JP2563929B2 - Ultrasonic diagnostic device in body cavity - Google Patents

Description

Description: TECHNICAL FIELD [0001] The present invention relates to an ultrasonic diagnostic apparatus in a body cavity in which an endoscope has an ultrasonic diagnostic function.

[Background technology]

2. Description of the Related Art An intracorporeal ultrasonic diagnostic apparatus is conventionally known as an integral combination of an endoscope and an ultrasonic scanning mechanism. In such an ultrasonic diagnostic apparatus, generally, an ultrasonic probe is rotatably arranged around a central axis of the ultrasonic probe at the tip of an insertion portion into the body cavity, and the ultrasonic probe is rotated outside the body cavity to rotate the probe. A drive motor as drive means is arranged in the drive unit of
Further, a hollow flexible shaft is inserted into the insertion portion as a power transmission means for drivingly connecting the probe to the drive motor. Then, the signal conductor from the probe is passed through the internal space of the flexible shaft and guided to the external ultrasonic diagnostic apparatus. Needless to say, the probe is rotated by the drive motor to scan the body cavity with ultrasonic waves. Further, as an optical observation means, an objective lens is arranged on the side surface of the distal end portion of the insertion portion, and the optical image obtained by this is guided to the eyepiece portion by an image guide fiber.

In the prior art, the ultrasonic probe is disposed at the distal end of the insertion section of the endoscope, and the flexible shaft that is the drive shaft occupies the central region of the insertion section. I had to place it on the side of the part. For this reason, the visual field direction of the optical observation means is limited to the lateral direction, and the direction in which the endoscope is inserted becomes a blind spot, which makes it difficult to operate the endoscope inside the body cavity. In particular, even if an attempt is made to use the above-mentioned known endoscope in a complicated meandering organ such as the large intestine, the endoscope is located deeper than the rectum due to the difficulty of operation due to the restriction of the viewing direction. Is almost impossible and, if possible, involves significant danger.

There is also known a configuration in which an objective lens of an optical observation unit is disposed on a distal end surface of an insertion portion of an endoscope, and an insertion direction of the endoscope and an optical viewing direction are matched. However, according to such a known configuration, the observation means shadows the view of the ultrasonic wave in that direction, and therefore the ultrasonic view of the entire circumference in the tomographic plane orthogonal to the axis of the endoscope tip portion is provided. It could not be obtained, and the obtained field of view was practically only about 180 °. Therefore, in order to obtain a complete ultrasonic diagnostic image of a target site in a body cavity, complicated and cumbersome operations such as twisting and rotating the endoscope in the body cavity are required.

[Disclosure of Invention]

The present invention has been made in view of the above-mentioned problems in the related art, and can be safely and easily operated even in a complicated and meandering narrow organ, and at least a wide range of ultrasonic waves covering at least almost the entire circumference. An object of the present invention is to propose an intra-body cavity ultrasonic diagnostic apparatus having a diagnostic range.

In order to achieve such an object, an intracorporeal ultrasonic diagnostic apparatus according to the present invention is an ultrasonic probe which is arranged at a tip portion of an insertion portion into a body cavity and can be rotated about its central axis. The distal end includes drive means disposed inside a drive portion outside the body cavity for rotating the tentacle, and hollow power transmission means inserted into the insertion portion to drive-couple the probe to the drive means. A hollow channel extending to an operating portion for controlling the operating function of the portion is formed so as to extend from the tip portion through the inside of the hollow power transmission means, and the hollow power transmission means is formed of an elastic body. It is characterized in that it is configured as a multi-layer structure having at least two layers, and a signal conductor extending from the ultrasonic probe to the operation section is arranged between the outer layer and the inner layer.

[Best mode for carrying out the invention]

The present invention will be described below with reference to the preferred embodiments shown in the drawings.

FIG. 1 is a conceptual diagram showing the overall configuration of an embodiment of an intracorporeal ultrasonic diagnostic apparatus according to the present invention. This ultrasonic diagnostic apparatus includes a flexible insertion portion to be inserted into a body cavity, and an operation portion 2 on a hand side for operating a distal end portion 1 of the insertion portion from outside. An ultrasonic probe 3 for performing ultrasonic diagnosis is arranged in the tip portion 1, and the probe 3 is a mechanical scanning type that can be rotated about the central axis of the tip portion 1 in the longitudinal direction, so-called. It should be a mechanical type. Further, a drive unit 4 for rotationally driving the ultrasonic probe 3 is arranged adjacent to the operation unit 2 and the drive unit 4 is mechanically connected to the probe 3 via a power transmission element described later. Drive coupling. In the present invention, all of the ultrasonic probe 3, its drive unit 4 and the power transmission element for connecting the two have a hollow structure, and a hollow channel is provided in a region near the central axis from the tip of the insertion unit to the operation unit 2. Should be arranged so as to extend therethrough.

The ultrasonic probe 3 has a known configuration including, for example, an ultrasonic vibrator made of a film of PZT, lithium niobate or a suitable polymer material, and a suitable damping material bonded and fixed to the vibrator. Shall be. As also shown in FIG.
The ultrasonic probe 3 is attached to a support member 5 having a hollow cylindrical shape, and the support member 5 is rotatably supported by a ball bearing 6 and a slide bearing 7. The front end of the hollow multilayer flexible shaft 8 as a part of the power transmission element is integrally connected to the rear end of the support member 5, and this flexible shaft 8 is inserted into the insertion portion of the ultrasonic diagnostic apparatus. And is extended to the drive unit 4 while being rotatably disposed in the flexible tube 9.

A mechanical scanning ultrasonic probe placed at the tip of the insertion part into the body cavity is connected to the drive motor in the drive part via a flexible shaft, and the signal lead wire from this probe is connected to the inside of the flexible shaft. An ultrasonic diagnostic apparatus having a configuration according to, for example, Japanese Patent Application Laid-Open No. 57-
It is described in Japanese Patent No. 190552 and is known. However, according to the present invention, the signal conductor is arranged at another location to configure the inside of the flexible shaft as a hollow channel that can be used for other purposes.

That is, in the embodiment shown in FIG. 3, the flexible shaft 8 includes an inner peripheral layer 8a formed of a close-wound coil, and an intermediate layer 8b formed of a coarsely wound coil of a wire rod relatively thicker than the coil rod of the inner peripheral layer 8a. And a three-layer structure of an outer peripheral layer 8c formed of a close-wound coil of a wire having a thickness similar to that of the coil of the inner peripheral layer 8a. Further, a very small coaxial cable as the signal conductor 10 from the ultrasonic probe 3 is slightly inserted into the gap space between the inner circumferential layer 8a and the outer circumferential layer 8c in the adjacent orbiting portion of the coarsely wound coil in the intermediate layer 8b. Place it in a vine with slack. In order to reliably prevent the signal conductor 10 from being crushed between the inner peripheral layer 8a and the outer peripheral layer 8c, the signal conductor 10
A wire thicker than 10 is used.

In the embodiment shown in FIG. 3, it is advantageous that the coil wires of the inner layer 8a and the outer layer 8c and the coil wire of the intermediate layer 8b are wound in mutually opposite directions. This is because such an arrangement makes it possible to realize a flexible shaft with smooth inner and outer surfaces and little disturbance.

Further, in the embodiment shown in FIG. 4, the flexible shaft 8 is made up of an inner peripheral layer 8a and an outer peripheral layer 8c formed of the same close-wound coil as in the embodiment of FIG. A three-layer structure including an intermediate layer 8b 'made of an elastic material such as rubber and arranged so as to form a gap;
The signal conductor (10) is arranged in the gap with a slight slack, and the thickness of the intermediate layer (8b ') is made larger than the diameter of the signal conductor (10) to prevent the signal conductor from being crushed.

In each of the embodiments shown in FIGS. 3 and 4, the signal conductor 10 is connected to the inner peripheral layer 8a of the flexible shaft 8.
Between the outer peripheral layer 8c and the outer peripheral layer 8c are completely protected by the intermediate layers 8b and 8b 'and are arranged with some slack, so that the insertion portion of the ultrasonic diagnostic apparatus bends when inserted into the body cavity. However, tensile stress does not act and there is virtually no risk of disconnection. Further, a hollow channel having a sufficient internal space in the full-flexible shaft 8 and serving a desired purpose can be secured over the entire length thereof as described later.

As shown in FIG. 5, the flexible shaft 8 having the above configuration is provided at the rear end side of the insertion portion in the ultrasonic diagnostic apparatus.
It is connected to a normal hollow shaft 11 having no flexibility. The hollow shaft 11 is provided with bearings 12, 1 disposed at appropriate positions in the drive unit 4.
It is rotatably supported by 3 and is drivingly connected to the drive motor 14 by a suitable connecting means 15. As shown in FIG. 5, the coupling means 15 includes a pulley 15a attached to the hollow shaft 11, a pulley 15b attached to the output shaft of the drive motor 14, and a belt 15c hung between the pulleys 15a, 15b. Belt drive coupling mechanism. Also, the first
As shown in the figure, the coupling means 15 may be constituted by a reduction gear mechanism attached to the hollow shaft 11 and the output shaft of the drive motor 14.

According to such an arrangement, by operating the drive motor 14, the output torque of the drive coupling means 15, the hollow shaft 11,
Flexible shaft 8 and hollow cylindrical support member 5
Is transmitted to the ultrasonic probe 3 at the distal end portion 1 of the insertion portion via the, and the probe 3 can be rotated by a required angle about the central axis of the distal end portion 1. Note that the drive unit 4 is provided so that the transmission / reception azimuth of the ultrasonic probe 3 can be detected.
Place the rotary encoder 16 inside the
The transmission / reception azimuth of the probe is detected as the rotation angle of the hollow shaft 11 by the use of the probe 16, and a required signal processing can be performed according to the detected value.

As shown in FIG. 2, the internal space 17 of the distal end portion 1 in the insertion portion of the diagnostic apparatus containing the ultrasonic probe 3 includes:
An ultrasonic transmission medium whose acoustic impedance has a value similar to that in a living body, for example, liquid paraffin is filled, and this transmission medium passes from the screw sealing point 18 on the distal end surface of the insertion portion to the inside of the flexible tube 9 described above. Completely fill up to a not-shown sealed portion in the operation portion 4. In order to fill all the gaps with the ultrasonic wave transmission medium, for example, a plurality of grooves 19 extending in the axial direction are formed on the non-sliding surface side of the sliding bearing 7, that is, on the side screwed to the supporting member 5. To form.

In addition, a pair of circumferential mounting grooves 20 for mounting a known balloon (not shown) is formed on the outer peripheral surface of the distal end portion 1 of the insertion portion. In order to allow the degassed water to be injected into and sucked out from the inside of the balloon with the balloons mounted in these grooves 20, a water injection port and a suction port are opened between the both mounting grooves 20, and the water injection port and the suction port are suctioned. The mouth is connected via a tube 21 to a water injection / suction mouthpiece (not shown) arranged on the operation unit 2 side.

The signal conductor 10 from the ultrasonic probe 3 is connected to the flexible shaft 8 from the distal end portion 1 of the insertion section to the drive section 4.
The passage between the inner peripheral layer 8a and the outer peripheral layer 8c is as described above with reference to FIGS. 3 and 4. On the front side of the connecting portion between the flexible shaft 8 and the hollow shaft 11, as shown in FIG. 6, the signal conductor 10 is arranged in a longitudinal groove 22 formed on the outer peripheral surface of the hollow shaft 11. Further, although not shown, longitudinal grooves are formed on the outside of the frame used for mounting each component in the drive unit 4, and in these grooves, the deaerated water is injected and sucked into the balloon. It houses the tube 21 and an operation wire for bending operation of a bending portion arranged adjacent to the distal end portion 1 of the insertion section.

The signal conductor 10 arranged in the longitudinal groove 22 on the outer peripheral surface of the hollow shaft 11 is connected to the slip ring 25 on the rear end side of the hollow shaft 11. The contact members 26 are brought into sliding contact with the slip ring 25, the conductors 27 connected to these contact members 26 are introduced into the operation portion 2, and the operation portion 2 is inserted into a so-called universal cord 28 to insert a super conductor (not shown). Can be connected to sound wave observation means.

As described above, in the present invention, the ultrasonic probe 3, the drive unit 4 thereof, and the power transmission elements 8, 11 for connecting the two are all hollow structures, and the central axis extends from the distal end portion 1 of the insertion unit to the operation unit 2. Is arranged so that the hollow channel extends through the vicinity of the hollow channel. Then, an endoscope section 29 capable of obtaining an optical visual field in the insertion direction of the insertion section is disposed in the hollow channel.

As shown in FIGS. 1, 2, and 7, the endoscope unit 29 includes an observation lens group 30 and an image guide for transmitting an optical image in the visual field in the insertion direction to the operation unit 2 side. Fiber 31, an illumination lens group 32 and a light guide fiber 33 for sending illumination light in the visual field direction, a nozzle 34 for ejecting water or air to wash the front surface of the lens group 30, 32 as required. Further, it has a channel 35, which has a channel 35 used for suction of liquid in the body cavity and insertion of forceps for biopsy of a tissue, and the like, which itself has a normal configuration. That is, when the insertion section is inserted into the body cavity, the endoscope section 29 looks through the eyepiece section 36 provided in the operation section 2 while illuminating the lens group 32 with the illumination light, and thereby through the lens group 30. The endoscopic image of the site to be diagnosed, that is, the target site can be observed.

The image fiber 31, the light guide fiber 33, and the channel 35 of the endoscope unit 29 are inserted through the support member 5, the flexible shaft 8, and the hollow shaft 11 of the ultrasonic probe 3 described above. With the rotation of 3,
There is a possibility that so-called entrainment may occur. Therefore,
In order to prevent such a co-rotation, as shown in FIG.
For example, it is desirable to cooperate with the anti-rotation bin 37.

8 and 9 show another embodiment of the endoscope unit 29 disposed in the hollow channel. This embodiment is essentially the same as the embodiment described above, except that the means for transmitting an optical image within the field of view in the insertion direction is constituted by the lens group 30, a solid-state imaging device 38 such as a CCD, and an electric cable 39. There is no substitute for an example.

In the present invention, as described above, the distal end portion 1 of the insertion portion is used.
A hollow channel that extends through the region in the vicinity of the central axis from the operation unit 2 to the operation unit 2 is used, and the endoscope unit is provided inside the hollow channel.
With the configuration in which the 29 is arranged, it is possible to realize an endoscope optical system capable of directly looking forward in the insertion direction. And
In any embodiment having such an endoscope optical system, there is no restriction on the viewing direction as in the prior art, and even in a narrow organ whose lumen is complicatedly meandering like the large intestine, the insertion direction is forward. The insertion part can be safely inserted to the target part while always checking, and the ultrasonic probe 3
Since it can be completely rotated over 0 °), it is possible to easily and surely obtain a complete ultrasonic diagnostic image of a target portion without requiring any difficult and complicated operation.

[Brief description of drawings]

FIG. 1 is a conceptual diagram showing the overall configuration of an intracorporeal ultrasonic diagnostic apparatus according to an embodiment of the present invention, FIG. 2 is a vertical cross-sectional view showing the specific configuration of the distal end portion of the insertion portion, and FIG. FIG. 4 is a perspective view showing an embodiment of a hollow multi-layer flexible shaft for coupling a sound wave probe to its driving portion, FIG. 4 is a perspective view showing another embodiment of the hollow multi-layer flexible shaft, and FIG. FIG. 6 is a vertical cross-sectional view showing a specific structure of the drive part of the probe, FIG. 6 is a cross-sectional view of the hollow shaft taken along the line VI-VI of FIG. 5, and FIG. 7 is a view of the insertion part in the arrangement of FIG. FIG. 8 is a front view showing the distal end surface, FIG. 8 is a longitudinal sectional view similar to FIG. 2 showing another embodiment of the endoscope optical system, and FIG. 9 shows the distal end surface of the insertion portion in the arrangement of FIG. FIG. 8 is a front view similar to FIG. 7. 1 ... Tip part of flexible insertion part 2 ... Operation part, 3 ... Ultrasonic probe 4 ... Driving part, 5 ... Support member 8 ... Flexible shaft 8a ... Inner peripheral layer, 8b, 8b ′ …… Middle layer 8c …… Outer layer, 10 …… Signal conductor 14 …… Drive motor, 29 …… Endoscope section 30 …… Observation lens group, 32 …… Illumination lens group 34 …… Nozzle, 35 …… Channel

Claims (1)

(57) [Claims] 1. An apparatus according to claim 1, wherein the insertion section is disposed at a distal end of an insertion section into a body cavity,
An ultrasonic probe that can be rotated about its central axis, a drive means that is arranged inside a drive portion outside the body cavity to rotate the probe, and the probe that is inserted into the insertion portion. A hollow power transmission means for drivingly connecting the child to the drive means, and a hollow channel extending to an operating portion for controlling the operating function of the distal end portion, the hollow channel extending from the distal end portion to the inside of the hollow power transmission means. The hollow power transmission means is formed as a multi-layered structure having at least two layers of elastic body, and extends from the ultrasonic probe to the operation portion between the outer layer and the inner layer. An ultrasonic diagnostic apparatus in a body cavity, wherein an existing signal lead wire is provided.