JPH07148171A - Tube-shaped inserting instrument - Google Patents

Abstract

PURPOSE:To lead an endoscope or an operative instrument of a small diameter to the lesion part certainly, by inserting the tip part of a tube-shaped inserting instrument to a mammilla opening closed with a sphincter muscle easily and safely, or by inserting the inserting instrument to a bile duct or a pancreatic duct individually. CONSTITUTION:A tip member 6, which is tapered to a point, is a hollow cylinder and is connected to the tip of a catheter 2 made of an elastic material, is formed out of an ultra elastic alloy material so that the tip member can be deformed elastically from an initial state held in a basic shape to a expanded state in which the tapered and hollow tip is expanded to the almost same diameter with the inner diameter of the catheter 2, so that the tip member 6 is expandable by the motion of an object inserted to the tip member 6 through the catheter 2.

Description

【発明の詳細な説明】Detailed Description of the Invention

【０００１】[0001]

【産業上の利用分野】本発明は生体腔内に挿入され、病
変部の観察や処置を行なうために用いられるカテーテル
等の管状挿入具に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a tubular inserter such as a catheter which is inserted into a living body cavity and is used for observing and treating a lesion.

【０００２】[0002]

【従来の技術】一般に、口から十二指腸まで挿入された
内視鏡の先端部のチャンネル開口部から可撓性を有する
弾性材料からなるカテーテルを外部側に突出させ、この
カテーテルの突出部を十二指腸乳頭に挿入し、さらに胆
管、あるいは膵管内に選択的に挿入したり、分岐する血
管に選択的にカテーテルを挿入する方法がある。2. Description of the Related Art Generally, a catheter made of an elastic material having flexibility is projected to the outside from a channel opening portion of a distal end portion of an endoscope inserted from the mouth to the duodenum, and the projection portion of the catheter is duodenal papilla. There is a method of selectively inserting into the bile duct or pancreatic duct, or selectively inserting a catheter into a branching blood vessel.

【０００３】ここで、カテーテルには手元側から先端部
側に至る管腔が形成されている。そして、胆管や膵管に
挿入されたカテーテルの管腔内に例えば細径の内視鏡
や、処置具（細胞診ブラシ等）等を挿通させるととも
に、挿通された内視鏡や、処置具の先端部をカテーテル
の先端より外部側に突出させ、胆管や膵管内の病変部の
観察や処置を行なうようになっている。なお、この時用
いるカテーテルの手元側から先端部側に至るまでの管腔
は細径の内視鏡や処置具を挿通させるために、一定以上
の管腔径が確保されている。Here, a lumen is formed in the catheter from the proximal side to the distal end side. Then, for example, a small-diameter endoscope or a treatment instrument (cytology brush, etc.) is inserted into the lumen of the catheter inserted into the bile duct or pancreatic duct, and the inserted endoscope or the tip of the treatment instrument is inserted. The part is projected to the outside from the tip of the catheter to observe and treat lesions in the bile duct and pancreatic duct. In addition, the lumen from the proximal side to the distal end side of the catheter used at this time has a certain diameter or more so that a thin endoscope or a treatment instrument can be inserted.

【０００４】[0004]

【発明が解決しようとする課題】上記従来構成のカテー
テルを用いる場合には内視鏡や処置具を円滑に挿通させ
るために手元側から先端部側に至るまで一定以上の管腔
径を確保する必要があるので、カテーテルの挿入部の外
径寸法は少なくとも管腔径以上になる。When the catheter having the above-mentioned conventional configuration is used, a lumen diameter of a certain level or more is secured from the proximal side to the distal end side in order to smoothly insert the endoscope and the treatment tool. Therefore, the outer diameter of the insertion portion of the catheter is at least equal to or larger than the lumen diameter.

【０００５】そのため、カテーテルの挿入部の先端部を
このカテーテルの管腔径よりも小さくすることができな
いので、口から十二指腸まで挿入された内視鏡の先端部
のチャンネル開口部から外部側に突出させたカテーテル
の突出部を十二指腸乳頭に挿入する作業に手間がかかる
問題がある。この場合、十二指腸の乳頭開口部は通常、
活約筋で閉まっているので、カテーテルの管腔内径より
も外径寸法が大きいカテーテルの先端部を活約筋により
閉まった乳頭開口部に挿入するには困難な場合がある。Therefore, since the tip of the insertion portion of the catheter cannot be made smaller than the lumen diameter of the catheter, it projects outward from the channel opening at the tip of the endoscope inserted from the mouth to the duodenum. There is a problem in that it takes time and effort to insert the protruding portion of the catheter into the duodenal papilla. In this case, the papillary opening in the duodenum is usually
Since it is closed by the activating muscle, it may be difficult to insert the tip of the catheter, which has an outer diameter larger than the inner diameter of the lumen of the catheter, into the nipple opening closed by the activating muscle.

【０００６】本発明は上記事情に着目してなされたもの
で、その目的は、活約筋により閉まった乳頭開口部へも
管状挿入具本体の先端部を容易に、かつ安全に挿入する
ことができ、胆管、膵管内へ選択的に挿入して細径の内
視鏡や処置具を体内の病変部まで確実に誘導させること
ができる管状挿入具を提供することにある。The present invention has been made in view of the above circumstances, and an object thereof is to easily and safely insert the distal end portion of the tubular insertion tool body into the nipple opening closed by the activating muscle. (EN) A tubular inserter capable of being selectively inserted into a bile duct or a pancreatic duct to reliably guide a thin endoscope or a treatment instrument to a lesion site in the body.

【０００７】[0007]

【課題を解決するための手段】本発明は弾性材料からな
る管状挿入具本体の先端に連結され、基本形状が略先細
中空状に形成された先端部材を設け、この先端部材を前
記基本形状で保持される初期状態から先細中空部分を前
記管状挿入具本体の内径寸法と略同径程度に拡開させた
拡開状態まで弾性変形可能な超弾性合金材料によって形
成し、前記管状挿入具本体内を通して前記先端部材に挿
入される挿入体の挿入動作にともない前記先端部材を拡
開可能にしたものである。According to the present invention, there is provided a tip member which is connected to the tip of a tubular inserter body made of an elastic material and which has a basic shape formed into a substantially tapered hollow shape. The tapered hollow portion is formed of a superelastic alloy material that is elastically deformable from the initial held state to an expanded state in which the tapered hollow portion is expanded to approximately the same diameter as the inner diameter of the tubular inserter body, and inside the tubular inserter body The tip member can be expanded with the insertion operation of the insert body inserted through the tip member.

【０００８】[0008]

【作用】管状挿入具本体の挿入時には先端部材の先細中
空部分を管状挿入具本体の内径寸法より小径な基本形状
の初期状態で保持させることにより、活約筋により閉ま
った乳頭開口部内等に管状挿入具本体の先端部を挿入す
る作業を容易化するとともに、管状挿入具本体内に挿入
体が挿入された場合にはこの管状挿入具本体内を通して
先端部材に挿入される挿入体の挿入動作にともない先端
部材を管状挿入具本体の内径寸法と略同径程度まで拡開
させ、管状挿入具本体内に挿入された挿入体を先端部材
の外部側に導出できるようにしたものである。[Operation] During insertion of the tubular inserter body, the tapered hollow portion of the distal end member is held in the initial state of the basic shape having a diameter smaller than the inner diameter of the tubular inserter body, so that it is tubular in the teat opening closed by the living muscle. In addition to facilitating the work of inserting the distal end portion of the insertion tool body, when the insertion body is inserted into the tubular insertion tool body, the insertion operation of the insertion body to be inserted into the tip member through the tubular insertion tool body can be performed. Along with this, the tip member is expanded to approximately the same diameter as the inner diameter of the tubular inserter body so that the insert body inserted in the tubular inserter body can be led out to the outside of the tip member.

【０００９】[0009]

【実施例】以下、本発明の第１の実施例を図１乃至図５
（Ｂ）を参照して説明する。図１（Ａ）はカテーテル１
全体の概略構成を示すものである。このカテーテル１に
は弾性を有する素材、例えばフッ素樹脂、ポリウレタ
ン、ポリエチレン等の合成樹脂材料からなり、可撓性を
有する管状のカテーテル本体（管状挿入具本体）２が設
けられている。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS.
This will be described with reference to (B). FIG. 1A shows a catheter 1.
It shows an overall schematic configuration. The catheter 1 is provided with a flexible tubular catheter body (tubular insertion tool body) 2 made of an elastic material, for example, a synthetic resin material such as fluororesin, polyurethane, or polyethylene.

【００１０】このカテーテル本体２には体腔内に挿入さ
れる挿入部３と、この挿入部３の基端部に連結された手
元側の接続口金部４とが設けられている。この接続口金
部４には図示しないシリンジが接続され、薬液等の注入
が行なわれるとともに、例えば図５に示す細径内視鏡、
処置具等の挿入体５が挿通されるようになっている。The catheter body 2 is provided with an insertion portion 3 to be inserted into a body cavity and a proximal connection mouth portion 4 connected to the base end portion of the insertion portion 3. A syringe (not shown) is connected to the connection mouth portion 4 for injecting a drug solution or the like and, for example, a small-diameter endoscope shown in FIG.
An insert body 5 such as a treatment tool is inserted.

【００１１】また、カテーテル本体２の先端側には超弾
性合金材料によって形成された密着コイル状の先端部材
６が連結されている。この先端部材６の基本形状は図１
（Ｂ），（Ｃ）に示すように略先細中空状に形成されて
いる。すなわち、この先端部材６の一端部にはコイルの
内外径がカテーテル本体２の内外径とほぼ同じ寸法とな
るように形成された接続部６ａが形成され、この接続部
６ａがカテーテル本体２の挿入部３の先端部に接続され
ている。さらに、この先端部材６は先端側に向かうに従
ってコイルの内外径が徐々に小さくなる略円錐形状に形
成されており、最先端にはコイルの内外径が最も小さい
小径部６ｂが形成されている。なお、図２はカテーテル
本体２の超弾性合金材料の歪みと応力との関係を示す特
性図である。Further, a distal end side 6 of the catheter main body 2 is connected to a distal end member 6 made of a superelastic alloy material and having a coil shape. The basic shape of this tip member 6 is shown in FIG.
As shown in (B) and (C), it is formed in a substantially tapered hollow shape. That is, a connecting portion 6a is formed at one end of the tip member 6 such that the inner and outer diameters of the coil are substantially the same as the inner and outer diameters of the catheter body 2, and the connecting portion 6a is inserted into the catheter body 2. It is connected to the tip of the part 3. Further, the tip member 6 is formed in a substantially conical shape in which the inner and outer diameters of the coil gradually decrease toward the tip side, and a small diameter portion 6b having the smallest inner and outer diameter of the coil is formed at the tip. 2 is a characteristic diagram showing the relationship between strain and stress of the superelastic alloy material of the catheter body 2.

【００１２】また、先端部材６とカテーテル本体２との
接続部は先端部材６のコイルの端部をカテーテル本体２
に埋め込む状態に成型される構成にしてもよく、また接
着剤によって接続される構成にしてもよい。The connecting portion between the tip member 6 and the catheter body 2 is such that the end portion of the coil of the tip member 6 is connected to the catheter body 2.
The structure may be such that it is molded so as to be embedded in, or the structure may be connected by an adhesive.

【００１３】次に、上記構成の作用について説明する。
ここでは、図３に示すように口から十二指腸７まで挿入
された内視鏡８の先端部のチャンネル開口部からカテー
テル１を外部側に突出させ、このカテーテル１の突出部
を十二指腸乳頭９に挿入し、さらに主膵管１０内に挿入
する一連の作業について説明する。Next, the operation of the above configuration will be described.
Here, as shown in FIG. 3, the catheter 1 is projected to the outside from the channel opening portion of the tip portion of the endoscope 8 inserted from the mouth to the duodenum 7, and the protruding portion of the catheter 1 is inserted into the duodenal papilla 9. Then, a series of operations for inserting the main pancreatic duct 10 will be described.

【００１４】まず、内視鏡８の先端部が口から十二指腸
７まで挿入されたのち、何も挿通されていないカテーテ
ル１がこの内視鏡８の処置具挿通チャンネル内に挿入さ
れる。このカテーテル１は通常、このカテーテル１内に
何も挿通されていない状態ではその先端部材６は略先細
中空状の円錐形状の基本形状で保持される。First, after the distal end of the endoscope 8 is inserted from the mouth to the duodenum 7, the catheter 1 with nothing inserted therein is inserted into the treatment instrument insertion channel of the endoscope 8. Normally, the tip member 6 of the catheter 1 is held in the basic shape of a substantially tapered hollow conical shape when nothing is inserted into the catheter 1.

【００１５】そして、先端部材６が基本形状で保持され
ているカテーテル１が内視鏡８の先端部のチャンネル開
口部から外部側に突出され、このカテーテル１の突出部
が十二指腸乳頭９に挿入される。ここで、カテーテル１
の先端部材６を十二指腸乳頭９に挿入する際には、先端
部材６の先端のコイルの内外径が最も小さい小径部６ｂ
を十二指腸乳頭９に挿入することができるので、カテー
テル１の先端を十二指腸乳頭９に挿入する際の挿入抵抗
を従来に比べて小さくすることができる。そのため、カ
テーテル１の先端を十二指腸乳頭９に挿入する作業を従
来に比べて容易に、かつ安全に行なうことができる。Then, the catheter 1 whose tip member 6 is held in the basic shape is projected outward from the channel opening portion of the tip portion of the endoscope 8, and the projecting portion of this catheter 1 is inserted into the duodenal papilla 9. It Where catheter 1
When inserting the tip member 6 into the duodenal papilla 9, the small-diameter portion 6b having the smallest inner and outer diameters of the coil at the tip of the tip member 6 is inserted.
Since it can be inserted into the duodenal papilla 9, the insertion resistance when inserting the tip of the catheter 1 into the duodenal papilla 9 can be made smaller than in the conventional case. Therefore, the work of inserting the tip of the catheter 1 into the duodenal papilla 9 can be performed more easily and safely than in the conventional case.

【００１６】また、十二指腸乳頭９の開口部から例えば
主膵管１０にカテーテル１が挿入されたのち、例えば細
径の内視鏡、処置具等の挿入体５がカテーテル１の手元
側の接続口金部４からカテーテル本体２の管腔２ａ内に
挿通される。After the catheter 1 is inserted into the main pancreatic duct 10 through the opening of the duodenal papilla 9, for example, an insertion body 5 such as a small-diameter endoscope or a treatment tool is connected to the catheter 1 at the proximal side. 4 is inserted into the lumen 2a of the catheter body 2.

【００１７】そして、この挿入体５がカテーテル本体２
の管腔２ａ内を通してカテーテル本体２の先端側に導か
れ、先端部材６内に挿入されると、図５（Ａ），（Ｂ）
に示すように先端部材６のコイルは挿入体５によって押
し拡げられる。このとき、超弾性合金からなる先端部材
６は非常に柔軟なので、先端部材６のコイルの先細中空
部分はカテーテル本体２の内径寸法と略同径程度まで簡
単に拡開され、カテーテル本体２内に挿入された挿入体
５を先端部材６の外部側に導出させることができる。The insert 5 is used as the catheter body 2.
5 (A), (B) when guided to the distal end side of the catheter main body 2 through the lumen 2a and inserted into the distal end member 6.
The coil of the tip member 6 is expanded by the insert 5 as shown in FIG. At this time, since the tip member 6 made of a superelastic alloy is very flexible, the tapered hollow portion of the coil of the tip member 6 is easily expanded to a diameter substantially the same as the inner diameter of the catheter body 2, and the inside of the catheter body 2 is expanded. The inserted body 5 can be led out to the outside of the tip member 6.

【００１８】そのため、図４に示すように乳頭９開口部
から、例えば主膵管１１に挿入されたカテーテル１の管
腔内１０に手元側から細径の内視鏡等の挿入体５を挿入
し、カテーテル１の先端から突出させることによって主
膵管１１内を観察することが可能となる。Therefore, as shown in FIG. 4, an insertion body 5 such as an endoscope having a small diameter is inserted from the proximal side into the lumen 10 of the catheter 1 inserted into the main pancreatic duct 11 through the opening of the nipple 9. The inside of the main pancreatic duct 11 can be observed by projecting it from the tip of the catheter 1.

【００１９】また、超弾性合金からなる先端部材６は非
常に柔軟で、かつ図２に示す特性図のように形状変化に
対して高い復元性を有しているので、カテーテル本体２
の先端部材６から突出された細径の内視鏡等の挿入体５
を先端部材６内に引き込むことにより、先端部材６は超
弾性合金の特性である高い復元性によって元の円錐形状
に復元する。Further, since the tip member 6 made of a superelastic alloy is very flexible and has a high resilience to a shape change as shown in the characteristic diagram of FIG.
Insertion body 5 such as a small-diameter endoscope protruding from the distal end member 6 of the
By pulling into the tip member 6, the tip member 6 is restored to the original conical shape due to the high resilience characteristic of the superelastic alloy.

【００２０】なお、細径の内視鏡等の挿入体５を挿通さ
せながらカテーテル１の位置をさらに主膵管１０内の深
部に進める時には細径の内視鏡等の挿入体５をカテーテ
ル１の先端部材６の先端よりわずかに引き込め、先端部
材６を元の円錐形状に復元させた状態でカテーテル１を
進ませる。これにより、カテーテル１を進ませる際には
先端部材６が先細状態になり、かつ柔軟となるため屈曲
蛇行を呈する膵管１１に対して安全に、かつ確実に挿入
を進ませることが可能となる。また、本実施例のカテー
テル１は血管内への挿入においても同様の効果が期待で
きる。When the position of the catheter 1 is advanced further into the main pancreatic duct 10 while the insertion body 5 such as an endoscope having a small diameter is inserted, the insertion body 5 such as an endoscope having a small diameter is inserted into the catheter 1. The catheter 1 is advanced while being slightly retracted from the tip of the tip member 6 and the tip member 6 is restored to the original conical shape. As a result, when the catheter 1 is advanced, the distal end member 6 becomes a tapered state and becomes flexible, so that it is possible to safely and surely advance the insertion into the pancreatic duct 11 exhibiting a meandering bend. In addition, the catheter 1 of this embodiment can be expected to have the same effect when inserted into a blood vessel.

【００２１】そこで、上記構成のものにあってはカテー
テル１の先端に超弾性合金材料によって形成され、基本
形状が略先細中空状の密着コイル状の先端部材６を設
け、カテーテル１内に何も挿通されていない状態ではこ
の先端部材６を略先細中空状の基本形状で保持させるよ
うにしたので、カテーテル１内に何も挿通されていない
状態でこのカテーテル１の先端を十二指腸乳頭９に挿入
することにより、活約筋により閉まった乳頭９の開口部
へもカテーテル１の先端部材６を容易に、かつ安全に挿
入することができる。In view of the above, in the above-described structure, a tip end member 6 is formed of a super elastic alloy material at the tip of the catheter 1 and has a basic shape that is a substantially tapered hollow shape. Since the tip member 6 is held in a substantially tapered basic shape when it is not inserted, the tip of the catheter 1 is inserted into the duodenal papilla 9 when nothing is inserted into the catheter 1. As a result, the distal end member 6 of the catheter 1 can be easily and safely inserted into the opening of the papilla 9 closed by the living muscle.

【００２２】さらに、超弾性合金からなる先端部材６は
非常に柔軟なので、例えば細径の内視鏡、処置具等の挿
入体５がカテーテル１の先端部材６内に挿入された際
に、先端部材６のコイルの先細中空部分はカテーテル本
体２の内径寸法と略同径程度まで簡単に拡開され、カテ
ーテル本体２内に挿入された挿入体５を先端部材６の外
部側に導出させることができる。そのため、病変部まで
挿入されたカテーテル１の先端から細径の内視鏡や処置
具等の挿入体５を突出させることによって確実に病変部
まで誘導させることが可能となる。Further, since the tip member 6 made of a superelastic alloy is very flexible, when the insert 5 such as a small-diameter endoscope or a treatment tool is inserted into the tip member 6 of the catheter 1, the tip member 6 is inserted. The tapered hollow portion of the coil of the member 6 is easily expanded to a diameter approximately the same as the inner diameter of the catheter body 2, and the insert 5 inserted in the catheter body 2 can be led out to the outside of the tip member 6. it can. Therefore, it is possible to reliably guide the lesion to the lesion by causing the insertion body 5 such as the endoscope or the treatment instrument having a small diameter to protrude from the tip of the catheter 1 inserted to the lesion.

【００２３】また、図６（Ａ），（Ｂ）は本発明の第２
の実施例を示すものである。これは、カテーテル本体２
の先端側に超弾性合金材料によって形成された粗巻コイ
ル状の先端部材１１を連結させたものである。この先端
部材１１の基本形状は略先細中空状に形成され、この先
端部材１１の一端部にコイルの内外径がカテーテル本体
２の内外径とほぼ同じ寸法となるように形成された接続
部１１ａがカテーテル本体２の挿入部３の先端部に接続
されている。さらに、この先端部材１１は先端側に向か
うに従ってコイルの内外径が徐々に小さくなる略円錐形
状に形成されており、最先端にはコイルの内外径が最も
小さい小径部１１ｂが形成されている。Further, FIGS. 6A and 6B show the second embodiment of the present invention.
FIG. This is the catheter body 2
A tip end member 11 of a roughly wound coil formed of a superelastic alloy material is connected to the tip end side of the. The basic shape of the tip member 11 is formed into a substantially tapered hollow shape, and a connecting portion 11a is formed at one end of the tip member 11 so that the inner and outer diameters of the coil are substantially the same as the inner and outer diameters of the catheter body 2. It is connected to the tip of the insertion portion 3 of the catheter body 2. Further, the tip member 11 is formed in a substantially conical shape in which the inner and outer diameters of the coil gradually decrease toward the tip side, and a small diameter portion 11b having the smallest inner and outer diameter of the coil is formed at the tip.

【００２４】そこで、上記構成のものにあってはカテー
テル１の先端に超弾性合金材料によって形成され、基本
形状が略先細中空状の粗巻コイル状の先端部材１１を設
け、カテーテル１内に何も挿通されていない状態ではこ
の先端部材１１を略先細中空状の基本形状で保持させる
ようにしたので、第１の実施例と同様にカテーテル１内
に何も挿通されていない状態でこのカテーテル１の先端
を十二指腸乳頭９に挿入することにより、活約筋により
閉まった乳頭９の開口部へもカテーテル１の先端部材１
１を容易に、かつ安全に挿入することができる。In view of the above, in the above-described structure, the tip end of the catheter 1 is formed of a superelastic alloy material, and is provided with the tip member 11 in the form of a coarse coil having a substantially tapered hollow basic shape. Even when the catheter 1 is not inserted, the tip member 11 is held in a substantially tapered basic shape. Therefore, like the first embodiment, the catheter 1 is inserted with nothing inserted into the catheter 1. By inserting the tip of the catheter into the duodenal papilla 9, the tip member 1 of the catheter 1 can be inserted into the opening of the papilla 9 closed by the activating muscle.
1 can be easily and safely inserted.

【００２５】さらに、超弾性合金からなる先端部材１１
は非常に柔軟なので、例えば細径の内視鏡、処置具等の
挿入体５がカテーテル１の先端部材１１内に挿入された
際に、先端部材１１のコイルの先細中空部分はカテーテ
ル本体２の内径寸法と略同径程度まで簡単に拡開され、
カテーテル本体２内に挿入された挿入体５を先端部材１
１の外部側に導出させることができ、病変部まで挿入さ
れたカテーテル１の先端から細径の内視鏡や処置具等の
挿入体５を突出させることによって確実に病変部まで誘
導させることが可能となる。Further, the tip member 11 made of superelastic alloy
Is very flexible, so that when the insertion body 5 such as a small-diameter endoscope or treatment instrument is inserted into the distal end member 11 of the catheter 1, the tapered hollow portion of the coil of the distal end member 11 is It can be easily expanded to about the same diameter as the inner diameter,
The insertion member 5 inserted into the catheter body 2 is attached to the tip member 1
1 can be guided to the outside of the lesion 1 and can be reliably guided to the lesion by protruding the insertion body 5 such as a thin endoscope or a treatment instrument from the tip of the catheter 1 that has been inserted to the lesion. It will be possible.

【００２６】また、図７（Ａ）乃至図１０（Ｂ）は上述
したカテーテル１とは異なる構成の第１の変形例のカテ
ーテル２１を示すものである。このカテーテル２１には
図７（Ａ），（Ｂ）に示すように弾性を有する素材から
なる可撓性のカテーテル本体２２の先端に密着コイル形
状の先端部材２３が接続されている。Further, FIGS. 7A to 10B show a catheter 21 of a first modification having a structure different from that of the catheter 1 described above. As shown in FIGS. 7 (A) and 7 (B), the catheter 21 is connected to a distal end of a flexible catheter body 22 made of an elastic material, and a tip member 23 in the form of a close contact coil.

【００２７】さらに、先端部材２３の密着コイル２４内
にはこのコイル２４の伸びを規制するワイヤ状の規制部
材２５がこのコイル２４の軸心方向に沿って取付けられ
ている。この規制部材２５は金属線材からなり、先端部
材２３の曲げ方向には可撓性を有し、コイル２４の軸心
方向には剛性を有するものとなっている。なお、規制部
材２５は先端部材２３のコイル２４に対してその両端で
のみ接続されて取付けられる構成にしてもよく、また、
規制部材２５の全体がコイル２４の全長に亙り接続され
て取付けられる構成にしてもよい。Further, a wire-shaped restricting member 25 for restricting the extension of the coil 24 is mounted in the close contact coil 24 of the tip member 23 along the axial direction of the coil 24. The restriction member 25 is made of a metal wire, has flexibility in the bending direction of the tip member 23, and has rigidity in the axial direction of the coil 24. The regulation member 25 may be attached to the coil 24 of the tip member 23 by being connected only at both ends thereof.
The entire restricting member 25 may be connected and attached over the entire length of the coil 24.

【００２８】また、先端部材２３の先端部には内部側に
向けて突起２６が突設されている。この突起２６は先端
部材２３のコイル２４内における規制部材２５の取付け
位置に対して対向する位置に取付けられている。A projection 26 is provided at the tip of the tip member 23 so as to extend inward. The protrusion 26 is mounted at a position facing the mounting position of the regulating member 25 in the coil 24 of the tip member 23.

【００２９】また、図８はカテーテル２１内に挿入され
る挿入体の一種である生検鉗子２７の先端部分を示すも
のである。この生検鉗子２７には挿入部２８の先端部に
先端部材２９が取付けられている。この先端部材２９の
先端部には開閉操作可能な略カップ状の一対の開閉部材
３０ａ，３０ｂを備えた処置部３０が設けられている。FIG. 8 shows the distal end portion of the biopsy forceps 27 which is a kind of insert body inserted into the catheter 21. A tip member 29 is attached to the tip of an insertion portion 28 of the biopsy forceps 27. The distal end of the distal end member 29 is provided with a treatment section 30 provided with a pair of opening and closing members 30a and 30b that can be opened and closed.

【００３０】さらに、この先端部材２９の基端部にはカ
テーテル２１の先端部材２３における密着コイル２４の
突起２６と係合する略円形フランジ状の操作突部３１が
突設されている。この操作突部３１はカテーテル２１の
内部に生検鉗子２７が挿通され、この生検鉗子２７の先
端部がカテーテル２１の先端部材２３から外部側に突出
される際に密着コイル２４の突起２６と当接して係合す
るように構成されている。Further, a substantially circular flange-shaped operation projection 31 that engages with the projection 26 of the contact coil 24 of the distal end member 23 of the catheter 21 is provided at the proximal end of the distal end member 29. The biopsy forceps 27 is inserted into the inside of the catheter 21 in the operation projection 31, and when the tip of the biopsy forceps 27 is projected from the tip member 23 of the catheter 21 to the outside, It is configured to abut and engage.

【００３１】次に、上記構成の作用について説明する。
まず、カテーテル２１内に細径の内視鏡等の挿入体５、
或いは図８の生検鉗子２７を挿通した場合には細径の内
視鏡等の挿入体５の先端面、或いは図８の生検鉗子２７
の操作突部３１に先端部材２３の突起２６が当接する。
この状態で、さらに手元側から細径の内視鏡等の挿入体
５や、生検鉗子２７を押し込むと突起２６に挿入体５の
押し込み方向の負荷がかかり、先端部材２３のコイル２
４はこの突起２６を介して軸心方向に伸びる方向に押圧
される。Next, the operation of the above configuration will be described.
First, the insertion body 5 such as a small-diameter endoscope is inserted into the catheter 21,
Alternatively, when the biopsy forceps 27 of FIG. 8 is inserted, the distal end surface of the insertion body 5 such as an endoscope having a small diameter, or the biopsy forceps 27 of FIG.
The projection 26 of the tip member 23 abuts on the operation projection 31.
In this state, if the insert body 5 such as an endoscope having a smaller diameter or the biopsy forceps 27 is further pushed from the proximal side, a load is applied to the protrusion 26 in the pushing direction of the insert body 5, and the coil 2 of the distal end member 23.
4 is pressed through the protrusion 26 in a direction extending in the axial direction.

【００３２】このとき、先端部材２３のコイル２４は突
起２６の位置に対して対向する位置側では規制部材２５
によってコイル２４の伸びが規制される。そのため、先
端部材２３のコイル２４は図１０（Ａ），（Ｂ）に示す
ようにカテーテル２１内に挿通される細径の内視鏡等の
挿入体５や、生検鉗子２７とともに、規制部材２５の取
付け側を内側とする方向に湾曲する。なお、細径の内視
鏡等の挿入体５や、生検鉗子２７にかけられる負荷を減
少、もしくは除去すると先端部材２３はコイル２４の弾
性力により元の直線形状に復帰する。At this time, the coil 24 of the tip member 23 is located at the position opposite to the position of the protrusion 26 at the regulating member 25.
The expansion of the coil 24 is regulated by. Therefore, as shown in FIGS. 10A and 10B, the coil 24 of the distal end member 23, together with the biopsy forceps 27 and the insertion member 5 such as an endoscope having a small diameter inserted into the catheter 21, together with the restriction member. Bend in the direction in which the mounting side of 25 is the inside. When the load applied to the insert body 5 such as an endoscope having a small diameter or the biopsy forceps 27 is reduced or removed, the tip end member 23 returns to the original linear shape by the elastic force of the coil 24.

【００３３】そこで、上記構成のものにあってはカテー
テル２１内に挿通させた細径の内視鏡等の挿入体５や、
生検鉗子２７を手元側で押し引き操作することによって
カテーテル２１の先端を所定の方向に任意の角度で湾曲
させることができる。Therefore, in the case of the above-mentioned structure, the insertion body 5 such as an endoscope having a small diameter inserted through the catheter 21,
By pushing and pulling the biopsy forceps 27 on the proximal side, the tip of the catheter 21 can be bent in a predetermined direction at an arbitrary angle.

【００３４】また、図９は本変形例のカテーテル２１を
第１の実施例と同様に口から十二指腸７まで挿入された
内視鏡８のチャンネル内に挿通し、この内視鏡８の先端
部のチャンネル開口部からカテーテル２１の先端部を外
部側に突出させ、このカテーテル２１の突出部を十二指
腸乳頭９に挿入し、さらに主膵管１０内に挿入した状態
を示すものである。Further, FIG. 9 shows that the catheter 21 of this modification is inserted into the channel of the endoscope 8 inserted from the mouth to the duodenum 7 as in the first embodiment, and the distal end portion of the endoscope 8 is inserted. The distal end portion of the catheter 21 is projected to the outside from the channel opening portion, and the protruding portion of the catheter 21 is inserted into the duodenal papilla 9 and further inserted into the main pancreatic duct 10.

【００３５】そして、このカテーテル２１内に細径内視
鏡等の挿入体５を挿通して主膵管１０内の観察を行う場
合、主膵管１０の管腔は細く、また屈曲蛇行を呈するこ
とが多いため通常では管腔視野を得ることが困難な場合
がある。この場合には細径内視鏡５の押し引き操作でカ
テーテル２１の先端を湾曲させることにより、細径内視
鏡５の視野方向を変化させて主膵管１０の管腔視野を得
ることができる。When the inside of the main pancreatic duct 10 is observed by inserting the insertion body 5 such as a thin endoscope into the catheter 21, the lumen of the main pancreatic duct 10 may be thin and exhibit a meandering bend. It is often difficult to obtain a luminal field because of the large number. In this case, by bending the tip of the catheter 21 by pushing and pulling the thin endoscope 5, the visual field direction of the thin endoscope 5 can be changed to obtain the luminal visual field of the main pancreatic duct 10. .

【００３６】また、図１１（Ａ），（Ｂ）は第１の変形
例のカテーテル２１をさらに変形させた第２の変形例を
示すものである。この第２の変形例のカテーテル２１の
先端部材２３のコイル２４には図１１（Ａ）に示すよう
に予め湾曲された湾曲部４１が形成されている。この湾
曲部４１には規制部材２５が湾曲の外側となる方向に配
置されている。FIGS. 11A and 11B show a second modification in which the catheter 21 of the first modification is further modified. In the coil 24 of the distal end member 23 of the catheter 21 of the second modified example, a curved portion 41 that is curved in advance is formed as shown in FIG. 11 (A). The restricting member 25 is arranged on the curving portion 41 in a direction on the outer side of the curving.

【００３７】そして、カテーテル２１内に細径の内視鏡
等の挿入体５、或いは図８の生検鉗子２７を挿通させ、
細径の内視鏡等の挿入体５の先端面、或いは図８の生検
鉗子２７の操作突部３１を先端部材２３の突起２６に当
接させた状態で、さらに手元側から細径の内視鏡等の挿
入体５や、生検鉗子２７を押し込むことにより、図１１
（Ｂ）に示すように先端部材２３の湾曲部４１をあらか
じめ湾曲している図１１（Ａ）の湾曲方向とは逆方向に
湾曲させることができる。そのため、この場合にはカテ
ーテル２１内に挿入される細径内視鏡等の挿入体５や、
生検鉗子２７の押し引き調整によって図１１（Ａ）の湾
曲方向、または図１１（Ｂ）の湾曲方向の２方向への湾
曲制御が可能になる。Then, the insertion body 5 such as an endoscope having a small diameter or the biopsy forceps 27 shown in FIG. 8 is inserted into the catheter 21,
With the distal end surface of the insert body 5 such as an endoscope having a small diameter or the operating projection 31 of the biopsy forceps 27 of FIG. By pushing in the insert body 5 such as an endoscope or the biopsy forceps 27, FIG.
As shown in FIG. 11B, the bending portion 41 of the tip member 23 can be bent in a direction opposite to the bending direction of FIG. Therefore, in this case, the insertion body 5 such as a small-diameter endoscope to be inserted into the catheter 21,
By adjusting the push and pull of the biopsy forceps 27, it is possible to control bending in two directions, that is, the bending direction of FIG. 11A or the bending direction of FIG. 11B.

【００３８】また、図１２乃至図１４（Ｂ）は第３の変
形例のカテーテル５１を示すものである。このカテーテ
ル５１には可撓性を有するカテーテル本体５２の先端に
図１２に示すように略Ｖ字形の切り込み部５３が形成さ
れている。12 to 14B show a catheter 51 of a third modified example. In this catheter 51, a substantially V-shaped cut portion 53 is formed at the tip of a flexible catheter body 52 as shown in FIG.

【００３９】さらに、カテーテル本体５２にはＶ字形の
切り込み部５３の両側の対向する一対の切り込み端部５
４ａ，５４ｂ間に温度変化に応じて伸縮する形状記憶合
金線材（以下、ＳＭＡワイヤと称する）５５が架設され
ている。Further, in the catheter body 52, a pair of facing cut ends 5 on both sides of a V-shaped cut portion 53 are provided.
A shape memory alloy wire rod (hereinafter referred to as SMA wire) 55 that expands and contracts according to temperature changes is installed between 4a and 54b.

【００４０】また、各ＳＭＡワイヤ５５の両端はカテー
テル本体５２内に埋め込まれ、カテーテル本体５２の後
方に向けてこのカテーテル５１の軸心方向に沿っ延設さ
れている。さらに、ＳＭＡワイヤ５５の両端部は接続部
材５６を介して通電リード線５７の一端部に接線されて
いる。このリード線５７はカテーテル本体５２の手元側
まで延設されている。Both ends of each SMA wire 55 are embedded in the catheter body 52, and extend toward the rear of the catheter body 52 along the axial direction of the catheter 51. Further, both ends of the SMA wire 55 are tangentially connected to one end of the conducting lead wire 57 via the connecting member 56. The lead wire 57 extends to the proximal side of the catheter body 52.

【００４１】さらに、カテーテル５１の手元側にはリー
ド線５７の他端部に接続される図示しない通電制御部が
設けられ、術者の操作によってＳＭＡワイヤ５５に選択
的に通電できるよう構成される。なお、ＳＭＡワイヤ５
５には図示しない絶縁被膜が形成されている。そして、
各ＳＭＡワイヤ５５への非通電時にはカテーテル本体５
２の先端の切り込み部５３が開いた状態で保持されると
ともに、各ＳＭＡワイヤ５５への通電時には各ＳＭＡワ
イヤ５５の非通電時よりもその長さが収縮する状態に変
形し、各ＳＭＡワイヤ５５の収縮動作にともないカテー
テル本体５２の先端の切り込み部５３が閉じられるよう
になっている。Further, an unillustrated energization controller connected to the other end of the lead wire 57 is provided on the proximal side of the catheter 51 so that the SMA wire 55 can be selectively energized by an operator's operation. . In addition, SMA wire 5
An insulating coating film (not shown) is formed on 5. And
When the SMA wire 55 is not energized, the catheter body 5
The notch portion 53 at the tip of 2 is held in an open state, and when each SMA wire 55 is energized, it is deformed into a state in which its length contracts more than when the SMA wire 55 is not energized. The notch 53 at the tip of the catheter main body 52 is closed along with the contraction operation of.

【００４２】また、カテーテル本体５２は手元側に接続
される図示しない接続口金から先端に至るまで管腔が形
成されており、この管腔には細径の内視鏡等の挿入体５
が挿通可能となっている。Further, the catheter body 52 has a lumen formed from a connection mouthpiece (not shown) connected to the proximal side to a tip thereof, and the insertion body 5 such as an endoscope having a small diameter is formed in the lumen.
Can be inserted.

【００４３】次に、上記構成の作用について説明する。
まず、カテーテル本体５２のＳＭＡワイヤ５５への非通
電時にはカテーテル本体５２の先端の切り込み部５３が
開いた状態で保持される。Next, the operation of the above configuration will be described.
First, when the SMA wire 55 of the catheter body 52 is not energized, the notch 53 at the tip of the catheter body 52 is held in an open state.

【００４４】また、カテーテル本体５２の手元側で通電
制御部を操作し、リード線５７を通じてＳＭＡワイヤ５
５に通電された場合にはこのＳＭＡワイヤ５５が通電加
熱され、図１３に示すＳＭＡワイヤ５５の加熱温度と収
縮量との関係を示す特性曲線に沿ってこのＳＭＡワイヤ
５５がカテーテル本体５２の軸心方向に沿って収縮動作
を始める。このとき、カテーテル本体５２の先端に設け
られる切り込み部５３はＳＭＡワイヤ５５の収縮による
長さ変化によって切り込み部５３が閉じられる状態に変
形する。In addition, the energization controller is operated on the proximal side of the catheter main body 52, and the SMA wire 5 is passed through the lead wire 57.
When the SMA wire 55 is energized, the SMA wire 55 is energized and heated, and the SMA wire 55 moves along the axis of the catheter body 52 along a characteristic curve showing the relationship between the heating temperature of the SMA wire 55 and the shrinkage amount shown in FIG. A contraction motion is started along the direction of the heart. At this time, the notch 53 provided at the tip of the catheter main body 52 is deformed into a state in which the notch 53 is closed due to the change in length due to the contraction of the SMA wire 55.

【００４５】そして、ＳＭＡワイヤ５５への通電量を減
少、あるいは通電を止めるとＳＭＡワイヤ５５の温度は
放冷されて低下する。そのため、カテーテル本体５２の
切り込み部５３はカテーテル本体５２自体の弾性力によ
って元の形状に戻り、ＳＭＡワイヤ５５も元の形状に戻
る。When the amount of electricity supplied to the SMA wire 55 is reduced or the electricity supply is stopped, the temperature of the SMA wire 55 is left to cool and falls. Therefore, the notch 53 of the catheter body 52 returns to its original shape due to the elastic force of the catheter body 52 itself, and the SMA wire 55 also returns to its original shape.

【００４６】また、上記カテーテル５１の使用方法につ
いて図１４（Ａ），（Ｂ）を参照して説明する。まず、
図１４（Ａ）に示すように細径の内視鏡５８が挿通され
たカテーテル５２を体腔内の病変部５９の近傍まで挿入
する。この状態で、細径の内視鏡５８によって観察・診
断を行った後、細径の内視鏡５８を図１４（Ｂ）中に破
線で示すようにカテーテル本体５２の管腔内まで引き込
む。A method of using the catheter 51 will be described with reference to FIGS. 14 (A) and 14 (B). First,
As shown in FIG. 14 (A), the catheter 52, into which the thin endoscope 58 is inserted, is inserted up to the vicinity of the lesioned part 59 in the body cavity. In this state, after the observation and diagnosis are performed by the thin endoscope 58, the thin endoscope 58 is pulled into the lumen of the catheter main body 52 as shown by the broken line in FIG. 14 (B).

【００４７】このように細径の内視鏡５８がカテーテル
本体５２の管腔内まで引き込まれた状態で続いて、図１
４（Ｂ）に示すようにカテーテル５１の先端を病変部５
９に押し付ける。In this state, the thin endoscope 58 is drawn into the lumen of the catheter main body 52, and then, as shown in FIG.
As shown in FIG.
Press on 9.

【００４８】そして、手元側での通電制御部を操作する
ことでＳＭＡワイヤ５５を通電加熱させ、ＳＭＡワイヤ
５５の収縮に伴うカテーテル本体５２の切り込み部５３
が閉じる動作によって病変部５９の組織の採取を行な
う。The SMA wire 55 is energized and heated by operating the energization control section on the hand side, and the cut section 53 of the catheter body 52 accompanying the contraction of the SMA wire 55 is generated.
The tissue of the lesioned part 59 is collected by the closing operation of.

【００４９】そこで、上記構成のカテーテル５１を用い
れば細径の内視鏡５８を病変部５９まで誘導した後、挿
入されたカテーテル５１や内視鏡５８を抜き替えること
なしに病変部５９の組織の採取を行なうことができる。Therefore, if the catheter 51 having the above-mentioned configuration is used, after guiding the thin endoscope 58 to the lesioned part 59, the tissue of the lesioned part 59 can be removed without replacing the inserted catheter 51 or endoscope 58. Can be collected.

【００５０】なお、上記第３の変形例のカテーテル５１
ではカテーテル本体５２の先端に略Ｖ字形の切り込み部
５３を形成した構成のものを示したが、図１５（Ａ）〜
（Ｃ）に示す第４の変形例のカテーテル６１のようにカ
テーテル本体５２の先端近傍の外周面に略Ｖ字形の切り
込み部６３を形成する構成にしてもよい。Incidentally, the catheter 51 of the third modified example.
In FIG. 15 (A), although a structure in which a substantially V-shaped cut portion 53 is formed at the tip of the catheter body 52 is shown in FIG.
Like the catheter 61 of the fourth modification shown in (C), a substantially V-shaped notch 63 may be formed on the outer peripheral surface near the tip of the catheter body 52.

【００５１】この場合、カテーテル本体６２にはＶ字形
の切り込み部６３の両側の対向する一対の切り込み端部
６４ａ，６４ｂ間に温度変化に応じて伸縮する形状記憶
合金線材（以下、ＳＭＡワイヤと称する）６５が架設さ
れている。In this case, in the catheter body 62, a shape memory alloy wire rod (hereinafter referred to as SMA wire) which expands and contracts between a pair of opposing cut end portions 64a and 64b on both sides of the V-shaped cut portion 63 according to temperature change. ) 65 is installed.

【００５２】また、各ＳＭＡワイヤ６５の両端はカテー
テル本体６２内に埋め込まれ、カテーテル本体６２の後
方に向けてこのカテーテル６１の軸心方向に沿っ延設さ
れている。さらに、ＳＭＡワイヤ６５の両端部は接続部
材６６を介して通電リード線６７の一端部に接線されて
いる。このリード線６７はカテーテル本体６２の手元側
まで延設されている。Both ends of each SMA wire 65 are embedded in the catheter body 62, and extend toward the rear of the catheter body 62 along the axial direction of the catheter 61. Further, both ends of the SMA wire 65 are tangentially connected to one end of the energization lead wire 67 via the connecting member 66. The lead wire 67 extends to the proximal side of the catheter body 62.

【００５３】さらに、カテーテル６１の手元側にはリー
ド線６７の他端部に接続される図示しない通電制御部が
設けられ、術者の操作によってＳＭＡワイヤ６５に選択
的に通電できるよう構成される。そして、各ＳＭＡワイ
ヤ６５への非通電時にはカテーテル本体６２の切り込み
部６３が開いた状態で保持されるとともに、各ＳＭＡワ
イヤ６５への通電時には各ＳＭＡワイヤ６５の非通電時
よりもその長さが収縮する状態に変形し、各ＳＭＡワイ
ヤ６５の収縮動作にともないカテーテル本体６２の先端
の切り込み部６３が閉じられるようになっている。Further, an unillustrated energization controller connected to the other end of the lead wire 67 is provided on the proximal side of the catheter 61 so that the SMA wire 65 can be selectively energized by an operator's operation. . When the SMA wire 65 is not energized, the notch 63 of the catheter body 62 is held in an open state, and when the SMA wire 65 is energized, its length is longer than that when the SMA wire 65 is not energized. It is transformed into a contracted state, and the notch 63 at the tip of the catheter body 62 is closed as the SMA wire 65 contracts.

【００５４】また、上記構成のカテーテル６１の使用時
には図１５（Ｂ）に示すように細径の内視鏡５８が挿通
されたカテーテル６２を体腔内の病変部５９の近傍まで
挿入し、この状態で、細径の内視鏡５８によって観察・
診断を行った後、細径の内視鏡５８を図１５（Ｃ）中に
破線で示すようにカテーテル本体６２の管腔内まで引き
込む。このとき、内視鏡５８はカテーテル本体６２の切
り込み部６３の後方位置まで引き込まれる。Further, when the catheter 61 having the above-mentioned structure is used, as shown in FIG. 15B, the catheter 62 having the thin endoscope 58 inserted therein is inserted up to the vicinity of the lesioned part 59 in the body cavity, and this state Then, observe with a small-diameter endoscope 58.
After the diagnosis is performed, the thin endoscope 58 is retracted into the lumen of the catheter main body 62 as indicated by a broken line in FIG. At this time, the endoscope 58 is retracted to the rear position of the notch 63 of the catheter body 62.

【００５５】このように細径の内視鏡５８がカテーテル
本体５２の管腔内の切り込み部６３の後方位置まで引き
込まれた状態で続いて、図１５（Ｃ）に示すようにカテ
ーテル６１の先端部外周面の切り込み部６３の部分を病
変部５９に押し付ける。In this state, the thin endoscope 58 is retracted to the rear position of the notch 63 in the lumen of the catheter body 52, and then the distal end of the catheter 61 as shown in FIG. 15C. The cutout portion 63 on the outer peripheral surface is pressed against the lesion portion 59.

【００５６】そして、手元側での通電制御部を操作する
ことでＳＭＡワイヤ６５を通電加熱させ、ＳＭＡワイヤ
６５の収縮に伴うカテーテル本体６２の切り込み部６３
が閉じる動作によって病変部５９の組織の採取を行な
う。Then, the SMA wire 65 is electrically heated by operating the energization control unit on the hand side, and the cut portion 63 of the catheter body 62 due to the contraction of the SMA wire 65.
The tissue of the lesioned part 59 is collected by the closing operation of.

【００５７】そこで、上記構成のカテーテル６１を用い
れば第３の変形例のカテーテル５１と同様に細径の内視
鏡５８を病変部５９まで誘導した後、挿入されたカテー
テル６１や内視鏡５８を抜き替えることなしに病変部５
９の組織の採取を行なうことができる。Therefore, if the catheter 61 having the above-mentioned structure is used, like the catheter 51 of the third modification, a thin-diameter endoscope 58 is guided to the lesion portion 59, and then the inserted catheter 61 or endoscope 58 is used. Lesion 5 without replacing
Nine tissues can be harvested.

【００５８】また、図１６（Ａ）は内視鏡７１の挿入部
７２の先端部分を示すものである。この挿入部７２の先
端部分には図１７（Ａ）に示すように湾曲ユニット７６
が着脱可能に装着される略円環状の段差部７３が形成さ
れている。ここで、挿入部７２はマルチルーメンチュー
ブによって形成されている。そして、挿入部７２の先端
部分における段差部７３の内側の小径部７４には光学系
チャンネル等の複数のチャンネル７５…が形成されてい
る。FIG. 16A shows the tip portion of the insertion portion 72 of the endoscope 71. As shown in FIG. 17A, the bending unit 76 is provided at the tip of the insertion portion 72.
A step portion 73 having a substantially annular shape is detachably mounted. Here, the insertion portion 72 is formed by a multi-lumen tube. A plurality of channels 75, etc., such as optical system channels, are formed in the small diameter portion 74 inside the step portion 73 at the tip portion of the insertion portion 72.

【００５９】さらに、湾曲ユニット７６には図１７
（Ｂ）に示すようにマルチルーメンチューブからなるユ
ニット本体７７が設けられている。このユニット本体７
７には軸心部位に挿入部７２の先端部分の小径部７４が
挿入される円孔７８が形成されているとともに、この円
孔７８の周囲に３つの略円弧形状のルーメン７９…が形
成されている。なお、３つのルーメン７９…の先端開口
部は気密状態に閉塞されている。Further, the bending unit 76 is shown in FIG.
As shown in (B), a unit body 77 made of a multi-lumen tube is provided. This unit body 7
7, a circular hole 78 into which the small diameter portion 74 of the distal end portion of the insertion portion 72 is inserted is formed in the axial center portion, and three substantially arcuate lumens 79 ... Are formed around the circular hole 78. ing. The distal end openings of the three lumens 79 ... Are closed in an airtight state.

【００６０】また、内視鏡７１の挿入部７２には３つの
送気用チューブ８０が配設されている。これらの送気用
チューブ８０の先端部は挿入部７２の段差部７３内に突
設されている。そして、湾曲ユニット７６のユニット本
体７７が挿入部７２の先端部分の段差部７３内に装着さ
れた状態で各チューブ８０の先端突設部が湾曲ユニット
７６の各ルーメン７９内に挿入されて連通されるように
なっている。Further, three air supply tubes 80 are arranged in the insertion portion 72 of the endoscope 71. The tips of these air supply tubes 80 are provided so as to project into the stepped portion 73 of the insertion portion 72. Then, with the unit main body 77 of the bending unit 76 mounted in the stepped portion 73 of the distal end portion of the insertion portion 72, the distal protruding portion of each tube 80 is inserted into each lumen 79 of the bending unit 76 and communicated with each other. It has become so.

【００６１】さらに、湾曲ユニット７６のユニット本体
７７と挿入部７２の先端部分との連結部には挿入部７２
の外径寸法よりも小径なＣリング状の締結部材８１が取
付けられている。そして、この締結部材８１によって図
１６（Ｂ）に示すように湾曲ユニット７６のユニット本
体７７の各ルーメン７９が圧潰され、挿入部７２の送気
用チューブ８０と湾曲ユニット７６の各ルーメン７９と
の間が連通された状態で湾曲ユニット７６のユニット本
体７７と挿入部７２の先端部分との連結部が気密に連結
されている。Further, the insertion portion 72 is provided at the connecting portion between the unit main body 77 of the bending unit 76 and the tip portion of the insertion portion 72.
A C-ring-shaped fastening member 81 having a smaller diameter than the outer diameter dimension of is attached. 16B, each lumen 79 of the unit main body 77 of the bending unit 76 is crushed by the fastening member 81, and the air supply tube 80 of the insertion portion 72 and each lumen 79 of the bending unit 76 are crushed. The connecting portion between the unit main body 77 of the bending unit 76 and the distal end portion of the insertion portion 72 is airtightly connected in a state where the spaces are communicated.

【００６２】また、図１８は内視鏡７１の挿入部７２と
湾曲ユニット７６との連結部の変形例を示すものであ
る。本変形例には挿入部７２の先端部分における段差部
７３の外周部位に延出される円環状の連結部９１が突設
され、この連結部９１の内周面に雌ねじ部９２が形成さ
れている。さらに、この連結部９１の雌ねじ部９２には
連結リング９３の外周面に形成された雄ねじ部９４が着
脱可能に螺着されている。この連結リング９３の内周面
側にはシリコンゴムからなるゴムリング９５が形成され
ている。FIG. 18 shows a modification of the connecting portion between the insertion portion 72 of the endoscope 71 and the bending unit 76. In this modification, an annular connecting portion 91 extending from the outer peripheral portion of the step portion 73 at the tip portion of the insertion portion 72 is provided in a protruding manner, and an internal thread portion 92 is formed on the inner peripheral surface of the connecting portion 91. . Further, a male screw portion 94 formed on the outer peripheral surface of the connecting ring 93 is detachably screwed to the female screw portion 92 of the connecting portion 91. A rubber ring 95 made of silicon rubber is formed on the inner peripheral surface side of the connecting ring 93.

【００６３】そして、内視鏡７１の挿入部７２と湾曲ユ
ニット７６との連結時には連結リング９３のねじ込み操
作にともないゴムリング９５が内側に膨らみ、これによ
って湾曲ユニット７６のユニット本体７７の各ルーメン
７９が圧潰され、挿入部７２の送気用チューブ８０と湾
曲ユニット７６の各ルーメン７９との間が連通された状
態で湾曲ユニット７６のユニット本体７７と挿入部７２
の先端部分との連結部が気密に連結されるようになって
いる。なお、本発明は上記実施例に限定されるものでは
なく、本発明の要旨を逸脱しない範囲で種々変形実施で
きることは勿論である。At the time of connecting the insertion portion 72 of the endoscope 71 and the bending unit 76, the rubber ring 95 swells inward as the connecting ring 93 is screwed in, whereby each lumen 79 of the unit body 77 of the bending unit 76. Is crushed and the air supply tube 80 of the insertion portion 72 and the lumens 79 of the bending unit 76 are in communication with each other, the unit main body 77 of the bending unit 76 and the insertion portion 72 are connected.
The connecting portion with the tip end of the is airtightly connected. It should be noted that the present invention is not limited to the above-mentioned embodiments, and it is needless to say that various modifications can be made without departing from the gist of the present invention.

【００６４】[0064]

【発明の効果】本発明によれば管状挿入具本体の先端に
連結され、基本形状が略先細中空状に形成された先端部
材を基本形状から管状挿入具本体の内径寸法と略同径程
度に拡開させた拡開状態まで弾性変形可能な超弾性合金
材料によって形成し、管状挿入具本体内を通して先端部
材に挿入される挿入体の挿入動作にともない先端部材を
拡開可能にしたので、活約筋により閉まった乳頭開口部
へも管状挿入具本体の先端部を容易に、かつ安全に挿入
することができ、かつ胆管、膵管内へ選択的に挿入して
細径の内視鏡や処置具を体内の病変部まで確実に誘導さ
せることができる。According to the present invention, the tip member, which is connected to the tip of the tubular inserter body and has a basic shape formed into a substantially tapered hollow, is made to have a diameter approximately the same as the inner diameter of the tubular inserter body from the basic shape. It is made of a super-elastic alloy material that can be elastically deformed to the expanded state, and the tip member can be expanded with the insertion operation of the insert body inserted into the tip member through the tubular inserter body. The distal end of the tubular inserter body can be easily and safely inserted into the nipple opening that is closed by the sphincter muscles, and can be selectively inserted into the bile duct or pancreatic duct to provide a thin endoscope or treatment. The tool can be reliably guided to a lesion in the body.

【図面の簡単な説明】[Brief description of drawings]

【図１】 本発明の第１の実施例を示すもので、（Ａ）
はカテーテル全体の概略構成を示す斜視図、（Ｂ）はカ
テーテルの先端部分を示す斜視図、（Ｃ）は同縦断面
図。FIG. 1 shows a first embodiment of the present invention (A)
Is a perspective view showing a schematic configuration of the entire catheter, (B) is a perspective view showing a distal end portion of the catheter, and (C) is a longitudinal sectional view thereof.

【図２】 管状挿入具本体の超弾性合金材料の歪みと応
力との関係を示す特性図。FIG. 2 is a characteristic diagram showing the relationship between strain and stress of the superelastic alloy material of the tubular insert body.

【図３】 十二指腸まで挿入された内視鏡からカテーテ
ルを十二指腸乳頭に挿入する状態を示す縦断面図。FIG. 3 is a vertical cross-sectional view showing a state in which a catheter is inserted into the duodenal papilla from an endoscope inserted up to the duodenum.

【図４】 乳頭の開口部から主膵管に挿入されたカテー
テル内に挿入された細径の内視鏡によって主膵管内を観
察する状態を示す縦断面図。FIG. 4 is a vertical cross-sectional view showing a state in which the inside of the main pancreatic duct is observed by an endoscope having a small diameter inserted into a catheter inserted into the main pancreatic duct from an opening portion of the papilla.

【図５】 カテーテル内に細径の内視鏡が挿入された状
態を示すもので、（Ａ）はカテーテルの先端部分を示す
斜視図、（Ｂ）は同縦断面図。5A and 5B show a state in which a small-diameter endoscope is inserted into the catheter, wherein FIG. 5A is a perspective view showing the distal end portion of the catheter, and FIG.

【図６】 本発明の第２の実施例を示すもので、（Ａ）
はカテーテルの先端部分を示す斜視図、（Ｂ）は同縦断
面図。FIG. 6 shows a second embodiment of the present invention (A)
Is a perspective view showing the distal end portion of the catheter, and FIG.

【図７】 第１の変形例のカテーテルを示すもので、
（Ａ）はカテーテルの先端部分を示す斜視図、（Ｂ）は
同縦断面図。FIG. 7 shows a catheter of a first modified example,
(A) is a perspective view showing the distal end portion of the catheter, and (B) is a longitudinal sectional view thereof.

【図８】 カテーテル内に挿入される生検鉗子の先端部
分を示す側面図。FIG. 8 is a side view showing the distal end portion of the biopsy forceps inserted into the catheter.

【図９】 主膵管に挿入されたカテーテルの先端部の湾
曲動作状態を示す縦断面図。FIG. 9 is a vertical cross-sectional view showing a bending operation state of a distal end portion of a catheter inserted into a main pancreatic duct.

【図１０】 カテーテルの先端部の湾曲動作状態を示す
もので、（Ａ）はカテーテルの先端部分を示す斜視図、
（Ｂ）は同縦断面図。FIG. 10 is a perspective view showing a distal end portion of the catheter, showing a bending operation state of the distal end portion of the catheter;
(B) is the same longitudinal cross-sectional view.

【図１１】 第２の変形例のカテーテルを示すもので、
（Ａ）はカテーテルの先端部の縦断面図、（Ｂ）はカテ
ーテルの先端部の逆方向への湾曲状態を示す縦断面図。FIG. 11 shows a catheter of a second modified example,
(A) is a vertical cross-sectional view of the distal end portion of the catheter, and (B) is a vertical cross-sectional view showing a curved state of the distal end portion of the catheter in the opposite direction.

【図１２】 第３の変形例のカテーテルを示す要部の斜
視図。FIG. 12 is a perspective view of a main part showing a catheter of a third modified example.

【図１３】 ＳＭＡワイヤの加熱温度と収縮量との関係
を示す特性図。FIG. 13 is a characteristic diagram showing the relationship between the heating temperature of an SMA wire and the amount of shrinkage.

【図１４】 カテーテルの使用状態を示すもので、
（Ａ）は体腔内の病変部の近傍まで挿入されたカテーテ
ル内に挿通された細径の内視鏡による病変部の観察・診
断状態を示す斜視図、（Ｂ）はカテーテルの先端部によ
る病変部組織の採取状態を示す斜視図。FIG. 14 shows a state of use of the catheter,
(A) is a perspective view showing an observation / diagnosis state of a lesion part by a small-diameter endoscope inserted into a catheter inserted to the vicinity of the lesion part in a body cavity, and (B) is a lesion part by the tip part of the catheter FIG. 3 is a perspective view showing a collection state of a partial tissue.

【図１５】 第４の変形例のカテーテルを示すもので、
（Ａ）はカテーテルの先端部分を示す斜視図、（Ｂ）は
カテーテル内に細径の内視鏡が挿通された状態を示す斜
視図、（Ｃ）はカテーテルの先端部による病変部組織の
採取状態を示す斜視図。FIG. 15 shows a catheter of a fourth modified example,
(A) is a perspective view showing a distal end portion of a catheter, (B) is a perspective view showing a state in which a small-diameter endoscope is inserted into the catheter, and (C) is a collection of diseased tissue by the distal end portion of the catheter. The perspective view which shows a state.

【図１６】 （Ａ）は内視鏡の挿入部の先端部分を示す
斜視図、（Ｂ）はＣリングの取付け状態を示す横断面
図。16A is a perspective view showing a distal end portion of an insertion portion of an endoscope, and FIG. 16B is a cross-sectional view showing a mounted state of a C ring.

【図１７】 （Ａ）は内視鏡本体の挿入部から湾曲ユニ
ットを取外した状態を示す分解斜視図、（Ｂ）は湾曲ユ
ニットの横断面図。FIG. 17A is an exploded perspective view showing a state in which the bending unit is removed from the insertion portion of the endoscope body, and FIG. 17B is a cross-sectional view of the bending unit.

【図１８】 内視鏡本体の挿入部と湾曲ユニットとの連
結部の変形例を示す縦断面図。FIG. 18 is a vertical cross-sectional view showing a modified example of the connecting portion between the insertion portion of the endoscope main body and the bending unit.

【符号の説明】[Explanation of symbols]

２…カテーテル本体（管状挿入具本体）、５…挿入体、
６，１１…先端部材。2 ... Catheter body (tubular insertion tool body), 5 ... Insert body,
6, 11 ... Tip member.

Claims (1)

【特許請求の範囲】[Claims] 【請求項１】 弾性材料からなる管状挿入具本体の先端
に連結され、基本形状が略先細中空状に形成された先端
部材を設け、この先端部材を前記基本形状で保持される
初期状態から先細中空部分を前記管状挿入具本体の内径
寸法と略同径程度に拡開させた拡開状態まで弾性変形可
能な超弾性合金材料によって形成し、前記管状挿入具本
体内を通して前記先端部材に挿入される挿入体の挿入動
作にともない前記先端部材を拡開可能にしたことを特徴
とする管状挿入具。1. A tip member connected to the tip of a tubular insert body made of an elastic material and having a basic shape formed into a substantially tapered hollow shape is provided, and the tip member is tapered from an initial state in which it is held in the basic shape. The hollow portion is formed of a superelastic alloy material that is elastically deformable to an expanded state in which the hollow portion is expanded to a diameter substantially the same as the inner diameter of the tubular insertion tool body, and is inserted into the tip member through the tubular insertion tool body. A tubular insertion tool, wherein the distal end member can be expanded with the insertion operation of the insertion body.