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WO2018034080A1 - Outil d'aide à l'avancement/rétraction pour outil de traitement et système endoscopique - Google Patents

Outil d'aide à l'avancement/rétraction pour outil de traitement et système endoscopique Download PDF

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Publication number
WO2018034080A1
WO2018034080A1 PCT/JP2017/025147 JP2017025147W WO2018034080A1 WO 2018034080 A1 WO2018034080 A1 WO 2018034080A1 JP 2017025147 W JP2017025147 W JP 2017025147W WO 2018034080 A1 WO2018034080 A1 WO 2018034080A1
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WO
WIPO (PCT)
Prior art keywords
cylinder
endoscope
tube
tool
base
Prior art date
Application number
PCT/JP2017/025147
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English (en)
Japanese (ja)
Inventor
哲寛 山田
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Publication of WO2018034080A1 publication Critical patent/WO2018034080A1/fr

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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
    • 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
    • A61B1/012—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 characterised by internal passages or accessories therefor
    • A61B1/018—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 characterised by internal passages or accessories therefor for receiving instruments
    • G—PHYSICS
    • G02—OPTICS
    • G02B—OPTICAL ELEMENTS, SYSTEMS OR APPARATUS
    • G02B23/00—Telescopes, e.g. binoculars; Periscopes; Instruments for viewing the inside of hollow bodies; Viewfinders; Optical aiming or sighting devices
    • G02B23/24—Instruments or systems for viewing the inside of hollow bodies, e.g. fibrescopes

Definitions

  • the present invention relates to an advance / retreat assist tool and an endoscope system for assisting the advance / retreat movement of a treatment instrument with respect to an endoscope channel.
  • US 2008/242925 A1 discloses an endoscopic treatment tool that is inserted into a body cavity through a forceps plug and channel of an endoscope, and collects and excises cells and tissues at a predetermined site in the body cavity. Yes.
  • This treatment tool has a structure capable of fixing the treatment tool to the inner peripheral surface of the mouthpiece of the treatment tool insertion opening to which the forceps plug is attached.
  • the present invention provides a treatment tool advancing / retreating aid and an endoscope system capable of facilitating movement of a treatment tool along the axial direction in a state where an appropriate treatment tool is inserted into a channel of an endoscope. With the goal.
  • the advance / retreat assist tool attached to the proximal end side of the insertion portion of the endoscope and assisting the advance / retreat movement of the treatment instrument inserted into the insertion portion of the endoscope is A base attached to an endoscope, a first tube attached to the base and having a passage through which the treatment instrument is inserted, and provided on one end side of the first tube, the base being the endoscope When passing through the forceps plug attached to the treatment instrument insertion port of the endoscope, and passing through the passage of the first tube and the tube tip passing through the treatment tool insertion port.
  • the treatment instrument is inserted into the inside while holding the outer surface of the treatment instrument, and moved in a direction along the central axis of the passage with respect to the base and the first cylinder by an external operation. Tube and the base are attached to the endoscope. In eclipse state, and a holding portion for holding the state of the cylindrical tip has penetrated into the forceps plug.
  • FIG. 1 is a schematic diagram illustrating an endoscope system according to the first embodiment.
  • FIG. 2 is a schematic perspective view showing an advance / retreat assist tool for a treatment instrument that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 3 is a schematic cross-sectional view showing a state in which the treatment tool is inserted into the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 4 is a schematic cross-sectional view showing an advance / retreat assisting tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 1 is a schematic diagram illustrating an endoscope system according to the first embodiment.
  • FIG. 2 is a schematic perspective view showing an advance / retreat assist tool for a treatment instrument that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 3 is a schematic cross-sectional view showing a state in which the
  • FIG. 5 is a perspective view of the endoscope system according to the first embodiment, in which the treatment tool is fixed to the state shown in FIG. 3 in a state where the treatment tool is inserted into an advance / retreat assist tool that can be attached to the endoscope. It is a schematic sectional drawing which shows the state which moved.
  • FIG. 6 shows a lineup of the endoscope system according to the first embodiment in which the first cylinder and the cylinder tip used in the advance / retreat assist tool are integrated, and the cylinder tip selected from a plurality of cylinders It is the schematic which shows the state which is going to insert in the forceps stopper of an endoscope.
  • FIG. 6 shows a lineup of the endoscope system according to the first embodiment in which the first cylinder and the cylinder tip used in the advance / retreat assist tool are integrated, and the cylinder tip selected from a plurality of cylinders
  • FIG. 7A is a schematic cross-sectional view showing an example of a liquid leakage preventing member used for an advance / retreat assisting tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 7B is a schematic cross-sectional view showing an example of a liquid leakage preventing member used in the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 7C is a schematic cross-sectional view showing an example of a liquid leakage preventing member used for the advance / retreat assist tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 7A is a schematic cross-sectional view showing an example of a liquid leakage preventing member used for an advance / retreat assisting tool that can be attached to the endoscope in the endoscope system according to the first embodiment.
  • FIG. 7B is a schematic cross-sectional view showing an example of a liquid leakage preventing
  • FIG. 8A is a schematic cross-sectional view showing an advance / retreat assisting tool in which a liquid leakage preventing member is arranged at a position different from FIGS. 3 to 5 in an endoscope system according to a modification of the first embodiment.
  • FIG. 8B is a schematic cross-sectional view showing an advance / retreat assisting tool in which a liquid leakage preventing member is arranged at a position different from FIGS. 3 to 5 in an endoscope system according to a modification of the first embodiment.
  • FIG. 9A shows a state in which in the endoscope system according to the modification of the first embodiment, the advancing / retreating assisting tool can be fixed at a predetermined position of the endoscope by using a holding unit different from those in FIGS. 3 to 5.
  • FIG. 9B is a schematic diagram illustrating a state in which the advance / retreat assist tool is fixed at a predetermined position of the endoscope using a holding unit different from that in FIGS. 3 to 5 in the endoscope system according to the modified example of the first embodiment.
  • FIG. 10 is a schematic cross-sectional view showing an advance / retreat assisting tool that can be attached to an endoscope in the endoscope system according to the second embodiment.
  • FIG. 11A is a schematic diagram illustrating a state in which the user grips the operation unit of the endoscope with the left hand and the moving unit of the insertion / retraction assist tool with the right hand in the endoscope system according to the third embodiment. is there.
  • FIG. 9B is a schematic diagram illustrating a state in which the advance / retreat assist tool is fixed at a predetermined position of the endoscope using a holding unit different from that in FIGS. 3 to 5 in the endoscope system according to the modified example of the first embodiment.
  • FIG. 10 is
  • FIG. 11B is a schematic cross-sectional view showing a state in which the treatment tool is inserted into the advance / retreat assist tool attached to the endoscope in the endoscope system according to the third embodiment.
  • FIG. 12 is a schematic cross-sectional view showing a state in which a treatment tool is inserted through an advance / retreat assisting tool attached to an endoscope in the endoscope system according to the fourth embodiment.
  • An endoscope of an endoscope system described below is used by being inserted into a hole (lumen) of a examinee (subject).
  • the treatment tool auxiliary tool (advance / retreat aid) 14 applied to the endoscope system 11 finely adjusts the position in the longitudinal direction of the treatment tool 13 passed through the treatment tool insertion channel 26 of the endoscope 12. It is used when doing.
  • the auxiliary tool 14 can finely adjust the position in the longitudinal direction of the treatment tool 13 by the user's operation.
  • an endoscope system 11 includes an endoscope 12, a treatment instrument 13 that is passed through the endoscope 12, and an advance / retreat assist tool 14 that is detachably attached to the endoscope 12.
  • a controller (image processing unit) 15 that performs image processing based on a subject image captured by the endoscope 12, and a display unit (monitor) 16 that displays a video generated by the image processing in the controller 15. ing.
  • the endoscope 12 (insertion device) includes an insertion portion 17 that is inserted along a longitudinal direction L into a duct such as a lumen of a subject, and an operation that is provided at the proximal end of the insertion portion 17 and is gripped by a user.
  • the insertion portion 17 defines the longitudinal direction L by the distal end and the proximal end. As shown in FIG. 1, the insertion portion 17 includes a distal end configuration portion 22, a bending portion 23, and a tube portion 24 in order from the distal end to the proximal end.
  • the tube part 24 has flexibility.
  • the bending portion 23 can be bent in a plurality of directions (for example, four directions, up, down, left, and right) by a knob 25 of the operation portion 18 by a known mechanism.
  • the endoscope 12 has an illumination optical system, an observation optical system, and a treatment instrument insertion channel 26.
  • the endoscope 12 has an air / water supply mechanism and a suction mechanism.
  • the air / water feeding mechanism has a nozzle (not shown) at the tip of the insertion portion 17 and is operated by the first button 27 of the operation portion 18.
  • the suction mechanism communicates with the treatment instrument insertion channel 26 and is operated by the second button 28 of the operation unit 18.
  • the treatment instrument insertion channel 26 is branched into a known suction path, for example, inside the insertion portion 17 or inside the operation portion 18. By pressing the second button 28, the suctioned material is discharged from the opening at the tip of the treatment instrument insertion channel 26 through the base, the tube, the suction path, and the universal cord 21.
  • the illumination optical system and the observation optical system are provided over the insertion portion 17 (the distal end configuration portion 22, the bending portion 23, the tube portion 24), the operation portion 18, and the universal cord 21 of the endoscope 12.
  • the illumination optical system has an illumination window at the distal end configuration portion 22.
  • the observation optical system has an observation window in the tip configuration part 22.
  • the distal end of the treatment instrument insertion channel 26 is opened at the distal end constituting portion 22, and the proximal end thereof is opened at the proximal end side of the tube portion 24 or the operation portion 18.
  • An appropriate treatment instrument 13 can be passed inside the treatment instrument insertion channel 26.
  • the treatment tool 13 includes a general treatment tool (surgical instrument) that is passed through the treatment tool insertion channel 26 of the endoscope 12.
  • the treatment tool 13 can perform appropriate treatment within the field of view of the endoscope 12, such as approaching the affected area and incising and excising the living tissue of the affected area.
  • the treatment tool 13 includes a guide wire, a catheter, and the like that are used together with other treatment tools and guide the treatment tool to the affected part.
  • the operation unit 18 shown in FIG. 1 is provided with a treatment instrument insertion port 31 (see FIGS. 3 to 5) located at the proximal end of the treatment instrument insertion channel 26.
  • a forceps plug 32 (see FIGS. 3 to 6) is detachably attached to the treatment instrument insertion port 31.
  • the auxiliary tool 14 is attached to the proximal end side of the insertion part 17 of the endoscope 12 or the operation part 18, and inserts and removes (insertion and removal) of the treatment tool 13 inserted through the insertion part 17 of the endoscope 12. That is, it is used to assist the forward / backward (forward and backward) movement.
  • the auxiliary tool 14 can advance and retract the treatment tool 13 passed through the treatment tool insertion channel 26 of the endoscope 12 along its central axis C. As shown in FIG. 1 to FIG. 3, the auxiliary tool 14 is an endoscope that is attached to a predetermined position of the endoscope 12 and the base 41 is opposed to the treatment instrument insertion port 31 of the endoscope 12.
  • the base 41, the first cylinder 43, the cylinder tip 44, and the second cylinder 45 are formed of an appropriate material such as a metal material or a synthetic resin material.
  • the first cylinder 43, the cylinder tip 44, and the second cylinder 45 it is preferable that an insulating coating is applied.
  • the first cylinder 43 and the cylinder tip 44 may be integrated or separate.
  • the first cylinder 43, the cylinder tip 44, the second cylinder 45, and the advance / retreat mechanism 46 constitute a moving unit 47 for moving the treatment instrument 13 along the central axis C.
  • maintenance part 42 is formed with strip
  • the holding part 42 may be attached to the endoscope 12 at one place or may be attached at a plurality of places.
  • the treatment tool 13 needs to be inserted into the channel 26.
  • the base 41 is attached in the vicinity of the treatment instrument insertion port 31 provided on the proximal end side of the insertion portion 17 in the endoscope 12. Therefore, the base 41 is attached in the vicinity of the forceps plug 32 including the forceps plug 32 attached to the treatment instrument insertion port 31.
  • the base 41 includes a base body 51 and a support member 52 that forms a part of the advance / retreat mechanism 46 in the present embodiment.
  • the base main body 51 and the substantially cylindrical support member 52 are shown as being connected by screws 53, but it is of course preferable that they are integrated.
  • the base main body 51 preferably has a fitting portion 51 a that is fitted to a proximal end side of the insertion portion 17 of the endoscope 12 or a predetermined position of the operation portion 18.
  • the fitting portion 51 a of the base main body 51 covers the outside of the forceps plug 32 by its shape and is fitted to the proximal end side of the insertion portion 17 of the endoscope 12 or the operation portion 18. (See FIGS. 3 to 5).
  • the support member 52 is formed in a substantially cylindrical shape, covers the outer sides of the first cylinder 43 and the second cylinder 45, and has a second relationship with respect to the support member 52 due to the relationship between a cam pin 92 and a restriction groove 93 described later.
  • the tube 45 is prevented from rotating around the central axis C.
  • the first cylinder 43, the cylinder tip 44, and the second cylinder 45 form a passage 48 through which the treatment instrument 13 is inserted.
  • the second cylinder 45 includes a cylindrical main body 61 and a fixing portion 62 that fixes the treatment instrument 13. As shown in FIGS. 3 and 5, the main body 61 can protrude and retract (project and retract) with respect to the support member 52 of the base 41.
  • the fixing portion 62 is formed on an elastically deformable cylindrical body (cylindrical elastic member) 63 such as a rubber material supported on the base end surface 61 a of the main body 61 and a side surface adjacent to the base end surface 61 a of the main body 61.
  • a cap 64 having a screw part 64a screwed to the screw part 61b.
  • the cylindrical body 63 is elastically denatured between the state shown in FIG. 3 and the state shown in FIG.
  • the cylindrical body 63 can be used as a liquid leakage prevention portion from the inside to the outside of the cylindrical body 63 by changing its state. And the cylindrical body 63 can hold
  • the cap 64 has an opening 64b.
  • the opening 64b of the cap 64 has an inner diameter through which the treatment tool 13 can be passed. For this reason, the second cylinder 45 is treated inside the first cylinder 43 and the cylinder tip 44 in a state where the outer surface of the treatment instrument 13 that has passed through the passage 48 of the first cylinder 43 is held by the fixing portion 62. The tool 13 is inserted.
  • a liquid leakage preventing member 71 is disposed on the outer peripheral surface of the first cylinder 43.
  • the liquid leakage preventing member 71 for example, an O-ring (ring member) formed of a rubber material is used.
  • the outer peripheral surface of the liquid leakage preventing member 71 is in close contact with the inner peripheral surface of the second cylinder 45. Therefore, the liquid that has passed through the passage 48 of the first cylinder 43 is prevented from leaking to the outside of the second cylinder 45 through the inner peripheral surface of the second cylinder 45.
  • the liquid leakage preventing member 71 it is also preferable to use a sponge-like member that absorbs liquid instead of using an O-ring.
  • the sponge-like member is also preferably ring-shaped.
  • the liquid leakage prevention member 71 does not necessarily need to use an O-ring unless the liquid leaks from the passage 48.
  • the advance / retreat mechanism 46 includes an arm 81, a dial (rotary body) 82, and a cam that converts the rotation of the dial 82 into an advance / retreat movement of the second tube 45 (treatment instrument 13). And a mechanism 83.
  • the cam mechanism 83 is an example of a conversion mechanism that converts the turning force of the dial 82 into a force that moves the second cylinder 45 forward and backward in the direction along the central axis C of the first cylinder 43.
  • the arm portion 81 is formed on the base 41 and extends in a direction away from the central axis C.
  • the dial 82 is supported by the arm portion 81 and is rotatable about a rotation shaft 81a.
  • the rotation shaft 81a extends substantially parallel to the central axis C.
  • the cam mechanism 83 includes a cam groove 91 formed in a spiral shape on the outer peripheral surface of the dial 82, a cam pin 92 that protrudes radially outward from the base 41 to the central axis C in the second cylinder 45, And a restriction groove 93 provided on the support member 52 of the base 41 for allowing the cam pin 92 to move within a predetermined range along the central axis C and restricting movement in the circumferential direction with respect to the central axis C. .
  • the cam pin 92 is engaged with the cam groove 91.
  • the cam pin 92 is preferably formed in the vicinity of the lower end in FIGS. 3 to 5 in the second cylinder 45 in consideration of the assembling property with respect to the support member 52.
  • the restriction groove 93 is formed in the support member 52 of the base 41 substantially parallel to the central axis C of the first cylinder 43.
  • the cam pin 92 of the second cylinder 45 protrudes outside the support member 52 so as to be slidable within a predetermined range along the central axis C in the regulation groove 93 of the cylindrical support member 52 of the base 41.
  • the advance / retreat mechanism 46 can move the second tube 45 along the central axis C with respect to the first tube 43 by rotating the dial 82 with the user's finger, thereby moving the treatment tool 13 back and forth.
  • the cam groove 91 is formed, by holding the hand, for example, when viewed from the arrow E side (the side opposite to the arm 81 side of the dial 82) in FIG. Rotate.
  • the cam pin 92 moves in a direction away from the first arm portion 81 of the base 41 (upper side in FIGS. 3 to 5) by the action of the cam groove 91.
  • the second cylinder 45 moves to the upper side in FIGS. 3 to 5 with respect to the first cylinder 43.
  • the protrusion amount which the 2nd cylinder 45 protrudes with respect to the supporting member 52 of the base 41 becomes large.
  • the dial 82 is rotated clockwise as viewed from the arrow E side in FIG.
  • the cam pin 92 moves in the direction approaching the arm portion 81 (the lower side in FIGS. 3 to 5) by the action of the cam groove 91.
  • the second cylinder 45 moves downward in FIG. 3 to FIG. 5 with respect to the first cylinder 43.
  • the protrusion amount which the 2nd cylinder 45 protrudes with respect to the supporting member 52 of the base 41 becomes small.
  • the dial 82 when the dial 82 is rotated by the user's finger, the amount of protrusion of the second cylinder 45 relative to the first cylinder 43 due to the action of the cam mechanism 83 (the cam groove 91, the cam pin 92, and the restriction groove 93). Can be adjusted. For this reason, the second cylinder 45 moves in the direction along the central axis C of the passage 48 of the first cylinder 43 with respect to the base 41 and the first cylinder 43 by an external operation.
  • a cylindrical tube tip 44 is provided on one end side of the first tube 43 (the lower end side in FIGS. 3 to 6).
  • the inner diameter of the tube tip 44 is preferably the same as the inner diameter of the first tube 43. For this reason, there is no step on the inner peripheral surface at the boundary between one end of the first tube 43 and the proximal end (proximal end) of the tube distal end portion 44.
  • a step 43 a is formed on the outer peripheral surface at the boundary between one end of the first tube 43 and the base end (proximal end) of the tube tip 44.
  • the tube distal end 44 penetrates the forceps plug 32 attached to the treatment instrument insertion port 31 of the endoscope 12 when the base 41 of the auxiliary tool 14 is attached to the endoscope 12, and the treatment instrument insertion port 31.
  • a distal end 44a extending therethrough.
  • the distal end 44 a has an outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31.
  • a male threaded portion 44b projecting radially outward is formed at a position closer to the step 43a at the boundary between the first tube 43 and the tube tip 44 than the distal end 44a in the tube tip 44.
  • the support member 52 of the base 41 is formed with a penetrating fitting portion 52a that supports the step 43a.
  • the male screw portion 44 b penetrates the fitting portion 52 a of the support member 52.
  • a nut 49 can be screwed into the male screw portion 44b.
  • the support member 52 of the base 41 can be sandwiched between the first tube 43 and the nut 49. Therefore, the first cylinder 43 and the cylinder tip 44 can be fixed to the base 41 at predetermined positions.
  • the forceps plug 32 of the endoscope 12 is generally treated more than the first valve 32 a closer to the opening edge 31 a of the treatment instrument insertion port 31 and the first valve 32 a.
  • a slit-like second valve 32b located at a position away from the opening edge 31a of the tool insertion port 31.
  • the first valve 32 a and the second valve 32 b are used to prevent liquid leakage through the channel 26 (see FIG. 1) of the endoscope 12 and the treatment instrument insertion port 31.
  • the first valve 32a and the second valve 32b are required to prevent liquid leakage through the channel 26 of the endoscope 12 even when the treatment instrument 13 is inserted. For this reason, the first valve 32a and the second valve 32b exhibit a large sliding resistance when the treatment instrument 13 is moved along its axial direction.
  • the tube distal end portion 44 provided on one end side of the first tube 43 has the first valve 32 a and the second valve 32 of the forceps plug 32 when the auxiliary tool 14 is appropriately attached to the endoscope 12. It penetrates the valve 32b.
  • the treatment tool 13 passes through the inside of a tube distal end portion 44 disposed inside the first valve 32a and the second valve 32b of the forceps plug 32. For this reason, when the treatment tool 13 is inserted and removed along the axial direction, friction between the forceps plug 32 and the treatment tool 13 does not occur.
  • the first valve 32a and the second valve 32b of the forceps plug 32 and the outer peripheral surface of the distal end portion of the tube distal end portion 44 with respect to the male threaded portion 44b are in close contact with each other to be in an airtight and liquid tight state. ing. Therefore, fluid (gas and liquid) flows from between the first valve 32 a and the second valve 32 b of the forceps plug 32 and the outer peripheral surface of the tube distal end portion 44 through the treatment instrument insertion port 31 from the endoscope 12. Leakage can be suppressed.
  • the user of the endoscope 12 of the present embodiment generally holds the operation unit 18 with the left hand and the insertion unit 17 with the right hand.
  • the auxiliary tool 14 is fixed at a predetermined position of the endoscope 12. At this time, the auxiliary tool 14 is assembled and can be used simply by being attached to an appropriate part of the endoscope 12.
  • the distal end 44 a of the tube tip 44 of the auxiliary tool 14 penetrates the forceps plug 32 attached to the treatment instrument insertion port 31 of the endoscope 12 and penetrates the treatment instrument insertion port 31.
  • the second valve 32b and the first valve 32a of the forceps plug 32 are pushed away at the distal end 44a of the tube tip 44, and the distal end 44a is opened to the opening edge of the treatment instrument insertion port 31 of the endoscope 12. It arrange
  • the base 41 of the auxiliary tool 14 is fitted into a predetermined part of the endoscope 12.
  • the auxiliary tool 14 is fixed to the endoscope 12 by the holding unit 42.
  • the holding part 42 holds the state where the tube tip part 44 penetrates the forceps plug 32 in a state where the base 41 is attached to the endoscope 12.
  • the holding unit 42 holds the state where the auxiliary tool 14 is attached to the endoscope 12, and the auxiliary tool 14 is prevented from dropping unintentionally during use of the endoscope 12.
  • the main body 61 and the cap 64 of the second cylinder 45 according to the state of the cylindrical body 63 between the base end 61 a of the main body 61 of the second cylinder 45 and the cap 64.
  • the screwing state between is changed.
  • the distal end of the treatment instrument 13 is passed through the first tube 43 and the passage 48 of the tube distal end portion 44 through the opening 64b of the cap 64, the inner peripheral surface 63a of the tubular body 63, and the main body 61 of the second tube 45.
  • the treatment tool 13 is passed through the channel 26 (see FIG. 1).
  • the cap 64 is rotated at the maximum projecting position of the treatment tool 13, and the treatment tool 13 is moved on the inner peripheral surface 63 a of the cylindrical body 63.
  • the outer peripheral surface of is held. That is, when the second cylinder 45 is held at the position shown in FIG. 3 with respect to the first cylinder 43 and the outer peripheral surface of the treatment instrument 13 is held using the cylindrical body 63, the endoscope 12 is shown in FIG. 1. It is preferable that the distal end of the treatment instrument 13 protrudes from the distal end of the channel 26.
  • the outer diameter of the portion protruding from the tip of the channel 26 (see FIG. 1) through the auxiliary instrument 14 is smaller than the inner diameter of the passage 48 of the auxiliary instrument 14 and the inner diameter of the channel 26. good.
  • the inner peripheral surface 63 a of the cylindrical body 63 is in close contact with the outer peripheral surface of the treatment instrument 13. For this reason, liquid leakage to the outside of the second cylinder 45 through the space between the inner peripheral surface of the second cylinder 45 and the outer peripheral surface of the treatment instrument 13 in a state where the treatment instrument 13 is inserted into the second cylinder 45. To prevent.
  • the channel 26 shown in FIG. It is preferable that the distal end of the treatment instrument 13 slightly protrudes from the distal end of the channel 26 or that the distal end of the channel 26 is retracted.
  • the cam pin 92 of the second tube 45 is farthest from the arm portion 81 of the base 41, the distal end of the treatment instrument 13 is drawn into the distal end of the channel 26 of the endoscope 12 and protrudes. Preferably not.
  • the left hand When it is desired to increase the protruding amount of the treatment instrument 13 with respect to the tip of the channel 26 shown in FIG. 1, with the left hand held the operation unit 18, the left hand is opened (the finger is moved away from the palm of the left hand). Move. That is, the dial 82 is rotated clockwise as viewed from the arrow E side in FIG. 3 (the side of the dial 82 opposite to the arm portion 81 side). Here, the cam pin 92 is kept engaged with the cam groove 91 by the restriction groove 93. For this reason, the cam pin 92 moves in a direction approaching the treatment instrument insertion port 31 by the action of the cam groove 91 based on the rotation of the dial 82.
  • the second cylinder 45 moves (advances) toward the distal end side of the channel 26 with respect to the first cylinder 43. Since the treatment tool 13 is fixed to the second tube 45, the distal end of the treatment tool 13 protrudes from the distal end of the channel 26 of the insertion portion 17 of the endoscope 12, or the protrusion amount increases. At this time, the first valve 32 a and the second valve 32 b of the forceps plug 32 do not generate friction with the treatment instrument 13. For this reason, even when the finger is moved in a direction away from the palm surface, which is ergonomically difficult to apply force, the rotation of the dial 82 and the forward movement of the treatment instrument 13 can be lightened.
  • the resistance force when the second cylinder 45 slides with respect to the first cylinder 43 includes the frictional force between the first cylinder 43 and the second cylinder 45, and the advance / retreat mechanism (dial 82). Includes at least one of frictional forces applied when the second cylinder 45 is moved forward and backward.
  • the left hand is grasped with the operation part 18 being grasped with the left hand ( Move your finger in the direction to bring your finger close to the palm of your left hand. That is, the dial 82 is rotated counterclockwise as viewed from the arrow E side in FIG. At this time, the second cylinder 45 moves (retreats) toward the side opposite to the tip side of the channel 26 with respect to the first cylinder 43.
  • the treatment tool 13 Since the treatment tool 13 is fixed to the second tube 45, the protrusion amount of the distal end of the treatment tool 13 with respect to the distal end of the channel 26 of the insertion portion 17 of the endoscope 12 is reduced, or the distal end of the treatment tool 13 is drawn into the channel 26. .
  • the first valve 32 a and the second valve 32 b of the forceps plug 32 do not generate friction with the treatment instrument 13. For this reason, even when the finger is moved in a direction approaching the palm surface, which is ergonomically easy to apply force, the rotation of the dial 82 and the backward movement of the treatment instrument 13 can be reduced.
  • the liquid leakage prevention member 71 and the outer peripheral surface of the first tube 43 Liquid leakage between the inner peripheral surface of the second cylinder 45 is also prevented. Furthermore, even when the treatment tool 13 is not disposed, the fixing portion 62 prevents liquid leakage through the second tube 45.
  • the auxiliary tool 14 When the auxiliary tool 14 is attached to a predetermined position of the endoscope 12, the first valve 32 a and the second valve 32 b of the forceps plug 32 can be pushed away by the tube distal end portion 44. Therefore, the auxiliary tool 14 according to the present embodiment can eliminate friction between the first tool 32a and the second valve 32b of the forceps plug 32 and the treatment tool 13. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 44 and the forceps plug 32 between the outer peripheral surface of the tube tip 44 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented.
  • the liquid leakage prevention member 71 between the first cylinder 43 and the second cylinder 45 can prevent liquid from leaking outside from the auxiliary tool 14. Regardless of whether or not the treatment instrument 13 is disposed on the auxiliary instrument 14, the fixing portion 62 can prevent the liquid from leaking out from the auxiliary instrument 14.
  • the treatment instrument 13 When the treatment instrument 13 is moved using the auxiliary instrument 14, that is, when the second cylinder 45 is moved with respect to the first cylinder 43, the largest resistance is generated on the outer peripheral surface of the first cylinder 43. And the liquid leakage preventing member 71 disposed between the inner periphery of the second cylinder 45. It can be said that the resistance of the liquid leakage preventing member 71 can be made significantly smaller than the resistance between the forceps plug 32 and the treatment instrument 13. For this reason, compared with the past, the force required to move the treatment tool 13 by moving the second cylinder 45 relative to the first cylinder 43 can be reduced.
  • the second valve 32b and the first valve 32a of the forceps plug 32 increase as the outer diameter of the treatment tool 13 increases. It is expected that the sliding resistance passing through will increase.
  • the second end 32b and the first valve 32a of the forceps plug 32 are pushed away by the tube tip 44. For this reason, if the treatment instrument 13 has an outer diameter through which the passage 48 can be passed, the first cylinder is ignored even if the outer diameter of the treatment instrument 13 changes, if the presence of the channel 26 (see FIG. 1) is ignored.
  • the sliding resistance for moving the second cylinder 45 relative to 43 can be prevented from changing. Even in the case where the relative positions of the first cylinder 43 and the second cylinder 45 are adjusted by ergonomically moving the hand in a direction that is difficult to move, the force required for operating the advance / retreat mechanism 46 is required. Thus, the auxiliary tool 14 of the treatment tool 13 with improved operability can be provided.
  • the cylinder tip 44 provided in the first cylinder 43 can be formed in an appropriate shape.
  • the cylinder tip 44 shown in FIG. 6 is selectively used.
  • the cylinder tip 44 provided in the leftmost first cylinder 43 in FIG. 6 has been described in the above-described embodiment, and thus the description thereof is omitted.
  • the cylinder tip 44 provided on the first cylinder 43 that is second from the left in FIG. 6 is formed with a smaller diameter toward the lower side in FIG.
  • the tube tip portion 44 is tapered such that one end side (distal end 44a) has a smaller outer diameter than the other end side (first tube 43 side). It is formed in a shape.
  • the inner diameter of the tube tip 44 may be constant, or may be formed with a smaller diameter toward the lower side in FIG.
  • the tube tip 44 provided on the third tube 43 from the left (second from the right) in FIG. 6 is a protrusion (radially outwardly protruding) on the outer peripheral surface of the distal end 44a. (Diameter enlarged portion) 44c.
  • the protrusion 44 c has a maximum outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31.
  • the protrusion 44c has a smaller diameter toward the lower side in FIG.
  • the protrusion 44c is formed in a tapered shape in which one end side (distal end 44a) is smaller in diameter than the other end side (first cylinder 43 side).
  • the protrusion 44c may be formed integrally with the tube tip 44, and may be fixed in the vicinity of the distal end 44a of the tube tip 44 by, for example, screwing or bonding.
  • the cylinder tip 44 provided on the fourth cylinder (the rightmost) first cylinder 43 from the left in FIG. 6 is a protrusion (diameter enlarged part) protruding radially outward on the outer peripheral surface of the distal end 44a. ) 44d.
  • the protrusion 44 d has a maximum outer diameter that is smaller than the inner diameter of the treatment instrument insertion port 31.
  • the outer peripheral surface of the protrusion 44d is formed into a curved surface like a part of a sphere.
  • the protrusion 44d of the tube tip 44 particularly has an arc-shaped chamfer whose one end side (distal end 44a) is smaller in diameter than the other end side (first tube 43 side).
  • the protrusions 44c and 44d in FIG. 6 may be formed integrally with the cylinder tip 44, and it is also preferable that the protrusions 44c and 44d are formed separately from, for example, a plastic material or a rubber material.
  • the protrusions 44c and 44d are separate bodies, the protrusions 44c and 44d are fixed to the cylinder tip 44 by fitting or screw fixing. That is, it is also preferable that the tube tip portion 44 has a separate part that can be attached to and detached from the tube tip portion 44.
  • the liquid leakage preventing member 71 is not limited to one having a circular cross section (see FIGS. 6 and 7A). 7B can make the contact area with respect to the inner peripheral surface of the second cylinder 45 smaller than that of the circular cross section shown in FIG. 7A. For this reason, when the liquid leakage prevention member 71 shown in FIG. 7B is used, the sliding resistance in the direction along the central axis C with respect to the inner peripheral surface of the second cylinder 45 is smaller than when the member shown in FIG. 7A is used. Can be small.
  • the dial 82 has a direction that is easy to rotate and a direction that is difficult to rotate due to ergonomic influence.
  • the dial 82 can be easily rotated and the direction in which it is difficult to rotate while maintaining watertightness and liquidtightness. And can be formed.
  • liquid leakage prevention member 71 is not limited to a member whose cross section is symmetric with respect to the virtual line T perpendicular to the central axis C.
  • a member whose cross section is asymmetric with respect to the imaginary line T such as a liquid leakage prevention member 71 shown in FIG. 7C.
  • the liquid leakage preventing member 71 is formed of a plurality of bodies such as two bodies.
  • the liquid leakage prevention member 71 is provided not on the outer peripheral surface of the first tube 43 but on the inner peripheral surface of the second tube 45.
  • the liquid leakage prevention member 71 is also preferably provided on both the outer peripheral surface of the first cylinder 43 and the inner peripheral surface of the second cylinder 45.
  • the holding portion 42 for attaching the auxiliary tool 14 to the endoscope 12 can be variously changed.
  • the base 41 can be fixed to the outer shell of the endoscope 12 shown in FIG. 1 with a fixing screw (fixing tool) 42a penetrating the base body 51.
  • the number of fixing screws 42a is not limited to one, and a plurality of fixing screws 42a is preferable.
  • the holding portion 42 shown in FIGS. 2 to 5 may be used together with the fixing screw 42a. As shown in FIG.
  • the auxiliary tool 14 may be used as a fixing tool that fixes a flexible band (band-like member) 42 b formed on a base 41 and made of a soft material such as a rubber material to the endoscope 12. good.
  • the base 41 preferably includes an arm (fixing tool) 42c having a snap-fit structure that is deformed when the endoscope 12 is attached to the operation unit 18.
  • the arm 42c is formed in a substantially C shape and can be elastically deformed to hold the outer peripheral surface of the operation unit 18. In this way, various structures are employed for holding the base 41 of the auxiliary tool 14 in a state of being fixed to the endoscope 12.
  • the assisting tool (advance / retreat assisting tool) 114 includes a base 41 attached to a predetermined position of the endoscope 12 (see FIG. 1), and the treatment tool insertion port 31 of the endoscope 12.
  • a holding portion 42 attached to the endoscope 12 so as to face the first tube, a first tube 143 attached to the base 41, a tube tip 44 provided on one end side of the first tube 143, and a first tube
  • a second cylinder 145 that moves relative to the first cylinder 143 along the central axis C of 143, and an advance / retreat mechanism 46 that moves the second cylinder 145 forward and backward along the central axis C relative to the first cylinder 143.
  • the cam pin 92 extends radially outward from the side surface of the second cylinder 145.
  • the cam pin 92 is disposed in the restriction groove 93 of the base 41.
  • the tube tip portion 44 can push away the second valve 32b and the first valve 32a of the forceps plug 32. Therefore, the auxiliary tool 14 according to the present embodiment can eliminate friction between the treatment tool 13 and the first valve 32a and the second valve 32b of the forceps plug 32 shown in FIG. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 44 and the forceps plug 32 between the outer peripheral surface of the tube tip 44 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented.
  • a liquid leakage prevention member 71 is disposed between the inner peripheral surface of the first cylinder 143 and the outer peripheral surface of the second cylinder 145.
  • the liquid leakage prevention member 71 is provided between the inner peripheral surface of the tube 143 and the outer peripheral surface of the second tube 145. It can be said that the resistance of the liquid leakage preventing member 71 can be made significantly smaller than the resistance between the forceps plug 32 and the treatment instrument 13. For this reason, compared with the past, the force required to move the treatment tool 13 by moving the second cylinder 145 relative to the first cylinder 143 can be reduced.
  • tube tip 44 instead of the tube tip 44 according to the present embodiment, an appropriate tube tip 44 shown in FIG. 6 can be used.
  • liquid leakage preventing member 71 shown in FIG. 7B and / or FIG. 7C can be used instead of the liquid leakage preventing member 71 shown in FIG.
  • the position of the liquid leakage preventing member 71 can be appropriately set as shown in FIGS. 8A and 8B.
  • auxiliary tool 114 when the auxiliary tool 114 according to the present embodiment is fixed to the endoscope 12 (see FIG. 1), not only the holding portion 42 shown in FIG. 10 is used, but also a fixing screw 42a (see FIG. 9A) and a flexible band 42b. And the arm 42c (refer FIG. 9B) can be used suitably.
  • the endoscope system 11 concerning 3rd Embodiment is demonstrated.
  • the assisting tool (advance / retreat assisting tool) 214 according to the present embodiment, the structure for moving the second tube 45 relative to the first tube 43 is different from the assisting device 14 of the first embodiment.
  • the auxiliary tool 214 of the present embodiment can adjust the protrusion amount of the treatment tool 13 relative to the tip of the channel 26 with the right hand instead of the user's left hand.
  • a wire 222 is connected to a second cylinder 45 that is movable with respect to the first cylinder 43 via a moving body 292.
  • the moving body 292 can move within a predetermined range in the direction along the central axis C.
  • the wire 222 is inserted into the guide tube 224 having flexibility.
  • a moving body 222a that is operated by a user with a right hand (for example, a thumb and an index finger) such as a ring shape or a block shape is fixed.
  • Fixed to the distal end of the guide tube 224 is a fixed body 224a that is supported by the user's right hand, such as a fixing ring.
  • the movable body 222a of the wire 222 can be moved by the right hand along the axial direction of the wire 222.
  • a moving body 292 is connected to the proximal end of the wire 222 on the side opposite to the moving body 222a.
  • a moving body 292 is put in and out of the proximal end of the guide tube 224.
  • the moving body 292 protrudes from the proximal end of the guide tube 224. Since the moving body 292 moves toward the proximal end along the central axis C, the second cylinder 45 moves (retreats) toward the opposite side of the first end of the channel 26 with respect to the first cylinder 43. ) Since the treatment tool 13 is fixed to the second tube 45, the protrusion amount of the distal end of the treatment tool 13 with respect to the distal end of the channel 26 of the insertion portion 17 of the endoscope 12 is reduced, or the distal end of the treatment tool 13 is drawn into the channel 26. . At this time, the first valve 32a and the second valve 32b of the forceps plug 32 are pushed away by the tube tip portion 44, and the treatment tool 13 is inserted inside the tube tip portion 44. No friction is generated between them.
  • the moving body 292 When the moving body 222 a of the wire 222 is moved away from the fixed body 224 a of the guide tube 224, the moving body 292 is disposed at the proximal end of the guide tube 224. Since the moving body 292 moves toward the distal end side along the central axis C, the second cylinder 45 moves (advances) toward the distal end side of the channel 26 with respect to the first cylinder 43. Since the treatment tool 13 is fixed to the second tube 45, the distal end of the treatment tool 13 protrudes from the distal end of the channel 26 of the insertion portion 17 of the endoscope 12, or the amount of protrusion increases.
  • the liquid leakage prevention member 71 between the first cylinder 43 and the second cylinder 45 can prevent liquid from leaking outside from the auxiliary tool 214.
  • the second cylinder 45 is arranged outside the first cylinder 43.
  • the inner side of the first cylinder 143 is described.
  • the assisting tool (advance / retreat assisting tool) 314 includes a base 341 attached to a predetermined position of the endoscope 12 (see FIG. 1), and an endoscope so that the base 341 faces the treatment tool insertion port 31 of the endoscope 12.
  • a holding portion 42 (see FIGS. 2 to 5, 8A and 8B) attached to the mirror 12, a first tube 343 attached to the base 341, and a tube tip provided on one end side of the first tube 343 344, a second cylinder 345 that moves relative to the first cylinder 343 along the central axis C of the first cylinder 343, and the second cylinder 345 along the central axis C with respect to the first cylinder 343.
  • an advancing / retreating mechanism 346 (moving mechanism).
  • the first cylinder 343 and the cylinder tip 344 are formed as separate bodies.
  • the first cylinder 343 and the cylinder tip 344 are fixed with a fixing screw 349.
  • the cylinder tip 344 is fixed to the base 341.
  • the advance / retreat mechanism 346 includes a dial 382 and a cam mechanism 383 that converts rotation of the dial 382 into advance / retreat movement of the second cylinder 345 and the treatment instrument 13.
  • the first cylinder 343 and the second cylinder 345 are arranged concentrically.
  • a second cylinder 345 is disposed inside the first cylinder 343.
  • the dial 382 is disposed concentrically with the first cylinder 343 and the second cylinder 345.
  • the cam mechanism 383 includes a cam cylinder 391 having a cam groove 391a, a cam pin 392 provided in the second cylinder 345, and a restriction groove 393 provided in the first cylinder 343.
  • the cam cylinder 391 is fixed to the inner peripheral surface of the dial 382.
  • a liquid leakage preventing member 371 a is disposed between the inner peripheral surface of the first cylinder 343 and the outer peripheral surface of the second cylinder 345.
  • a liquid leakage preventing member 371b is disposed between the tube tip 344 and the first tube 343.
  • Liquid leakage prevention members 371c and 371d are disposed between the outer peripheral surface of the first tube 343 and the dial 382.
  • the central axis C of the cylinder tip 344 is inclined with respect to the central axis C of the first cylinder 343 and the second cylinder 345.
  • the user of the endoscope 12 of this embodiment fixes the auxiliary tool 314 at a predetermined position of the endoscope 12.
  • the auxiliary tool 314 is assembled and can be used simply by being attached to an appropriate part of the endoscope 12.
  • the distal end 344 a of the tube tip 344 of the auxiliary tool 314 passes through the forceps plug 32 attached to the treatment tool insertion port 31 of the endoscope 12 and penetrates the treatment tool insertion port 31. That is, the distal end 344a of the forceps plug 32 is pushed away by the distal end 344a of the tube tip 344 and the first valve 32a (see FIG.
  • the base 341 of the auxiliary tool 314 is fitted into a predetermined part of the endoscope 12.
  • the auxiliary tool 314 is fixed to the endoscope 12 with the mounting screw 42a.
  • the attachment screw 42a is used as a holding portion that holds the state where the tube distal end portion 344 penetrates the forceps plug 32 in a state where the base 341 is attached to the endoscope 12.
  • the attachment screw 42a prevents the auxiliary tool 314 from dropping unintentionally during use of the endoscope 12.
  • the first tube is provided by the liquid leakage prevention members 371a, 371b, 371c, and 371d. Liquid leakage between the outer peripheral surface of 343 and the inner peripheral surface of the second cylinder 345 is also prevented. Further, even when the treatment instrument 13 is not disposed, the fixing portion 62 prevents liquid leakage through the second cylinder 345.
  • the auxiliary tool 314 When the auxiliary tool 314 is attached to a predetermined position of the endoscope 12, the first valve 32 a and the second valve 32 b of the forceps plug 32 can be pushed away by the tube distal end portion 344. Therefore, the auxiliary tool 314 according to the present embodiment can eliminate friction between the first tool 32 a and the second valve 32 b of the forceps plug 32 and the treatment tool 13. On the other hand, liquid leaks between the outer peripheral surface of the tube tip 344 and the forceps plug 32 between the outer peripheral surface of the tube tip 344 and the first valve 32 a and the second valve 32 b of the forceps plug 32. Can be prevented.
  • the liquid leakage prevention members 371a to 371d between the first cylinder 343 and the second cylinder 345 can prevent the liquid from leaking from the auxiliary tool 314 to the outside.
  • the second valve 32b and the first valve 32a of the forceps plug 32 increase as the outer diameter of the treatment tool 13 increases. It is expected that the sliding resistance passing through will increase.
  • the second end 32b and the first valve 32a of the forceps plug 32 are pushed away by the tube tip 344. For this reason, if the treatment instrument 13 has an outer diameter through which the passage 48 can pass, the sliding resistance that moves the second cylinder 345 with respect to the first cylinder 343 ignores the presence of the channel 26. Even if the outer diameter of the treatment instrument 13 changes, it can be prevented from changing.
  • the auxiliary tool 314 of the treatment tool 13 with improved force and reduced operability can be provided.
  • the distal end of the tube tip 344 is allowed to have an appropriate shape like the tube tip 44 shown in FIG.
  • the holding portion used when fixing the base 341 to the endoscope 12 is not limited to the fixing screw 42a, and an appropriate one can be used.

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Abstract

L'invention concerne un outil d'aide à l'avancement/rétraction, comprenant : une base fixée à un endoscope ; un premier tube ayant un trajet à travers lequel un outil de traitement est inséré ; une partie d'extrémité distale de tube qui est située au niveau d'un côté d'extrémité du premier tube, qui pénètre dans un bouchon de forceps fixé à un orifice d'insertion d'outil de traitement de l'endoscope tandis que la base est fixée à l'endoscope, et qui pénètre dans l'orifice d'insertion d'outil de traitement ; et un second tube, dans lequel l'outil de traitement est inséré tout en maintenant la surface externe de l'outil de traitement qui a traversé le trajet du premier tube, et qui, en raison d'une opération depuis l'extérieur, se déplace dans une direction suivant l'axe central du trajet par rapport à la base et au premier tube.
PCT/JP2017/025147 2016-08-18 2017-07-10 Outil d'aide à l'avancement/rétraction pour outil de traitement et système endoscopique WO2018034080A1 (fr)

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JP2016-160772 2016-08-18
JP2016160772A JP2019201673A (ja) 2016-08-18 2016-08-18 処置具の進退補助具及び内視鏡システム

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Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH02264653A (ja) * 1990-03-06 1990-10-29 Olympus Optical Co Ltd カテーテル
JP2001061775A (ja) * 1999-08-25 2001-03-13 Olympus Optical Co Ltd 内視鏡用送液具
JP2007289673A (ja) * 2006-04-26 2007-11-08 Olympus Medical Systems Corp 内視鏡用処置具
JP2013233232A (ja) * 2012-05-07 2013-11-21 Forte Grow Medical Kk 内視鏡用色素散布チューブ
WO2015076154A1 (fr) * 2013-11-21 2015-05-28 オリンパスメディカルシステムズ株式会社 Dispositif de traitement endoscopique
WO2015087939A1 (fr) * 2013-12-11 2015-06-18 オリンパス株式会社 Instrument de traitement pour endoscope
WO2016098566A1 (fr) * 2014-12-18 2016-06-23 オリンパス株式会社 Outil d'assistance de déplacement vers l'avant / vers l'arrière, dispositif d'insertion, et système d'endoscope

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH02264653A (ja) * 1990-03-06 1990-10-29 Olympus Optical Co Ltd カテーテル
JP2001061775A (ja) * 1999-08-25 2001-03-13 Olympus Optical Co Ltd 内視鏡用送液具
JP2007289673A (ja) * 2006-04-26 2007-11-08 Olympus Medical Systems Corp 内視鏡用処置具
JP2013233232A (ja) * 2012-05-07 2013-11-21 Forte Grow Medical Kk 内視鏡用色素散布チューブ
WO2015076154A1 (fr) * 2013-11-21 2015-05-28 オリンパスメディカルシステムズ株式会社 Dispositif de traitement endoscopique
WO2015087939A1 (fr) * 2013-12-11 2015-06-18 オリンパス株式会社 Instrument de traitement pour endoscope
WO2016098566A1 (fr) * 2014-12-18 2016-06-23 オリンパス株式会社 Outil d'assistance de déplacement vers l'avant / vers l'arrière, dispositif d'insertion, et système d'endoscope

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