JPH0984747A - Ultrasonic endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a sufficient elevation angle of a puncture needle without enlarging a tip hard part by providing such a constitution that the force point for elevating forceps situated on a forceps elevating base is situated on the outside from the outer profile of the tip hard part in the insertion of the forceps to a forceps channel. SOLUTION: A forceps elevating base 15 is proratable through a rotating shaft 20, and a forceps wire 14 for operating the forceps elevating base 15 is connected through a fixed part 21. In the collection of a lesional tissue by a puncture needle 16, the forceps elevating base 15 is operated through the forceps elevating nob of an operation part. Namely, the forceps elevating base 15 is rotated by advancing the forceps wire 14 so that the force point 23 side of the forceps elevating base 15 is moved to an ultrasonic oscillator 8 side around the rotating shaft 20 to lay the forceps elevating base 15 in the state protruded to the outside from the outer profile of a tip hard part. Thus, the relative distance between the fulcrum 24 of the puncture needle 16 and the force point 23 of the forceps elevating base 15 becomes about double the relative distance between the rotating shaft 20 and the fulcrum 24, and the puncture needle 16 can be elevated through the forceps elevating base 15 with a minimum force.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic endoscope capable of ultrasonically diagnosing the inside of a body cavity by optically inserting the insertion portion into the body cavity.

[0002]

2. Description of the Related Art Ultrasound endoscopes are used to safely insert an insertion portion while optically observing the inside of a body cavity for a digestive tract wall or a deep organ such as the pancreas that is difficult to diagnose by ultrasonic diagnosis from outside the body. While observing the surface of the lumen wall by optical observation, ultrasonic diagnosis of the internal tissue of the body cavity is performed by driving an ultrasonic transducer provided at the tip of the insertion section. In addition, the puncture needle is projected from the forceps channel outlet of the distal end hard portion of the linear ultrasonic endoscope, the convex ultrasonic endoscope, or the like,
It is also practiced to puncture the tissue of the diagnosis area under ultrasound guidance to collect the diseased tissue. For example, Japanese Patent Laid-Open No. 6-630
Japanese Unexamined Patent Publication No. 41 discloses the contents of performing treatment such as ultrasonic guided puncture with a convex type electronic scanning type ultrasonic probe.

[0003]

The puncture-compatible ultrasonic endoscope in which the insertion portion is inserted while optically observing the inside of the body cavity includes a side-view type and a front perspective type depending on the optical observation direction. These puncture-capable ultrasonic endoscopes are used when the lesioned tissue is collected by puncturing the tissue of the diagnosis area under the guidance of an ultrasonic image depicting the tissue on the side of the distal end. It is almost the same as the mirror insertion axis direction. Therefore, even if an attempt is made to puncture a tissue surface that is substantially parallel to the endoscope insertion axis direction, the puncture needle will be punctured in the tangential direction, and the puncture needle will be slippery, making it difficult to perform proper puncture. For this reason,
It may be possible to raise the puncture needle and puncture it while maintaining an angle to the tissue surface, but it is difficult to raise a hard puncture needle and it is difficult to obtain a sufficient elevation angle. .

In view of the above problems, a forceps raising base may be provided as a means for raising the puncture needle, and the forceps raising base may be formed large. However, in order to provide a large forceps raising base at the tip of the insertion portion. The tip hard part must be designed to be large and long. As described above, if the distal end hard portion is large and long, the patient to be inserted into the body cavity suffers from a great deal of pain, and the insertion into the body cavity cannot be performed smoothly, which makes rapid examination difficult.

The present invention has been proposed to solve the above-mentioned problems, and it is possible to increase the size of the hard end portion without increasing the size.
It is intended to provide an ultrasonic endoscope provided with a forceps raising base that can obtain a sufficient raising angle of a puncture needle.

[0006]

In order to achieve the above object, the present invention provides an ultrasonic transducer, a forceps channel outlet, and rotatable forceps at the tip of an insertion portion having a hard tip portion, a bending portion, and a flexible tube. In an ultrasonic endoscope including a raising base, a force point for raising the forceps raising base on the forceps raising base when inserting the forceps into the forceps channel is located outside the outer contour of the distal end hard portion. However, when the insertion portion is inserted into the body cavity, at least the force point is located closer to the hand side than the forceps raising base rotation shaft, and the entire forceps raising base is stored in the distal end hard portion. It was used as an ultrasonic endoscope.

As described above, when the forceps is inserted into the forceps channel, the force point for raising the forceps on the forceps raising base is located outside the outer contour of the hard tip portion, and the force point relative to the fulcrum applied to the forceps. Since the distance becomes long, the forceps raising base greatly raises the puncture needle with a small force, and the lesioned tissue can be collected by puncturing the tissue of the diagnostic portion from an appropriate angle under ultrasonic guidance. Further, at least when the insertion point is inserted into the body cavity, the force point is located on the hand side with respect to the forceps raising base rotation shaft. Can be inserted into.

[0008]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings. 1 to 5 show a first embodiment of the present invention. In the first embodiment, when inserting the insertion part into the body cavity, the forceps raising base is housed in the tip hard part, and when the diseased tissue is collected in the body cavity, the forceps raising base is projected from the outer contour of the tip hard part to perform puncture. The present invention relates to a convex type ultrasonic endoscope having excellent electric safety and capable of raising a needle largely with a small force.

FIG. 1A is an overall view of an ultrasonic endoscope.
The operation unit 1 has an angle knob 2 and a forceps channel inlet 3. The insertion portion 4 continuing from the operation portion 1 is provided with a convex ultrasonic transducer in a front perspective, a tip hard portion 5 made of hard resin, a bending portion 6 that can be bent vertically and horizontally by turning the angle knob 2, and a flexible portion. It has a tube 7.

FIG. 2 is an enlarged perspective view of the hard tip portion 5. As shown in the figure, the distal end hard portion 5 is provided with a convex ultrasonic transducer 8 for electrically performing beam focusing at the distal end, and is used when the convex ultrasonic transducer 8 is inserted into the body cavity on the proximal side. A light guide having a cover glass 9, an objective lens 10 communicating with a CCD camera (not shown), an air / water inlet 11 used for cleaning the objective lens 10, and a forceps channel outlet 12a through which a puncture needle is projected. , A non-metallic forceps wire 14 that is moved forward and backward by turning the forceps raising knob 13 (FIG. 1B) of the operation unit 1, and a hard resin made of a hard resin that is connected to the forceps wire 14 and rotates by the forward and backward movement of the forceps wire 14. A forceps raising base 15 is provided.

FIG. 3 is a perspective view for explaining the raising operation of the puncture needle 16 protruding from the forceps channel outlet 12a. The puncture needle 16 includes a super elastic pipe-shaped needle 17 and
The needle 17 has a metallic stylet (core bar) 18 inserted through the entire length of the needle 17, and a coil sheath 19 for guiding and protecting the needle 17. And FIG. 3A
3B shows a state in which the puncture needle 16 protrudes from the forceps channel outlet 12a in the same posture through the forceps channel, and FIG. 3B shows the puncture needle by moving the forceps wire 14 and raising the forceps raising base 15. 16 shows a state in which 16 is raised by a θ angle.

FIG. 4 is a vertical sectional view showing the vicinity of the forceps raising base 15. The forceps raising base 15 is configured to be rotatable in the arrow direction via the rotary shaft 20, and the forceps wire 14 for operating the forceps raising base 15 is connected via the fixing portion 21. Further, the forceps raising base 15 is formed with a through hole 22 which communicates with the forceps channel 12 when stored in the hard tip portion. Incidentally, 23 is a force point on the forceps raising base 15, and 24 is a fulcrum on the forceps channel outlet 12a.

With this structure, when the forceps raising base 15 is rotated and returned to the hand side (this state is shown in FIG. 4), the forceps raising base 15 rotates.
It is located in the space 25 formed closer to the operator than the outside and is housed within the outer contour of the hard end portion. In this case, the force point 23 of the forceps raising base 15 is located closer to the hand side than the rotary shaft 20, and is close to the fulcrum of the forceps channel outlet 12a.

On the other hand, when the forceps raising base 15 is rotated toward the ultrasonic transducer 8 side by moving the forceps wire 14 and positioned as shown in FIG. 5, the puncture needle 16 shown by the chain double-dashed line is the forceps. It can be projected from the channel outlet 12a and is supported so as to contact the force point 23 of the forceps raising base 15. At the same time, the puncture needle 16 moves the forceps channel outlet 12
It contacts the fulcrum 24 of a.

The first embodiment is not limited to the convex type ultrasonic endoscope, but other electronic scanning type ultrasonic endoscopes such as linear type and sector type, and mechanical type. It can also be applied to a sector-type ultrasonic endoscope. Further, as the hard resin selected as the material for the distal end hard portion 5 and the forceps raising base 15, an appropriate material such as polysulfone or modified PPC may be used.

Further, when the forceps raising base 15 is formed so that the vicinity of the force point 23 for raising the forceps when supporting the forceps protrudes into the ultrasonic scanning range, and is configured to be visible on the ultrasonic image, the forceps raising base 15 Since the end portion of the is largely outside the outer contour of the hard end portion and falls within the ultrasonic operation range, the position of the end portion of the forceps raising base can be drawn near the ultrasonic transducer surface position on the ultrasonic image.

Next, the operation of the first embodiment will be described. To collect the diseased tissue with the puncture needle 16,
First, the insertion portion 4 is inserted into the body cavity with the forceps raising base 15 housed in the distal end hard portion 5 (the state shown in FIG. 4).
In this case, if necessary, the through hole 2 of the forceps raising base 15
Through the 2 and the forceps channel 12, the dirt and the like in the body cavity is sucked. When the distal end of the insertion section 4 reaches the target diagnosis section, the forceps raising base 15 is operated via the forceps raising knob 13 shown in FIG. 1B, but by moving the forceps wire 14, As shown in FIG.
The forceps raising base 15 is rotated so that the force point 23 side of (1) moves to the ultrasonic transducer 8 side around the rotation shaft 20. Then
The forceps raising base 15 is in a state of protruding outside from the outer contour of the hard end portion. In this state, the fulcrum 24 of the puncture needle 16
The relative distance between the force point 23 of the forceps raising base 15 is the rotation axis 2
The relative distance between 0 and the fulcrum 24 becomes nearly twice, and the puncture needle 16 can be raised via the forceps raising base 15 with a minimum force.

In this state, the puncture needle 16 is inserted from the forceps channel inlet 3 (FIG. 1A) and inserted through the forceps channel 12. Then, as shown in FIG. 3A, the puncture needle 16 is projected from the forceps channel outlet 12a. Then, as shown in FIG. 5, the puncture needle 16 is supported by the forceps raising base 15. However, since the raising angle of the puncture needle 16 is not sufficient in the state shown in FIGS. 3A and 5, the forceps raising base 15 is operated via the forceps raising knob 13 shown in FIG. The forceps raising base 15 is raised to be retracted.
Then, the puncture needle 16 is raised as shown in FIG. 3B.

As described above, according to the first embodiment, since the storage space 25 of the forceps raising base 15 in the distal end hard portion 5 is formed on the proximal side, the puncture needle 16 can be raised. When the forceps raising base 15 is provided, the fulcrum 24 for raising the puncture needle 16 is located on the hand side. On the other hand, since the force point 23 of the forceps raising base 15 is located on the ultrasonic transducer 8 side, the relative distance between the fulcrum 24 and the force point 23 becomes long, and the puncture needle 16 is raised at a large angle with a small force. be able to. Further, since the forceps raising base 15 is configured to raise the puncture needle 16 at a position protruding outward from the outer contour of the hard tip portion, a large space for operating the forceps raising base 15 is formed in the hard tip portion 5. You do n’t have to
The length of the distal rigid portion 5 can be shortened, and the patient's pain can be reduced and the smoothness of insertion of the insertion portion 4 can be realized.

Further, when inserting and removing the insertion portion 4 in the body cavity,
Since the forceps raising base 15 can be housed in the distal end hard portion 5, it is possible to avoid the damage of the tissue in the body cavity of the patient due to the reduced number of protrusions, and to realize the smooth insertion of the insertion portion 4. In addition, since the metal portion is not exposed at the distal end hard portion 5, even if it is used in combination with a high-frequency treatment tool, electrical safety is not impaired.

6 to 8 show a second embodiment of the present invention. The parts corresponding to those in the first embodiment are designated by the same reference numerals. In the second embodiment, when inserting the insertion part into the body cavity, the forceps raising base is housed in the tip hard part, and when the diseased tissue is collected in the body cavity, the forceps raising base is made to largely protrude from the outer contour of the tip hard part. The present invention relates to a convex type ultrasonic endoscope having excellent electrical safety in which a puncture needle can be largely raised with a small force and the end position of a forceps raising base can be confirmed on an ultrasonic image.

FIG. 6 is a partial sectional view of the hard tip portion corresponding to FIG. 4 in the first embodiment. In the second embodiment, the forceps raising base made of hard resin is formed of two divided bodies, and the forceps wire 14 moves forward and backward to operate as shown in FIGS. 6A and 6B. As shown, the forceps wire 14 is connected to the first forceps raising base 15a.
This first forceps raising base 15a is adapted to rotate via a second rotary shaft 20b. On the other hand, the second forceps raising base 15b is rotatably fixed to the distal end hard portion via the first rotation shaft 20a. Note that 23 is a force point on the first forceps raising base 15a for raising the forceps, and 24 is a fulcrum at the forceps channel outlet 12a.

As shown in FIG. 6B, when the forceps wire 14 is retracted, the first forceps raising base 15a rotates through the second rotation shaft 20b and is positioned in the storage space 25, and at the same time, the second forceps raising base 15a moves. The forceps raising base 15b is the first rotary shaft 20a.
It rotates through and stops when it stands up. In this case, the second forceps raising base 15b abuts on the forceps channel outlet end face 12b to prevent further rotation. In this case, the force point 23 on the first forceps raising base 15a is located on the hand side of the first rotation shaft 20a and near the fulcrum 23 at the forceps channel outlet 12a.

Further, when the forceps wire 14 is advanced, the first forceps raising base 15a rotates through the second rotation shaft 20b and largely projects from the storage space 25, as shown in FIG. 6A. The second forceps raising base 15b rotates via the first rotation shaft 20a and abuts the bottom surface 25a continuous with the storage space 25 to prevent further rotation. In this case, the first forceps raising base 15
The force point 23 at a is located apart from the fulcrum 24 at the forceps channel outlet 12a. Reference numeral 26 indicates an ultrasonic scanning range. Other configurations are similar to those of the first embodiment.

The second embodiment is not limited to the convex type ultrasonic endoscope, but other electronic scanning type ultrasonic endoscopes such as linear type and sector type, and mechanical type. It can also be applied to a sector-type ultrasonic endoscope. The material of the forceps raising base 15 is polysulfone or modified PP.
A hard resin such as C may be appropriately selected and used.

Next, the operation of the second embodiment will be described. To collect the diseased tissue with the puncture needle, first, the first forceps raising base 15a and the second forceps raising base 15b are used.
With the tip stored in the tip rigid portion 5 (state of FIG. 6B),
Insert the insertion part into the body cavity. When the distal end of the insertion portion reaches the target diagnostic portion, the forceps raising base is operated via the forceps raising knob 13 shown in FIG. 1B, but by moving the forceps wire 14, it is shown in FIG. 6A. As described above, the first forceps raising base 15a and the second forceps raising base 15b
Is rotated and the force point 23 on the first forceps raising base 15a moves to the ultrasonic transducer 8 side. Then, the vicinity of the force point 23 of the first forceps raising base 15 a largely protrudes outside the outer contour of the hard tip portion and enters the ultrasonic operation range 26.

In this state, the forceps channel inlet 3 (see FIG.
The puncture needle 16 is inserted from A) and is inserted through the forceps channel 12. Then, as shown in FIG. 7, the puncture needle 16 is projected from the forceps channel outlet 12a and supported on the first forceps raising base 15a. In this state, since the raising angle of the puncture needle 16 is not sufficient, the forceps raising knob 13 shown in FIG. 1B is operated to retract the forceps wire 14 and raise the first forceps raising base 15a.

As described above, according to the second embodiment, in addition to the effect of the first embodiment, since the forceps raising base 15 is formed of two divided bodies, the forceps raising base 15a,
When 15b projects outside the outer contour of the hard tip as shown in FIG. 7, the position of the force point 23 acting on the puncture needle 16 is the first.
According to the embodiment described above, the puncture needle 16 is further separated from the fulcrum 24 which is required when bending. Therefore, the puncture needle 16 can be raised with a smaller force. Further, since the forceps raising base 15 is formed of two divided bodies, the freedom of movement is increased, and the puncture needle 16 is raised without buckling at one place as in the case of the first embodiment. Easier to do.

Further, since the end portion of the first forceps raising base 15a largely protrudes outside the outer contour of the hard tip portion and enters the ultrasonic operation range 26, as shown in FIG. The position 28 of the upper end of the upper base is the position 29 of the ultrasonic transducer surface.
Pictured in the vicinity. Therefore, the orientation of the puncture needle 16 is facilitated during ultrasonic diagnosis, and the diagnosis time can be shortened.

The contents described in the above embodiments can be understood as the following inventions. 1. In an ultrasonic endoscope including an ultrasonic transducer, a forceps channel outlet, and a rotatable forceps raising base at the tip of an insertion portion having a hard tip, a bending portion, and a flexible tube, the forceps raising base is used as a forceps. The force point that raises the forceps on the forceps raising base when inserting the forceps into the channel is located outside the outer contour of the rigid tip portion, and at least the force point rotates when the insertion portion is inserted into the body cavity. An ultrasonic endoscope characterized in that the forceps raising base is located closer to the hand side than the shaft and is housed entirely in the distal end hard portion. In this way, since the storage space for the forceps raising base in the hard tip portion is formed on the hand side, when the forceps raising base is in a state in which the puncture needle can be raised, the fulcrum for raising the puncture needle is the hand side. Since the force point of the forceps raising base is located on the ultrasonic transducer side, the relative distance between the fulcrum and the force point becomes long, and the puncture needle can be raised at a large angle with a small force. In addition, since the forceps raising base operates the puncture needle at a position protruding outward from the outer contour of the hard tip portion, it is not necessary to form a large space for operating the forceps raising base in the hard tip portion. The length of the hard tip can be shortened, and the patient's pain can be reduced and the smoothness of insertion of the insertion section can be realized. Further, when inserting and removing the insertion part in the body cavity, the forceps raising base can be housed in the distal end hard part, so that it is possible to prevent the protrusions from becoming small and avoid damaging the tissue in the body cavity of the patient. The smoothness of insertion can be realized.

2. The forceps raising base is formed by connecting at least two divided bodies, and the first forceps raising base is rotatably fixed to the second forceps raising base via a rotation shaft and has a force point for raising the forceps. The ultrasonic endoscope according to claim 1, wherein the second forceps raising base is rotatably fixed to the distal end hard portion via a rotation shaft. As described above, since the forceps raising base is formed of the two divided bodies, the forceps raising base largely protrudes outside the outer contour of the hard tip portion, and the position of the force point acting on the puncture needle is necessary when bending the puncture needle. Move further from the fulcrum. Therefore, the puncture needle can be raised with a smaller force. Further, since the forceps raising base is formed of two divided bodies, the freedom of movement is increased, and the puncture needle does not buckle at one place and can be easily raised.

3. The forceps raising base is formed so that the vicinity of the force point for raising the forceps when supporting the forceps protrudes into the ultrasonic scanning range, and is configured to be visible on the ultrasonic image. The ultrasonic endoscope according to the item. In this way, the end of the forceps raising base largely protrudes outside the outer contour of the hard tip portion and falls within the ultrasonic operation range.Therefore, place the end of the forceps raising base near the ultrasonic transducer surface position on the ultrasonic image. Is depicted. Therefore, the orientation of the puncture needle is facilitated during ultrasonic diagnosis, and the diagnosis time can be shortened.

[Brief description of drawings]

FIG. 1 is an overall view and a partially enlarged view of an ultrasonic endoscope according to a first embodiment of the present invention.

FIG. 2 is an enlarged perspective view of the hard tip portion.

FIG. 3 is a perspective view showing the forceps protruding from a forceps channel, and a perspective view showing the forceps being raised.

FIG. 4 is a longitudinal sectional view showing the vicinity of the forceps raising base.

FIG. 5 is a vertical sectional view showing the relationship between the forceps raising base and the puncture needle.

FIG. 6 is a vertical cross-sectional view for explaining the operation of the forceps raising base according to the second embodiment of the present invention.

FIG. 7 is a vertical cross-sectional view showing the relationship between the forceps raising base and the puncture needle.

FIG. 8 is an explanatory diagram showing a depiction state in the ultrasonic image.

[Explanation of symbols]

 8 Ultrasonic Transducer 9 Light Guide Cover Glass 10 Objective Lens 11 Air / Water Supply Port 12a Forceps Channel Outlet 14 Forceps Wire 15 Forceps Raising Platform

Claims (1)

[Claims] 1. An ultrasonic endoscope including an ultrasonic transducer, a forceps channel outlet, and a rotatable forceps raising base at the tip of an insertion portion having a hard tip portion, a bending portion, and a flexible tube. The force point for raising the forceps on the forceps on the forceps raising base when the forceps is inserted into the forceps channel is located outside the outer contour of the rigid tip portion, and at least the force points when the insertion portion is inserted into the body cavity. An ultrasonic endoscope, wherein the forceps raising base is located closer to the hand side than the rotation axis, and the entire forceps raising base is housed in the distal end hard portion.