JP2001046376A - Ultrasonic endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To materialize an ultrasonic endoscope which enables an operator to easily carry out treatment while checking the front end position of a treatment implement under ultrasonic observation. SOLUTION: A lead-out port 14a of a treatment implement insertion channel 14 is opened at the front end face of a front end rigid part 11 so as to incline at an angle α in a direction intersecting with the central axis 10a in the longitudinal direction of the insertion part, by which the lead-out port 14a is opened in a direction intersecting with the central axis 66a of an ultrasonic scanning surface. In addition, the central axis 14b in the longitudinal direction of the lead-out port 14a may be disposed on the ultrasonic scanning surface. As a result, the treatment implement, such as a puncture needle projected from the lead-out port 14a may be directed and guided toward the central axis 6a of the ultrasonic scanning surface and the easy treatment may be carried out while the front end position of the treatment implement is checked under the ultrasonic observation.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

[0001] The present invention relates to an ultrasonic endoscope provided with an ultrasonic probe.

[0002]

2. Description of the Related Art By inserting an elongated insertion portion into a body cavity, an internal organ or the like in the body cavity can be observed, and if necessary, various treatments can be performed using a treatment tool inserted into a treatment tool channel. Mirrors are widely used. As described above, some endoscopes having the treatment instrument insertion channel can perform an ultrasonic diagnosis by inserting an ultrasonic probe through the treatment instrument insertion channel, guiding the ultrasonic probe to a target site, and oscillating an ultrasonic beam.

Further, an ultrasonic probe is provided at the tip of an insertion portion to be inserted into a body cavity so that an ultrasonic tomographic image can be obtained by the ultrasonic probe, and a treatment tool can be inserted into the insertion portion. An ultrasonic endoscope has been put into practical use, which is provided with a through channel and allows a treatment tool to protrude from an outlet provided at a distal end of the treatment tool insertion channel to perform a treatment such as collecting a diseased tissue. I have. Such an ultrasonic endoscope includes a radial scanning type that scans in a direction orthogonal to the insertion axis direction to obtain an ultrasonic tomographic image in a lateral direction, and an ultrasonic endoscope with respect to the insertion axis direction. For example, there is a sector scanning type in which an ultrasonic tomographic image in a forward direction is obtained by scanning in a parallel forward direction.

[0004] For example, in Japanese Patent Application Laid-Open No. 7-289549, an ultrasonic probe is provided at the tip of an endoscope, and by rotating the ultrasonic probe, the ultrasonic probe is perpendicular to the insertion direction of the endoscope. An ultrasonic endoscope having a structure for obtaining an ultrasonic image of a cross section has been proposed. Japanese Patent Application Laid-Open No. 1-280446 discloses that a puncture needle is provided in the ultrasonic scanning range of an ultrasonic probe in which a number of ultrasonic transducers are arranged in a convex shape from the distal end to one side surface of the endoscope. An ultrasonic endoscope protruding is proposed. Further, the ultrasonic endoscope described in Japanese Patent Application Laid-Open No. 7-149885 has an ultrasonic vibrator provided on a peripheral body portion of a hard distal end, and the hard distal end is provided in a predetermined direction in a direction opposite to a leading direction of a puncture device. There has been proposed a device in which the puncture device is led out into the scanning range of the ultrasonic transducer by bending the angle. Further, Japanese Utility Model Laid-Open No. 3-116816 proposes an ultrasonic endoscope provided to transmit and receive ultrasonic waves toward the side of a distal end body provided at a distal end.

[0005]

However, the ultrasonic endoscope described in the above-mentioned Japanese Patent Application Laid-Open No. 7-289549,
Since only an ultrasonic image perpendicular to the longitudinal direction of the insertion section can be obtained, only one section of the treatment tool such as a puncture needle protruding from the treatment tool insertion channel provided in the endoscope toward the diagnostic site is subjected to ultrasound. Since it is displayed in a substantially dot shape on the image, there is a problem that the tip position of the treatment tool cannot be confirmed. Also, in the ultrasonic endoscope described in Japanese Patent Application Laid-Open No. 1-280446, the puncture needle can only protrude at the end of the ultrasonic scanning range. The operation must be complicated. Further, Japanese Unexamined Patent Application Publication No. 7-143985
The ultrasonic endoscope described in Japanese Unexamined Patent Publication No. 3-116816 and Japanese Utility Model Laid-Open Publication No. 3-116816 can project a puncture device in a direction intersecting with the center axis of an ultrasonic scanning range, and a puncture target portion is formed at the center of the ultrasonic scanning range. Puncturing is possible by capturing, but there is a problem that puncturing in the forward direction of the endoscope is impossible.

[0006] The present invention has been made in view of these circumstances, and guides a treatment tool protruding from a treatment tool lead-out port toward a central axis of an ultrasonic scanning surface, thereby obtaining an ultrasonic image under ultrasonic observation. It is an object of the present invention to provide an ultrasonic endoscope that can easily perform a treatment while confirming a position of a distal end of a treatment tool.

[0007]

In order to achieve the above object, the present invention provides a treatment instrument insertion channel, and a treatment instrument outlet of the treatment instrument insertion channel is formed on the distal end side,
In an ultrasonic endoscope in which the central axis of the ultrasonic scanning surface is substantially parallel to the central axis in the longitudinal direction of the elongated insertion portion, the treatment instrument outlet is arranged in a direction intersecting with the central axis of the ultrasonic scanning surface. In addition to the opening, a longitudinal center axis of the treatment instrument outlet is provided on the ultrasonic scanning surface. With this configuration, an ultrasonic endoscope that can easily perform a treatment while confirming the position of the distal end of the treatment tool under ultrasonic observation is realized.

[0008]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 10 show a first embodiment of the present invention.
1 is an explanatory diagram showing a schematic configuration of an ultrasonic endoscope system, FIG. 2 is a cross-sectional view showing a configuration of a distal end portion of the ultrasonic endoscope, and FIG. FIG. 4 is an explanatory view showing a configuration of a contactor, FIG. 4 is an explanatory view showing a configuration of a base end portion of an ultrasonic transmission medium suction tube and an ultrasonic transmission medium injection tube, and FIG. 5 is an illustration showing a lubricating oil hole communicating with a guide tube. FIG. 6, FIG. 6 is a front view and a side view of an ultrasonic endoscope showing a scanning state of the ultrasonic probe, FIG. 7 is a perspective view showing a scanning state of the ultrasonic probe, and FIG. Explanatory drawing showing an example of an ultrasonic tomographic image displayed on a monitor screen obtained by a child,
FIG. 9 is an explanatory view showing an endoscope image observed from the eyepiece, FIG. 10 is an explanatory view showing an ultrasonic transmission medium filled in a balloon provided on the distal end side of the insertion section, and an excessive FIG. 5 is an explanatory diagram when the O-ring of the balloon is detached from the balloon groove and the ultrasonic transmission medium flows out when the ultrasonic transmission medium is filled.

As shown in FIG. 1, the ultrasonic endoscope system according to the present embodiment includes an ultrasonic probe as an ultrasonic diagnostic apparatus at an ultrasonic transmitting / receiving section, which will be described later, protruding from a distal end rigid portion 11 of an insertion section 10. Provided ultrasonic endoscope (hereinafter abbreviated as endoscope) 1
And a light source unit (not shown) for supplying illumination light to an illumination optical system provided in the endoscope 1 and a signal processing unit for processing an electric signal transmitted from an ultrasonic probe into an image signal. The ultrasonic observation device 2, a monitor 3 for displaying an image signal generated by the ultrasonic observation device 2, and an image recording device 4 including a video device or a video printer for recording an image displayed on the monitor 3 are mainly used. Is configured.

The ultrasonic endoscope 1 has a flexible insertion portion 10 to be inserted into a body cavity, and a main operation portion 5 serving also as a grip portion connected to a base end of the insertion portion 10. A sub-operation unit 7 having an eyepiece 6 provided at the rear end of the main operation unit 5 and having a rotary drive source such as a servo motor (not shown) provided therein.
And a light source connector 8a extending from the side of the main operation unit 5 and detachably connected to a light source unit (not shown) at a base end.
And an ultrasonic connector 9a extending from a side portion of the sub-operation portion 7 and detachably connected to a signal processing portion of the ultrasonic diagnostic observation device 2 at a base end portion. It mainly comprises an ultrasonic code 9.

The insertion portion 10 includes, in order from the distal end, a rigid distal end portion 11 formed of a hard member, a curved portion 12 that can be bent vertically, and a flexible tube portion 13 formed of an elongated and flexible sheath. Are connected. A treatment instrument such as a puncture needle is inserted through the insertion section 10 into the main operation section 5,
A treatment instrument outlet 5a serving as an entrance of the treatment instrument insertion channel 14 that has an outlet at a treatment instrument outlet (hereinafter simply referred to as an outlet) 14a opened at the distal end surface 11a of the distal end rigid portion 11 shown in FIG. Is provided. The main operation section 5 includes a bending operation knob 5b for bending the bending section 12 in a desired direction, an air supply / water supply button 5c for performing air supply and water supply operations, and a suction button 5d for performing suction. Is provided.

In the present embodiment, the outlet 14a is opened in a direction intersecting with the center axis of the ultrasonic scanning surface.
By providing the central axis in the longitudinal direction of the outlet 14a on the ultrasonic scanning surface, a treatment tool such as a puncture needle protruding from the outlet 14a is directed toward the central axis of the ultrasonic scanning surface in the forward direction of the insertion section. The outlet 14a of the treatment instrument insertion channel 14 is formed so that the treatment can be performed while confirming the distal end position of the treatment instrument under ultrasonic observation.

[0013] As shown in FIG.
A bag-like tip cap 20 made of a plastic material such as high-density polyethylene, polymethylpentene, or the like which has excellent ultrasonic permeability and an elastic material that transmits ultrasonic waves is disposed on the distal end surface 11a side. I have. Inside the distal end cap 20, for example, an ultrasonic wave is rotated in the direction of an arrow by a flexible shaft which will be described later and an ultrasonic wave is inserted into the insertion portion longitudinal axis 1
An ultrasonic probe 21 that performs radial scanning by emitting light in a direction perpendicular to 0a, and is emitted in a direction perpendicular to the insertion portion longitudinal center axis 10a that is provided alongside the ultrasonic probe 21. And a reflector 22 having a reflecting surface 22a formed at an angle of 45 degrees with respect to the ultrasonic probe 21 for reflecting a part of the ultrasonic waves in the insertion portion forward direction as indicated by a dashed line. Thus, the ultrasonic transmission / reception unit 23 is configured.

The tip cap 20 is filled with a liquid ultrasonic transmission medium, such as liquid paraffin, water, carboxymethylcellulose aqueous solution, or KY jelly, having an ultrasonic transmission characteristic. Reference numerals 24, 2
Reference numeral 4a denotes a balloon groove for mounting a balloon (see FIG. 10), which will be described later, for filling an ultrasonic transmission medium such as degassed water with the subject, and reference numeral 25 denotes an ultrasonic wave such as degassed water in the balloon. Reference numeral 26 denotes a water supply / suction groove which communicates with the balloon water supply / suction port 25. That is, the balloon water supply / suction port 25 is open at the bottom of the water supply / suction groove 26. The balloon groove 24a is formed in a balloon locking member provided on the outer peripheral surface of the distal end cap 20 so as not to obstruct part of the path of the ultrasonic wave reflected in the forward direction of the insertion portion.

FIG. 2B is a front view of the distal end of the insertion portion 10, FIG. 2C is a cross-sectional view taken along the line AA of FIG. 2B, and FIG. 2D is a line BB of FIG. It is sectional drawing. 2 (b), (c),
As shown in FIG. 3D, a treatment tool insertion channel 14 for guiding a treatment instrument into the body cavity, a light guide 15 serving as an illumination optical system for illuminating the inside of the body cavity, and observation of the inside of the body cavity are provided in the insertion portion 10. Guide 16, a flexible shaft 28 covered with a guide tube 27 for rotating the ultrasonic probe 21, a balloon water supply / suction tube 29 communicating with the balloon water supply / suction port 25, A medium injection tube 30 for injecting the ultrasonic transmission medium, a medium suction tube 31 for sucking the medium, and the like are provided in the distal end cap 20. The image guide 16 and the light guide 15 are arranged so as to cover the periphery of the image guide 16. Further, the guide tube 27 is filled with a lubricating oil for improving the slidability between the flexible shaft 28 and the inner peripheral surface of the guide tube 27.

[0016] As shown in FIG.
An optical system having a light guide 15 disposed around an image guide 16 and a treatment instrument insertion channel 1
Four outlets 14a are provided. This outlet 14a
As shown in FIG. 2C, a plane formed by a longitudinal center axis 14b of the outlet 14a and a substantially central portion of a reflection surface 22a of the reflector 22 is formed by the ultrasonic probe 21. And is provided so as to be included in the insertion unit front direction scanning plane which is emitted in a direction perpendicular to the insertion unit longitudinal direction central axis 10a direction and reflected by the reflection surface 22a,
The outlet 14a is opened by being inclined by an angle α in a direction intersecting with the insertion portion longitudinal center axis 10a. Thereby, the outlet 14a is opened in a direction intersecting with the center axis 66a of the ultrasonic scanning surface, and the longitudinal center axis 14b of the outlet 14a can be provided on the ultrasonic scanning surface, The treatment tool protruding from the outlet 14a can be arranged toward the central axis 66a in the ultrasonic scanning plane which is reflected by the reflection surface 22a and emitted in the forward direction of the insertion section.

As shown in FIG. 3A, the ultrasonic probe 21
Is a rotatable flexible shaft 28 extending from a rotary drive source provided in the sub-operation unit 7, a housing 32 integrally fixed to a distal end of the flexible shaft 28, and a housing 32. A bearing portion 33 that holds the flexible shaft 28 so as to rotate smoothly by a rotational force thereof, and an O-ring 34 that maintains water tightness between the inside of the distal end cap 20 and the inside of the guide tube 27.
And so on.

FIG. 3B is an enlarged view of a portion A in FIG. 3A, and FIG. 3C is a sectional view taken along the line BB in FIG. 3B. FIG.
As shown in (b) and (c), the housing 32 includes:
Backing material 35 which is an ultrasonic absorber formed by molding an elastic body such as polychloroprene rubber containing ferrite or epoxy resin containing tungsten powder, a flat piezoelectric element 37 such as zirconate titanate or titanate, epoxy resin The concave lens-shaped acoustic lens 38 formed by
It is fixed by. Reference numeral 40 denotes a signal that is inserted through the flexible shaft 28, electrically connects the ultrasonic probe 21 and the ultrasonic observation device 2, and receives and converts the ultrasonic signal with an ultrasonic drive signal or an ultrasonic probe. Signal line for transmitting the electrical signal obtained.

As shown in FIG.
The base end sides of the tube 0 and the medium suction tube 31 are connected to a medium injection block 41 and a medium suction block 42 disposed in the holding portion of the main operation portion 5 through the insertion portion 10, respectively. The medium injection block 41 and the medium suction block 42 have the same structure, and have a communication hole 43 communicating with the medium injection tube 30 and the medium suction tube 31. A seal screw 45 provided with an O-ring 44 is screwed and fixed to the communication hole 43. With the seal screw 45 removed, the ultrasonic transmission medium into the tip cap 20 is removed. Injection or suction can be performed. That is, when injecting the ultrasonic transmission medium into the tip cap 20, the communication hole 4 of the medium injection block 41 is used.
3 while the medium is sucked from the communication hole 43 of the medium suction block 42. The medium injection tube 30 and the medium suction tube 31 are
It is externally fitted to a connection pipe 46 protruding from the medium injection block 41 and the medium suction block 42.
7 and are integrally fixed. The main operation unit 5
A through hole 5e for attaching and detaching the seal screw 45 is formed at a position corresponding to the communication hole 43.

As shown in FIG. 5, a first lubricating oil hole 51 communicating with the groove 32a of the bearing 33 provided on the rear side of the housing 32 of the ultrasonic probe 21 is formed in the distal end component 11. ing. A seal screw 54 provided with an O-ring 53 is screwed and fixed to the first lubricating oil hole 51, similarly to the communication hole 43. The sealing screw 54 is located in the groove 32 a of the bearing 33, and the ultrasonic probe 2 is bent by bending the insertion portion 10 and the bending portion 12.
1 is regulated.

On the other hand, the base end of the guide tube 27 in which the flexible shaft 28 is inserted is connected to a connecting portion 5 protruding from a lubricating oil block 55 provided in the main operating portion 5.
5a is screwed into the lubrication block 55, and the tightening rubber 56 is provided with the tightening rubber 56.
7 and press the guide tube 2 into the connecting portion 55a.
7 is pressed and fixed. The lubricating block 55 is formed with a shaft insertion hole 58 through which a shaft fixed to the rear end of the flexible shaft 28 is inserted. A lubricating oil hole 52 communicates. A seal screw 60 provided with an O-ring 59 is screwed and fixed to the second lubricating oil hole 52, similarly to the communication hole 43.

With the seal screw 54 and the seal screw 60 removed, lubricating oil is injected from one lubricating oil hole 51 (or 52), while the other lubricating oil hole 52
By sucking the lubricating oil from (or 51), the lubricating oil can be filled in the guide tube 27. Reference numeral 61 denotes a bearing for receiving a shaft connected to the coil shaft, reference numeral 62 denotes a watertight ring for preventing the lubricating oil from flowing out through the shaft, and reference numeral 63 denotes the bearing. It is a holding screw member for preventing the falling off of 61. The operation of the ultrasonic endoscope configured as described above will be described. The surgeon inserts the insertion section 10 of the ultrasonic endoscope 1 toward a target site while observing the inside of the body cavity while looking through the eyepiece section 6. Then, if it is confirmed that the distal end cap 20 disposed on the distal end rigid portion 11 of the insertion section 10 has reached the target site, the ultrasonic scanning is performed, so that the ultrasonic transmission medium is transmitted through the treatment instrument insertion channel 14. After filling the body cavity with, ultrasonic observation is performed.

The transmission of the high-voltage pulse from the ultrasonic observation apparatus 2 to the ultrasonic probe 21 is started, and the motor in the sub-operation unit 7 is driven. Then, the flexible shaft 2
8 starts rotating, and the ultrasonic probe 21 is excited by the transmitted high-voltage pulse to emit ultrasonic waves. The housing 32 is rotated by the rotation of the flexible shaft 28, and ultrasonic waves emitted from the ultrasonic probe 21 in a direction perpendicular to the direction of the central axis 10 a in the insertion portion longitudinal direction pass through the distal end cap 20 and enter the living body. The ultrasonic wave is emitted in a direction perpendicular to the direction of the central axis 10a of the insertion portion in the longitudinal direction of the insertion portion to start radial scanning as shown by the oblique line in FIG.

When the ultrasonic wave emitted from the ultrasonic probe 21 strikes the reflecting surface 22a of the reflector 22, the ultrasonic wave is reflected by the reflecting surface 22a as shown in FIG. The scanning is performed in the forward direction of the insertion portion indicated by oblique lines. Further, when the housing 32 rotates and the ultrasonic wave emitted from the ultrasonic probe 21 passes over the reflecting surface 22a, the ultrasonic wave emitted from the ultrasonic probe 21 is changed as shown in FIG. The sound wave passes through the distal end cap 20 and is propagated in a direction perpendicular to the direction of the central axis 10a in the longitudinal direction of the insertion portion, and scans a surface indicated by oblique lines perpendicular to the direction of the central axis 10a in the longitudinal direction of the insertion portion.

That is, as shown in FIG. 7, the ultrasonic endoscope 1 according to the present embodiment comprises an ultrasonic probe 21 rotated by a flexible shaft 28 in a distal end cap 20 and an ultrasonic probe 21. By providing the reflecting member 22 having the reflecting surface 22a formed side by side with the constituent housing 32, the rotating ultrasonic probe 21 can be rotated in a direction perpendicular to the direction of the insertion portion longitudinal center axis 10a by one rotating ultrasonic probe 21. It has two scanning ranges: a radial scanning range 65 for emitting ultrasonic waves, and a forward scanning range 66 for inserting parts for emitting ultrasonic waves forward with respect to the central axis in the longitudinal direction of the insertion part.

Under ultrasonic observation having these two scanning ranges, a treatment tool such as a tissue puncture needle 71 is inserted from the insertion port 5a, and the puncture needle 71 is inserted into the body cavity from the outlet port 14a via the treatment tool channel 14. 6 (see FIGS. 6 (b) and 7) and push it toward the observation site. Then
Since the plane formed by the central axis of the outlet 14a, the substantially central portion of the reflection surface 22a, and the scanning surface in the forward direction of the insertion portion substantially match, the puncture needle 71 protruding from the outlet 14a The needle part 72 is arranged in the scanning plane in the forward direction of the insertion part reflected by the reflection surface 22a. In addition, outlet 14a
Angle α in the direction intersecting the insertion portion longitudinal center axis 10a.
The needle portion 72 of the puncture needle 71 protrudes from the outlet 14a toward the central axis 66a (the central axis of the ultrasonic scanning surface) of the forward scanning range 66 because the needle portion 72 is inclined and opened. For this reason, as shown in FIG. 8, the outlet 14 is displayed on the insertion unit front direction ultrasonic tomographic image 67 showing the insertion unit front direction scanning range 66 of the ultrasonic tomographic image displayed on the screen 3a of the monitor 3.
Since the needle portion ultrasonic image 101 of the puncture needle 71 protruding from a is drawn to the distal end, the positional relationship between the distal end of the puncture needle 71 and the observation site and the puncture are determined by the ultrasonic tomographic image displayed on the screen 3a. The tissue can be easily sucked while checking the depth and the like.

On the monitor 3, as shown in FIG. 8, a radial ultrasonic tomographic image 68 obtained from a radial scanning plane perpendicular to the longitudinal axis 10a of the insertion portion on the screen 3a.
And an insertion-portion forward-direction ultrasonic tomographic image 67 obtained from the insertion-portion front-direction scanning plane are displayed as concentric ultrasonic tomographic images.

As shown in FIG. 9, a part of the distal end cap 20 is visible in the endoscope image 103 observed from the eyepiece 6. The mask portion 105 of the endoscope image 103 is provided with a mark 104 indicating the appearance of the distal end cap 20 that cannot be confirmed in the endoscope image 103. As described above, a part of the ultrasonic wave emitted from the ultrasonic probe 21 disposed at the distal end of the flexible shaft 28 rotated by the driving source in the direction perpendicular to the direction of the central axis 10a in the insertion portion longitudinal direction. By providing the reflector 22 having the reflecting surface 22a for reflecting in the distal end direction of the insertion portion in the housing 32 and in the distal end cap 20, one rotation without forming the distal end portion 11 with a large diameter. The ultrasonic probe 21
It is possible to obtain a scanning surface perpendicular to the direction of the central axis 10a in the insertion portion longitudinal direction and a scanning surface in the insertion portion forward direction. In addition, since the outlet 14a is provided so as to correspond to the reflecting surface so that the treatment tool protruding from the outlet 14a of the treatment tool insertion channel 14 is always arranged in the scanning plane in the forward direction of the insertion portion, the outlet 14a is provided. The distal end of the treatment tool protruding from the tomographic image can be drawn on the ultrasonic tomographic image (insertion part forward ultrasonic tomographic image) 67.

Further, since the outlet 14a is inclined and opened in a direction intersecting the insertion portion longitudinal center axis 10a,
The outlet 14a is opened in a direction intersecting with the center axis 66a of the ultrasonic scanning surface, and the central axis 14b in the longitudinal direction of the outlet 14a can be provided on the ultrasonic scanning surface. Can be projected toward the central axis 66a of the forward scanning range 66,
The distal end cap 20 is provided in front of the observation optical system, but the operator can recognize the appearance of the distal end cap 20 that can be partially confirmed in the endoscope image by the mark 104 of the mask portion 105.

As a result, the insertion section 10 of the ultrasonic endoscope 1 can be safely inserted into the body cavity, and when performing puncture under ultrasonic observation, the target puncture site is located at the center of the ultrasonic forward scan range 66. In this state, the tissue can be collected safely, promptly and reliably while checking not only the puncture position of the puncture needle 71 but also the puncture depth.

In the above operation, the ultrasonic observation is performed after the body cavity is filled with the ultrasonic transmission medium, but the ultrasonic transmission is performed using the balloon 64 as shown in FIG. When securing the medium,
An ultrasonic transmission medium such as degassed water from the balloon water supply / suction tube 29 is injected into the balloon 64 through the suction port 25, and the balloon 64 is filled with the ultrasonic transmission medium and expanded. At this time, if the ultrasonic transmission medium is excessively filled in the balloon 64, the O-ring of the balloon 64 comes off from the balloon groove 24a as shown in FIG. 10B, and the ultrasonic transmission medium flows out. . This allows
The balloon 64 can be prevented from being ruptured due to overexpansion of the balloon 64, and the balloon 64 itself can be prevented from falling into the body cavity.

The present invention is not limited to only the above-described embodiments, but can be variously modified without departing from the gist of the invention.

(Second Embodiment) FIG. 11 is a sectional view showing a configuration of a distal end portion of an ultrasonic endoscope according to a second embodiment of the present invention. In the first embodiment, the treatment instrument insertion channel 14 is connected to the insertion portion longitudinal center axis 10.
a, the treatment instrument insertion channel 1
4 is configured to be opened by being inclined at an angle α in a direction intersecting with the insertion portion longitudinal center axis 10a, but in the present embodiment, the treatment instrument insertion channel 14
Is disposed from the vicinity of the center of the insertion portion 10 toward the outer peripheral surface of the distal end rigid portion 11, and the outlet 14a is connected to the insertion portion longitudinal center axis 1
The opening is formed so as to be inclined by an angle β in a direction intersecting with 0a. The other configuration is the same as that of FIG. 2 and thus the description is omitted, and the same configuration is denoted by the same reference numeral.

The treatment instrument insertion channel 14b disposed in the distal end rigid portion 11 is disposed from the vicinity of the center of the insertion portion 10 toward the outer peripheral surface of the distal end rigid portion 11, and extends the outlet 14a to the length of the insertion portion. The opening is formed so as to be inclined by an angle β in a direction intersecting the hand direction central axis 10a.

As a result, the treatment instrument insertion channel 1
4 is located near the center of the insertion section 10, so that the insertion section 1
By arranging (laying out) the other internal components in the vicinity of the center of the insertion portion 10, the outer diameter of the distal end hard portion 11 on the curved portion 12 side can be reduced, and the diameter of the insertion portion 10 can be reduced.

(Third Embodiment) FIG. 12 is a sectional view showing a configuration of a distal end portion of an ultrasonic endoscope according to a third embodiment of the present invention. In the first and second embodiments, the ultrasonic probe 21 is configured as a mechanical radial scan to transmit a driving force from a driving unit provided in the sub-operation unit 7 via the flexible shaft 28.
In the present embodiment, an ultrasonic endoscope is configured as an electronic radial scan in which an electronic scanning ultrasonic probe and a transducer cable are arranged instead of providing the ultrasonic probe 21 at the tip of the flexible shaft 28. I do. The other configuration is the same as that of FIG. 2 and thus the description is omitted, and the same configuration is denoted by the same reference numeral.

As shown in FIG. 12 (a), the outlet 14a of the treatment instrument insertion channel 14 is provided on the distal end surface of the distal end rigid portion 11 in a direction intersecting with the central axis 10a in the longitudinal direction of the insertion portion as in FIG. The opening is inclined by the angle α. FIG.
1, the treatment instrument insertion channel 14b is inserted into the insertion portion 1
It is also possible to arrange the outlet port 14a so as to be inclined by an angle β in a direction intersecting the insertion portion longitudinal center axis 10a by disposing the tip hard portion 11 toward the outer peripheral surface from near the center of 0. good.

FIG. 12 (b)
As shown in (1), an electronic radial scanning ultrasonic probe 150 is provided at the end of the transducer cable 151, and the electronic radial scanning ultrasonic probe 150 is provided on the distal end cap 20 along with the reflector 22. ing.

Thus, when the flexible shaft 28 and the flexible shaft 28 are rotated, the drive unit is not required, and the sub-operation unit 7 provided with the drive unit is not required. As a result, the operation unit becomes smaller and lighter, and the operability of the ultrasonic endoscope can be improved.

When securing the ultrasonic transmission medium using the balloon 64, it is necessary to fill the balloon 64 with the ultrasonic transmission medium and inflate the balloon 64.
When the balloon 64 is inflated, it interferes with the outlet 14a of the treatment tool insertion channel 14 for projecting a treatment tool such as a puncture tool, and if the treatment tool such as a puncture tool is further projected in this state, the balloon 64 may be ruptured. This occurs. Therefore, the balloon 64 is configured not to burst even if a treatment tool such as a puncture tool is protruded.

As shown in FIG. 13, the balloon 200 is attached to the
An ultrasonic transmission medium reservoir 201 is formed in the front. Thereby, when the needle portion 72 of the puncture needle 71 is projected and punctured into the insertion portion forward direction scanning portion 66 at a site (such as a bronchus) where the ultrasonic transmission medium cannot be stored in the body cavity, the balloon 200 is inflated. Instead, the ultrasonic transmission medium is brought into contact with the body cavity with the ultrasonic transmission medium sealed in the ultrasonic transmission medium reservoir 201 of the balloon 200. Ultrasonic waves are transmitted to and received from the forward direction scanning unit 66 via the ultrasonic wave transmission medium reservoir 201.

As a result, since the ultrasonic transmission medium can be reliably positioned in the forward scanning section 66, a portion (such as a bronchus) where the ultrasonic transmission medium cannot be stored in the body cavity.
However, a forward scanning ultrasound image is obtained and puncturing is possible. In addition, since the needle portion 72 of the puncture needle 71 can be protruded from the forward scanning section 66 without inflating the balloon 200, when the puncture needle 71 is protruded from the outlet 14a, the balloon 200 is broken and debris falls into the body cavity. The danger of letting go can be avoided. Further, since the balloon 200 is not inflated, the balloon can be prevented from coming off due to excessive inflation and falling off due to rupture.

Further, as shown in FIG.
In the configuration in which the ultrasonic transmission medium reservoir 203 has a larger cross-sectional area than the balloon opening, the ultrasonic transmission medium reservoir 203 is large, so that the contact area between the body cavity and the balloon 202 can be increased. An ultrasonic image of the forward scanning unit 66 can be obtained in a wider range.

As a result, since the ultrasonic transmission medium can be reliably positioned in the forward scanning section, the forward scanning ultrasonic image can be obtained even in a part (such as a bronchus) where the ultrasonic transmission medium cannot be stored in the body cavity. And puncture is possible. In addition, since the needle portion 72 of the puncture needle 71 can be protruded into the forward operation portion without inflating the balloon 202, the outlet port 1
When projecting the puncture needle 71 from 4a, the danger of breaking the balloon 202 and dropping debris into the body cavity can be avoided.
Further, since the balloon 202 is not inflated, the balloon 202 can be prevented from coming off due to excessive inflation and falling off due to destruction.

It should be noted that the present invention is not limited to only the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

[Supplementary note] (Supplementary note 1) A treatment tool insertion channel is provided, and a treatment tool outlet of the treatment tool insertion channel is formed at the distal end side. In the ultrasonic endoscope in which the central axis of the ultrasonic scanning surface is substantially parallel, the treatment tool outlet is opened in a direction intersecting with the central axis of the ultrasonic scanning surface, and the longitudinal direction of the treatment instrument outlet is An ultrasonic endoscope, wherein a direction center axis is provided on the ultrasonic scanning surface.

(Supplementary note 2) The ultra-high-pressure supercharger according to Supplementary note 1, wherein the treatment instrument insertion channel is disposed from the insertion portion side of the rigid distal end portion toward the side outer peripheral surface of the rigid distal end portion. Sonic endoscope.

(Appendix 3) At the tip of the elongated insertion portion,
An ultrasonic endoscope having an ultrasonic transmission / reception unit that scans in front of the insertion unit and having a balloon enclosing an ultrasonic transmission medium used in the ultrasonic transmission / reception unit, wherein a balloon groove for attaching one end of the balloon is provided. The balloon is formed on the balloon locking member provided without obstructing the path of the ultrasonic wave reflected in the forward direction of the insertion portion, and when the ultrasonic transmission medium is excessively filled in the balloon, the balloon is moved from the balloon groove to the balloon. An ultrasonic endoscope characterized in that one end is detached.

(Appendix 4) At the tip of the elongated insertion portion,
An ultrasonic endoscope including an ultrasonic transmitting / receiving unit that scans in front of the insertion unit and a balloon that encloses an ultrasonic transmission medium used in the ultrasonic transmitting / receiving unit, wherein the balloon includes the ultrasonic transmitting / receiving unit Ultrasound endoscope having a longer overall length, wherein an ultrasonic transmission medium reservoir is formed in a forward scanning section of the ultrasonic transmission / reception section when attached to the ultrasonic transmission / reception section. mirror.

(Additional Item 5) The ultrasonic endoscope according to Additional Item 4, wherein a cross-sectional area of the ultrasonic transmission medium reservoir is larger than a cross-sectional area of the ultrasonic transmission / reception unit.

[Additional Objectives] (Additional Items 1 and 2) An ultrasonic endoscope of an insertion portion forward scanning type capable of easily performing a treatment while confirming a distal end portion of a treatment instrument under ultrasonic observation is realized.

(Additional Item 3) Insertion part forward scanning type ultrasonic wave provided with a balloon capable of enclosing the ultrasonic transmission medium without destroying the balloon when the balloon is excessively filled with the ultrasonic transmission medium Realize an endoscope.

(Additional Items 4 and 5) Ultrasonic waves can be provided without allowing the balloon to be destroyed when a treatment tool such as a puncture needle is protruded from the treatment tool outlet through a treatment tool such as a puncture needle. An ultrasonic endoscope of a forward scanning type with an insertion portion provided with a balloon capable of enclosing a transmission medium is realized.

[Additional Action] (Additional Items 1 and 2) There is an action of guiding the treatment tool projected from the treatment tool outlet (outlet) toward the center axis of the ultrasonic scanning surface.

(Additional Item 3) There is an effect that the balloon is not broken when the ultrasonic transmission medium is excessively filled in the balloon.

(Additional Items 4 and 5) The ultrasonic transmission medium reservoir of the balloon for enclosing the ultrasonic transmission medium is positioned in the forward scanning section of the ultrasonic transmission / reception section, and between the ultrasonic diagnostic site and the ultrasonic transmission / reception section. There is an effect that an ultrasonic transmission medium is interposed.

[Additional effects] (Additional items 1 and 2) The ultrasonic endoscope can be safely inserted, and when puncturing is performed after ultrasonic observation, the puncture target site is located at the center of the ultrasonic forward scanning range. In this state, the tissue can be collected safely, quickly and reliably while checking not only the puncture position of the puncture needle but also the puncture depth.

(Additional Item 3) The balloon can be prevented from being ruptured due to excessive inflation of the balloon, and the balloon itself can be prevented from falling into the body cavity.

(Additional Items 4 and 5) Since the ultrasonic transmission medium can be surely positioned in the forward scanning section, the ultrasonic transmission medium in the body cavity cannot be stored (for example, the bronchus). A scanned ultrasound image is obtained and puncturing is possible. In addition, since the needle portion of the puncture needle can protrude from the front operation portion without inflating the balloon, when the puncture needle is protruded from the outlet, the danger of breaking the balloon and dropping debris into the body cavity can be avoided. In addition, since the balloon is not inflated, the balloon can be prevented from coming off due to overinflation and falling off due to destruction.

[0060]

As described above, according to the present invention, it is possible to realize an ultrasonic endoscope which can easily perform a treatment while confirming the position of the distal end of the treatment instrument under ultrasonic observation.

[Brief description of the drawings]

FIG. 1 to FIG. 10 relate to a first embodiment of the present invention, and FIG. 1 is an explanatory diagram showing a schematic configuration of an ultrasonic endoscope system.

FIG. 2 is a sectional view showing a configuration of a distal end portion of the ultrasonic endoscope.

FIG. 3 is an explanatory diagram showing a configuration of an ultrasonic probe.

FIG. 4 is an explanatory view showing a configuration of a base end portion of an ultrasonic transmission medium suction tube and an ultrasonic transmission medium injection tube.

FIG. 5 is an explanatory view showing a lubricating oil hole communicating with a guide tube.

FIG. 6 is a front view and a side view of the ultrasonic endoscope showing a scanning state of the ultrasonic probe.

FIG. 7 is a perspective view showing a scanning state of the ultrasonic probe.

FIG. 8 is an explanatory diagram showing an example of an ultrasonic tomographic image displayed on a monitor screen obtained by an ultrasonic probe.

FIG. 9 is an explanatory diagram showing an endoscope image observed from an eyepiece.

FIG. 10 is an explanatory view in which an ultrasonic transmission medium is filled in a balloon provided on the distal end side of the insertion portion, and an O-ring of the balloon from a balloon groove when the ultrasonic transmission medium is excessively filled in the balloon. FIG. 5 is an explanatory diagram when the ultrasonic transmission medium flows out of the apparatus.

FIG. 11 is a sectional view showing a configuration of a distal end portion of an ultrasonic endoscope according to a second embodiment of the present invention.

FIG. 12 is a sectional view showing a configuration of a distal end portion of an ultrasonic endoscope according to a third embodiment of the present invention.

FIG. 13 is an explanatory view showing an electronic scanning ultrasonic endoscope provided with an electronic scanning ultrasonic probe.

FIG. 14 is an explanatory view showing an electronic scanning ultrasonic endoscope provided with another electronic scanning ultrasonic probe.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic endoscope (ultrasonic diagnostic apparatus) 10 ... Insertion part 10a ... Longitudinal center axis of an insertion part 11 ... Tip rigid part 14 ... Treatment tool insertion channel 14a ... Outlet (treatment instrument outlet) 14b ... Central axis in the longitudinal direction of the outlet 21 ... Ultrasonic probe 22 ... Reflector 64, 200, 202 ... Balloon 65 ... Radial scanning range 66 ... Scanning direction in front of insertion part 67 ... Ultrasonic tomographic image 71 in insertion part forward direction ... Puncture needle (treatment instrument) 72 ... needle part 101 ... needle part ultrasonic image 103 ... endoscope image 104 ... mark 150 ... electronic radial scanning ultrasonic probe 151 ... transducer cable

Continued on the front page F term (reference) 4C061 AA00 BB01 BB08 CC00 DD03 FF36 FF43 GG15 HH02 HH04 HH05 NN05 WW16 YY04 YY12 4C301 AA02 BB02 BB03 BB28 BB30 EE13 FF05 FF15 FF17 GA15 GB20 GB29 GC31 GC03 GC03

Claims (1)

[Claims] 1. A treatment tool insertion channel is disposed, a treatment tool outlet of the treatment tool insertion channel is formed at a distal end side, and an ultrasonic scanning surface of an ultrasonic scanning surface is formed with respect to a longitudinal center axis of an elongated insertion portion. In an ultrasonic endoscope having a central axis substantially parallel, the treatment tool outlet is opened in a direction intersecting with a center axis of the ultrasonic scanning surface, and the longitudinal center axis of the treatment tool outlet is set to An ultrasonic endoscope provided on a sound wave scanning surface.