插入管的操作特性重要，特別是對于結(jié)腸鏡而言。為了易于插入，該儀器必須能夠準(zhǔn)確傳輸內(nèi)鏡醫(yī)師施加的所有細(xì)微運(yùn)動和扭矩。內(nèi)窺鏡醫(yī)師施加于軸近端部分的任何旋轉(zhuǎn)（扭矩）都必須以1：1的比例傳遞至器械的遠(yuǎn)端，盡管這種能力會在器械成環(huán)時失去。扁平的螺旋金屬帶正好在插入管皮下延伸，從而增強(qiáng)了儀器的扭轉(zhuǎn)能力。
The operating characteristics of the insertion tube are important, especially for colonoscopy. For ease of insertion, the instrument must be able to accurately transmit all subtle movements and torques applied by the endoscopist. Any rotation (torque) applied by the endoscopist to the proximal part of the shaft must be transmitted to the distal end of the instrument in a ratio of 1:1, although this ability will be lost when the instrument is looped. The flat spiral metal belt extends just under the skin of the insertion tube, so as to enhance the torsion ability of the instrument.
由于這些帶的纏繞方向相反，因此在管子受到扭轉(zhuǎn)時它們會相互鎖定，從而將管子一端的旋轉(zhuǎn)準(zhǔn)確地傳遞到另一端。同時，這些螺旋帶之間的間隙使軸可以自由彎曲。這些帶也使插入管呈圓形。它們的剛度可防止插入管的內(nèi)部組件受到外力擠壓。這些螺旋帶被編織成管狀網(wǎng)的細(xì)絲不銹鋼絲覆蓋。將塑料聚合物層（通常為黑色（在結(jié)腸鏡上為深綠色））擠出到該金屬絲網(wǎng)上，以創(chuàng)建插入管的光滑外表面。聚合物層為插入管提供了無創(chuàng)，生物相容和水密的表面。
Because the winding direction of these tapes is opposite, they will lock each other when the pipe is twisted, so as to accurately transfer the rotation of one end of the pipe to the other end. At the same time, the clearance between these helical belts allows the shaft to bend freely. These bands also round the insertion tube. Their stiffness prevents the internal components of the inserted tube from being squeezed by external forces. These spiral belts are covered with thin stainless steel wires woven into tubular nets. A plastic polymer layer, usually black (dark green on colonoscopy), is extruded onto the wire mesh to create a smooth outer surface of the insertion tube. The polymer layer provides a non-invasive, biocompatible and watertight surface for the insertion tube.
經(jīng)驗(yàn)表明，對于檢查上消化道的固定解剖結(jié)構(gòu)而言，更堅固的插入管是良好選擇。結(jié)腸具有曲折和可自由移動的環(huán)，用更靈活的儀器檢查。儀器應(yīng)足夠松散（非剛性），以易于適應(yīng)患者的曲折解剖結(jié)構(gòu)，并在結(jié)腸壁和腸系膜上施加小的力。器械還應(yīng)具有足夠的柱強(qiáng)度，以防止在推動器械的近端時發(fā)生彎曲。結(jié)腸鏡除具有靈活性外，還應(yīng)具有足夠的彈性，以使其在向后拉時會彈回拉直狀態(tài)。這有助于消除循環(huán)。

Experience has shown that a stronger insertion tube is a good choice for examining the fixed anatomy of the upper gastrointestinal tract. The colon has a tortuous and freely movable ring, which can be examined with a more flexible instrument. The instrument should be loose enough (non rigid) to easily adapt to the patient's tortuous anatomy and exert small forces on the colon wall and mesentery. The instrument shall also have sufficient column strength to prevent bending when pushing the proximal end of the instrument. In addition to flexibility, the colonoscope should also have enough elasticity so that it will bounce back to the straightened state when pulled back. This helps eliminate loops.
獲得柔韌性，彈性，柱強(qiáng)度和扭轉(zhuǎn)能力的組合是插入管設(shè)計的藝術(shù)和科學(xué)。這些特性之一的改進(jìn)通常會對其他一個或多個負(fù)面影響。設(shè)計通常是這些理想特性之間的折衷，經(jīng)過幾個月的臨床測試證實(shí)。為了進(jìn)一步改善插入，胃鏡和結(jié)腸鏡插入管的柔性通常在端部到端部之間變化。正如圖3.3示出，遠(yuǎn)端40cm的結(jié)腸鏡插入管的是顯著比近側(cè)部分更柔軟。柔性的這種變化是通過在制造過程中改變管的外部聚合物層在金屬絲網(wǎng)上擠出時的配方來實(shí)現(xiàn)的。
The combination of flexibility, elasticity, column strength and torsion is the art and science of insert tube design. Improvements in one of these features usually have a negative impact on one or more others. Design is usually a compromise between these ideal characteristics, which has been confirmed by clinical tests for several months. To further improve insertion, the flexibility of gastroscopy and colonoscopy insertion tubes usually varies from end to end. As shown in Figure 3.3, the distal 40 cm colonoscopy insertion tube is significantly softer than the proximal part. This change in flexibility is achieved by changing the formulation of the outer polymer layer of the tube extruded on the wire mesh during the manufacturing process.
擠出機(jī)包含兩種類型的樹脂，一種明顯比另一種硬。當(dāng)插入管的遠(yuǎn)端穿過機(jī)器時，一層柔軟的樹脂被應(yīng)用到絲網(wǎng)的遠(yuǎn)端40厘米處。在靠近管中部的過渡區(qū)域內(nèi)，這種軟樹脂逐漸被硬樹脂替代。插入管的近端部分（50至160 cm）僅由硬質(zhì)樹脂制成。結(jié)果是插入管具有柔軟的遠(yuǎn)側(cè)部分，可無創(chuàng)地彎曲通過彎曲的結(jié)腸，而較硬的近側(cè)部分可有效防止結(jié)腸中已被結(jié)腸鏡矯正的部分中的環(huán)再形成。
The extruder contains two types of resins, one of which is significantly harder than the other. When the distal end of the insertion tube passes through the machine, a layer of soft resin is applied to the distal end of the screen 40 cm. In the transition area near the middle of the pipe, this soft resin is gradually replaced by hard resin. The proximal portion of the insertion tube (50 to 160 cm) is made of hard resin only. As a result, the insertion tube has a soft distal portion that can be noninvasively bent through the curved colon, while the hard proximal portion can effectively prevent the re formation of the ring in the portion of the colon that has been corrected by colonoscopy.
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