JP2010273709A - Hood for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hood for an endoscope, capable of providing a sufficient visual field when a submucosal layer just under a lesion is exfoliated in the endoscopic submucosal dissection (ESD). <P>SOLUTION: The hood 1 for the endoscope includes a tubular attached part 2 to be detachably attached to the outer surface of the distal end of a nasal endoscope 4, and a guide tube 3 which is attached to the outer peripheral surface of the attached part 2 and into which forceps 15 can be inserted. The guide tube 3 is attached so that its axis crosses the axis of the endoscope 4. A water feed tube 7 is disposed on the outer peripheral surface of the attached part 2. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to an endoscope hood that is attached to a distal end portion of an endoscope.

  In recent years, a method called ESD (Endoscopic Submucosal Dissection) has been proposed as a method for treating initial cancer in the surface layer of the digestive tract such as the esophagus, stomach, small intestine, and large intestine. The ESD is performed by injecting a drug such as physiological saline into the submucosal layer of a lesioned part of the digestive tract to raise the lesioned part, and excising the submucosal layer using a tool such as a high-frequency knife. It is a method of removing the part. According to the ESD, it is considered that the lesioned part can be excised extensively in a wide area and can be surely cured if it is an early stage cancer.

  Conventionally, in the ESD, a local injection needle is inserted into a forceps channel of an endoscope, the drug is injected into the submucosal layer by the local injection needle, and then the incision is made in the forceps channel instead of the local injection needle. A knife is inserted, and the submucosal layer is peeled off by the cutting knife. However, the method as described above has a problem that it is troublesome to replace the local injection needle and the incision knife, and a sufficient field of view cannot be obtained when the submucosal layer just under the lesioned part is peeled off.

  In order to solve the above problem, a hood that includes a guide tube and is attached to the distal end of an endoscope has been proposed (for example, see Patent Document 1). According to the hood, by inserting the local injection needle into the guide tube, the local injection needle injects the drug into the submucosal layer, while the forceps channel of the endoscope is provided with the cutting knife. The submucosal layer can be peeled off with the knife for incision.

  Further, according to the hood, a grasping forceps is inserted into the guide tube, and the lesioned part is attracted to the endoscope side by the grasping forceps. Operation is supposed to be possible.

JP 2005-192675 A

  However, in the conventional hood, even if the lesioned part is attracted to the endoscope side by the grasping forceps inserted through the guide tube, the effect of counter traction is insufficient and a sufficient visual field cannot be obtained. There is an inconvenience.

  An object of the present invention is to provide an endoscopic hood capable of solving such inconvenience and obtaining a sufficient visual field when peeling the submucosal layer directly under a lesion in ESD.

  In order to achieve such an object, an endoscope hood of the present invention has a cylindrical mounting portion that is detachably mounted on the outer peripheral surface of the distal end portion of the endoscope, and is attached to the outer peripheral surface of the mounting portion. An endoscope hood comprising a guide tube through which forceps can be inserted is characterized in that the guide tube is attached in a direction intersecting the axis of the endoscope.

  In the endoscope hood of the present invention, the guide tube through which the forceps can be inserted has a predetermined angle with respect to the direction in which the axis intersects the axis of the endoscope, that is, the axis of the endoscope. Is attached to the outer peripheral surface of the mounting portion. Therefore, when the lesioned part is grasped by the forceps inserted through the guide tube and pulled in the direction of the guide tube, the lesioned part is lifted obliquely upward according to an angle formed by the guide tube and the endoscope. Counter traction effect can be obtained.

  Therefore, according to the endoscope hood of the present invention, it is possible to obtain a sufficient visual field when peeling the submucosal layer directly under the lesion in ESD.

  Moreover, it is preferable that the endoscope hood of the present invention includes a water supply tube on the outer peripheral surface of the mounting portion. The endoscope hood of the present invention can secure a visual field by supplying water to the vicinity of the distal end portion of the endoscope through the water supply tube, and an accurate bleeding point can be obtained when performing hemostatic treatment. Can be identified.

  The endoscope hood of the present invention can be used not only for oral endoscopes but also for nasal endoscopes.

The side view which shows the structure of the hood for endoscopes of this invention. The perspective view which shows the usage example of the hood for endoscopes of this invention.

  Next, embodiments of the present invention will be described in more detail with reference to the accompanying drawings.

  As shown in FIG. 1, the endoscope hood 1 of the present embodiment includes a cylindrical mounting portion 2 and a guide tube 3 attached to the outer peripheral surface of the mounting portion 2. The mounting portion 2 is detachably mounted on the outer peripheral surface of the distal end portion of the nasal endoscope 4, for example. The mounting portion 2 includes a support member 6 including an inclined portion 5 that is inclined from the proximal end portion toward the distal end portion on the outer peripheral surface thereof.

  The guide tube 3 is attached to the mounting portion 2 along the inclined portion 5 of the support member 6. As a result, the guide tube 3 is attached to the mounting portion 2 in a direction in which the axis intersects the axis of the nasal endoscope 4. The guide tube 3 has an inner diameter of, for example, 2.8 mm, and can be inserted with forceps such as hemostatic forceps and gripping forceps.

  The support member 6 is supported by being inserted through the tip of the water supply tube 7. The distal end portion of the water supply tube 7 is disposed below the support member 6 along the outer peripheral surface of the mounting portion 2, and the axis of the water supply tube 7 is parallel to the axis of the nasal endoscope 4. Yes.

  Next, as a usage example of the endoscope hood 1, a case where ESD is performed by the transnasal endoscope 4 to which the endoscope hood 1 is attached will be described.

  In the ESD, as shown in FIG. 2 (a), first, lesions in the surface layer 11 of the digestive tract such as the esophagus, stomach, small intestine, large intestine, etc., via the forceps channel (not shown) of the nasal endoscope 4 A marking 13 is applied around the portion 12. Next, the lesioned part 12 is raised by locally injecting a drug such as physiological saline or sodium hyaluronate solution into the submucosal layer of the lesioned part 12 through the forceps channel. Then, the entire circumference of the lesioned part 12 is incised by a cutting knife 14 such as a hook knife inserted through the forceps channel to form a cut part 15.

  Next, as shown in FIG. 2 (b), the lesioned part 12 is grasped by the grasping forceps 16 inserted through the guide tube 3 and pulled toward the guide tube 3. In this way, the guide tube 3 is attached to the mounting part 2 in a direction in which the axis intersects the axis of the nasal endoscope 4, so that the lesioned part 12 is the tip of the nasal endoscope 4. Is lifted obliquely upward with respect to the portion As a result, a sufficient counter traction effect can be obtained for the portion to be peeled immediately under the lesioned part 12 and a sufficient visual field can be secured for the nasal endoscope 4.

  Therefore, next, as shown in FIG. 2C, the submucosal layer just under the lesioned part 12 is incised and peeled off by the IT knife 17 inserted through the forceps channel.

  If peeling of the submucosal layer directly under the lesioned part 12 has progressed, the grasping forceps 16 grips the further back part directly under the lesioned part 12 and pulls it in the direction of the guide tube 3, and FIG. 2 (b) and FIG. The operation of c) is repeated. As a result, the workability at the time of incising and peeling off the submucosa layer can be dramatically improved. Finally, as shown in FIG. Can be excised. Although the excision mark 18 is formed in the surface layer 11 of the digestive tract, the excision mark 18 can be easily recovered.

  In the present embodiment, the case where the endoscope hood 1 is attached to the nasal endoscope 4 has been described. However, the endoscope hood 1 may be attached to an oral endoscope. In this embodiment, the case where the endoscope hood 1 includes the water supply tube 7 is described. However, the endoscope hood 1 does not necessarily include the water supply tube 7.

  DESCRIPTION OF SYMBOLS 1 ... Endoscope hood 1, 2 ... Mounting part, 3 ... Guide tube, 4 ... Transnasal endoscope, 7 ... Water supply tube, 15 ... Grasping forceps.

Claims (3)

An endoscope hood comprising: a cylindrical mounting portion that is detachably mounted on an outer peripheral surface of a distal end portion of an endoscope; and a guide tube that is attached to the outer peripheral surface of the mounting portion and allows insertion of forceps. ,
An endoscope hood characterized in that the guide tube is attached in a direction whose axis intersects the axis of the endoscope.   The endoscope hood according to claim 1, further comprising a water supply tube on an outer peripheral surface of the mounting portion.   The endoscope hood according to claim 1 or 2, wherein the endoscope is a transnasal endoscope.

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