JP2016140574A - Endoscope - Google Patents

Endoscope Download PDF

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JP2016140574A
JP2016140574A JP2015018739A JP2015018739A JP2016140574A JP 2016140574 A JP2016140574 A JP 2016140574A JP 2015018739 A JP2015018739 A JP 2015018739A JP 2015018739 A JP2015018739 A JP 2015018739A JP 2016140574 A JP2016140574 A JP 2016140574A
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end side
distal end
tube body
insertion portion
treatment instrument
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JP6495027B2 (en
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松田　英二
Eiji Matsuda
英二 松田
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Olympus Corp
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Olympus Corp
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Abstract

PROBLEM TO BE SOLVED: To provide an endoscope which allows a distal end side insertion part to be inserted deep into a narrow lumen to enable observation and which also allows a treatment instrument introduced into a treatment instrument insertion channel of a proximal end side insertion part to be led out of the vicinity of an observation window in the distal end side to enable observation, treatment, etc. of a target site.SOLUTION: The endoscope comprises: a proximal end side insertion part 6 provided in on the operation part side of an insertion part 3; a distal end side insertion part 5 provided on the distal end side of the proximal end side insertion part 6 and preset smaller in the outer shape than the proximal end side insertion part 6; a flexible tube body 28 constituting the proximal end side of a treatment instrument insertion channel 30; and an expandable/contractible elastic tube body 16 having a predetermined elastic force, which is provided integrally with the distal end side insertion part 5 along the longitudinal direction thereof, at least a part of the outer peripheral surface of the elastic tube body constituting an outer surface of the distal end side insertion part 5, and the distal end side opening of which is arranged in the distal end face of the distal end side insertion part 5 and the proximal end side opening of which is in communication with the distal end side opening of the tube body 28 to constitute the distal end side of the treatment instrument insertion channel 30.SELECTED DRAWING: Figure 4

Description

本発明は、処置具が挿通される処置具挿通チャンネルを挿入部に有する内視鏡に関する。   The present invention relates to an endoscope having a treatment instrument insertion channel through which a treatment instrument is inserted in an insertion portion.

医療分野、工業分野等において、体内或いは装置内等に挿入される細長で可撓性を有する挿入部を備えた内視鏡が使用されている。可撓性を有する挿入部は、先端側から順に、先端部、湾曲部、及び可撓管部を連設して構成されている。   In the medical field, the industrial field, and the like, an endoscope having an elongated and flexible insertion portion that is inserted into a body or an apparatus is used. The insertion portion having flexibility is configured by connecting a distal end portion, a bending portion, and a flexible tube portion in order from the distal end side.

内視鏡においては、細長な挿入部の先端部に、観察部位の観察画像を撮像するための観察光学系が設けられている。また、挿入部の先端側には、体内深部への挿入を容易に行えるようにするため、及び先端部の観察光学系を所望する方向に向けることを可能にするため、湾曲部が設けられている。また、内視鏡の挿入部内には、処置具を体腔内等に導入するための処置具挿通チャンネルが設けられている。   In an endoscope, an observation optical system for capturing an observation image of an observation site is provided at the distal end of an elongated insertion portion. In addition, a bending portion is provided on the distal end side of the insertion portion so that the insertion into the deep part of the body can be easily performed and the observation optical system of the distal end portion can be directed in a desired direction. Yes. In addition, a treatment instrument insertion channel for introducing the treatment instrument into a body cavity or the like is provided in the insertion portion of the endoscope.

特許文献１には細径の管腔内に対して処置具挿通チャンネルを挿入すること無く、挿入部と共に処置具を容易に挿入できるようにした内視鏡装置が開示されている。この内視鏡装置が備える内視鏡の挿入部は、円筒形状の外形を有する基端側挿入部と、三日月状の外形を有する先端側挿入部とを備え、先端側挿入部が基端側挿入部よりも細くなっている。
この構成によれば、例えば、基端側挿入部を十二指腸まで挿入し、先端側挿入部を膵胆管系の管腔内に挿入する手技を行える。 Patent Document 1 discloses an endoscope apparatus in which a treatment instrument can be easily inserted together with an insertion portion without inserting a treatment instrument insertion channel into a small-diameter lumen. The endoscope insertion portion provided in the endoscope apparatus includes a proximal-side insertion portion having a cylindrical outer shape and a distal-side insertion portion having a crescent-shaped outer shape, and the distal-side insertion portion is proximal. It is thinner than the insertion part.
According to this configuration, for example, it is possible to perform a procedure of inserting the proximal insertion portion into the duodenum and inserting the distal insertion portion into the lumen of the pancreaticobiliary system.

なお、特許文献１の図２等には、基端側挿入部と先端側挿入部との境界部分の境界面には、基端側挿入部内を挿通する処置具挿通チャンネルの開口となる処置具導出口が設けられ、先端側挿入部には、処置具導出口から導出された処置具を誘導する凹面で構成された処置具案内溝が設けられていることが開示されている。   Note that FIG. 2 and the like in Patent Document 1 show a treatment instrument that is an opening of a treatment instrument insertion channel that passes through the proximal insertion portion at the boundary surface between the proximal insertion portion and the distal insertion portion. It is disclosed that a lead-out port is provided, and that a distal-end-side insertion portion is provided with a treatment tool guide groove formed of a concave surface that guides the treatment tool led out from the treatment tool lead-out port.

また、特許文献１の図３等には、基端側挿入部の外面と同軸で同径の円筒面に沿った外面を有する下側外面と、下側外面から連設され円筒面に沿って円弧状に湾曲した凹面状の上側外面を有する先端部が示され、先端部の先端面には観察窓、照明窓、送気送水口が配置されていることが開示されている。   Further, in FIG. 3 and the like of Patent Document 1, a lower outer surface having an outer surface that is coaxial with the outer surface of the proximal-side insertion portion and has the same diameter as the cylindrical surface, and a continuous outer surface from the lower outer surface are provided along the cylindrical surface. A tip portion having a concave upper outer surface curved in an arc shape is shown, and it is disclosed that an observation window, an illumination window, and an air / water supply port are arranged on the tip surface of the tip portion.

また、特許文献１の図４等には、湾曲部における湾曲構造が例示されている。湾曲部を構成する複数の節輪は、全体が外皮に覆われて、その外皮によって先端側挿入部の下側外面及び上側外面が形成され、第１節輪及び第２節輪の各々は、横断面において下側外面及び上側外面とで形成される外面と略同一形状の環状部材を有していることが開示されている。   Further, FIG. 4 and the like of Patent Document 1 illustrate a bending structure in the bending portion. The plurality of node rings constituting the curved portion are entirely covered with an outer skin, and the lower outer surface and the upper outer surface of the distal end side insertion portion are formed by the outer skin, and each of the first and second joint rings is It is disclosed that an annular member having substantially the same shape as the outer surface formed by the lower outer surface and the upper outer surface in the cross section is disclosed.

特開２０１２−１９２０８０号公報JP 2012-192080 A

しかしながら、特許文献１の内視鏡では、処置具が処置具挿通チャンネルの開口から導出されて観察窓の視野範囲内に到達するまでの移動中の間、処置具の位置、状態を視認することができない。また、開口から導出された処置具の移動距離が先端側挿入部の長さ分長くなることにより、処置具を目的部位に配置させることが難しくなる。特に、処置具挿通チャンネルの径に対して細径な超音波プローブ等においては、処置具挿通チャンネル内においても大きくふらつくおそれがあり、目的部位に到達させること、および、到達後安定して保持することが困難である。さらに、開口が観察窓を有する先端面から離間していることによって観察画面に表示された汚物の吸引が困難である。   However, in the endoscope of Patent Document 1, the position and state of the treatment tool cannot be visually recognized during the movement until the treatment tool is led out from the opening of the treatment tool insertion channel and reaches the visual field range of the observation window. . In addition, since the movement distance of the treatment instrument derived from the opening is increased by the length of the distal insertion portion, it is difficult to place the treatment instrument at the target site. In particular, in an ultrasonic probe or the like having a small diameter relative to the diameter of the treatment instrument insertion channel, there is a possibility that the treatment instrument insertion channel may fluctuate greatly. Is difficult. Furthermore, since the opening is separated from the front end surface having the observation window, it is difficult to suck the filth displayed on the observation screen.

本発明は、上記事情に鑑みてなされたものであり、細径な管腔深部に先端側挿入部を挿入して観察すること、及び基端側挿入部の処置具挿通チャンネルに導入された処置具を先端面の観察窓近傍から導出させて目的部位の観察、処置等が可能な内視鏡を提供することを目的にしている。   The present invention has been made in view of the above circumstances, and is to observe by inserting a distal-end-side insertion portion into a small-diameter deep lumen, and a treatment introduced into a treatment instrument insertion channel of the proximal-end insertion portion. An object of the present invention is to provide an endoscope in which a tool can be derived from the vicinity of the observation window on the distal end surface and the target part can be observed and treated.

本発明の一態様の内視鏡は、操作部から延出する内視鏡挿入部の該操作部側に設けられた基端側挿入部と、前記基端側挿入部の先端側に設けられ、外形を該基端側挿入部より小さく設定した先端側挿入部と、前記基端側挿入部の内孔内に配設される、内視鏡用処置具が挿通される処置具挿通チャンネルの基端側を構成する可撓性を有するチューブ体と、内孔を有し、前記先端側挿入部の長手方向に沿って一体に設けられて外周面の少なくとも一部が該先端側挿入部の外表面を構成すると共に、該内孔の先端開口が当該先端側挿入部の先端面側に配置されて基端側開口が前記チューブ体の先端側開口に連通して処置具挿通チャンネルの先端側を構成する予め定めた弾性力を有して拡縮自在な弾性チューブ体と、を具備している。   An endoscope according to one aspect of the present invention is provided on a proximal end side insertion portion provided on an operation portion side of an endoscope insertion portion extending from an operation portion, and on a distal end side of the proximal end side insertion portion. A distal-end-side insertion portion whose outer shape is set smaller than the proximal-end-side insertion portion, and a treatment instrument insertion channel that is disposed in the inner hole of the proximal-end insertion section and into which an endoscope treatment instrument is inserted. A flexible tube body constituting the proximal end side, an inner hole, and integrally provided along the longitudinal direction of the distal end side insertion portion, at least a part of the outer peripheral surface of the distal end side insertion portion The distal end side of the treatment instrument insertion channel is configured to constitute the outer surface, the distal end opening of the inner hole is disposed on the distal end side of the distal end side insertion portion, and the proximal end side opening communicates with the distal end side opening of the tube body And an elastic tube body that has a predetermined elastic force and can be expanded and contracted.

本発明によれば、細径な管腔深部に先端側挿入部を挿入して観察すること、及び基端側挿入部の処置具挿通チャンネルに導入した処置具を先端面の観察窓近傍から導出させて目的部位の観察、処置等が可能な内視鏡を実現できる。   According to the present invention, the distal end side insertion portion is inserted into the deep lumen and observed, and the treatment instrument introduced into the treatment instrument insertion channel of the proximal end insertion portion is derived from the vicinity of the observation window on the distal end surface. Thus, an endoscope capable of observing and treating a target site can be realized.

内視鏡の構成を説明する図The figure explaining the composition of an endoscope 内視鏡挿入部の先端面を正面から見た図Front view of the distal end of the endoscope insertion section 先端側挿入部と基端側挿入部とが一体な挿入部本体及び弾性チューブ体を説明する図The figure explaining the insertion part main body and elastic tube body with which the front end side insertion part and the base end side insertion part are integrated 図２のＹ４−Ｙ４の断面図であって、内視鏡挿入部及び処置具挿通チャンネルを説明する図It is sectional drawing of Y4-Y4 of FIG. 2, Comprising: The figure explaining an endoscope insertion part and a treatment tool penetration channel 挿入部に設けられた処置具チャンネルに生検鉗子を挿通して体内に導出させるまでを説明する図、および最大直径ｓ１の処置具を導出させるた状態を説明する図The figure explaining a biopsy forceps being inserted in the treatment tool channel provided in the insertion part until it leads out into the body, and the figure explaining the state where the treatment tool of the maximum diameter s1 was led out 挿入部に設けられた処置具チャンネルに超音波プローブを挿通して体内に導出させるまでを説明する図The figure explaining until it inserts an ultrasonic probe in the treatment tool channel provided in the insertion part, and makes it lead out in the body 内視鏡挿入部及び処置具挿通チャンネルの他の構成例を説明する図The figure explaining the other example of composition of an endoscope insertion part and a treatment implement penetration channel 内視鏡挿入部及び処置具挿通チャンネルの別の構成例を説明する図The figure explaining another structural example of an endoscope insertion part and a treatment tool penetration channel 挿入部本体に対して取り付け取り外しが可能な先端側チューブ体を説明する図The figure explaining the front end side tube body which can be attached or removed with respect to an insertion part main body ステント留置用処置具を説明する図であって、中心線を挟んで一方側が断面図であり、他方側が外観図である。It is a figure explaining the treatment tool for stent placement, Comprising: One side is sectional drawing on both sides of a centerline, and the other side is an external view. ステント留置用処置具を内視鏡にセットした状態を説明する図The figure explaining the state which set the treatment tool for stent placement to the endoscope ステント留置用処置具を目的部位に留置している状態を説明する図The figure explaining the state which has detained the treatment tool for stent placement in the target part

以下、図面を参照して本発明の実施の形態を説明する。
なお、以下の説明に用いる各図面は、模式的に示すものであり、各構成要素を図面上で認識可能な程度に示すために、各部材の寸法関係や縮尺等は、各構成要素毎に縮尺を異ならせてあるものであり、本発明は、これらの図に記載された構成要素の数量、構成要素の形状、構成要素の大きさの比率、及び各構成要素の相対的な位置関係のみに限定されるものではない。 Embodiments of the present invention will be described below with reference to the drawings.
In addition, each drawing used for the following description is shown schematically, and in order to show each component to the extent that it can be recognized on the drawing, the dimensional relationship and scale of each member are for each component. The scales are different, and the present invention is limited to the quantity of components described in these drawings, the shape of components, the ratio of the sizes of components, and the relative positional relationship of each component. It is not limited to.

図１に示す内視鏡１は、例えば気管支用内視鏡であって、操作部２と、内視鏡挿入部（以下、挿入部と略記する）３と、ユニバーサルケーブル４と、を備えている。
挿入部３は、後述する先端側挿入部５及び基端側挿入部６を有し、先端側挿入部５には、先端部７、湾曲部８が設けられている。 An endoscope 1 shown in FIG. 1 is an endoscope for bronchi, for example, and includes an operation unit 2, an endoscope insertion unit (hereinafter abbreviated as an insertion unit) 3, and a universal cable 4. Yes.
The insertion portion 3 has a distal end side insertion portion 5 and a proximal end insertion portion 6 described later, and the distal end side insertion portion 5 is provided with a distal end portion 7 and a bending portion 8.

操作部２は、操作者が把持するための把持部９を備え、把持部９を含む操作部２には、湾曲レバー１０、複数の操作ボタン１１、処置具導入口１２等が設けられている。
湾曲レバー１０および複数の操作ボタン１１は、把持部９を把持した手の例えば親指等により湾曲操作される。複数の操作ボタン１１は、例えばフリーズ信号を発生させるフリーズスイッチ、写真撮影を行なう際のレリーズ信号を発生させるレリーズスイッチ、観察モードの切替指示を行うための観察モード切替スイッチ等である。 The operation unit 2 includes a grip unit 9 for an operator to grip. The operation unit 2 including the grip unit 9 is provided with a bending lever 10, a plurality of operation buttons 11, a treatment instrument introduction port 12, and the like. .
The bending lever 10 and the plurality of operation buttons 11 are operated to bend by a hand holding the holding unit 9 such as a thumb. The plurality of operation buttons 11 are, for example, a freeze switch for generating a freeze signal, a release switch for generating a release signal when taking a picture, an observation mode switching switch for instructing to switch an observation mode, and the like.

処置具導入口１２には内視鏡用処置具が挿入される。内視鏡処置具は、把持鉗子、ブラシ、超音波プローブ等であり、処置具導入口１２から後述する処置具挿通チャンネル内に挿通され、先端開口（図２の符号３ｍ）から気管内に導出される。   An endoscope treatment tool is inserted into the treatment tool introduction port 12. The endoscopic treatment instrument is a grasping forceps, a brush, an ultrasonic probe, or the like, and is inserted into a treatment instrument insertion channel, which will be described later, from the treatment instrument introduction port 12, and is led into the trachea from the distal end opening (reference numeral 3m in FIG. 2). Is done.

ユニバーサルケーブル４は、挿入部３の例えば側部から延出されており、基端部には図示されていないビデオプロセッサ、光源装置に接続されるコネクタを有する。
符号１３は、折止部であり、挿入部３の基端側部の座屈を防止する。 The universal cable 4 extends from, for example, a side portion of the insertion portion 3, and has a connector connected to a video processor and a light source device (not shown) at the proximal end portion.
Reference numeral 13 denotes a bend portion that prevents buckling of the proximal end side portion of the insertion portion 3.

図２に示すように挿入部３の先端面３ａは、例えば略Ｄ字形状であって、先端面３ａには観察窓１４と例えば２つの照明窓１５とが設けられている。先端面３ａのＤ字状の外形形状は、基端側挿入部６の外形形状に比べて予め小さく形成されている。   As shown in FIG. 2, the distal end surface 3a of the insertion portion 3 is, for example, substantially D-shaped, and an observation window 14 and, for example, two illumination windows 15 are provided on the distal end surface 3a. The D-shaped outer shape of the distal end surface 3 a is formed in advance smaller than the outer shape of the proximal end side insertion portion 6.

なお、照明窓は、２つ以上、或いは、１つであってもよい。
先端面３ａは、平面で構成された平面外面２４ｆと、凸曲面で構成された凸曲面外面２４ｃと、を有する後述する先端部構成部材（以下、先端構成部材と略記）２４の先端面である。
符号１６は、後述する弾性チューブ体であり、先端側挿入部５を構成する。先端開口３ｍは、弾性チューブ体１６の先端側内孔内面と平面外面２４ｆとの間の隙間である。 The number of illumination windows may be two or more or one.
The distal end surface 3a is a distal end surface of a later-described distal end component member (hereinafter, abbreviated as a distal end component member) 24 having a planar outer surface 24f configured by a plane and a convex curved outer surface 24c configured by a convex curved surface. .
Reference numeral 16 denotes an elastic tube body, which will be described later, and constitutes the distal end side insertion portion 5. The tip opening 3m is a gap between the tip-side inner hole inner surface of the elastic tube body 16 and the planar outer surface 24f.

図２−図４を参照して挿入部３の構成を具体的に説明する。
図３に示すように挿入部３は、操作部２側に設けられた基端側挿入部６と、先端側挿入部の先端側に設けられた先端側挿入部５と、を有する。先端側挿入部５の外形が基端側挿入部６の外形より予め定めた寸法小さく形成されている。そして、本実施形態において、先端側挿入部５は、弾性チューブ体１６と、先端側挿入部本体２１と、で構成される。 The structure of the insertion part 3 is demonstrated concretely with reference to FIGS.
As shown in FIG. 3, the insertion portion 3 includes a proximal-side insertion portion 6 provided on the operation portion 2 side and a distal-side insertion portion 5 provided on the distal end side of the distal-side insertion portion. The outer shape of the distal end side insertion portion 5 is formed smaller than the outer shape of the proximal end side insertion portion 6 by a predetermined dimension. And in this embodiment, the front end side insertion part 5 is comprised with the elastic tube body 16 and the front end side insertion part main body 21. As shown in FIG.

基端側挿入部６は、可撓管部であって、長手軸に直交する断面形状は略円形である。基端側挿入部６は、図示されていない芯材であるフレックス（不図示）と、該フレックスの外周に被覆された網状管であるブレード（不図示）と、該ブレードの外周を被覆する柔軟な外皮樹脂２２と、により主に構成されている。   The proximal side insertion portion 6 is a flexible tube portion, and the cross-sectional shape orthogonal to the longitudinal axis is substantially circular. The proximal end side insertion portion 6 includes a flex (not shown) that is a core material (not shown), a braid (not shown) that is a mesh tube coated on the outer periphery of the flex, and a flexible material that covers the outer periphery of the blade. The outer cover resin 22 is mainly configured.

図４に示すように基端側挿入部６の先端側は、糸巻き接着部（図６、図７の符号３ｓ参照）等により連結部材２３の基端側に一体に固定される。
符号２８は、チューブ体であり、貫通孔２８ｈを有し、予め定めた可撓性を有する。チューブ体２８は、基端側挿入部６が有する内孔内に軸方向に沿って配設されて、符号３０に示す処置具挿通チャンネルの基端側を構成する。 As shown in FIG. 4, the distal end side of the proximal end side insertion portion 6 is integrally fixed to the proximal end side of the connecting member 23 by a bobbin adhering portion (see reference numeral 3 s in FIGS. 6 and 7) or the like.
Reference numeral 28 denotes a tube body having a through hole 28h and having a predetermined flexibility. The tube body 28 is disposed along the axial direction in the inner hole of the proximal insertion portion 6 and constitutes the proximal end side of the treatment instrument insertion channel indicated by reference numeral 30.

チューブ体２８の先端部は、連結部材２３の基端側の予め定めた取付部に一体固定される。符号２３ｈは、連結部材２３に設けられたチャンネル用孔であり、チューブ体２８の貫通孔２８ｈに連通して内視鏡処置具が挿通される処置具挿通チャンネルを構成する。
図３に示す弾性チューブ体１６は、貫通孔である内孔１６ｈを有し、予め定めた弾性力を有して拡縮自在である。符号１６ｍ１は先端側開口、符号１６ｍ２は基端側開口である。
なお、先端側挿入部６の可撓管部にマルチルーメンチューブを使用することでチューブ体２８、或いは、連結部材２３を省略することも可能となる。 The distal end portion of the tube body 28 is integrally fixed to a predetermined attachment portion on the proximal end side of the connecting member 23. Reference numeral 23h is a channel hole provided in the connecting member 23, and constitutes a treatment instrument insertion channel through which the endoscope treatment instrument is inserted in communication with the through hole 28h of the tube body 28.
The elastic tube body 16 shown in FIG. 3 has an inner hole 16h, which is a through hole, and has a predetermined elastic force and can be expanded and contracted. Reference numeral 16m1 denotes a distal end side opening, and reference numeral 16m2 denotes a proximal end side opening.
In addition, it becomes possible to omit the tube body 28 or the connecting member 23 by using a multi-lumen tube for the flexible tube portion of the distal end side insertion portion 6.

先端側挿入部本体２１は、先端面３ａを有する硬質柱部材である先端構成部材２４と、先端構成部材２４に連設する本体湾曲部２５と、により主に構成されている。
本体湾曲部２５は、湾曲部組２６と、湾曲部組２６を被覆する湾曲ゴム２７と、により主に構成される。湾曲部組２６は、複数の湾曲駒をそれぞれ回動自在に連結され、図示されていない湾曲ワイヤによって図２の矢印Ｙｕ方向及び矢印Ｙｄ方向に湾曲する構成になっている。
なお、先端側挿入部５内には、図示は省略しているが、イメージガイドファイバまたはＣＣＤなどを具備する撮像ユニットおよび照明用ライトガイドファイバーバンドル等が内蔵され、基端側挿入部６を介して操作部２内に延出されている。 The distal-end-side insertion portion main body 21 is mainly configured by a distal-end constituent member 24 that is a hard column member having a distal-end surface 3 a and a main-body bending portion 25 that is connected to the distal-end constituent member 24.
The main body bending portion 25 is mainly configured by a bending portion set 26 and a bending rubber 27 that covers the bending portion set 26. The bending portion set 26 is configured such that a plurality of bending pieces are rotatably connected to each other and bent in the arrow Yu direction and the arrow Yd direction in FIG. 2 by a bending wire (not shown).
Although not shown in the drawing, the distal end side insertion portion 5 incorporates an imaging unit equipped with an image guide fiber or CCD, a light guide fiber bundle for illumination, and the like. Are extended into the operation unit 2.

湾曲部組２６の構成は公知であり、図４においては湾曲駒を一つずつ記載すること無く複数の湾曲駒の図示を省略している。湾曲部組２６は、先端側から順に図示されていない先端側湾曲駒、複数の中間湾曲駒、基端側湾曲駒を挿入部３の軸方向に沿って設けて構成されてる。各湾曲駒は、先端面３ａと略同様なＤ字形状の環状部材であって、平面外面と凸曲面外面とを有する。   The configuration of the bending portion set 26 is known, and a plurality of bending pieces are not shown in FIG. 4 without describing the bending pieces one by one. The bending portion set 26 is configured by providing a distal-end bending piece, a plurality of intermediate bending pieces, and a proximal-end bending piece that are not shown in order from the distal end side along the axial direction of the insertion portion 3. Each bending piece is a D-shaped annular member that is substantially the same as the distal end surface 3a, and has a planar outer surface and a convex curved outer surface.

図４に示す先端構成部材２４の基端側の予め定めた部分には湾曲部組２６の先端側湾曲駒が一体に固定され、連結部材２３の先端側の予め定めた部分には基端側湾曲駒が一体に固定される。湾曲部組２６を被覆した湾曲ゴム２７には平面ゴム面２７ｆと凸曲面ゴム面２７ｃと、が設けられる。   The distal end side bending piece of the bending portion set 26 is integrally fixed to a predetermined portion on the proximal end side of the distal end component member 24 shown in FIG. The bending piece is fixed integrally. A curved rubber 27 covering the curved set 26 is provided with a flat rubber surface 27f and a convex curved rubber surface 27c.

平面ゴム面２７ｆと先端構成部材２４の平面外面２４ｆとが連続した同一平面となり、凸曲面ゴム面２７ｃと該ゴム面２７ｃ先端側の先端構成部材２４の凸曲面外面２４ｃ及び当該ゴム面２７ｃ基端側の連結部材２３の外周面とが連続した同一凸曲面となる。   The flat rubber surface 27f and the flat outer surface 24f of the tip constituent member 24 are continuous and the same plane, and the convex curved rubber surface 27c, the convex curved outer surface 24c of the tip constituent member 24 on the tip side of the rubber surface 27c, and the base end of the rubber surface 27c. The outer peripheral surface of the connecting member 23 on the side is the same convex curved surface.

なお、湾曲駒は、平面外面と凸曲面外面とで形作られる環状部材に限定されるものでは無く、平面外面の代わりに前述した円弧状に湾曲した凹曲面を有する凹曲面外面と凸曲面外面とで形作られる環状部材等であってもよい。   The bending piece is not limited to the annular member formed by the planar outer surface and the convex curved outer surface. It may be an annular member formed by

弾性チューブ体１６は、先端側挿入部本体２１の長手方向に沿って被覆配置される。弾性チューブ体１６を先端側挿入部本体２１に装着することによって先端側挿入部５が構成される。   The elastic tube body 16 is disposed so as to cover the longitudinal direction of the distal end side insertion portion main body 21. The distal end side insertion portion 5 is configured by mounting the elastic tube body 16 on the distal end side insertion portion main body 21.

弾性チューブ体１６は、先端側挿入部本体２１に対して接着、或いは、溶着等によって一体固定される。具体的に、弾性チューブ体１６の基端側開口１６ｍ２側の内面は、全周に渡って連結部材２３の先端側外周面に被覆配置され、例えば接着固定される。
この接着固定状態において、弾性チューブ体１６の外表面と基端側挿入部６の外皮樹脂２２の外表面とは連続した同一周面、または、弾性チューブ体１６の基端部が外皮樹脂２２の外表面に対して出っ張って構成される。 The elastic tube body 16 is integrally fixed to the distal end side insertion portion main body 21 by adhesion or welding. Specifically, the inner surface of the elastic tube body 16 on the proximal end side opening 16m2 side is disposed so as to cover the distal end side outer peripheral surface of the connecting member 23 over the entire circumference, and is bonded and fixed, for example.
In this bonded and fixed state, the outer surface of the elastic tube body 16 and the outer surface of the outer skin resin 22 of the base end side insertion portion 6 are the same continuous peripheral surface, or the base end portion of the elastic tube body 16 is the outer shell resin 22. Consists of protruding to the outer surface.

一方、弾性チューブ体１６の先端側開口１６ｍ１側の内面の一部は、先端構成部材２４の凸曲面外面２４ｃに対しては密着配置され、残りの内面は先端構成部材２４の平面外面２４ｆに対峙し、隙間を設けて配置される。このとき、弾性チューブ体１６の先端面と、先端構成部材２４の先端面３ａとは略同一な平面になる。   On the other hand, a part of the inner surface of the elastic tube body 16 on the distal end side opening 16m1 side is disposed in close contact with the convex curved outer surface 24c of the distal end component member 24, and the remaining inner surface faces the planar outer surface 24f of the distal end component member 24. However, it is arranged with a gap. At this time, the distal end surface of the elastic tube body 16 and the distal end surface 3a of the distal end component member 24 are substantially the same plane.

また、弾性チューブ体１６の中間部分の内面は、湾曲ゴム２７の凸曲面ゴム面２７ｃに対しては密着配置され、残りの内面は湾曲ゴム２７の平面ゴム面２７ｆに対峙し、予め定めた隙間を設けて配置される。   In addition, the inner surface of the intermediate portion of the elastic tube body 16 is disposed in close contact with the convex curved rubber surface 27c of the curved rubber 27, and the remaining inner surface faces the flat rubber surface 27f of the curved rubber 27, with a predetermined gap. Is provided.

そして、密着配置された弾性チューブ体１６の内面と、凸曲面外面２４ｃ及び凸曲面ゴム面２７ｃとは接着固定される。これに対して、弾性チューブ体１６の内面と、平面外面２４ｆ及び平面ゴム面２７ｆとの間に設けられた隙間である弾性チューブ体１６の内孔１６ｈの一部の内面１６ｉ（図５の（Ａ）参照）と平面外面２４ｆ及び平面ゴム面２７ｆとで構成される先端側空間５Ｓ（図５の（Ａ）参照）は、処置具挿通チャンネル３０を構成する先端側チャンネル孔１６ｈ１（図５の（Ａ）参照）となる。   Then, the inner surface of the elastic tube body 16 arranged in close contact with the convex curved outer surface 24c and the convex curved rubber surface 27c are bonded and fixed. On the other hand, a part of the inner surface 16i of the inner hole 16h of the elastic tube body 16 which is a gap provided between the inner surface of the elastic tube body 16 and the planar outer surface 24f and the planar rubber surface 27f (FIG. 5 ( The distal-side space 5S (see FIG. 5A) formed by the planar outer surface 24f and the planar rubber surface 27f is a distal-side channel hole 16h1 (see FIG. 5) that constitutes the treatment instrument insertion channel 30. (See (A)).

つまり、本実施形態において、挿入部３内に設けられる処置具挿通チャンネル３０は、先端側を構成する内孔１６ｈの一部を含む先端側空間５Ｓと、連結部材２３のチャンネル用孔２３ｈと、チューブ体２８の貫通孔２８ｈと、で構成される。そして、処置具挿通チャンネル３０は、吸引チャンネルを兼用する。   That is, in this embodiment, the treatment instrument insertion channel 30 provided in the insertion portion 3 includes the distal end side space 5S including a part of the inner hole 16h constituting the distal end side, the channel hole 23h of the connecting member 23, And a through hole 28h of the tube body 28. The treatment instrument insertion channel 30 also serves as a suction channel.

上述のように構成した内視鏡１の作用を説明する。
本実施形態において、挿入部３を構成する基端側挿入部６の外形は、口腔側の気管支に配置されるように設定されている。基端側挿入部６に比べて外形の小さい先端側挿入部５の外形は、深部に位置する細径な気管支に挿入されるように設定されている。 The operation of the endoscope 1 configured as described above will be described.
In this embodiment, the external shape of the proximal end side insertion part 6 which comprises the insertion part 3 is set so that it may be arrange | positioned to the oral cavity side bronchus. The outer shape of the distal-side insertion portion 5 having a smaller outer shape than that of the proximal-side insertion portion 6 is set so as to be inserted into a small diameter bronchus located in the deep portion.

この構成によれば、先端側挿入部５を深部の気管支内に挿通させて良好な観察を行うことができる。   According to this configuration, the distal end side insertion portion 5 can be inserted into the deep bronchus and good observation can be performed.

また、処置具挿通チャンネル３０が、吸引管路を兼用する構成においては、弾性チューブ体１６の先端面と挿入部３の先端面３ａとが連続した同一面であるため、先端開口３ｍが先端面３ａ近傍に配置されるので、観察画面上に映し出された汚物の吸引を行うことが可能になる。   In the configuration in which the treatment instrument insertion channel 30 also serves as a suction conduit, the distal end opening 3m is the distal end surface because the distal end surface of the elastic tube body 16 and the distal end surface 3a of the insertion portion 3 are continuous. Since it is arranged in the vicinity of 3a, it becomes possible to suck the filth projected on the observation screen.

ここで、図５、図６を参照して処置具を挿入部３に設けられた処置具挿通チャンネル３０に挿通する場合について説明する。
図５を参照して処置具の１つである生検鉗子４１の体内への導出を説明する。
生検を行う際、医師等は、処置具である生検鉗子４１を処置具導入口１２から処置具挿通チャンネル３０内に挿通させる。すると、生検鉗子４１は、図５の（Ａ）に示すようにチューブ体２８の貫通孔２８ｈ内を矢印Ｙ５Ａに示すように先端開口３ｍに向かって進行していく。 Here, with reference to FIG. 5 and FIG. 6, a case where the treatment instrument is inserted into the treatment instrument insertion channel 30 provided in the insertion portion 3 will be described.
With reference to FIG. 5, the derivation | leading-out to the body of the biopsy forceps 41 which is one of the treatment tools is demonstrated.
When performing a biopsy, a doctor or the like inserts a biopsy forceps 41 as a treatment tool into the treatment tool insertion channel 30 from the treatment tool introduction port 12. Then, the biopsy forceps 41 advances toward the tip opening 3m as shown by an arrow Y5A in the through hole 28h of the tube body 28 as shown in FIG.

その後、連結部材２３のチャンネル用孔２３ｈ内を通過し、弾性チューブ体１６の内孔１６ｈを含む先端側空間５Ｓ内に導入され、進行されていく。すると、内孔１６ｈ内に導入された生検鉗子４１の大径な鉗子部４１ａが図５の（Ｂ）の破線に示すように縮径している弾性チューブ体１６に当接し、該チューブ体１６の有する弾性力に抗して徐々に実線に示すように拡径させつつ進行していく。   After that, it passes through the channel hole 23h of the connecting member 23, is introduced into the distal end side space 5S including the inner hole 16h of the elastic tube body 16, and proceeds. Then, the large-diameter forceps 41a of the biopsy forceps 41 introduced into the inner hole 16h comes into contact with the elastic tube body 16 having a reduced diameter as shown by the broken line in FIG. It progresses while gradually expanding the diameter as shown by the solid line against the elastic force of 16.

そして、図５の（Ｃ）に示すように弾性チューブ体１６を拡径させて先端開口３ｍから生検鉗子４１が導出される。この後、医師は、観察画面を観察しつつ鉗子部４１ａを目的部位に向けて移動させて生検を行う。符号４１ｂは、シースである。   Then, as shown in FIG. 5C, the diameter of the elastic tube body 16 is expanded and the biopsy forceps 41 is led out from the distal end opening 3m. Thereafter, the doctor performs biopsy by moving the forceps 41a toward the target site while observing the observation screen. Reference numeral 41b is a sheath.

図６を参照して処置具の１つであって径寸法が細径な超音波プローブ４２の体内への導出を説明する。
超音波観察を行う際、医師等は、処置具である超音波プローブ４２を処置具導入口１２から処置具挿通チャンネル３０内に挿通させる。すると、超音波プローブ４２は、図６の（Ａ）に示すようにチューブ体２８の貫通孔２８ｈ内を矢印Ｙ６Ａに示すように先端開口３ｍに向かって進行していく。 With reference to FIG. 6, the lead-out of the ultrasonic probe 42, which is one of the treatment instruments and has a small diameter, into the body will be described.
When performing ultrasonic observation, a doctor or the like inserts the ultrasonic probe 42 as a treatment instrument into the treatment instrument insertion channel 30 from the treatment instrument introduction port 12. Then, the ultrasonic probe 42 advances toward the tip opening 3m as shown by an arrow Y6A in the through hole 28h of the tube body 28 as shown in FIG.

その後、連結部材２３のチャンネル用孔２３ｈ内を通過し、弾性チューブ体１６の内孔１６ｈを含む先端側空間５Ｓ内に導入され、進行されていく。すると、内孔１６ｈ内に導入された超音波プローブ４２が図６の（Ｂ）に示すように縮径している弾性チューブ体１６に当接し、該チューブ体１６の有する弾性力に抗して徐々に実線に示すように拡径させつつ進行していく。   After that, it passes through the channel hole 23h of the connecting member 23, is introduced into the distal end side space 5S including the inner hole 16h of the elastic tube body 16, and proceeds. Then, the ultrasonic probe 42 introduced into the inner hole 16h comes into contact with the elastic tube body 16 having a reduced diameter as shown in FIG. 6B, and resists the elastic force of the tube body 16. Progress while gradually expanding the diameter as shown by the solid line.

そして、図６の（Ｃ）に示すように弾性チューブ体１６を拡径させて先端開口３ｍから超音波プローブ４２が導出される。ここで、医師は、観察画面を観察しつつ超音波探触子部４２ａを目的観察部位に密着させて超音波観察を行う。   Then, as shown in FIG. 6C, the diameter of the elastic tube body 16 is expanded and the ultrasonic probe 42 is led out from the distal end opening 3m. Here, the doctor performs ultrasonic observation by closely contacting the ultrasonic probe portion 42a with the target observation site while observing the observation screen.

この超音波観察時において、超音波プローブ４２のシース４２ｂは、チューブ体１６の内面と先端構成部材２４の平面外面２４ｆとの間に配置される。そして、超音波プローブ４２のシース４２ｂは、弾性チューブ体１６の有する平面外面２４ｆに向かって縮径しようとする弾性力によって押圧されて保持される。   During this ultrasonic observation, the sheath 42 b of the ultrasonic probe 42 is disposed between the inner surface of the tube body 16 and the planar outer surface 24 f of the tip constituting member 24. Then, the sheath 42b of the ultrasonic probe 42 is pressed and held by an elastic force to reduce the diameter toward the planar outer surface 24f of the elastic tube body 16.

この結果、超音波探触子部４２ａを目的観察部位に安定した状態で密着させて良好な超音波観察を行える。
このように、挿入部３を、基端側挿入部６と、外形が基端側挿入部６の外形より小さい先端側挿入部５とで構成した上で、先端側挿入部５の外表面を処置具挿通チャンネル３０の先端側を構成する内孔１６ｈを有する弾性チューブ体１６で構成する。 As a result, the ultrasonic probe part 42a can be brought into close contact with the target observation site in a stable state, and good ultrasonic observation can be performed.
As described above, the insertion portion 3 is constituted by the proximal end side insertion portion 6 and the distal end side insertion portion 5 whose outer shape is smaller than the outer shape of the proximal end side insertion portion 6, and the outer surface of the distal end side insertion portion 5 is formed. The elastic tube body 16 has an inner hole 16 h that constitutes the distal end side of the treatment instrument insertion channel 30.

この結果、基端側挿入部６に比べて外形が小さな先端側挿入部５を、体内の深部に位置する細径な部位まで容易に挿入することができる上、処置具挿通チャンネル３０を構成するチューブ体２８の貫通孔２８ｈ内に挿通した処置具を弾性チューブ体１６の弾性力に抗して拡径させつつ押し進めていくこと体内深部の観察部位に導出することができる。   As a result, the distal-end-side insertion portion 5 having a smaller outer shape than the proximal-end-side insertion portion 6 can be easily inserted to a small-diameter portion located deep in the body, and the treatment instrument insertion channel 30 is configured. Pushing the treatment tool inserted into the through hole 28h of the tube body 28 while expanding the diameter against the elastic force of the elastic tube body 16 can be led to an observation site deep in the body.

また、外形が小さな処置具においては、体内深部の観察部位に導いた後、弾性チューブ体１６の有する弾性力によって処置具のシース部分を押圧保持して処置具のふらつきを防止することができる。   In the case of a treatment instrument having a small outer shape, the sheath of the treatment instrument can be pressed and held by the elastic force of the elastic tube body 16 after being guided to an observation site deep in the body to prevent the treatment instrument from wobbling.

なお、上述した内視鏡においては、図５の（Ｄ）に示すように弾性チューブ体１６を拡径させて先端開口３ｍから最大直径がｓ１の処置具４３を導出させることができる。このとき、挿入部の最大外形はＳである。   In the endoscope described above, as shown in FIG. 5D, the diameter of the elastic tube body 16 can be expanded, and the treatment instrument 43 having the maximum diameter s1 can be led out from the distal end opening 3m. At this time, the maximum outer shape of the insertion portion is S.

上述した実施形態においては、弾性チューブ体１６の内面と、平面外面２４ｆ及び平面ゴム面２７ｆとの間に設けられた隙間、即ち、弾性チューブ体１６の内孔１６ｈの一部の内面１６ｉと平面外面２４ｆ及び平面ゴム面２７ｆとで構成される先端側空間５Ｓを、処置具挿通チャンネル３０を構成する先端側チャンネル孔１６ｈ１としている。   In the above-described embodiment, the gap provided between the inner surface of the elastic tube body 16 and the planar outer surface 24f and the planar rubber surface 27f, that is, a part of the inner surface 16i of the inner hole 16h of the elastic tube body 16 and the planar surface. The distal end side space 5S formed by the outer surface 24f and the flat rubber surface 27f is used as a distal end side channel hole 16h1 constituting the treatment instrument insertion channel 30.

しかし、先端側チャンネル孔は、この構成に限定されるものでは無く、先端側チャンネル孔を図７、或いは、図８に示すように構成してもよい。
図７を参照して先端側チャンネル孔の他の構成例を説明する。 However, the front end side channel hole is not limited to this configuration, and the front end side channel hole may be configured as shown in FIG. 7 or FIG.
With reference to FIG. 7, another configuration example of the front end side channel hole will be described.

図７の（Ａ）に示すように先端側チャンネル孔１６ｈａは、弾性チューブ体１６の内面１６ｉと、先端構成部材２４の凹曲面外面２４ｆａ及び湾曲部組２６を覆う湾曲ゴム２７の凹曲面ゴム面２７ｆａとの間に設けられる隙間である。   As shown in FIG. 7A, the distal-side channel hole 16ha has an inner surface 16i of the elastic tube body 16, a concave curved rubber surface of the curved rubber 27 covering the concave curved outer surface 24fa and the curved portion set 26 of the distal constituent member 24. It is a gap provided between 27fa.

凹曲面外面２４ｆａ及び凹曲面ゴム面２７ｆａは、平面側の中央部に、軸方向凹曲面溝５Ｇを設けて形作られている。軸方向凹曲面溝５Ｇは、先端側チャンネル孔１６ｈａの一部を構成し、予め定めた半径で窪んで形作られる。   The concave curved outer surface 24fa and the concave curved rubber surface 27fa are formed by providing an axial concave curved groove 5G at the center on the flat surface side. The axially concave curved groove 5G constitutes a part of the tip side channel hole 16ha and is formed to be depressed at a predetermined radius.

上述した図５の（Ｄ）に示すように先端側チャンネル孔１６ｈ１からは、軸方向凹曲面溝５Ｇが形成されていない平面である平面外面２４ｆ上を移動して処置具４３が導出される。   As shown in FIG. 5D described above, the treatment instrument 43 is led out from the distal-side channel hole 16h1 by moving on the planar outer surface 24f, which is a plane on which the axial concave curved groove 5G is not formed.

これに対して、図７の（Ｂ）に示すように先端側チャンネル孔１６ｈａからは、軸方向凹曲面溝５Ｇに沿って処置具４４が進行して導出される。
この結果、先端側チャンネル孔１６ｈａを有する挿入部３においては、挿入部３の外形が同じ寸法Ｓであっても、先端開口３ｍから処置具４３の外形ｓ１に比べて外形が大きな（ｓ２）処置具４４を体内に向けて導出させることが可能になる。 On the other hand, as shown in FIG. 7B, the treatment instrument 44 is led out from the distal-side channel hole 16ha along the axial concave curved groove 5G.
As a result, in the insertion portion 3 having the distal end side channel hole 16ha, the outer shape is larger than the outer shape s1 of the treatment instrument 43 from the distal end opening 3m (s2) even if the outer shape of the insertion portion 3 is the same dimension S (s2). The tool 44 can be led out toward the body.

なお、チャンネル用孔２３ｈの内径及び貫通孔２８ｈの内径は、軸方向凹曲面溝５Ｇの寸法に対応させて大きく設定してある。
また、先端側チャンネル孔１６ｈａ内から例えば、超音波プローブ４２を導出させた場合、超音波プローブ４２のシース４２ｂは、チューブ体１６の内面と軸方向凹曲面溝５Ｇの周面との間に配置される。そして、超音波プローブ４２のシース４２ｂは、弾性チューブ体１６の有する軸方向凹曲面溝５Ｇの底部に向かって縮径する弾性力によって押圧されて保持される。
その他の構成は、上述した実施形態と同様であり、同部材には同符号を付して説明を省略する。 The inner diameter of the channel hole 23h and the inner diameter of the through hole 28h are set to be large corresponding to the dimension of the axial concave curved groove 5G.
Further, for example, when the ultrasonic probe 42 is led out from the tip side channel hole 16ha, the sheath 42b of the ultrasonic probe 42 is disposed between the inner surface of the tube body 16 and the peripheral surface of the axial concave curved groove 5G. Is done. The sheath 42b of the ultrasonic probe 42 is pressed and held by an elastic force that reduces the diameter toward the bottom of the axial concave curved groove 5G of the elastic tube body 16.
Other configurations are the same as those of the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

図８を参照して挿入部を構成する先端側挿入部および先端側チャンネル孔の別の構成例を説明する。
図８の（Ａ）、（Ｂ）に示すように挿入部３は、先端側チューブ体１６Ｃと、挿入部本体２０とで構成されている。本実施形態の先端側チャンネル孔は、先端側チューブ体１６Ｃが有する貫通孔１６Ｃｈである。先端側チューブ体１６Ｃは、貫通孔１６Ｃｈを有し、弾性チューブ体１６と略同様に予め定めた弾性力を有して拡縮自在である。 With reference to FIG. 8, another configuration example of the distal end side insertion portion and the distal end side channel hole constituting the insertion portion will be described.
As shown in FIGS. 8A and 8B, the insertion portion 3 includes a distal end side tube body 16 </ b> C and an insertion portion main body 20. The tip side channel hole of the present embodiment is a through hole 16Ch included in the tip side tube body 16C. The distal end side tube body 16 </ b> C has a through hole 16 </ b> Ch and has a predetermined elastic force substantially in the same manner as the elastic tube body 16 and can be expanded and contracted.

本実施形態において、先端側チューブ体１６Ｃの基端開口側の基端部外周は、全周に渡って連結部材２３の先端側内周面に嵌入配置された上で、例えば接着固定される。
この接着固定状態において、先端側チューブ体１６Ｃの内面と連結部材２３のチャンネル用孔２３ｈの内面とは連続した同一周面として構成する。このことによって、処置具のスムーズな挿抜作業を実現できる。 In the present embodiment, the outer periphery of the proximal end portion of the distal end side tube body 16C on the proximal end opening side is fitted and arranged on the distal end side inner peripheral surface of the connecting member 23 over the entire circumference, and is, for example, bonded and fixed.
In this bonded and fixed state, the inner surface of the distal end side tube body 16C and the inner surface of the channel hole 23h of the connecting member 23 are configured as the same continuous peripheral surface. Thereby, a smooth insertion / extraction operation of the treatment instrument can be realized.

また、先端側チューブ体１６Ｃは、全長に渡って図８の（Ｂ）に示す軸方向凹曲面溝５Ｇ内に収容配置され、この配置状態において例えば接着固定される。したがっで、本実施形態において、先端側チューブ体１６Ｃの軸方向凹曲面溝５Ｇとの接着面以外の外周面が、挿入部３の外表面の一部を構成する。   Further, the distal end side tube body 16C is accommodated and disposed in the axially concave curved groove 5G shown in FIG. 8B over the entire length, and is bonded and fixed, for example, in this disposed state. Therefore, in this embodiment, the outer peripheral surface other than the adhesive surface with the axial concave groove 5G of the distal tube body 16C constitutes a part of the outer surface of the insertion portion 3.

即ち、本実施形態において、先端側挿入部５の外表面は、主に、先端側チューブ体１６Ｃと湾曲ゴム２７とで構成される。そして、処置具挿通チャンネル３０は、先端側を構成する先端側チューブ体１６Ｃの貫通孔１６Ｃｈと、連結部材２３のチャンネル用孔２３ｈと、チューブ体２８の貫通孔２８ｈと、で構成される。   That is, in the present embodiment, the outer surface of the distal end side insertion portion 5 is mainly composed of the distal end side tube body 16 </ b> C and the curved rubber 27. The treatment instrument insertion channel 30 includes a through hole 16Ch of the distal end side tube body 16C constituting the distal end side, a channel hole 23h of the connecting member 23, and a through hole 28h of the tube body 28.

先端側チューブ体１６Ｃの貫通孔１６Ｃｈは、処置具が挿入されていない状態において三日月形状の縮径状態であり、先端側に予め定めた寸法の隙間を形成する。   The through-hole 16Ch of the distal end side tube body 16C is in a crescent-shaped reduced diameter state when no treatment tool is inserted, and forms a gap having a predetermined dimension on the distal end side.

先端側チューブ体１６Ｃの貫通孔１６Ｃｈ内には、外形がｓ１の処置具４３、及び、超音波プローブ４２等が挿通可能である。先端側チューブ体１６Ｃの先端側の隙間は、処置具４２、４３がチューブ内を進行することによって拡径され、図８の（Ｃ）、（Ｄ）に示すように先端側開口１６ｍ１から処置具４３、４２が導出される。
なお、その他の構成は、上述した実施形態と同様であり、同部材には同符号を付して説明を省略する。 The treatment tool 43 having an outer shape s1, the ultrasonic probe 42, and the like can be inserted into the through hole 16Ch of the distal end side tube body 16C. The clearance on the distal end side of the distal side tube body 16C is expanded by the treatment tools 42 and 43 moving through the tube, and the treatment tool is opened from the distal end side opening 16m1 as shown in FIGS. 8 (C) and 8 (D). 43 and 42 are derived.
Other configurations are the same as those in the above-described embodiment, and the same members are denoted by the same reference numerals and description thereof is omitted.

図９を参照して挿入部本体に対して取り付け取り外しが可能な先端側チューブ体の構成を説明する。
図９の（Ａ）に示すように本実施形態の挿入部３は、挿入部本体２０と、先端側チューブ体１６Ｄと、で構成されている。 With reference to FIG. 9, the structure of the distal end side tube body that can be attached to and detached from the insertion portion main body will be described.
As shown in FIG. 9A, the insertion portion 3 of the present embodiment includes an insertion portion main body 20 and a distal end side tube body 16D.

図９の（Ａ）、（Ｂ）に示すように先端側チューブ体１６Ｄは、先端側に凸部１６Ｄａを有し、基端側にフランジ１６Ｄｂを有している。フランジ１６Ｄｂは、基端側外周面全周から外方に突出し、基端面から軸方向に予め定めた幅に設定されている。そして、フランジ外方端１６ｒの軸方向断面形状は、曲面形状に設定されている。
一方、凸部１６Ｄａは、先端側外周面から外方に突出する断面形状が図９の（Ｃ）に示すように凸字形状の凸部である。凸部１６Ｄａの長さは、先端面から軸方向に予め定めた長さに設定されている。 As shown in FIGS. 9A and 9B, the distal end side tube body 16D has a convex portion 16Da on the distal end side and a flange 16Db on the proximal end side. The flange 16Db protrudes outward from the entire circumference of the base end side outer peripheral surface, and is set to a predetermined width in the axial direction from the base end surface. The axial cross-sectional shape of the flange outer end 16r is set to a curved surface shape.
On the other hand, the convex portion 16Da is a convex portion having a convex shape as shown in FIG. The length of the convex portion 16Da is set to a predetermined length in the axial direction from the tip surface.

そして、凸部１６Ｄａは、図９の（Ａ）に示す先端部７に形成された軸方向溝７ａ内に配置されるようになっている。これに対して、フランジ１６Ｄｂは、連結部材２３に形成された周状凹部２３ｂ内に配置されるようになっている。
周状凹部２３ｂの軸方向断面形状は、フランジ端部１６ｒと同様に曲面形状に設定されている。 And convex part 16Da is arrange | positioned in the axial direction groove | channel 7a formed in the front-end | tip part 7 shown to (A) of FIG. On the other hand, the flange 16 </ b> Db is arranged in a circumferential recess 23 b formed in the connecting member 23.
The axial cross-sectional shape of the circumferential concave portion 23b is set to a curved surface shape like the flange end portion 16r.

図９の（Ａ）−（Ｄ）に示すように軸方向溝７ａは、断面形状が凸字形状であって、終端面７ｅを有している。凸部１６Ｄａは、当接平面１６Ｄｃを有し、当接平面１６Ｄｃが軸方向溝７ａの当接面７ｂに当接することにより、先端側チューブ体１６Ｄが挿入部本体２０の軸方向に対して直交する方向に暴れること、および、脱落することが防止される。   As shown in FIGS. 9A to 9D, the axial groove 7a has a convex cross-sectional shape and has a terminal surface 7e. The convex portion 16Da has an abutment plane 16Dc, and the abutment plane 16Dc abuts against the abutment surface 7b of the axial groove 7a, so that the distal end side tube body 16D is orthogonal to the axial direction of the insertion portion main body 20. It is possible to prevent the violence in the direction of falling and the falling off.

先端側チューブ体１６Ｃは、以下の手順で挿入部本体２０に対して取り付けられる。
医療従事者は、図９の（Ｂ）の矢印Ｙ９ｂ１に示すように凸部１６Ｄａの基端側を軸方向溝７ａの先端側に配置し、矢印Ｙ９ｂ２に示すように先端側チューブ体１６Ｃのフランジ１６Ｄｂを連結部材２３のチャンネル用孔２３ｈの先端開口に配置する。 The distal end side tube body 16C is attached to the insertion portion main body 20 in the following procedure.
The medical worker arranges the proximal end side of the convex portion 16Da at the distal end side of the axial groove 7a as indicated by an arrow Y9b1 in FIG. 9B, and the flange of the distal end side tube body 16C as indicated by an arrow Y9b2. 16Db is arranged at the tip opening of the channel hole 23h of the connecting member 23.

この後、医療従事者は、フランジ１６Ｄｂを弾性変形させつつチャンネル用孔２３ｈ内を弾性力に抗して移動させ、周状凹部２３ｂ内に係入配置させる。この係入状態において、凸部１６Ｄａは、軸方向溝７ａ内に係入配置される。この結果、先端側チューブ体１６Ｃが挿入部本体２０に一体的に取り付けられた状態になる。
なお、凸部１６Ｄａの端面は、終端面７ｅに当接すること無く、予め定めた距離離間している。 Thereafter, the medical worker moves the channel 16h in the channel hole 23h against elastic force while elastically deforming the flange 16Db, and engages and disposes it in the circumferential recess 23b. In this engaged state, the convex portion 16Da is engaged and disposed in the axial groove 7a. As a result, the distal end side tube body 16 </ b> C is integrally attached to the insertion portion main body 20.
Note that the end surface of the convex portion 16Da is separated from the end surface 7e by a predetermined distance without coming into contact with the end surface 7e.

この取り付け状態において、先端側チューブ体１６Ｄは、接着されること無く、軸方向凹曲面溝５Ｇ内に収容配置される。したがっで、本実施形態において、先端側チューブ体１６Ｄの軸方向凹曲面溝５Ｇとの接触面以外の外周面が、挿入部３の外表面の一部を構成する。   In this attached state, the distal end side tube body 16D is accommodated and disposed in the axially concave curved groove 5G without being bonded. Therefore, in this embodiment, the outer peripheral surface other than the contact surface with the axial concave curved groove 5G of the distal end side tube body 16D constitutes a part of the outer surface of the insertion portion 3.

なお、先端側チューブ体１６Ｄの貫通孔１６Ｃｈは、処置具が挿入されていない状態において三日月形状の縮径状態であり、先端側に予め定めた寸法の隙間を形成する。
先端側チューブ体１６Ｄのその他の構成及び作用は、上述した先端側チューブ体１６Ｃと同様である。 The through hole 16Ch of the distal end side tube body 16D is in a crescent-shaped reduced diameter state when no treatment instrument is inserted, and forms a gap having a predetermined dimension on the distal end side.
Other configurations and operations of the distal end side tube body 16D are the same as those of the distal end side tube body 16C described above.

この構成によれば、先端側チューブ体１６Ｄを使い捨てにして、観察終了後、先端側チューブ体１６Ｄを挿入部本体２０から取り外して挿入部本体２０の洗浄、消毒等を行える。この結果、挿入部３の洗浄、消毒作業性の向上を図ることができる。
なお、チューブ体１６Ｄの挿入部本体２０からの取り外し手順は、まず、フランジ１６Ｄｂの周状凹部２３ｂに対する係入状態を解除し、その後、凸部１６Ｄａの軸方向溝７ａに対する係入状態を解除することによって行う。 According to this configuration, the distal end side tube body 16D is made disposable, and after the observation is finished, the distal end side tube body 16D can be detached from the insertion portion main body 20 to clean, disinfect, etc. the insertion portion main body 20. As a result, it is possible to improve the cleaning and disinfection workability of the insertion portion 3.
In order to remove the tube body 16D from the insertion portion main body 20, first, the engagement state of the flange 16Db with respect to the circumferential recess 23b is released, and then the engagement state of the protrusion 16Da with respect to the axial groove 7a is released. By doing.

ところで、気管支内にシリコンステントを留置する手技が行われている。この手技においては、内視鏡を外套管から外した上で、盲目下でステント留置を行う、或いは、Ｘ線透過下でステント留置を行う、ことが知られている。   By the way, a technique of placing a silicon stent in the bronchi has been performed. In this technique, it is known that the stent is placed under blindness or the stent is placed under X-ray transmission after the endoscope is removed from the mantle tube.

上述した手技においては、シリコンステントを気管支内の予め定めた部位に確実に留置することが難しい。このため、内視鏡下において、留置位置を確認した上でシリコンステントを気管支内の所望する位置に留置させたいという要望がある。   In the above-described procedure, it is difficult to securely place the silicon stent at a predetermined site in the bronchus. For this reason, there is a desire to place the silicon stent at a desired position in the bronchus after confirming the placement position under the endoscope.

図１０に示す符号５０はステント留置用処置具であり、ステント留置用処置具５０は、透明で摩擦係数の低い樹脂部材で形成されている。
ステント留置用処置具５０は、シース部５１と、筒状部５２と、有する。
シース部５１は、処置具挿通チャンネル内に挿入される棒状部である。シース部５１の一端部は、内視鏡の処置具導入口から予め定め量、導出される。 Reference numeral 50 shown in FIG. 10 is a stent placement treatment tool, and the stent placement treatment tool 50 is formed of a transparent resin member having a low friction coefficient.
The stent placement treatment instrument 50 includes a sheath portion 51 and a tubular portion 52.
The sheath portion 51 is a rod-like portion that is inserted into the treatment instrument insertion channel. One end portion of the sheath portion 51 is led out in a predetermined amount from the treatment instrument introduction port of the endoscope.

筒状部５２は、シース部５１の他端側に設けられた折り返し部であって柔軟性を有する。筒状部５２は、内視鏡の挿入部の外形より小さな内径寸法の凹部空間（以下、凹部と略記する）５３を有している。凹部５３の棒状部近傍には周方向に等間隔に複数の通気口５４が設けられている。通気口５４は、貫通孔であって、凹部５３内と外部とを連通する。   The cylindrical portion 52 is a folded portion provided on the other end side of the sheath portion 51 and has flexibility. The cylindrical portion 52 has a recessed space (hereinafter abbreviated as a recessed portion) 53 having an inner diameter smaller than the outer shape of the insertion portion of the endoscope. In the vicinity of the bar-shaped portion of the recess 53, a plurality of vent holes 54 are provided at equal intervals in the circumferential direction. The vent 54 is a through-hole and communicates the inside of the recess 53 with the outside.

凹部５３の内周面の予め定めた位置には中心軸５０ａ方向に突出する周状凸部５５、５６が設けられている。第１周状凸部５５と第２周状凸部５６との間には後述するシリコンステント（図１１の符号６０）が配置される。   Circumferential convex portions 55 and 56 projecting in the direction of the central axis 50 a are provided at predetermined positions on the inner peripheral surface of the concave portion 53. A silicon stent (reference numeral 60 in FIG. 11), which will be described later, is disposed between the first circumferential convex portion 55 and the second circumferential convex portion 56.

第１周状凸部５５は、筒状部５２を図１１に示すように予め定めた折り返し状態にしたとき、挿入部先端側に配置され、第２周状凸部５６は折り返し状態において挿入部先端面から離間して配置される。   The first circumferential convex portion 55 is disposed on the distal end side of the insertion portion when the cylindrical portion 52 is set in a predetermined folded state as shown in FIG. 11, and the second circumferential convex portion 56 is inserted in the folded state. It arrange | positions away from the front end surface.

周状凸部５５、５６の高さは、予め定めた寸法であって、第２周状凸部５６の高さが第１周状凸部５６の高さより予め高く設定してある。第２周状凸部５６は、シリコンステント６０の脱落を防止する脱落防止面になるとともに、シリコンステント６０を押し出す押出し面とを兼用する。   The heights of the circumferential convex portions 55 and 56 are predetermined dimensions, and the height of the second circumferential convex portion 56 is set higher than the height of the first circumferential convex portion 56 in advance. The second circumferential convex portion 56 serves as a drop-off preventing surface that prevents the silicon stent 60 from falling off, and also serves as an extruded surface that pushes out the silicon stent 60.

図１１、図１２を参照してステント留置用処置具５０の作用を説明する。
シリコンステント６０を内視鏡６１に取り付けるために、医療従事者は、ステント留置用処置具５０のシース部５１を、内視鏡６１の挿入部６２の先端開口６２ｍから処置具挿通チャンネル６３内に挿通していく。 The operation of the stent placement treatment tool 50 will be described with reference to FIGS.
In order to attach the silicon stent 60 to the endoscope 61, a medical worker moves the sheath portion 51 of the stent placement treatment tool 50 from the distal end opening 62 m of the insertion portion 62 of the endoscope 61 into the treatment tool insertion channel 63. I will go through.

そして、図示されていないシース部５１の一端部を処置具導入口（不図示）から導出させる一方、凹部５３の棒状部近傍に設けられた通気口５４を先端開口６２ｍの予め定めた位置に配置させる。   Then, one end portion of the sheath portion 51 (not shown) is led out from the treatment instrument introduction port (not shown), while the vent hole 54 provided in the vicinity of the rod-like portion of the recess 53 is disposed at a predetermined position of the distal end opening 62m. Let

次に、医療従事者は、筒状部５２を折り返す。そして、第１周状凸部５５と第２周状凸部５６とを挿入部６２の先端側外周面上に配置する。このとき、第１周状凸部５５は、挿入部６２の先端面６２ａ近傍に配置され、第２周状凸部５６は挿入部６２の先端面６２ａから予め定めた距離離間して配置される。このとき、第１周状凸部５５と通気口５４との間の筒状部５２が挿入部６２の先端面６２ａ上に配置される。   Next, the medical worker folds the tubular portion 52. Then, the first circumferential convex portion 55 and the second circumferential convex portion 56 are arranged on the outer peripheral surface on the distal end side of the insertion portion 62. At this time, the first circumferential convex portion 55 is disposed in the vicinity of the distal end surface 62a of the insertion portion 62, and the second circumferential convex portion 56 is disposed at a predetermined distance from the distal end surface 62a of the insertion portion 62. . At this time, the cylindrical portion 52 between the first circumferential convex portion 55 and the vent hole 54 is disposed on the distal end surface 62 a of the insertion portion 62.

次いで、医療従事者は、第１周状凸部５５と第２周状凸部５６との間にシリコンステント６０を設置する。
この結果、シリコンステント６０の挿入部先端部への取り付けが完了する。
ここで、医師は、シリコンステント６０を留置するため、挿入部６２を気管支内へ挿入する。このとき、内視鏡６１の図示されていない照明光学系から出射される照明光は、筒状部５２を通過して観察部位に向けて照射される。 Next, the medical staff installs the silicon stent 60 between the first circumferential convex portion 55 and the second circumferential convex portion 56.
As a result, the attachment of the silicon stent 60 to the distal end portion of the insertion portion is completed.
Here, the doctor inserts the insertion portion 62 into the bronchus in order to place the silicon stent 60. At this time, illumination light emitted from an illumination optical system (not shown) of the endoscope 61 passes through the cylindrical portion 52 and is irradiated toward the observation site.

また、照明光に照らされた観察部位の観察像は、筒状部５２越しに内視鏡６１の観察光学系６４によって撮像されて、図示されていないモニタの画面上に観察部位の内視鏡画像として表示される。   An observation image of the observation site illuminated by the illumination light is captured by the observation optical system 64 of the endoscope 61 through the cylindrical portion 52, and the endoscope of the observation site is displayed on a monitor screen (not shown). Displayed as an image.

医師は、内視鏡画像を観察しつつ挿入部６２の先端部を気管支内の狭窄部に向けて移動して対峙させる。この挿入部挿入時、シリコンステント６０は、高さの高い第２周状凸部５６によって脱落することが防止される。また、医師は、必要に応じて管内の汚物を通気口５４から処置具挿通チャンネル６３内に吸引する。   The doctor moves and confronts the distal end portion of the insertion portion 62 toward the stenosis portion in the bronchus while observing the endoscopic image. When the insertion portion is inserted, the silicon stent 60 is prevented from falling off by the second circumferential convex portion 56 having a high height. Further, the doctor sucks dirt in the tube from the vent hole 54 into the treatment instrument insertion channel 63 as necessary.

次に、医師は、シリコンステント６０を気管支内に留置するため、処置具導入口から導出されているシース部５１を手元側移動させる引き戻し操作を行う。すると、シース部５１が処置具挿通チャンネルを徐々に図１１中の矢印Ｙ１１ａ、図１２中の矢印Ｙ１２ａ方向に移動されていく。   Next, in order to place the silicon stent 60 in the bronchus, the doctor performs a pull-back operation for moving the sheath portion 51 led out from the treatment instrument introduction port to the hand side. Then, the sheath portion 51 is gradually moved in the direction of the arrow Y11a in FIG. 11 and the arrow Y12a in FIG. 12 through the treatment instrument insertion channel.

このシース部５１の移動に伴って、挿入部６２の先端側外周面に折り返して配置されている筒状部５２が図１１中の矢印Ｙ１１ｂ、図１２中の矢印Ｙ１２ｂ方向に移動を開始する。すると、第１周状凸部５５及び第２周状凸部５６も同方向に移動されていく。   Along with the movement of the sheath portion 51, the cylindrical portion 52 that is folded back on the outer peripheral surface of the insertion portion 62 starts to move in the direction of the arrow Y11b in FIG. 11 and the arrow Y12b in FIG. Then, the first circumferential convex portion 55 and the second circumferential convex portion 56 are also moved in the same direction.

そして、医師が引き続き引き戻し操作を行うことによって、第１周状凸部５５は、挿入部６２の外周面上から挿入部６２の先端面６２ａ上を移動し、その後、処置具挿通チャンネル６３内を移動していく。一方、第２周状凸部５６は、挿入部６２の外周面上を先端側に移動していく。   Then, when the doctor continues to perform the pull-back operation, the first circumferential convex portion 55 moves on the distal end surface 62a of the insertion portion 62 from the outer peripheral surface of the insertion portion 62, and then in the treatment instrument insertion channel 63. Move. On the other hand, the second circumferential convex portion 56 moves to the distal end side on the outer peripheral surface of the insertion portion 62.

この結果、、第１周状凸部５５と第２周状凸部５６との間に設置されていたシリコンステント６０は、挿入部６２の先端側から押し出されて、狭窄部（不図示）に留置される。   As a result, the silicon stent 60 installed between the first circumferential convex portion 55 and the second circumferential convex portion 56 is pushed out from the distal end side of the insertion portion 62 and becomes a narrowed portion (not shown). Detained.

このように、透明で摩擦係数の低い樹脂部材でステント留置用処置具５０を形成し、ステント留置用処置具５０の筒状部５２を折り返して挿入部先端面及び挿入部先端側外周面に配置する。この結果、医師は、観察光学系を通してシリコンステント６０の留置位置を確認しつつ留置作業を行うことができる。   As described above, the treatment device 50 for stent placement is formed of a transparent resin member having a low coefficient of friction, and the cylindrical portion 52 of the treatment device 50 for stent placement is folded and disposed on the distal end surface of the insertion portion and the outer peripheral surface on the distal end side of the insertion portion. To do. As a result, the doctor can perform the placement operation while confirming the placement position of the silicon stent 60 through the observation optical system.

また、挿入部先端側外周面に折り返して配置される筒状部５２に周状凸部５５、５６を設け、２つの周状凸部５５、５６の間にシリコンステント６０を予め配置しておく。この結果、内視鏡挿入部を挿入する作業と同時にシリコンステント６０を観察部位に導くことができる。   In addition, circumferential convex portions 55 and 56 are provided on the cylindrical portion 52 that is folded back and arranged on the outer peripheral surface on the distal end side of the insertion portion, and the silicon stent 60 is disposed in advance between the two circumferential convex portions 55 and 56. . As a result, the silicon stent 60 can be guided to the observation site simultaneously with the operation of inserting the endoscope insertion portion.

加えて、ステント留置用処置具５０のシース部５１を引き戻し操作して、挿入部６２の先端側外周面に折り返して配置されている筒状部５２を移動させて第２周状凸部５６を挿入部先端側に移動させる。このことによって、、第１周状凸部５５と第２周状凸部５６との間に設置されていたシリコンステント６０を内視鏡画像を観察しつつ狭窄部に留置ることができる。   In addition, the sheath portion 51 of the stent placement treatment instrument 50 is pulled back to move the cylindrical portion 52 that is folded back on the distal end side outer peripheral surface of the insertion portion 62 to move the second circumferential convex portion 56. Move to the distal end of the insertion section. Thereby, the silicon stent 60 installed between the first circumferential convex portion 55 and the second circumferential convex portion 56 can be placed in the narrowed portion while observing the endoscopic image.

以上の各実施の形態に記載した発明は、その実施の形態、及び変形例に限ることなく、その他、実施段階ではその要旨を逸脱しない範囲で種々の変形を実施し得ることが可能である。   The invention described in each of the above-described embodiments is not limited to the embodiments and modifications, and various modifications can be made without departing from the scope of the invention in the implementation stage.

１…内視鏡 ２…操作部 ３…挿入部 ３ａ…先端面 ３ｍ…先端開口
４…ユニバーサルケーブル ５…先端側挿入部 ５Ｇ…軸方向凹曲面溝
５Ｓ…先端側空間 ６…基端側挿入部 ７…先端部 ７ａ…軸方向溝 ７ｂ…当接面
８…湾曲部 ９…把持部 １０…湾曲レバー １１…操作ボタン １２…処置具導入口
１４…観察窓 １５…照明窓 １６…弾性チューブ体
１６Ｃ、１６Ｄ…先端側チューブ体 １６Ｃｈ…貫通孔 １６Ｄａ…凸部
１６Ｄｂ…フランジ １６Ｄｃ…当接平面 １６ｈ…内孔
１６ｈ１…先端側チャンネル孔 １６ｈａ…先端側チャンネル孔 １６ｉ…内面
１６ｍ１…先端側開口 １６ｍ２…基端側開口 １６ｒ…フランジ端部
２１…先端側挿入部本体 ２２…外皮樹脂 ２３…連結部材 ２３ｂ…周状凹部
２３ｈ…チャンネル用孔 ２４…先端構成部材 ２４ｃ…凸曲面外面 ２４ｆ…平面外面
２４ｆａ…凹曲面外面 ２５…本体湾曲部 ２６…湾曲部組 ２７…湾曲ゴム
２７ｃ…凸曲面ゴム面 ２７ｆａ…凹曲面ゴム面 ２８…チューブ体 ２８ｈ…貫通孔
３０…処置具挿通チャンネル ４１…生検鉗子 ４１ａ…鉗子部 ４１ｂ…シース
４２…超音波プローブ ４２ａ…超音波探触子部 ４２ｂ…シース ４３、４４…処置具
５０…ステント留置用処置具 ５０ａ…中心軸 ５１…シース部 ５２…筒状部
５３…凹部 ５４…通気口 ５５…第１周状凸部 ５６…第２周状凸部
６０…シリコンステント ６１…内視鏡 ６２…挿入部 ６２ａ…先端面
６２ｍ…先端開口 ６３…処置具挿通チャンネル ６４…観察光学系 DESCRIPTION OF SYMBOLS 1 ... Endoscope 2 ... Operation part 3 ... Insertion part 3a ... Tip surface 3m ... Tip opening
4 ... Universal cable 5 ... Tip side insertion part 5G ... Axial concave curved groove
5S ... distal end side space 6 ... proximal end side insertion portion 7 ... distal end portion 7a ... axial groove 7b ... abutting surface 8 ... bending portion 9 ... gripping portion 10 ... bending lever 11 ... operation button 12 ... treatment instrument introduction port 14 ... Observation window 15 ... Illumination window 16 ... Elastic tube
16C, 16D ... distal end side tube body 16Ch ... through hole 16Da ... convex part
16Db ... Flange 16Dc ... Contact plane 16h ... Inner hole
16h1 ... tip side channel hole 16ha ... tip side channel hole 16i ... inner surface
16 m 1 ... Opening on the front end side 16 m 2 ... Opening on the base end side 16 r ... End of the flange
21 ... distal end side insertion portion main body 22 ... outer shell resin 23 ... connecting member 23b ... circumferential recess
23h ... Channel hole 24 ... Tip component 24c ... Convex curved outer surface 24f ... Planar outer surface 24fa ... Concave curved outer surface 25 ... Main body curved portion 26 ... Curved portion set 27 ... Curved rubber
27c ... Convex curve rubber surface 27fa ... Concave curve rubber surface 28 ... Tube body 28h ... Through hole
DESCRIPTION OF SYMBOLS 30 ... Treatment tool insertion channel 41 ... Biopsy forceps 41a ... Forceps part 41b ... Sheath 42 ... Ultrasonic probe 42a ... Ultrasonic probe part 42b ... Sheath 43, 44 ... Treatment tool 50 ... Stent placement treatment tool 50a ... Center Shaft 51 ... Sheath part 52 ... Cylindrical part 53 ... Concave 54 ... Vent 55 ... First circumferential convex part 56 ... Second circumferential convex part 60 ... Silicon stent 61 ... Endoscope 62 ... Insert part 62a ... Front end surface
62 m ... tip opening 63 ... treatment instrument insertion channel 64 ... observation optical system

Claims (8)

操作部から延出する内視鏡挿入部の該操作部側に設けられた基端側挿入部と、
前記基端側挿入部の先端側に設けられ、外形を該基端側挿入部より予め小さく設定した先端側挿入部と、
前記基端側挿入部の内孔内に配設される、内視鏡用処置具が挿通される処置具挿通チャンネルの基端側を構成する可撓性を有するチューブ体と、
内孔を有し、前記先端側挿入部の長手方向に沿って一体に設けられて外周面の少なくとも一部が該先端側挿入部の外表面を構成すると共に、該内孔の先端開口が該先端側挿入部の先端面側に配置されて基端側開口が前記チューブ体の先端側開口に連通して処置具挿通チャンネルの先端側を構成する予め定めた弾性力を有して拡縮自在な弾性チューブ体と、
を具備することを特徴とする内視鏡。 A proximal-side insertion portion provided on the operation portion side of the endoscope insertion portion extending from the operation portion;
A distal end side insertion portion provided on the distal end side of the proximal end side insertion portion, the outer shape of which is set in advance smaller than the proximal end insertion portion;
A flexible tube body constituting a proximal end side of a treatment instrument insertion channel, through which an endoscope treatment instrument is inserted, disposed in an inner hole of the proximal end insertion portion;
An inner hole is provided integrally along the longitudinal direction of the distal end side insertion portion, and at least a part of the outer peripheral surface forms the outer surface of the distal end side insertion portion, and the distal end opening of the inner hole is The proximal end side opening disposed on the distal end surface side of the distal end side insertion portion communicates with the distal end side opening of the tube body and has a predetermined elastic force that constitutes the distal end side of the treatment instrument insertion channel and is expandable and contractable. An elastic tube body;
An endoscope comprising: 前記処置具挿通チャンネルの先端側の内孔は、前記先端側挿入部の平面外面及び凸曲面外面と、前記弾性チューブ体の内面との間に設けられる隙間であることを特徴とする請求項１に記載の内視鏡。   The inner hole on the distal end side of the treatment instrument insertion channel is a gap provided between a planar outer surface and a convex curved outer surface of the distal insertion portion and an inner surface of the elastic tube body. The endoscope according to 1. 前記処置具挿通チャンネルの先端側の内孔は、前記弾性チューブ体と同様な弾性力を有して拡縮自在であるチューブ体の貫通孔であることを特徴とする請求項１に記載の内視鏡。   2. The internal view according to claim 1, wherein the inner hole on the distal end side of the treatment instrument insertion channel is a through hole of a tube body that has the same elastic force as the elastic tube body and can be expanded and contracted. mirror. 前記先端側挿入部の平面外面の中央部及び凸曲面外面の中央部に、軸方向に延びる軸方向凹曲面溝を設けたことを特徴とする請求項２又は請求項３に記載の内視鏡。   The endoscope according to claim 2 or 3, wherein an axial concave curved groove extending in the axial direction is provided in a central portion of the flat outer surface and a central portion of the convex curved outer surface of the distal end side insertion portion. . 前記先端側挿入部の先端面と前記弾性チューブ体の先端面とが連続した同一面であることを特徴とする請求項１に記載の内視鏡。   The endoscope according to claim 1, wherein the distal end surface of the distal end side insertion portion and the distal end surface of the elastic tube body are the same continuous surface. 前記処置具挿通チャンネルは、吸引チャンネルを兼用することを特徴とする請求項１に記載の内視鏡。   The endoscope according to claim 1, wherein the treatment instrument insertion channel also serves as a suction channel. 前記軸方向凹曲面溝には、先端側チューブ体が着脱自在であることを特徴とする請求項４に記載の内視鏡。   The endoscope according to claim 4, wherein a distal end side tube body is detachably attached to the axially concave curved groove. 前記先端側チューブ体の先端側には、前記先端側挿入部を構成する先端部に形成された軸方向溝に配置される、先端側外周面から外方に突出する凸部を有し、
該先端側チューブ体の基端側には、連結部材の内面に形成された周状凹部に配置される、基端側外周面の全周から外方に突出するフランジを有する、
ことを特徴とする請求項７に記載の内視鏡。 On the distal end side of the distal end side tube body, it has a convex portion that protrudes outward from the outer peripheral surface on the distal end side, which is disposed in an axial groove formed in the distal end portion constituting the distal end side insertion portion,
The proximal end side of the distal end side tube body has a flange that protrudes outward from the entire circumference of the proximal end side outer peripheral surface, which is disposed in a circumferential recess formed on the inner surface of the connecting member.
The endoscope according to claim 7.
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