Medical instrument for endoscopic use

The disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the tube and is projected forwardly with respect to the over tube from a distal end of the tube. A balloon is disposed on an external surface of the over tube and is expandable outwardly in a radial direction of the over tube.

TECHNICAL FIELD

The disclosed technology relates to a medical instrument for endoscopic use.

DESCRIPTION OF THE RELATED ART

A Japanese Patent Application JP 2005-334237 (PTL 1) discloses a coupling tool for attaching guiding tubes to direct treatment tools to a distal end of an inserting portion of an endoscope.

According to this coupling tool, it is possible to treat an affected part while disposing and observing, within a field of view of the endoscope, distal ends of the treatment tools guided via the guiding tubes disposed on an outside in a radial direction of the inserting portion of the endoscope.

However, the coupling tool of PTL 1 attaches the guiding tubes directing the treatment tools, to a distal end of the inserting portion of the endoscope. Thus, when a curved portion of the endoscope is operated to perform treatment by a treatment tool introduced via a channel of the endoscope, the treatment tools directed via the guiding tubes are also moved in synchronism with the operation of the endoscope. The treatment may therefore become difficult. For example, in a case where a treatment of cutting a tissue by the treatment tool passed through the channel of the endoscope is performed by operating the curved portion of the endoscope while a surrounding tissue is raised by the treatment tools passed via the guiding tubes, the treatment becomes difficult when the treatment tools raising the tissue are also moved so as to follow the operation of the endoscope.

BRIEF SUMMARY OF EMBODIMENTS

One aspect of the disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the tube and is projected forwardly with respect to the over tube from a distal end of the tube. A balloon is disposed on an external surface of the over tube and is expandable outwardly in a radial direction of the over tube.

Another aspect of the disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A first tube is disposed concentrically outwardly of the over tube so that the treatment tool is inserted through the first tube projected forwardly with respect to the over tube from a distal end of the first tube. A second tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the second tube and is projected forwardly with respect to the over tube from a distal end of the second tube so as to be separated from the first tube. A balloon is disposed on an external surface of the over tube and is expandable between the first tube and the second tube and outwardly in a radial direction of the over tube and the balloon at a time of expansion being located radially outwardly of the first tube and the second tube.

DETAILED DESCRIPTION OF THE EMBODIMENTS

In the following description, various embodiments of the technology will be described. For purposes of explanation, specific configurations and details are set forth in order to provide a thorough understanding of the embodiments. However, it will also be apparent to one skilled in the art that the technology disclosed herein may be practiced without the specific details. Furthermore, well-known features may be omitted or simplified in order not to obscure the embodiment being described.

The disclosed technology has been made in view of the circumstances described hereinbefore. It is an object of the disclosed technology to provide a medical device that can facilitate treatment by allowing a treatment tool directed into a field of view of an endoscope via an outside of the endoscope to be operated independently of the movement of the endoscope.

A medical instrument for endoscopic use1according to one embodiment of the disclosed technology will be described in the following with reference to the drawings.

As depicted inFIGS.1to3, the medical instrument for endoscopic use1according to the present embodiment is a ring-shaped attachment detachably attached to a distal end portion of a long over tube120having an inner hole121through which an endoscope110is made to penetrate. The medical instrument for endoscopic use1includes: a main body3having a central hole2of an inside diameter for fitting an outer peripheral surface of the distal end portion of the over tube120; and channels4arranged in four positions of the main body3at equal intervals in a circumferential direction.

As depicted inFIG.2, an outer peripheral surface of the main body3at one end in the direction of a central axis O is chamfered over an entire circumference. The channels4each extends along the direction of the central axis O of the main body3. Each channel4includes a distal end opening4adisposed in a chamfered surface3aof the main body3and a proximal end opening4bdisposed in another end surface3bin the direction of the central axis O. Each channel4is inclined in a direction of approaching the central axis O toward the distal end opening4afrom the proximal end opening4b. Inclining means5is thereby formed.

Each channel4is opened outward in a radial direction by a slit6. As depicted inFIG.3, a long flexible tube7is fitted in the slit6. The tube7can be attached to the channel4by inserting the tube7into the channel4from the slit6while compressing the tube7in the radial direction, and allowing the tube7to be restored by an elastic restoring force. The tube7may be bonded to the channel4by an adhesive. In addition, the tube7is preferably longer than the over tube120.

Because the inclining means5is formed by inclining the channel4as described hereinbefore, the tube7fitted in the channel4is inclined in the direction of approaching the central axis O of the main body3toward a distal end.

The action of the thus formed medical instrument for endoscopic use1according to the present embodiment will be described in the following.

In order to treat an affected part X within the body of a patient by using the medical instrument for endoscopic use1according to the present embodiment, as depicted inFIG.3, the distal end portion of the over tube120is fitted into the central hole2of the main body3, and the distal end portion of the over tube120and the central hole2of the main body3are fixed to each other by a frictional force caused by the fitting or an adhesive. In addition, a distal end portion of a tube7is fitted to each channel4disposed in the main body3, and the distal end portion of the tube7and the channel4are fixed to each other by a frictional force or an adhesive. The central axis O of the main body3and a longitudinal central axis P of the over tube120thereby coincide with each other.

Then, the endoscope110is inserted into the inner hole121of the over tube120from a proximal end side, and a front surface of the endoscope110is disposed in the vicinity of a distal end of the over tube120.

In this state, the endoscope110is actuated. An assembly of the endoscope110, the over tube120, the medical instrument for endoscopic use1according to the present embodiment, and the tube7is inserted into a body while an image of the front of the over tube120is checked. The distal end of the over tube120is disposed at a position where the affected part X as a treatment target site is disposed within a field of view of the endoscope110.

Then, one of the tubes7that is located on an upper side of the image obtained by the endoscope110is selected. A treatment tool130such as holding forceps is inserted from a proximal end of the tube7. The treatment tool130is projected from the distal end of the tube7supported by the channel4of the main body3.

With the medical instrument for endoscopic use1according to the present embodiment, the channel4attached to the distal end portion of the over tube120and supporting the tube7on an outside in a radial direction of the over tube120is inclined in a direction of approaching the longitudinal central axis P of the over tube120toward the front. Thus, by merely projecting the treatment tool130from the distal end of the tube7, it is possible to make the treatment tool130appear within the image from the upper side of the image, move downward, and reach the affected part X disposed within the field of view.

As depicted inFIG.3, a surrounding tissue of the affected part X is held by operating the treatment tool130that has reached the affected part X. The surrounding tissue held can be raised by merely moving the treatment tool130in a direction of pulling out the treatment tool130from the inside of the tube7to the proximal end side (solid line arrow inFIG.3) or in a direction of pushing out the treatment tool130to a distal end side (alternate long and short dashed line arrow inFIG.3).

Then, in this state, the raised tissue can be cut by displacing a treatment tool140such as an electric scalpel introduced via a channel not depicted but disposed in the endoscope110, by advancing or retreating the endoscope110and operating a curving portion of the endoscope110.

In this case, in the present embodiment, the treatment tool130raising the surrounding tissue is supported by the medical instrument for endoscopic use1attached to the over tube120. Thus, the treatment tool130raising the surrounding tissue can be maintained in a stationary state irrespective of operation of the endoscope110at a time of cutting the tissue. In a case where the treatment tool130is attached to the endoscope110as in related art, the treatment tool130is moved in synchronism with the operation of the endoscope110, and therefore the raised tissue is moved in synchronism with the operation of the endoscope110. However, the medical instrument for endoscopic use1according to the present embodiment does not cause such an inconvenience, and can facilitate treatment.

In addition, in the present embodiment, the slits6open the channels4outward in the radial direction. Thus, a material thickness does not need to be secured on the outside in the radial direction. An outside diameter dimension of the main body3can therefore be reduced to improve ease of insertion of the main body3into the body.

Incidentally, while description has been made of a case where the tube7guiding the treatment tool130is attached to the channel4disposed in the main body3in the present embodiment, the treatment tool130may be used after being directly inserted into the channel4.

In addition, while the channels4are arranged at four positions at equal intervals in the circumferential direction, the intervals do not have to be equal to each other, and the number of channels4may be any number as long as the number is one or more.

In addition, as depicted inFIG.4andFIG.5, the channels4may be closed on the outside in the radial direction. Thus, in a case where the treatment tool130is directly inserted into a channel4, or in a case where a tube7is attached by fitting alone, the treatment tool130or the tube7can be prevented from coming off the channel4easily.

In addition, only a ring-shaped attachment attached to the over tube120has been illustrated as the medical instrument for endoscopic use1according to the present embodiment. However, in place of this, a medical instrument obtained by attaching the tubes7to the channels4or integrally forming the tubes7and the channels4as depicted inFIG.6may be adopted, or a medical instrument obtained by fitting the over tube120or integrally forming the over tube120as depicted inFIG.7may be adopted.

In addition, as depicted inFIG.8, the over tube120may include a balloon8capable of being expanded and contracted in the radial direction on the proximal end side as compared to the ring-shaped main body3and on an external surface of the over tube120. When the balloon8is expanded in a case where an affected part X within a lumen is treated, the balloon8presses the tubes7outward in the radial direction of the over tube120. The tubes7pressed outward in the radial direction and the expanded balloon8are pressed against the lumen to fix the over tube120to the lumen. The treatment can be thereby further facilitated.

In addition, as depicted inFIG.11, the balloon8may include recessed portions8athat become protrusive inward in the radial direction from a maximum outside diameter dimension of the balloon8when the balloon8is expanded. It is preferable that the recessed portions8ahave same phases as the tubes7and are arranged in the same number as that of tubes7.

Consequently, when the balloon8is expanded, the balloon8is pressed against the lumen in a state in which the tubes7are arranged in the recessed portions8aof the balloon8. The over tube120can be thereby fixed to the lumen.

In addition, in the present embodiment, four channels4are arranged at intervals in the circumferential direction, and the tubes7are attached to the respective channels4. However, there is a case where the over tube120is twisted in a state of being inserted in a body, and it becomes unclear to which channel4a proximal end portion of a tube7exposed to the outside of the body corresponds. In order to resolve this inconvenience, as depicted inFIG.9, marks9and10, i.e. a distal end side identifying indication and a proximal end side identifying indication, which associate the inner surface of the distal end of the over tube120and the proximal end of the tube7with each other, may be respectively arranged on the inner surface of the distal end of the over tube120and the proximal end of the tube7.

Thus, the mark9on the inner surface of the over tube120can be disposed within the field of view of the endoscope110by disposing the endoscope110in a position retracted to the proximal end side with respect to the over tube120. A mark10of a different shape or color is provided for each channel4to which a tube7is attached. The position of the channel4to which the tube7is attached can thereby be recognized, i.e. identified, based on the mark10on the proximal end side of the tube7.

In other words, the treatment tool130can be projected on the upper side in the endoscope image by selecting the tube7disposed on the upper side in the endoscope image and corresponding to the mark10, and inserting the treatment tool130from the proximal end side of the tube7.

It is to be noted that the mark9is not limited to being disposed on the inner surface of the inner hole121of the over tube120. The over tube120may be formed of a transparent material, and the mark9may be disposed in some position visually recognizable from the inside of the inner hole121of the over tube120by the endoscope110, the position being a position on the outer surface of the over tube120, the inner surface of the central hole2of the medical instrument for endoscopic use1into which hole the outer surface of the over tube120is fitted, or the like.

In addition, in the present embodiment, a case has been illustrated in which a channel4itself is inclined as the inclining means5for inclining and projecting the treatment tool130inserted in the channel4in a direction toward the central axis O. However, the inclining means5is not limited to this. For example, as depicted inFIG.10, the channel4itself may be arranged substantially in parallel with the central axis O, and an inclining surface11, i.e. a guide surface, which guides the treatment tool130projected from the distal end opening4aof the channel4toward the inside in the radial direction, may be disposed in front of the channel4. The inclining surface11may be disposed over the whole circumference in the circumferential direction as depicted inFIG.10, or may be disposed partially in circumferential positions corresponding to the channels4. In this case, the outer peripheral surface at one end of the main the body portion3may not be chamfered.

In sum, one aspect of the disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the tube and is projected forwardly with respect to the over tube from a distal end of the tube. A balloon is disposed on an external surface of the over tube and is expandable outwardly in a radial direction of the over tube.

The balloon expands outwardly in the radial direction of the over tube while maintaining a state of being separated from the tube. The balloon include at least one of recessed portion that become protrusive inward in the radial direction from a maximum outside diameter dimension of the balloon when the balloon is expanded and the tube is placed in the recess portion. The balloon is disposed between the over tube and the tube and presses the tube outwardly by expanding in the radial direction. A plurality of tubes are disposed at intervals in a circumferential direction of the over tube. The medical instrument further comprises a main body disposed on a distal end portion of the over tube and having a channel retaining the tube therein. The main body has inclining means for inclining the tube toward a front in a direction of approaching a longitudinal central axis of the over tube. At least one of the plurality of tubes has a proximal end side mark so as to be distinguishable by an operator. A distal end side mark corresponding to the proximal end side mark and is disposed in a position visually recognizable from an inner surface side of the over tube. The medical instrument for endoscopic use further comprises a flexible endoscope that is inserted into the over tube.

Another aspect of the disclosed technology is directed to a medical instrument for endoscopic use. The medical instrument comprises an elongated open ended over tube configured to receive an endoscope in a direction along a longitudinal central axis of the over tube. The endoscope travels retractably from a distal end of the over tube. A first tube is disposed concentrically outwardly of the over tube so that the treatment tool is inserted through the first tube projected forwardly with respect to the over tube from a distal end of the first tube. A second tube is disposed concentrically outwardly of the over tube so that a treatment tool is inserted through the second tube and is projected forwardly with respect to the over tube from a distal end of the second tube so as to be separated from the first tube. A balloon is disposed on an external surface of the over tube and is expandable between the first tube and the second tube and outwardly in a radial direction of the over tube and the balloon at a time of expansion being located radially outwardly of the first tube and the second tube.

While various embodiments of the disclosed technology have been described above, it should be understood that they have been presented by way of example only, and not of limitation. Likewise, the various diagrams may depict an example schematic or other configuration for the disclosed technology, which is done to aid in understanding the features and functionality that can be included in the disclosed technology. The disclosed technology is not restricted to the illustrated example schematic or configurations, but the desired features can be implemented using a variety of alternative illustrations and configurations. Indeed, it will be apparent to one of skill in the art how alternative functional, logical or physical locations and configurations can be implemented to implement the desired features of the technology disclosed herein.

The presence of broadening words and phrases such as “one or more,” “at least,” “but not limited to” or other like phrases in some instances shall not be read to mean that the narrower case is intended or required in instances where such broadening phrases may be absent. Additionally, the various embodiments set forth herein are described in terms of exemplary schematics, block diagrams, and other illustrations. As will become apparent to one of ordinary skill in the art after reading this document, the illustrated embodiments and their various alternatives can be implemented without confinement to the illustrated examples. For example, block diagrams and their accompanying description should not be construed as mandating a particular configuration.