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WO2019008633A1 - Outil d'assistance à l'insertion et système d'assistance à l'insertion - Google Patents

Outil d'assistance à l'insertion et système d'assistance à l'insertion Download PDF

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Publication number
WO2019008633A1
WO2019008633A1 PCT/JP2017/024347 JP2017024347W WO2019008633A1 WO 2019008633 A1 WO2019008633 A1 WO 2019008633A1 JP 2017024347 W JP2017024347 W JP 2017024347W WO 2019008633 A1 WO2019008633 A1 WO 2019008633A1
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WO
WIPO (PCT)
Prior art keywords
guide pipe
insert
tubular portion
insertion portion
endoscope
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/JP2017/024347
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English (en)
Japanese (ja)
Inventor
翔太 二宮
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 JP2018539925A priority Critical patent/JP6479281B1/ja
Priority to PCT/JP2017/024347 priority patent/WO2019008633A1/fr
Publication of WO2019008633A1 publication Critical patent/WO2019008633A1/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
    • A61B1/005—Flexible endoscopes
    • A61B1/01—Guiding arrangements therefore
    • 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
    • A61B1/233—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 for the nose, i.e. nasoscopes, e.g. testing of patency of Eustachian tubes

Definitions

  • the present invention relates to an insertion assisting tool through which an insert is inserted, and an insertion assisting system using the insertion assisting tool.
  • WO 2016 / 035509A discloses an insertion aid used in conjunction with an endoscope for observing the paranasal sinuses.
  • This insertion aid includes a guide pipe which is curved in one direction and into which an insert such as the insertion portion of the endoscope is inserted.
  • the insert is inserted into the guide pipe from the proximal side and protrudes distally from an opening provided at the distal end of the guide pipe.
  • the tip of the insert is adjusted in direction by being inserted into the guide pipe.
  • the insert is an endoscope, the distal end of the insertion portion of the endoscope is guided to a desired observation position.
  • an insertion aid comprising: a first tubular portion into which a soft insert can be inserted and the insert is inserted straight or substantially straight.
  • an insertion assisting system comprising: a soft insert; a first tubular portion through which the insert is inserted in a straight or substantially straight state; and a direction relative to the first tubular portion.
  • a guide pipe having a second tubular portion which is bent at a predetermined angle and into which the insert is inserted while being curved, a guide pipe having an opening through which the insert can be protruded to the distal end side, and the first tubular And an angle changing portion provided at a tip end of the portion to make a bending angle of the insert smaller than the predetermined angle of the guide pipe.
  • FIG. 1 is a schematic view showing an endoscope system according to a first embodiment.
  • FIG. 2 is a perspective view schematically showing a guide pipe according to the first embodiment.
  • FIG. 3 is a view of the guide pipe according to the first embodiment as viewed from the tip side.
  • FIG. 4 is a view schematically showing a cross section taken along the line AA of FIG.
  • FIG. 5 is a view schematically showing the inside of the guide pipe when the insertion portion of the endoscope is inserted into the guide pipe according to the first embodiment.
  • FIG. 6 is a view schematically showing a cross section taken along the line BB in FIG.
  • FIG. 7 is a perspective view schematically showing a guide pipe according to a first modification of the first embodiment.
  • FIG. 1 is a schematic view showing an endoscope system according to a first embodiment.
  • FIG. 2 is a perspective view schematically showing a guide pipe according to the first embodiment.
  • FIG. 3 is a view of the guide pipe according to the first embodiment as
  • FIG. 8 is a view schematically showing the inside of a guide pipe according to a second modification of the first embodiment.
  • FIG. 9 is a perspective view schematically showing a guide pipe according to a second modification of the first embodiment.
  • FIG. 10 is a view schematically showing the inside of a guide pipe according to a third modification of the first embodiment.
  • FIG. 11 is a perspective view schematically showing a guide pipe according to a third modification of the first embodiment.
  • FIG. 12 is a view schematically showing the inside of a guide pipe according to a fourth modification of the first embodiment.
  • FIG. 13 is a view schematically showing the inside of a guide pipe according to a fourth modification of the first embodiment.
  • FIG. 14 is a view schematically showing the inside of the guide pipe when the insertion portion of the endoscope is inserted into the guide pipe according to the fourth modified example of the first embodiment.
  • FIG. 15 is a view schematically showing a cross section taken along line CC in FIG.
  • FIG. 16 is a view schematically showing the inside of a guide pipe according to a fifth modification of the first embodiment.
  • FIG. 17 is a perspective view schematically showing a guide pipe according to a sixth modified embodiment of the first embodiment.
  • FIG. 18 is a view schematically showing the inside of the guide pipe when the insertion portion of the endoscope is inserted into the guide pipe according to the sixth modification of the first embodiment.
  • FIG. 19 is a perspective view schematically showing a guide pipe according to a seventh modified embodiment of the first embodiment.
  • FIG. 15 is a view schematically showing a cross section taken along line CC in FIG.
  • FIG. 16 is a view schematically showing the inside of a guide pipe according to a fifth modification of the first embodiment
  • FIG. 20 is a view of the guide pipe according to the second embodiment as viewed from the side opposite to the bending direction of the bending portion.
  • FIG. 21 is a view schematically showing the inside of a guide pipe according to a second embodiment.
  • FIG. 22 is a view schematically showing the inside of the guide pipe when the insertion portion of the endoscope is inserted into the guide pipe according to the second embodiment.
  • FIG. 23 is a view schematically showing the inside of a guide pipe according to a first modification of the second embodiment.
  • FIG. 24 is a view schematically showing the inside of a guide pipe according to a second modification of the second embodiment.
  • FIG. 25 is a view schematically showing the inside of a guide pipe according to a third embodiment.
  • the endoscope system (treatment system) 11 includes an endoscope unit (insertion assistance system) 12, a control unit (controller) 15 connected to the endoscope unit 12, and a control unit 15. And a display unit (monitor) 16 connected to the The endoscope unit 12 includes an endoscope (insert) 22 and an insertion device (insertion assisting tool) 23.
  • the display unit 16 is configured by a general liquid crystal monitor or the like, and displays an image acquired by the endoscope 22 as an image (endoscope image).
  • the endoscope system 11 is, for example, mainly used to treat or observe the paranasal sinuses.
  • the endoscope system 11 and the endoscope unit 12 which concern on this embodiment can also be used for treating or observing other site
  • the insertion device 23 includes a grip (housing) 24 and a guide pipe 25 projecting from the grip 24.
  • the gripping portion (handle unit) 24 is gripped by the user and appropriately operated.
  • One end of the guide pipe 25 is connected to the grip 24, and an opening 28 is provided at the other end.
  • the guide pipe 25 is curved at an appropriate angle (a predetermined angle) in order to guide the insert such as the endoscope 22 to a desired position in the body cavity.
  • the guide pipe 25 may be formed of a rigid material such as stainless steel, or may be formed by combining a rigid material and a flexible material having flexibility such as, for example, a silicone material.
  • the side toward the grip portion 24 is set as the base end side
  • the side toward the opening 28 is set as the tip side.
  • the endoscope 22 is attached to the insertion device 23 and used.
  • the endoscope 22 includes an insertion portion 31 inserted into the guide pipe 25 and a support portion 33 supported by the insertion device 23.
  • the proximal end of the insertion portion 31 is fixed to the support portion 33.
  • One end of the cable 35 is connected to the support portion 33.
  • the other end of the cable 35 is connected to the control unit 15.
  • the insertion portion 31 can protrude from the opening 28 of the guide pipe 25 with respect to the guide pipe 25.
  • an observation optical system formed of an illumination window, an actuator, an illumination fiber, a plurality of light reception fibers and the like is disposed inside the insertion portion 31.
  • the control unit 15 controls the observation optical system.
  • the control unit 15 causes the light from the light source to be incident on the illumination fiber, and images the light received through the plurality of light reception fibers. Then, the control unit 15 displays the imaged image on the display unit 16. At this time, an image of a portion opposed to the distal end surface 32 of the insertion portion 31 is displayed on the display unit 16 as an observation image.
  • the endoscope 22 may be of any type such as a scanning type, a fiber type, or an imaging element type.
  • the insertion portion 31 Most of the entire length of the insertion portion 31 is formed as a flexible portion. That is, the insertion portion 31 has flexibility as a whole. Therefore, the insertion portion 31 is curved according to the shape of the guide pipe 25 by being inserted into the guide pipe 25.
  • the flexible portion of the entire length of the insertion portion 31 may have an appropriate elasticity (stiffness) by itself, and for example, a tube may be provided outside the insertion portion 31 of the endoscope 22.
  • the insert may cooperate with the insertion portion 31 of the endoscope 22 to have an appropriate elasticity.
  • the flexible portion of the entire length of the insertion portion 31 has an appropriate elasticity by itself will be described.
  • the insertion portion 31 is moved along the longitudinal axis L of the guide pipe 25 described later by the operation of the holding portion 24 by the advancing and retracting mechanism 42, and the direction is changed by the guide pipe 25 by appropriate elasticity (Kosi).
  • the tip of the insertion portion 31 is guided to a position where the opening 28 is disposed.
  • a bending operation unit is provided in the gripping unit 24, and the distal end of the insertion unit 31 can be bent by an operation input on the bending operation unit.
  • the distal end of the insertion portion 31 is provided with a rigid portion, and the rigid portion forms the distal end of the insertion portion 31.
  • the gripping portion 24 is provided with an advancing and retracting mechanism 42.
  • the advancing and retracting mechanism 42 advances and retracts the insertion portion 31 of the endoscope 22 with respect to the guide pipe 25.
  • the advancing and retracting mechanism 42 is connected to the support portion 33 of the endoscope.
  • the advancing and retracting mechanism 42 is configured by, for example, a knob or the like that can move with respect to the gripping unit 24.
  • the operator moves the insertion portion 31 of the endoscope 22 relative to the guide pipe 25 by moving the advancing and retracting mechanism 42 with respect to the holding portion 24, and the amount of protrusion of the insertion portion 31 from the tip of the guide pipe 25 Adjust the The user can observe, for example, a desired position in the paranasal sinus by adjusting the position of the distal end of the insertion portion 31 with respect to the guide pipe 25.
  • the guide pipe 25 is formed in a substantially cylindrical shape.
  • the inner diameter of the guide pipe 25 is formed larger than the outer diameter of the insertion portion 31 of the endoscope 22. Therefore, the guide pipe 25 can insert the insertion portion 31 of the endoscope 22 as an insert.
  • the guide pipe 25 includes a straight pipe portion (first tubular portion) 51 and a curved portion (second tubular portion) 52.
  • a holder 54 is fixed to the proximal end of the straight pipe portion 51.
  • the holder 54 is fixed to the grip 24.
  • the straight pipe portion 51 and the bending portion 52 form a conduit through which the insertion portion 31 of the endoscope 22 is inserted.
  • the straight pipe portion 51 defines a longitudinal axis L.
  • the straight pipe portion 51 extends substantially straight along the longitudinal axis L.
  • the central axis of the guide pipe 25 in the straight pipe portion 51 substantially coincides with the longitudinal axis L.
  • the first tubular portion will be described here using the straight pipe portion 51 extended substantially straight along the longitudinal axis L, but if the insertion path of the insert is straight or substantially straight, it is appropriately bent You may use a curved tube.
  • the curved portion 52 is disposed on the tip end side of the straight pipe portion 51.
  • the tip of the curved portion 52 forms the tip of the guide pipe 25.
  • An opening 28 communicating the inside and the outside of the guide pipe 25 is formed at the tip 52 b of the curved portion 52.
  • the distal end 52 b of the bending portion 52 and a portion in the vicinity thereof may be formed as a straight pipe, or may be formed as a bent pipe.
  • the curved portion 52 is continuous with the straight pipe portion 51. Therefore, the distal end 51 b of the straight pipe portion 51 and the proximal end 52 a of the bending portion 52 substantially coincide with each other. Further, the distal end portion 55 of the straight pipe portion 51 is located near the proximal end 52 a of the bending portion 52.
  • the bending portion 52 extends from the straight pipe portion 51 toward the tip end, and is curved in one direction with respect to the longitudinal axis L (the straight pipe portion 51). Therefore, in the bending portion 52, the central axis is separated from the longitudinal axis L as it goes from the proximal end 52a to the distal end 52b.
  • the direction in which the bending portion 52 curves with respect to the straight pipe portion 51 (longitudinal axis L), that is, the bending portion with respect to the straight pipe portion 51 (longitudinal axis L)
  • the direction in which the tip 52 b of 52 is located is taken as the bending direction of the guide pipe 25 and the bending portion 52.
  • the bending direction of the guide pipe 25 intersects the longitudinal axis L.
  • a direction substantially perpendicular to the longitudinal axis L and substantially perpendicular to the bending direction of the guide pipe 25 is taken as a width direction.
  • the outline formed by the curved portion 52 has a substantially arc shape.
  • a portion on the side where the above-mentioned substantially arc-shaped central point is located with respect to the central axis of the guide pipe 25 is an inner area S1.
  • region S2 Let the part on the opposite side to the located side be outer side area
  • the bending angle ⁇ of the guide pipe 25 is defined.
  • the bending angle ⁇ indicates the angle at which the end of the guide pipe 25 is curved with respect to the extending direction of the straight pipe portion 51.
  • the bending angle ⁇ is an angle formed by the direction in which the distal end 52 b of the bending portion 52 faces, with respect to the direction from the proximal end to the distal end along the central axis (L) in the straight pipe portion 51 .
  • the bending angle ⁇ may be any of acute angle, right angle and obtuse angle. In the present embodiment, the bending angle ⁇ is an obtuse angle.
  • the guide pipe 25 of this embodiment is used, for example, for observation or treatment of the maxillary sinus in the paranasal sinuses. Also, in one embodiment, the bending angle ⁇ is an acute angle. In this case, the guide pipe 25 is used, for example, to observe or treat the frontal sinus of the sinus.
  • a slit 61 is formed in the guide pipe 25 as a friction reduction area (friction reduction mechanism).
  • the slits 61 are provided in the outer region S2 of the curved portion 52.
  • the slit 61 is a groove recessed from the inner surface to the outer surface of the curved portion 52 and communicates the inner peripheral surface and the outer peripheral surface of the guide pipe 25.
  • the slit 61 is extended along the extending direction of the curved portion 52.
  • the proximal end 61 a of the slit 61 is located on the distal side with respect to the proximal end 52 a of the curved portion 52, and the distal end 61 b of the slit 61 is located on the proximal side with respect to the distal end 52 b of the curved portion 52.
  • the width of the slit 61 is preferably smaller than the outer diameter of the insertion portion 31 of the endoscope 22.
  • the width and extension length of the slit 61 are appropriately determined in accordance with the shape (outer diameter), stiffness, physical properties and the like of the insert.
  • the slit 61 is formed in a size that does not prevent the end of an insert such as the insertion portion 31 of the endoscope 22 from being inserted to the opening 28 provided at the end of the guide pipe 25.
  • the edge of the slit 61 is formed into a smooth shape by chamfering or the like.
  • the tip end of the insert such as the insertion portion 31 of the endoscope 22 is prevented from being caught by the edge of the slit 61.
  • the guide 22 When observing, for example, the inside of the paranasal sinus using the endoscope system 11, the guide 22 is disposed in the state where the distal end surface 32 of the insertion portion 31 of the endoscope 22 is disposed in the vicinity of the opening 28 of the guide pipe 25.
  • the pipe 25 is inserted into the body cavity, and the tip of the guide pipe 25 is placed in the vicinity of the desired observation position. Then, the amount of projection of the distal end surface 32 of the insertion portion 31 of the endoscope 22 with respect to the opening 28 of the guide pipe 25 is adjusted by the operation of the advancing and retracting mechanism 42 to observe the inside of the paranasal sinus.
  • inserts such as various tubes for suction, water supply, and washing liquid input, and a treatment tool for treatment of the affected area are appropriately selected and inserted.
  • a treatment tool for treatment of the affected area is appropriately selected and inserted.
  • an example of inserting the insertion portion 31 of the endoscope 22 into the guide pipe 25 will be described as an example of the insert.
  • the insertion portion 31 of the endoscope 22 when the insertion portion 31 of the endoscope 22 passes through the curved portion 52 of the guide pipe 25, the insertion portion 31 has a longitudinal axis L along the curved shape of the curved portion 52. It moves in the guide pipe 25 while curving. In particular, the distal end of the insertion portion 31 of the endoscope 22 moves toward the opening 28 of the guide pipe 25 while contacting the outer region S2 of the bending portion 52. At this time, the inner peripheral surface of the guide pipe 25 and the outer peripheral surface of the insertion portion 31 of the endoscope 22 come into contact with each other, causing friction between the guide pipe 25 and the endoscope 22.
  • Friction generated between the endoscope 22 and the insertion portion 31 mainly increases in the bending portion 52 and the outer region S2 near the proximal end 52 a of the bending portion 52. Therefore, when the insertion portion 31 passes through the bending portion 52, the bending portion 52 and the distal end portion 55 of the straight pipe portion 51 located near the proximal end 52a of the bending portion 52 on the inner peripheral surface of the guide pipe 25. The contact surface is in contact with the insertion portion 31.
  • the slit 61 is provided in the outer region S2 of the bending portion 52.
  • the outer peripheral surface of the insertion portion 31 of the endoscope 22 does not contact the inner peripheral surface of the bending portion 52 in the portion disposed in the slit 61. That is, in the region of the curved portion 52 where the slit 61 is provided, the outer peripheral surface of the insertion portion 31 of the endoscope 22 and the inner peripheral surface of the guide pipe 25 do not contact. Therefore, in the present embodiment, the contact area where the outer peripheral surface of the insertion portion 31 and the inner peripheral surface of the guide pipe 25 contact is smaller than when the slit 61 is not provided.
  • the insertion portion 31 of the endoscope 22 is inserted into the guide pipe 25 In this case, the friction generated between the outer peripheral surface of the endoscope 22 and the inner peripheral surface of the guide pipe 25 is reduced.
  • the insertion portion and the guide pipe are provided by providing the slit 61 serving as the friction reduction region in the curved portion 52 which contacts the insertion when the insert such as the endoscope 22 passes.
  • the contact area between the guide pipe 25 and the insert is reduced. This reduces the force required to insert the insert into the guide pipe 25 and makes it easier to insert the insert.
  • FIG. 7 is a view showing a guide pipe 25 of a first modified example of the present embodiment.
  • the guide pipe 25 is provided with a plurality of slits (grooves) 62 as a friction reduction area.
  • each of the slits 62 is extended along the extending direction of the guide pipe 25 in the outer region S ⁇ b> 2 of the curved portion 52.
  • the slits 62 are spaced apart from one another about the longitudinal axis of the guide pipe 25.
  • the respective widths and extension lengths of the slits 62 are appropriately set in accordance with the insert.
  • a slit 62 is provided as a friction reduction area in the curved portion 52 which contacts the insert when the insert such as the endoscope 22 passes.
  • FIGS. 8 and 9 are views showing a guide pipe 25 of a second modified example of the embodiment.
  • the guide pipe 25 is provided with a plurality of slits (grooves) 63 extending along the circumference of the central axis of the guide pipe 25 as a friction reduction area.
  • Each of the slits 63 is provided in the outer region S2 of the bending portion 52.
  • the slits 63 are spaced apart from one another in the extending direction of the guide pipe 25.
  • the respective widths and extension lengths of the slits 63 are appropriately set in accordance with the insert.
  • a slit 63 is provided as a friction reduction area in the curved portion 52 which contacts the insert when the insert such as the endoscope 22 passes.
  • the contact area between the insertion portion 31 and the guide pipe 25 is reduced by the slit 63, and the force (the amount of force) required when inserting an insert such as the endoscope 22 into the guide pipe 25 can be reduced.
  • the edge (edge) of the slit 63 be chamfered. In this case, catching when the insert of the endoscope 22 or the like contacts the edge of the slit 63 is prevented as much as possible.
  • FIGS. 10 and 11 show a guide pipe 25 according to a third modification of the present embodiment.
  • the guide pipe 25 is provided with a plurality of slits (grooves) 64 extending in a spiral shape around the central axis of the guide pipe 25 as a friction reduction area.
  • Each of the slits 64 is provided in the outer region S2 of the bending portion 52.
  • the slits 64 are spaced apart from one another. For this reason, the slits 64 are not continuous as shown in FIG.
  • the respective widths and extension lengths of the slits 64 are appropriately set in accordance with the insert.
  • a slit 64 is provided as a friction reduction area in the curved portion 52 which comes in contact with the insert when the insert such as the endoscope 22 passes.
  • the contact area between the insertion portion 31 and the guide pipe 25 is reduced by the slit 64, and the force (the amount of force) required when inserting the insert such as the endoscope 22 into the guide pipe 25 can be reduced.
  • the edge (edge) of the slit 64 be chamfered. In this case, catching when the insert of the endoscope 22 or the like contacts the edge of the slit 64 is prevented as much as possible.
  • FIGS. 12 and 13 are views showing a guide pipe 25 of a fourth modified example of the present embodiment.
  • a protrusion (concave and convex portion) 65 that protrudes toward the inside (for example, the central axis) of the guide pipe 25 is provided as a friction reduction region.
  • a plurality of protrusions 65 are provided in the outer region S2 of the curved portion 52.
  • Each of the protrusions 65 extends along the extending direction of the guide pipe 25 and is disposed apart from each other.
  • variety and extension length of the protrusion part 65 are suitably set according to the insert.
  • the projecting portion 65 is provided in the bending portion 52. As shown in FIGS. 14 and 15, when the insertion portion 31 of the endoscope 22 passes through the guide pipe 25, the outer peripheral surface of the insertion portion 31 contacts the projection 65 at the portion where the projection 65 is disposed. It contacts and does not contact the inner circumferential surface of the curved portion 52. Therefore, in the region where the projecting portion 65 is provided in the curved portion 52, the outer peripheral surface of the insertion portion 31 of the endoscope 22 does not contact the portion other than the projecting portion 65 in the inner peripheral surface of the guide pipe 25.
  • the contact area where the outer peripheral surface of the insertion portion 31 and the inner peripheral surface of the guide pipe 25 contact is smaller than when the protrusion 65 is not provided, and occurs between the guide pipe 25 and the insertion portion 31. Friction is reduced. Thereby, the force (force amount) required when inserting the insert such as the endoscope 22 into the guide pipe 25 can be reduced.
  • positioned in the guide pipe 25 is provided as a friction reduction area
  • FIG. 16 is a view showing a guide pipe 25 of a fifth modified example of the present embodiment.
  • a groove 66 is formed on the inner peripheral surface of the guide pipe 25 as a friction reducing area, from the inner peripheral surface of the guide pipe 25 toward the outer peripheral surface.
  • a plurality of grooves 66 are provided in the outer region S2 of the curved portion 52.
  • Each of the groove portions 66 is extended along the extending direction of the guide pipe 25 and is disposed apart from each other. The width and extension length of each of the grooves 66 are appropriately set in accordance with the insert.
  • a groove 66 is provided as a friction reduction region in the curved portion 52 that contacts the insert when the insert such as the endoscope 22 passes.
  • the groove 66 disposed in the guide pipe 25 is provided as the friction reducing area, the guide pipe 25 does not open to the outside in the friction reducing area. Therefore, in the present modification, the contact area between the insertion portion 31 and the guide pipe 25 is reduced, and the insertion portion 31 is prevented from being exposed to the outside of the guide pipe 25 in the friction reduction region.
  • FIGS. 17 and 18 are views showing a guide pipe 25 according to a sixth modification of the present embodiment.
  • a slit (groove) 67 is provided on the inner peripheral surface of the guide pipe 25 as a friction reduction area, which communicates the inner peripheral surface and the outer peripheral surface of the guide pipe 25.
  • the slits 67 are provided in the inner region S1 of the curved portion 52.
  • the slits 67 are extended along the extending direction of the guide pipe 25. The width and extension length of the slit 67 are appropriately set in accordance with the insert.
  • the insertion portion 31 of the endoscope 22 passes through the guide pipe 25, the outer periphery of the insertion portion 31 is also in the inner region S1 of the bending portion 52 due to elasticity (flexibility) of the flexible portion of the insertion portion 31.
  • the surface and the inner circumferential surface of the guide pipe 25 come in contact with each other. Therefore, also in the present modification, the insertion portion 31 and the guide pipe 25 are provided by providing the slit 67 as the friction reduction region in the curved portion 52 which contacts the insert when the insert such as the endoscope 22 passes.
  • the contact area of the guide 22 can be reduced, and the force (amount of force) required when inserting the insert of the endoscope 22 or the like into the guide pipe 25 can be reduced.
  • FIG. 19 is a view showing a guide pipe 25 of a seventh modified example of the present embodiment.
  • a low friction member 68 is attached to the slit 61 of the guide pipe 25 as a friction reduction area.
  • the low friction member 68 is formed of a material having a smaller coefficient of friction than the member forming the guide pipe 25.
  • the low friction member 68 is attached to the outer region S2 of the curved portion 52 along the extending direction of the guide pipe 25 and forms a part of the inner peripheral surface of the curved portion 52.
  • the outer peripheral surface of the insertion portion 31 of the endoscope 22 contacts the low friction member 68 in the portion where the low friction member 68 is disposed. For this reason, compared with the case where the slit 61 and the low friction member 68 are not disposed, the friction generated between the outer peripheral surface of the insertion portion 31 and the inner peripheral surface of the guide pipe 25 is smaller.
  • Second Embodiment A second embodiment of the present invention will be described with reference to FIGS.
  • the second embodiment is a modification of the configuration of the first embodiment as follows.
  • the same parts as those of the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.
  • a slit (groove) 81 is formed in the guide pipe 25 as a friction reduction area.
  • the slit 81 is extended along the extending direction (central axis) of the guide pipe 25 and communicates the inner peripheral surface and the outer peripheral surface of the guide pipe 25.
  • the slit 81 is extended over a range from the tip end 55 of the straight pipe portion 51 to a part of the bending portion 52.
  • the slits 81 are provided in the outer region S2 of the guide pipe 25. That is, the slit (angle changing portion) 81 is located on the opposite side of the opening 28 of the guide pipe 25 with respect to the longitudinal axis L of the straight pipe portion 51 of the guide pipe 25.
  • the distal end 81 b of the slit 81 is located closer to the distal end than the proximal end 52 a (51 b) of the bending portion 52, and the proximal end 81 a of the slit 81 is located proximal to the distal end 51 b of the straight pipe portion 51.
  • the width and extension length of the slit 81 are appropriately determined in accordance with the shape (outer diameter), stiffness, physical properties and the like of the insert.
  • the operation and effects of the endoscope system 11 and the insertion device 23 of the present embodiment will be described.
  • the insertion portion 31 of the endoscope 22 passes through the curved portion 52 of the guide pipe 25, the flexible portion of the insertion portion 31 at the distal end portion of the straight pipe portion 51 Due to the elasticity (flexibility) of the flexible portion, the distal end portion of the straight pipe portion 51 is separated from the inner circumferential surface toward the slit 81. Then, at the tip end of the straight pipe portion 51, a part of the flexible portion of the insertion portion 31 intrudes into the slit 81. When passing through the slit 81, the insertion portion 31 curves in the direction (arrow E2 side in FIG.
  • the insertion portion 31 curves in the direction opposite to the bending direction of the guide pipe 25.
  • the insertion portion 31 is curved with respect to the central axis L of the straight pipe portion 51.
  • the central axis of the insertion portion 31 is positioned in the opposite direction to the bending direction (opening 28) of the guide pipe 25 with respect to the central axis (longitudinal axis L) of the guide pipe 25.
  • the portion from the portion in contact with the tip 81 b of the slit 81 to the tip of the insertion portion 31 is disposed in the guide pipe 25 and contacts the inner circumferential surface of the curved portion 52 of the guide pipe 25.
  • the insertion portion 31 in the vicinity of the distal end 81b of the slit 81, the insertion portion 31 is inclined with respect to the longitudinal axis L in a direction toward the bending direction of the bending portion 52 toward the distal end. Therefore, the central axis of the insertion portion 31 in the vicinity of the distal end 81 b of the slit 81 is inclined with respect to the longitudinal axis L.
  • the inclination angle ⁇ of the central axis of the insertion portion 31 in the vicinity of the tip 81 b of the slit 81 with respect to the longitudinal axis L is larger than 0 ° and smaller than 90 °.
  • the central axis of the insertion portion 31 in the vicinity of the distal end 81 b of the slit 81 is the center of the straight pipe portion 51. With respect to the axis L, it changes by the inclination angle ⁇ . For this reason, the insertion portion 31 apparently has an angle ⁇ smaller than the bending angle ⁇ of the guide pipe 25 by an angle ⁇ in a portion from the vicinity of the tip 81 b of the slit 81 to the end (opening 28) of the bending portion 52 , Curving.
  • the angle ⁇ of the central axis of the insertion portion 31 at the distal end (28) of the bending portion 52 with respect to the central axis of the insertion portion 31 in the vicinity of the distal end 81b of the slit 81 is the apparent bending angle of the insertion portion 31 Become.
  • the slits 81 is an angle changing portion that makes the bending angle of the insert 31 apparently smaller than the bending angle ⁇ of the guide pipe 25.
  • the force required to insert the insertion portion 31 into the guide pipe 25 decreases as the apparent bending angle ⁇ of the insertion portion 31 decreases.
  • the bending angle of the insertion portion 31 is apparently reduced.
  • the force required to insert the insert such as the insertion portion 31 of the endoscope 22 into the guide pipe 25 becomes smaller, and the insert becomes easier to insert.
  • the distal end of the insertion portion 31 is positioned in the bending portion 52, that is, on the distal end side of the proximal end 52a of the bending portion 52, an elastic force generated by the bending of the insertion portion 31 acts on the guide pipe 25 from the insertion portion 31. By doing this, the friction generated between the insertion portion 31 and the guide pipe 25 is increased.
  • the friction generated between the insertion portion 31 and the guide pipe 25 increases as the angle ⁇ between the advancing direction of the insertion portion 31 with respect to the guide pipe 25 and the direction of the force pressing the insertion portion 31 increases.
  • the friction generated between the insertion portion 31 and the guide pipe 25 increases as the bending angle ⁇ of the guide pipe 25 increases.
  • the central axis (direction) of the insertion portion 31 in the vicinity of the distal end 81b of the slit 81 is the bending direction of the guide pipe 25.
  • the direction of the force pressing the insertion portion 31 of the endoscope 22 apparently follows the central axis of the insertion portion 31 from the direction along the longitudinal axis L (arrow D1) It changes to (arrow D2).
  • the direction of the force pushing the insertion portion 31 apparently is in the vicinity of the proximal end 52a of the bending portion 52 from the direction along the longitudinal axis L (arrow D1) It changes in the direction (arrow D2) along the central axis of the part 31. Therefore, in the bending portion 52, the angle ⁇ between the advancing direction of the insertion portion 31 and the direction of the force pressing the insertion portion 31 is smaller by the angle ⁇ than in the case where the slit 81 is not provided.
  • the angle ⁇ between the advancing direction of the insertion portion 31 and the direction of the force pressing the insertion portion 31 is the advancing direction of the insertion portion 31 when the slit 81 is not provided.
  • the angle ⁇ is smaller than the angle ⁇ with the direction of the force pressing the insertion portion 31.
  • the slit 81 is provided in the curved portion 52 contacting the insertion portion 31 when the insertion portion 31 of the endoscope 22 passes through the curved portion 52 and the distal end 55 of the straight pipe portion 51
  • the angle ⁇ between the advancing direction of the insertion portion 31 and the direction of the force pressing the insertion portion 31 becomes smaller, so that the friction generated between the insertion portion 31 and the guide pipe 25 becomes smaller.
  • the slit 81 is a friction reduction area that reduces the friction between the insertion portion 31 and the guide pipe 25 on the tip end side of the portion where the slit 81 is provided. Since the friction generated between the insertion portion 31 and the guide pipe 25 is reduced, the force required when inserting the insert such as the insertion portion 31 of the endoscope 22 into the guide pipe 25 is reduced, and the insertion It becomes easy to insert.
  • the bending portion is a part of the insertion portion 31 in the slit 81 by entering the tip side with respect to the inner peripheral surface of the guide pipe 25.
  • the bending angle of the insertion portion 31 at 52 may be increased, and the force required when inserting the insert into the guide pipe 25 may be increased.
  • the direction of the insert in the vicinity of the distal end 81 b of the slit 81 is provided by providing the slit 81 in a range including the distal end 55 of the straight pipe portion 51 provided on the proximal end side with respect to the curved portion 52. Changes, and the friction generated between the insert and the guide pipe 25 is reduced.
  • FIG. 23 is a view showing a guide pipe 25 of a first modified example of the present embodiment.
  • the guide pipe 25 is provided with a groove 82 as a friction reducing area and an angle changing part.
  • the groove 82 extends along the central axis of the guide pipe 25 and is recessed from the inner peripheral surface of the guide pipe 25 toward the outer peripheral surface.
  • the groove portion 82 is extended in a range from the tip end portion 55 of the straight pipe portion 51 to a part of the curved portion 52 in the outer region S2.
  • the distal end 82 b of the groove 82 is positioned more distal than the proximal end 52 a (51 b) of the curved portion 52, and the proximal end 82 a of the groove 82 is positioned proximal to the distal end 51 b of the straight pipe 51.
  • the groove 82 is provided in the guide pipe 25, when the insertion portion 31 of the endoscope 22 passes through the curved portion 52 of the guide pipe 25, a part of the insertion portion 31 intrudes into the groove 82. And the insertion part 31 curves with respect to the central axis L of the straight pipe part 51 in the groove part 82. As shown in FIG. Therefore, the central axis of the insertion portion 31 is inclined with respect to the longitudinal axis L near the tip 82 b of the groove 82.
  • the groove 82 is provided as the friction reducing area and the angle changing portion, so that the angle ⁇ between the advancing direction of the insertion portion 31 and the direction of the force pushing the insertion portion 31 and the insertion The apparent bending angle of the portion 31 is reduced. Thereby, the friction generated between the insertion portion 31 and the guide pipe 25 is reduced, and the force (the amount of force) required when inserting the insertion portion 31 of the endoscope 22 into the guide pipe 25 can be reduced.
  • the groove 82 is provided, so the guide pipe 25 does not open to the outside in the straight pipe portion 51 and the curved portion 52.
  • the insertion portion 31 can be curved in the groove portion 82 and the insertion portion 31 can be prevented from being exposed to the outside of the guide pipe 25. Then, suction or liquid feeding can be performed through the opening 28 of the guide pipe 25.
  • FIG. 24 is a view showing a guide pipe 25 of a second modified example of the present embodiment.
  • the guide pipe 25 is provided with a slit 81 as a friction reducing area and an angle changing portion.
  • an exposure preventing member 83 covering the slit 81 is attached to the guide pipe 25 from the outer peripheral side.
  • the exposure preventing member 83 is formed separately from the guide pipe 25.
  • the guide pipe 25 does not open to the outside.
  • the provision of the exposure preventing member 83 prevents the guide pipe 25 from being opened to the outside in the straight pipe portion 51 and the curved portion 52.
  • the insertion portion 31 can be curved in the slit 81 and the insertion portion 31 can be prevented from being exposed from the slit 81 to the outside of the guide pipe 25.
  • the exposure preventing member 83 is formed separately from the guide pipe 25, it can be easily assembled by attaching the exposure preventing member 83 to the guide pipe 25 from the outside.
  • the guide pipe 25 has the friction reducing area described in the first embodiment and each modification of the first embodiment, and the angle described in the second embodiment and each modification of the second embodiment. Both the change unit and the change unit may be provided.
  • the guide pipe 25 may be provided with both the slit 61 similar to the first embodiment and the slit 81 similar to the second embodiment. ,preferable.
  • the insertion assisting tool (23) is capable of inserting a soft insert (31), and the first tubular portion (51) and the first tubular portion through which the insert (31) is inserted in a straight or substantially straight state
  • a conduit (51, 52) having a second tubular portion (52) curved in one direction with respect to (51), and an opening (28) capable of projecting the insert (31) to the distal end side
  • the guide pipe (25), the distal end (55) of the first tubular portion (51), and the second tubular portion (52) are provided on at least a part of the guide pipe (25) 31) and a friction reducing area (61; 62; 63; 64; 65; 66; 67; 68; 81; 82) to reduce the friction between them.
  • the present invention is not limited to the above embodiment, and can be variously modified in the implementation stage without departing from the scope of the invention.
  • the embodiments may be implemented in combination as appropriate as possible, in which case the combined effect is obtained.
  • the above embodiments include inventions of various stages, and various inventions can be extracted by an appropriate combination of a plurality of disclosed configuration requirements.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biophysics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Otolaryngology (AREA)
  • Instruments For Viewing The Inside Of Hollow Bodies (AREA)
  • Endoscopes (AREA)

Abstract

L'invention concerne un outil d'assistance à l'insertion comprenant : un tuyau de guidage dans lequel un objet insérable souple peut être inséré, le tuyau de guidage étant composé d'un conduit comprenant une première partie tubulaire à travers laquelle l'objet insérable est inséré dans un état droit ou sensiblement droit et une seconde partie tubulaire courbée dans une direction par rapport à la première partie tubulaire, et une ouverture à travers laquelle l'objet insérable peut faire saillie distalement; et une zone de réduction de frottement pour réduire le frottement entre le tuyau de guidage et l'objet insérable, disposée sur la seconde partie tubulaire et/ou une section d'extrémité distale de la première partie tubulaire.
PCT/JP2017/024347 2017-07-03 2017-07-03 Outil d'assistance à l'insertion et système d'assistance à l'insertion Ceased WO2019008633A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
JP2018539925A JP6479281B1 (ja) 2017-07-03 2017-07-03 挿入補助具
PCT/JP2017/024347 WO2019008633A1 (fr) 2017-07-03 2017-07-03 Outil d'assistance à l'insertion et système d'assistance à l'insertion

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/024347 WO2019008633A1 (fr) 2017-07-03 2017-07-03 Outil d'assistance à l'insertion et système d'assistance à l'insertion

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WO2019008633A1 true WO2019008633A1 (fr) 2019-01-10

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0843745A (ja) * 1994-07-27 1996-02-16 Fujikura Ltd 湾曲プローブとその製法
JP2008040001A (ja) * 2006-08-03 2008-02-21 Olympus Corp 内視鏡用ガイドチューブ及び内視鏡装置、並びにチューブ曲げ加工装置
JP2008048946A (ja) * 2006-08-25 2008-03-06 Olympus Corp 内視鏡用ガイドチューブ及び内視鏡装置
JP2010264190A (ja) * 2009-05-18 2010-11-25 Hoya Corp 挿管支援具、挿管支援装置および挿管支援システム
JP2011510773A (ja) * 2008-02-05 2011-04-07 デワエル，フランク 操向可能チューブ
JP2012213438A (ja) * 2011-03-31 2012-11-08 Fujifilm Corp 光プローブ
WO2016035509A1 (fr) * 2014-09-05 2016-03-10 オリンパス株式会社 Outil de traitement pour endoscope, unité d'outil de traitement et système de traitement

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0843745A (ja) * 1994-07-27 1996-02-16 Fujikura Ltd 湾曲プローブとその製法
JP2008040001A (ja) * 2006-08-03 2008-02-21 Olympus Corp 内視鏡用ガイドチューブ及び内視鏡装置、並びにチューブ曲げ加工装置
JP2008048946A (ja) * 2006-08-25 2008-03-06 Olympus Corp 内視鏡用ガイドチューブ及び内視鏡装置
JP2011510773A (ja) * 2008-02-05 2011-04-07 デワエル，フランク 操向可能チューブ
JP2010264190A (ja) * 2009-05-18 2010-11-25 Hoya Corp 挿管支援具、挿管支援装置および挿管支援システム
JP2012213438A (ja) * 2011-03-31 2012-11-08 Fujifilm Corp 光プローブ
WO2016035509A1 (fr) * 2014-09-05 2016-03-10 オリンパス株式会社 Outil de traitement pour endoscope, unité d'outil de traitement et système de traitement

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