JPH11206778A - Endoceliac ultrasonic wave probe - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoceliac ultrasonic wave probe with excellent piercing operability capable of easily performing disinfection or the like to the endoceliac ultrasonic wave probe itself and easily changing a piercing direction. SOLUTION: An ultrasonic vibrator 12 is incorporated at a tip part 11 and an attachment 5 for piercing for freely moving a flexible shaft provided with a guide hole for guiding a piercing needle 35 is freely attachably and detachably mounted to the endoceliac ultrasonic wave probe main body 4 for radially transmitting and receiving ultrasonic waves. The flexible shaft is moved by operating an operation knob 42 on the hand side of the attachment 5 for piercing. Thus, a flexible guide member is moved along the slide guide groove of a slide supporting part 32 bent so as to be along the ultrasonic wave radiation surface of an attachment tip part 21, and the direction of projecting and piercing the piercing needle 35 guided and inserted to the piercing needle guide hole of the guide member is varied.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a supersonic body having a function of inserting a puncture needle under ultrasonic observation by an ultrasonic vibrator arranged at a distal end of an insertion portion inserted into a body cavity. Related to an acoustic probe.

[0002]

2. Description of the Related Art In recent years, in addition to an endoscope, an ultrasonic diagnostic apparatus using ultrasonic waves is sometimes used as an in-vivo diagnostic apparatus for diagnosing or examining a body cavity by inserting it into a body cavity. In such a diagnostic device, under ultrasonic observation,
It is often performed to collect diseased tissue with a puncture needle.
For this reason, some intracorporeal ultrasonic probes inserted into the body cavity have a guide mechanism or a passage for guiding the puncture direction of the puncture needle.

A first conventional example of an intracorporeal ultrasonic probe is an ultrasonic endoscope disclosed in Japanese Patent Application Laid-Open No. 7-204160. In this conventional example, a replaceable passage forming piece is provided so that the projecting direction of the puncture needle can be changed. Further, as a second conventional example, for example, Japanese Utility Model 6-27
Japanese Patent Publication No. 128 discloses that a detachable puncture attachment can be attached to an ultrasonic probe in a body cavity.

[0004]

In the first prior art, when the puncturing direction is to be changed, the path forming piece must be changed each time the puncturing direction is changed, which requires a troublesome operation.
Also, in order to change after insertion into the body cavity, the ultrasonic endoscope must be removed from the body cavity and changed. The burden on the patient increased, the patient suffered more, and the operability was low. Further, in the case where the passage is provided in the ultrasonic endoscope main body, it may take time to disinfect or sterilize after use.

[0005] In this regard, in the second conventional example, it is not necessary to provide a passage for the intracavity ultrasonic probe itself.
Although there is an advantage that disinfection and the like can be performed easily in a short time, there is a disadvantage that the puncture direction cannot be changed.

SUMMARY OF THE INVENTION The present invention has been made in view of the above points, and it is possible to easily disinfect the ultrasonic probe itself in the body cavity and to easily change the puncture direction, thereby improving the puncture operability. It is intended to provide an internal ultrasonic probe.

[0007]

SUMMARY OF THE INVENTION A body cavity ultrasonic probe according to the present invention comprises a body cavity ultrasonic probe body having an ultrasonic transducer disposed at a distal end of a long insertion portion to be inserted into the body cavity. An intracavity ultrasonic probe having an ultrasonically guided puncture attachment that is detachably attachable to the internal ultrasonic probe main body and has a puncture needle guide portion for inserting a puncture needle inserted into a living organ. By providing the puncture needle insertion angle adjusting means for changing the insertion angle of the puncture needle into the living organ in the ultrasonically guided puncture attachment, disinfection and the like can be easily performed on the ultrasonic probe itself in the body cavity. And the puncturing direction can be easily changed, ensuring good puncturing operability.

[0008]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 5 relate to a first embodiment of the present invention, FIG. 1 shows a configuration of an ultrasonic diagnostic apparatus having the first embodiment, and FIG. FIG. 2A shows the configuration of the ultrasonic probe body in the body cavity (FIG. 2A shows the configuration of the ultrasonic probe body in the body cavity, and FIG. 2B shows the configuration of the distal end portion thereof). 4) shows the configuration of the puncture attachment, FIG. 4 shows the electrical configuration of the puncture attachment, and FIG. 5 shows the operation of the present embodiment.

As shown in FIG. 1, an ultrasonic diagnostic apparatus 1 includes an ultrasonic probe 2 in the body cavity according to the first embodiment of the present invention, and an ultrasonic probe 2 connected to the ultrasonic probe 2 in the body cavity to transmit and receive ultrasonic waves. The ultrasonic observation device 3 drives the ultrasonic transducer 12 and performs signal processing on a received signal, and displays an ultrasonic tomographic image.

The intracavity ultrasonic probe 2 includes an intracavity ultrasonic probe main body 4 inserted into the body cavity, and an ultrasonically guided puncture attachment (hereinafter referred to as an attachment) detachably attached to the intracavity ultrasonic probe main body 4. Simply referred to as a puncture attachment) 5.

As shown in FIG. 2, the ultrasonic probe body 4 in the body cavity has a long insertion portion 6 inserted into the body cavity (specifically, for transvaginal or transrectal), and this insertion portion. 6 has a grip portion 7 provided at a rear end thereof, and an ultrasonic code 8 having one end extending from the rear end of the grip portion 7, and a connector 9 is provided at the other end of the ultrasonic code 8. The connector 9 is detachably connected to the ultrasonic observation device 3. An ultrasonic transducer 12 that is driven to rotate is disposed inside the distal end portion 11 of the insertion section 6, and a signal line (not shown) connected to the ultrasonic transducer 12 is connected to the insertion section 6, the grip section 7, and the ultrasonic wave. The inside of the cord 8 is inserted to reach the connector 9.

Then, the connector 9 is connected to a transmitting circuit 14 and a receiving circuit 15 via a demultiplexing circuit 13 inside the ultrasonic observation apparatus 3. The transmission circuit 14 generates a high-frequency pulse for transmission, and applies the high-frequency pulse to the ultrasonic vibrator 12 via the demultiplexing circuit 13 connected to the transmission circuit 14 at the time of transmission to generate ultrasonic waves in a pulse form. Out to the inspection site side such as a living organ. Note that the demultiplexing circuit 13 may be provided in the ultrasonic probe 2.

Thereafter, the demultiplexing circuit 13 is switched to a state of being connected to the receiving circuit 15, and the reflected ultrasonic waves reflected at the examination site are again received by the ultrasonic transducer 12 and converted into electric signals. The signal is led to the receiving circuit 15 via the branching circuit 13.

The receiving circuit 15 amplifies and detects the envelope signal, converts the signal to a luminance signal proportional to the amplitude of the echo signal, A / D converts the signal, temporarily stores it in the memory, and stores the signal data stored in the memory. Is further digitally scanned and converted into a video signal in a rectangular coordinate system,
And is input to a monitor 17 via a superimpose circuit 16, and an ultrasonic tomographic image is displayed on a display surface of the monitor 17.

As shown in FIG. 2, a first concave portion 1 is formed on the outer peripheral surface of the ultrasonic probe main body 4 in the body cavity near the base end of the distal end portion 11 thereof.
8, and a second concave portion 19 is provided on the outer peripheral surface near the front end of the gripping portion 7. As shown in FIG. 3, a convex portion provided on the distal end portion of the puncture attachment 5, that is, on the attachment distal end portion 21. 22 is fitted into the first concave portion 18, and the mounting ring 24 provided on the proximal body 23 of the puncture attachment 5 is fitted into the second concave portion 19, whereby FIG.
As shown in the figure, the puncture attachment 5 can be detachably positioned and fixed or attached to the ultrasonic probe body 4 in the body cavity.

FIG. 2 is an enlarged view of the tip 11 of FIG.
As shown in (B), the distal end portion 11 of the ultrasonic probe body 4 in the body cavity is covered with an acoustic cap 25 made of a material such as hard polyethylene or polymethylpentene which is ultrasonically permeable to the base end. It is installed in such a manner.

The acoustic cap 25 has a semi-cylindrical shape at the distal end and a rotatable support 26 provided with a pulley or the like at the center of the inside thereof is rotatably mounted on a shaft 27, and the rotatable support 26 is It is connected to a motor (not shown) arranged inside the base end of the distal end portion 11 or inside the grip portion 7 via a rotation transmitting member 28 such as a belt or a wire that is bridged, and is driven to rotate at a constant speed as indicated by an arrow.

The outer peripheral side of the rotary support 26 is cut out, and the ultrasonic vibrator 12 is fixed to the rotary support 26. The ultrasonic vibrator 12 is rotated around the shaft 27 together with the rotation of the rotary support 25, and synchronized with this rotation, the ultrasonic vibrator 12 is rotated. The ultrasonic wave is transmitted / received from the ultrasonic wave transmitting / receiving surface.
Then, by transmitting and receiving ultrasonic waves in a predetermined angle range, an ultrasonic tomographic image corresponding to a drawing range 29 indicated by a two-dot chain line in FIG. 2A can be displayed on the monitor 17.

The inside of the acoustic cap 25 is filled with an acoustic medium 30 for transmitting ultrasonic waves, transmits the ultrasonic waves emitted from the ultrasonic vibrator 12, and further transmits the ultrasonic waves on the tip side of the acoustic cap 25. The acoustic wave is transmitted through the radiation surface portion and emitted radially, and the ultrasonic wave is emitted toward the examination site side in the body cavity which is tightly pressed by the acoustic cap 25.

An encoder (not shown) is attached to the rotary support 26 to detect the rotational angle position of the ultrasonic vibrator 12 and output it to the transmitting circuit 14.
Outputs a transmission signal in synchronization with the detection signal. Further, a slip ring (not shown) is attached to the shaft 27 so that electric signals can be transmitted between the rotating support 26 side (that is, the rotor side) and the non-rotating shaft 27 side (that is, the stator side). I have to. Note that the encoder may be connected to a motor in the holding unit 7.

In the present embodiment, the puncture attachment 5 shown in FIG. 3 is detachably attached to the ultrasonic probe body 4 in the body cavity so that the puncture operation can be performed under observation by an ultrasonic tomographic image. .

The puncture attachment 5 is provided with an attachment tip 21 at the tip of a long shaft 31 and a hand body 23 at the rear end of the shaft 31. The attachment distal end 21 has a substantially plate shape with a distal end bent, and a convex portion 22 that can be fitted into the first concave portion 18 of the distal end portion 11 of the intracavity ultrasonic probe main body 4 on both sides thereof.
Is protruding.

That is, the attachment distal end 21 is in contact with, for example, both peripheral portions of the outer peripheral surface (ultrasonic radiation surface) on the upper side of the distal end portion 11 of the intracavity ultrasonic probe main body 4 so that the distal end can be positioned and fixed. The side has a slide support portion 32 bent downward in an arc shape, and the protrusions 22 extend from both sides of the base end of the attachment distal end portion 21.

The slide support portion 32 has a bent and substantially plate shape, and has a concave portion formed by notching the center portion from the front end side. A slide guide groove 34 is provided in which both ends of a flexible, substantially plate-shaped guide member 33 are fitted and slidable. This guide member 3
Reference numeral 3 denotes a puncture needle guide hole 36 serving as a puncture needle guide portion through which the puncture needle 35 can pass at the center (FIGS. 5A and 5B).
Reference).

A distal end of a flexible shaft 38 having a hollow guide hole 37 through which the puncture needle 35 can pass so as to communicate with the puncture needle guide hole 36 is fixed to the rear end of the guide member 33. Have been.

The flexible shaft 38 has a shaft insertion hole 39 formed in the attachment tip 21 and the shaft 31.
Through the rear end to the main body 23 at the hand side. This hand side main body 23 is provided with a hole communicating with the shaft insertion hole 39. Then, from the rear end of this hole, the flexible shaft 3
The puncture needle 35 is inserted so as to pass through the guide hole 37 in 8, the puncture needle 35 inserted into the flexible shaft 38 is removed, or the rear end side of the puncture needle 35 protruding from this hole is By moving the puncture needle 35 back and forth, an operation of moving the puncture needle 35 forward and backward can be performed.

The rear end of the flexible shaft 38 is exposed in the elongated hole 41 provided on the upper side of the main body 23 at the hand side, and the base end is fixed to the rear end of the flexible shaft 38. An operation knob 42 as a hand-side operation means protrudes from the long hole 41 to the outside.

By operating the operation knob 42 to move the flexible shaft 38 in the longitudinal direction in the elongated hole 41, the operation of moving the flexible shaft 38 back and forth can be performed. The flexible, substantially plate-shaped guide member 33 fixed to the tip of the flexible shaft 38 can be moved along the bent slide guide groove 34.

Since the slide guide groove 34 is bent along the ultrasonic radiation surface on the outer peripheral surface of the acoustic cap 25 as shown in FIG. 3 or FIGS. Guide member 3 having flexibility along
By moving the puncture needle 3, the puncture needle puncture direction can be changed (or adjusted) so that the direction (or angle) of projection (puncture) of the puncture needle 35 guided by the puncture needle guide hole 36 of the guide member 33 can be changed (or adjusted). A mechanism or a puncture needle insertion angle adjusting means (hereinafter simply referred to as a direction changing mechanism or an angle adjusting means) 43 is formed.

The puncture needle 35 also has appropriate flexibility and elasticity. When the guide member 33 bends, the puncture needle 35 bends along the inner wall of the puncture needle guide hole 36 when the guide member 33 is bent, and a bending force acts. Otherwise, it will be linear due to its elasticity.

Further, in this embodiment, means for displaying information such as the projection direction (or insertion direction) and the distance of the puncture needle 35 on the ultrasonic tomographic image even when the operation knob 42 is operated is provided. I have.

For this purpose, as shown in FIG. 4, for example, an operation knob 42 (attached to the rear end of the flexible shaft 38) has a resistance value depending on the moving position of the operation knob 42, such as a slide resistor. Of the flexible shaft 3
8 is connected to a position detecting means 45 capable of detecting the reference position on the distal end side (specifically, detecting the distal end position of the puncture needle guide hole 36 of the guide member 33 connected to the distal end of the flexible shaft 38). The output signal of the position detecting means 45 is input to a position signal transmitting circuit 46, and the position signal transmitting circuit 46 outputs a position signal.

This position signal is transmitted by a signal transmission cable 47 extending from the rear end of the hand side main body 23, and a connector 48 provided at the end of the cable 47 is connected to the observation device 3.
To the arithmetic processing circuit 4 in the observation device 3
9 is input.

In the arithmetic processing circuit 49, the puncture needle guide hole 36 in the initial state in which the operation knob 42 is set at the rearmost position.
, And reference information such as a radius of curvature of the slide guide groove 34 is stored in advance.

Then, an arithmetic processing for converting the input position signal into an insertion direction (or an insertion angle) with reference to these information is performed, and the operation result is converted into image information, and a superimpose circuit 16 is provided. Output to the monitor 17 via
Needle protrusion using the reference position of the puncture needle 35 on the ultrasonic tomographic image on the display surface of the monitor 17, for example, the tip position of the guide member 33 as the reference position of the puncture needle 35 as shown in FIGS. Start point marker 51, insertion distance marker 5 indicating insertion distance
2 is displayed.

FIG. 5A shows the distal end side of the intracavity ultrasonic probe 2 in the initial state in which the operation knob 42 is set at the rearmost predetermined position, and FIG. 5C shows the state in this state. FIG. 5 shows markers displayed on the display surface of the monitor 17.
(B) shows the distal end side of the intracavity ultrasonic probe 2 when the operation knob 42 is moved forward in the state of FIG. 5 (A), and FIG. 5 (D) shows the display on the monitor 17 in this state. 2 shows a marker displayed on the surface.

Although the ultrasonic tomographic image and the image of the puncture needle are not displayed in FIGS. 5C and 5D, the markers 51 and 52 are actually superimposed on them. The operation of the present embodiment having such a configuration will be described below.

The protrusion 22 of the puncture attachment 5 and the mounting ring 24 are fitted into the first concave portion 18 and the second concave portion 19 of the intracavity ultrasonic probe main body 4, respectively, as shown in FIG. Body body ultrasonic probe body 4
To the body cavity ultrasonic probe 2 having the puncture attachment 5 attached thereto.

Then, the connectors 9 and 48 are connected to the observation device 3. Then, the intracavity ultrasonic probe 2 is inserted into the body cavity, and the semi-cylindrical ultrasonic radiation surface portion of the acoustic cap 25 at the distal end portion 11 is pressed against an ultrasonic examination site such as a living organ. When inserting into a body cavity,
The puncture needle 35 is inserted without being attached to the puncture attachment 5, or when the puncture needle 35 is inserted in the attached state, the puncture needle 35 is retracted more rearward than the state shown in FIG. 1 or FIG. .

Then, a power switch (not shown) is turned on,
Further, an instruction operation for displaying an ultrasonic tomographic image is performed by a keyboard or a foot switch (not shown). Then, the transmission circuit 14 applies a transmission signal to the ultrasonic vibrator 12 in a pulsed manner, and ultrasonic waves are sequentially transmitted radially from the rotationally driven ultrasonic vibrator 12 in synchronization with the rotational position, and the acoustic cap The ultrasonic wave is transmitted through the 25 ultrasonic emission surfaces and scans the inspection site side with ultrasonic waves in a predetermined imaging range 29.

The ultrasonic waves transmitted in the form of pulses are reflected at the portion where the acoustic impedance on the inspection site is changing to become reflected ultrasonic waves. The ultrasonic waves are received by the ultrasonic vibrator 12, and the electric signals, that is, the echoes are received. The signal is converted into a signal, the signal is processed by the receiving circuit 15, and the ultrasonic tomographic image is displayed on the display surface of the monitor 17 via the superimposing circuit 16.

The operator observes the ultrasonic tomographic image and, if there is a portion that should be biopsied, operates an indicator switch (not shown) for displaying a marker to display the monitor 17 on the display surface of the monitor 17 as shown in FIG. ), A needle protrusion start point marker 51 and an insertion distance marker 52 indicating the insertion distance are displayed.

In this case, the position information of the distal end position of the puncture needle guide hole 36 of the guide member 33 in the initial state in which the operation knob 42 is set at the rearmost position in the long hole 41 is calculated in advance as needle protrusion start point information. Since it is stored in the circuit 49, the needle protrusion start point marker 51 is displayed. Further, a line obtained by adding distance information to a line obtained by extending the distal end side of the puncture needle guide hole 36 is displayed as an insertion distance marker 52.

Then, the operation knob 4 is positioned so that the tissue portion to be punctured by the puncture needle 35 is positioned on the insertion distance marker 52 indicating the insertion distance in front of the needle projection start point marker 51.
2 is moved back and forth to adjust the puncture angle.

When this adjustment is completed, the distal end of the puncture needle 35 is inserted from the rear end of the proximal body 23 of the puncture attachment 5. Then, the puncture needle 35 is drawn in the drawing range 29.
When it reaches the inside, an image of the puncture needle 35 is also displayed. In the present embodiment, since the guide member 33 is a member having ultrasonic transparency, the tip side of the guide member 33 and the like protruding into the drawing range 29 of the ultrasonic wave and the protruding portion thereof (the living body) can be used. Ultrasound images (for organs) can be observed.

Then, when the distal end of the puncture needle 35 reaches the distal end of the guide member 33, the puncture needle 35 is further advanced by the distance of the puncture distance marker 52, whereby a biopsy is performed by puncture. The tip of the puncture needle 35 can be easily guided to the tissue at the target site to be tried, and the tissue can be collected.

Then, by performing the operation of pulling out the puncture needle 35, the collected tissue can be inspected in detail. Furthermore, when performing tissue collection at other sites,
As described above, the operation knob 42 is moved back and forth, and the puncture angle is adjusted so that the tissue portion to be punctured by the puncture needle 35 is positioned on the puncture distance marker 52.
The same operation can be performed by inserting the puncture attachment 5 from the rear end side of the hand side main body 23 of the puncture attachment 5.

After the completion of the ultrasonic diagnosis, the intracavity ultrasonic probe 2 is pulled out of the body cavity and separated into the intracavity ultrasonic probe main body 4 and the puncture attachment 5, whereby the intracavity ultrasonic probe is separated. Since the probe body 4 has a structure that is easy to wash and disinfect without providing a guide hole or the like for the puncture needle 35, it can be easily washed and disinfected in a short time, and can be used for the next inspection after a short time. .

On the other hand, if a plurality of puncture attachments 5 are prepared as puncture attachments 5, another puncture attachment 5 is attached to the sterilized intracavity ultrasonic probe main body 4 in a short time, and the same inspection is performed. Can be used for

As described above, in the present embodiment, the angle adjusting means 43 which can remotely adjust the projecting direction of the tip of the puncture needle 35 by the operation on the hand side within the drawing range 29 of the ultrasonic wave is provided. In addition, the tissue at the site to be punctured with the puncture needle 35 can be easily collected.

In the present embodiment, the angle adjusting means 4
The adjustment of 3 allows the puncture needle 35 in that state to be displayed on the ultrasonic tomographic image in the insertion direction and distance in which the puncture needle 35 is guided, so that the puncture operation can be performed easily and easily. In addition, it is possible to perform the collection of the tissue at successively different positions, for example, much more easily than in the conventional example.

In the present embodiment, the puncture attachment 5 provided with the angle adjusting means 43 is detachably attached to the body ultrasonic probe body 4 so as to be detachable from the existing body cavity ultrasonic probe body. Also, by forming the mounting concave portion 18 and the like, it is possible to realize an intracorporeal ultrasonic probe that can easily adjust the insertion angle of the puncture needle. Further, as described above, the ultrasonic probe body in the body cavity can be easily cleaned and disinfected in a short time.

The puncture attachment 5 may be disposable. Also, in the present embodiment, the intracavity ultrasonic probe main body 4 has been described as being capable of mechanically moving the ultrasonic transducer 12 to transmit and receive ultrasonic waves in a predetermined scanning range. A sound transducer may be used.

Although the present embodiment has been described with respect to scanning ultrasonic waves radially, a linear type scanning linearly may be used. The center axis of the ultrasonic scanning range is in the direction along the insertion axis in this embodiment, but in the case of the linear type, the puncture needle insertion angle can be adjusted within the scanning range as the direction perpendicular to the insertion axis. It is good. Also, the puncture angle may be adjustable within the scanning range for an ultrasonic probe that performs radial scanning in a direction perpendicular to the insertion axis.

In the present embodiment, the puncture attachment 5 is configured to output a position signal. However, the position signal is further converted into an angle signal corresponding to the insertion angle of the puncture needle 35 to convert the position signal to the observation device 3 side. It may be configured to output to the arithmetic processing circuit 49.

In the present embodiment, the guide member 33 is an ultrasonic-permeable member, but the part into which the puncture needle 35 is inserted is located on the front side, and the guide member 33 is temporarily provided.
Even if the ultrasonic waves are attenuated or shielded, ultrasonic observation is not always indispensable because the portion where the puncture needle 35 is inserted can be observed by ultrasonic waves.

(Second Embodiment) Next, a second embodiment of the present invention will be described with reference to FIG. FIG. 6 shows the configuration of the distal end portion of the puncture attachment according to the second embodiment of the present invention. The present embodiment has a puncture attachment 61 having a configuration different from that of the first embodiment, and this puncture attachment 61 is detachably attached to the in-body-cavity ultrasonic probe main body 4 described in the first embodiment. It is designed to be attached.

As shown in FIG. 6, puncture attachment 6
Reference numeral 1 denotes an attachment tip 63 provided on the tip side of a long shaft (not shown). The attachment tip 63 is configured such that a bottom surface 64 thereof abuts on an upper surface of the tip 11 of the intracavity ultrasonic probe main body 4. , This attachment tip 6
The protrusions 65 protrude from both sides on the base end side of 3, and can be positioned and fixed by being fitted into the first recess 18 of the tip end 11.

The attachment distal end portion 63 has a concave portion 65 formed by cutting off the distal end side from the upper side, and a raising base 66 for raising the puncture needle 35 (see, for example, FIG. 3 of the first embodiment). Is stored.

The raising table 66 is attached to a shaft 67 at a position near the bottom of its rear end, and both ends of the shaft 67 are rotatably supported on the wall surfaces on both sides of the concave portion 65 of the attachment distal end portion 63. The distal end of the operation wire 69 is fixed to a wire attachment portion 68 at a position near the front bottom portion of the raising base 66, and the operation wire 69 is connected to the shaft portion through the attachment distal end portion 63 and the wire guide hole of the shaft portion. Is fixed to a pulley provided on a hand-side main body (not shown) at the rear end.

The pulley is provided with an operation knob. By operating the operation knob, the operation wire 69 is pulled to raise the operation wire 69 from the state shown in FIG. 6A as shown in FIG. 6B. The upper base 66 is rotated about a shaft 67 so that the raising base 66 can be raised.

A puncture needle guide hole 71 through which a puncture needle is inserted is provided in the attachment distal end portion 63, and this puncture needle guide hole 71 extends through a shaft portion to a puncture needle insertion port of the proximal body. .

The tip of the puncture needle guide hole 71 is opened at a concave portion 65, and the raising table 6 disposed in the concave portion 65 is provided.
6, a puncture needle guide hole 72 is provided in a portion facing the puncture needle guide hole 71.

While the piercing needle guide hole 72 does not raise the raising table 66, the center axis C2 of the puncture needle guide hole 71 coincides with the center axis C1 of the puncture needle guide hole 71 as shown in FIG. 6A. 6B, the direction of the center axis C2 is directed obliquely toward the upper front side as shown in FIG. 6B.

In this way, the puncture needle guide holes 71, 72
To form an angle adjusting means 73 that can change the direction in which the puncture needle 35 protrudes from the puncture needle guide hole 72. That is, by adjusting the angle adjusting means 73, the protruding direction of the puncture needle 35 can be changed within the depiction range 29 indicated by the two-dot chain line in FIG.

Further, for example, a pulley rotated by the operation knob is provided with a rotation angle detecting means such as a rotary encoder for detecting the rotation angle, and a rotation angle signal output from the rotation angle detecting means is provided by an observation device. 3 is input to the arithmetic processing circuit 49.

Then, the arithmetic processing circuit 49 calculates the insertion angle of the puncture needle 35 from the input rotation angle signal by arithmetic processing, and sets the reference position such as the tip position of the puncture needle guide hole 72 on the display surface of the monitor 17. A marker and an insertion distance marker from the reference position are displayed. In this case, the puncture needle 3 includes information about the rotation angle around the shaft 67 of the erecting base 66 with respect to each rotation angle position where the pulley is rotated.
The information required for performing the arithmetic processing of the insertion angle of No. 5 is stored in the information storage unit of the arithmetic processing circuit 49 in advance.

In the present embodiment, the direction in which the puncture needle 35 is projected can be adjusted by rotating the raising table 66 around the axis 67. Other configurations are the same as those of the first embodiment. Further, the operation and effect are almost the same as those of the first embodiment.

When the abdominal cavity is to be examined, an insufflation needle is inserted into the abdomen to perform insufflation.
In this case, in the past, the insufflation needle was inserted through the experience of the operator, but the following ultrasonic system is used so that even inexperienced operators can easily insufflate without damaging the organs etc. in the abdominal cavity. Alternatively, a device may be configured.

This ultrasonic apparatus uses, for example, an extracorporeal electronic scanning convex probe (hereinafter simply abbreviated as extracorporeal convex probe) 81 provided with a convex ultrasonic emission surface 80 as shown in FIG. The extracorporeal convex probe 81 can be positioned and fixed to the abdominal wall lifting tool 83 shown in FIG.

The abdominal wall lifting device 83 has a first groove portion 85a and a second groove portion 85b for positioning and fixing the extracorporeal convex probe 81 to a quadrangular cylindrical abdominal wall raising device body 84.
Are provided on inner wall surfaces facing each other, and a first protrusion 86a and a second protrusion 86b provided on both outer surfaces on the rear end side of the ultrasonic radiation surface 80 of the extracorporeal convex probe 81 are respectively provided with a first protrusion 86b. It is positioned and fixed by being fitted into the groove 85a and the second groove 85b so that the mounting state shown in FIG. 9 can be set.

As shown in FIG. 7A, the extracorporeal convex probe 81 has a shape which is symmetrical with respect to the center axis C. For example, a slip stopper 87 is provided on the right side thereof.
The index in the scanning direction is also used so that the right side is displayed on the right side of the ultrasonic tomographic image.

Also, as shown in FIG.
4, gripping arms 89 a and 89 b holding the abdominal wall 88 (see FIG. 9) and holding the gripped portions are provided on the left and right sides of the shaft 4 so as to be rotatable around a shaft 90 provided at the base end thereof. The arms 89a and 89b are urged by a coil spring 91 in a direction in which the distal ends close. In addition, each gripping arm 89
A concave / convex portion 92 having a slip-preventing function is provided on an inner surface of the front end side of the a and 89b for gripping the abdominal wall 88.

Further, the abdominal wall lifting tool main body 84 is provided with a first groove portion 85a and a second groove portion 85b for mounting the extracorporeal convex probe 81, for example, in a space on the right side of the insufflation needle 93 ( An insufflation needle insertion tube 94 for inserting the insufflation needle 94 is rotatably mounted via an insertion angle adjusting shaft 95.

The insufflation needle 9 is inserted into the insufflation needle insertion tube 94.
3, the insufflation needle 93 is guided in the direction of the central axis c of the insufflation needle insertion tube 94, and the insufflation needle 93 can be inserted into the abdominal wall 88 located in that direction.
An angle detector 96 is attached to the insertion angle adjusting shaft 95, and detects and outputs a signal corresponding to the tilt angle of the insufflation needle 94 from the reference direction.

As shown in FIG. 10, the output of the angle detector 96 is input to an angle signal transmitting circuit 97 provided in the vicinity thereof,
It is converted into an angle signal. This angle signal is input to an arithmetic processing circuit 49 'in the ultrasonic observation apparatus 3' via a cable (not shown in FIGS. 8 and 9) extended from the abdominal wall lifting tool main body 84.

The ultrasonic observation apparatus 3 'basically has the configuration shown in FIG.
Has the same configuration as the ultrasonic observation apparatus 3 shown in FIG. The arithmetic processing circuit 49 'calculates the insertion route of the insufflation needle 93 by using the input angle signal, converts the route into an image signal indicating the insertion route, and superimposes it (shown in FIG. 1). Output to the monitor 17 via the circuit 16. Then, the insertion route of the insufflation needle 93 is superimposed and displayed on the ultrasonic tomographic image.

Therefore, the surgeon sets as shown in FIG. 9 and observes an ultrasonic tomographic image of the ultrasonic imaging range 97 by the extracorporeal convex probe 81, so that the puncture route may hit an intraperitoneal organ or the like. By inserting the insufflation needle 93 by adjusting the insufflation needle insertion tube 94 in such an angle direction, the insufflation needle 9 can be easily inserted without damaging the internal organs of the body cavity.
3 can be inserted.

The present invention also includes an embodiment constructed by partially combining the above-described embodiments and the like.

[Supplementary Notes] An intra-cavity ultrasonic probe main body having an ultrasonic vibrator disposed at the distal end of a long insertion portion inserted into a body cavity, and detachably attachable to the intra-cavity ultrasonic probe main body to pierce a living organ An ultrasonically guided puncture attachment having a puncture needle guide portion for inserting a puncture needle to be inserted, wherein the puncture needle is inserted into a living organ by the ultrasonically guided puncture attachment. An intracorporeal ultrasonic probe comprising a puncture needle insertion angle adjusting means for changing an insertion angle.

2. A puncture needle insertion angle adjusting means of the ultrasound-guided puncture attachment includes a second puncture needle guide communicating with a first puncture needle guide provided on a main body of the ultrasound-guided puncture attachment. A resin guide provided, and operating means provided on the hand side of the ultrasonically guided puncture attachment for adjusting the amount of movement of the resin guide, wherein the resin guide is an ultrasonic 2. The intracavity ultrasonic probe according to claim 1, having transparency and flexibility, and being deformable and movable along the shape of the ultrasonic radiation surface of the intracavity ultrasonic probe main body.

3. The puncture needle insertion angle adjusting means of the ultrasonically guided puncture attachment includes a puncture needle elevating means provided at a distal end of the ultrasonically guided puncture attachment, and a proximal side of the ultrasonically guided puncture attachment. 2. The intracorporeal ultrasonic probe according to claim 1, further comprising operating means for raising the puncture needle provided in the puncture needle. 4. An ultrasonic probe body for an intracavity in which an ultrasonic vibrator is disposed at a distal end of a long insertion portion inserted into a body cavity, which is detachable from the ultrasonic probe body for an intracavity and is inserted into a living organ. An ultrasound-guided puncture attachment having a puncture needle guide for inserting a puncture needle, and an ultrasonic observation device connected to an intracorporeal ultrasonic probe main body and displaying an ultrasonic tomographic image of a living organ. In the ultrasonic system, the ultrasonically guided puncture attachment comprises a puncture needle insertion angle adjusting means for varying the insertion angle of the puncture needle into the living organ, and a puncture needle insertion angle into the living organ. It has an angle detecting means for detecting, and has a processing circuit for transmitting an angle signal to an ultrasonic observation device to which the body probe is connected, and the ultrasonic observation device is under the ultrasonic guide. For puncture Ultrasound system by processing the angle signal transmitted from Attachment, characterized in that tightening become capable of displaying insertion path of the puncture needle on the ultrasonic tomographic image.

5. For inserting a puncture needle that can be detachably attached to the body probe inside the body cavity in which an ultrasonic transducer is arranged at the tip of a long insertion portion inserted into the body cavity, and inserted into a living organ. In the ultrasonically guided puncture attachment having a puncture needle guide portion, the ultrasonically guided puncture attachment may be provided with a puncture needle insertion angle adjusting means for changing an insertion angle of a puncture needle into a living organ. Characteristic ultrasonic guided puncture attachment. 6. An abdominal wall elevating device for grasping and raising an abdominal wall of a living body, wherein the abdominal wall elevating device is detachable from an ultrasonic probe having an ultrasonic vibrator disposed therein, and is used to inject gas into the abdominal cavity. An ultrasonically guided abdominal wall elevating tool for inserting a pneumoperitoneum needle, which is provided with an insufflation needle guide part for penetrating an insufflation needle inserted into an abdominal cavity connected to an abdominal device.

7. 7. The ultrasonically guided lower insufflation needle according to claim 6, wherein the abdominal wall lifting tool includes an insufflation needle insertion angle adjusting means for changing an insertion angle of the insufflation needle into the abdominal cavity. Abdominal wall lifting tool for insertion. 8. An ultrasonic probe for obtaining an ultrasonic tomographic image of a living body having a built-in ultrasonic vibrator, an abdominal wall lifting device for detachably holding the abdominal wall and lifting the ultrasonic probe, and the ultrasonic probe And an ultrasonic observation apparatus for displaying an ultrasonic tomographic image, wherein the abdominal wall lifting device is inserted into an abdominal cavity connected to an insufflation device for injecting gas into the abdominal cavity. A pneumoperitoneal abdomen guide portion for inserting the pneumoperitoneal needle, a pneumoperitoneal needle insertion angle adjusting means for varying the insertion angle of the pneumoperitoneal needle into the abdominal cavity, and an insertion angle detecting means; The ultrasonic observation device has a processing circuit for transmitting an angle signal to the observation device, and the ultrasonic observation device performs an arithmetic process on the angle signal transmitted from the abdominal wall lifting device, and inserts a pneumoperitoneal needle on an ultrasonic tomographic image. An ultrasonic system characterized in that it is possible to display an image.

[0085]

As described above, according to the present invention, an ultrasonic probe body in a body cavity in which an ultrasonic vibrator is disposed at the tip of a long insertion portion inserted into a body cavity; An ultrasonically guided puncture attachment having a puncture needle guide portion for detachably attachable to the ultrasonic probe main body and having a puncture needle guide for penetrating a living organ, The ultrasound-guided puncture attachment is equipped with a puncture needle insertion angle adjustment means that changes the insertion angle of the puncture needle into the living organ, so disinfection, etc., can be easily performed on the ultrasonic probe itself in the body cavity. In addition, the puncture direction can be easily changed, and good puncture operability can be ensured.

[Brief description of the drawings]

FIG. 1 is a configuration diagram of an ultrasonic diagnostic apparatus provided with a first embodiment of the present invention.

FIG. 2 is a diagram showing a configuration of an intracorporeal ultrasonic probe.

FIG. 3 is a perspective view showing a configuration of a puncture attachment.

FIG. 4 is a block diagram showing a configuration of an electric system of the puncture attachment.

FIG. 5 is an explanatory diagram of the operation of the present embodiment.

FIG. 6 is a sectional view showing a configuration of a distal end portion of a puncture attachment according to a second embodiment of the present invention.

FIG. 7 is a plan view and a right side view showing the extracorporeal ultrasonic probe attached to the abdominal wall lifting device.

FIG. 8 is a sectional view showing an abdominal wall lifting device.

FIG. 9 is a view showing the abdominal wall lifting device in a use state.

FIG. 10 is a block diagram showing a configuration of an electric system provided on the abdominal wall lifting device.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic diagnostic apparatus 2 ... Intracavity ultrasonic probe 3 ... Ultrasonic observation apparatus 4 ... Intracavity ultrasonic probe main body 5 ... Attachment for puncture 6 ... Insertion part 7 ... Grip part 8 ... Ultrasonic code 9 ... Connector 11 ... Tip 12: Ultrasonic vibrator 14: Transmission circuit 16: Superimpose circuit 18, 19: Depression 21: Attachment tip 22 ... Convex 23: Hand side body 24 ... Mounting ring 25 ... Acoustic cap 29: Rendering range DESCRIPTION OF SYMBOLS 31 ... Shaft part 32 ... Slide support part 33 ... Guide member 34 ... Slide guide groove 35 ... Puncture needle 36 ... Puncture needle guide hole 38 ... Flexible shaft 41 ... Long hole 42 ... Operation knob 43 ... Angle adjusting means 45 ... Position Detecting means 46 ... Position signal transmitting circuit 49 ... Calculation processing circuit 51 ... needle protrusion start point marker 52 ... Puncture distance marker

Claims (2)

[Claims] 1. An intrabody cavity ultrasonic probe main body having an ultrasonic transducer disposed at a distal end of a long insertion portion inserted into a body cavity, and detachably attachable to the intracavity ultrasonic probe body. An ultrasound guided puncture attachment having a puncture needle guide portion for inserting a puncture needle inserted into a living organ, wherein the ultrasound guided puncture attachment has a puncture needle. An intracorporeal ultrasonic probe provided with a puncture needle insertion angle adjusting means for changing an insertion angle into a living organ. 2. A puncture needle which can be detachably attached to an ultrasonic probe main body in a body cavity in which an ultrasonic transducer is arranged at a distal end of a long insertion portion inserted into a body cavity, and is inserted into a living organ. An ultrasonically guided puncture attachment having a puncture needle guide portion for inserting a puncture needle, wherein the puncture needle insertion angle adjusting means for changing the insertion angle of a puncture needle into a living organ with the ultrasonically guided puncture attachment An attachment for puncture under ultrasound guidance, characterized in that a puncture attachment is provided.