JP2015156903A - ultrasonic endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic endoscope capable of cleansing a tip opening part of a balloon suction pipeline and/or a balloon injection pipeline with a flexible cleansing brush inserted into the balloon suction pipeline and/or the balloon injection pipeline.SOLUTION: An ultrasonic endoscope includes an ultrasonic probe 45 covered with a balloon, a tip hard part 19 for supporting the ultrasonic probe, balloon suction pipelines 31 and 54 in which a tip opening part 37 formed at one end opens in a balloon fitting part 52 on the surface of the tip hard part, and balloon injection pipelines 35 and 53 in which a tip opening part 33 formed at one end opens at a position different from the tip opening part of the balloon fitting part. A part provided to the tip hard part of at least one of the balloon suction pipeline and the balloon injection pipeline includes parallel parts 32 and 36 parallel to an axis line of the tip hard part, and the tip opening part that extends from the tip parts of the parallel parts to the tip side of an insertion part, and inclines at an acute angle with respect to the axis line.

Description

  The present invention relates to an ultrasonic endoscope.

FIG. 12 and Patent Document 1 are conventional examples of ultrasonic endoscopes.
The ultrasonic endoscope includes an operation unit and an insertion unit extending from the operation unit. The distal end portion of the insertion portion is provided with a distal end hard portion made of a hard resin material, and an ultrasonic probe is supported in a fixed state on the distal end hard portion. A portion located rearward from the distal end portion (the distal end hard portion) of the insertion portion has flexibility. A balloon mounting part for mounting a balloon made of an elastic material is formed on the surface of the distal end hard part and the ultrasonic probe.
Inside the operation portion and the insertion portion, a balloon suction conduit and a balloon water injection conduit are provided as mutually independent conduits. Both the tip ends of the balloon suction conduit and the balloon water injection conduit are formed at the tip hard portion. The portions provided at the distal end hard portion of the balloon suction conduit and the balloon water injection conduit are both a parallel portion parallel to the axis of the distal end hard portion, and from the distal end portion of the parallel portion to the radially outer portion of the distal end portion from the distal end hard portion (this A distal end opening extending in the direction perpendicular to the axis) and opening at the balloon mounting portion.

  When performing ultrasonic diagnosis, first, deaerated water is supplied to the balloon water injection conduit, and this deaerated water is injected between the balloon mounting portion and the inner surface of the balloon through the opening at the tip of the balloon water injection conduit. Then, since the balloon is inflated, ultrasonic diagnosis can be performed by transmitting ultrasonic waves from the ultrasonic probe after bringing the inflated balloon into contact with the body cavity wall of the subject.

  In addition, when the negative pressure of the suction source connected to the endoscope is applied to the balloon suction line after the endoscopic operation by the ultrasonic endoscope is finished, the deaeration injected between the balloon mounting portion and the balloon inner surface is performed. Water is aspirated by the aspiration source via a balloon aspiration line. Then, the balloon contracts and comes into close contact with the surface of the ultrasonic probe.

JP 2005-111548 A

When the balloon is removed from the ultrasonic endoscope, the subject's filth (body fluid, etc.) may be sucked using the balloon suction line (negative pressure). However, when the filth is sucked using the balloon suction line (negative pressure), it is necessary to clean the filth attached to the inner surface of the balloon suction line with the cleaning brush inserted into the balloon suction line from behind.
However, since the tip opening of the balloon suction conduit is orthogonal to the parallel part (axis of the tip hard part), it is difficult to insert the cleaning brush into the tip opening and project it to the outer peripheral side of the balloon mounting part. It was. That is, it was difficult to clean the tip opening of the balloon suction conduit with the cleaning brush.
In addition, after using the ultrasonic endoscope, it is necessary to clean the balloon injection conduit with a cleaning brush, but as with the balloon suction conduit, the tip opening of the balloon injection conduit is cleaned with the cleaning brush. It was difficult to do.

  The present invention can clean the balloon suction conduit and / or the tip opening of the balloon injection conduit with the flexible cleaning brush inserted into the balloon suction conduit or / and the balloon injection conduit. An object is to provide an ultrasonic endoscope.

  An ultrasonic endoscope according to the present invention includes an ultrasonic probe provided on a surface of a distal end portion of an insertion portion extending from an operation portion and covered with a balloon detachably attached to the distal end portion, and a part of the insertion portion. None and a tip hard portion that supports the ultrasonic probe, a balloon that is disposed inside the operation portion and the insertion portion, and a tip opening formed at one end opens at a balloon mounting portion on the surface of the tip hard portion. A suction conduit, and a balloon irrigation conduit disposed inside the operation portion and the insertion portion and having a tip opening formed at one end opened at a position different from the tip opening of the balloon mounting portion. In the ultrasonic endoscope, at least one of the balloon suction conduit and the balloon water injection conduit includes a parallel portion parallel to the axis of the distal hard portion, and a tip of the parallel portion. It is characterized in that it comprises a, and the distal end opening portion inclined at an acute angle with respect to the insertion portion of the extending toward the distal end side and the axis line of parts.

The opening area of the balloon attachment part side end part of the tip opening part of the balloon suction pipe line and the balloon water injection pipe line may be larger than the cross-sectional area of the connection part between the tip opening part and the parallel part.
In this case, the opening shape of the balloon mounting portion side end portion of the tip opening portion of the balloon suction conduit and the balloon water injection conduit is a length in a direction parallel to the axis rather than a circumferential length of the insertion portion. May have a long slot shape.

The balloon mounting portion of the distal end hard portion has a large diameter portion, and a small diameter constriction portion adjacent to the large diameter portion and having a short radial distance around the axis as compared with the large diameter portion. The tip opening of the balloon suction conduit and the balloon injection conduit may be formed in the small diameter constricted portion.
In this case, the balloon mounting portion includes a pair of large-diameter portions spaced apart in the axial direction, and the small-diameter constricted portion in which the radial distance gradually decreases as the pair extends from the pair of large-diameter portions toward each other. , May be provided.

In the ultrasonic endoscope according to the present invention, the portion provided at the distal end hard portion of at least one of the balloon suction conduit and the balloon water injection conduit includes a parallel portion parallel to the axis of the distal end hard portion, and a distal end portion of the parallel portion. A distal end opening extending toward the distal end side of the insertion portion and inclined at an acute angle with respect to the axis of the distal end hard portion.
Therefore, when a flexible cleaning brush is inserted into the parallel part of the balloon suction conduit or the balloon water injection conduit, this cleaning brush connects the parallel part and the tip opening part (if they make an obtuse angle). It passes smoothly and proceeds to the tip opening, and further protrudes from the tip opening to the outer peripheral side of the balloon mounting portion.
Therefore, it is possible to clean not only the parallel portion of the balloon suction conduit and the balloon water injection conduit but also the tip opening by the cleaning brush.

1 is an external view showing an embodiment of an ultrasonic endoscope to which the present invention is applied. It is the perspective view seen from the front end part of an insertion part, and its neighborhood part from the front. FIG. 3 is a perspective view similar to FIG. 2 showing the ultrasonic probe omitted. It is sectional drawing which follows the IV-IV arrow line of FIG. It is sectional drawing which follows the VV arrow line of FIG. It is the perspective view seen from the back which fractures | ruptures and shows a part of front-end | tip hard part. It is a side view which shows the front end part of an insertion part, and a part of its vicinity part by cross-sectional view. It is the vertical side view cut | disconnected in the same position as FIG. 5 of a front-end | tip hard part. It is the vertical side view cut | disconnected in the same position as FIG. 4 of a front-end | tip hard part. FIG. 10 is a cross-sectional view similar to FIG. 9 when a cleaning brush is inserted into the suction tube and the balloon suction hole. It is sectional drawing corresponding to FIG. 8 of a comparative example. It is sectional drawing similar to FIG. 10 of a prior art example.

Hereinafter, an embodiment of the present invention will be described with reference to FIGS. The front-rear direction of the ultrasonic endoscope 10 in the following description is such that the distal end side (front end fixing member 50 side) of the insertion portion 12 is “front”, and the connector portion side connected to the end portion of the universal tube 13 (and The ultrasonic connector portion side) connected to the end of the ultrasonic image transmission tube 14 is “rear”.
An ultrasonic endoscope 10 illustrated in FIG. 1 includes an operation unit 11, an insertion unit 12 that extends forward from the operation unit 11, a universal tube 13 that extends from the operation unit 11 in a different direction from the insertion unit 12, and ultrasonic image transmission. Tube 14, a connector part (not shown) provided at the end of the universal tube 13, and an ultrasonic connector part (not shown) provided at the end of the ultrasonic image transmission tube 14. . The connector portion can be connected to a processor (image processing device / light source device, not shown), and the ultrasonic connector portion can be connected to an ultrasonic diagnostic device (not shown). Both the ultrasonic diagnostic apparatus and the processor are connected to a monitor (not shown).
The insertion portion 12 is formed with a bending portion 17 that bends in the vertical direction and the left-right direction in accordance with the rotation operation of the bending operation lever 15 provided in the operation portion 11. Thus, the flexible tube portion 18 can be bent.

A distal end hard portion 19 made of hard resin is provided in a portion of the insertion portion 12 in front of the curved portion 17.
The distal end hard portion 19 is a substantially rotationally symmetric integral molded product having its own axis 19a (the axis of the insertion portion 12) as a center. The distal end hard portion 19 includes a central cylindrical portion 20, a water injection side partition wall 25, a suction side partition wall 26, and an outer peripheral side cylindrical portion 27 as large components.
A central concave portion 21 extending forward is formed in the rear end surface of the central cylindrical portion 20. An objective lens hole 22 having a circular cross section and a pair of illumination lens holes 23 are formed on the front end face of the central cylindrical portion 20 as holes extending rearward, and the rear end portions of these holes are all in the center. It communicates with the recess 21. The objective lens L1 is fitted and fixed to the front end portion of the objective lens hole 22, and an imaging element 16A located immediately after the objective lens L1 is provided inside the objective lens hole 22. The image signal cable 16B extending rearward from the image sensor 16A passes through the objective lens hole 22, the internal space of the insertion portion 12, the internal space of the operation portion 11, and the internal space of the universal tube 13 to the connector portion. It extends. On the other hand, the illumination lens L <b> 2 is fitted and fixed to the front end portions of the pair of illumination lens holes 23. Further, a front end portion of a light guide fiber bundle (not shown) is inserted into each of the pair of illumination lens holes 23, and the front end portion of each light guide fiber bundle is connected to the corresponding illumination lens L2. The rear end portion of each light guide fiber bundle extends through the internal space of the insertion portion 12, the internal space of the operation portion 11, and the internal space of the universal tube 13 to the connector portion.
In addition, an ultrasonic probe contact surface 24 is formed on the outer peripheral portion of the central cylindrical portion 20, which is annular when viewed from the front, and is a plane orthogonal to the axis 19 a of the distal end hard portion 19.

The water injection side partition wall 25 and the suction side partition wall 26 are respectively connected to portions that are separated by 180 ° in the circumferential direction of the outer peripheral surface of the central cylindrical portion 20. Both the water injection side partition wall 25 and the suction side partition wall 26 linearly extend in a direction parallel to the axis 19 a of the distal end hard portion 19. The rear end positions of the water injection side partition wall 25 and the suction side partition wall 26 coincide with the rear end position of the central columnar part 20, and the front ends of the water injection side partition wall 25 and the suction side partition wall 26 are front ends of the central columnar part 20. It ends behind the position.
The outer peripheral side cylindrical portion 27 is a cylindrical body that is coaxial with the central columnar portion 20, and the water injection side partition wall 25 and the suction side partition wall 26 are connected to two locations on the inner peripheral surface thereof. The rear end position of the outer peripheral side cylindrical portion 27 coincides with the rear end positions of the water injection side partition wall 25 and the suction side partition wall 26. The front end position of the outer peripheral side cylindrical portion 27 is located in front of the front end positions of the water injection side partition wall 25 and the suction side partition wall 26 and behind the ultrasonic probe contact surface 24.
In the vicinity of the rear end of the outer peripheral surface of the outer cylindrical portion 27, an annular flange 28 centering on the axis 19 a of the central cylindrical portion 20 is projected. The portion located between the front end portion of the outer peripheral surface of the outer peripheral side cylindrical portion 27 and the annular flange 28 is constituted by the front end portion (large diameter portion) and the small diameter constricted portion 29 smaller in diameter than the annular flange 28 (large diameter portion). It is. As shown in the drawing, the diameter of the small-diameter constricted portion 29 (the radial distance from the axis 19a of the hard tip portion 19) gradually decreases as it approaches the front end portion and the annular flange 28 (that is, the front end portion and the annular shape). The intermediate position of the flange 28 is the smallest diameter).
Further, a rear annular groove 30 centering on the axis 19 a of the distal end hard portion 19 is recessed in a portion located immediately before the annular flange 28 on the outer circumferential surface of the outer circumferential side cylindrical portion 27. Further, the rear end portion of the outer peripheral surface of the outer cylindrical portion 27 is configured to cover the outer end surface of the portion excluding the front end portion of the insertion portion 12 and the flexible outer tube 12a in a fixed state. is there.

Balloon suction holes 31 (balloon suction conduits) are formed in the suction side partition wall 26 and in the front end portion of the outer peripheral side cylindrical portion 27. As shown in FIGS. 4 and 9, the balloon suction hole 31 is a hole including a parallel portion 32 and a tip opening portion 33. The parallel portion 32 is a hole having a circular cross section that extends forward from the rear end surface of the suction side partition wall 26 in a direction parallel to the axis 19 a of the distal end hard portion 19. As shown in the drawing, the front end of the parallel portion 32 terminates behind the front end of the suction side partition wall 26. The tip opening 33 extends from the front end of the parallel portion 32 toward the front end of the outer cylindrical portion 27 (the outer peripheral surface of the outer cylindrical portion 27) and has an acute angle on the outer peripheral side with respect to the axis 19a of the tip hard portion 19. An inclined hole. As shown in the drawing, the cross-sectional area of the front end opening 33 gradually increases from the rear end (connecting portion with the parallel portion 32) toward the front end (opening on the surface of the outer cylindrical portion 27). . The shape of the front end portion (opening portion) of the tip opening portion 33 is not circular, but is a long hole shape in which the length in the direction parallel to the axis 19a of the tip hard portion 19 is longer than the circumferential length of the tip hard portion 19. The front end (opening) is formed in the small diameter constricted portion 29 (see FIG. 9).
Balloon water injection holes 35 (balloon water injection pipes) are formed in the water injection side partition wall 25 and in the front end portion of the outer peripheral side cylindrical portion 27. The balloon water injection hole 35 is a hole symmetric with respect to the balloon suction hole 31 and the axis 19 a of the distal end hard portion 19, and corresponds to the parallel portion 36 corresponding to the parallel portion 32 and the distal end opening 33. A tip opening 37. The parallel portion 36 is a hole having a circular cross section extending forward from the rear end surface of the water injection side partition wall 25 in a direction parallel to the axis 19 a of the distal end hard portion 19, and its front end terminates behind the front end of the water injection side partition wall 25. doing. The tip opening 37 extends from the front end of the parallel portion 36 toward the front end of the outer cylindrical portion 27 (the outer peripheral surface of the outer cylindrical portion 27) and has an acute angle on the outer peripheral side with respect to the axis 19 a of the tip hard portion 19. It is an inclined hole, and the cross-sectional area of the tip opening 37 gradually increases from the rear end (connecting portion with the parallel portion 36) toward the front end (opening on the surface of the outer cylindrical portion 27). Yes. Further, the shape of the front end portion (opening portion) of the distal end opening portion 37 is a long hole shape in which the length in the direction parallel to the axis 19a of the distal end hard portion 19 is longer than the circumferential length of the distal end hard portion 19. The (opening) is formed in the small diameter constricted portion 29 (see FIG. 2).

Further, a flexible insertion hole 39 that penetrates the distal end hard portion 19 in the front-rear direction while avoiding the water injection side partition wall 25 and the suction side partition wall 26 is provided between the central cylindrical portion 20 of the distal end hard portion 19 and the outer peripheral side cylindrical portion 27. It is formed. The flexible insertion hole 39 is composed of a pair of axis parallel portions 40 and one tapered portion 41.
The pair of axis parallel parts 40 are holes having a circular arc section centering on the axis 19a of the distal end hard part 19, and the front ends of the water injection side partition wall 25 and the suction side partition wall 26 are moved forward from the rear end surface of the distal end hard part 19. (The same front-rear position as the intermediate position in the front-rear direction of the tip openings 33, 37, position A in FIG. 8). The central angle around the axis 19a of the distal end hard portion 19 of each axis parallel portion 40 is slightly smaller than 180 °.
The tapered portion 41 is reduced in diameter toward the rear from the same position as the front end of the outer cylindrical portion 27 to the same front and rear position (position B in FIG. 8) as the front end surfaces of the water injection side partition wall 25 and the suction side partition wall 26. It is an annular hole centering on an axis 19a that extends and has a rear portion connected to the front ends of the pair of axis parallel portions 40. As shown in FIG. 8, the inner peripheral portion (inner peripheral side position of the inner surface) of the front portion of the taper portion 41 is located on the outer peripheral side from the inner peripheral portion (inner peripheral side position of the inner surface) of the axis parallel portion 40. Moreover, the inner peripheral part of the front end part (part located between the position A and the position B in FIG. 8) of the pair of axis parallel parts 40 is ahead of the rear end position (position B in FIG. 8) of the taper part 41. positioned. That is, the inner peripheral portion of the front end portion of the pair of axis parallel portions 40 also serves as the inner peripheral portion of the rear portion of the tapered portion 41.

The axis parallel part 40 and the taper part 41 (both the axis parallel part 40 and the taper part 41 are not formed) are integrally formed with the hard tip 19 by integrally molding the hard tip 19 with a hard resin material. It is processed using the first cutting tool T1 and the second cutting tool T2.
The processing procedure of the axis parallel part 40 and the taper part 41 with respect to the distal end hard part 19 is as follows.
The first cutting tool T1 is a cylindrical end mill. The second cutting tool T2 is also a cylindrical end mill, and its outer diameter is smaller than that of the first cutting tool T1.
When processing, first, the distal end hard portion 19 is fixed with a jig (not shown).
Next, the front end portion (blade portion) of the first cutting tool T1 is brought into contact with the rear end surface of the distal end hard portion 19 while rotating (rotating) around its own axis T1a.
Subsequently, the first cutting tool T1 is advanced to a position A in FIG. 8 in a direction parallel to the axis 19a of the distal end hard portion 19. Further, the first cutting tool T1, which continues to rotate, is revolved (moved in the circumferential direction) around the axis 19a at an angle smaller than 180 ° with the front-rear position thereof being fixed, so that the axis of one eye is parallel. The part 40 is processed. And it pulls back from the axial parallel part 40 which formed 1st cutting tool T1. Next, after moving the first cutting tool T1 to a position where the circumferential phase is shifted by 180 ° from the axis parallel part 40, the front end of the first cutting tool T1 rotated about the axis T1a is used as the distal end hard part. 19 is brought into contact with the rear end face. Then, the first cutting tool T1 is advanced in the direction parallel to the axis 19a to the position A in FIG. 8, and the first cutting tool T1, which continues to rotate, is 180 ° centered on the axis 19a with its front-rear position fixed. Another axis parallel part 40 is machined by revolving at a smaller angle. And after that, the 1st cutting tool T1 is pulled back from the said axis parallel part 40. As shown in FIG. When the two axis parallel portions 40 are formed in the distal end hard portion 19 in this manner, a portion located between the two axis parallel portions 40 is left without being cut. The two remaining portions are the water injection side partition wall 25 and the suction side partition wall 26.

Next, after the portion of the second cutting tool T2 located closest to the axis 19a is made to coincide with the position of the outer peripheral edge of the contact surface 24 of the ultrasonic probe, the rear end portion (blade portion) of the second cutting tool T2 is the tip. The hard part 19 (the part located on the inner peripheral side of the front end surface of the outer peripheral side cylindrical part 27) is brought into contact from the front.
Subsequently, while rotating the second cutting tool T2 around the axis T2a, the second cutting tool T2 is moved backward to a position B (behind position A) in FIG. 8 in a direction parallel to the axis 19a of the distal end hard portion 19. Further, the second cutting tool T2, which continues to rotate, is revolved 360 ° around the axis 19a (moving in the circumferential direction) with the front-rear position fixed, thereby forming the inner peripheral side portion of the tapered portion 41. To do.
Further, after pulling forward from the hole in which the second cutting tool T2 is formed, the second cutting tool T2 rotating around the axis T2a is slightly moved to the outer peripheral side and is acute with respect to the axis 19a of the distal end hard portion 19 Then, the rear end portion (blade portion) of the second cutting tool T2 is brought into contact with the distal end hard portion 19 from the front and moved rearward to the position B as it is. Further, the second cutting tool T2 that continues to rotate is revolved 360 ° around the axis 19a with the front-rear position and the inclination angle fixed, thereby forming the outer peripheral side portion of the tapered portion 41.
Further, the second cutting tool T2 is pulled forward from the hole on the outer peripheral side, the second cutting tool T2 is slightly moved to the inner peripheral side, and the inclination angle with respect to the distal end hard portion 19 is slightly reduced, and then around the axis T2a. While rotating, the rear end portion of the second cutting tool T2 is brought into contact with the distal end hard portion 19 from the front, and further moved backward to the position B. Then, after reversing to position B, the second cutting tool T2 is revolved 360 ° around the axis 19a with its front-rear position and inclination angle fixed, so that there is a gap between the inner peripheral portion and the outer peripheral portion of the tapered portion 41. The remaining portion is cut to complete the entire tapered portion 41 having an annular shape when viewed from the front.

An ultrasonic probe 45 having an annular shape in front view is attached to the front portion of the central cylindrical portion 20 of the distal end hard portion 19.
The ultrasonic probe 45 is formed by integrating an annular backing material 46, a piezoelectric element 47, and an acoustic lens 48 in the radial direction. The front end portions of the two flexible printed circuit boards 49 are fixed at two positions in the circumferential direction of the rear end portion of the piezoelectric element 47, and each flexible printed circuit board 49 and the piezoelectric element 47 can be electrically connected to each other.

The ultrasonic probe 45 penetrates the rear end portions of the two flexible printed circuit boards 49 from the front to the rear with respect to the tapered portion 41 of the distal end hard portion 19 and the two axis parallel portions 40, and then backs the backing material. The rear end face 46 is brought into surface contact with the ultrasonic probe contact face 24 (see FIG. 7), so that it is attached to the distal end hard portion 19.
As shown in FIGS. 7 and 8, the flexible insertion hole 39 of the distal end hard portion 19 has the rear end portion of the taper portion 41 connected to the front end portion of the axis parallel portion 40. There is no step (in the radial direction) at the connection portion (portion C in FIG. 8) between the (outer peripheral portion) and the (outer peripheral portion) of the front end portion of the axis parallel portion 40. Further, the inner peripheral portion of the front end portion of the pair of axis parallel portions 40 of the distal end hard portion 19 is positioned forward of the rear end position of the taper portion 41 (the inner peripheral portion of the front end portion of the pair of axis parallel portions 40 is tapered. It also serves as the inner peripheral part of the rear part of the part 41). Therefore, although the outer peripheral part of the taper part 41 approaches the inner peripheral side toward the rear, the rear part (the part located rearward from the position A) of the taper part 41 is not narrowed (the radial dimension is not shortened). . Therefore, when the rear end portion of the flexible printed board 49 is inserted into the tapered portion 41 and the axis parallel portion 40 from the front (when passing through), the rear end portion of the flexible printed board 49 may be caught on the inner surface of the flexible insertion hole 39. There is almost no. Accordingly, the assembly workability (yield) of the ultrasonic endoscope 10 is good.
The rear end portions of the two flexible printed boards 49 extending rearward from the ultrasonic probe 45 pass through the insertion portion 12, the operation portion 11, and the ultrasonic image transmission tube 14 to reach the ultrasonic connector portion. It extends.

A front end fixing member 50 having an annular shape and made of an insulating material is fixed to the front end portion of the central cylindrical portion 20 of the distal end hard portion 19. Since the front end fixing member 50 and the distal end hard portion 19 (the ultrasonic probe contact surface 24) sandwich the ultrasonic probe 45 from the front and rear, the ultrasonic probe 45 is fixed to the distal end hard portion 19. In addition, a front annular groove 51 similar to the rear annular groove 30 is recessed in the outer peripheral surface of the front end fixing member 50.
Positioned between the outer peripheral surface of the outer peripheral side cylindrical portion 27 of the distal end hard portion 19, the outer peripheral surface of the ultrasonic probe 45 (acoustic lens 48), and the rear annular groove 30 and the front annular groove 51 of the outer peripheral surface of the front end fixing member 50. The part to be configured constitutes the balloon mounting part 52.

A flexible water injection tube 53 (balloon water injection conduit) and a suction tube 54 (balloon suction conduit) are disposed inside the insertion portion 12, the operation portion 11, the universal tube 13, and the connector. Yes (see FIGS. 6, 9 and 10). A water supply port and a suction base protrude from the surface of the connector portion, the rear end portion of the water injection tube 53 is connected to the water supply port, and the rear end portion of the suction tube 54 is connected to the suction base. (Not shown). On the other hand, the front end portion of the water injection tube 53 is connected to the rear portion of the water injection side partition wall 25 (balloon water injection hole 35) of the distal end hard portion 19, and the front end portion of the suction tube 54 is connected to the suction side partition wall 26 (balloon suction wall). It is connected to the rear part of the hole 31) (see FIGS. 6, 9, and 10).
Further, inside the operation unit 11, a water supply cylinder and a suction cylinder (both are divided into two parts, the front and rear) are connected to the intermediate portions of the water injection tube 53 and the suction tube 54, respectively. (Not shown) are provided in a fixed state. The outer ends of the water supply cylinder and the suction cylinder are open on the surface of the operation unit 11. A water supply button 56 and a suction button 57 are respectively attached to the water supply cylinder and the suction cylinder so as to freely protrude and retract through the respective outer openings.

Next, the usage procedure and operation of the ultrasonic endoscope 10 having the above configuration will be described.
First, the connector part of the ultrasonic endoscope 10 is connected to the processor, and the ultrasonic connector part is connected to the ultrasonic diagnostic apparatus. Further, a negative pressure source (not shown) is connected to the suction cap provided in the connector portion of the ultrasonic endoscope 10, and a water supply source (not shown) is connected to the water supply port.
When a light source provided inside the processor is caused to emit light, light generated by this light source is supplied from the connector part to the light guide fiber bundle, and is emitted to the outside from a pair of illumination lenses L2 provided at the distal end part of the insertion part 12. Is done. Further, an observation image that has passed through the objective lens L1 and is picked up by the image pickup device 16A is converted into image data by the image pickup device 16A, and this image data is transmitted to the processor via the image signal cable 16B. The processor processes the image data and displays it on the monitor.
Further, the balloon mounting portion 52 of the insertion portion 12 is covered with a cylindrical balloon (not shown) made of an elastic material (for example, silicon rubber) and opened at both ends, and a thick portion formed at the opening edge portions before and after the balloon. Is fitted into the rear annular groove 30 and the front annular groove 51. As described above, since the small diameter constricted portion 29 is formed in the outer peripheral side cylindrical portion 27 of the distal end hard portion 19, the inner surface of the balloon does not adhere to the entire small diameter constricted portion 29 (small diameter constricted portion). A gap is formed between the center of the balloon and the balloon).

  The suction button 57 provided on the operation unit 11 is pushed from the initial position into the operation unit 11. Then, since the negative pressure (suction force) of the negative pressure source reaches the entire suction tube 54, the negative pressure reaches the balloon from the tip opening 33 of the balloon suction hole 31. However, the outer opening of the tip opening 33 has a long hole shape (not a circular hole) (the opening area on the front end side of the tip opening 33 is the rear end of the tip opening 33 (connecting portion with the parallel portion 32)). Furthermore, since the tip opening 33 is formed in the small-diameter constricted portion 29, the entire outer opening of the tip opening 33 is immediately present by the balloon (between the balloon mounting portion 52 and the inner surface of the balloon). As a result, the air that was present between the balloon mounting portion 52 and the inner surface of the balloon is trapped in the balloon mounting portion 52 and the inner surface of the balloon. The possibility of remaining in between is small. That is, there is a possibility that a part of the outer opening of the tip opening 33 is blocked by the balloon before the air existing between the balloon mounting part 52 and the inner surface of the balloon is (almost) completely sucked. The other part of the outer opening of the tip opening 33 is likely to remain open before the air is (nearly) completely aspirated, so it exists between the balloon mounting 52 and the inner surface of the balloon. There is a high possibility that the air that has been removed can be almost completely sucked from the tip opening 33 (after the air suction is completed, the entire outer opening of the tip opening 33 is blocked by the balloon, The inner surface of the balloon is in close contact).

Next, the insertion portion 12 is inserted into the body cavity of the subject while watching the monitor, and the water supply button 56 provided on the operation portion 11 is pushed into the inside of the operation portion 11 from the initial position. Then, deaerated water is supplied from the water supply source to the water injection tube 53, and this deaerated water is supplied from the balloon water injection hole 35 to between the balloon mounting portion 52 and the inner surface of the balloon to inflate the balloon.
Since the tapered portion 41 of the distal end hard portion 19 has a tapered shape that decreases in diameter from the front to the rear, as shown in FIGS. 9 and 10, the tapered portion 41 (rear end portion) is formed on the suction side partition wall 26 ( And the connection part between the front-end part of the water injection side partition wall 25) and the outer peripheral side cylindrical part 27 is not broken, and the balloon water injection hole 35 (and the suction side partition wall 26 of the water injection side partition wall 25 is not broken. The balloon suction holes 31) are not in communication with each other. Therefore, there is no possibility that the deaerated water that has flowed into the balloon water injection hole 35 flows from the taper portion 41 to the entire flexible insertion hole 39 and adheres to the flexible printed circuit board 49 located in the flexible insertion hole 39.
On the other hand, if the hole corresponding to the taper part 41 is formed using the 2nd cutting tool (cylindrical end mill same as the 1st cutting tool T1) shown in FIG. 11 which is a comparative example instead of the taper part 41 ( When the second cutting tool is moved rearward to position B in FIG. 11, the hole (rear end portion) corresponding to the taper portion 41 has a front end portion and an outer periphery of the suction side partition wall 26 (and the water injection side partition wall 25). The connection part between the side cylindrical parts 27 is broken (see the phantom line in FIG. 9), and the taper part 41 and the suction side partition wall 26 (and the water injection side partition wall 25) communicate with each other. Therefore, in this case, the deaerated water that has flowed into the balloon water injection hole 35 flows into the flexible insertion hole 39 and adheres to the two flexible printed boards 49 positioned in the flexible insertion hole 39.

  When an electric current is supplied from the ultrasonic diagnostic apparatus to one flexible printed circuit board 49 after the inflated balloon is brought into contact with the body cavity wall, the piezoelectric element 47 to which a voltage is applied via the flexible printed circuit board 49 vibrates. (However, excessive vibration is suppressed by the backing material 46). Then, the ultrasonic wave generated by the piezoelectric element 47 reaches the body cavity wall via the acoustic lens 48, the deaerated water, and the balloon, and the sound wave reflected by the body cavity wall is received by the piezoelectric element 47 and converted into a voltage signal. Since this voltage signal is sent to the ultrasonic diagnostic apparatus via the other flexible printed circuit board 49, an ultrasonic image is displayed on the monitor.

  Further, after the endoscopic operation by the ultrasonic endoscope 10 is completed, when the suction button 57 provided on the operation unit 11 is pushed into the operation unit 11 from the initial position, a negative pressure (suction) of the negative pressure source is generated. Force) reaches between the balloon mounting portion 52 and the inner surface of the balloon via the balloon suction hole 31 (suction tube 54), so that degassed water is sucked by the negative pressure source and the inner surface of the balloon is moved to the balloon mounting portion 52. In close contact. Therefore, the insertion portion 12 of the ultrasonic endoscope 10 can be smoothly pulled out from the body cavity of the subject.

  In addition, when the insertion unit 12 is inserted into the body cavity of the subject without mounting the balloon on the balloon mounting unit 52, the ultrasonic endoscope 10 operates the suction button 57 provided on the operation unit 11 to perform the above negative operation. By applying the negative pressure (suction force) of the pressure source to the balloon suction hole 31 via the suction tube 54, it is possible to suck the filth (body fluid, etc.) of the subject by the negative pressure source.

After the ultrasonic diagnosis and the suction operation are completed and the insertion portion 12 is pulled out from the body cavity of the subject, the balloon suction hole 31, the balloon water injection hole 35, the water injection tube 53, and the suction tube 54 are cleaned as shown in FIG. It is possible to clean with the brush 60. The cleaning brush 60 includes a linear body portion 61 having flexibility, and a brush portion 62 provided at the distal end portion of the body portion 61.
For example, after removing the suction button 57 from the ultrasonic endoscope 10, the tip of the cleaning brush 60 (on the brush portion 62 side) is connected to the suction tube 54 through the suction cylinder, for example, from the outside opening of the suction cylinder. It is inserted into the front half (portion located in the insertion portion 12), and the tip of the cleaning brush 60 is inserted into the balloon suction hole 31. Then, the front end portion of the cleaning brush 60 smoothly passes over the connecting portion of the parallel portion 32 and the front end opening portion 33 (if they form an obtuse angle with each other), and from the outer opening of the front end opening portion 33 as shown in FIG. It protrudes outside the hard tip 19. Accordingly, the cleaning brush 60 (brush portion 62) can clean the front half of the suction tube 54 and the entire inner peripheral surface of the balloon suction hole 31 (parallel portion 32, tip opening portion 33). Further, after removing the negative pressure source from the suction base, the distal end portion of the cleaning brush 60 is inserted into the suction base, and the distal end portion of the cleaning brush 60 is connected to the latter half portion of the suction tube 54 (connector portion and universal tube 13). If the suction cylinder is inserted through a portion located inside the suction tube 54, the entire inner peripheral surface of the rear half of the suction tube 54 can be cleaned by the cleaning brush 60 (brush portion 62).
On the other hand, after the water supply button 56 is removed from the ultrasonic endoscope 10, the front end portion of the cleaning brush 60 (brush portion 62 side) is inserted from the outer opening of the water supply cylinder through the water supply cylinder. When inserted into the portion (the portion located in the insertion portion 12) and the balloon water injection hole 35, the tip of the cleaning brush 60 is connected to the parallel portion 36 and the tip opening 37 (if they form an obtuse angle with each other) And smoothly protrude from the outer opening of the tip opening 37 to the outside of the tip hard portion 19 (not shown). Accordingly, the cleaning brush 60 (brush portion 62) can clean the front half of the water injection tube 53 and the entire inner peripheral surface of the balloon water injection hole 35 (parallel portion 36, tip opening 37). Further, after removing the water supply source from the water supply port, the front end portion of the cleaning brush 60 is inserted into the water supply port, and the front end portion of the cleaning brush 60 is inserted into the latter half of the water tube 53 (inside the connector portion and the universal tube 13). If the water supply cylinder is inserted through the (positioned portion), the entire inner peripheral surface of the rear half of the water tube 53 can be cleaned by the cleaning brush 60 (brush portion 62).

As mentioned above, although this invention was demonstrated using the said embodiment, this invention can be implemented, giving various deformation | transformation.
For example, the tip openings 33 and 37 may be formed only in one of the balloon suction hole 31 and the balloon water injection hole 35, and the other may be formed, for example, in a tip opening extending in a direction orthogonal to the parallel parts 32 and 36. Good.
Furthermore, the cross-sectional shape of the axis parallel part 40 does not have to be a complete arc shape, and may be a substantially arc shape.
Further, the ultrasonic probe 45 does not need to have an annular shape, and may be a so-called convex type, for example.
Further, when the flexible insertion hole 39 is formed in the distal end hard portion 19, the taper portion 41 may be formed first by the second cutting tool T2, and then the axis parallel portion 40 may be formed by the first cutting tool T1.
The number of the axis parallel parts 40 provided in the distal end hard part 19 may be a plurality other than two.

DESCRIPTION OF SYMBOLS 10 Ultrasonic endoscope 11 Operation part 11a Treatment tool insertion port protrusion 11b Cap 12 Insertion part 12a Outer tube 13 Universal tube 14 Ultrasound image transmission tube 15 Bending operation lever 17 Bending part 18 Flexible tube part 19 Hard tip part 19a Axis 20 Central cylindrical portion 21 Central concave portion 22 Objective lens hole 23 Illumination lens hole 24 Ultrasonic probe contact surface 25 Water injection side partition wall 26 Suction side cut wall 27 Outer peripheral side cylindrical portion 28 Annular flange (large diameter portion)
29 Small-diameter constricted portion 30 Rear annular groove 31 Balloon suction hole (balloon suction conduit)
32 Parallel portion 33 Tip opening 35 Balloon injection hole (balloon injection conduit)
36 Parallel portion 37 Tip opening 39 Flexible insertion hole 40 Axis parallel portion 41 Tapered portion 45 Ultrasonic probe 46 Backing material 47 Piezoelectric element (vibrator)
48 acoustic lens 49 flexible printed circuit board 50 front end fixing member 51 front annular groove 52 balloon mounting part 53 water supply tube (balloon water injection conduit)
54 Suction tube (balloon suction line)
56 Button for water supply 57 Button for suction 60 Brush 61 for cleaning Body part 62 Brush part L1 Objective lens L2 Illumination lens T1 First cutting tool T2 Second cutting tool T1a T2a Axis line

Claims (5)

An ultrasonic probe which is provided on the surface of the distal end portion of the insertion portion extending from the operation portion and is covered by a balloon detachably attached to the distal end portion;
A hard tip portion that forms part of the insertion portion and supports the ultrasonic probe;
A balloon suction conduit disposed inside the operation portion and the insertion portion and having a tip opening formed at one end thereof opened at a balloon mounting portion on the surface of the tip hard portion;
A balloon irrigation conduit disposed at a position different from the distal end opening of the balloon mounting portion, the distal end opening disposed inside the operation unit and the insertion unit and formed at one end;
In an ultrasonic endoscope comprising:
A portion provided in the distal end hard portion of at least one of the balloon suction conduit and the balloon injection conduit,
A parallel part parallel to the axis of the hard tip part,
The tip opening extending from the tip of the parallel portion toward the tip of the insertion portion and inclined at an acute angle with respect to the axis;
An ultrasonic endoscope comprising: The ultrasonic endoscope according to claim 1,
Ultrasound endoscopy where the opening area of the balloon opening portion side end portion of the tip opening portion of the balloon suction conduit and the balloon water injection conduit is larger than the cross-sectional area of the connecting portion of the tip opening portion and the parallel portion. mirror. The ultrasonic endoscope according to claim 2, wherein
The opening shape of the balloon attachment portion side end portion of the tip opening portion of the balloon suction conduit and the balloon injection conduit is longer than the length in the circumferential direction of the insertion portion. Ultrasound endoscope that has a hole shape. The ultrasonic endoscope according to any one of claims 1 to 3,
The balloon mounting portion of the distal end hard portion has a large diameter portion, and a small diameter constriction portion adjacent to the large diameter portion and having a short radial distance around the axis as compared with the large diameter portion. ,
An ultrasonic endoscope in which the tip opening portion of the balloon suction conduit and the balloon water injection conduit is formed in the small diameter constricted portion. The ultrasonic endoscope according to claim 4, wherein
The balloon mounting part is
A pair of large diameter portions spaced apart in the axial direction;
The small diameter constricted portion in which the radial distance gradually decreases as extending in a direction approaching each other from the pair of large diameter portions;
An ultrasonic endoscope comprising:

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