Abstract: A pharyngeal intubation guiding device includes lengthwise extending tongue-side and palate-side walls that cooperatively define a guiding duct. The tongue-side wall is configured to conform to the rear end of a patient's tongue to permit the guiding duct to confront the opening of the patient's larynx. The palate-side wall has an outer contour which establishes a guideway towards the opening of the patient's esophagus. A lengthwise extending laryngoscope guiding channel and a lengthwise extending endotracheal tube guiding groove are disposed in the guiding duct. A viewing window is disposed to define a terminal end of the laryngoscope guiding channel. The endotracheal tube guiding groove has a lead-in port to permit an endotracheal tube introduced therein to be removable laterally. A lengthwise extending conduit is disposed in the guiding duct to permit an aspirator tube to reach the patient's trachea to suck out phlegm.

Abstract: A stylet with a camera device is disclosed, which is used along with an endotracheal tube. The stylet with a camera device comprises: a tube body, placed in the endotracheal tube, the tube body having a front end and a rear end, the rear end of the tube body having a bending part; an image capturing unit, used for capturing an image, the image capturing unit being connected to the front end of the tube body; a display unit, used for displaying the image, the display unit being connected to the bending part, and the display unit being electrically connected to the image capturing unit, wherein the display unit is located in a rear side of the endotracheal tube; and an operating member, connected to the rear end or the display unit, wherein the operating member allows a user to apply force so as to make the front end of the tube body protrude from one end of the endotracheal tube.

Abstract: A laryngoscope blade is provided. The blade includes a base, a relatively straight main blade portion and a distal tip. The relatively straight main blade portion has a length that extends from the base. The distal tip has a length that extends from the main blade portion. The distal tip further has a width that extends out beyond the width of the main blade in a select direction. The distal tip further yet has a bend at a select location about its length.

Abstract: A two-piece video laryngoscope includes a disposable handle/blade unit having a handgrip portion with a cavity at the proximal end, a curved distal end portion extending from the handgrip portion terminating in a terminal face containing a LED and a lens and digital image sensor connected with a first connector in the cavity, and a tube receptacle channel extending distally along the dorsal surface of and a vacuum/oxygen passageway extending through the curved distal end portion; and a power/video module releasably engaged in the cavity having a flat panel display pivotally mounted at the proximal end thereof and containing a rechargeable battery and electrical and video circuitry connected with a second connector. An endotracheal tube is received and releasably retained in the tube receptacle channel in a preloaded condition. When assembled, the connectors are engaged to complete the electrical and video circuits and allow viewing of insertion and intubation.

Abstract: A low cost camera and radio frequency transmitter are detachably coupled to an endotracheal tube to obtain an image in real time of tissue at the distal end of the endotracheal tube. The image recorded by the camera is transmitted to a low cost radio frequency receiver nearby and conveyed to a video monitor to display the image. The use of a wireless transmission system avoids the presence of wires and cords that otherwise might become entangled and cause the endotracheal tube to be inadvertently repositioned or pulled out of the patient.

Abstract: A bite block intended primarily for use with upper gastrointestinal endoscopy comprises a unitary body that fits into the mouth between the teeth or dental ridges. The bite block includes a central passageway large enough to accommodate a gastroscope. The bite block also has a surface which lies exterior to the oral cavity and extends around the outer surface of the lips. A suction wand is releasably connected to the body and extends into the intra-oral portion thereof where it forms an angle and allows suction drainage of pooled oral fluids from the cheek cavity. The interior tip of the suction wand has a terminal opening as well as multiple circumferentially arranged secondary openings adjacent the terminal opening all of which allow suction drainage of oral fluids with diminished occlusion by the oral tissues.

Abstract: One aspect of the invention provides an airway management device including: an endotracheal tube having a proximal end and a distal end and a sheath adjacent to the endotracheal tube. The sheath includes a proximal end and a distal end. The distal end of the endotracheal tube extends beyond the distal end of the sheath. Another aspect of the invention provides a surgical kit including an airway management device and instructions for use. The airway management device includes: an endotracheal tube having a proximal end and a distal end and a sheath adjacent to the endotracheal tube. The sheath includes a proximal and a distal end. The distal end of the endotracheal tube extends beyond the distal end of the sheath.

Abstract: An intubation device is provided for use with a guide apparatus having a track that is adapted to be associated with an endoscope such that bending of the track is substantially decoupled from bending of the endoscope. The intubation device includes an elongated, flexible tube and a mating member attached to the tube and adapted to slidingly engage the track external of the endoscope. The intubation device further includes a tissue bolster disposed on the proximal portion of the tube and changeable between a collapsed and an expanded configuration. The tube is positionable inside the upper gastrointestinal tract of a patient such that the proximal end of the tube is externalized through the gastric and abdominal walls of the patient, and wherein the tissue bolster is securable against the inner gastric wall when the tissue bolster is in the expanded configuration.

Abstract: “An endotracheal intubation device includes an inflatable cuff connected to an inflation tube, visualization means, where the visualization means include means to enlighten and an image guide, where the means to enlighten, the image guide, and the inflation tube are associated to a first three ways connector adapted to connect the endotracheal intubation device to a control panel; a packaging is also provided containing the endotracheal intubation device wherein the first three ways connector is placed across the packaging so as to allow checking the endotracheal intubation device without impairing its sterility with an endotracheal intubation device tester; an intubation method is further provided using the packaging, the control panel and the endotracheal intubation device tester.

Abstract: An endoscope with a flexible elongate insertion shaft, an illumination guide extending longitudinally through the insertion shaft, and an image guide extending longitudinally through the insertion shaft. The insertion shaft is formed along an outer surface with at least one longitudinally extending channel longitudinally traversable by an elongate endoscopic instrument. The channel having a longitudinally extending slot so that the channel is open to the ambient environment along at least a portion of its length.

Abstract: A surgical imaging device and method configured to be inserted into a surgical site. The surgical imaging device includes a plurality of prongs. Each one of the prongs has an image sensor mounted thereon. The image sensors provide different image data corresponding to the surgical site, thus enabling a surgeon to view a surgical site from several different angles. The prongs may be moveable between a first position, suitable for insertion though a small surgical incision, and a second position, in which the prongs are separated from each other. In addition, the prongs may be bendable.

Abstract: The present invention provides delivery systems for and methods of delivering conduction protein genetic material to cardiac cells in localized areas of the heart to improve the conductance therein. More specifically, there is provided a system and method for delivering connexin proteins or nucleic acid molecules encoding connexin proteins to a site in the heart which has been determined by mapping procedures to have a conduction disturbance. For cases where conduction is impaired, selected genetic material is delivered to cells around the disturbance area, in order to enhance overall conductivity patterns; in other cases, genetic material is selected to slow conduction in affected areas, so as to prevent, e.g., brady-tachy syndrome.

Abstract: An endotracheal intubation device having a curvable portion and internal optics or a viewing device which facilitate the insertion of an endotracheal tube into a patient. The device has a handle and a trigger. When the trigger is squeezed the curvable portion curves in a controlled manner from a fully straight configuration.

Abstract: A scope adapted for insertion and manipulation in a difficult pathway is disclosed. The scope comprises at least one module for manipulating the scope. The scope may further comprise an illumination source, an image sensor, a power source, and a viewing member for viewing images of a cavity or other anatomical member of a patient. In one embodiment the scope is intended to facilitate insertion of an intubating device, which comprises an elongated semi-rigid stylet including first and second ends and at least one inner lumen connected to a module. Additionally, a flexible tip is provided for manipulating one end of the scope and allowing greater flexibility when maneuvering a difficult pathway. In another embodiment, fluids are provided through an interior portion of the scope, allowed to at least partially contact the lens located at the distal end of the scope, and subsequently cleanse or defog the lens for improving vision via the scope.

Abstract: An endoscope, comprising an elongated tubular shaft for introducing into a body of a patient, the shaft having a longitudinal axis and a distal end, and further having an opening the distal end. A light guide is arranged along the shaft and has a light-emitting distal end, the light-emitting distal end being arranged in the area of the opening of the shaft in order to radiate light from the opening.

Abstract: An endotracheal intubation device having a curvable portion and internal optics or a viewing device which facilitate the insertion of an endotracheal tube into a patient. The device has a handle and a trigger. When the trigger is squeezed the curvable portion curves in a controlled manner from a fully straight configuration.

Abstract: The present invention relates to an intraoral medical device comprising: • a mouth opener (2) formed by a tubular element (4) arranged to define an access to the oral cavity of the patient, • a tongue depressor (1) designed to be inserted removably into the tubular element (4) and having:—a channel (12) through which a breathable gas is injected and which opens out at the distal end of said tongue depressor,—a conduit through which surgical instruments are passed and which opens out at the distal end of said tongue depressor, the mouth opener (2) comprising an injection conduit (20) designed to be connected to a source of breathable gas and configured to inject said gas into the oral cavity of the patient when the tongue depressor (1) is not inserted in the tubular element (4) and to inject said gas into the injection channel (12) of said tongue depressor when the latter is inserted in said tubular element.

Abstract: An interventional aid for medical interventions, including a tube body with a tube jacket which permits intubation and which, while leaving a lumen to permit ventilation, includes a functional aid for performing an interventional function. The functional aid includes an orientation mechanism orienting the tube body during the medical intervention.

Abstract: An endobronchial blocker catheter for use in blocking a selected mainstem bronchus under guidance of a bronchoscope. The endobronchial blocker catheter comprises a tubular assembly and an elongated body that receives the tubular assembly. The tubular assembly comprises a tubular member and a loop disposed at a distal end of the tubular member. The loop is sized such that the bronchoscope is passable through the loop. The elongated body has a plurality of lumens therein, and an inflatable blocker balloon disposed about a distal portion of the elongated body. One of the lumens extends to an interior of the balloon to accomplish inflation of the balloon for retaining the blocker catheter in the mainstem bronchus, and another lumen is sized for receiving the tubular assembly in a manner such that the loop extends from a distal end of the elongated body. The blocker catheter is guided by the bronchoscope to the desired inflation site via the loop.

Abstract: A scope adapted for insertion, manipulation and improved visibility in a difficult pathway is disclosed. The scope comprises at least one module for manipulating the scope. The scope may further comprise an illumination source, an image sensor, a power source, and a viewing member for viewing images of a cavity or other anatomical member of a patient. The scope may further comprise alternative pathways for air or fluid flow to exit the distal tip for the purpose of minimizing trauma and improving visibility. In one embodiment the scope is intended to facilitate insertion of an intubating device, which comprises an elongated semi-rigid stylet including first and second ends and at least one inner lumen connected to a module. Additionally, a flexible tip is provided for manipulating one end of the scope and allowing greater flexibility when maneuvering a difficult pathway. A method for navigating a difficult pathway is also disclosed.

Abstract: The present invention relates to a guided endotracheal intubation endoscope. A guide catheter is used to position an endoscope and a tube for intubation of a patient. The endoscope can include a steering device for steering the endoscope in at least two directions, as well as suction, irrigation and retraction devices for maintaining a clear field of view.

Abstract: An image-type intubation-aiding device comprises a small-size image sensor and a light source module both placed into an endotracheal tube to help doctors with quick intubation. Light from light emission devices in the light source module passes through a transparent housing and is reflected by a target and then focused. The optical signal is converted into a digital or analog electric signal by the image sensor for displaying on a display device after processing. Doctors can thus be helped to quickly find the position of trachea, keep an appropriate distance from a patient for reducing the possibility of infection, and lower the medical treatment cost. Disposable products are available to avoid the problem of infection. The intubation-aiding device can be used as an electronic surgical image examination instrument for penetration into a body. Moreover, a light source with tunable wavelengths can be used to increase the spot ratio of nidus.

Abstract: A flexible fiber optic bronchoscope with one-way valve is provided in which a unidirectional flow control valve is inserted between the bronchoscopic manifold port and the sealing cap. A compressible diaphragmatic seal with radial slits separate resiliently returnable valve flaps that deformably compress around the shaft of any inserted conduit. A circumscribing housing for typically affixing along a lower receiving ring to the bronchoscopic manifold port to which the sealing cap would normally be attached. An upwardly extending, annular attachment protuberance thereby provides the attachment for the conventional sealing cap.

Abstract: A handle with a video display is attached to a flexible stylet containing firming and bending tendons. Trigger controlled anatomic shaping provides steerage to the stylet which is inserted into an endotracheal tube or other tube for insertion into body orifices. The stylet and mounted endotracheal tube are guided by a video image from a camera and light on the distal end of the stylet. A storage container and sterilization and prep kit enable the device to be immediately available for reuse when needed.

Abstract: A device for facilitating fluid delivery to the trachea of a patient which comprises, a tubular housing adapted to be sealably mounted on an elongate element of an endoscope for examining the trachea of the patient and configured to mount an adapter for an endotracheal tube for intubating the patient over and around the elongate element, the housing having at least one inlet into a cavity inside the housing for supplying at least a first fluid and an outlet for delivering the first fluid between the elongate element and an inside wall of the endotracheal tube mounted on the adapter.

Abstract: An endoscope device having a curvable portion and a pivotable lever enclosed within a housing connected to a spring means for returning the trigger and the control wire to a resting position once a user is finished squeezing the trigger. The pivotable lever defines first and second end connected to an adjustment wire and a control wire respectively. When the trigger is squeezed the curvable portion curves in a controlled manner from a fully straight configuration.

Abstract: The invention relates to a laryngeal mask airway device (1) for insertion into a patient to provide an airway passage to the patient's glottic opening, the device comprising an airway tube(2), a mask (3) attached to the airway tube, the mask comprising a body (4) including a peripheral inflatable cuff (5), an outlet (6) and an inlet (7), the mask being attached to the airway tube via the inlet for gaseous communication between the tube and the outlet, there being at least one fibre-optic cable (23, 24) terminating adjacent the outlet for receiving, in use, an image of the patient's glottic opening, and means (50) for viewing the image, the viewing means being disposed such that the viewing means remains in the user's field of view during manipulation of the device by the user to view the glottic opening.

Abstract: A bolster assembly for use in aligning a tubular interventional device along an outer epidermal layer of a patient. A base portion of the assembly has a first surface for contacting the epidermal layer at an exit site of the tubular interventional device from the body of the patient, and has a second surface generally opposite the first surface. An elongated member is engaged with the base portion second surface and extends therefrom at a first angle. The elongated member and the base portion are structured and aligned to define a passageway to enable passage therethrough of the tubular interventional device. The elongated member is capable of flexure relative to the base portion from the first angle to a second angle generally parallel to the epidermal layer. A retaining member is provided for releasably retaining the elongated member at the second angle.

Abstract: A low cost camera and radio frequency transmitter are coupled to an endotracheal tube to obtain an image in real time of tissue at the distal end of the endotracheal tube. The image recorded by the camera is transmitted to a low cost radio frequency receiver nearby and conveyed to a video monitor to display the image. The use of a wireless transmission system avoids the presence of wires and cords that otherwise might become entangled and cause the endotracheal tube to be inadvertently repositioned or pulled out of the patient.

Abstract: A two piece endotracheal intubation device is provided having a multidirectional eyepiece, a suction port and a fiber optic assembly that enables a practitioner to apply suction to a patient's airway while at the same time visualizing the airway from any position relative to the patient for insertion of the endotracheal tube.

Abstract: The present invention provides delivery systems for and methods of delivering conduction protein genetic material to cardiac cells in localized areas of the heart to improve the conductance therein. More specifically, there is provided a system and method for delivering connexin proteins or nucleic acid molecules encoding connexin proteins to a site in the heart which has been determined by mapping procedures to have a conduction disturbance. For cases where conduction is impaired, selected genetic material is delivered to cells around the disturbance area, in order to enhance overall conductivity patterns; in other cases, genetic material is selected to slow conduction in affected areas, so as to prevent, e.g., brady-tachy syndrome.

Abstract: The present invention relates to an illuminated airway product that will allow visualization of the airway of a patient during intubation. The illuminated airway product includes a light source such as an LED disposed at its distal end. The LED shines axially, radially, or in both directions from the airway intubation device. The airway product includes an on-board voltage source. Hence, no additional or external voltage sources or components are necessary to light the device. The airway device may further include one or more lumens or tubes for delivering air, suctioning debris or fluids, delivering medicine, radio-opaqueness, etc. An inflatable cuff may be associated with the endotracheal tube such that collateral flow of air is prevented. An inflation lumen or tube is fluidly coupled to the inflatable cuff. The shape of the endotracheal tube may be adjusted either by use of a stylet or suction trocar made out of a malleable material such as aluminum or by inclusion of a malleable wire within the tube.

Abstract: An endotracheal tube introducer (“introducer”) that slides within an endotracheal tube. The introducer has a tubular wall that defines a lumen extending between a split proximal end and a distal end of the introducer. The tubular wall has an outer diameter that is less than an inner diameter of the endotracheal tube. The tubular wall is circumscribed by an invertible shroud. The invertible shroud flexes distal-ward (“forward”) proximal-ward (“rearward”). The proximal end of the introducer is introduced into a distal end of the endotracheal tube and the shroud is manually retroflexed rearward to cover the sharp margins of the end of the endotracheal tube prior to its insertion into a patient's airway. After the endotracheal tube has been properly positioned, the introducer is withdrawn, the motion of its withdrawal anteflexing the shroud forward for removal through the endotracheal tube.

Abstract: This invention relates to an apparatus which is used in conjunction with an endotracheal tube to provide visual information during intubation. The visual information is used by a medical practitioner in order to successfully insert and position the endotracheal tube into the trachea of a patient who is being intubated.

Abstract: A multi lumen endotracheal tube having a balloon cuff to seal a patient's trachea during intubation. The ET tube having a main lumen for the exchange of respiratory and medicinal gases consequent to a medical procedure, a secondary lumen for inflation of the balloon cuff, and a tertiary lumen for transmission of sound waves via air medium contained therein, permitting ausculatory monitoring of a patient's breath sounds during intubation and subsequent monitoring of cardiac and respiratory activity after sealing of the ET tube. The ET tube is particularly a adapted for utilization by an anesthetist by including temperature sensor to permit remote monitoring of body core temperature and body cavity ausculation of cardiac and respiratory activity.

Abstract: A method and apparatus for endotracheal intubation with simultaneous oxygenation/ventilation employs a curved guide and a light wand to ensure proper placement of the endotracheal tube in the patient's airway. The light wand has an elongated flexible member with a light source at its distal tip. The wand is inserted through an endotracheal tube until the light is adjacent to the distal end of the endotracheal tube. A curved guide is inserted into the patient's mouth and upper airway so that its distal end is positioned above the larynx. The wand and endotracheal tube are then advanced along the guide until the distal end of the endotracheal tube passes through the larynx and the light source is externally observable at a predetermined location through the anterior tracheal wall.

Abstract: An endoscopic intubation system, in particular for babies or very small childern, comprises an endoscope and an endotracheal tube, where the endoscope includes a substantially bend-resistent shaft whose outer diameter is slightly smaller than an inner diameter of the tube, so that the tube can be slid onto the shaft and where the shaft is at least partially curved. The shaft comprises a continuously curved portion starting from the distal end.

Abstract: An endotracheal visualization stylet having a self-contained light source and camera, providing ease of use, economy of manufacture and superior optics.

Abstract: An apparatus and method for coupling a gastroscope (30) to a gastrostomy feeding tube apparatus (10) such that both can be introduced together into the alimentary tract, thereby eliminating the need to separately introduce the gastroscope afterward in order to verify that the gastrostomy feeding tube (11) has been correctly placed within the stomach of the patient. The gastrostomy feeding tube includes a coupling member (12), such as an elongate tract or thread, that is accessible about the second end (26) thereof. The elongate tract is drawn through the working channel (31) of the gastroscope by an engagement member (29), such as snare, which then allows the distal end (33) of the gastroscope to be advanced into the end cap (18) of the feeding tube so that the two can be pulled together into the stomach. In another embodiment, the coupling member comprises an integrated attachment member (39), such as hook, to which the engaging member can attach.

Abstract: An operational remote controller integrates a joystick for bending a bending portion of an inserted portion in an endoscope. A bending lever stands on the joystick. For every automatically returning of the bending lever to a neutral position, a CPU of the operational remote controller detects the neutral position and sets an insensitive band within a predetermined range of the neutral position. Thus, the insensitive band can be set within a relatively narrow range irrespective of variation of neutral positions. The CPU supplies positional information of the bending lever to a control circuit for controlling a motor drive circuit. The control circuit controls a motor drive circuit based on the supplied positional information, and the motor drive circuit drives a motor to bend the bending portion of the inserted portion.

Abstract: The invention relates to a device for introducing an intubation tube into the trachea. The inventive device comprises a shaft, a receiving element arranged at the distal end of said shaft to which a proximal end of an intubation tube can be mounted and a coupling arranged at the proximal end of the shaft for coupling an endoscope thereto.

Abstract: The invention relates to an endoscope-type device, particularly an endoscope for emergency intubation, comprising a holding portion (7) and a shaft (1) which is configured to be flexible at least in partial areas, with at least two longitudinal bendable pulling and/or pushing elements acting on said shaft (1) in the axial direction at different distances from the proximal end, with said pulling and/or pushing elements extending as far as the proximal end and being lockably received in a fixing device, and with said endoscope-type device comprising an endoscope tip (50) whose movement is controllable via control means (54) and a control device (52) arranged in the proximal portion.

Abstract: A two piece endotracheal intubation device is provided having a multidirectional eyepiece, a suction port and a fiber optic assembly that enables a practitioner to apply suction to a patient's airway while at the same time visualizing the airway from any position relative to the patient for insertion of the endotracheal tube.

Abstract: An enhanced endotracheal tube utilizing a fiber optic bundle positioned in its wall section to transmit light and a reflectively coated bore to transmit images is disclosed. Additional passages formed in the wall of the endotracheal tube are adapted to receive a stylette and to act as an air passage for inflating an inflatable cuff formed on the inner end of the endotracheal tube. The light transmitted through the fiber optic bundle aids in illuminating the patient's laryngeal area and the image is reflected along the reflectively coated bore to aid the physician in intubating the patient. Alternative embodiments using a bore with a sleeve having a different refractive index from that of the tube material and an enhanced endotracheal tube for use with children are shown.

Abstract: Apparatus, methods, and kits, are provided for use in combination with a conventional bronchoscope or other lung viewing scope. In particular, sheaths having an inflatable cuff at their distal end are provided to receive a viewing scope through a lumen thereof. The sheaths thus provide an inflatable cuff on a viewing scope assembly so that the scope can be used in procedures which require selective isolation of regions of a patient's lungs. In particular embodiments, the sheaths may include stop elements for properly positioning a viewing scope therein, pressure transducers for providing accurate lung pressure information during procedures, and the like. Methods for using and forming sheaths having inflatable cuffs are also described.

Abstract: An operational remote controller integrates a joystick for bending a bending portion of an inserted portion in an endoscope. A bending lever stands on the joystick. For every automatically returning of the bending lever to a neutral position, a CPU of the operational remote controller detects the neutral position and sets an insensitive band within a predetermined range of the neutral position. Thus, the insensitive band can be set within a relatively narrow range irrespective of variation of neutral positions. The CPU supplies positional information of the bending lever to a control circuit for controlling a motor drive circuit. The control circuit controls a motor drive circuit based on the supplied positional information, and the motor drive circuit drives a motor to bend the bending portion of the inserted portion.

Abstract: An optical fiber viewing assembly for an endoscope has a light guide with an elastically flexible portion and a substantially rigid pre-curved distal portion. The viewing assembly is particularly suited for traversing bends of relatively small radii in an endotracheal breathing tube without scraping accumulated biological material from the inner surface of the breathing tube that could collect on the distal end of the light guide and obscure the endoscopic view.

Abstract: A cost-effective fiberoptic endotracheal intubation aid that comprises a petalled tubular stylet, a medial member and a compress device is disclosed. The petalled tubular stylet is a section of tube made of malleable material and has a proximal end splitted into multiple longitudinal petals of certain length. The medial member is a resilient thin flat sheet with edge curb and the compress device is a clamp-like device.Such an intubation aid can be easily used in combination with conventional flexible fiberoptic bronchoscope and conventional endotracheal tube (E.T.). It will make the flexible insertion probe of F.O. bronchoscope as firm, preformable and manipulatable as a regular solid-wire stylet. Intubators using the present invention are able to visualize patient's pharynx area and simultaneously manipulate the tubular stylet for guiding E.T. into patient's trachea to a desired location.

Abstract: An endoscopic intubation system, in particular for babies or very small childern, comprises an endoscope and an endotracheal tube, where the endoscope includes a substantially bend-resistent shaft whose outer diameter is slightly smaller than an inner diameter of the tube, so that the tube can be slid onto the shaft and where the shaft is at least partially curved. The shaft comprises a continuously curved portion starting from the distal end.

Abstract: An endoscope for endotracheal intubation includes an elongated insertion section having a handle operation section, a bending operation mechanism and a bending mechanism for bending the insertion section, the bending mechanism including a long elastic member having one end positioned near the distal end portion of the insertion section and the other end fixedly coupled to the bending operation mechanism, a push-pull member having one end positioned near the distal end portion of the insertion section and the other end connected to the bending mechanism, a hollow member for coupling together distal end portions of the elastic member and the push-pull member so as to cause the portions to oppose each other along a bending direction, wherein the distal end portions of the elastic member and the push-pull member, which are coupled together with the hollow member, are provided integrally so as to provide a free end.