JPH0975354A - Peeler and disposition device for endoscope - Google Patents
Peeler and disposition device for endoscopeInfo
- Publication number
- JPH0975354A JPH0975354A JP8032162A JP3216296A JPH0975354A JP H0975354 A JPH0975354 A JP H0975354A JP 8032162 A JP8032162 A JP 8032162A JP 3216296 A JP3216296 A JP 3216296A JP H0975354 A JPH0975354 A JP H0975354A
- Authority
- JP
- Japan
- Prior art keywords
- blood vessel
- stripper
- endoscope
- main body
- observation
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】この発明は、例えば内視鏡的
に伏在静脈等の皮下血管を採取する採取術に用いる剥離
子および内視鏡用処置装置に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dissector and a treatment apparatus for an endoscope used for a surgical operation for collecting a subcutaneous blood vessel such as a saphenous vein endoscopically.
【０００２】[0002]
【従来の技術】下肢の伏在静脈等の皮下血管を採取する
採取術は、メス等によって表皮をその皮下の血管に沿っ
て切開し、さらに表皮の下層の脂肪組織、血管上結合組
織まで切開して採取しようとする長さの血管を露出さ
せ、露出した血管の両端を切断して体外に採取してい
る。2. Description of the Related Art A technique for collecting subcutaneous blood vessels such as the saphenous veins of the lower limbs is performed by incising the epidermis along the subcutaneous blood vessels with a scalpel, etc. Then, the blood vessel of the length to be collected is exposed, and both ends of the exposed blood vessel are cut and collected outside the body.
【０００３】しかし、前述した採取術は、表皮に大きな
切開を加えるため、治癒までの時間が長くかかるととも
に、切開部が瘢痕状となり硬化するため、足を動かす
時、引きつって痛みを感じるという問題がある。However, in the above-mentioned harvesting operation, a large incision is made in the epidermis, so that it takes a long time to heal and the incision becomes scar-like and hardens. Therefore, when the user moves his / her foot, he / she feels pain. There's a problem.
【０００４】そこで、米国特許第５，３３４，１５０号
明細書に示す内視鏡的に採取術を行うことができる観察
機能付きトラカールが開発された。これは、内視鏡一体
型処置具で、皮下の特定組織を観察しながら目的部位に
挿入し、処置することができ、また先端部が先細り形状
であるため、目的部位に確実にアプローチできるという
利点がある。Therefore, a trocar with an observation function has been developed which is capable of performing an endoscopic sampling operation as shown in US Pat. No. 5,334,150. This is an endoscopic integrated treatment instrument that can be inserted into a target site for treatment while observing a specific subcutaneous tissue, and the tip portion is tapered, so that the target site can be reliably approached. There are advantages.
【０００５】また、特公平４−１０３２８号公報に示す
内視鏡用案内管は、内視鏡を挿入可能な管体から構成さ
れており、管体を表皮の切開部を介して体内に挿入し、
体内の深部を観察できるようになっている。The guide tube for an endoscope disclosed in Japanese Patent Publication No. 10328/1992 is composed of a tubular body into which an endoscope can be inserted, and the tubular body is inserted into the body through an incision in the epidermis. Then
You can observe deep inside the body.
【０００６】[0006]
【発明が解決しようとする課題】しかしながら、前述し
た観察機能付きトラカールは、先端部が先細り形状であ
るため、目的部位に確実にアプローチできる反面、先端
が鋭利であるため、対象組織および周辺組織に損傷を与
える恐れがある。また、前述した内視鏡案内管は、管体
の先端部が丸く形成されているため、対象組織および周
辺組織に損傷を与える心配はないが、血管等の採取時に
血管の周囲の結合組織を血管と切り離すことはできず、
他の処置具と併用せざるを得ない。However, since the trocar with the observation function described above has a tapered tip, it can reliably approach the target site, while it has a sharp tip, so it does not affect the target tissue and the surrounding tissue. May cause damage. Further, in the above-mentioned endoscope guide tube, since the distal end portion of the tubular body is formed into a round shape, there is no fear of damaging the target tissue and the surrounding tissue, but the connective tissue around the blood vessel is removed when collecting the blood vessel. Cannot be separated from blood vessels,
There is no choice but to use it with other treatment tools.
【０００７】この発明は前記事情に着目してなされたも
ので、その目的とするところは、目的部位へのアプロー
チが確実であると共に、対象組織および周辺組織に損傷
を与えることなく、血管の採取時に血管の周囲の結合組
織を血管から剥離でき、操作性の優れた剥離子および内
視鏡用処置装置を提供することにある。The present invention has been made in view of the above circumstances, and its purpose is to collect a blood vessel without damaging the target tissue and the surrounding tissue while ensuring the approach to the target site. Another object of the present invention is to provide a dissector and an endoscopic treatment device which can exfoliate the connective tissue around the blood vessel from the blood vessel and have excellent operability.
【０００８】[0008]
【課題を解決するための手段】この発明は、前記目的を
達成するために、請求項１は、内視鏡が挿入可能で、先
端の少なくとも一部に観察窓を有する細長い管状の本体
部を有する剥離子において、前記本体部の最先端部に、
鈍的形状で皮切部から挿入して血管とその周囲組織とを
剥離する先端部を有することを特徴とする剥離子にあ
る。In order to achieve the above object, the present invention provides a slender tubular main body portion having an observation window at least at a distal end thereof, into which an endoscope can be inserted. In the stripper having, at the most distal end of the main body,
A dissector having a blunt shape and having a tip part that is inserted from a skin cut part and separates a blood vessel and its surrounding tissue.
【０００９】請求項２は、内視鏡と、この内視鏡の挿入
部が装着可能で、先端の少なくとも一部に観察窓を有す
る細長い管状の剥離子本体部と、この剥離子本体部の最
先端部に設けられ、鈍的形状で皮切部から挿入して血管
とその周囲組織とを剥離する先端部を有することを特徴
とする内視鏡用処置装置にある。According to a second aspect of the present invention, there is provided an endoscope, an elongated tubular stripper main body portion to which the insertion portion of the endoscope can be attached and which has an observation window at least at a part of its tip, and the stripper main body portion. The treatment device for an endoscope is provided at the most distal end portion, and has a distal end portion that is bluntly inserted from the skin cut portion and separates the blood vessel and surrounding tissue.
【００１０】内視鏡に剥離子を装着して伏在静脈等の皮
下血管を採取する場合、表皮に設けた皮切部から剥離子
の先端部を皮下組織の内部に挿入することにより、内視
鏡観察下で血管とその周辺の組織とを剥離することがで
きる。When a dissector is attached to an endoscope and a subcutaneous blood vessel such as a saphenous vein is collected, the distal end of the dissector is inserted into the subcutaneous tissue from a skin cut portion provided in the epidermis. The blood vessel and the tissue around it can be separated under the observation under an endoscope.
【００１１】[0011]
【発明の実施の形態】以下、この発明の各実施形態を図
面に基づいて説明する。図１〜図４は剥離子および内視
鏡用処置装置の第１の実施形態を示し、１は硬性内視鏡
である。この硬性内視鏡１は観察光学系と照明光学系を
内挿する硬性の挿入部２と、この挿入部２の基端部に設
けられた内視鏡接続部３を有する内視鏡本体部４とから
構成されている。Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 show a first embodiment of a dissector and a treatment device for an endoscope, and 1 is a rigid endoscope. The rigid endoscope 1 includes an endoscope main body having a rigid insertion part 2 for inserting an observation optical system and an illumination optical system, and an endoscope connection part 3 provided at a proximal end of the insertion part 2. 4 and.
【００１２】挿入部２の先端部には挿入部２の軸線に対
して傾斜する斜視型の観察窓および照明窓を有する先端
構成部５が設けられている。内視鏡本体部４にはライト
ガイドケーブル（図示しない）と接続されるコネクタ７
および内視鏡本体部４の軸部８の軸線に対して直交する
方向に突出する接続ピン９が設けられている。At the tip of the insertion section 2, there is provided a tip forming section 5 having a perspective type observation window and an illumination window which are inclined with respect to the axis of the insertion section 2. The endoscope body 4 has a connector 7 connected to a light guide cable (not shown).
Further, a connection pin 9 is provided which protrudes in a direction orthogonal to the axis of the shaft 8 of the endoscope main body 4.
【００１３】１０は剥離子（ベインダイセクター）であ
る。この剥離子１０は細長い管状の本体部１１と先端部
１２とから構成されている。本体部１１は内視鏡本体部
４の軸部８に対して嵌合可能な太径パイプ部１３と、こ
の太径パイプ部１３の先端部に接続され硬性内視鏡１の
挿入部２が挿入可能な細径パイプ部１４およびこの細径
パイプ部１４の先端部に接続され硬性内視鏡１の先端構
成部５を覆う透明な観察部１５とから構成されている。Reference numeral 10 is a stripper (vane dissector). The stripper 10 is composed of an elongated tubular body 11 and a tip 12. The main body portion 11 includes a large-diameter pipe portion 13 that can be fitted to the shaft portion 8 of the endoscope main body portion 4, and an insertion portion 2 of the rigid endoscope 1 that is connected to the distal end portion of the large-diameter pipe portion 13. It is composed of a thin pipe portion 14 that can be inserted, and a transparent observation portion 15 that is connected to the distal end portion of the thin pipe portion 14 and covers the distal end forming portion 5 of the rigid endoscope 1.
【００１４】観察部１５は透明な合成樹脂材料によって
円筒状に形成されており、その先端部は軸線に対して傾
斜する傾斜面１６によって閉塞されて前記先端部１２が
形成されている。傾斜面１６は観察部１５の周壁部と肉
厚を略等しくしており、これによって傾斜面１６がプリ
ズムにならないようにして鮮明に透視できるようにして
いる。さらに、先端部１２は、組織への挿入性を良くす
るために平面視で、先細になるように両側部１７がカッ
トされていると共に、その最先端部分は血管に傷を付け
ないように鈍的形状をなしている。The observing portion 15 is formed of a transparent synthetic resin material in a cylindrical shape, and its tip is closed by an inclined surface 16 inclined with respect to the axis to form the tip 12. The inclined surface 16 has substantially the same thickness as the peripheral wall portion of the observation unit 15, so that the inclined surface 16 does not become a prism so as to allow clear see-through. Further, the distal end portion 12 is cut at both sides 17 so as to be tapered in a plan view so as to improve insertability into tissue, and the distal end portion is dull so as not to damage a blood vessel. It has a typical shape.
【００１５】また、観察部１５の軸方向の長さＬ＝３０
ｍｍ程度であり、観察部１５の直径φＡとし、細径パイ
プ部１４の直径φＢとすると、 φＡ＞φＢに形成され
ている。さらに、観察部１５の先端部１２を残してその
後方に位置する下部にはその軸方向の亘って円弧状の凹
溝１８が形成されており、血管をガイドとして剥離子１
０を押し進めることができるようになっており、同時に
血管の保護も兼ねている。The length L of the observation section 15 in the axial direction is L = 30.
If the diameter of the observation portion 15 is φA and the diameter of the small diameter pipe portion 14 is φB, then φA> φB. Further, an arcuate groove 18 is formed in the lower part of the observation part 15 left behind the observation part 15 behind the observation part 15 in the axial direction, and the dissector 1 is guided by the blood vessel.
It is able to push 0, and at the same time protects blood vessels.
【００１６】また、太径パイプ部１３の基端部には内視
鏡本体部４の軸部８に対して嵌合する段付き嵌合部１９
が設けられ、この段付き嵌合部１９の底部にはゴムリン
グ等の弾性部材２０が収納されている。段付き嵌合部１
９の周壁には接続ピン９と係合するＬ字状に屈曲した一
対のスリット２１が設けられている。そして、接続ピン
９とスリット２１とを係合することによって硬性内視鏡
１と剥離子１０とが接続され、同時に弾性部材２０が軸
部８によって圧縮され、硬性内視鏡１と剥離子１０とが
回り止めされる回転規制部材２２を構成している。A stepped fitting portion 19 which is fitted to the shaft portion 8 of the endoscope main body 4 is provided at the base end portion of the large diameter pipe portion 13.
An elastic member 20 such as a rubber ring is housed in the bottom of the stepped fitting portion 19. Step fitting part 1
A pair of slits 21 that are bent into an L-shape and that engage with the connection pins 9 are provided on the peripheral wall of 9. Then, by engaging the connection pin 9 and the slit 21, the rigid endoscope 1 and the stripper 10 are connected, and at the same time, the elastic member 20 is compressed by the shaft portion 8 and the rigid endoscope 1 and the stripper 10 are connected. Constitutes a rotation restricting member 22 for preventing rotation of and.
【００１７】次に作用について説明する。硬性内視鏡１
の挿入部２を剥離子１０に挿入し、剥離子１０の段付き
嵌合部１９を内視鏡本体部４の軸部８に嵌合し、接続ピ
ン９とスリット２１とを位置決めした後、硬性内視鏡１
もしくは剥離子１０を回すと、接続ピン９がスリット２
１に係合し、同時に弾性部材２０が軸部８によって圧縮
され、硬性内視鏡１と剥離子１０とが回転規制された状
態に接続される。Next, the operation will be described. Rigid endoscope 1
After inserting the insertion portion 2 of the inserter 2 into the stripper 10, fitting the stepped fitting portion 19 of the stripper 10 into the shaft portion 8 of the endoscope body 4, and positioning the connection pin 9 and the slit 21, Rigid endoscope 1
Alternatively, when the stripper 10 is turned, the connecting pin 9 is slit 2
1, the elastic member 20 is simultaneously compressed by the shaft portion 8, and the rigid endoscope 1 and the stripper 10 are connected in a state in which the rotation is restricted.
【００１８】このように硬性内視鏡１の挿入部２に剥離
子１０を嵌合すると、図３に示すように、先端構成部５
が剥離子１０の観察部１５の内部で、先端近傍に位置
し、観察部１５の傾斜面１６が斜め上向きになるのに対
し、先端構成部５の観察方向Ｏは斜め下向きとなる。When the stripper 10 is fitted into the insertion portion 2 of the rigid endoscope 1 in this way, as shown in FIG.
Is located in the vicinity of the tip inside the observation portion 15 of the stripper 10, and the inclined surface 16 of the observation portion 15 is directed obliquely upward, whereas the observation direction O of the tip forming portion 5 is oblique downward.
【００１９】このように硬性内視鏡１に剥離子１０を装
着して伏在静脈等の皮下血管を採取する採取術に用いる
場合について説明すると、図４（ａ）において、２３は
表皮、２４は表皮２３の下層の脂肪等の皮下組織、２５
は皮下組織２４の下層の血管上結合組織、２６は伏在静
脈等の血管である。表皮２３の一部にメスを入れ、皮下
組織２４および血管上結合組織２５を皮切し、その皮切
部２７から剥離子１０の先端部１２を挿入すると、先端
部１２は血管上結合組織２５に到達する。このときの硬
性内視鏡１の観察像は図４（ｂ）に示すようになり、硬
性内視鏡１の視野内に剥離子１０の先端部１２と血管上
結合組織２５を含む血管２６が入る。As described above, the case in which the detachment device 10 is attached to the rigid endoscope 1 and is used in a collection operation for collecting a subcutaneous blood vessel such as a saphenous vein will be described. In FIG. Is subcutaneous tissue such as fat under the epidermis 23, 25
Is a connective tissue on the lower layer of the subcutaneous tissue 24, and 26 is a blood vessel such as a saphenous vein. When a scalpel is placed in a part of the epidermis 23, the subcutaneous tissue 24 and the connective tissue 25 on the blood vessel are cut, and when the tip 12 of the dissector 10 is inserted from the cut portion 27, the tip 12 becomes a connective tissue on the blood vessel 25 To reach. The observation image of the rigid endoscope 1 at this time is as shown in FIG. 4B, and the distal end portion 12 of the dissector 10 and the blood vessel 26 including the connective tissue 25 on the blood vessel are in the visual field of the rigid endoscope 1. enter.
【００２０】この状態で、剥離子１０を押し進めると、
剥離子１０の先端部１２により血管２６と血管上結合組
織２５とが剥離され、血管２６が露出し、血管２６の途
中の側枝２６ａも露出して硬性内視鏡１の視野内に入
る。したがって、硬性内視鏡１によって血管２６を観察
しながら血管２６と血管上結合組織２５とを剥離するこ
とができる。In this state, when the stripper 10 is pushed forward,
The blood vessel 26 and the connective tissue 25 on the blood vessel are separated by the tip 12 of the dissector 10, the blood vessel 26 is exposed, and the side branch 26a in the middle of the blood vessel 26 is also exposed and enters the visual field of the rigid endoscope 1. Therefore, the blood vessel 26 and the connective tissue 25 on the blood vessel can be separated while observing the blood vessel 26 with the rigid endoscope 1.
【００２１】このとき、剥離子１０の観察部１５には凹
溝１８が設けられているため、凹溝１８が血管２６と嵌
合して剥離子１０を血管２６に沿って押し進めることが
でき、また先端部１２は先細であるが、その最先端部分
は鈍的形状をなしているため、血管２６に傷を付けるこ
となく、剥離することができる。At this time, since the observation groove 15 of the stripper 10 is provided with the recessed groove 18, the recessed groove 18 fits into the blood vessel 26 and the stripper 10 can be pushed along the blood vessel 26. Further, although the tip portion 12 is tapered, the tip end portion thereof has a blunt shape, so that it can be peeled off without damaging the blood vessel 26.
【００２２】図５および図６は第２の実施形態を示し、
第１の実施形態と同一構成部分は同一番号を付して説明
を省略する。図５に示す３０は直視型の硬性内視鏡２９
の挿入部を示し、３１は観察窓および照明窓を有する先
端構成部である。挿入部３０に嵌合された剥離子３２の
観察部３３は透明な合成樹脂材料等によって構成され、
その先端部３４は円錐状に形成されている。この先端部
３４の最先端部分は傷を付けることがないように鈍的形
状をなしている。FIGS. 5 and 6 show a second embodiment,
The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. Reference numeral 30 shown in FIG. 5 denotes a direct-viewing rigid endoscope 29.
The reference numeral 31 designates an insertion portion of the above, and numeral 31 is a tip forming portion having an observation window and an illumination window. The observation part 33 of the stripper 32 fitted to the insertion part 30 is made of a transparent synthetic resin material or the like,
The tip portion 34 is formed in a conical shape. The tip end portion 34 has a blunt shape so as not to damage it.
【００２３】第１の実施形態と同様に、図６に示すよう
に、皮切部２７から剥離子３２の先端部３４を挿入する
と、先端部３４は血管上結合組織２５に到達する。この
とき、硬性内視鏡２９の視野内に剥離子３２の先端部３
４と血管上結合組織２５を含む血管２６が入る。As in the first embodiment, as shown in FIG. 6, when the distal end portion 34 of the dissector 32 is inserted from the skin cut portion 27, the distal end portion 34 reaches the supravascular connective tissue 25. At this time, the distal end portion 3 of the stripper 32 is placed in the visual field of the rigid endoscope 29.
4 and a blood vessel 26 containing the supravascular connective tissue 25 enters.
【００２４】この状態で、剥離子３２を押し進めると、
剥離子３２の先端部３４が血管２６と血管上結合組織２
５とが剥離され、血管２６が露出し、血管２６の途中の
側枝２６ａも露出して硬性内視鏡２９の視野内に入る。
したがって、硬性内視鏡２９によって血管２６を観察し
ながら血管２６と血管上結合組織２５とを剥離すること
ができる。このとき、剥離子３２の観察部３３には凹溝
１８が設けられているため、凹溝１８が血管２６と嵌合
して剥離子３２を血管２６に沿って押し進めることがで
き、また観察部３３の先端部３４は円錐状であるが、そ
の最先端部分は鈍的形状をなしているため、血管２６に
傷を付けることなく、剥離することができる。In this state, if the stripper 32 is pushed forward,
The tip portion 34 of the dissector 32 has the blood vessel 26 and the vascular connective tissue 2
5 is peeled off, the blood vessel 26 is exposed, and the side branch 26a in the middle of the blood vessel 26 is also exposed and enters the visual field of the rigid endoscope 29.
Therefore, the blood vessel 26 and the above-vascular connective tissue 25 can be separated while observing the blood vessel 26 with the rigid endoscope 29. At this time, since the observation groove 33 of the stripper 32 is provided with the recessed groove 18, the recessed groove 18 can be fitted into the blood vessel 26 to push the stripper 32 along the blood vessel 26. Although the tip end portion 34 of 33 has a conical shape, the tip end portion thereof has a blunt shape, so that it can be peeled off without damaging the blood vessel 26.
【００２５】図７および図８は第３の実施形態を示し、
第１の実施形態と同一構成部分は同一番号を付して説明
を省略する。図７に示す３５は剥離子であり、剥離子３
５の観察部３６は透明な合成樹脂材料等によって構成さ
れ、その先端部３７における上部は流線形で、下部は傾
斜面３８に形成されている。この先端部３７の最先端部
分は傷を付けることがないように鈍的形状をなしてい
る。FIGS. 7 and 8 show a third embodiment,
The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. Reference numeral 35 shown in FIG.
The observation part 36 of No. 5 is made of a transparent synthetic resin material or the like, and the upper part of the tip part 37 is streamlined and the lower part is formed on the inclined surface 38. The tip of the tip portion 37 has a blunt shape so as not to damage it.
【００２６】第１の実施形態と同様に、図８に示すよう
に、皮切部２７から剥離子３５の先端部３７を挿入する
と、先端部３７は血管上結合組織２５に到達する。この
とき、硬性内視鏡１の視野内に剥離子３５の先端部３７
と血管上結合組織２５を含む血管２６が入る。As in the first embodiment, as shown in FIG. 8, when the tip portion 37 of the dissector 35 is inserted from the skin cut portion 27, the tip portion 37 reaches the supravascular connective tissue 25. At this time, the distal end portion 37 of the peeler 35 is placed in the visual field of the rigid endoscope 1.
And a blood vessel 26 including the connective tissue 25 on the blood vessel enters.
【００２７】この状態で、剥離子３５を押し進めると、
剥離子３５の先端部３７により血管２６と血管上結合組
織２５とが剥離され、血管２６が露出し、血管２６の途
中の側枝２６ａも露出して硬性内視鏡１の視野内に入
る。したがって、硬性内視鏡１によって血管２６を観察
しながら血管２６と血管上結合組織２５とを剥離するこ
とができる。このとき、観察部３６の先端部３７は円錐
状であるが、その最先端部分は鈍的形状をなしているた
め、血管２６に傷を付けることなく、剥離することがで
きる。In this state, when the stripper 35 is pushed forward,
The blood vessel 26 and the connective tissue 25 on the blood vessel are separated by the tip portion 37 of the dissector 35, the blood vessel 26 is exposed, and the side branch 26a in the middle of the blood vessel 26 is also exposed and enters the visual field of the rigid endoscope 1. Therefore, the blood vessel 26 and the connective tissue 25 on the blood vessel can be separated while observing the blood vessel 26 with the rigid endoscope 1. At this time, the tip portion 37 of the observation portion 36 has a conical shape, but the tip end portion thereof has a blunt shape, and therefore the blood vessel 26 can be peeled off without being damaged.
【００２８】図９には、本実施形態における剥離子３５
の具体的な寸法の一例が示されている。図示のように、
観察部３６の全長Ａは１８ｍｍ、全幅Ｂは８ｍｍ、全高
Ｃは８ｍｍ、最先端点Ｐの高さＤは下面Ｇから１．５ｍ
ｍ、先端角度αは３０°、下面Ｇから最先端点Ｐに達す
る角度βは１０°に設定されている。また、下面Ｇの両
側の角部ＥはＲ１〜３のＲ面取りが施され、先端部３７
の稜線部ＦはＲ１以上のＲ面取りが施され、共に鈍的形
状をなしている。なお、下面Ｇは平面をなしており、ま
た、本体部１１の外径Ｈは６ｍｍであり観察部３６の全
高Ｃに対してＣ＞Ｈの関係になっている。FIG. 9 shows the stripper 35 in this embodiment.
An example of the specific dimensions of is shown. As shown,
The total length A of the observing section 36 is 18 mm, the total width B is 8 mm, the total height C is 8 mm, and the height D of the tip point P is 1.5 m from the lower surface G.
m, the tip angle α is set to 30 °, and the angle β from the lower surface G to the extreme point P is set to 10 °. Further, the corners E on both sides of the lower surface G are chamfered with R1 to R3, and the tip portion 37
The ridgeline portion F of R is chamfered to be R1 or more, and both have a dull shape. The lower surface G is a flat surface, and the outer diameter H of the main body portion 11 is 6 mm, which is C> H with respect to the total height C of the observation portion 36.
【００２９】このような寸法に設定された剥離子３５
は、その観察部３６の最先端点Ｐが血管２６直上の結合
組織２５へと挿入される。この時の状態が図１０に縦断
面図として示されている。観察部３６の下側すなわち血
管２６直上に位置する面Ｇが平面であるため、剥離子３
５自体が軸回りに回転して先端部３７が意図しない方向
に向くことが防止される。The peeler 35 set to such a size
Is inserted into the connective tissue 25 immediately above the blood vessel 26. The state at this time is shown in FIG. 10 as a vertical sectional view. Since the surface G below the observation section 36, that is, the surface G located immediately above the blood vessel 26 is a flat surface,
It is prevented that 5 itself rotates around the axis and tip portion 37 faces in an unintended direction.
【００３０】また、側枝血管２６ａは血管本管２６と同
様に剥離子３５の挿入層の直下に位置するため、先端部
３７を挿入していくと、側枝血管２６ａは図１０に示す
ように周囲組織と一緒に上方へ吊り上げられるが、その
際、剥離子３５の先端部３７の下面角部Ｅで側枝血管２
６ａを圧迫したりあるいは切断したりする事態が考えら
れる。また、最先端部Ｐがシャープである場合には血管
２６に損傷を与える虞もある。しかしながら、図９に示
すように角部Ｅに曲率半径１ｍｍ以上のＲ面取りを施
し、先端部３７をＲ１以上に設定することにより、血管
２６を損傷することなく挿入することが可能となる。こ
れまでの検討より、角部Ｅは曲率半径 ３ｍｍのＲ面取
をすることが望ましいと判明している。Further, since the side branch blood vessel 26a is located immediately below the insertion layer of the dissector 35 like the main blood vessel 26, as the tip portion 37 is inserted, the side branch blood vessel 26a is surrounded by the surroundings as shown in FIG. The tissue is lifted up together with the tissue, and at that time, the side branch blood vessel 2 is formed at the lower surface corner E of the tip portion 37 of the dissector 35.
It is conceivable that the 6a is pressed or cut. In addition, if the tip portion P is sharp, the blood vessel 26 may be damaged. However, as shown in FIG. 9, the corner E is chamfered with a radius of curvature of 1 mm or more, and the tip portion 37 is set to R1 or more, so that the blood vessel 26 can be inserted without damage. From the studies so far, it has been found that it is desirable that the corner E be rounded with a radius of curvature of 3 mm.
【００３１】図１１および図１２は第４の実施形態を示
し、第１の実施形態と同一構成部分は同一番号を付して
説明を省略する。図１１に示す３９は剥離子であり、剥
離子３９の観察部３９ａは透明な合成樹脂材料等によっ
て構成され、その先端部４０のおける上部は流線形で、
下部は開口窓４１に形成されている。この先端部４０の
最先端部分は傷を付けることがないように鈍的形状をな
している。11 and 12 show a fourth embodiment, and the same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted. Reference numeral 39 shown in FIG. 11 is a stripper, and an observation portion 39a of the stripper 39 is made of a transparent synthetic resin material or the like, and an upper portion of its tip portion 40 is streamlined,
The lower part is formed in the opening window 41. The tip end portion 40 has a blunt shape so as not to damage it.
【００３２】第１の実施形態と同様に、図１２に示すよ
うに、皮切部２７から剥離子３９の先端部４０を挿入す
ると、先端部４０は血管上結合組織２５に到達する。こ
のとき、硬性内視鏡１の視野内に剥離子３９の先端部４
０と血管上結合組織２５を含む血管２６が入る。Similar to the first embodiment, as shown in FIG. 12, when the distal end portion 40 of the dissector 39 is inserted from the skin cut portion 27, the distal end portion 40 reaches the connective tissue 25 on the blood vessel. At this time, the distal end portion 4 of the stripper 39 is placed within the visual field of the rigid endoscope 1.
A blood vessel 26 including 0 and connective tissue 25 on the blood vessel enters.
【００３３】この状態で、剥離子３９を押し進めると、
剥離子３９の先端部４０の開口窓４１の開口に血管２６
が入り込み、血管２６の上面を開口窓４１の開口縁が摺
動しながら進行し、血管２６と血管上結合組織２５とが
剥離され、血管２６が露出し、血管２６の途中の側枝２
６ａも露出して硬性内視鏡１の視野内に入る。したがっ
て、硬性内視鏡１によって血管２６を観察しながら血管
２６と血管上結合組織２５とを剥離することができる。
このとき、観察部３９ａの先端部４０は円錐状である
が、その最先端部分は鈍的形状をなしているため、血管
２６に傷を付けることなく、剥離することができる。In this state, when the stripper 39 is pushed forward,
The blood vessel 26 is placed in the opening of the opening window 41 of the distal end portion 40 of the stripper 39.
Enter, and the opening edge of the opening window 41 slides on the upper surface of the blood vessel 26, the blood vessel 26 and the connective tissue 25 on the blood vessel are separated, the blood vessel 26 is exposed, and the side branch 2 in the middle of the blood vessel 26 is exposed.
6a is also exposed and enters the visual field of the rigid endoscope 1. Therefore, the blood vessel 26 and the connective tissue 25 on the blood vessel can be separated while observing the blood vessel 26 with the rigid endoscope 1.
At this time, the distal end portion 40 of the observation portion 39a has a conical shape, but the tip end portion thereof has a blunt shape, so that the blood vessel 26 can be peeled off without being damaged.
【００３４】図１３は第５の実施形態を示し、第１の実
施形態と同一構成部分は同一番号を付して説明を省略す
る。図１３に示す４２はバルーンであり、このバルーン
４２は剥離子１０の先端部１２を残して観察部１５の外
周部を包囲するように装着されている。このバルーン４
２にはチューブ４３が接続され、このチューブ４３は本
体部１１の基端側に導かれ、シリンジ４４に接続されて
いる。FIG. 13 shows a fifth embodiment, and the same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted. Reference numeral 42 shown in FIG. 13 is a balloon, and the balloon 42 is mounted so as to surround the outer peripheral portion of the observation unit 15 except for the distal end portion 12 of the stripper 10. This balloon 4
A tube 43 is connected to 2, and the tube 43 is guided to the proximal end side of the main body 11 and connected to the syringe 44.
【００３５】図１３（ａ）に示すように、バルーン４２
を収縮した状態で、第１の実施形態と同様に、皮切部２
７から剥離子１０の先端部１２を挿入すると、先端部１
２は血管上結合組織２５に到達する。このとき、硬性内
視鏡１の視野内に剥離子１０の先端部１２と血管上結合
組織２５を含む血管２６が入る。As shown in FIG. 13A, the balloon 42
In the contracted state, as in the first embodiment, the skin cutting portion 2
When the tip portion 12 of the stripper 10 is inserted from 7, the tip portion 1
2 reaches the connective tissue 25 on the blood vessel. At this time, the distal end portion 12 of the dissector 10 and the blood vessel 26 including the vascular connective tissue 25 enter the visual field of the rigid endoscope 1.
【００３６】この状態で、剥離子１０を押し進めると、
剥離子１０の先端部１２によって血管２６と血管上結合
組織２５とが剥離され、血管２６が露出し、血管２６の
途中の側枝２６ａも露出して硬性内視鏡１の視野内に入
る。したがって、硬性内視鏡１によって血管２６を観察
しながら血管２６と血管上結合組織２５とを剥離するこ
とができる。In this state, if the stripper 10 is pushed forward,
The blood vessel 26 and the connective tissue 25 on the blood vessel are separated by the tip portion 12 of the dissector 10, the blood vessel 26 is exposed, and the side branch 26a in the middle of the blood vessel 26 is also exposed and enters the visual field of the rigid endoscope 1. Therefore, the blood vessel 26 and the connective tissue 25 on the blood vessel can be separated while observing the blood vessel 26 with the rigid endoscope 1.
【００３７】剥離子１０がある程度進行したところで、
図１３（ｂ）に示すように、シリンジ４４によって液体
等の流体を送り込むと、チューブ４３を介してバルーン
４２に流体が充填され、バルーン４２が膨張する。そし
て、剥離した血管２６と血管上結合組織２５との間を押
し広げることができる。したがって、血管２６と血管上
結合組織２５との剥離をいっそう確実にすることができ
る。剥離子１０をさらに前進させるときには、図１３
（ａ）に示すように、バルーン４２を収縮して剥離子１
０を押し進めた後、再びバルーン４２を膨張する操作を
繰り返すことにより、血管２６の周囲の空間を広げるこ
とができる。When the stripper 10 has advanced to some extent,
As shown in FIG. 13B, when a fluid such as a liquid is fed by the syringe 44, the balloon 42 is filled with the fluid via the tube 43, and the balloon 42 is inflated. Then, the space between the separated blood vessel 26 and the above-vascular connective tissue 25 can be spread. Therefore, the separation between the blood vessel 26 and the connective tissue 25 on the blood vessel can be further ensured. When the stripper 10 is further advanced, as shown in FIG.
As shown in (a), the balloon 42 is deflated to remove the peeler 1.
After pushing 0, the space around the blood vessel 26 can be expanded by repeating the operation of expanding the balloon 42 again.
【００３８】図１４〜図１８は第１の実施形態における
回転規制部材２２の変形例を示し、第１の実施形態と同
一構成部分は同一番号を付して説明を省略する。図１４
は剥離子１０の太径パイプ部１３の嵌合部４５に軸方向
に沿って一対のスリット４６を設け、内視鏡本体部４の
軸部８に嵌合部４５を嵌合したときに接続ピン９とスリ
ット４６とが係合して硬性内視鏡１と剥離子１０とが回
り止めされるようにしたものである。14 to 18 show a modification of the rotation restricting member 22 in the first embodiment. The same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted. FIG.
Is provided with a pair of slits 46 in the fitting portion 45 of the large-diameter pipe portion 13 of the stripper 10 along the axial direction, and is connected when the fitting portion 45 is fitted in the shaft portion 8 of the endoscope body 4. The pin 9 and the slit 46 are engaged with each other so that the rigid endoscope 1 and the stripper 10 are prevented from rotating.
【００３９】図１５および図１６は剥離子１０の太径パ
イプ部１３の嵌合部４５に軸方向に沿って一対のスリッ
ト４７を設け、このスリット４７に接続ピン９の軸径よ
り狭幅の狭幅部４７ａと接続ピン９と嵌合して抜け止め
される嵌合部４７ｂとから構成したものである。このよ
うに構成することにより、内視鏡本体部４の軸部８に嵌
合部４５を嵌合したときに接続ピン９とスリット４７と
が係合して硬性内視鏡１と剥離子１０とが回り止めされ
る。15 and 16, a pair of slits 47 are provided in the fitting portion 45 of the large-diameter pipe portion 13 of the stripper 10 along the axial direction, and the slit 47 has a width narrower than the axial diameter of the connecting pin 9. It is composed of a narrow portion 47a and a fitting portion 47b that fits with the connection pin 9 and is prevented from coming off. With such a configuration, when the fitting portion 45 is fitted to the shaft portion 8 of the endoscope body 4, the connection pin 9 and the slit 47 are engaged with each other, and the rigid endoscope 1 and the stripper 10 are engaged. And are stopped.
【００４０】図１７および図１８は剥離子１０の太径パ
イプ部１３の嵌合部４５に軸方向に沿って一対のスリッ
ト４８を設けると共に、外周面にねじ部４９を設け、こ
のねじ部４９に締付け環体５０を螺合できるようにした
ものである。このように構成することにより、内視鏡本
体部４の軸部８に嵌合部４５を嵌合したときに接続ピン
９とスリット４８とが係合して硬性内視鏡１と剥離子１
０とが回り止めされ、さらに締付け環体５０を回してね
じ部４９に螺合することにより、硬性内視鏡１と剥離子
１０とを確実に接続できる。17 and 18, a pair of slits 48 are provided in the fitting portion 45 of the large-diameter pipe portion 13 of the stripper 10 along the axial direction, and a screw portion 49 is provided on the outer peripheral surface. The tightening ring body 50 can be screwed into. With this configuration, when the fitting portion 45 is fitted into the shaft portion 8 of the endoscope body 4, the connection pin 9 and the slit 48 engage with each other, and the rigid endoscope 1 and the stripper 1 are attached.
0 is prevented from rotating, and the tightening ring body 50 is further rotated and screwed into the threaded portion 49, so that the rigid endoscope 1 and the stripper 10 can be reliably connected.
【００４１】図１９ないし図２３は剥離子の本体部に対
して観察部を着脱自在にした例を示している。なお、第
１の実施形態と同一の構成部分については同一符号を付
してその説明を省略する。FIGS. 19 to 23 show an example in which the observation section is made detachable from the main body of the peeler. The same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.
【００４２】図１９は本体部１１に対して観察部１５を
着脱する第１の構成例を示している。図１９の（ａ）に
示すように、観察部１５の後端の左右両側には巾着形状
をなしたスリット６１，６１が設けられている。また、
本体部１１の先端側にはその外周面の全周にわたって溝
が設けられており、この溝にはＯリング６２が嵌め込ま
れている。さらに、Ｏリング６２の後端側には、観察部
１５のスリット６１，６１と係合可能な左右一対の係合
ピン６３，６３が突設されている。この係合ピン６３，
６３の高さは、これを観察部１５のスリット６１，６１
に係合させた際に観察部１５の外表面から突出しない高
さに設定されている。FIG. 19 shows a first structural example in which the observation section 15 is attached to and detached from the main body section 11. As shown in (a) of FIG. 19, slits 61, 61 each having a purse shape are provided on the left and right sides of the rear end of the observation unit 15. Also,
A groove is provided on the front end side of the main body portion 11 over the entire outer peripheral surface thereof, and an O-ring 62 is fitted in the groove. Further, on the rear end side of the O-ring 62, a pair of left and right engaging pins 63, 63 engageable with the slits 61, 61 of the observing section 15 are projected. This engagement pin 63,
The height of 63 is the same as the slits 61, 61 of the observation unit 15.
The height is set so as not to project from the outer surface of the observation unit 15 when engaged with the.
【００４３】観察部１５を本体部１１に装着する場合
は、図１９の（ｂ）に示すように、観察部１５の内側に
本体部１１を挿入しながら係合ピン６３，６３をスリッ
ト６１，６１に嵌め入れる。この際、観察部１５と同様
の樹脂からなるスリット６１，６１は弾性変形して係合
ピン６３，６３をその内側に受け入れる。また、このよ
うに観察部１５を本体部１１に装着した状態では、Ｏリ
ング６２が観察部１５の内周に密着して観察部 １５の
内部を水密に保ち観察部１５の内面の曇りを防止する。
したがって、観察部１５を通じた内視鏡１の視野が良好
に確保される。When the observation section 15 is attached to the main body section 11, as shown in FIG. 19 (b), the engagement pins 63, 63 are provided with slits 61, while inserting the main body section 11 inside the observation section 15. Fit in 61. At this time, the slits 61, 61 made of the same resin as the observing section 15 are elastically deformed to receive the engagement pins 63, 63 inside thereof. Further, in the state where the observing section 15 is mounted on the main body section 11 as described above, the O-ring 62 is closely attached to the inner circumference of the observing section 15 to keep the inside of the observing section 15 watertight and prevent the inner surface of the observing section 15 from being fogged. To do.
Therefore, the visual field of the endoscope 1 through the observation unit 15 is ensured in a good condition.
【００４４】図２０および図２１は本体部１１に対して
観察部１５を着脱する第２の構成例を示している。図２
０の（ａ）に示すように、観察部１５の後端には筒状の
接続部材６４が接続されている。この接続部材６４の内
面には、図２０の（ａ）および図２１に示すように、そ
の周方向に沿って９０°の角度範囲で延びる周状溝６５
ａとこの周状溝６５ａを接続部材６４の後端縁へと開放
させる直線溝６５ｂとからなる一対の係合溝６５，６５
が互いに点対称をなして設けられている。20 and 21 show a second configuration example in which the observation section 15 is attached to and detached from the main body section 11. FIG.
As shown in (a) of 0, a tubular connecting member 64 is connected to the rear end of the observation unit 15. As shown in FIGS. 20A and 21, the inner surface of the connecting member 64 has a circumferential groove 65 extending in the angular range of 90 ° along the circumferential direction.
a and a pair of engagement grooves 65, 65 each of which has a circumferential groove 65a and a linear groove 65b which opens the peripheral groove 65a to the rear end edge of the connecting member 64.
Are provided in point symmetry with respect to each other.
【００４５】また、図２０の（ｂ）に示すように、本体
部１１の先端側にはその外周面の全周にわたって溝が設
けられており、この溝にはＯリング ６６が嵌め込まれ
ている。さらに、Ｏリング６６の後端側には、係合溝６
５，６５と係合可能な左右一対の係合ピン６７，６７が
突設されている。この係合ピン６７，６７の高さは、こ
れを観察部１５の係合溝６５，６５に係合させた際に周
状溝６５ａおよび直線溝６５ｂ内に収まる高さに設定さ
れている。Further, as shown in FIG. 20 (b), a groove is provided on the front end side of the main body portion 11 over the entire outer peripheral surface thereof, and an O-ring 66 is fitted into this groove. . Further, on the rear end side of the O-ring 66, the engaging groove 6
A pair of left and right engagement pins 67, 67 that can engage with 5, 5 are provided in a protruding manner. The heights of the engagement pins 67, 67 are set so that the engagement pins 67, 67 fit into the circumferential grooves 65a and the linear grooves 65b when they are engaged with the engagement grooves 65, 65 of the observation section 15.
【００４６】観察部１５を本体部１１に装着する場合
は、まず、係合ピン６７を直線溝６５ｂに挿入し、直線
溝６５ｂの終奥端で今度は周状溝６５ａに沿って観察部
１５を約９０°回転させれば良い。このように観察部１
５を本体部１１に装着した状態では、Ｏリング６６が観
察部１５の内周に密着して観察部１５の内部を水密に保
ち観察部１５の内面の曇りを防止する。したがって、観
察部１５を通じた内視鏡１の視野が良好に確保される。When the observation section 15 is attached to the main body section 11, first, the engaging pin 67 is inserted into the linear groove 65b, and the observation section 15 is inserted along the circumferential groove 65a at the end of the linear groove 65b. Should be rotated about 90 °. In this way, the observation section 1
In the state in which 5 is attached to the main body portion 11, the O-ring 66 is in close contact with the inner circumference of the observation portion 15 to keep the inside of the observation portion 15 watertight and prevent the inner surface of the observation portion 15 from being fogged. Therefore, the visual field of the endoscope 1 through the observation unit 15 is ensured in a good condition.
【００４７】なお、周状溝６５ａと直線溝６５ｂおよび
これらに係合する係合ピン６７を非対照位置に設けれ
ば、観察部１５の上下反転装着ができなくなり、手術中
の誤使用を防止することができる。If the circumferential groove 65a, the linear groove 65b, and the engaging pin 67 that engages with these are provided at non-contrast positions, the observation unit 15 cannot be mounted upside down, and misuse during surgery is prevented. can do.
【００４８】図２２および図２３は本体部１１に対して
観察部１５を着脱する第３の構成例を示している。図２
２の（ａ）に示すように、観察部１５の内面にはその全
周にわたって係止溝７０が設けられている。また、図２
２の（ｂ）に示すように、本体部１１の先端側の外周面
にはその全周にわたって２つの溝７３，７４が並設され
ている。これらの溝７３，７４のうち、先端側の溝７３
には、バネ性を有する素材によって形成されたＣ形状の
リング７１が装着されている。このＣ形状リング７１
は、図２３に示すように、実線で示す装着状態から一点
鎖線で示す縮径状態に弾性的に変形して溝７３内に完全
に埋没するようになっている。また、溝７４にはＯリン
グ７２が装着されている。22 and 23 show a third configuration example in which the observation section 15 is attached to and detached from the main body section 11. FIG.
As shown in FIG. 2A, a locking groove 70 is provided on the inner surface of the observation portion 15 over the entire circumference thereof. FIG.
As shown in FIG. 2B, two grooves 73 and 74 are provided side by side on the outer peripheral surface of the main body 11 on the distal end side over the entire circumference thereof. Of these grooves 73, 74, the groove 73 on the tip side
A C-shaped ring 71 formed of a material having a spring property is attached to the. This C-shaped ring 71
As shown in FIG. 23, is elastically deformed from the mounted state shown by the solid line to the reduced diameter state shown by the alternate long and short dash line so as to be completely buried in the groove 73. An O-ring 72 is attached to the groove 74.
【００４９】このような構成において、観察部１５の内
側に本体部１１を挿入していくと、溝７３内に装着され
たＣ形状リング７１は、観察部１５の内面によって押圧
されて、図２３の一点鎖線に示すようにその内径が縮径
して溝７３内に完全に埋没される。この状態でさらに本
体部１１を観察部１５内に挿入してＣ形状リング７１を
係止溝７０へと導入すると、Ｃ形状リング７１は、観察
部１５の内面からの押圧力が解除されてその内径が元の
状態まで拡径し、係止溝７０に係止される。これによっ
て、本体部１１に対して観察部１５が係止状態で装着さ
れる。また、この場合、Ｏリング７２は観察部１５の内
周に密着して観察部１５の内部を水密に保ち観察部１５
の内面の曇りを防止する。したがって、観察部１５を通
じた内視鏡１の視野が良好に確保される。With such a structure, when the main body 11 is inserted into the inside of the observation section 15, the C-shaped ring 71 mounted in the groove 73 is pressed by the inner surface of the observation section 15 and the state shown in FIG. As shown by the alternate long and short dash line, the inner diameter is reduced and the groove 73 is completely buried. In this state, when the main body 11 is further inserted into the observation portion 15 and the C-shaped ring 71 is introduced into the locking groove 70, the C-shaped ring 71 is released from the pressing force from the inner surface of the observation portion 15 and The inner diameter is expanded to the original state and locked in the locking groove 70. As a result, the observation unit 15 is attached to the main body unit 11 in a locked state. Further, in this case, the O-ring 72 is closely attached to the inner circumference of the observation unit 15 to keep the inside of the observation unit 15 watertight.
Prevents fogging on the inside. Therefore, the visual field of the endoscope 1 through the observation unit 15 is ensured in a good condition.
【００５０】図２４および図２５は第１の実施形態にお
ける剥離子と硬性内視鏡との接続部分の変形例を示して
いる。なお、第１の実施形態と同一の構成部分について
同一符号を付してその説明を省略する。24 and 25 show a modification of the connecting portion between the peeler and the rigid endoscope in the first embodiment. The same components as those in the first embodiment are designated by the same reference numerals and the description thereof will be omitted.
【００５１】図示のように、剥離子支持部材７５は、硬
性内視鏡１の挿入部２の先端側から挿入部２の外周面に
沿ってスライドされて内視鏡本体部４に装着される。硬
性内視鏡１のライトガイドコネクタ７は既存の任意のケ
ーブルに接続できるようにその口金部にキャップ式アダ
プター８１が設けられている。この場合、コネクタ７の
外径は寸法ｄに設定され、キャップ式アダプターの外径
はコネクタ７に装着した状態で寸法Ｄに設定されている
（図２４参照）。As shown in the figure, the stripper support member 75 is attached to the endoscope main body 4 by sliding from the distal end side of the insertion portion 2 of the rigid endoscope 1 along the outer peripheral surface of the insertion portion 2. . The light guide connector 7 of the rigid endoscope 1 is provided with a cap-type adapter 81 at its base so that it can be connected to any existing cable. In this case, the outer diameter of the connector 7 is set to the dimension d, and the outer diameter of the cap-type adapter is set to the dimension D when mounted on the connector 7 (see FIG. 24).
【００５２】また、剥離子支持部材７５にはその基端側
にジョイント部８２が設けられている。ジョイント部８
２は、その後端が開口し且つその奥部が広くなった略巾
着形状を成しており、開口部の最も幅の狭い部分の間隔
が寸法 Ｗ1 に設定されている。また、ジョイント部８
２の広い奥部は、ここにキャップ式アダプター８１を挿
入できる大きさ、すなわち、その最大径が寸法Ｗ2 に設
定されている。そして、上記各寸法間は、Ｗ2 ＞Ｄ＞Ｗ
1 ＞ｄなる関係に設定されている。すなわち、コネクタ
７にキャップ式アダプター８１が装着された状態では、
剥離子支持部材７５を内視鏡本体部４に取り付けること
はできないが、コネクタ７からキャップ式アダプター８
１を外した状態で剥離子支持部材７５を内視鏡本体部４
に取り付け、その後にコネクタ７にキャップ式アダプタ
ー８１を装着すると、剥離子支持部材７５が内視鏡本体
部４に固定的に装着されるようになっている。Further, the stripper support member 75 is provided with a joint portion 82 on the base end side thereof. Joint part 8
2 has a substantially drawstring shape with its rear end opened and its inner part widened, and the interval of the narrowest part of the opening is set to the dimension W 1 . Also, the joint part 8
The wide inner part of 2 has a size that allows the cap-type adapter 81 to be inserted therein, that is, the maximum diameter thereof is set to the dimension W 2 . And, between the above dimensions, W 2 >D> W
The relationship is 1 > d. That is, when the cap-type adapter 81 is attached to the connector 7,
Although the stripper support member 75 cannot be attached to the endoscope body 4, the connector 7 to the cap type adapter 8 cannot be attached.
1 is removed, the peeler support member 75 is attached to the endoscope main body 4
When the cap-type adapter 81 is attached to the connector 7 after that, the stripper support member 75 is fixedly attached to the endoscope body 4.
【００５３】剥離子支持部材７５の先端側には剥離子１
０を挿入するための装着口８３が開口しており、その上
方には剥離子１０を固定するための固定ネジ８４が抜け
止め用Ｃリング８５とともに設けられている。この場
合、固定ネジ８４の先端は剥離子１０の太径パイプ部１
３に設けられた系止孔 ８６と係合するようになってい
る。また、固定ネジ８４の取付け部位と対向する支持部
材７５の部位（接着口８３の底部）には開口が設けられ
ており、この開口には剥離子１０の回転規制を行なう規
制ピン８７が外側から挿入されて装着口８３に突出して
いる。そして、装着口８３に突出する規制ピン８７の突
出部位は剥離子１０の太径パイプ部１３に設けられた回
転規制溝８８と係合している。なお、この場合、回転規
制溝８８を上下２箇所に設ければ、観察部１５を反転し
た状態で使用でき、血管に接する面が曲面となって血管
の損傷をより小さくでき、特に、視野方向０°の前方視
型内視鏡との組み合わせにおいて、血管の下方側の剥離
も容易に行なえる。また、支持部材７５には、装着口８
３よりも基端側の部位に、硬性内視鏡１の挿入部２の径
よりも大きく且つ太径パイプ部１３の径よりも小さな孔
９０が設けられている。The stripper 1 is provided on the tip side of the stripper support member 75.
A mounting port 83 for inserting 0 is opened, and a fixing screw 84 for fixing the stripper 10 is provided above the mounting port 83 together with a retaining C ring 85. In this case, the tip of the fixing screw 84 is the large diameter pipe portion 1 of the stripper 10.
3 is designed to be engaged with a system stop hole 86 provided in No. 3. Further, an opening is provided in a portion of the support member 75 (bottom portion of the adhesion port 83) facing the attachment portion of the fixing screw 84, and a regulation pin 87 for regulating the rotation of the stripper 10 is provided from the outside in this opening. It is inserted and projects into the mounting opening 83. The protruding portion of the restriction pin 87 protruding into the mounting port 83 is engaged with the rotation restriction groove 88 provided in the large-diameter pipe portion 13 of the stripper 10. In this case, if the rotation restricting grooves 88 are provided at the upper and lower portions, the observation unit 15 can be used in an inverted state, and the surface in contact with the blood vessel becomes a curved surface to further reduce the damage to the blood vessel. In combination with a 0 ° forward-looking endoscope, detachment of the lower side of the blood vessel can be easily performed. Further, the support member 75 has a mounting opening 8
A hole 90 that is larger than the diameter of the insertion portion 2 of the rigid endoscope 1 and smaller than the diameter of the large-diameter pipe portion 13 is provided at a portion closer to the base end than 3.
【００５４】このような構成の剥離子支持部材７５によ
れば、係止ピンを有さない硬性内視鏡１であっても剥離
子１０との接続が可能となり、また、手術中に剥離子１
０を硬性内視鏡１から取り外す際に誤って支持部材７５
も外してしまうといった事態を防止できる。According to the stripper support member 75 having such a structure, even the rigid endoscope 1 having no locking pin can be connected to the stripper 10, and the stripper can be operated during surgery. 1
0 when removing 0 from the rigid endoscope 1 by mistake.
It is possible to prevent the situation where it is removed.
【００５５】図２６および図２７は、剥離子１０によっ
て周辺組織と剥離されて露出された血管を上方から保護
するプロテクタ９５を体内に容易に導入するための手段
を示している。FIGS. 26 and 27 show means for easily introducing the protector 95 into the body which protects the blood vessel exposed by being peeled off from the surrounding tissue by the peeler 10.
【００５６】図２６は、下肢の伏在静脈を採取するため
に第１の切開部１０１と第２の切開部１０２との間で剥
離子１０を皮下組織に貫通させた状態で、剥離子１０の
太径パイプ部１３にプロテクタ９５の細い先端側部分９
５ａを挿入接続して第２の切開部１０２から導出される
剥離子１０の案内によってプロテクタ９５を第１の切開
部１０１へと導入する様子を示している。なお、プロテ
クタ９５の本体部９５ｂの後端部にはＴ字状の係止部９
５ｃが設けられている。また、この係止部９５ｃには内
視鏡的血管摘出術を行なうために必要となる皮膚切開の
長さを印した指標９６，９６が設けられている。FIG. 26 shows a state in which the dissector 10 penetrates subcutaneous tissue between the first incision 101 and the second incision 102 to collect the saphenous vein of the lower limb. The thin tip portion 9 of the protector 95 is attached to the large-diameter pipe portion 13 of
5A shows a state in which the protector 95 is introduced into the first incision 101 by inserting and connecting 5a and guiding the stripper 10 drawn out from the second incision 102. In addition, a T-shaped locking portion 9 is provided at the rear end of the main body 95b of the protector 95.
5c is provided. Further, the locking portion 95c is provided with indexes 96, 96 indicating the length of the skin incision necessary for performing the endoscopic blood vessel resection.
【００５７】図２７に拡大して示すように、剥離子１０
の太径パイプ部１３の後端には、開口端が狭く且つ先端
側に向かって幅広に形成された略巾着形状のスリット９
２が左右に設けられている。As shown in the enlarged view of FIG.
At the rear end of the large-diameter pipe portion 13, the slit 9 is formed in a narrow drawstring shape having a narrow opening end and widening toward the front end side.
2 are provided on the left and right.
【００５８】このような構成において、内視鏡的血管摘
出術におけるプロテクタ設置作業を行なう場合には、前
述したように剥離子１０をガイドにして第１の切開部１
０１からプロテクタ９５を皮下に挿入していく。この場
合、プロテクタ９５の細い先端側部分９５ａを剥離子１
０の太径パイプ部１３の内側に差し込んだ状態で、剥離
子１０とプロテクタ９５の両方を把持して、両者が外れ
ないようにしながらプロテクタ９５を挿入していく。With such a structure, when the protector installation work is performed in the endoscopic blood vessel resection, the first incision portion 1 is guided by the stripper 10 as described above.
The protector 95 is inserted subcutaneously from 01. In this case, the thin tip side portion 95a of the protector 95 is attached to the stripper 1
In a state where the protector 95 and the protector 95 are both inserted into the inside of the large diameter pipe portion 13 of 0, the protector 95 is inserted while preventing both of them from coming off.
【００５９】このような作業時においては、例えば患者
の腹部の***によりプロテクタ９５の後端が持ち上がっ
た状態になるなど、剥離子１０とプロテクタ９５との軸
線が一致しなくなることがあるが、そのような場合で
も、本構成によれば、スリット９２により太径パイプ部
１３の部位でプロテクタ９５に比較的大きな自由度を付
与することができるため、プロテクタ９５を所定の方向
に動かして剥離子１０の軸線に対するプロテクタ９５の
軸線の位置を修正することができる。During such an operation, the axis of the stripper 10 and the protector 95 may not coincide with each other, for example, when the rear end of the protector 95 is lifted up due to the protrusion of the abdomen of the patient. Even in such a case, according to this configuration, the slit 92 can give a relatively large degree of freedom to the protector 95 at the portion of the large-diameter pipe portion 13, so that the protector 95 is moved in a predetermined direction and the stripper 10 is moved. The position of the axis of the protector 95 with respect to the axis can be modified.
【００６０】図２８および図２９には、剥離子１０とプ
ロテクタ９５との接続手段の別の例が示されている。図
２８の（ａ）および図２９に示すように、剥離子１０の
太径パイプ部１３には鍵型のスリット９７が設けられて
いる。このスリット９７は、周方向に沿って略９０°の
角度範囲で延びる周方向スリット部９７ａと、周方向ス
リット部９７ａの終端から太径パイプ部１３の軸方向に
沿って後端側に延びる軸方向スリット部９７ｂとからな
る。一方、プロテクタ９５には、図２８の（ｂ）に示す
ように、剥離子１０のスリット９７と係合可能な係合孔
９８が設けられている。28 and 29 show another example of the connecting means for connecting the stripper 10 and the protector 95. As shown in FIGS. 28A and 29, the large-diameter pipe portion 13 of the stripper 10 is provided with a key-shaped slit 97. The slit 97 includes a circumferential slit portion 97a extending in the angular range of about 90 ° along the circumferential direction, and an axis extending from the end of the circumferential slit portion 97a to the rear end side along the axial direction of the large diameter pipe portion 13. Direction slit portion 97b. On the other hand, the protector 95 is provided with an engagement hole 98 capable of engaging with the slit 97 of the stripper 10, as shown in FIG.
【００６１】このような構成において、剥離子１０とプ
ロテクタ９５とを接続する場合には、剥離子１０のスリ
ット９７にプロテクタ９５の係合孔９８を引掛ければ良
い。そして、この状態で、剥離子１０を引張ればプロテ
クタ９５が牽引されて皮下に引き込まれていく。スリッ
ト９７と係合孔９８との係合により、皮下で剥離子１０
とプロテクタ９５とが分離してしまうことが防止され、
プロテクタ９５を確実に皮下へ導入できる。In such a structure, when the stripper 10 and the protector 95 are connected to each other, the slit 97 of the stripper 10 may be engaged with the engagement hole 98 of the protector 95. Then, in this state, if the peeler 10 is pulled, the protector 95 is pulled and is drawn into the skin. The slit 97 and the engagement hole 98 are engaged with each other, so that the stripper 10 is subcutaneously removed.
It is prevented that the protector 95 and the protector 95 are separated from each other,
The protector 95 can be reliably introduced subcutaneously.
【００６２】図３０には、高周波電極を有する剥離子１
０が示されている。図３０の（ａ）に示すように、剥離
子１０の観察部１５の上部外表面には、１ｍｍ〜５ｍｍ
の長さの高周波電極１１３が設けられている。この高周
波電極１１３には外部と絶縁されたケーブル１１２が接
続されており、このケーブル１１２は剥離子１０の細長
い管状の本体部１１の外表面に固定されて外部の高周波
装置１１０に接続されている。高周波電極１１３を観察
部１５の上部外表面に設ける手段としては、図３０の
（ｂ）に示すように高周波電極１１３の先端部を屈曲形
状に形成してこれを観察部１５の内部に埋め込んだり、
あるいは、図３０の（ｃ）に示すように、高周波電極１
１３の先端部の上面を斜めに切断したテーパ状に形成し
たりすることが考えられる。これにより、皮下剥離中に
電極１１３の先端部が組織に突き刺さって電極１１３が
剥がれるといった事態を防ぐことができる。FIG. 30 shows a stripper 1 having a high frequency electrode.
0 is shown. As shown in (a) of FIG. 30, 1 mm to 5 mm is formed on the upper outer surface of the observation portion 15 of the stripper 10.
A high frequency electrode 113 having a length of 1 is provided. A cable 112 insulated from the outside is connected to the high-frequency electrode 113, and the cable 112 is fixed to the outer surface of the elongated tubular main body 11 of the stripper 10 and connected to the external high-frequency device 110. . As a means for providing the high-frequency electrode 113 on the outer surface of the upper portion of the observation section 15, as shown in FIG. 30B, the tip of the high-frequency electrode 113 is formed in a bent shape and embedded in the observation section 15. ,
Alternatively, as shown in (c) of FIG.
It is conceivable that the upper surface of the tip portion of 13 is formed into a tapered shape by obliquely cutting it. This can prevent a situation in which the tip of the electrode 113 pierces the tissue and peels off the electrode 113 during subcutaneous peeling.
【００６３】このような剥離子１０によれば、皮下剥離
作業中に固い組織に遭遇した時に電極１１３に高周波電
流を流してこの固い組織の一部を切開することができる
ため、更に深部に挿入していくことができる。また、一
端皮下に剥離子１０を挿入した後に電極１１３に高周波
電流を流して電極１１３を上方の組織に押し当てながら
引き戻すことにより、上方の組織が切り開かれて皮下の
腔を拡張することも可能となる。なお、この場合、電極
１１３がバイポーラ電極である場合には対極板は不要で
あるが、電極１１３がモノポーラ電極である場合には患
者に対極板を装着していることが条件となる。According to such a dissector 10, when a hard tissue is encountered during the subcutaneous dissection work, a high-frequency current can be applied to the electrode 113 to cut a part of this hard tissue, and therefore the dissector 10 can be inserted further deeply. You can do it. It is also possible to incise the upper tissue and expand the subcutaneous cavity by inserting a peeler 10 subcutaneously into one end and then applying a high-frequency current to the electrode 113 to pull back while pressing the electrode 113 against the upper tissue. Becomes In this case, when the electrode 113 is a bipolar electrode, the counter electrode plate is not necessary, but when the electrode 113 is a monopolar electrode, it is a condition that the patient is equipped with the counter electrode plate.
【００６４】なお、以上説明してきた実施態様によれ
ば、以下のごとき構成が得られる。 （付記１）内視鏡が挿入可能で、先端の少なくとも一部
に観察窓を有する細長い管状の本体部を有する剥離子に
おいて、前記本体部の最先端部に、鈍的形状で皮切部か
ら挿入して血管とその周囲組織とを剥離する先端部を有
することを特徴とする剥離子。According to the embodiment described above, the following constitution can be obtained. (Supplementary Note 1) An exfoliator having an elongated tubular main body having an observation window in at least a part of a distal end thereof, into which an endoscope can be inserted, wherein a distal end of the main body has a blunt shape from a skin cut portion. An exfoliator having a tip portion for inserting and exfoliating a blood vessel and its surrounding tissue.
【００６５】（付記２）本体部は、全体が透明部材で形
成されていることを特徴とする付記１記載の剥離子。 （付記３）先端部は、先細り形状であることを特徴とす
る 付記１記載の剥離子。 （付記４）先端部は、内視鏡視野の略中心に位置してい
ることを特徴とする付記１記載の剥離子。(Supplementary Note 2) The stripper according to Supplementary Note 1, wherein the main body is entirely formed of a transparent member. (Supplementary Note 3) The exfoliator according to Supplementary Note 1, wherein the tip portion has a tapered shape. (Supplementary Note 4) The detacher according to Supplementary Note 1, wherein the tip portion is located substantially at the center of the field of view of the endoscope.
【００６６】（付記５）先端部は、閉塞していることを
特徴とする付記１記載の剥離子。 （付記６）観察窓は、透明部材であることを特徴とする
付記１記載の剥離子。 （付記７）観察窓は、開口窓であることを特徴とする付
記１記載の剥離子。 （付記８）先端部は、本体部より太径であることを特徴
とする付記１記載の剥離子。(Supplementary Note 5) The stripper according to Supplementary Note 1, wherein the tip portion is closed. (Supplementary Note 6) The stripper according to Supplementary Note 1, wherein the observation window is a transparent member. (Supplementary Note 7) The stripper according to Supplementary Note 1, wherein the observation window is an opening window. (Supplementary Note 8) The stripper according to Supplementary Note 1, wherein the tip portion has a larger diameter than the main body portion.
【００６７】（付記９）先端部は、本体部の軸線に対し
て傾斜する傾斜面が設けられていることを特徴とする付
記１記載の剥離子。 （付記１０）先端部は、流線形であることを特徴とする
付記１記載の剥離子。(Supplementary Note 9) The stripper according to Supplementary Note 1, wherein the tip portion is provided with an inclined surface that is inclined with respect to the axis of the main body portion. (Supplementary Note 10) The stripper according to Supplementary Note 1, wherein the tip portion is streamlined.
【００６８】（付記１１）先端部は、その外周部にバル
ーンが設けられていることを特徴とする付記１記載の剥
離子。 （付記１２）本体部には、内視鏡との回転を規制する回
転規制部材が設けられていることを特徴とする付記１記
載の剥離子。 （付記１３）内視鏡と、この内視鏡の挿入部が挿入可能
で、先端の少なくとも一部に観察窓を有する細長い管状
の剥離子本体部と、この剥離子本体部の最先端部に設け
られ、鈍的形状で皮切部から挿入して血管とその周囲組
織とを剥離する先端部を有することを特徴とする内視鏡
用処置装置。(Supplementary Note 11) The exfoliator according to Supplementary Note 1, wherein a balloon is provided on the outer peripheral portion of the tip portion. (Supplementary Note 12) The peeler according to Supplementary Note 1, wherein the main body portion is provided with a rotation restricting member that restricts rotation with the endoscope. (Supplementary note 13) An endoscope, an elongated tubular disintegrator main body having an observation window in at least a part of a distal end thereof, into which an insertion portion of the endoscope can be inserted, and a distal end portion of the disintegrator main body are provided. A treatment device for an endoscope, which is provided with a blunt shape and has a tip portion which is inserted from a skin cut portion and separates a blood vessel and its surrounding tissue.
【００６９】（付記１４）剥離子本体部は、全体が透明
部材で形成されていることを特徴とする付記１３記載の
内視鏡用処置装置。 （付記１５）先端部は、先細り形状であることを特徴と
する付記１３記載の内視鏡処置装置。 （付記１６）先端部は、内視鏡視野の略中心に位置して
いることを特徴とする付記１３記載の内視鏡用処置装
置。(Supplementary Note 14) The endoscope treatment apparatus according to Supplementary Note 13, wherein the detachable body main body is entirely formed of a transparent member. (Supplementary Note 15) The endoscope treatment apparatus according to Supplementary Note 13, wherein the distal end portion has a tapered shape. (Supplementary note 16) The treatment device for an endoscope according to supplementary note 13, wherein the distal end portion is located substantially at the center of the field of view of the endoscope.
【００７０】（付記１７）先端部は、閉塞していること
を特徴とする付記１３記載の内視鏡用処置装置。 （付記１８）観察窓は、透明部材であることを特徴とす
る付記１３記載の内視鏡用処置装置。 （付記１９）観察窓は、開口窓であることを特徴とする
付記１３記載の内視鏡用処置装置。 （付記２０）先端部は、剥離子本体部より太径であるこ
とを特徴とする付記１３記載の内視鏡用処置装置。(Supplementary Note 17) The endoscope treatment apparatus according to Supplementary Note 13, wherein the distal end portion is closed. (Supplementary Note 18) The endoscopic treatment device according to Supplementary Note 13, wherein the observation window is a transparent member. (Supplementary note 19) The endoscopic treatment device according to supplementary note 13, wherein the observation window is an opening window. (Supplementary Note 20) The treatment device for an endoscope according to Supplementary Note 13, wherein the distal end portion has a diameter larger than that of the main body of the stripper.
【００７１】（付記２１）先端部は、剥離子本体部の軸
線に対して傾斜する傾斜面が設けられていることを特徴
とする付記１３記載の内視鏡用処置装置。 （付記２２）先端部は、流線形であることを特徴とする
付記１３記載の内視鏡用処置装置。 （付記２３）先端部は、その外周部にバルーンが設けら
れていることを特徴とする付記１３記載の内視鏡用処置
装置。 （付記２４）剥離子本体部には、内視鏡との回転を規制
する回転規制部材が設けられていることを特徴とする付
記１３記載の内視鏡用処置装置。(Supplementary note 21) The endoscope treatment apparatus according to supplementary note 13, wherein the distal end portion is provided with an inclined surface that is inclined with respect to the axis of the dissector body portion. (Supplementary Note 22) The endoscope treatment apparatus according to Supplementary Note 13, wherein the distal end portion is streamlined. (Supplementary note 23) The treatment device for an endoscope according to supplementary note 13, wherein a balloon is provided on the outer peripheral portion of the distal end portion. (Supplementary note 24) The endoscopic treatment device according to supplementary note 13, wherein the stripper main body portion is provided with a rotation restricting member that restricts rotation with the endoscope.
【００７２】（付記２５）観察窓を有する先端部材が、
内視鏡が挿入される細長い管状の本体部に対して着脱自
在であることを特徴とする付記１記載の剥離子。 （付記２６）先端部材と本体部を、スナップフィットで
装着することを特徴とする付記２５記載の剥離子。 （付記２７）先端部材と本体部を、キー溝係合とするこ
とを特徴とする付記２５記載の剥離子。 （付記２８）先端部材と本体部を、バネ変形により装着
することを特徴とする付記２５記載の剥離子。(Supplementary Note 25) The tip member having an observation window is
The stripper according to appendix 1, wherein the stripper is attachable to and detachable from an elongated tubular main body into which an endoscope is inserted. (Supplementary note 26) The peeler according to supplementary note 25, characterized in that the tip member and the main body are mounted by snap fitting. (Supplementary note 27) The stripper according to Supplementary note 25, wherein the tip end member and the main body portion are engaged with each other in a key groove. (Supplementary note 28) The stripper according to supplementary note 25, wherein the tip member and the main body are mounted by spring deformation.
【００７３】（付記２９）先端部材と本体部との間を、
水密構造とすることを特徴とする付記２５記載の剥離
子。 （付記３０）水密部材としてＯリングを用いたことを特
徴とする付記２９記載の剥離子。(Supplementary Note 29) Between the tip member and the main body,
26. The stripper according to appendix 25, which has a watertight structure. (Supplementary note 30) The stripper according to supplementary note 29, wherein an O-ring is used as the watertight member.
【００７４】[0074]
【発明の効果】以上説明したように、この発明の請求項
１によれば、内視鏡で観察しながら体内に挿入でき、目
的部位へのアプローチが確実であり、また先端部が鈍的
形状でるため、対象組織および周辺組織に損傷を与える
ことなく、血管の採取時に血管の周囲の結合組織を血管
から剥離できる。請求項２によれば、剥離子が内視鏡と
一体的であるため、目的部位を見失うことなく、操作性
に優れ、剥離処置を能率的に行うことができる。As described above, according to claim 1 of the present invention, it can be inserted into the body while observing with an endoscope, the approach to the target site can be ensured, and the tip portion has a blunt shape. Therefore, the connective tissue around the blood vessel can be detached from the blood vessel at the time of collecting the blood vessel without damaging the target tissue and the peripheral tissue. According to the second aspect, since the dissector is integrated with the endoscope, the target site is not lost, the operability is excellent, and the dissociation treatment can be efficiently performed.
【図１】この発明の第１の実施形態を示し、硬性内視鏡
と剥離子の斜視図。FIG. 1 is a perspective view of a rigid endoscope and a stripper according to a first embodiment of the present invention.
【図２】同実施形態の回転規制部材の縦断側面図。FIG. 2 is a vertical sectional side view of the rotation restricting member according to the embodiment.
【図３】同実施形態の剥離子を示し、（ａ）は平面図、
（ｂ）は縦断側面図、（ｃ）はＸ−Ｘ線に沿う断面図。FIG. 3 shows the peeler of the same embodiment, (a) is a plan view,
(B) is a vertical side view, and (c) is a cross-sectional view taken along line XX.
【図４】同実施形態の使用状態を示し、（ａ）は剥離操
作時の縦断側面図、（ｂ）同操作時の視野を示す図。4A and 4B show a usage state of the same embodiment, FIG. 4A is a vertical sectional side view during a peeling operation, and FIG. 4B is a view showing a visual field during the same operation.
【図５】この発明の第２の実施形態を示す剥離子の縦断
側面図。FIG. 5 is a vertical sectional side view of a peeler showing a second embodiment of the present invention.
【図６】同実施形態の使用状態を示し、剥離操作時の縦
断側面図。FIG. 6 is a vertical cross-sectional side view showing a usage state of the same embodiment, during a peeling operation.
【図７】この発明の第３の実施形態を示す剥離子の縦断
側面図。FIG. 7 is a vertical cross-sectional side view of a peeler showing a third embodiment of the present invention.
【図８】同実施形態の使用状態を示し、（ａ）は剥離操
作時の縦断側面図、（ｂ）同操作時の視野を示す図。8A and 8B show a usage state of the same embodiment, FIG. 8A is a vertical side view during a peeling operation, and FIG. 8B is a view showing a visual field during the same operation.
【図９】（ａ）は同実施形態の剥離子の観察部の具体的
な寸法形状を示す正面図、 （ｂ）は（ａ）の観察部の
側面図。9A is a front view showing a specific dimension and shape of an observation section of the peeler of the embodiment, and FIG. 9B is a side view of the observation section of FIG. 9A.
【図１０】図９の剥離子を皮下組織に挿入して状態を示
す断面図。10 is a cross-sectional view showing a state in which the dissector of FIG. 9 is inserted into subcutaneous tissue.
【図１１】この発明の第４の実施形態を示す剥離子の縦
断側面図。FIG. 11 is a vertical sectional side view of a peeler showing a fourth embodiment of the present invention.
【図１２】同実施形態の使用状態を示し、（ａ）は剥離
操作時の縦断側面図、（ｂ）同操作時の視野を示す図。12A and 12B show a usage state of the same embodiment, FIG. 12A is a vertical sectional side view during a peeling operation, and FIG. 12B is a view showing a visual field during the same operation.
【図１３】この発明の第５の実施形態を示し、（ａ）は
バルーンが収縮した状態の縦断側面図、（ｂ）はバルー
ンが膨張した状態の縦断側面図。13A and 13B show a fifth embodiment of the present invention, wherein FIG. 13A is a vertical sectional side view of the balloon in a deflated state, and FIG. 13B is a vertical sectional side view of the balloon in an inflated state.
【図１４】この発明の第１の実施形態における回転規制
部材の変形例を示し、硬性内視鏡と剥離子の斜視図。FIG. 14 is a perspective view of a rigid endoscope and a peeler, showing a modified example of the rotation restricting member according to the first embodiment of the present invention.
【図１５】この発明の第１の実施形態における回転規制
部材の変形例を示し、硬性内視鏡と剥離子の斜視図。FIG. 15 is a perspective view of a rigid endoscope and a peeler, showing a modified example of the rotation restricting member according to the first embodiment of the present invention.
【図１６】同変形例の作用説明図。FIG. 16 is an operation explanatory view of the modified example.
【図１７】この発明の第１の実施形態における回転規制
部材の変形例を示し、硬性内視鏡と剥離子の斜視図。FIG. 17 is a perspective view of a rigid endoscope and a peeler, showing a modification of the rotation restricting member according to the first embodiment of the present invention.
【図１８】同変形例の作用説明図。FIG. 18 is an operation explanatory view of the modified example.
【図１９】（ａ）は本体部に対して観察部を着脱する第
１の構成例を示す斜視図、（ｂ）は観察部と本体部とを
接続した状態を示す側断面図。FIG. 19A is a perspective view showing a first configuration example in which the observation section is attached to and detached from the main body section, and FIG. 19B is a side sectional view showing a state in which the observation section and the main body section are connected.
【図２０】本体部に対して観察部を着脱する第２の構成
例を示し、（ａ）は観察部の側断面図、（ｂ）は本体部
の側断面図。20A and 20B show a second configuration example in which the observation unit is attached to and detached from the main body unit, FIG. 20A is a side sectional view of the observation unit, and FIG. 20B is a side sectional view of the main body unit.
【図２１】図２０の（ａ）のＹーＹ線に沿う断面図。21 is a cross-sectional view taken along the line YY of FIG.
【図２２】本体部に対して観察部を着脱する第３の構成
例を示し、（ａ）は観察部の側断面図、（ｂ）は本体部
の側断面図。22A and 22B show a third configuration example in which the observation section is attached to and detached from the main body section, wherein FIG. 22A is a side sectional view of the observation section, and FIG.
【図２３】図２２の（ｂ）の本体部に装着されるＣ字形
状リングの正面図。23 is a front view of a C-shaped ring mounted on the main body of FIG. 22 (b).
【図２４】第１の実施形態における剥離子と硬性内視鏡
との接続部分の変形例を示す上面図。FIG. 24 is a top view showing a modified example of the connecting portion between the peeler and the rigid endoscope according to the first embodiment.
【図２５】第１の実施形態における剥離子と硬性内視鏡
との接続部分の変形例を示す側断面図。FIG. 25 is a side sectional view showing a modified example of the connecting portion between the peeler and the rigid endoscope according to the first embodiment.
【図２６】下肢の伏在静脈を採取するために剥離子の案
内によってプロテクタを皮下組織へ導入する様子を示す
図。FIG. 26 is a view showing a state in which a protector is introduced into the subcutaneous tissue by the guide of the dissector in order to collect the saphenous vein of the lower limb.
【図２７】図２６の状態における剥離子とプロテクタと
の接続部分を拡大して示す側面図。27 is a side view showing, in an enlarged manner, a connecting portion between the stripper and the protector in the state of FIG. 26. FIG.
【図２８】剥離子とプロテクタとの接続手段の別の例を
示し、（ａ）は剥離子の後端部の斜視図、（ｂ）はプロ
テクタの先端部の斜視図。28A and 28B show another example of the connecting means between the stripper and the protector, wherein FIG. 28A is a perspective view of the rear end of the stripper, and FIG. 28B is a perspective view of the tip of the protector.
【図２９】図２８における剥離子とプロテクタとの接続
状態を示す側断面図。29 is a side sectional view showing a connection state between the stripper and the protector in FIG. 28.
【図３０】高周波電極を有する剥離子の側断面図。FIG. 30 is a side sectional view of a peeler having a high-frequency electrode.
【符号の説明】 １…硬性内視鏡 ２…挿入部 ４…内視鏡本体部 １０…剥離子 １１…本体部 １２…先端部[Explanation of Codes] 1 ... Rigid endoscope 2 ... Insertion portion 4 ... End portion of endoscope body 10 ... Stripper 11 ... Body portion 12 ... Tip portion
フロントページの続き (72)発明者 小賀坂 高宏 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内 (72)発明者 岡部 洋 東京都渋谷区幡ヶ谷２丁目43番２号 オリ ンパス光学工業株式会社内Front page continuation (72) Inventor Takahiro Ogaka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Co., Ltd. (72) Inventor Hiroshi Okabe 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd.
Claims (2)
一部に観察窓を有する細長い管状の本体部を有する剥離
子において、 前記本体部の最先端部に、鈍的形状で皮切部から挿入し
て血管とその周囲組織とを剥離する先端部を有すること
を特徴とする剥離子。1. An exfoliator having an elongated tubular main body portion into which an endoscope can be inserted and having an observation window in at least a part of a distal end thereof, wherein a skin cutting portion having a blunt shape is provided at a distal end portion of the main body portion. An exfoliator having a tip portion for exfoliating a blood vessel and surrounding tissue from the blood vessel.
能で、先端の少なくとも一部に観察窓を有する細長い管
状の剥離子本体部と、この剥離子本体部の最先端部に設
けられ、鈍的形状で皮切部から挿入して血管とその周囲
組織とを剥離する先端部を有することを特徴とする内視
鏡用処置装置。2. An endoscope, an elongated tubular disintegrator body portion to which an insertion portion of the endoscope can be attached, and an observation window is provided at least at a part of a distal end thereof, and a distal end portion of the disintegrator body portion. A treatment device for an endoscope, which has a distal end portion which is provided in a blunt shape and is inserted from a skin cut portion to separate a blood vessel and its surrounding tissue.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP8032162A JP3061563B2 (en) | 1995-07-07 | 1996-02-20 | Peeler and treatment device for endoscope |
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP7-172139 | 1995-07-07 | ||
| JP17213995 | 1995-07-07 | ||
| JP8032162A JP3061563B2 (en) | 1995-07-07 | 1996-02-20 | Peeler and treatment device for endoscope |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JPH0975354A true JPH0975354A (en) | 1997-03-25 |
| JP3061563B2 JP3061563B2 (en) | 2000-07-10 |
Family
ID=26370688
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP8032162A Expired - Lifetime JP3061563B2 (en) | 1995-07-07 | 1996-02-20 | Peeler and treatment device for endoscope |
Country Status (1)
| Country | Link |
|---|---|
| JP (1) | JP3061563B2 (en) |
Cited By (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH1176247A (en) * | 1997-07-11 | 1999-03-23 | Olympus Optical Co Ltd | Surgical operation system |
| WO2007072767A1 (en) * | 2005-12-19 | 2007-06-28 | Nobuyuki Sakurazawa | Instrument for incising and dissecting tissue |
| JP2008000431A (en) * | 2006-06-23 | 2008-01-10 | Olympus Medical Systems Corp | Treatment device for endoscope |
| JP2008253785A (en) * | 2007-04-06 | 2008-10-23 | Olympus Medical Systems Corp | Dissection apparatus |
| US7662164B2 (en) | 2003-10-31 | 2010-02-16 | Olympus Corporation | Living-body tissue removing apparatus |
| JP2010099388A (en) * | 2008-10-27 | 2010-05-06 | Daiichikikai Co Ltd | Elevation aid |
| US7981127B2 (en) | 2001-12-27 | 2011-07-19 | Olympus Corporation | Treatment sheath for endoscopic blood vessel harvesting |
| US8080058B2 (en) | 2003-04-01 | 2011-12-20 | Depuy Mitek, Inc. | Method and apparatus for fixing a graft in a bone tunnel |
| US8105231B2 (en) | 2003-10-31 | 2012-01-31 | Olympus Corporation | Living-body tissue removing apparatus |
| US9314332B2 (en) | 2001-03-13 | 2016-04-19 | Depuy Mitek, Llc | Method and apparatus for fixing a graft in a bone tunnel |
| JP2016521142A (en) * | 2013-03-15 | 2016-07-21 | オリーブ・メディカル・コーポレイションＯｌｉｖｅ Ｍｅｄｉｃａｌ Ｃｏｒｐｏｒａｔｉｏｎ | Observation trocar with integrated prism for use with angled endoscopes |
| US10512475B2 (en) | 2011-08-24 | 2019-12-24 | Depuy Synthes Products, Inc | Cross pinning guide devices and methods |
| JP2021178177A (en) * | 2020-05-12 | 2021-11-18 | グローバス メディカル インコーポレイティッド | Locking variable-length compression screw, cross-reference to related applications, where this application claims priority to u.s. provisional application no. 63/023,291, filed may 12, 2020, which is incorporated herein by reference in its entirety |
-
1996
- 1996-02-20 JP JP8032162A patent/JP3061563B2/en not_active Expired - Lifetime
Cited By (16)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH1176247A (en) * | 1997-07-11 | 1999-03-23 | Olympus Optical Co Ltd | Surgical operation system |
| US9314332B2 (en) | 2001-03-13 | 2016-04-19 | Depuy Mitek, Llc | Method and apparatus for fixing a graft in a bone tunnel |
| US7981127B2 (en) | 2001-12-27 | 2011-07-19 | Olympus Corporation | Treatment sheath for endoscopic blood vessel harvesting |
| US8097010B2 (en) | 2001-12-27 | 2012-01-17 | Terumo Kabushiki Kaisha | Treatment sheath for endoscopic blood vessel harvesting |
| US8080058B2 (en) | 2003-04-01 | 2011-12-20 | Depuy Mitek, Inc. | Method and apparatus for fixing a graft in a bone tunnel |
| US7662164B2 (en) | 2003-10-31 | 2010-02-16 | Olympus Corporation | Living-body tissue removing apparatus |
| US8105231B2 (en) | 2003-10-31 | 2012-01-31 | Olympus Corporation | Living-body tissue removing apparatus |
| WO2007072767A1 (en) * | 2005-12-19 | 2007-06-28 | Nobuyuki Sakurazawa | Instrument for incising and dissecting tissue |
| JP2008000431A (en) * | 2006-06-23 | 2008-01-10 | Olympus Medical Systems Corp | Treatment device for endoscope |
| JP4624964B2 (en) * | 2006-06-23 | 2011-02-02 | オリンパスメディカルシステムズ株式会社 | Endoscopic treatment tool |
| JP4503081B2 (en) * | 2007-04-06 | 2010-07-14 | オリンパスメディカルシステムズ株式会社 | Peeling device |
| JP2008253785A (en) * | 2007-04-06 | 2008-10-23 | Olympus Medical Systems Corp | Dissection apparatus |
| JP2010099388A (en) * | 2008-10-27 | 2010-05-06 | Daiichikikai Co Ltd | Elevation aid |
| US10512475B2 (en) | 2011-08-24 | 2019-12-24 | Depuy Synthes Products, Inc | Cross pinning guide devices and methods |
| JP2016521142A (en) * | 2013-03-15 | 2016-07-21 | オリーブ・メディカル・コーポレイションＯｌｉｖｅ Ｍｅｄｉｃａｌ Ｃｏｒｐｏｒａｔｉｏｎ | Observation trocar with integrated prism for use with angled endoscopes |
| JP2021178177A (en) * | 2020-05-12 | 2021-11-18 | グローバス メディカル インコーポレイティッド | Locking variable-length compression screw, cross-reference to related applications, where this application claims priority to u.s. provisional application no. 63/023,291, filed may 12, 2020, which is incorporated herein by reference in its entirety |
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| Publication number | Publication date |
|---|---|
| JP3061563B2 (en) | 2000-07-10 |
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