JP2003310545A

JP2003310545A - Endoscope

Info

Publication number: JP2003310545A
Application number: JP2002126727A
Authority: JP
Inventors: Takatsugu Yamatani; 高嗣山谷; Koji Nakamoto; 孝治中本; Hisao Yabe; 久雄矢部
Original assignee: Olympus Optical Co Ltd
Current assignee: Olympus Corp
Priority date: 2002-04-26
Filing date: 2002-04-26
Publication date: 2003-11-05
Anticipated expiration: 2022-04-26
Also published as: JP3938710B2

Abstract

<P>PROBLEM TO BE SOLVED: To provide an endoscope which is wide in an oscillation range of a therapeutic instrument in carrying out a therapeutic treatment of the lesion under observation by the endoscope and is good in operability. <P>SOLUTION: The endoscope provided with an observation window 9 configurating an objective optical system for taking endoscope images and distal end side apertures of at least one or more therapeutic instrument insertion channels 17 within the distal end 5 of an endoscope insertion portion 2 is provided with oscillation means capable of oscillating the therapeutic instruments 53 led out of the distal end side apertures 43 of the channels 17 in the hour directions near the distal end side apertures 43 of the channels 17. The oscillation means is partly made freely externally attachable and detachable to and from the distal end 5 of the insertion portion 2. <P>COPYRIGHT: (C)2004,JPO

Description

【発明の詳細な説明】【０００１】【発明の属する技術分野】本発明は、処置具挿通用チャ
ンネルの先端側開口より導出される処置具を四方向に揺
動させて治療処置が行える内視鏡に関する。【０００２】【従来の技術】細長の挿入部を体腔内に挿入することに
より、体腔内臓器などを観察したり、必要に応じて挿入
部に設けられた処置具挿通用チャンネルに挿通した処置
具を用いて各種治療処置を行う医療用の内視鏡が従来か
ら広く用いられている。特に、針状電気メスなどの切開
用処置具を前記挿入部の処置具挿通用チャンネルに挿通
して体腔内の病変部位を内視鏡で観察しながら切除する
手技の有用性が広く認知されている。【０００３】このような手技に用いる内視鏡は、例え
ば、特開２００１−２１２０７８号公報に開示されてい
る。この公報には、挿入部に２つの処置具挿通チヤンネ
ルが設けられ、その処置具挿通チャンネルに挿通され、
挿入部先端から導出されたそれぞれの処置具である鉗子
を異なる方向に起上する２つの鉗子起上機構を備えた内
視鏡が開示されている。【０００４】【発明が解決しようとする課題】前記公報に開示されて
いる内視鏡は、挿入部に設けられた２つの処置具挿通用
チャンネルの先端開口部に、それぞれ異なる方向に起上
する鉗子起上機構を設けている。一方の処置具挿通用チ
ャンネルに挿通される把持用処置具（以下、把持鉗子と
称する）と、他方の処置具挿通用チャンネルに挿通され
る針状電気メス等の切開用処置具（以下、切開鉗子と称
する）とを組み合わせ、病変粘膜部もしくはその近傍を
把持鉗子で把持して吊り上げた後、切開鉗子で病変粘膜
部を切除するようになっている。【０００５】しかし、前記公報に開示された内視鏡の各
鉗子起上機構は、それぞれの処置具起上台を１本の起上
操作ワイヤで操作しているため、そのワイヤによる起上
方向への処置具の起上操作コントロールはしやすいが、
倒置する方向には操作コントロールしにくく、また各起
上台から導出される処置具は、各々２方向（上下または
左右）にしか動かすことができなく、処置具の操作方向
の制約により操作範囲が狭く内視鏡処置具の操作性が低
下する課題があった。【０００６】本発明は、上記課題に鑑みてなされたもの
であり、内視鏡の挿入部に設けられた処置具挿通用チャ
ンネルの先端開口から処置具を導出させて、内視鏡によ
る観察の基で、病変部切除や摘出等の処置を行う際の操
作性の優れた内視鏡を提供することを目的にしている。【０００７】【課題を解決するための手段】本発明の内視鏡は、内視
鏡挿入部の先端部に、内視鏡画像を撮らえる対物光学系
を構成する観察窓と、少なくとも１つ以上の処置具挿通
用チャンネルの先端側開口部を設けた内視鏡において、
少なくとも１つ以上の前記処置具挿通用チャンネルの先
端側開口部から導出される処置具を四方向に揺動可能な
揺動手段を前記処置具挿通用チャンネルの先端側開口部
近傍に設け、または前記揺動手段の一部を前記内視鏡挿
入部の先端部に着脱自在に外付け可能としたことを特徴
とする。【０００８】本発明の内視鏡により、処置具挿通用チャ
ンネルの先端側開口部近傍に設けられた揺動手段によ
り、前記処置具挿通チャンネルの先端側開口から導出さ
れた処置具は、上下左右四方向に揺動可能で、処置具の
操作範囲が拡大されると共に、操作性が向上する内視鏡
の提供が可能となった。【０００９】【発明の実施の形態】以下、図面を参照して本発明の実
施の形態について詳細に説明する。図１は本発明に係る
内視鏡の一実施形態の全体構成を示す斜視図、図２は本
発明に係る内視鏡の挿入部の先端部を正面から見た平面
図、図３は本発明に係る内視鏡の揺動台の操作範囲を説
明する説明図、図４は本発明に係る内視鏡の第１処置具
揺動台の構成を示す斜視図、図５は本発明に係る内視鏡
の第２の揺動台の構成を示す斜視図、図６は本発明に係
る内視鏡の第１の処置具による処置動作を説明する説明
図、図７は本発明に係る内視鏡の観察画像と処置具の操
作範囲を示すモニタ画像を説明する説明図、図８は本発
明に係る内視鏡の第１と第２の処置具による処置動作を
説明する説明図である。【００１０】最初に図１を用いて本発明に係る内視鏡の
全体構成を説明する。内視鏡１は、挿入部２と操作部３
とからなり、操作部３には、ライトガイドケーブル、及
び信号ケーブル等を内蔵したユニバーサルコード４が接
続されている。【００１１】前記挿入部２は、先端側から順に先端部
５、第１湾曲部６、第２湾曲部７、可撓管部８から構成
されている。【００１２】前記先端部５の先端面には、観察窓９、照
明窓１０、送気送水用ノズル１１、前方送水噴射口１２
が設けられていると共に、略Ｌ字状の処置具揺動台収納
部１３が形成され、その処置具揺動台収納部１３の内部
には、第１の処置具揺動台１４と第２の処置具揺動台１
５が揺動自在に保持されている。【００１３】前記観察窓９には、図示していないが対物
レンズと、観察部位を撮像する固体撮像素子とが設けら
れ、この固体撮像素子は、前記ユニバーサルコード４の
信号ケーブルに接続されている。または、対物レンズで
捉えた観察部位光を前記挿入部２と操作部３に内蔵され
た図示していないイメージガイドケーブルを介して、操
作部３に設けられている図示していない接眼光学系に導
光されるようになっている。【００１４】なお、前記ユニバーサルコード４は、図示
していないビデオプロセッサ装置に接続されており、前
記固体撮像素子の駆動制御と、撮像した画像信号を所定
の信号処理を行い記録媒体に記録したり、あるいはモニ
タに撮像画像表示を行う。【００１５】前記照明窓１０には、挿入部２、操作部
３、及びユニバーサルコード４に内蔵された照明光をガ
イドする図示していないライトガイドケーブルの端部が
配置され、前記ユニバーサルコード４に接続された照明
装置からの照明光がライトガイドケーブルで導光され
て、観察部位に投射されるようになっている。【００１６】前記送気送水用ノズル１１は、挿入部２と
操作部３に設けられた図示していない送気送水チャンネ
ルに連通され、その送気送水チャンネルに接続された送
気送水ポンプにより前記観察窓９に対して、送気及び送
水が行われるようになっている。【００１７】前記前方送水噴射口１２は、挿入部２と操
作部３に設けられた図示していない前方送水チャンネル
に連通されており、観察部位に対して、送水される際の
噴射口である。【００１８】前記第１の処置具揺動台１４と第２の処置
具揺動台１５は、操作部３に設けられた後述する第１の
処置具揺動台操作ノブ３３と第２の処置具揺動台操作ノ
ブ３４によって、揺動されるようになっており、第１の
処置具揺動台１４は視野の略左右方向に揺動し、第２の
処置具揺動台１５は視野の略上下方向に揺動するように
なっている。【００１９】前記第１湾曲部６は、操作部３に設けられ
た後述する第１の湾曲操作部２６によって、視野の略上
下と左右方向に湾曲できるようになっている。【００２０】前記第２湾曲部７は、操作部３に設けられ
た後述する第２の湾曲操作部２７によって、視野の略上
下方向に湾曲できるようになっている。【００２１】前記挿入部２の内部には、第１の処置具挿
通用チャンネル１７と第２の処置具挿通用チャンネル１
８が設けられている。【００２２】この第１の処置具挿通用チャンネル１７の
先端側開口は、前記第１の処置具揺動台１４に連通し、
後端側開口は、前記操作部３に設けられた第１の処置具
挿入口１９に連通している。【００２３】また、第２の処置具挿通用チャンネル１８
の先端側開口は、前記第２の処置具揺動台１５に連通
し、後端側開口は、前記操作部３に設けられた第２の処
置具挿入口２０に連通している。【００２４】前記操作部３は、揺動台操作部２２、把持
部２５、第１の湾曲操作部２６、第２の湾曲操作部２７
から構成されている。【００２５】揺動台操作部２２の内部には、図示してい
ないが、第１の処置具揺動台操作機構と第２の処置具揺
動台操作機構が設けられており、この揺動台操作部２２
の外部に設けられた第１の処置具揺動台操作機構の一部
でもある第１の処置具揺動台操作ノブ３３と、第２の処
置具揺動台操作機構の一部でもある第２の処置具揺動台
操作ノブ３４が設けられている。【００２６】つまり、第１の処置具揺動台操作ノブ３３
を操作すると、第１の処置具揺動台操作機構を介して、
前記第１の処置具揺動台１４が視野の略左右方向に遠隔
揺動し、第２の処置具揺動台操作ノブ３４を操作する
と、第２の処置具揺動台操作機構を介して、前記第２の
処置具揺動台１５が視野の略上下方向に遠隔揺動するよ
うになっている。なお、この第１と第２の処置具揺動台
１４，１５の揺動動作の詳細は後述する。【００２７】前記揺動台操作部２２の外表面には、前方
送水注入口２３と揺動台操作ワイヤ洗滌口２４が設けら
れており、前方送水注入口２３は、挿入部２の内部に設
けられた送水チャンネルを介して、前記先端部５に設け
られた前方送水噴射口１２に連通している。また、揺動
台操作ワイヤ洗滌口２４は、挿入部２の内部に設けられ
た後述する操作ワイヤ挿通チャンネル６０を介して、前
記先端部５の処置具揺動台収納部１３に連通している。
また、揺動台操作ワイヤ洗滌口２４には、図示していな
いシリンジが接続でき、洗滌液等を操作ワイヤ挿通チャ
ンネル６０に送ることができるようになっている。【００２８】前記第１の湾曲操作部２６は、外部に第１
の湾曲部操作ノブ（上下）３５、第１の湾曲部操作ノブ
（左右）３６、第１の回転／固定切換レバー（上下）３
８、第１の回転／固定切換ノブ（左右）３９が設けられ
ている。【００２９】前記第１の湾曲部操作ノブ（上下）３５
は、前記第１湾曲部６を上下方向に湾曲させる操作ノブ
で、第１の湾曲操作部２６または把持部２５の内部で第
１湾曲部６に接続されている上下用操作ワイヤ（図示せ
ず）に連結されている。【００３０】前記第１の湾曲部操作ノブ（左右）３６
は、前記第１湾曲部６を左右方向に湾曲させる操作ノブ
で、第１の湾曲操作部２６または把持部２５の内部で第
１湾曲部６に接続されている左右用操作ワイヤ（図示せ
ず）に連結されている。【００３１】前記第１の湾曲部操作ノブ（上下）３５に
よる前記第１の湾曲部６の湾曲操作と固定は、第１の回
転／固定切換レバー（上下）３８で切換えられ、前記第
１の湾曲部操作ノブ（左右）３６による前記第１の湾曲
部６の湾曲操作と固定は、第１の回転／固定切換ノブ
（左右）３９で切換えられるようになっている。【００３２】前記第２の湾曲操作部２７は、外部に第２
の湾曲部操作ノブ３７と、第２の回転／固定切換ノブ４
０が設けられている。【００３３】この第２の湾曲部操作ノブ３７は、前記第
２湾曲部７を上下方向に湾曲操作させるノブで、第２の
湾曲操作部２７または把持部２５の内部で第２湾曲部７
に接続された上下用操作ワイヤ（図示せず）に連結され
ている。【００３４】前記第２の湾曲部操作ノブ３７による前記
第２の湾曲部７の湾曲操作と固定は、第２の回転／固定
切換ノブ４０で切換えられるようになっている。【００３５】前記第１の湾曲操作部２６の近傍には、送
気送水制御ボタン２８と、吸引制御ボタン２９と、及び
画像制御ボタン３０が設けられている。【００３６】この送気送水制御ボタン２８は、前記挿入
部２の先端部５に設けられた送気送水用ノズル１１に接
続された送気送水ポンプを駆動制御するボタンで、前記
吸引制御ボタン２９は、図示していない操作部３から挿
入部２の先端部５に設けられている吸引チャンネルを介
して、前記送気送水用ノズル１１から送気送水した気体
や液体を吸引するポンプを駆動制御するボタンで、画像
制御ボタン３０は、前記ユニバーサルコード４に接続さ
れるビデオプロセッサを介して、モニタに表示されてい
る画像を制御するボタンであり、詳細の内容は本発明に
直接関係しないために省略する。【００３７】なお、前記操作部３と接続される前記挿入
部２の接続部分には、挿入部折れ防止部材４１が、前記
操作部３と接続される前記ユニバーサルコード４の接続
部分には、ユニバーサルコード折れ防止部材４２がそれ
ぞれ設けられて、挿入部２と、ユニバーサルコード４の
根元部分での折れを防止するようになっている。【００３８】次に、前記先端部５の先端の構成につい
て、図２を用いて説明する。前記先端部５の先端正面中
央部分には、観察窓９が設けられ、この観察窓９の図中
右側に照明窓１０，図中上側には、送気送水用ノズル１
１が、照明窓１０と送気送水用ノズル１１の間に前方送
水噴射口１２が設けられている。【００３９】前記観察窓９の図中左側から下側にかけ
て、略Ｌ字状の処置具揺動台収納部１３が設けられてい
る。【００４０】前記観察窓９の図中下側に位置する前記処
置具揺動台収納部１３には、第１の処置具揺動台１４が
配置されており、前記観察窓９の図中左側に位置する前
記処置具揺動台収納部１３には、第２の処置具揺動台１
５が配置されている。【００４１】前記第１の処置具揺動台１４と第２の処置
具揺動台１５には、それぞれ第１の処置具挿通孔４５と
第２の処置具挿通孔４６が設けられている。【００４２】この第１の処置具挿通孔４５と第２の処置
具挿通孔４６は、前記第１の処置具挿通用チャンネル１
７の開口４３（図中点線で示す）と第２の処置具挿通用
チャンネル１８の開口４４（図中点線で示す）にそれぞ
れが接続されている。【００４３】前記第２の処置具揺動台１５には、略Ｌ状
に形成された起上バー８０が設けられている。この起上
バー８０の基端は、第２の処置具揺動台１５に固定され
ており、先端側は前記第１の処置具挿通孔４５の図中下
側に延在されている。【００４４】また、前記第１の処置具揺動台１４と第２
の処置具揺動台１５の略両端近傍には、操作ワイヤ挿通
チャンネル６０がそれぞれ設けられている。【００４５】つまり、図３に示すように、前記第１の処
置具挿通用チャンネル１７に挿通された第１の処置具５
３は、前記第１の処置具挿通用チャンネル１７の開口４
３から第１の処置具揺動台１４の第１の処置具挿通孔４
５を介して、前記先端部５から外部へと導出または突出
される。【００４６】一方、前記第１の処置具揺動台１４の中央
部分には、第１の回転軸５５が設けられ、両端には、前
記操作ワイヤ挿通チャンネル６０に挿通された操作ワイ
ヤ５７の終端がワイヤ端末部材５８で固定接続されてい
る。【００４７】この操作ワイヤ５７の基端は、前記揺動台
操作部２２の第１の処置具揺動台操作機構を介して、第
１の処置具揺動台操作ノブ３３に接続固定されている。【００４８】すなわち、前記第１の揺動台操作ノブ３３
を回動操作することで、操作ワイヤ５７が牽引されて、
第１の処置具揺動台１４は、第１の回転軸５５を中心に
左右方向に回動し、第１の処置具揺動台１４の回動によ
り、第１の処置具挿通孔４５に挿通された第１の処置具
５３が左右に揺動するようになっている。【００４９】なお、第２の処置具揺動台１５の動作も同
じであるので、詳細説明は省略し、図３の図中に第２の
揺動台１５に関係する符号を（）書きで示している。【００５０】この第１の処置具揺動台１４の第１の処置
具挿通孔４５を介して突出された第１の処置具５３は、
図３に示すように、前記観察窓９の観察視野範囲内を２
点鎖線で示すように揺動する。図２で示した通り、観察
窓９は、第１の処置具揺動台１４の上側に配置されてい
る。そういう意味で、観察窓９を二点鎖線で示した。【００５１】つまり、前記揺動台操作部２２の第１の処
置具揺動台操作ノブ３３を回動操作すると、第１の処置
具揺動台操作機構を介して、第１の処置具揺動台１４に
接続された操作ワイヤ５７が牽引されて、第１の処置具
揺動台１４が第１の回転軸５５を回転中心として略左右
に揺動することで第１の処置具５３が揺動する。この第
１の処置具５３の先端の揺動軌跡は、円弧状を描く、す
なわち、第１の処置具５３が先端部５の軸方向の揺動中
立状態（位置）Ａから第１の処置具揺動台１４の揺動に
より、視野中心７７を中心に左右にほぼ均等に揺動する
（Ｌ１≒Ｌ２）ことになる。【００５２】一方、前方送水噴射口１２から送水される
送水の前方送水軌跡７８は、先端部５の先端面から約１
５ｍｍの距離で、視野中心７７の近傍を通るように前方
送水噴射口１２の噴射方向が調整されている。【００５３】なお、前記第１の処置具揺動台１４と第２
の処置具揺動台１５それぞれ牽引する４本の操作ワイヤ
を挿通する４本の操作ワイヤ挿通チャンネル６０は、前
記揺動台操作部２２内で１本に合流させ、その合流させ
た基端は、前記揺動台操作ワイヤ洗滌口２４に開口させ
るようになっている。これにより、揺動台操作ワイヤ洗
滌口２４が洗浄液を注入することで、前記操作ワイヤ挿
通チャンネル６０と操作ワイヤ５７の洗滌が可能とな
る。【００５４】次に、図４を用いて第１の処置具揺動台１
４の構成と揺動動作、図５を用いて第２の処置具揺動台
１５の構成と揺動動作をそれぞれ詳細に説明する。【００５５】図４に示すように、前記第１の処置具揺動
台１４の上面と下面の略中央には、第１の回転軸５５と
第２の回転軸５６が設けられており、この第１の回転軸
５５と第２の回転軸５６は、前記第１の処置具挿通孔４
５の中心と一致するように形成されている。【００５６】前記第１の回転軸５５と第２の回転軸５６
を中心にして第１の処置具揺動台１４の左右両端には、
２つの取付孔５９が設けられており、この取付孔５９に
は、前記操作ワイヤ５７のワイヤ端末部材５８がそれぞ
れ取り付けられている。【００５７】前記第１の回転軸５５と第２の回転軸５６
は、前記処置具揺動台収納部１３内に回転自在に保持さ
れ、この第１の回転軸５５と第２の回転軸５６を回転中
心として処置具揺動台収納部１３内で２本の操作ワイヤ
５７の交互牽引によって左右に遠隔揺動されるようにな
っている。尚、ワイヤ端末部材５８は取付孔５９に回動
自在に保持されている。【００５８】なお、図４は、第１の処置具揺動台１４の
第１の処置具挿通孔４５に挿通された第１の処置具５３
は、揺動中立状態である略ストレート状態で第１の処置
具挿通孔４５から突出された状態を示している。この第
１の処置具５３の図中下側には、前記起上バー８０が配
置されている。すなわち、前記操作ワイヤ５７が牽引さ
れると、第１の処置具揺動台１４の図中左右方向の揺動
により、第１の処置具５３は、前記起上バー８０の上側
を図中左右方向に揺動するようになっている。【００５９】一方、第２の処置具揺動台１５は、図５に
示すように、第１の処置具揺動台１４と同じに、第１の
回転軸５５と第２の回転軸５６を有し、かつ、操作ワイ
ヤ５７のワイヤ端末部材５８が取り付けられる２つの取
付孔５９を有すると共に、前記第１の処置具揺動台１４
と略直交する方向に取付固定されている。更に、この第
２の処置具揺動台１５には、前述したように第１の処置
具揺動台１４に挿通された第１の処置具５３と接するこ
とが可能な起上バー８０が設けられている。【００６０】この第２の処置具揺動台１５の操作ワイヤ
５７を牽引すると、第１の回転軸５５と第２の回転軸５
６を中心に図中上下方向に回動する。【００６１】この第２の処置具揺動台１５の上下方向の
回動により、起上バー８０も上下方向に回動し、図４に
示すように、第１の処置具揺動台１４から突出されてい
る第１の処置具５３を図中上下方向へと回動させるよう
になる。【００６２】この起上バー８０の長さを図４に示すよう
に、長さＬ３のように十分長く設定すれば、第１の処置
具揺動台１４の左右揺動の全範囲において、第１の処置
具５３を第２の処置具揺動台１５で上下に揺動操作でき
る。また長さＬ４のように短く設定すれば、第１の処置
具揺動台１４を観察方向に向って右側いっぱいに揺動さ
せた時だけ、第１の処置具５３を第２の処置具揺動台１
５で上下に揺動操作できる。【００６３】つまり、第１の処置具揺動台１４に挿通さ
れた第１の処置具５３は、第１の処置具揺動台１４の揺
動動作で揺動すると共に、第２の処置具揺動台１５の揺
動動作により、第２の処置具揺動台１５から延在された
起上バー８０で、第１の処置具揺動台１４と略直交する
方向への揺動が可能となる。【００６４】なお、この起上バー８０を第１の処置具揺
動台１４に設けて、第２の処置具揺動台１５に挿通され
た第２の処置具５４を、第２の処置具揺動台１５と略直
交する方向に揺動させるようにしても良いことは明らか
である。【００６５】このような内視鏡１による病変部の処置に
ついて、図６を用いて説明する。この図６は、第１の処
置具揺動台１４から突出した第１の処置具５３の揺動状
態を示している。第１の処置具揺動台１４を揺動操作す
ると、第１の処置具５３は、図中矢印Ｘ−Ｘで示すよう
に左右方向に揺動する。次に、第２の処置具揺動台１５
を揺動操作すると、起上バー８０により、第１の処置具
５３は図中矢印Ｙ−Ｙで示すように上下方向に揺動し
て、図中点線で示す位置に第１の処置具５３を移動させ
ることが出来る。【００６６】つまり、体腔内の病変粘膜Ｍの下に第１の
処置具５３として例えば切開鉗子の先端を誘導案内し、
第１の処置具揺動台１４と第２の処置具揺動台１５の揺
動動作により、第１の処置具５３を上下左右に揺動させ
ることで病変粘膜Ｍを左右にも上下にも切開が可能とな
る。【００６７】また、この第１の処置具５３の処置動作
は、前記挿入部２の先端部５の観察窓９に設けられた固
体撮像素子で撮像生成した観察部位の画像を図７に示す
ようにモニタ７３に表示する。つまり、観察窓９の視野
範囲の観察部位と第１の処置具５３の先端部分の揺動移
動範囲との画像を表示されるようになっている。【００６８】つまり、このモニタ７３に表示する観察部
位に対して、前記第１の処置具揺動台１４から突出され
た第１の処置具５３の先端を第１の処置具揺動台１４と
第２の処置具揺動台１５をそれぞれ操作することによっ
て、例えば、図７に示した斜線領域内を自由に動かすこ
とができ、この斜線領域内の病変粘膜Ｍの切開操作が可
能となる。【００６９】なお、この図７に示す透明タッチパネル８
１と、先端移動希望ライン８２については、後述する。【００７０】次に、前記内視鏡１による第１の処置具と
第２の処置具を用いた内視鏡処置の操作について図８を
用いて説明する。【００７１】この図８は、第１の処置具揺動台１４に挿
通させた第１の処置具５３は、図６で説明したと同様に
切開鉗子を挿通させ、第２の処置具揺動台１５に挿通さ
せる第２の処置具５４は、例えば把持鉗子とする。【００７２】この第２の処置具５４である把持鉗子で病
変粘膜Ｍを把持し、かつ、第２の処置具揺動台１５を操
作すると、第１の処置具５３が起上バー８０によって図
中Ｙ−Ｙ方向に、および第２の処置具５４が図中Ｙ’−
Ｙ’方向にそれぞれ揺動して、図中点線で示す第１の処
置具５３’と第２の処置具５４’の位置に揺動される。【００７３】すなわち、第２の処置具５４の把持鉗子で
把持された病変粘膜Ｍは図中上方に持ち上げられると共
に、その持ち上げられた病変粘膜Ｍの下側に第１の処置
具５３である切開鉗子が差し込まれることになる。【００７４】この状態で、前記第１の処置具揺動台１４
を図中Ｘ−Ｘ方向に揺動させると、病変粘膜Ｍの切開操
作が行われ、病変粘膜Ｍの切開が確実に、かつ容易に実
施できる。【００７５】なお、前記起上バー８０の長さを前述した
図４に示すように短い長さＬ４に設定すれば、第１の処
置具５３を一番右に揺動させた時にのみ、第１の処置具
５３を起上バー８０（第２の処置具揺動台１５）で上下
方向に揺動可能となる。つまり、起上バー８０の長さＬ
により、第１の処置具５３の揺動範囲を設定可能とな
る。【００７６】次に、本発明に内視鏡１に用いる第１の処
置具５３，または第２の処置具５４に用いる切開鉗子の
変形例について、図９と図１０を用いて説明する。【００７７】この図９と図１０に示す、切開具は、両振
り針状電気メス８３で、針状刃先８６と、この針状刃先
８６を右側に湾曲操作させるＲ側湾曲操作ワイヤ８４
と、前記針状刃先８６を左側に湾曲操作させるＬ側湾曲
操作ワイヤ８５が設けられている。このＲ側湾曲操作ワ
イヤ８４とＬ側湾曲操作ワイヤ８５の基端は、切開鉗子
の基端側に延在されており、前記Ｒ側湾曲操作ワイヤ８
４を牽引すると、図１０に示すように両振り針状電気メ
ス８３を右側に湾曲させることができ、Ｌ側湾曲操作ワ
イヤ８５を牽引すると両振り針状電気メス８３は、図１
０と反対の左側に湾曲する。【００７８】このような両振り針状電気メス８３を用い
ると、第１の処置具揺動台１４及び第２の処置具揺動台
１５で揺動させる揺動範囲に追加して、両振り針状電気
メス８３の湾曲によりを処置具の先端の揺動範囲を更に
拡大可能となる。【００７９】次に本発明の内視鏡の他の実施形態を図１
１乃至図１５を用いて説明する。この他の実施形態の内
視鏡は、第１湾曲部６と第２湾曲部７の湾曲操作、第１
の処置具揺動台１４と第２の処置具揺動台１５の揺動操
作、および前方送水噴射口１２からの前方送水を電動ス
イッチ部８７からの操作入力で動作させるものである。【００８０】具体的には、図１１に示すように、前述し
た揺動台操作部２２、第２の湾曲操作部２７に設けられ
ている操作ノブ３３，３４，３７及び回転／固定切換ノ
ブ４０を廃止すると共に、第１の湾曲操作部２６に代え
て、電動スイッチ部８７を設けている。【００８１】この電動スイッチ部８７は、図１２に示す
ように、第１の湾曲操作スイッチ９１、第２の湾曲操作
スイッチ９２、揺動台操作スイッチ９３、及び前方送水
操作スイッチ９４が設けられている。【００８２】この電動スイッチ部８７の第１の湾曲操作
スイッチ９１と第２の湾曲操作スイッチ９２は、第１の
湾曲部６と第２の湾曲部７をそれぞれ上下左右（Ｕ、
Ｄ、Ｌ、Ｒ）方向に湾曲操作指示するスイッチが設けら
れている。例えば、第1の湾曲操作スイッチ９１の上
（Ｕ）のスイッチがオンすると、図示していないモータ
が駆動して、第１の湾曲部６を上側に湾曲するように図
示していない湾曲ワイヤを牽引する。つまり、第１と第
２の湾曲操作スイッチ９１，９２の上下左右（Ｕ、Ｄ、
Ｌ、Ｒ）スイッチをオンするとそのオンされた方向に第
１と第２の湾曲部６，７が湾曲されるようになってい
る。【００８３】なお、この第１と第２の湾曲部６，７は上
下左右の四方向に湾曲可能としたが、いずれか一方を二
方向の湾曲とした際には、その二方向とした湾曲部の操
作スイッチは、二方向への湾曲指示スイッチのみとなる
ことは明らかである。【００８４】また、前記揺動台操作スイッチ９３は、第
１と第２の湾曲操作スイッチ９１，９２と同様に、上下
左右（Ｕ，Ｄ，Ｌ，Ｒ）スイッチと、そのスイッチのオ
ン操作により駆動し、前記処置具揺動台１４，１５に設
けられた操作ワイヤ５７を牽引するモータからなってい
る。【００８５】前記前方送水操作スイッチ９４は、揺動台
操作部２２の前方送水注入口２３に接続された前方送水
タンク８８からの送水をオン・オフ指示するスイッチで
ある。前記前方送水タンク８８には、滅菌水が貯水され
ており、この前方送水タンク８８から延びる送水チュー
ブ９０が前記前方送水注入口２３に接続されている。前
方送水タンク８８が加圧ポンプ８９により加圧される
と、前方送水タンク８８の滅菌水が前記送水チューブ９
０から前方送水注入口２３へと送水され、この前方送水
注入口２３から挿入部２のチャンネルを介して、前記先
端部５の前方送水噴射口１２から噴射されるようになっ
ている。この加圧ポンプ８９の駆動のオン・オフを前記
前方送水操作スイッチ９４で切換操作入力するものであ
る。【００８６】なお、前記電動スイッチ部８７の第１の湾
曲操作スイッチ９１、第２湾曲操作スイッチ９２、揺動
台操作スイッチ９３、前方送水操作スイッチ９４は術者
の親指で全て操作できるように円弧状に配設されている
と操作性効率が向上する。【００８７】このような、第１の湾曲部６、第２の湾曲
部７、及び処置具揺動台１４，１５を電動モータを用い
て湾曲操作または揺動操作させる電気制御タイプ内視鏡
による病変粘膜Ｍの処置について図１３乃至図１５を用
いて説明する。【００８８】図１３と図１４は、図１１を用いて前述し
た電動モータを用いた電気制御タイプの内視鏡１に使用
される処置具の揺動軌跡を示している。【００８９】図１３は、処置具の径が太い処置具Ａ９５
を用いた場合の揺動軌跡を示し、図１４は、処置具の径
が細い処置具Ｂを用いた場合の揺動軌跡を示している。
また、この図１３と図１４の各処置具の揺動軌跡は、観
察部位（病変粘膜Ｍ近傍）の画像を表示するモニタ７３
に、観察部位画像と共に表示される処置具の先端の揺動
状態を先端移動予測ライン９７として表示したものであ
る。【００９０】この図１３と図１４から処置具Ａ９５と処
置具Ｂ９６のように太さや硬さ等の違いによって、処置
具先端の揺動軌跡は異なり、更に、第１の処置具挿通孔
４５(第２の処置具挿通孔４６)の内径と挿通される処置
具の外径との関係、すなわちクリアランスの大小によっ
ても、揺動軌跡は変わる。【００９１】そこで、前記第１の処置具挿入口１９と第
２の処置具挿入口２０の内部に、挿通された処置具の種
類を認識する図示していない処置具検知手段を内蔵さ
せ、その処置具検知手段にて、第１の処置具挿通用チャ
ンネル１７と第２の処置具挿通用チャンネル１８に挿通
された処置具の種類を検知させ、その検知した処置具の
種類を基に、予め、蓄積記憶されている処置具の種類毎
の仕様や性能及び揺動軌跡などのデータを読み出し、モ
ニタ７３に処置具の種類や先端移動予測ライン９７を表
示させる。【００９２】この先端移動予測ライン９７は、その処置
具を一定量、例えば先端面から約15mm突出した状態で、
第１の処置具揺動台１４(第２の処置具揺動台１５)を揺
動させた時のその処置具先端が揺動する予測ラインであ
る。【００９３】この先端移動予測ライン９７をモニタ７３
に予め表示することで、術者は、使用する処置具先端の
動きを事前に把握することができ、処置が効率良く実行
できるようになる。【００９４】また、図７を用いて説明したモニタ７３の
ように、モニタ７３の画面を透明タッチパネル８１と
し、この透明タッチパネル８１に表示されている病変粘
膜Ｍの画像を用いて切開処置する際の処置具の先端移動
希望ライン８２を術者が透明タッチパネル８１の上を指
でなぞって入力する。そのなぞった先端移動希望ライン
８２を透明タッチパネル８１から読み取る図示していな
い読み取り手段と、その読み取り手段で読み取った先端
移動希望ライン８２のデータを基に、第１の処置具５３
（第２の処置具５４）の先端が先端移動希望ライン８２
のように揺動するように自動電気制御するようにすると
一層の処置具処理効率が改善できる。【００９５】次に、図１５を用いて、内視鏡１の挿入部
２には、一つの処置具挿通用チャンネルしか有せず、か
つ、先端部５にその一つの処置具挿通用チャンネルの開
口に一つの処置具揺動台をのみを有する内視鏡について
説明する。【００９６】この内視鏡の先端部５の内部には、第１の
処置具挿通用チャンネル１７に連通した開口に第１の処
置具揺動台１４のみが設けられており、この第１の処置
具揺動台１４には、第１の処置具５３として、例えば、
切開鉗子が挿通されている。更に、前記先端部５の先端
面の外周には、透明部材で形成された透明斜形フード９
８が装着されている。この透明斜形フード９８は、図１
５に示すように、第１の処置具５３が位置する図中上方
側が先端部５の先端面から外部に延在し、第１の処置具
５３が位置する図中の下側が先端部５の先端面と略同じ
位置となるような傾斜状に形成されている。【００９７】この透明傾斜フード９８を有する内視鏡を
用いて病変粘膜Ｍを切開する際には、透明斜形フード９
８の先端部で病変粘膜Ｍを押し上げ、その押し上げられ
た病変粘膜Ｍの下側に第１の処置具５３を差し込み、図
中矢印Ｘ−Ｘ方向に揺動させることで、切開処置が可能
となる。【００９８】つまり、第１の処置具揺動台１４側は、透
明傾斜フード９８が被っていないため、第１の処置具５
３の処置具の揺動を透明斜形フード９８で規制されるこ
となく、第１の処置具５３の揺動範囲が確保でき、か
つ、透明傾斜フード９８で病変粘膜Ｍを押し上げること
で病変粘膜Ｍの切開が確実にできる。【００９９】次に、図１６を用いて本発明の内視鏡の先
端部に設けられる処置具揺動台の他の実施形態を説明す
る。図１６は、内視鏡先端部の先端面の構成を示す平面
図である。【０１００】内視鏡の先端部５’の先端面の図中上側中
心部分に、観察窓９が設けられている。この観察窓９の
図中右側に送気送水用ノズル１１と前方送水噴射口１２
が順に設けられている。前記観察窓９の図中左側に第２
の処置具挿通口４６が設けられている。【０１０１】前記先端部５’の先端面の観察窓９の図中
下方向に下がった位置に略四角形状の処置具揺動台収納
部１３’が設けられ、この処置具揺動台収納部１３’の
図中左側には、照明窓１０が設けられている。【０１０２】この先端部５’に設けられている観察窓
９、送気送水用ノズル１１、前方送水噴射口１２、照明
窓１０、及び第２の処置具挿通用チャンネル１８の開口
４６は、前述の内視鏡１の先端部５に設けられているそ
れぞれと同じ機能と作用を行うものである。【０１０３】前記処置具揺動台収納部１３’には、内側
揺動台１０２と外側揺動台１０３の２重構造の揺動台が
設けられている。外側揺動台１０３は、前記揺動台収納
部１３’の図中の上下の内面に回転自在に軸止される第
１の回転軸５５と第２の回転軸５６と、この第１と第２
の回転軸５５，５６を中心に外側揺動台１０３を揺動操
作する操作ワイヤが挿通される二つの操作ワイヤ挿通チ
ャンネル６０，６０が設けられた外径が凸状で、内部に
内側揺動台１０２が配置される空間部を有している。【０１０４】前記内側揺動台１０２は、前記外側揺動台
１０３の空間部に、前記外側揺動台１０３の第１と第２
の回転軸５５，５６と直交する方向に第１と第２の回転
軸５５’，５６’が回転自在に軸止され、その内側揺動
台１０２を第１と第２の回転軸５５’，５６’を中心に
揺動操作する操作ワイヤが挿通される二つの操作ワイヤ
挿通チャンネル６０’，６０’が設けられ、かつ、内側
揺動台１０２の中心部には、第１の処置具挿通用チャン
ネル１７に連通した第２の処置具挿通孔４５が設けられ
ている。【０１０５】このような構成の先端部５’において、内
側揺動台１０２と外側揺動台１０３のそれぞれの第１の
回転軸と第２の回転軸５５，５６，５５’，５６’は互
いに直交しているために、操作ワイヤの牽引により内側
揺動台１０２を揺動させると、内側揺動台１０２のみが
揺動して、内側揺動台１０２の第１の処置具挿通孔４５
に挿通された処置具は、図中上下方向に揺動し、外側揺
動台１０３を揺動させると、外側揺動台１０３の揺動に
応じて、内側揺動台１０２も共に揺動して、内側揺動台
１０２の第１の処置具挿通孔４５に挿通された処置具
は、図中左右方向に揺動される。【０１０６】つまり、内側揺動台１０２の第１の処置具
挿通孔４５に挿通された処置具は、内側揺動台１０２で
上下に揺動され、外側揺動台１０３で左右に揺動される
ことになる。【０１０７】このような内視鏡の先端部５’のように内
側揺動台１０２と外側揺動台１０３からなる二重構成の
揺動台とすることで、処置具を四方向に揺動可能とな
り、処置効率の向上が可能となった。【０１０８】次に、図１７を用いて本発明に係る内視鏡
に用いる揺動台の他の実施形態を説明する。なお、図１
７は本発明に係るに内視鏡の揺動台の他の実施形態を示
す斜視図である。【０１０９】この他の実施形態の揺動台は、複数の湾曲
駒９９、９９，９９からなる揺動管１００である。湾曲
駒９９は、長さが比較的短い円筒形状で、その円筒形状
の対向する外側面から一対の接続片が延出されている。
この接続片によって前後の湾曲駒９９が９０度づつ角度
を代えて回転自在に接続されて揺動管１００が形成され
ている。このようにして複数の湾曲駒９９を回転自在に
接続した揺動管１００の基端は、前記先端部５の第１の
処置具挿通用チャンネル１７の開口４３に回動自在に取
付、揺動管１００の先端の湾曲駒９９には、４本の揺動
管操作ワイヤ１０１を接続する。【０１１０】このような構成の揺動管１００を用いて、
それぞれの揺動管操作ワイヤ１０１を牽引操作すると揺
動管１００は、上下左右に湾曲可能となり、揺動管１０
０に前記第１の処置具挿通用チャンネル１４の開口４３
から導出されて、揺動管１００の湾曲駒９９の内側に挿
通された処置具が上下左右へと揺動することができる。
これにより、一つの揺動管１００で処置具を四方向に揺
動可能となり、処置動作の効率改善が可能となった。【０１１１】次に、図１８乃至図２０を用いて、本発明
に係る内視鏡の揺動台の応用例を説明する。図１８は本
発明に係る内視鏡の応用例である外付け揺動台の構成を
示す斜視図、図１９は本発明に係る内視鏡の応用例であ
る外付け揺動台の操作ノブを説明する説明図、図２０は
本発明に係る内視鏡の応用例である外付け揺動台の先端
面を示す平面図である。【０１１２】本発明に係る内視鏡の揺動台の応用例であ
る外付け揺動台を用いる内視鏡について、図１８を用い
て説明する。【０１１３】この内視鏡の挿入部２と操作部３には、第
１の処置具挿通用チャンネルが設けられ、前記挿入部２
の先端部５には、前記第１の処置具挿通用チャンネルに
連通し、かつ、第１の処置具のみを二方向にのみ揺動す
る第１の揺動台１４が設けられている。【０１１４】このような内視鏡に、処置具揺動台付き外
付けチャンネル１０４を取り付けることで、前記第１の
揺動台１４から導出された第１の処置具を第１の揺動台
１４と異なる方向に揺動可能とするものである。【０１１５】この処置具揺動台付き外付けチャンネル１
０４は、内視鏡の先端部５の外周に装着可能な外付けチ
ャンネル先端部１０８とチャンネル部１０９からなって
いる。外付けチャンネル先端部１０８は、図２０に示
すように、前記内視鏡の先端部５の外周が装着される先
端部取付孔１０７が設けらると共に、この先端部取付孔
１０７の図中左側には、第２の処置具揺動台収納部１
３”が設けられている。この第２の処置具揺動台収納部
１３”には、第２の処置具挿通孔４６’と起上バー８
０’を有する第２の処置具揺動台１５’が設けられてい
る。【０１１６】つまり、この外付けチャンネル先端部１０
８には、図２で説明した第２の揺動台１５と同じ構成の
第２の処置具揺動台１５’が設けられている。【０１１７】この第２の処置具揺動台１５’の第１の処
置具挿通孔４６’は、チャンネル部１０９に内蔵されて
いる第２の処置具挿通用チャンネル１８と連通されてお
り、更に、第２の処置具揺動台１５’を揺動操作する２
本の操作ワイヤ５７がチャンネル部１０９に内挿されて
いる。【０１１８】この操作ワイヤ５７は、図１９に示すよう
に、操作部３の第２の処置具揺動台操作ノブ３４に設け
られた操作ワイヤ取り付け口１０５にワイヤ固定部材１
０６で取付固定されている。【０１１９】つまり、第２の処置具揺動台操作ノブ３４
を回動させると、操作ワイヤ５７が牽引されて、第２の
処置具揺動台１５’が揺動し、この第２の処置具揺動台
１５’の揺動により、第２の処置具挿通用チャンネル１
８に挿通されて、第２の処置具揺動台１５’から導出さ
れた第２の処置具が揺動される。更に、この第２の処置
具揺動台１５’の揺動により、先端部５の第１の処置具
揺動台１４から導出されている第１の処置具も起上バー
８０’によって起上揺動される。【０１２０】すなわち、一種類の処置具しか使用でき
ず、かつ、二方向にのみ処置具が揺動できない内視鏡に
対して、処置具揺動台付き外付けチャンネル１０４を取
り付けることにより、第２の処置具を使用することがで
き、かつ、この第２の処置具揺動台１５’を内視鏡の先
端部５の第１の揺動台１４と直交する揺動方向となるよ
うに取り付けることで、第２の処置具揺動台１５’の揺
動により、先端部５の第１の処置具を四方向に揺動可能
となる。これにより、内視鏡に用いる処置具の種類によ
り揺動操作を自由に選択できる為に内視鏡による処置操
作の効率が向上する。【０１２１】なお、前記処置具揺動台付き外付けチャン
ネル１０４のチャンネル部１０９には、手元取付部１１
０が設けられ、この手元取付部１１０は、内視鏡の挿入
部折れ防止部材４１に設けられた凹部１１１に嵌合する
ようになっている。これにより、処置具揺動台付き外付
けチャンネル１０４は、内視鏡の挿入部２の先端部５と
挿入部折れ防止部材４１によって、確実に保持固定でき
る。【０１２２】［付記］以上詳述した本発明の実施形態に
よれば、以下のごとき構成を得ることができる。【０１２３】（付記１）内視鏡挿入部の先端部に、内視
鏡画像を撮らえる対物光学系を構成する観察窓と、少な
くとも１つ以上の処置具挿通用チャンネルの先端側開口
部を設けた内視鏡において、少なくとも１つ以上の前記
処置具挿通用チャンネルの先端側開口部から導出される
処置具を四方向に揺動可能な揺動手段を前記処置具挿通
用チャンネルの先端側開口部近傍に設け、または前記揺
動手段の一部を前記内視鏡挿入部の先端部に着脱自在に
外付け可能としたことを特徴とする内視鏡。【０１２４】（付記２）前記揺動手段は、第１の処置具
挿通用チャンネルを介して導出される第１の処置具を所
定の方向に揺動させる第１処置具揺動台と、第２の処置
具挿通用チャンネルを介して導出される第２の処置具を
前記第１の処置具の揺動方向と略直交する方向に揺動さ
せ、かつ前記第１処置具揺動台から導出される第１の処
置具を同一方向に揺動させる第２処置具揺動台と、から
なることを特徴とする付記１記載の内視鏡。【０１２５】（付記３）前記揺動手段は、複数の湾曲駒
から構成された揺動管であることを特徴とする付記１記
載の内視鏡。【０１２６】（付記４）前記揺動手段は、所定の方向に
揺動可能な内側揺動台と、その外側に配置され、前記内
側揺動台の揺動方向と略直交する方向に揺動可能な外側
揺動台と、からなることを特徴とする付記１記載の内視
鏡。【０１２７】（付記５）内視鏡挿入部の先端部に、内視
鏡画像を撮らえる対物光学系を構成する観察窓と、第１
処置具挿通用チャンネルを介して導出される第１の処置
具を所定の方向に移動させる第１処置具揺動台と、を設
けた内視鏡において、第２処置具挿通用チャンネルと、
そのチャンネルを介して導出される第２の処置具および
前記第１の処置具を所定の方向に移動させる第２処置具
揺動台とからなる第２処置具揺動台付き外付けチャンネ
ルを、前記先端部の外周に着脱可能にしたことを特徴と
する内視鏡。【０１２８】（付記６）内視鏡挿入部の先端部に、内視
鏡画像を撮らえる対物光学系を構成する観察窓と、第１
処置具挿通用チャンネルを介して導出される第１の処置
具を所定の方向に揺動させる第１処置具揺動台と、第２
処置具挿通用チャンネルを介して導出される第２の処置
具および前記第１の処置具を所定の方向に揺動させる第
２処置具揺動台とを設けたことを特徴とする内視鏡。【０１２９】【発明の効果】本発明の内視鏡は、少なくとも１つの処
置具を、例えば上下左右４方向に単一の操作手段で揺動
操作でき、内視鏡処置操作の効率と向上すると共に、内
視鏡の挿入部の小型細径化が実現できる効果を有してい
る。Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment tool
Swing the treatment tool from the opening on the tip side of the channel in four directions.
The present invention relates to an endoscope that can be moved to perform a therapeutic treatment. [0002] Inserting an elongated insertion portion into a body cavity
Observe organs in the body cavity and insert as necessary
Treatment inserted through the treatment instrument insertion channel provided in the part
Medical endoscopes that perform various treatments using tools
Widely used. In particular, incisions such as needle-shaped electric scalpels
Treatment instrument is inserted into the treatment instrument insertion channel of the insertion section.
To remove the lesion in the body cavity while observing it with an endoscope
The usefulness of the technique is widely recognized. An endoscope used for such a procedure is, for example,
For example, Japanese Patent Application Laid-Open No. 2001-212078 discloses
You. This publication states that two treatment tool insertion channels are inserted into the insertion section.
Is provided, and is inserted into the treatment tool insertion channel,
Forceps, which are the respective treatment tools derived from the distal end of the insertion section
Equipped with two forceps raising mechanisms for raising the forceps in different directions
An endoscope is disclosed. SUMMARY OF THE INVENTION [0004]
Endoscope for inserting two treatment tools provided in the insertion section
Raised in different directions at the channel tip opening
A forceps raising mechanism is provided. One treatment tool insertion
A grasping treatment instrument inserted into the channel (hereinafter referred to as grasping forceps)
) Is inserted through the other treatment tool insertion channel.
Incision treatment tool such as a needle-shaped electric scalpel (hereinafter referred to as incision forceps)
) And the lesion mucosal part or its vicinity
After grasping and lifting with grasping forceps, the incised forceps
The part is cut off. However, each of the endoscopes disclosed in the above publication is
The forceps raising mechanism raises each treatment tool raising table to one
Since the operation is performed using the operation wire, start up using that wire
It is easy to control the operation of raising the treatment tool in the direction,
Operation control is difficult in the direction of inversion, and
The treatment tool led out from the upper table has two directions (up and down or
It can be moved only to the left and right), and the operating direction of the treatment tool
Operation range is narrow due to restrictions of
There was a task to go down. [0006] The present invention has been made in view of the above problems.
And a treatment instrument insertion chamber provided in the insertion portion of the endoscope.
The treatment tool is led out from the distal end opening of the
Operation when performing procedures such as resection or removal of lesions based on observation
It aims to provide an endoscope with excellent workability. [0007] An endoscope according to the present invention comprises an endoscope.
Objective optical system at the distal end of the mirror insertion section to capture endoscopic images
Window and at least one or more treatment tools inserted
In the endoscope provided with the opening on the distal end side of the channel for
At least one end of the treatment instrument insertion channel
The treatment tool derived from the end opening can be swung in four directions
Opening the swinging means to the distal end side of the treatment instrument insertion channel
Provided in the vicinity, or a part of the swing means is inserted into the endoscope.
Features that it can be detachably attached to the tip of the entrance
And With the endoscope of the present invention, a treatment instrument insertion chamber
Swinging means provided near the opening on the tip side of the channel.
Out of the distal end opening of the treatment instrument insertion channel.
Can be swung up, down, left, and right in four directions.
An endoscope that expands the operating range and improves operability
Is now available. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram showing an embodiment of the present invention;
The embodiment will be described in detail. FIG. 1 according to the invention
FIG. 2 is a perspective view showing the overall configuration of an embodiment of the endoscope, and FIG.
Plane viewed from the front of the distal end of the insertion section of the endoscope according to the invention
FIGS. 3A and 3B illustrate the operation range of the rocking table of the endoscope according to the present invention.
FIG. 4 shows a first treatment tool of an endoscope according to the present invention.
FIG. 5 is a perspective view showing a configuration of a swing table, and FIG. 5 is an endoscope according to the present invention.
FIG. 6 is a perspective view showing the configuration of a second swing table according to the present invention.
For explaining the treatment operation of the endoscope with the first treatment tool
FIGS. 7 and 8 show the observation image of the endoscope and the operation of the treatment tool according to the present invention.
FIG. 8 is an explanatory view for explaining a monitor image showing a working range, and FIG.
The treatment operation by the first and second treatment tools of the endoscope according to Ming
FIG. First, an endoscope according to the present invention will be described with reference to FIG.
The overall configuration will be described. The endoscope 1 includes an insertion unit 2 and an operation unit 3
The operation unit 3 includes a light guide cable and
And universal cable 4 with built-in signal cable
Has been continued. [0011] The insertion portion 2 has a distal end portion in order from a distal end side.
5, a first bending portion 6, a second bending portion 7, and a flexible tube portion 8
Have been. An observation window 9 and an illumination
Light window 10, air / water supply nozzle 11, front water supply / injection port 12
Is provided, and a substantially L-shaped treatment tool rocking table is stored.
A part 13 is formed, and the inside of the treatment tool swing table storage part 13 is formed.
The first treatment tool swing table 14 and the second treatment tool swing table 1
5 is held swingably. Although not shown, the observation window 9 has an objective
A lens and a solid-state image sensor for imaging the observation site are provided.
This solid-state imaging device is
Connected to signal cable. Or with an objective lens
The captured observation part light is built in the insertion part 2 and the operation part 3.
Operation via an image guide cable (not shown).
To an eyepiece optical system (not shown) provided in
It is designed to be illuminated. The universal cord 4 is shown in FIG.
Connected to a video processor device that is not
Drive control of the solid-state image sensor
Signal processing to record on a recording medium or monitor
The captured image is displayed on the screen. The illumination window 10 has an insertion section 2 and an operation section.
3 and the illumination light contained in the universal cord 4
The end of the light guide cable (not shown)
Lighting arranged and connected to said universal cord 4
Illumination light from the device is guided by the light guide cable.
Therefore, it is projected on the observation site. The air / water supply nozzle 11 has an insertion portion 2
An air / water supply channel (not shown) provided in the operation unit 3
To the air supply and water supply channel.
The air supply pump sends air to the observation window 9
Water is going to be done. The front water supply injection port 12 is operated with the insertion section 2.
Front water supply channel (not shown) provided in operation section 3
To the observation site when water is supplied.
It is an injection port. The first treatment tool swing table 14 and the second treatment
The tool rocking table 15 is provided with a first
The treatment tool rocking table operation knob 33 and the second treatment tool rocking table operation knob
, And is swung by the
The treatment tool swing table 14 swings substantially in the horizontal direction of the visual field, and the second
The treatment tool swing table 15 swings substantially vertically in the visual field.
Has become. The first bending section 6 is provided on the operation section 3.
By using a first bending operation unit 26 described later,
It can be bent down and left and right. The second bending section 7 is provided on the operation section 3.
The second bending operation section 27 described later makes it possible to substantially increase the visual field.
It can be bent downward. A first treatment instrument is inserted inside the insertion portion 2.
Passage channel 17 and second treatment tool insertion channel 1
8 are provided. The first treatment instrument insertion channel 17
The distal end opening communicates with the first treatment tool rocking table 14,
The rear end side opening is a first treatment tool provided in the operation unit 3.
It communicates with the insertion port 19. The second treatment instrument insertion channel 18
The opening on the distal end side communicates with the second treatment tool swing table 15
The rear end side opening is formed by a second process provided in the operation unit 3.
It communicates with the fixture insertion opening 20. The operation unit 3 includes a swing table operation unit 22, a grip
Unit 25, first bending operation unit 26, second bending operation unit 27
It is composed of The inside of the swing table operating section 22 is not shown.
However, the first treatment tool swing table operation mechanism and the second treatment tool
A gantry operating mechanism is provided, and the gantry operating section 22
Of a first treatment tool rocking table operation mechanism provided outside the device
However, the first treatment tool rocking table operation knob 33 and the second treatment tool
A second treatment tool swing table that is also a part of the placement tool swing table operation mechanism
An operation knob 34 is provided. That is, the first treatment tool swing table operation knob 33
Is operated, via the first treatment tool rocking table operation mechanism,
The first treatment tool rocking table 14 is remote from the left and right directions of the visual field.
Swings and operates the second treatment tool swing table operation knob 34.
And the second treatment tool swing table operating mechanism,
The treatment tool rocking table 15 remotely rocks substantially vertically in the visual field.
Swelling. The first and second treatment tool rocking tables
Details of the swinging operations of 14, 15 will be described later. On the outer surface of the swing table operating section 22, a front
A water supply inlet 23 and a rocking table operation wire washing port 24 are provided.
The front water feed inlet 23 is provided inside the insertion section 2.
Provided at the distal end portion 5 through the water supply channel
It is in communication with the forward water supply injection port 12 that is provided. Also rocking
The table operation wire cleaning port 24 is provided inside the insertion section 2.
Through an operation wire insertion channel 60 described later.
The distal end portion 5 communicates with the treatment tool swing table storage portion 13.
Further, the swinging table operation wire cleaning port 24 is not shown.
A syringe can be connected, and the cleaning liquid etc.
It can be sent to the channel 60. The first bending operation section 26 is provided with a first
Bending section operation knob (up / down) 35, first bending section operation knob
(Left and right) 36, first rotation / fixed switching lever (up and down) 3
8. First rotary / fixed switching knob (left and right) 39 is provided
ing. The first bending portion operation knob (up and down) 35
Is an operation knob for bending the first bending portion 6 in a vertical direction.
In the first bending operation section 26 or the grip section 25,
1 Up and down operation wires (not shown) connected to the bending portion 6
). The first bending portion operation knob (left and right) 36
Is an operation knob for bending the first bending portion 6 in the left-right direction.
In the first bending operation section 26 or the grip section 25,
1 Left and right operation wires (shown in FIG.
). The first bending portion operation knob (up and down) 35
The bending operation and fixing of the first bending portion 6 by the first
The switching is performed by a rotation / fixed switching lever (up / down) 38,
The first bending by the first bending portion operation knob (left and right) 36
The bending operation and fixing of the portion 6 are performed by a first rotation / fixing switching knob.
(Left and right) 39 can be switched. The second bending operation section 27 is provided with a second
And the second rotary / fixed switching knob 4
0 is provided. The second bending portion operation knob 37 is
2 A knob for bending the bending portion 7 in a vertical direction.
The second bending portion 7 inside the bending operation portion 27 or the grip portion 25
Connected to the up / down operation wire (not shown)
ing. The second bending portion operation knob 37 is used to
The bending operation and fixing of the second bending portion 7 are performed by the second rotation / fixing.
Switching can be performed by a switching knob 40. In the vicinity of the first bending operation section 26,
A pneumatic water supply control button 28, a suction control button 29, and
An image control button 30 is provided. The air / water control button 28 is
It contacts the air / water supply nozzle 11 provided at the tip 5 of the section 2.
The button for driving and controlling the continued air / water supply pump,
The suction control button 29 is inserted from the operation unit 3 (not shown).
Through a suction channel provided at the tip 5 of the inlet 2
And the gas supplied and supplied from the supply and supply nozzle 11
And a button to drive and control the pump that sucks the liquid.
The control button 30 is connected to the universal cord 4.
Displayed on the monitor via the video processor
Button for controlling the image to be displayed.
Omitted because it is not directly related. Note that the insertion unit connected to the operation unit 3
The connecting portion of the portion 2 has an insertion portion breaking prevention member 41,
Connection of the universal cord 4 connected to the operation unit 3
In the part, the universal cord break prevention member 42
The insertion part 2 and the universal cord 4 are provided respectively.
It is designed to prevent breakage at the root. Next, the configuration of the tip of the tip 5 will be described.
This will be described with reference to FIG. In front of the tip of the tip 5
An observation window 9 is provided in the center, and in the drawing of the observation window 9
Illumination window 10 on the right side, and air / water supply nozzle 1 on the upper side in the figure.
1 is fed forward between the illumination window 10 and the air / water supply nozzle 11.
A water injection port 12 is provided. The observation window 9 extends from the left side to the lower side in the drawing.
And a substantially L-shaped treatment tool rocking table storage unit 13 is provided.
You. The processing unit located below the observation window 9 in FIG.
A first treatment tool rocking table 14 is provided in the table rocking table storage unit 13.
Before being positioned on the left side of the observation window 9 in the drawing.
The treatment instrument rocking table storage section 13 has a second treatment tool rocking table 1.
5 are arranged. The first treatment tool swing table 14 and the second treatment
The tool swing table 15 has a first treatment tool insertion hole 45 and a
A second treatment tool insertion hole 46 is provided. The first treatment instrument insertion hole 45 and the second treatment
The tool insertion hole 46 is provided in the first treatment tool insertion channel 1.
7 (indicated by a dotted line in the figure) and the second treatment tool insertion
Each opening 44 (shown by a dotted line) in the channel 18
Is connected. The second treatment tool swing table 15 has a substantially L-shaped
Is provided. This rise
The base end of the bar 80 is fixed to the second treatment tool swing table 15.
The distal end is located below the first treatment tool insertion hole 45 in the drawing.
Side. The first treatment tool swing table 14 and the second treatment tool
The operation wire is inserted in the vicinity of substantially both ends of the treatment tool rocking table 15 of FIG.
Each channel 60 is provided. That is, as shown in FIG.
First treatment tool 5 inserted through placement tool insertion channel 17
3 is an opening 4 of the first treatment instrument insertion channel 17
3 to the first treatment tool insertion hole 4 of the first treatment tool rocking table 14
5 is drawn out or projected from the tip 5 to the outside through
Is done. On the other hand, the center of the first treatment tool swing table 14
A first rotation shaft 55 is provided in the
The operation wire inserted through the operation wire insertion channel 60
The end of the wire 57 is fixedly connected by a wire terminal member 58.
You. The proximal end of the operation wire 57 is connected to the swing table
Via the first treatment tool swing table operation mechanism of the operation unit 22,
It is connected and fixed to one treatment tool rocking table operation knob 33. That is, the first swing table operation knob 33
Is operated, the operation wire 57 is pulled,
The first treatment tool swing table 14 is arranged around the first rotation shaft 55.
The first treatment tool rocking table 14 rotates in the left and right direction.
The first treatment instrument inserted through the first treatment instrument insertion hole 45
53 swings right and left. The operation of the second treatment tool swing table 15 is the same.
Therefore, the detailed description is omitted, and the second
Reference numerals related to the swing table 15 are shown in parentheses. The first treatment of the first treatment tool rocking table 14
The first treatment tool 53 protruding through the tool insertion hole 45
As shown in FIG. 3, the range of the observation field of the observation window 9 is 2
Swing as shown by the dashed line. Observation as shown in FIG.
The window 9 is arranged above the first treatment tool rocking table 14.
You. In that sense, the observation window 9 is indicated by a two-dot chain line. That is, the first processing of the swing table operating section 22
When the fixture rocking base operation knob 33 is rotated, the first treatment is performed.
To the first treatment tool rocking table 14 via the tool rocking table operation mechanism
When the connected operation wire 57 is pulled, the first treatment tool
The swing table 14 is substantially left and right about the first rotation shaft 55 as a rotation center.
The first treatment instrument 53 swings. This second
The swing trajectory of the distal end of the first treatment instrument 53 draws an arc shape.
That is, the first treatment tool 53 is swinging in the axial direction of the distal end portion 5.
From the standing state (position) A to the swing of the first treatment tool swing table 14
Swings substantially evenly left and right around the center of view 77
(L1 ≒ L2). On the other hand, water is supplied from the front water supply injection port 12.
The forward water supply trajectory 78 of the water supply is approximately 1
At a distance of 5 mm, pass forward near the center 77 of the visual field
The injection direction of the water supply injection port 12 is adjusted. Note that the first treatment tool swing table 14 and the second treatment tool
Four operating wires to each of the treatment instrument rocking table 15
The four operation wire insertion channels 60 for inserting
Merge into one in the rocking table operation unit 22 and merge
The base end is opened to the rocking table operation wire cleaning port 24.
It has become so. As a result, the swing table operation wire washing
The cleaning wire is injected into the cleaning port 24 to insert the operation wire.
The cleaning of the communication channel 60 and the operation wire 57 becomes possible.
You. Next, referring to FIG. 4, the first treatment tool swing table 1 will be described.
4 and the swing operation, the second treatment tool swing table using FIG.
15 and the swinging operation will be described in detail. As shown in FIG. 4, the first treatment instrument swings.
A first rotation shaft 55 is provided substantially at the center of the upper surface and the lower surface of the base 14.
A second rotating shaft 56 is provided, and the first rotating shaft 56
55 and the second rotating shaft 56 are connected to the first treatment instrument insertion hole 4.
5 is formed so as to coincide with the center. The first rotating shaft 55 and the second rotating shaft 56
At the left and right ends of the first treatment tool rocking table 14
Two mounting holes 59 are provided, and the mounting holes 59
The wire terminal member 58 of the operation wire 57 is
Attached. The first rotating shaft 55 and the second rotating shaft 56
Is rotatably held in the treatment tool swing table storage unit 13.
Rotating the first rotation shaft 55 and the second rotation shaft 56.
As a heart, two operation wires in the treatment instrument rocking table storage unit 13
57 can be rocked left and right by alternate towing.
ing. In addition, the wire terminal member 58 rotates to the mounting hole 59.
It is freely held. FIG. 4 shows the first treatment tool rocking table 14.
First treatment instrument 53 inserted into first treatment instrument insertion hole 45
Is the first treatment in a substantially straight state that is a swing neutral state.
The state where it protruded from the tool insertion hole 45 is shown. This second
The raising bar 80 is arranged on the lower side in FIG.
Is placed. That is, the operation wire 57 is pulled.
Then, the first treatment tool rocking table 14 is rocked in the horizontal direction in the figure.
As a result, the first treatment instrument 53 is positioned above the raising bar 80.
Swing in the left-right direction in the figure. On the other hand, the second treatment tool swing table 15 is shown in FIG.
As shown, the same as the first treatment tool rocking table 14,
It has a rotating shaft 55 and a second rotating shaft 56, and
The two ends to which the wire end members 58 of the
The first treatment tool rocking table 14 having a hole 59
It is attached and fixed in a direction substantially perpendicular to the direction. In addition,
As described above, the first treatment instrument swing table 15 has the first treatment
It comes into contact with the first treatment tool 53 inserted through the
The raising bar 80 is provided. Operation wire of the second treatment tool swing table 15
57, the first rotating shaft 55 and the second rotating shaft 5
6 is turned around in the vertical direction in the figure. The vertical direction of the second treatment tool swing table 15
By the rotation, the raising bar 80 also rotates in the vertical direction.
As shown in FIG.
To rotate the first treatment instrument 53 in the vertical direction in the figure.
become. The length of the raising bar 80 is shown in FIG.
If the length is set sufficiently long as the length L3, the first treatment
In the entire range of right and left swing of the tool swing table 14, the first treatment is performed.
The tool 53 can be operated to swing up and down by the second treatment tool swing table 15.
You. If the length is set as short as the length L4, the first treatment
The tool swing table 14 is swung all the way to the right side in the observation direction.
Only when the first treatment tool 53 is
5 allows the user to swing up and down. That is, the first treatment tool
The first treatment instrument 53 is moved by the swing of the first treatment instrument swing table 14.
Of the second treatment tool rocking table 15
Extended from the second treatment tool rocking table 15 by the moving operation.
The raising bar 80 is substantially perpendicular to the first treatment tool rocking table 14.
Swing in the direction becomes possible. Note that the raising bar 80 is swung by the first treatment tool.
It is provided on the moving table 14 and is inserted through the second treatment tool rocking table 15.
The second treatment instrument 54 is substantially directly connected to the second treatment instrument swing table 15.
It is clear that it is possible to swing in the intersecting direction
It is. For treatment of a lesion by such an endoscope 1
This will be described with reference to FIG. FIG. 6 shows the first process.
The oscillating state of the first treatment tool 53 protruding from the table swinging table 14
State. The first treatment tool rocking table 14 is rocked.
Then, the first treatment instrument 53 moves as indicated by arrows XX in the figure.
Swings to the left and right. Next, the second treatment tool swing table 15
Swinging operation, the raising bar 80 causes the first treatment tool
53 swings up and down as shown by arrows Y-Y in the figure.
Then, the first treatment instrument 53 is moved to the position indicated by the dotted line in the figure.
Rukoto can. That is, the first under the lesion mucosa M in the body cavity
For example, the distal end of the incision forceps is guided and guided as the treatment tool 53,
The swing of the first treatment tool swing table 14 and the second treatment tool swing table 15
The first treatment instrument 53 is swung up, down, left, and right by the moving operation.
This makes it possible to incise the lesion mucosa M both left and right and up and down.
You. The treatment operation of the first treatment instrument 53
Are fixed on the observation window 9 of the distal end portion 5 of the insertion section 2.
FIG. 7 shows an image of the observation site generated and imaged by the body image sensor.
Displayed on the monitor 73 as follows. That is, the field of view of the observation window 9
Oscillation between the observation part in the range and the tip of the first treatment tool 53
The moving range and the image are displayed. That is, the observation unit displayed on the monitor 73
From the first treatment tool rocking table 14
The tip of the first treatment tool 53 is connected to the first treatment tool swing table 14.
By operating the second treatment tool rocking table 15 respectively,
Thus, for example, the user can freely move in the shaded area shown in FIG.
The incision operation of the lesion mucosa M in the shaded area is possible.
It works. The transparent touch panel 8 shown in FIG.
1 and the tip movement desired line 82 will be described later. Next, a first treatment tool using the endoscope 1
FIG. 8 shows the operation of the endoscopic treatment using the second treatment tool.
It will be described using FIG. FIG. 8 shows a state in which the
The first treatment instrument 53 passed through is similar to that described with reference to FIG.
The incision forceps is inserted and inserted into the second treatment instrument rocking table 15.
The second treatment tool 54 to be used is, for example, a grasping forceps. A disease is caused by the grasping forceps as the second treatment tool 54.
The user holds the deformed mucous membrane M and operates the second treatment tool rocking table 15.
When made, the first treatment instrument 53 is moved
In the middle Y-Y direction and the second treatment tool 54
It swings in the Y 'direction, and the first process indicated by the dotted line in the figure.
It is swung to the position of the placement tool 53 'and the second treatment tool 54'. That is, the grasping forceps of the second treatment tool 54
When the grasped lesion mucosa M is lifted upward in the figure,
First, a first treatment is performed on the lower side of the lifted lesion mucosa M.
The cutting forceps, which is the tool 53, is inserted. In this state, the first treatment tool swing table 14
Is swung in the XX direction in the figure, the incision operation of the lesion mucosa M is performed.
Operation, the incision of the lesion mucosa M is performed reliably and easily.
Can be applied. Note that the length of the raising bar 80 is as described above.
If the length is set to the short length L4 as shown in FIG.
Only when the placing tool 53 is swung to the far right, the first treatment tool
53 is raised and lowered by the raising bar 80 (the second treatment tool rocking table 15).
Swinging in any direction. That is, the length L of the raising bar 80
Thereby, the swing range of the first treatment instrument 53 can be set.
You. Next, the first processing used for the endoscope 1 in the present invention will be described.
Of the dissecting forceps used for the placement tool 53 or the second treatment tool 54
A modified example will be described with reference to FIGS. The dissecting device shown in FIGS. 9 and 10
The needle-shaped electric knife 83 is used to form a needle-shaped blade 86 and the needle-shaped blade.
R side bending operation wire 84 for bending operation of 86 to the right
And L-side bending for operating the needle-shaped cutting edge 86 to the left.
An operation wire 85 is provided. This R side bending operation tool
The proximal ends of the ear 84 and the L-side bending operation wire 85 are incised forceps.
Of the R-side bending operation wire 8
4 is pulled, as shown in FIG.
Can be bent to the right, and the L-side bending operation
When the ear 85 is towed, the double-needle electric knife 83 is
Curves to the left, opposite to 0. Using such a double-needle electric knife 83,
Then, the first treatment tool swing table 14 and the second treatment tool swing table
15 In addition to the swing range that swings with
The bending range of the scalpel 83 further increases the swing range of the distal end of the treatment tool.
It can be expanded. Next, another embodiment of the endoscope of the present invention is shown in FIG.
This will be described with reference to FIGS. Of this other embodiment
The endoscope performs a bending operation of the first bending portion 6 and the second bending portion 7,
Of the first and second treatment tool swing tables 14 and 15
Operation and forward water supply from the forward water supply injection port 12
It is operated by an operation input from the switch 87. Specifically, as shown in FIG.
Provided in the swing table operation unit 22 and the second bending operation unit 27.
Operating knobs 33, 34, 37
And abolish the first bending operation section 26
Thus, an electric switch 87 is provided. This electric switch 87 is shown in FIG.
As described above, the first bending operation switch 91 and the second bending operation
Switch 92, rocking table operation switch 93, and forward water supply
An operation switch 94 is provided. First Bending Operation of Electric Switch 87
The switch 91 and the second bending operation switch 92 are connected to the first
The bending portion 6 and the second bending portion 7 are vertically and horizontally (U,
A switch for instructing a bending operation in the D, L, and R directions is provided.
Have been. For example, on the first bending operation switch 91
When the switch (U) is turned on, a motor (not shown)
Is driven to bend the first bending portion 6 upward.
Pull a curved wire not shown. That is, first and second
2 bending operation switches 91 and 92 (U, D,
L, R) When the switch is turned on, the
The first and second bending portions 6 and 7 are bent.
You. Note that the first and second curved portions 6 and 7 are
It was possible to bend in four directions, lower left and right, but either one was
When bending in two directions, operating the bending part in the two directions
The operation switch is only a bending direction switch in two directions
It is clear. The swing table operation switch 93 is
Like the first and second bending operation switches 91 and 92,
Left and right (U, D, L, R) switches and the
The treatment tool swing table 14, 15
Consists of a motor that pulls the operating wire 57
You. The front water supply operation switch 94 is provided on a rocking table.
Front water supply connected to front water supply inlet 23 of operation unit 22
With a switch that instructs on / off of water supply from tank 88
is there. Sterilized water is stored in the front water supply tank 88.
A water supply tube extending from the front water supply tank 88.
A valve 90 is connected to the front water supply inlet 23. Previous
Water supply tank 88 is pressurized by pressurizing pump 89
And the sterilized water in the front water supply tank 88 is supplied to the water supply tube 9.
0 to the front water supply inlet 23, and this front water supply
From the inlet 23 through the channel of the insertion section 2,
The water is injected from the front water supply injection port 12 at the end 5.
ing. The on / off operation of the pressurizing pump 89 is determined by
The switching operation is input by the forward water supply operation switch 94.
You. The first bay of the electric switch unit 87
Song operation switch 91, second bending operation switch 92, swing
The table operation switch 93 and the forward water supply operation switch 94 are the operator
Are arranged in an arc so that all can be operated with the thumb
And operability efficiency is improved. The first bending portion 6 and the second bending portion
The electric motor is used for the part 7 and the treatment tool swing tables 14 and 15
Electronically controlled endoscope that bends or rocks
13 to 15 for treatment of lesion mucosa M by
Will be described. FIGS. 13 and 14 are the same as those described above with reference to FIG.
Used for an electric control type endoscope 1 using an electric motor
2 shows a swing locus of the treatment tool to be performed. FIG. 13 shows a treatment tool A95 in which the diameter of the treatment tool is large.
FIG. 14 shows a swing trajectory in the case of using
Shows a swing trajectory in the case where the treatment tool B having a small thickness is used.
In addition, the swing trajectory of each treatment tool shown in FIGS.
A monitor 73 that displays an image of the observation site (near the lesion mucosa M)
And the tip of the treatment tool displayed with the observation site image
The state is displayed as a tip movement prediction line 97.
You. 13 and FIG. 14, the treatment tool A95 and the
Depending on the difference in thickness and hardness like the fixture B96, treatment
The swing locus of the distal end of the instrument is different, and the first treatment instrument insertion hole
45 (the second treatment instrument insertion hole 46) and the treatment to be inserted
Depending on the outer diameter of the tool, that is, the size of the clearance.
However, the swing trajectory changes. Therefore, the first treatment instrument insertion port 19 and the
The type of the treatment tool inserted into the inside of the treatment tool insertion port 20 of No. 2
Built-in treatment tool detection means (not shown)
And the first treatment tool insertion chamber is detected by the treatment tool detection means.
Channel 17 and the second treatment instrument insertion channel 18
The type of the detected treatment tool is detected, and the detected
For each type of treatment tool stored and stored in advance based on the type
Read data such as specifications and performance of the
The type of the treatment tool and the tip movement prediction line 97 are displayed in the terminal 73.
Let me show you. This tip movement prediction line 97 is
With the tool protruding a certain amount, for example, about 15 mm from the tip surface,
The first treatment tool rocking table 14 (the second treatment tool rocking table 15) is rocked.
This is a predicted line where the tip of the treatment tool will swing when moved.
You. The tip movement prediction line 97 is monitored by the monitor 73.
Is displayed in advance, the surgeon can use the tip of the treatment tool to be used.
Movement can be grasped in advance, and treatment can be executed efficiently
become able to. The monitor 73 described with reference to FIG.
As described above, the screen of the monitor 73 is
Then, the lesion viscosity displayed on the transparent touch panel 81 is displayed.
Movement of the distal end of the treatment tool when performing incision treatment using the image of the membrane M
The operator points the desired line 82 on the transparent touch panel 81
Stroke and enter. The traced tip movement hope line
82 is read from the transparent touch panel 81.
Reading means and the tip read by the reading means
Based on the data of the movement desired line 82, the first treatment tool 53
The tip of the (second treatment instrument 54) is the tip movement desired line 82
If you use automatic electric control to swing like
The treatment instrument processing efficiency can be further improved. Next, referring to FIG. 15, an insertion portion of the endoscope 1 will be described.
2 has only one treatment instrument insertion channel.
One of the treatment instrument insertion channels is opened at the tip 5.
Endoscope with only one treatment tool swing table in mouth
explain. [0096] Inside the distal end portion 5 of this endoscope, a first
The first treatment is inserted into the opening communicating with the treatment instrument insertion channel 17.
Only the fixture swing table 14 is provided, and this first treatment is performed.
As the first treatment tool 53, for example,
Incision forceps have been inserted. Further, the tip of the tip 5
A transparent oblique hood 9 formed of a transparent member is provided on the outer periphery of the surface.
8 is attached. This transparent oblique hood 98 is the same as that shown in FIG.
As shown in FIG. 5, the upper side in the figure where the first treatment tool 53 is located
Side extends from the distal end surface of the distal end portion 5 to the outside, and the first treatment instrument
The lower side in the figure where 53 is located is substantially the same as the distal end surface of the distal end portion 5
It is formed in an inclined shape so as to be positioned. The endoscope having the transparent inclined hood 98 is
When dissecting the lesion mucosa M by using the transparent oblique hood 9
8 pushes up the diseased mucosa M at the tip,
The first treatment instrument 53 is inserted under the affected mucosa M,
Incision treatment is possible by swinging in the middle arrow XX direction
Becomes That is, the first treatment tool rocking table 14 side is transparent.
Since the bright inclined hood 98 is not covered, the first treatment tool 5
The swinging of the treatment tool 3 is restricted by the transparent oblique hood 98.
In addition, the swing range of the first treatment instrument 53 can be secured,
Pushing up the lesion mucosa M with the transparent inclined hood 98
The incision of the diseased mucosa M can be surely performed. Next, referring to FIG. 16, the tip of the endoscope of the present invention will be described.
Another embodiment of the treatment tool rocking table provided at the end will be described.
You. FIG. 16 is a plan view showing the configuration of the distal end surface of the endoscope distal end portion.
FIG. In the upper part of the end surface of the end portion 5 'of the endoscope in the drawing.
An observation window 9 is provided in the heart. Of this observation window 9
On the right side of the figure, the air / water supply nozzle 11 and the front water supply / injection port 12 are shown.
Are provided in order. The observation window 9 has a second
The treatment tool insertion port 46 is provided. In the drawing of the observation window 9 at the distal end surface of the distal end portion 5 '.
Approximately square treatment tool rocking table stored in the downward position
The treatment instrument rocking table storage section 13 ′ is provided with a section 13 ′.
An illumination window 10 is provided on the left side in the figure. An observation window provided at the tip 5 '
9. Air / water supply nozzle 11, front water supply injection port 12, lighting
Opening of window 10 and second treatment instrument insertion channel 18
Reference numeral 46 denotes an end provided on the distal end portion 5 of the endoscope 1 described above.
They perform the same functions and functions. The treatment tool rocking table storage section 13 ′ has an inside
A swing table having a double structure of the swing table 102 and the outer swing table 103
Is provided. The outer swing table 103 stores the swing table.
The third portion 13 'rotatably fixed to the upper and lower inner surfaces of the portion 13' in the drawing.
The first rotation shaft 55 and the second rotation shaft 56, and the first and second rotation shafts
Of the outer swing table 103 about the rotary shafts 55 and 56
Two operation wires through which the operation wire
The outer diameter at which the channels 60, 60 are provided is convex, and
It has a space in which the inner swing table 102 is arranged. The inner rocking table 102 is provided with the outer rocking table.
In the space 103, the first and second
First and second rotations in a direction orthogonal to the rotation axes 55 and 56 of
The shafts 55 ′ and 56 ′ are rotatably fixed on the shaft, and swing inside.
Mount the table 102 about the first and second rotation shafts 55 ', 56'
Two operation wires through which the operation wire for swinging operation is inserted
Insertion channels 60 ′, 60 ′ are provided and
A first treatment tool insertion channel is provided at the center of the swing table 102.
A second treatment tool insertion hole 45 communicating with the tunnel 17 is provided.
ing. In the distal end portion 5 'having such a structure,
The first of each of the side swing table 102 and the outer swing table 103
The rotating shaft and the second rotating shafts 55, 56, 55 ', 56'
Because they are perpendicular to each other,
When the swing table 102 is swung, only the inner swing table 102
Swings to the first treatment tool insertion hole 45 of the inner swing table 102.
The treatment tool inserted through the
When the moving table 103 is rocked, the outer rocking table 103 is rocked.
Accordingly, the inner swing table 102 also swings together, and the inner swing table 102
The treatment tool inserted into the first treatment tool insertion hole 45 of 102
Is swung right and left in the figure. That is, the first treatment tool of the inner swing table 102
The treatment tool inserted into the insertion hole 45 is
Swinged up and down and swung right and left by the outer swing table 103
Will be. [0107] As in the case of the end portion 5 'of such an endoscope, the inside is
Of a double configuration consisting of the side swing table 102 and the outer swing table 103
The swing table allows the treatment tool to swing in four directions.
Thus, treatment efficiency can be improved. Next, an endoscope according to the present invention will be described with reference to FIG.
Another embodiment of the swing table used for the embodiment will be described. FIG.
7 shows another embodiment of the endoscope swing table according to the present invention.
FIG. The swing table according to the other embodiment has a plurality of curved surfaces.
An oscillating tube 100 composed of pieces 99, 99, 99. Curvature
The piece 99 has a cylindrical shape with a relatively short length.
A pair of connecting pieces extend from the opposing outer surfaces.
This connecting piece allows the front and rear bending pieces 99 to form an angle of 90 degrees.
The swing tube 100 is formed rotatably instead of
ing. Thus, the plurality of bending pieces 99 can be freely rotated.
The proximal end of the connected swing tube 100 is the first end of the distal end 5.
It is rotatably attached to the opening 43 of the treatment instrument insertion channel 17.
The bending piece 99 at the tip of the rocking tube 100 has four rocking
The pipe operation wire 101 is connected. Using the oscillating tube 100 having such a configuration,
When the respective swing tube operation wires 101 are pulled, the swing
The moving tube 100 can be bent up, down, left, and right.
0 to the opening 43 of the first treatment instrument insertion channel 14
And inserted inside the bending piece 99 of the swing tube 100.
The passed treatment tool can swing up, down, left, and right.
Thus, the treatment tool is swung in four directions by one swing tube 100.
It is possible to improve the efficiency of the treatment operation. Next, the present invention will be described with reference to FIGS.
An application example of the rocking table of the endoscope according to the above. Figure 18 is a book
The configuration of an external swing table which is an application example of the endoscope according to the present invention
FIG. 19 is a perspective view showing an application example of the endoscope according to the present invention.
FIG. 20 is an explanatory view for explaining the operation knob of the external rocking table.
The tip of an external swing table which is an application example of the endoscope according to the present invention
It is a top view showing a surface. [0112] This is an application example of the endoscope swing table according to the present invention.
An endoscope using an external swing table is described with reference to FIG.
Will be explained. The insertion section 2 and the operation section 3 of the endoscope
1 is provided with a treatment instrument insertion channel,
At the distal end portion 5 of the first treatment instrument insertion channel
Communicate and swing only the first treatment tool in two directions
A first swing table 14 is provided. [0114] Such an endoscope is provided with a treatment tool swing table.
By attaching the attachment channel 104, the first
The first treatment tool derived from the swing table 14 is moved to the first swing table.
14 can be swung in a different direction. This external channel 1 with the treatment tool rocking table
Reference numeral 04 denotes an external cable which can be attached to the outer periphery of the end portion 5 of the endoscope.
Consisting of channel tip 108 and channel 109
I have. The external channel tip 108 is shown in FIG.
Where the outer circumference of the distal end portion 5 of the endoscope is mounted.
An end mounting hole 107 is provided.
107, the second treatment tool rocking table storage unit 1
3 "is provided. The second treatment tool rocking table storage section
13 ″ has a second treatment tool insertion hole 46 ′ and a raising bar 8
A second treatment tool rocking table 15 'having 0' is provided.
You. That is, the external channel tip 10
8 has the same configuration as the second swing table 15 described in FIG.
A second treatment tool rocking table 15 'is provided. The first treatment tool swinging table 15 ′
The fixture insertion hole 46 ′ is built in the channel portion 109.
In communication with the second treatment tool insertion channel 18
Further, the second treatment tool rocking table 15 'is rocked.
The operation wire 57 is inserted into the channel portion 109
I have. The operation wire 57 is connected as shown in FIG.
Provided on the second treatment tool swing table operation knob 34 of the operation unit 3.
The wire fixing member 1
It is attached and fixed at 06. That is, the second treatment tool swing table operation knob 34
Is turned, the operation wire 57 is pulled, and the second
The treatment tool rocking table 15 ′ rocks, and the second treatment tool rocking table
By the swing of 15 ', the second treatment instrument insertion channel 1
8 and is led out from the second treatment tool swing table 15 '.
The second treatment instrument thus set is swung. Furthermore, this second treatment
The first treatment tool of the distal end portion 5 is caused by the swing of the tool swing base 15 ′.
The first treatment tool derived from the swing table 14 is also a raising bar.
It is swung up by 80 '. That is, only one kind of treatment tool can be used.
Endoscope that does not swing in only two directions
On the other hand, the external channel 104 with the
By attaching, the second treatment tool can be used.
And the second treatment tool rocking table 15 ′ is moved forward of the endoscope.
The swing direction is orthogonal to the first swing table 14 of the end 5.
The second treatment tool rocking table 15 ′
The first treatment instrument at the tip 5 can be swung in four directions by movement
Becomes Thereby, depending on the type of treatment tool used for the endoscope,
The endoscope can be used to freely select the swing operation.
The efficiency of cropping is improved. It should be noted that the external instrument with the treatment tool rocking table
The channel portion 109 of the flannel 104 has a hand mounting portion 11
0 is provided, and this hand mounting portion 110 is used to insert an endoscope.
Fits into the concave portion 111 provided in the part break prevention member 41
It has become. With this, the treatment tool swing table with external
The channel 104 is connected to the distal end 5 of the insertion section 2 of the endoscope.
It can be securely held and fixed by the insertion part break prevention member 41.
You. [Appendix] The embodiment of the present invention described in detail above
According to this, the following configuration can be obtained. (Appendix 1) Endoscope is inserted into the distal end of the endoscope insertion section.
An observation window that constitutes the objective optical system for taking mirror images
At least one distal end opening of at least one treatment instrument insertion channel
In an endoscope provided with a part, at least one or more of the
Derived from the distal end opening of the treatment instrument insertion channel
The treatment instrument is inserted through a swinging means capable of swinging the treatment instrument in four directions.
Near the opening on the tip side of the
A part of the moving means is detachably attached to the distal end of the endoscope insertion section.
An endoscope that can be externally attached. (Supplementary Note 2) The swing means is a first treatment tool.
A first treatment tool led out through the insertion channel is provided.
A first treatment tool swing table that swings in a fixed direction, and a second treatment
The second treatment tool led out through the tool insertion channel
The first treatment instrument is swung in a direction substantially orthogonal to the swing direction.
And a first process derived from the first treatment tool swing table.
A second treatment tool rocking table for rocking the table in the same direction;
2. The endoscope according to claim 1, wherein (Supplementary Note 3) The swinging means includes a plurality of curved pieces.
Supplementary note 1 characterized in that it is a rocking tube composed of
Endoscope. (Supplementary Note 4) The oscillating means moves in a predetermined direction.
A swingable inner swing table, and an outer swing table,
The outer side that can swing in a direction substantially perpendicular to the swing direction of the side swing table
An endoscope comprising: a swing table;
mirror. (Appendix 5) Endoscope is inserted into the distal end of the endoscope insertion section.
An observation window constituting an objective optical system for taking a mirror image;
First treatment led out via treatment instrument insertion channel
A first treatment tool rocking table for moving the tool in a predetermined direction.
In the girder endoscope, a second treatment tool insertion channel,
A second treatment instrument derived through the channel;
A second treatment tool for moving the first treatment tool in a predetermined direction
External channel with a second treatment tool swing table comprising a swing table
The outer periphery of the tip portion is detachable.
Endoscope. (Supplementary Note 6) The distal end of the endoscope insertion section
An observation window constituting an objective optical system for taking a mirror image;
First treatment led out via treatment instrument insertion channel
A first treatment tool rocking table for rocking the tool in a predetermined direction;
Second treatment led out via treatment instrument insertion channel
A tool for rocking the tool and the first treatment tool in a predetermined direction.
An endoscope provided with a two-treatment instrument rocking table. According to the endoscope of the present invention, at least one
Swing the fixture with a single operating means, for example, in four directions, up, down, left, and right
Operable and improves the efficiency of endoscopic procedures
It has the effect that the insertion section of the endoscope can be reduced in size and diameter.
You.

【図面の簡単な説明】【図１】本発明に係る内視鏡の一実施形態の全体構成を
示す斜視図。【図２】本発明に係る内視鏡の挿入部の先端部を正面か
ら見た平面図。【図３】本発明に係る内視鏡の揺動台の動作を説明する
説明図。【図４】本発明に係る内視鏡の第１処置具揺動台の構成
を示す斜視図。【図５】本発明に係る内視鏡の第２の揺動台の構成を示
す斜視図。【図６】本発明に係る内視鏡の第１の処置具の操作を説
明する説明図。【図７】本発明に係る内視鏡の観察画像と処置具の操作
範囲を示すモニタ画像を説明する説明図。【図８】本発明に係る内視鏡の第１と第２の処置具によ
る処置動作を説明する説明図。【図９】本発明に係る内視鏡に用いる処置具の変形例の
構成を説明する説明図。【図１０】本発明に係る内視鏡に用いる処置具の変形例
の使用状態を説明する説明図。【図１１】本発明に係る内視鏡の他の実施形態を全体構
成を示す斜視図。【図１２】本発明に係る内視鏡の他の実施形態に用いる
電動スイッチ部を説明する説明図。【図１３】本発明に係る内視鏡の他の実施形態における
処置具の先端移動ラインを説明する説明図。【図１４】本発明に係る内視鏡の他の実施形態における
処置具の先端移動ラインを説明する説明図。【図１５】本発明に係る内視鏡の先端部の他の実施形態
を説明する説明図。【図１６】本発明に係る内視鏡先端部の先端面の構成を
示す平面図。【図１７】本発明に係る内視鏡の揺動台の他の実施形態
を示す斜視図。【図１８】本発明に係る内視鏡の応用例である外付け揺
動台を示す斜視図。【図１９】本発明に係る内視鏡の応用例である外付け揺
動台の操作ノブを示す平面図。【図２０】本発明ら係る内視鏡の応用例である外付け揺
動台の先端部先端面を示す平面図。【符号の説明】１…内視鏡２…挿入部３…操作部４…ユニバーサルコード５…先端部９…観察窓１３…処置具揺動台収納部１４…第１の処置具揺動台１５…第２の処置具揺動台１７…第１の処置具挿通用チャンネル１８…第２の処置具挿通用チャンネル２２…揺動台操作部３３…第１の処置具揺動台操作ノブ３４…第２の処置具揺動台操作ノブ４５…第１の処置具挿通孔４６…第２の処置具挿通孔８０…起上バーBRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a perspective view showing an overall configuration of an embodiment of an endoscope according to the present invention. FIG. 2 is a plan view of the distal end of the insertion section of the endoscope according to the present invention as viewed from the front. FIG. 3 is an explanatory view for explaining the operation of the rocking table of the endoscope according to the present invention. FIG. 4 is a perspective view showing a configuration of a first treatment tool rocking table of the endoscope according to the present invention. FIG. 5 is a perspective view showing a configuration of a second swing table of the endoscope according to the present invention. FIG. 6 is an explanatory diagram for explaining the operation of the first treatment tool of the endoscope according to the present invention. FIG. 7 is an explanatory diagram for explaining an observation image of the endoscope and a monitor image showing an operation range of the treatment tool according to the present invention. FIG. 8 is an explanatory diagram for explaining a treatment operation by the first and second treatment tools of the endoscope according to the present invention. FIG. 9 is an explanatory diagram illustrating a configuration of a modification of the treatment tool used for the endoscope according to the present invention. FIG. 10 is an explanatory diagram illustrating a use state of a modification of the treatment tool used for the endoscope according to the present invention. FIG. 11 is a perspective view showing the overall configuration of another embodiment of the endoscope according to the present invention. FIG. 12 is an explanatory diagram illustrating an electric switch unit used in another embodiment of the endoscope according to the present invention. FIG. 13 is an explanatory view illustrating a distal end movement line of a treatment tool in another embodiment of the endoscope according to the present invention. FIG. 14 is an explanatory view illustrating a distal end movement line of a treatment tool in another embodiment of the endoscope according to the present invention. FIG. 15 is an explanatory view illustrating another embodiment of the distal end portion of the endoscope according to the present invention. FIG. 16 is a plan view showing a configuration of a distal end surface of an endoscope distal end portion according to the present invention. FIG. 17 is a perspective view showing another embodiment of the rocking table of the endoscope according to the present invention. FIG. 18 is a perspective view showing an external swing table which is an application example of the endoscope according to the present invention. FIG. 19 is a plan view showing an operation knob of an external rocking table as an application example of the endoscope according to the present invention. FIG. 20 is a plan view showing a distal end surface of a distal end portion of an external swing table which is an application example of the endoscope according to the present invention. [Description of Signs] 1 endoscope 2 insertion section 3 operation section 4 universal cord 5 distal end section 9 observation window 13 treatment tool swing table storage section 14 first treatment tool swing table 15 .., The second treatment tool rocking table 17, the first treatment tool insertion channel 18, the second treatment tool insertion channel 22, the rocking table operation section 33, and the first treatment tool rocking table operation knob 34. Second treatment tool rocking table operation knob 45 ... first treatment tool insertion hole 46 ... second treatment tool insertion hole 80 ... raising bar

───────────────────────────────────────────────────── フロントページの続き (72)発明者矢部久雄東京都渋谷区幡ヶ谷２丁目43番２号オリンパス光学工業株式会社内Ｆターム(参考） 4C061 FF35 HH24 ────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Hisao Yabe 2-43-2 Hatagaya, Shibuya-ku, Tokyo Ori Inside of Opus Optical Co., Ltd. F term (reference) 4C061 FF35 HH24

Claims

【特許請求の範囲】【請求項１】内視鏡挿入部の先端部に、内視鏡画像を撮
らえる対物光学系を構成する観察窓と、少なくとも１つ
以上の処置具挿通用チャンネルの先端側開口部を設けた
内視鏡において、少なくとも１つ以上の前記処置具挿通用チャンネルの先
端側開口部から導出される処置具を四方向に揺動可能な
揺動手段を前記処置具挿通用チャンネルの先端側開口部
近傍に設け、または前記揺動手段の一部を前記内視鏡挿
入部の先端部に着脱自在に外付け可能としたことを特徴
とする内視鏡。Claims: 1. An observation window constituting an objective optical system for taking an endoscope image, and an end of at least one treatment instrument insertion channel at an end of an endoscope insertion section. In the endoscope provided with the side opening, a swinging means capable of swinging a treatment tool derived from at least one or more distal end openings of the treatment tool insertion channel in four directions is provided for the treatment tool insertion. An endoscope, wherein the endoscope is provided near a distal end opening of a channel, or a part of the swing means can be detachably attached to a distal end of the endoscope insertion portion.