 according to the first embodiment and the second embodiment, and further on the pressing area side protruding portion 71 and the non-pressing area side protrusion.
  • An auxiliary member that forms the portion 72 and smoothly realizes elastic deformation so that the opening area of the distal end opening 61 of the endoscope caps 1 and 11 according to the first and second embodiments is reduced. is there.
  • the cap body 21 is made of the same material that can be elastically deformed. In the natural state, the cap main body 21 maintains a substantially cylindrical shape in which the cross-sectional shape of the tip opening 61 in a cross section orthogonal to the central axis L1 of the cap main body 21 is circular. On the other hand, the cap main body 21 can be elastically deformed so that the distance between the pressing region 4 and the non-pressing region 5 is reduced when an external force is applied, and when the applied external force is released, the initial shape of the substantially cylindrical shape again. To be restored.
  • FIG. 15 is a perspective view showing an initial shape of the endoscope cap 12 according to the present embodiment.
  • the endoscope cap 12 according to the present embodiment has a distal end opening 61 that opens in a substantially circular shape in a natural state.
  • the pressing region side protruding portion 71 includes External force (reaction force from the living tissue side) is applied.
  • the pressing region side protrusion 71 is bent in a direction intersecting the central axis L1 of the cap body 21, as shown in FIG.
  • a broken line portion 71b is formed at the distal end portion 71a.
  • the region 71c on the tip end 71a side of the broken line portion 71b of the pressing region side protrusion 71 is elastically deformed from a curved shape to a flat shape.
  • the area 71c elastically deformed into a flat shape of the pressing area side protrusion 71 has an outer peripheral surface that abuts on the living tissue.
  • the pressing region 4 of the distal end portion 9 of the endoscope cap 12 is pressed toward the living tissue side.
  • the endoscope insertion portion 100 is further pushed to the living tissue side in a state where the flat-shaped pressing region side protruding portion 71 is in contact with the living tissue.
  • the broken line portion 71b is positioned at the first elastic deformation point P of the tip opening 61, and the pressing region side protrusion 71 is elastically deformed. That is, the pressing region side protruding portion 71 is elastically deformed so as to have a flat shape.
  • the pair of first deformable portions 8 is radially outward of the cap body 21 (in the direction indicated by the arrow F shown in FIG. 17) by the operation described with reference to FIG. 4. ) Elastically deforms so that the radius of curvature becomes smaller. That is, the pair of first deformable portions 8 is elastically deformed in a direction away from each other.
  • the pressing area 4, the non-pressing area 5, and the non-pressing area side projecting portion 72 have their respective arc shapes spread and elastically deformed into a flat shape.
  • the pressing area 4 and the non-pressing area 5 are close to each other, and the pressing area side protruding portion 71 and the non-pressing area side protruding portion 72 are close to each other, so that the opening width of the tip opening 61 of the cap body 2 is increased. Get smaller.
  • the distal end portion 9 of the cap body 21 can be easily inserted between the submucosa 200 and the muscle layer 201, and the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle. It can enter between the layers 201.
  • the endoscope insertion portion 100 is connected to the submucosa 200 and the muscle. It can enter between the layers 201.
  • region 5 can raise the cut
  • FIG. Therefore, as in the first embodiment, when the observation field of view by the endoscope is ensured and the treatment target site is treated by the treatment tool such as a high-frequency knife, the incised submucosal layer 200 prevents the treatment. Can be prevented.
  • the endoscope cap 12 is configured to elastically deform the pressing region side protruding portion 71 before the pressing region 4 when pressed to the living tissue side, and the pressing region side protruding portion 71. Functions as a guide for elastically deforming the pair of first deformable portions 8 radially outward.
  • the endoscope cap 12 according to the present embodiment can be elastically deformed so that the pressing region side protruding portion 71 and the non-pressing region side protruding portion 72 are flat and close to each other. Therefore, the distal end portion of the endoscope cap 12 can be formed in a substantially flat plate shape, and the endoscope cap 12 can easily enter between the end portion 200a of the submucosal layer 200 and the muscle layer 201.
  • the configuration of the cap body 21 is not limited to the configuration of the present embodiment.
  • the pressing region side protruding portion 71 and the non-pressing region side are formed on the distal end portion 9 of the cap body 2 according to the first embodiment and the second embodiment.
  • the structure which provides the protrusion part 72 may be sufficient.
  • the cap body is formed of an acrylic elastomer
  • the material forming the cap body is not limited to this, and a known soft material used for an endoscope cap can be used.
  • crosslinking process and the example which makes the thickness of the pressing area
  • the means for making the rigidity of the non-pressing region 5 smaller than the rigidity of the pressing region 4 is not limited to this, and the non-pressing region 5 and the pressing region 4 can be formed by combining materials having relatively different rigidity. is there.
  • the pair of first deformable portions 8 are arranged at positions including the first elastic deformation point P located on the straight line L2 including the central axis L1 of the cap body 2 and extending in the radial direction of the cap body 2.
  • transformation part may be the structure provided in the position which is located on the straight line parallel to the diameter of the cap main body 2, and the press area
  • a configuration in which the pair of first deforming portions are located on a straight line between the central axis L1 and the pressing region 4 or between the central axis L1 and the non-pressing region 5 and parallel to the straight line L2 may be employed.
  • an endoscope cap that can be easily operated to allow the distal end of the endoscope apparatus to be submerged between the submucosal layer and the muscular layer, and that can raise the submucosal layer.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Molecular Biology (AREA)
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  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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  • Orthopedic Medicine & Surgery (AREA)
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  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Otolaryngology (AREA)
  • Endoscopes (AREA)

Abstract

La présente invention porte sur une coiffe d'endoscope pourvue d'un corps principal de coiffe, d'une unité de montage, et, agencés au niveau de l'extrémité avant du corps principal de bouchon dans la direction circonférentielle du corps principal de coiffe, d'une région de pression, d'une paire de premières parties de déformation qui se déforment élastiquement en raison d'une force externe agissant sur la région de pression, et d'une région de non-pression qui est positionnée sur le côté de la paire de premières parties de déformation à l'opposé de la région de pression de sorte que la région de pression et la région de non-pression prennent en sandwich la paire de premières parties de déformation. La région de pression a une rigidité plus élevée que la région de non-pression, le corps principal de coiffe se déforme de manière élastique de telle sorte que, lorsque la force extérieure agit sur la région de pression, la paire de premières parties de déformation se séparent l'une de l'autre radialement vers l'extérieur par rapport au corps principal de coiffe et se déforment de manière élastique de telle sorte que la région de pression et la région de non-pression se rapprochent et la zone d'ouverture au niveau de l'extrémité avant du corps principal de coiffe se rétrécit.
PCT/JP2015/065768 2014-07-30 2015-06-01 Coiffe d'endoscope Ceased WO2016017264A1 (fr)

Priority Applications (1)

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JP2016526249A JPWO2016017264A1 (ja) 2014-07-30 2015-06-01 内視鏡用キャップ

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JP2014155275 2014-07-30
JP2014-155275 2014-07-30

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WO2016017264A1 true WO2016017264A1 (fr) 2016-02-04

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220079423A1 (en) * 2020-09-17 2022-03-17 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Endoscopic tip extender

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001224550A (ja) * 2000-02-15 2001-08-21 Asahi Optical Co Ltd 内視鏡の先端部
JP2003093325A (ja) * 2001-09-25 2003-04-02 Olympus Optical Co Ltd 内視鏡用フード部材
JP2003245244A (ja) * 2002-02-25 2003-09-02 Olympus Optical Co Ltd 先端フード部材
WO2008026445A1 (fr) * 2006-08-30 2008-03-06 Olympus Medical Systems Corp. Capuchon de tête pour endoscope et endoscope avec capuchon
JP2014068817A (ja) * 2012-09-28 2014-04-21 Fujifilm Corp 内視鏡用状態視認装置
WO2015072330A1 (fr) * 2013-11-15 2015-05-21 オリンパスメディカルシステムズ株式会社 Capuchon sur pointe d'endoscope et dispositif d'endoscope

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002301010A (ja) * 2001-04-05 2002-10-15 Asahi Optical Co Ltd フード付き内視鏡の先端部
JP5754630B2 (ja) * 2011-05-24 2015-07-29 オリンパス株式会社 内視鏡用フード

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2001224550A (ja) * 2000-02-15 2001-08-21 Asahi Optical Co Ltd 内視鏡の先端部
JP2003093325A (ja) * 2001-09-25 2003-04-02 Olympus Optical Co Ltd 内視鏡用フード部材
JP2003245244A (ja) * 2002-02-25 2003-09-02 Olympus Optical Co Ltd 先端フード部材
WO2008026445A1 (fr) * 2006-08-30 2008-03-06 Olympus Medical Systems Corp. Capuchon de tête pour endoscope et endoscope avec capuchon
JP2014068817A (ja) * 2012-09-28 2014-04-21 Fujifilm Corp 内視鏡用状態視認装置
WO2015072330A1 (fr) * 2013-11-15 2015-05-21 オリンパスメディカルシステムズ株式会社 Capuchon sur pointe d'endoscope et dispositif d'endoscope

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220079423A1 (en) * 2020-09-17 2022-03-17 Gyrus Acmi, Inc. D/B/A Olympus Surgical Technologies America Endoscopic tip extender

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