JPH10216134A - Puncture needle system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To realize a low invasion while allowing sufficiently bringing of a sufficient tissue into a notch part by making traverse surfaces of a part where outer and inner needles are pierced into a body cavity and the notch part longitudinally rectangular. SOLUTION: The rear end of a needle 8 of an outer needle 3 is bonded by an adhesive or the like at the tip part of an outer needle grip part 9 and the section of a part to be pierced into a body cavity to the position 8p from the tip of the needle 8 is made hollow with the cross section thereof made longitudinally rectangular or oval. The rear end part of the needle 11 of the inner needle 4 is connected by an adhesive or the like to the tip part of an inner needle grip part 12 and the part of the needle to the position 11p from the tip part of the needle 11 is made longitudinally rectangular or oval in cross section. The tip part of the needle 11 is provided with a notch part 13 whose depth is in the direction of the vertical length of the vertically rectangular cross section. The inner needle 4 is housed into the outer needle 3 and especially, is so shaped to be housed tight into the outer needle 3 with the notch 13 exposed.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture needle system for percutaneously or endoscopically biopsying a tissue or a cell of a living body. The present invention relates to a puncture needle system comprising a solid inner needle and having a cutout portion on a side surface of the inner needle.

[0002]

2. Description of the Related Art A conventional puncture needle system for percutaneously or endoscopically biopsying a tissue or cell of a living body has been proposed.
There is one disclosed in Japanese Patent Publication No. 52-23191. In the puncture needle system disclosed in Japanese Patent Publication No. 52-23191, the outer needle and the inner needle are generally cylindrical and circular, respectively, and a cutout portion is provided on the side surface near the tip of the inner needle. , On the tip side of the notch,
One having a protruding hook on the rear end side is applied.

A procedure for collecting a tissue at a target site by the puncture needle system disclosed in Japanese Patent Publication No. 52-23191 is as follows. That is, (1) The puncture needle is inserted into the target site in a state where the cutout portion of the inner needle is completely accommodated in the outer needle. (2) Pull out the outer needle to the side of the hand until the notch of the inner needle appears. (3) The tissue at the target site is taken into the cutout portion by the elastic force of the tissue. (4) The outer needle is quickly pushed out to the distal end side until the cutout portion of the inner needle completely fits in the outer needle, and the tissue taken into the cutout portion is cut. (5) Remove the entire puncture needle. Tissue is collected according to the procedure described above.

[0004]

Problems to be Solved by the Invention
In order to collect a sufficient amount of tissue for pathological examination with the puncture needle system disclosed in Japanese Patent No. 191, it is necessary to take in a sufficient amount of tissue in the cutout portion. Therefore,
In the case of a cylindrical needle such as the puncture needle disclosed in JP-A-231191, the outside diameter of the needle is increased to increase the amount of tissue taken into the notch.

However, when the outer diameter of the puncture needle having a cylindrical cross-section is increased as in the puncture needle system disclosed in Japanese Patent Publication No. 52-23191, the puncture path,
In particular, you will have a large space in the notch,
The hole took a long time to heal completely.

[0006] It is an object of the present invention to solve the above-mentioned problems and to provide a minimally invasive puncture needle system at the same time that sufficient tissue can be taken into the notch.

[0007]

A puncture needle system according to the present invention comprises: a tubular outer needle; and an inner needle that moves freely within the outer needle and has a cutout near the distal end thereof. In a state in which the inner needle is inserted into the outer needle, a puncture needle system for collecting body cavity tissue by piercing them into a body cavity, and a body cavity insertion portion of the outer needle and the inner needle, and The cross section of the notch is vertically long.

[0008] In the above puncture needle system, since the outer needle and the inner needle are inserted into the body cavity and the cross section of the notch is elongated, the notch is deepened and a large amount of tissue is formed. Can be taken into the notch. At the same time, since the puncture path is vertically elongated, the tissue in the puncture path can easily adhere in the lateral direction, and the treatment time of the puncture path, in particular, the space in the tissue sampling portion can be reduced.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 6 are views showing a structure of a puncture needle system according to a first embodiment of the present invention, and FIG. 1 is a longitudinal sectional view of the puncture needle system.
2, 3, and 5 are longitudinal sectional views of a sheath, an outer needle, and an inner needle which constitute the puncture needle system, respectively. FIG.
(A) and (B) are cross-sectional views taken along the line AA in FIG.
6A and 6B are sectional views of FIGS. 6A and 6B, respectively.
3 is a cross-sectional view taken along line CC of FIG.

The present puncture needle system can collect a sufficient amount of tissue and can speed up postoperative treatment. The structure and operation of the puncture needle system will be described in detail below. As shown in the longitudinal sectional view of FIG. 1, the present puncture needle system 1 mainly includes a sheath 2, an outer needle 3, and an inner needle 4.

As shown in FIG. 2, the sheath 2 includes a sheath portion 5 having flexibility over its entire length, and a sheath gripping portion 6 formed of a material such as hard plastic. The rear end of the sheath 5 and the distal end of the sheath gripper 6 are connected by an adhesive. The hole 7 penetrating the center of the sheath 2 has a shape that allows the needle 8 of the outer needle 3 described later to be inserted and removed.

The outer needle 3 is a metal needle 8 as shown in FIG.
And the outer needle gripping portion 9, and the rear end of the needle 8 and the tip of the outer needle gripping portion 9 are bonded with an adhesive or the like. The section of the portion 8a to be inserted into the body cavity from the distal end of the needle 8 to the position 8p is a hollow rectangular elongated shape as shown in FIG. 4A showing an AA cross section in FIG. 3, or , Having an oval cross section. The portion 8b behind the position 8p has an annular cross section as shown in FIG. 4B, which shows a cross section taken along line BB of FIG. The needle 11 of the inner needle 4 described later can be inserted into and removed from the inner peripheral portion of the needle 8.

The inner needle 4 includes a metal needle 11 and an inner needle grip 1.
The rear end of the needle 11 and the front end of the inner needle grip 12 are connected by an adhesive or the like. The cross section of the needle 11 is such that the needle portion 11a from the tip to the position 11p has a vertically long rectangular shape as shown in FIG.
Alternatively, it has an elliptical cross section. The position 1
The needle portion 11b behind 1p has a circular cross section as shown in FIG. 6B showing a DD cross section in FIG. In addition, the distal end of the needle 11 has a cutout portion 13 whose depth direction is the longitudinal direction of the longitudinal section. The inner needle 4 is housed in the outer needle 3 and, when the notch 13 is exposed, fits into the outer needle 3 without any gap.

FIG. 1 shows a state in which the puncture needle system 1 is assembled and the outer needle 3 is completely protruded from the sheath 2.
The position 8p is located within the sheath portion 5 of the sheath 2.

Next, the procedure of the tissue sampling operation by the puncture needle system 1 will be described with reference to FIGS. (1) First, the endoscope is inserted to the vicinity of the target puncture site. (2) The cutout portion 13 of the inner needle 4 is completely accommodated in the needle 8 of the outer needle 3. At the same time, the outer needle 3 is completely housed inside the sheath portion 5, and the puncture needle system 1 is inserted into the endoscope forceps channel. (3) The distal end of the sheath 5 is pressed against the wall of the body cavity. (4) The tip of the needle 8 is pierced to a position just before the target puncture site. (5) Insert the needle 11 until the notch 13 is located at the target site. Here, the tissue at the target site is taken into the notch 13. (6) While taking care not to move the notch portion 13 with respect to the target puncture site, the outer needle grip 9 is relatively positioned with respect to the inner needle grip 12, and the tip of the needle 8 is notched. The part 13 is advanced until it is completely covered, and the tissue at the target site is cut. (7) The tip of the needle 8 is retracted until it completely fits in the sheath portion 5. (8) With the needle 8 housed in the sheath portion 5, the puncture needle system 1 is removed from the endoscope forceps channel. (9) The tissue piece is collected from the notch 13.

By the above operation, the tissue at the target puncture site can be collected. Then, the part inserted into the body cavity of the needle 8 and the needle 11 by the above-described operation is as shown in FIG.
Alternatively, the shape is limited to the vertically long cross-sectional shape in FIG.

According to the puncture needle system 1 described above, the notch 1 is deeper along the longitudinal direction of the longitudinal cross section as compared with a needle having a substantially circular cross section having the same puncture path cross sectional area.
3 can be provided, so that a large amount of tissue can be taken in when collecting tissue at the target site for puncture.
Furthermore, since the cross section of the needle inserted into the body cavity is a vertically long cross-sectional shape, the puncture path is a hole having a vertically long cross section, so after tissue collection, the wall surfaces in the width direction of the cross section easily adhere to each other, In addition, since the bleeding is suppressed, the healing period of the punctured portion after the operation is shortened.

As a modification of the notch shape provided on the needle 11 of the inner needle 4 of the puncture needle system 1, a needle 21 having a notch shape for the inner needle as shown in FIG. 7 is proposed. Can also. FIG. 7A is a side view of the cutout portion 23 of the needle 21 of the above modification, and FIG.
FIG. 8 is a cross-sectional view taken along the line HH in FIG. 7A, in which the bottom surface of the notch 23 of the needle 21 forms a concave curved surface 23 a. By adopting the notch shape as described above, the collected tissue is easily accommodated, and the effect of reducing the risk of falling off of the tissue is further obtained.

Next, a puncture needle system handle according to a second embodiment of the present invention will be described. The outer needle 33 (see FIG. 10) of the same type as that applied to the puncture needle system 1 of the first embodiment and the inner needle 4 can be attached to the puncture needle system handle 101, A puncture needle system handle capable of improving the aimability of a target puncture site and preventing a reduction in the suction effect of the endoscope when the puncture needle system is attached.

FIG. 8 is a longitudinal sectional view showing a state where the entire puncture needle system handle 101 of the present embodiment is assembled. The puncture needle system bundle 101 mainly includes an endoscope fixing portion 102 and an outer cover 103. , A sheath 104, and an outer needle slider 105.

The endoscope fixing section 102 includes a fixing section main body 106.
An adjustment groove 108 is provided on a side surface of the fixing portion main body 106, and a screw portion 109 and a screw portion 110 are provided at opening portions at the front and rear ends, respectively. The screw portion 109 can be connected to a forceps base 134 (see FIG. 11) of an endoscope to be described later. Retaining 1
07 is provided with a female screw on the inside,
06.

The outer cover 103 includes an adjusting screw 111, a cover body 112, and a sheath fixing cylinder 113. A screw hole 114 is provided on the side of the tip of the cover body 112.
Is provided, and a screw portion 115 is provided in the rear end in the axial direction. Further, by screwing the adjustment screw 111 into the screw hole 114, the endoscope fixing portion 102 and the outer cover 10 are
3 can be fixed.

The sheath fixing cylinder 113 is screw-fixed at its rear end with a screw portion 115 of the cover body 112. A screw portion 116 is provided at the tip of the sheath fixing cylinder 113, and the sheath 104 can be screw-fixed. The cross section of the sheath fixing cylinder 113 is cylindrical, and the abutting portion 117
And the outer diameter is larger at the front end side than at the rear end side. In the middle of the distal end side of the sheath fixing cylinder 113, an O-ring groove 1 is provided.
18 are provided.

The sheath 104 includes a fixing portion 119 and a sheath portion 120, and both are adhered and fixed.
The fixing part 119 is fixed to the sheath fixing cylinder 113 by the screw part 116.
Screw.

The outer needle slider 105 is connected to the slider body 12
1 and a stopper 122. Stopper 122
Consists of a ring 123 and a tapered screw 124.
A screw portion 125 is provided inside the ring 123. The tapered screw 124 has a tapered shape and is
As shown in the -E section, the section is a cylindrical ring screw with a C-shaped notch perpendicular to the axis. Therefore, ring 1
By tightening 23, the stopper 122 is fixed to the slider body 121. An outer needle mounting portion 126 is provided at the rear end of the slider body 121.

An O-ring 127 is inserted into the O-ring groove 118 of the sheath fixing cylinder 113 to maintain the airtightness between the fixing part main body 106 and the inner surface and the sheath fixing cylinder 113.

FIG. 10 shows the puncture needle system handle 10.
FIG. 4 is a cross-sectional view of the outer needle 33 of the puncture needle that can be mounted on the outer needle 33. The outer needle 33 is provided with a female screw portion 39a on the distal end side of the outer needle grip portion 39 in contrast to the outer needle 3 of FIG. Is different. The outer needle grip 39 is formed by the female screw 39a.
It can be fixed to the outer needle mounting part 126 in FIG. Outer needle 3
3 is the same as the outer needle 3 applied to the first embodiment except for the above structure. Further, the inner needle 4 inserted into the outer needle 33 is the same as that shown in FIG. Further, the puncture needle 101 shown in FIG. 8 is applied, and the sheath 2 shown in FIG. 2 is not applied.

In the system handle to which the puncture needle having the above configuration is applied, the outer cover 103 is attached to the endoscope fixing section 1.
After adjusting the amount of advance and retreat of the sheath 104, the sheath 104 can be fixed to the endoscope fixing unit 102 by the adjustment screw 111. The outer needle slider 105 can move forward and backward with respect to the outer cover 103, and the amount of protrusion of the outer needle 33 can be adjusted by a stopper 122.

FIG. 11 shows the handle 10 of the puncture needle system.
1 of the endoscope forceps base 134 to which the base 1 can be attached
1 is a sectional view of FIG. In the peripheral portion 131 of the base, the suction channel 132 is opened at an air supply suction port (not shown) at the end of the endoscope, and an arrow direction D2 on the forceps base 134 side at the channel branch portion 133 and a suction device (not shown) It branches in the arrow direction D3 on the connection port side. The puncture needle system handle 101 can be attached to and detached from the forceps base 134 by the screw portion 109 of the puncture needle system handle 101.

Next, a procedure of a tissue sampling operation using the puncture needle system handle will be described. (1) First, the depth from the body cavity wall to the target puncture site is measured by X-ray diagnosis, ultrasonic diagnosis, or the like. (2) Assemble the puncture needle system handle 101 as shown in FIG. (3) The outer needle 33 is passed through the puncture needle system handle 101. (4) Referring to the result of the depth measurement from the body cavity wall to the target puncture site, the stopper 122 projects the outer needle 33 from the sheath 120 so that the notch 13 can be positioned without shifting from the target target site. Adjust the volume. (5) Pull out the outer needle 33 from the puncture needle system handle 101. (6) The notch 13 of the inner needle 4 is completely accommodated in the needle 8 of the outer needle 33. At the same time, the needle 8 is completely housed inside the sheath portion 120. (7) Pull out the outer needle slider 105 to the maximum at the hand side so that the tip of the needle 8 is completely housed inside the sheath portion 120. (8) Insert the endoscope to the vicinity of the target puncture site. (9) The sheath 104 is inserted into the forceps channel of the endoscope from the forceps base 134, and the puncture needle system handle 101 is connected to the forceps base 134 via a male screw (not shown) with the screw 109. (10) After the distal end 120a of the sheath portion 120 is pressed against the wall surface of the body cavity, the sheath 104 is fixed to the outer cover 103 with the adjusting screw 111. (11) Insert the needle 8 of the outer needle 33 until the tip of the needle 8 is located immediately before the target site. (12) The needle 11 of the inner needle 4 is inserted into the notch 13 until the notch 13 is located at the target portion, and the tissue is taken into the notch 13. (13) While the inner needle holding portion 12 is fixed so as not to move relative to the endoscope fixing portion 102, the stopper 12
The outer needle slider 105 is pushed in until the 2 abuts, and the tissue taken in the notch 13 is stored in the outer needle 33. (14) The tip of the needle 8 is completely housed inside the sheath portion 104, and the sheath portion 104 is removed from the endoscope forceps channel. (15) The tissue piece is collected from the notch 13. By the above operation procedure, tissue can be collected with the configuration of the present embodiment.

Puncture needle system handle 1 of the present embodiment
According to No. 01, when the puncture needle system handle 101 is connected to perform the suction operation of the endoscope, the suction object is as shown in FIG.
Is sucked in the suction channel 132 from the direction of the arrow direction D1. However, no flow occurs in the arrow direction D2 because the space 128 is sealed by the O-ring 127 in FIG. Therefore, the sucked matter flows only in the arrow direction D3 without leaking in the arrow direction D2. Further, by using the puncture needle system handle 101, the needle can be quickly inserted into the target site by setting the insertion amount of the present needle in advance.

Puncture needle system handle 1 of the present embodiment
01, in addition to the effect of the first embodiment, a sufficient suction effect can be obtained even when the puncture needle device is attached, and further, the stopper is provided so that the needle tip can be promptly guided to the target site. By performing the adjustment in advance, the puncture can be performed safely and quickly.

Next, an ultrasonic endoscope distal end portion 201 applied to an ultrasonic endoscope-guided puncture system according to a third embodiment of the present invention will be described. The puncture needle system 1 of the first embodiment or the puncture needle handle 101 of the second embodiment can be attached to the distal end portion of the ultrasonic endoscope. Second
In addition to the purpose of the device of the embodiment, the configuration of the tip portion is reduced in size, and puncturing is performed under an ultrasonic endoscope guide capable of capturing images of a cross section perpendicular to the probe insertion axis and a cross section parallel to the probe insertion axis. 3 is an ultrasonic endoscope tip (ultrasonic probe) for an ultrasonic endoscope-guided puncture system.

FIG. 12 is a longitudinal sectional view of the distal end portion 201 of the ultrasonic endoscope according to the present embodiment, and FIG.
It is -F sectional drawing. The distal end portion 201 of the present ultrasonic endoscope includes:
It is mainly composed of a probe section 202 and an endoscope section 203.

The probe section 202 is covered by a tip cover 204, and has a mirror support section 205, a sector vibrator section 206, and a radial vibrator section 207 inside.
And an acoustic medium such as water is filled.

The mirror support 205 is provided on the support body 2.
08, a pin 209, a bearing 210, a driven bevel gear 211, and a mirror 212. In addition, the support section main body 208 is provided at the hand side with an endoscope section 2 described later.
03 is fixed to the main body 222. Further, a pin 209 is held via a bearing 210 on the distal end side of the support portion main body 208. A driven bevel gear 211 and a mirror 212 having an inclined surface 212a are fixed to the pin 209. Therefore, the driven bevel gear 211 and the mirror 212
Is held rotatably about the axis of

The sector vibrator section 206 is supported by the support section main body 21.
3 and a vibrator 214. Support body 213
Is fixed to a main body 222 of an endoscope unit 203 described later on the hand side, and a vibrator 214 is fixed on the distal end side. The vibrator 214 is fixed to the support body 213 such that the sound axis thereof coincides with the center axis of the pin 209.
Further, the vibrator 214 is provided with a changeover switch 2 described later.
53 (see FIG. 14) and connected by a cable 215 extending through the inside of an unillustrated ultrasonic endoscope.

The radial vibrator section 207 includes a drive bevel gear 216 and a vibrator 217. Vibrator 21
Reference numeral 7 is provided on the side of the hub near the drive bevel gear 216. The drive bevel gear 216 is fixed with a cylindrical shaft 218 extending from a rotation drive unit 257 (described later) and having an axis coincident with the probe insertion axis. Power is shaft 2
18 to the drive bevel gear 216. The tip of a cable 219 extending from the rear end of the shaft 218 is connected to the vibrator 217. Cable 219
The rear end extends to a slip ring 256 (see FIG. 14) described below provided at the rear end of the shaft 218. Therefore, the vibrator 217 is electrically connected to the changeover switch 253 (see FIG. 14) via the slip ring 256.

The drive bevel gear 216 and the driven bevel gear 211 are arranged perpendicular to each other. Therefore, the rotation of the driving bevel gear 216 is controlled by the driven bevel gear 2.
11 converts the rotation into a right-angle rotation. This causes the mirror 212 to rotate about an axis perpendicular to the axis of the shaft 218. The mirror 212 is provided with an inclined surface 212a that reflects ultrasonic waves emitted from the transducer 214 perpendicularly to the central axis of the transducer.

The present probe unit 20 configured as described above
In 2, the ultrasonic wave emitted from the transducer 214 is
By rotating the mirror 212 with the above-described configuration, it is possible to scan a cross section PL1 parallel to the shaft 218 that rotates about the probe insertion axis. On the other hand, the ultrasonic wave emitted from the vibrator 217 rotates about the axis of the drive bevel gear 216 and the shaft 218.
It is possible to scan a cross section PL2 perpendicular to.

The endoscope 203 comprises a main body 222, a light guide lens 223, an objective lens 224, and a forceps raising base 225. The main body 222 is provided with a forceps projection port 226 through which the forceps and the puncture needle can be projected through the plane of the cross section PL1.

The light guide lens 223 includes the endoscope unit 2
Light from a light source device (not shown) is radiated into the body cavity by a light fiber extending through the inside of the body 03.

The objective lens 224 is connected to an image fiber extending from an eyepiece provided in an endoscope operation unit (not shown) through the inside of the endoscope (not shown), and an optical image in a body cavity is connected to the eyepiece. It is projected through the lens.

The forceps raising table 225 can be operated by operating an operation section (not shown) to raise the forceps without falling off the cross section PL1.

Next, the configuration and operation principle of a control circuit for controlling the ultrasonic endoscope distal end portion 201 according to the present embodiment will be described with reference to the block diagram of the control circuit shown in FIG. A signal to start ultrasonic scanning is sent from the control unit 251 for controlling the ultrasonic endoscope distal end portion 201 to the transmission circuit 25.
2, the transmission circuit 252 transmits a transmission pulse signal to the vibrator 214 or 217 via the changeover switch 253. The transmission pulse signal is transmitted to the oscillator 214
Alternatively, it is converted into an ultrasonic wave at 217. Further, the transducer 214 or 217 receives the reflected ultrasonic wave and converts it into an electric signal. This electric signal is sent to the receiving circuit 254 via the changeover switch 253, and after being amplified, is sent to the control unit 251.

The control unit 251 obtains the reflection position and the magnitude of the ultrasonic reflected wave from the reception timing and the magnitude of the signal. Further, the control unit 251 scans the ultrasonic wave based on the above-described principle, obtains the position and the size of the reflected wave on each scanning line, converts the size into a luminance, and then converts the ultrasonic image on the monitor 255. Project.

By switching the changeover switch 253, one of the scanning of the cross section PL1 and the scanning of the cross section PL2 can be selected. That is, when the changeover switch 253 is connected to the contact 258 side, the vibrator 21
4, an ultrasonic wave is emitted, and an image of the cross section PL1 can be taken by reflection of the ultrasonic wave by the mirror 212 rotating about an axis perpendicular to the insertion axis. On the other hand, when the changeover switch 253 is connected to the contact 259 side, an ultrasonic wave is emitted from the vibrator 217 and the cross section P is generated by rotation of the radial vibrator portion 207 about the insertion axis.
It is possible to take an image of L2.

The operation of collecting tissue using the puncture needle system 1 while observing a tomographic image using the ultrasonic endoscope distal end portion 201 of the system of the present embodiment configured as described above. Will be described. (1) First, as shown in FIG. 15, the ultrasonic endoscope distal end portion 201 is inserted into a lumen 802 having a lesion portion 801 in the periphery. (2) When the changeover switch 253 is connected to the contact 258, ultrasonic scanning of the section PL1 is performed, and the section PL1 parallel to the insertion axis as shown on the monitor screen of FIG.
Is obtained. Also, this cross section PL
By observing the one ultrasonic image, it is also possible to confirm the image 263 of the inserted puncture needle. (3) When the changeover switch 253 is connected to the terminal 259, ultrasonic scanning of the section PL2 is performed, and a screen 262 of a tomographic image of the section PL2 perpendicular to the insertion axis is obtained as shown in FIG. Note that the cross section PL2 is a radial cross section that has been widely used in the past, and the position of an organ around the lumen 802 can be easily grasped from an image of this cross section.

By appropriately switching the changeover switch 253 as described above, the puncture needle system shown in the first embodiment or the second embodiment can be checked while confirming two types of tomographic images of the lesion. Can be used to collect tissue.

As described above, according to the ultrasonic endoscope distal end portion 201 of this embodiment, in addition to the effects of the first and second embodiments, the probe portion can be further miniaturized. Also, in a device such as an ultrasonic endoscope that requires a small tip configuration, the position of an organ or tumor around the lumen can be adjusted without rotating the probe section in a cross section perpendicular to the insertion axis. , Can be easily confirmed. At the same time, by observing the ultrasonic image of the puncture needle protruding from the channel of the ultrasonic endoscope with an image of a cross section parallel to the insertion axis, it is possible to more quickly and safely follow the ultrasonic endoscope guide. Puncture can be performed.

Next, an ultrasonic endoscope-guided puncture system according to a fourth embodiment of the present invention will be described.
Ultrasound endoscope-guided puncture system 30 of the present embodiment
1 is an ultrasonic endoscope tip portion 20 according to the second embodiment.
1, a system in which the puncture needle system 1 of the first embodiment or the puncture needle system handle 101 of the second embodiment can be mounted, and the device of the third embodiment. In addition to the object of the present invention, there is provided an ultrasonic endoscope-guided puncture system capable of easily determining a protrusion length of a needle.

FIG. 18 is a block diagram showing a control circuit of the ultrasonic endoscope-guided puncture system 301 according to this embodiment. In the system according to the present embodiment, a puncture gauge memory unit 302 is added to control unit 251. Otherwise, the configuration is the same as that of the system of the third embodiment.

The puncture gauge memory section 302 has a scale 311 at a distance from the forceps protrusion 226 in FIG.
(See FIG. 19). The image information of the puncture gauge memory unit 302 is superimposed on the ultrasonic tomographic image by a trigger signal from the control unit 251 and is superimposed on the monitor 25.
5 is shown on the screen.

FIG. 19 shows an image of a cross section PL 1 (see FIG. 12) taken by the ultrasonic endoscope-guided puncture system according to the present embodiment, and distance scale 311 stored in puncture gauge memory section 302. 21 is a display screen 310 of the monitor 255 displaying the image information of the monitor 255 in a superimposed manner. In this way, the distance scale 311 is defined by a concentric arc within a range in which the puncture needle system can be raised with the forceps protrusion 226 as a center.

Next, an operation procedure by the system according to the present embodiment will be described. In this case, a description will be given assuming that the puncture needle system handle 201 according to the second embodiment is applied. (1) First, the tip portion 201 of the ultrasonic endoscope is moved to the lesion portion 80.
Insert to the vicinity of 1. (2) Adjust the position of the tip so that the lesion portion 801 is photographed in the ultrasonic image of the cross section PL1. (3) The trigger signal is transmitted from the control unit 251 and the image information of the puncture gauge memory unit 302 is displayed on the ultrasonic image on the monitor 255. (4) The distance X from the distal end portion 120a of the sheath portion 120 to the lesion portion 801 in a state where the sheath portion 120 is projected from the forceps projection port 226 is exceeding the sheath portion on the screen 310 of the monitor 255 in FIG. Tip 312a of sound image 312
It is measured on the distance scale 311 based on the image position and the image of the lesion portion 801. (5) Adjust the stopper 122 so that the outer needle 33 projects by the distance X. Operations other than those described above are the same as those of the system according to the third embodiment.

According to the ultrasonic endoscope-guided puncture system 301 of this embodiment, in addition to the effects of the system of the third embodiment, the distance scale 311 on the monitor 255 allows the distal end 120a of the sheath 120 to be moved. Can instantly grasp the distance X from the to the lesion part 801,
The protrusion length of the needle can be easily determined.

In the system of the present embodiment, a tomographic image of a section PL1 parallel to the insertion axis of the ultrasonic endoscope and including a forceps projecting path in the plane and a section PL2 perpendicular to the insertion axis are selected. This embodiment has been described as an embodiment of the ultrasonic endoscope which can be observed visually. However, the system according to the present embodiment is not limited to this. The ultrasonic endoscope in a form in which only the tomographic image of the cross section PL1 can be captured and the function of capturing the tomographic image of the cross section PL2 is omitted. It is also possible to apply to such as. Further, the present invention can be applied to an ultrasonic endoscope having an electronic scanning probe capable of photographing the cross section PL1.

Next, an ultrasonic endoscope-guided puncture system according to a fifth embodiment of the present invention will be described.
Ultrasound endoscope-guided puncture system 40 of the present embodiment
Reference numeral 1 denotes the puncture needle system 1 according to the first embodiment, or the puncture needle system handle 101 according to the second embodiment.
Can be attached, and the ultrasonic endoscope is advanced and retracted into the body cavity in a state where the forceps erecting stand protrudes from the end of the ultrasonic endoscope when raised, thereby preventing the wall of the body cavity from being damaged. It is an ultrasonic endoscope-guided puncture system.

FIG. 20 is a side view of an ultrasonic endoscope distal end portion 401 applied to the system of the present embodiment.
1 is a sectional view taken along line GG of FIG. In the forceps raising mechanism of the ultrasonic endoscope distal end portion 401 of the present system, FIG.
As shown at 0 and 21, the rotating shaft 403 of the forceps raising table 402
Is provided with an encoder 404 for detecting the rotation angle of the forceps raising table 402. The configuration of the ultrasonic endoscope distal end portion 401 other than the above is the same as the configuration of the ultrasonic endoscope distal end portion 201 in FIG.

FIG. 22 is a block diagram of a control circuit of the system according to the present embodiment. In this control circuit, the detection signal cable 405 connected to the encoder 404 of the ultrasonic endoscope distal end portion 401 is connected to the control unit 251 (FIG. 22).
See). The warning output line of the control unit 251 is connected to the speaker 407 via the switch 406. The configuration of the control circuit other than the above is the same as the configuration of the control circuit of FIG.

In the control circuit shown in FIG.
The angle information detected by the controller 04 is digitized by the controller 251. The controller 251 stores the angle at the raising position P1 of the forceps raising table 402 as a critical value. When the forceps raising table 402 is raised, it is digitized by the control unit 251, but a warning sound is emitted from the speaker 407 when the angle becomes larger than the critical value, for example, the position P2.
Further, when returning to the rising state at an angle smaller than the critical value, for example, at the position P0 or the like, the above-mentioned warning sound is controlled to be stopped.

Next, the operation of the ultrasonic endoscope-guided puncture system according to the present embodiment configured as described above will be described. In the process of inserting the ultrasonic endoscope distal end portion 401 to the target site, the switch 406 is turned on. In this state, when the forceps raising table 402 is raised above the position P1, the forceps raising table 402 is projected from the ultrasonic endoscope distal end portion 401 to the operator by a warning sound. Warning that The same operation is performed in the process of removing the ultrasonic endoscope distal end portion 401 from the body cavity.

Further, when it is not necessary to move the distal end portion 401 of the ultrasonic endoscope greatly, for example, during operation of raising the forceps, the switch 406 is turned off to stop the generation of a warning sound, and the forceps raise is performed. The above operation can be performed. In addition,
Operations other than those described above are the same as those of the system according to the third embodiment.

As described above, according to the ultrasonic endoscope-guided puncture system of the fifth embodiment, in addition to the effects of the system of the third embodiment, the forceps raising table is By issuing a warning sound in a state where the ultrasonic endoscope protrudes from the distal end of the ultrasonic endoscope, it is possible to prevent the ultrasonic endoscope from moving forward and backward in the body cavity to damage the body cavity wall.

In the ultrasonic endoscope-guided puncture system according to the fifth embodiment, the forceps raising table 402
Is configured to warn the user that it is protruding from the ultrasonic endoscope distal end portion 401 by a warning sound. This warning is displayed on the monitor 255 by displaying “ELEVATOR!” Or the like. Alternatively, both may be used in combination. Further, in the ultrasonic endoscope-guided puncture system according to the above-described embodiment, the raising position of the forceps raising table 402 is detected by the rotation angle detecting encoder 404 of the rotation shaft 403.
May be an optical type or a magnetic type other than the detection switch type.

The gist of the present invention is not applied only to the system of each of the above embodiments. For example, the gist of the present invention is applied to a general endoscope having no ultrasonic tomographic image observation function. It is also possible to apply.

[Supplementary Note] Based on the embodiments described above, a puncture needle system, an ultrasonic probe, an endoscope, or the like having the following configuration can be proposed. That is, 1. A tubular outer needle, moving freely forward and backward in the outer needle,
An inner needle having a notch in the vicinity of the distal end portion, and in a state where the inner needle is inserted into the outer needle, a puncture needle system for collecting body cavity tissue by inserting these into the body cavity, A puncture needle system, wherein a cross section of the outer needle and the inner needle in a body cavity and a cross section of the notch are vertically long.

(Effect of Appendix 1) According to the configuration of Appendix 1,
A large amount of tissue can be taken into the notch provided in the needle. In addition, since the wall surfaces of the vertically long puncture path cross section in the direction of the narrow width are easily adhered to each other, the healing of the punctured portion after operation is faster than that of a needle having a circular cross section of the same area.

2. In a puncture needle system comprising a tubular outer needle and a solid inner needle which can be inserted through the outer needle and has a cutout portion on a side surface near a tip, the inner needle of the outer needle and the inner needle is inserted into the body. A puncture needle system, wherein a cross-sectional shape of a portion is vertically long, and a cutout portion is provided in a longitudinal direction of the vertically long cross section.

3. 3. The puncture needle system according to claim 2, wherein the cross-sectional shape of the body insertion portion is substantially rectangular.

(Effect of Supplementary Note 2 or 3) Supplementary note 2 or 3
According to the configuration described above, since the notch is provided in the longitudinal direction of the needle having the vertically long cross section, the notch can be provided deep, and a large amount of tissue can be taken into the notch. On the other hand, since the puncture path is vertically long, the tissue in the puncture path is easily brought into close contact in the horizontal direction, and the treatment time in the puncture path, particularly in the space of the tissue sampling portion can be reduced.

4. An outer needle and an inner needle, a cylindrical outer cover that can be connected to a mouthpiece for inserting treatment tools in a forceps channel of an endoscope, and an outer sheath that covers the outer needle can be fixed and housed inside the outer cover. A puncture needle system comprising a fixed cylinder, wherein a puncture needle system is provided with airtight holding means capable of holding a gap between the outer cover and the fixed cylinder in an airtight manner.

5. The puncture needle system according to claim 4, wherein the airtight holding means is a rubber ring.

6. The puncture needle system according to claim 4, wherein the slider mechanism comprises an outer needle provided at a rear end, and the slider mechanism is provided with a stopper abutting on the fixed cylinder.

(Background of Supplementary Notes 4 to 6) Conventionally, a puncture needle system for biopsy of a living tissue or cells under a medical endoscope, particularly, a tubular outer needle and a solid insertable through the outer needle. There has been a puncture needle system which is composed of a large inner needle, has a concave portion on the side surface of the inner needle, and can preset or adjust the protruding length of the needle and the sheath covering the needle. As the puncture needle system, for example, there is one disclosed in JP-A-7-178098. The puncture needle system disclosed in the above publication,
An outer cover that can be fixed to the endoscope is provided, and a rigid fixation to which the sheath of the puncture needle is connected and the outer cover are fixed with screws, etc., and the length of protrusion of the sheath from the endoscope end is made variable. is there.

(Problem to Supplementary Notes 4 and 5) The puncture needle system disclosed in the above-mentioned Japanese Patent Application Laid-Open No. 7-178098 has a forceps channel because there is a gap between the fixed tube at the rear end of the sheath and the outer cover. When sucking the dirt from the endoscope from the endoscope, air leaks from the gap between the connection pipe and the mantle pipe, making it difficult to perform sufficient suction.

[0096] The objects of Supplementary Notes 4 and 5 are to solve the above-mentioned problem and to provide a puncture needle device that can perform sufficient suction from the forceps channel even when the puncture needle is inserted into the forceps channel of the endoscope.

(Effect of Supplementary Note 4 or 5) Supplementary note 4 or 5
According to the configuration, when suction is applied from the forceps channel while the puncture needle is inserted from the endoscope forceps channel,
Since the inside of the outer cover of the puncture needle is kept airtight, a sufficient suction effect can be obtained.

(Problem to Supplementary Note 6) The disclosed example of Japanese Patent Application Laid-Open No. 7-178098, which has been conventionally proposed as a puncture needle, has no means for adjusting the protruding length of the needle. Inspection had to be performed while adjusting the protrusion length, and the inspection time was long.

An additional object of the present invention is to solve the above problem and to provide a means for guiding a needle to a target portion smoothly.

(Effect of Appendix 6) According to the configuration of Appendix 6,
Puncturing can be performed safely and quickly by adjusting the stopper in advance so that the needle tip does not exceed the target site.

7. A first vibrator provided at the distal end of the probe and having a sound axis perpendicular to the insertion axis; and a first vibrator provided at the distal end and rotating about the sound axis of the ultrasonic wave, and transmitting the ultrasonic wave emitted from the vibrator in a right angle direction. A reflecting mirror having a reflecting surface that reflects light to the mirror, a cylindrical shaft that drives the reflecting mirror and rotates about the insertion axis of the probe, and converts the rotational driving of the cylindrical shaft into a vertical direction to rotate the reflecting mirror. An ultrasonic probe provided with a second vibrator disposed on a side surface of the cylindrical shaft and generating an ultrasonic wave in a direction perpendicular to the axis of the cylindrical shaft, the ultrasonic probe being a front sector ultrasonic probe including a gear mechanism that performs the following.

8. 7. The ultrasonic probe according to claim 7, further comprising means for selecting driving of the first transducer and the second transducer.

(Background of Supplementary Notes 7 and 8) Conventionally, an ultrasonic probe which is inserted into the body and performs ultrasonic diagnosis, particularly, an ultrasonic probe capable of observing an ultrasonic tomographic image of two orthogonal cross sections. Regarding the sound wave probe, see Japanese Utility Model Application Laid-Open No.
No. 0, JP-A-5-146434, and JP-A-5-237112. The disclosures of these publications disclose a first rotating shaft centered on an insertion shaft transmitted from an operation unit, a first ultrasonic vibrator provided on the first rotating shaft, and a first rotating shaft. A second rotation axis orthogonal to the axis and a second ultrasonic transducer provided on the second rotation axis, and two ultrasonic waves orthogonal to the first and second ultrasonic transducers The tomographic image is made observable.

For example, if the techniques of the disclosed examples are applied to an ultrasonic probe for puncturing in a body cavity, the probe tip and peripheral organs in the body cavity can be further observed while observing an ultrasonic tomographic image perpendicular to the insertion axis. The position of the puncture needle can be confirmed with an ultrasonic tomographic image parallel to the insertion axis, making it possible for the surgeon to be familiar with ultrasonic tomographic images perpendicular to the insertion axis. Also, the position of the peripheral organ can be easily confirmed, and the puncture can be performed safely.

(Issues for Supplementary Notes 7 and 8)
The aforementioned Japanese Utility Model Application Laid-Open No. 63-96810,
In the disclosure examples such as Japanese Patent No. 6434 and Japanese Patent Application Laid-Open No. 5-237112, an ultrasonic transducer is provided on the second rotation axis, and thus an electric signal is transmitted to the second ultrasonic transducer. For this purpose, it is necessary to provide a slip ring at the tip. Therefore, when the above disclosed example is applied to an intracavity probe or the like such as an ultrasonic endoscope, the outer diameter of the probe portion is increased by an amount corresponding to the space for providing the slip ring. This was a factor that reduced the ease of insertion into the device.

[0093] The additional objects 7 and 8 are to solve the above-mentioned problem, and to provide an intra-cavity probe in which the outer diameter of the probe portion is reduced and an ultrasonic image of two orthogonal cross sections can be drawn. And

(Effect of Appendix 7 or 8) Appendix 7 or 8
According to the configuration, it is possible to reduce the size of the tip,
In addition, while observing the treatment tool protruding from the probe channel with an ultrasonic tomographic image parallel to the insertion axis, the position of peripheral organs and tumor near the probe can be determined with an ultrasonic tomographic image perpendicular to the insertion axis. Easy to find.

9. An ultrasonic probe capable of capturing an ultrasonic tomographic image for transmitting and receiving ultrasonic waves, and an ultrasonic probe having a channel provided to guide a puncture needle in the ultrasonic tomographic image, In the ultrasound-guided puncture probe system consisting of an ultrasonic observation device that transmits and receives pulse signals to and from an ultrasonic probe and displays an ultrasonic tomographic image, the distance from the needle outlet is centered on the needle outlet. An ultrasonic-guided puncture probe system, wherein a display device for displaying in an arc shape superimposed on an ultrasonic tomographic image is provided in an ultrasonic observation device.

(Background of Supplementary Note 9) Conventionally, an ultrasonic-guided puncture probe system having a channel that can be inserted by a treatment instrument and observing the treatment instrument by ultrasonic waves, particularly, the insertion position of a puncture needle There is a system that superimposes and displays information on ultrasonic tomographic images.

The probe system disclosed in the above-mentioned Japanese Patent Publication No. 57-7739 discloses an insertion position of an puncture needle superimposed on an ultrasonic tomographic image in advance to display the insertion position and the ultrasonic tomographic image. By moving the probe so that the puncture site described above coincides with the puncture site, the puncture site can be accurately punctured. Further, the one disclosed in Japanese Patent Publication No. 60-30217 discloses a circuit for detecting the angle of a puncture needle guide, in which the projection path of the puncture needle is superimposed and displayed on an ultrasonic tomographic image, and punctures the target site accurately and safely. The needle is to be reached.

In actuality, when puncturing is performed under an ultrasonic guide, in the systems of the above two disclosed examples, after confirming the protruding path of the needle, the puncture is performed on an ultrasonic tomographic image which has been widely used conventionally. It was necessary to determine the protrusion length of the needle using the function of measuring the distance between points.

(Problem to Supplementary Note 9) In the case of an ultrasound-guided puncture probe used in a body cavity, it is necessary to complete the puncture promptly in order to reduce the pain of the patient. And Tokiko Sho 60-302
In the case of the system disclosed in Japanese Patent Publication No. 17, the operator needs to perform the operation of the probe and, at the same time, obtain the puncture path, and then perform the operation of determining the protruding length of the needle with the distance measurement function. It was a barrier to diagnosis.

[0094] It is an object of Supplementary Note 9 to solve the above-mentioned problem and to provide a puncture system capable of easily determining the protruding length of the needle.

(Effect of Appendix 9) According to the configuration of Appendix 9,
The distance from the puncture needle outlet to the lesion site can be grasped instantaneously.

10. In an endoscope having an observation optical system, a forceps channel for inserting and removing forceps, and a forceps raising table for raising procedures guided to the distal end by the forceps channel, the forceps raising table is located at the distal end of the endoscope. An endoscope apparatus comprising: a sensor for detecting that the forceps elevating base is protruding from the endoscope; and a warning unit for warning an operator from the signal of the sensor that the forceps raising base is protruding from the endoscope end.

11. The forceps raising table is rotatably mounted around a rotation axis fixed to the distal end of the endoscope, and has a point of action for pushing up forceps at a position separated from the rotation axis. An endoscope apparatus according to attachment 10, wherein:

12. The endoscope apparatus according to claim 11, wherein the sensor is an angle sensor that detects a rotation angle, and a rotation axis of the angle sensor is fixed to a rotation axis of the rotary forceps raising stand.

13. 13. The endoscope apparatus according to Supplementary Note 10, 11, or 12, further comprising switching means for selecting operation or stop of the sensor.

(Background of Supplementary Notes 10 to 13) Conventionally, an endoscope which is inserted into a body cavity and observes an optical image of the body cavity, particularly, a forceps channel for projecting the forceps from the endoscope end, and a forceps channel For example, Japanese Utility Model Publication No. Sho 53-1832 discloses an endoscope having a forceps raising base for raising the robot at a predetermined angle.

The endoscope according to the above-described disclosed example has a structure in which the forceps raising base, ie, the surface on which the forceps swings by the forceps raising base, intersects the optical axis of the observation optical system. An observation optical system is provided. Then, by using an endoscope as in the above disclosed example, it is possible to confirm the state of the forceps such as the protrusion amount of the forceps on the optical image, and it is possible to safely use the forceps.

(Problems for Supplementary Notes 10 to 13) For example,
When it is possible to raise hard forceps over the entire length,
It is necessary to provide a long guide portion of the forceps raising table to increase the distance between the support point for lifting the forceps and the rotation center of the forceps raising table. In this case, when the forceps raising table swings, a range in which the forceps raising table protrudes from the distal end portion of the endoscope occurs. Furthermore, since the optical system has a limited viewing angle, the forceps raising base becomes a blind spot in the optical field of view, and it is extremely difficult to optically observe the state of the forceps raising base. Therefore, if the operator neglects to store the forceps raising table that has been erroneously raised, there is a risk of tearing and damaging the body cavity wall with the forceps raising table when inserting and removing the endoscope.

[0103] The objects of Supplementary Notes 10 to 13 are to solve the above-mentioned problem and to propose an endoscope apparatus capable of safely inserting and removing an endoscope having a large forceps raising stand.

(Effects of Supplementary Notes 10 to 13) Supplementary Notes 10 to 13
In any of the configurations, when the forceps raising stand protrudes from the endoscope distal end, the warning means operates to avoid the danger of inserting and removing the endoscope with the forceps raising stand protruding from the endoscope distal end. can do.

[0105]

As described above, according to the puncture needle system of the present invention, a large amount of tissue can be taken into the notch provided in the needle. Further, since the wall surfaces in the narrow width direction of the puncture path cross section of the vertically long shape easily adhere to each other, the healing of the punctured portion after the operation can be accelerated as compared with a needle having a circular cross section of the same area.

[Brief description of the drawings]

FIG. 1 is a longitudinal sectional view of a puncture needle system according to a first embodiment of the present invention.

FIG. 2 is a longitudinal sectional view of a sheath constituting the puncture needle system of FIG. 1;

FIG. 3 is a longitudinal sectional view of an outer needle constituting the puncture needle system of FIG. 1;

FIG. 4 is a cross-sectional view of FIG. 3, wherein FIG.
4A is a cross-sectional view of FIG. 3, and FIG. 4B is a cross-sectional view of FIG.

FIG. 5 is a longitudinal sectional view of an inner needle constituting the puncture needle system of FIG. 1;

6 is a cross-sectional view of FIG. 5, and FIG.
6B is a cross-sectional view of FIG. 5, and FIG. 6B is a cross-sectional view of FIG.

FIG. 7 is a view showing a shape of a modified example of the inner needle of the puncture needle system of FIG. 1, and FIG. 7 (A) is a side view of a cutout portion of the needle of the modified example, and FIG. B) is H in FIG.
It is -H sectional drawing.

FIG. 8 is a vertical cross-sectional view of the entire puncture needle system handle according to the second embodiment of the present invention in an assembled state.

FIG. 9 is a sectional view taken along line EE of FIG. 8;

FIG. 10 is a longitudinal sectional view of an outer needle of the puncture needle attachable to the puncture needle system handle of FIG. 8;

FIG. 11 is a cross-sectional view of a peripheral portion of the endoscope forceps base to which the puncture needle system handle of FIG. 8 can be attached.

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

FIG. 13 is a sectional view taken along line FF of FIG. 12;

FIG. 14 is a block diagram showing a control circuit for controlling the distal end portion of the ultrasonic endoscope shown in FIG. 12;

FIG. 15 is a diagram showing a state when the distal end portion of the ultrasonic endoscope in FIG. 12 is inserted into a lesion part.

FIG. 16 is a monitor screen showing a tomographic image of a cross section parallel to an insertion axis when the distal end portion of the ultrasonic endoscope in FIG. 15 is inserted into a lesion portion.

FIG. 17 is a monitor screen showing a tomographic image of a cross section perpendicular to the insertion axis when the distal end portion of the ultrasonic endoscope in FIG. 15 is inserted into a lesion portion.

FIG. 18 is a block configuration diagram of a control circuit of an ultrasonic endoscope-guided puncture system according to a fourth embodiment of the present invention.

19 is a monitor screen in which distance scale information is superimposed and displayed on an image of a cross section parallel to the insertion axis in the puncture system guided by an acoustic endoscope in FIG. 18;

FIG. 20 is a side view of the distal end portion of the ultrasonic endoscope of the ultrasonic endoscope-guided puncture system according to the fifth embodiment of the present invention.

21 is a sectional view taken along line GG of FIG. 20.

FIG. 22 is a block diagram of a control circuit of the ultrasonic endoscope-guided puncture system in FIG. 20;

[Explanation of symbols]

 1 puncture needle system 3, 23, 33 outer needle 4 inner needle 13, 23 notch

Claims (1)

[Claims] 1. A state in which a tubular outer needle is provided, and an inner needle that moves freely within the outer needle and has a notch near a distal end thereof, and the inner needle is inserted through the outer needle. In a puncture needle system that collects body cavity tissue by piercing them into a body cavity, the outer needle and the inner needle have a punctured part in the body cavity, and the cutout has a vertically long cross section. A puncture needle system, characterized in that: