Endoscopic system that uses overtube

Abstract

With a first endoscope inserted through an overtube, the overtube is orally inserted into an object being examined, and a distal end portion of an insertion tube of the first endoscope is made to advance, within the object, from a jejunum via a jejunum-to-jejunum anastomosed portion and a jejunum-anastomosed bent portion so that the distal end portion is located adjacently to a Vater's papilla of a duodenum. The overtube is then sent to a position which is adjacent to the Vater's papilla along the insertion tube of the first endoscope. After this, the first endoscope is pulled from the overtube. A second endoscope is then inserted into the overtube to make a distal end portion of its insertion tube protrude from the distal end of the overtube and is located adjacently to the Vater's papilla. The second endoscope thus-approached is used to treat the Vater's papilla and the tissue therearound.

1 . An endoscopic system comprising:
 an overtube having an insertion channel formed along an axial direction thereof;   an endoscope inserted into the insertion channel of the overtube for use thereof; and   assist means for assisting, when the overtube is inserted adjacently to a jejunum-to-jejunum anastomosed portion of a jejunum of an object being examined in a state where the endoscope is kept being inserted into the insertion channel of the overtube, changes of an insertion path along which the overtube is inserted from the jejunum to the jejunum-to-jejunum anastomosed portion.   
     
     
         2 . The endoscopic system of  claim 1 , wherein the assist means comprises a balloon that positionally fixes the overtube onto the jejunum, the balloon being loaded to an outer surface of the overtube and expanded by supplying air thereto so that the balloon comes into contact with the jejunum. 
     
     
         3 . The endoscopic system of  claim 1 , wherein the assist means is an oblique opening that is formed at a distal end portion of the overtube and that is oblique to an axial direction of the overtube,
 wherein, when the distal end portion of the overtube reaches the jejunum-to-jejunum anastomosed portion, the overtube is rotated on the axial direction so that the oblique opening is directed towards the jejunum-to-jejunum anastomosed portion.   
     
     
         4 . The endoscopic system of  claim 3 , wherein the distal end portion is bent so as to direct the oblique opening towards a direction perpendicular to the axial direction. 
     
     
         5 . The endoscopic system of  claim 1 , wherein the overtube has a slit formed entirely through the overtube in the axial direction thereof. 
     
     
         6 . The endoscopic system of  claim 1 , wherein the assist means is either a side opening or a slit which is formed through the overtube and which allows an insertion tube of the endoscope inserted in the insertion channel to advance towards a radial direction perpendicular to the axial direction. 
     
     
         7 . The endoscopic system of  claim 1 , wherein the assist means is a bendable portion which is formed at the overtube and bent in response to operations so as to enable a distal end portion of the overtube to be changed in a direction thereof. 
     
     
         8 . The endoscopic system of  claim 1 , wherein the overtube is made up of an inner tube into which the endoscope is inserted and an outer tube into which the inner tube is inserted. 
     
     
         9 . The endoscopic system of  claim 1 , wherein the endoscope is marked by a marker indicative of an amount by which a distal end portion of an insertion tube of the endoscope is protruded from an distal end of the overtube in a state where the overtube is inserted. 
     
     
         10 . The endoscopic system of  claim 8 , wherein the assist means is a bendable portion which is formed at the outer tube and bent in response to operations so as to enable a distal end portion of the outer tube to be changed in a direction thereof. 
     
     
         11 . The endoscopic system of  claim 10 , wherein the inner tube comprises a bendable portion which is bent in response to operations so as to enable a distal end portion of the inner tube to be changed in a direction thereof. 
     
     
         12 . The endoscopic system of  claim 8 , wherein each of the inner tube and the outer tube has a marker for mutually positioni ng both inner and outer tubes in a circumferential direction around the axial direction. 
     
     
         13 . The endoscopic system of  claim 8 , comprising lock means for positionally locking both inner and outer tubes in the axial direction. 
     
     
         14 . The endoscopic system of  claim 1 , wherein the endoscope is either a forward-viewing endoscope or an oblique-viewing endoscope which allows the overtube to be guided from the jejunum to a target portion via the jejunum-to-jejunum anastomosed portion.