JP3183067B2 - Fluid supply / discharge device for ultrasonic endoscope - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a fluid supply / discharge device for an ultrasonic endoscope, which is capable of feeding an ultrasonic transmission medium and aspirating a body fluid.

[0002]

2. Description of the Related Art An ultrasonic endoscope is configured such that an endoscope observation mechanism and an ultrasonic observation mechanism are provided at a distal end portion of an insertion portion into a body cavity. Is
The configuration shown in FIG. 5 is conventionally used. In the drawing, reference numeral 1 denotes an insertion portion, and an endoscope main body 2 of the insertion portion 1 is formed with an endoscope observation mechanism mounting portion 2a by chamfering the side surface so as to be partially flat. The illumination window 3 and the observation window 4 are mounted on the endoscope observation mechanism mounting section 2a, and a cleaning fluid is supplied toward the observation window 4 to the step formed by the endoscope observation mechanism mounting section 2a. Nozzle 5 is open. Further, a treatment tool lead-out port 6 for leading out a forceps and other treatment tools is opened at a position in front of the observation window 4 in the endoscope observation mechanism mounting portion 2a. Further, a cap 7 protrudes from a distal end surface 2b of the distal end portion main body 2 in the insertion portion 1, and an ultrasonic vibrator 8 is provided in the cap 7.

When performing an ultrasonic diagnosis using the ultrasonic vibrator 8, it is necessary to prevent air from intervening between the ultrasonic vibrator 8 and the inner wall of the body cavity. To this end, an ultrasonic transmission medium is sealed inside the cap 7, but it is necessary to supply an ultrasonic transmission medium such as degassed water in order to eliminate air between the cap 7 and the inner wall of the body cavity. There is.
A treatment instrument insertion channel is connected to the treatment instrument outlet 6, and the treatment instrument insertion channel extends to a main body operation section connected to the insertion section 1, and introduces a treatment instrument provided in the main body operation section. Connected to the unit. Thus, by using the insertion path of the treatment instrument as a supply path of the ultrasonic transmission medium and connecting the ultrasonic transmission medium supply source to the treatment instrument introduction section, the treatment instrument outlet port 6 can be connected via the treatment instrument insertion channel. An ultrasonic transmission medium is supplied. In addition, in order to secure an observation field of view in the body cavity, etc., suction of body fluid or the like in the observation target portion is performed, and the insertion path of the treatment tool is also used as this suction path. In this case, The treatment instrument insertion channel is connected to a suction source and operated by a suction valve provided in the main body operation unit, or a syringe or other suction source is connected to the treatment instrument introduction unit.

[0004]

As described above, when the treatment tool outlet is provided in front of the observation window, the length of the distal end body of the insertion portion in the axial direction becomes longer. In particular, in the ultrasonic endoscope, since the cap for accommodating the ultrasonic vibrator is provided in a state of protruding further forward from the distal end main body, a hard portion at the distal end portion of the insertion portion is provided. Significantly longer. The body cavity into which the insertion part is inserted is in a complicatedly curved state, and there are some parts that are considerably narrowed. Therefore, if the hard part at the distal end of the insertion part becomes long, the insertion operation of the insertion part into the body cavity is performed. However, there are problems such as worsening of the sex and significant pain to the patient. Here, the treatment tool outlet is disposed at a position in front of the observation window, but if the arrangement is moved to an appropriate position, the length of the hard portion can be reduced to some extent.
However, when the treatment tool is led out from the treatment tool outlet, it is dangerous if the treatment tool cannot be contained in the observation field of view obtained through the observation window. The length of the tip body cannot be reduced.

The present invention has been made in view of the above points, and an object of the present invention is to make it possible to shorten a hard portion at the tip of an ultrasonic endoscope.

[0006]

In order to achieve the above-mentioned object, the present invention provides an endoscope observation mechanism at a distal end main body of an insertion portion into a body cavity, and a cap which protrudes from a distal end surface. It was mounted in the ultrasonic endoscope comprising providing an ultrasonic transducer within the cap, the tip body
Is located at a position avoiding the endoscope observation mechanism
A concave groove is formed on two surfaces, a surface and a tip surface, and a fluid passage is communicated with the concave groove so that the fluid passage can be connected to an ultrasonic transmission medium supply source or a suction source. The feature is.

[0007]

[Effect] An ultrasonic endoscope is usually used for inspection and diagnosis, and even if an affected part is found, a treatment tool is inserted through a treatment tool insertion channel of the ultrasonic endoscope. Is very rarely performed. Therefore, in the present invention, a treatment tool outlet for guiding the treatment tool is not provided. As a result, the illumination window and the observation window can be arranged on the distal end side of the distal end portion main body. As a result, the length of the hard portion can be reduced by the amount excluding the treatment instrument outlet. However, the treatment instrument outlet is used not only for dispensing the treatment instrument but also as a path for supplying the ultrasonic transmission medium and sucking the body fluid and the like. For this purpose, a fluid passage for supplying and sucking liquid is required, but the arrangement position of the fluid passage is not limited as in the treatment instrument outlet. Therefore, the fluid passage is opened in a portion of the side surface of the distal end main body that does not interfere with the endoscope observation mechanism. Therefore, the opening of the fluid passage does not enter the field of view of the endoscope observation mechanism.

When suction is performed through the fluid passage, the inner wall of the body cavity may be sucked through the opening of the fluid passage. As described above, since the opening of the fluid passage is provided at a position that cannot be confirmed by the endoscope observation mechanism, it cannot be detected that the inner wall of the body cavity has been sucked into the opening, and the suction is continued as it is. In addition, even if the suction is stopped, the inner wall of the body cavity is held in a suctioned state due to the negative pressure in the passage, and if the insertion portion is moved in this state, the inner wall of the body cavity is pulled and is significantly damaged. Will be. However, since the opening portion in the fluid passage is open to the concave groove extending from the side surface toward the distal end surface,
The opening is continuously open on two surfaces, the side surface and the distal end surface of the distal end portion main body. Therefore, even if the inner wall of the body cavity is in contact with the portion of the concave groove that opens to the side surface of the distal end body, the inner wall of the body cavity is not sucked because the distal end surface is not closed. In particular, since the cap projects from the distal end surface of the distal end body, and the opening on the distal end surface side is located near the cap, the inner wall of the body cavity does not come into contact with this portion. Therefore, even if the fluid passage is opened at a position outside the field of view of the endoscope observation mechanism,
There is no inconvenience such as damage to the inner wall of the body cavity.

The fluid passage must have a somewhat large diameter, and has a diameter substantially the same as that of the conventional treatment tool insertion channel. The fluid passage has an ultrasonic transmission medium supply source or a suction source. Are detachably connected to each other, so that a body having substantially the same mechanism as the treatment instrument introduction section is provided in the main body operation section, and the treatment instrument introduction section is provided with a fluid having substantially the same structure as the treatment instrument insertion channel. Can be used as a passage. With this, the conventional insertion path of the treatment instrument is used as it is, and as a fluid passage in the distal end body,
An opening can be made in the concave groove, so that the configuration of the distal end body can be changed only slightly. However, if a structure substantially the same as that of the treatment instrument introduction portion and substantially the same structure as the treatment instrument insertion channel is provided, an operator or the like may erroneously insert the treatment instrument into the fluid passage. . Since the opening of the fluid passage cannot be observed by the endoscope observation mechanism, it is dangerous if the treatment tool is led out from the fluid passage. In order to avoid such a situation, the treatment instrument may be prevented from being inserted by bending the fluid passage halfway. Of course, even if the fluid passage is bent, the function of supplying and discharging the fluid does not substantially decrease.

[0010]

Embodiments of the present invention will be described below in detail with reference to the drawings. First, FIG. 1 shows a main configuration of an ultrasonic endoscope. In the figure, reference numeral 10 denotes a main body operation unit, and 11 denotes an insertion unit. The insertion portion 11 has a flexible portion 11a for most of the length from the portion connected to the main body operation portion 10, and the flexible portion 1a.
An angle portion 11b is connected to 1a, and a tip body 11c is connected to the angle portion 11b. Angle part 11
b allows an angle operation to turn the tip body 11c in a desired direction.
Is provided with an endoscope observation mechanism.
Is provided with an ultrasonic observation mechanism on the tip end surface thereof.

FIG. 2 shows the appearance of the distal end portion of the insertion portion 11. As is clear from the figure, the distal end main body 11c of the insertion portion 11 is chamfered to form a flattened endoscope observation mechanism mounting portion 12. An illumination window 13 for illuminating the inside of a body cavity is provided in the endoscope observation mechanism mounting section 12.
And an observation window 14 for observing the inside of the body cavity,
A nozzle 15 for supplying a cleaning fluid toward the observation window 14 is opened at a step portion on the base end side of the endoscope observation mechanism mounting portion 12. A cap 17 is provided so as to protrude from a distal end surface 16 of the distal end portion main body 11c, and an ultrasonic vibrator 18 is provided inside the cap 17. Regarding the above points, there is no particular difference from the above-mentioned prior art.

Here, the distal end main body 11c of the insertion portion 11 is not provided with a treatment instrument outlet, and therefore, the length of the distal end main body 11c can be shortened by the amount that the treatment instrument outlet is not attached. However, since the treatment tool outlet is also used as a supply and discharge port of a fluid for supplying an ultrasonic transmission medium and sucking a body fluid or the like, the supply and discharge port of this fluid is provided.

For this reason, a portion different from the endoscope observation mechanism mounting portion 12 in the peripheral torso of the distal end portion main body 11c, FIG.
In this case, the position of the endoscope observation mechanism mounting portion 12 is approximately 9
A concave groove 19 is formed at a position where the phase is changed by 0 °. By extending the concave groove 19 toward the distal end face 16 in the axial direction of the distal end body 11c, the peripheral body side surface and the distal end face 16 are continuously formed in the distal end body 11c. It is in an open state. And
The recess 19 has a fluid passage 2 provided in the tip body 11c.
0 is open.

A communicating portion 20a to the concave groove 19 in the fluid passage 20 is oriented in a direction orthogonal to the axis of the tip main body 11c. It is directed in the axial direction of 11c, extends through the insertion section 11 to the main body operation section 10, and is connected to the connection section 21 provided in the main body operation section 10.
At least an ultrasonic transmission medium supply source can be detachably connected to the connection section 21.

FIG. 1 shows an example of these ultrasonic transmission medium supply sources. The ultrasonic transmission medium supply source includes a tank 30 and an air pump 31 that pressurizes the liquid level in the tank 30. A pipe 32 connected from the air pump 31 to the liquid level in the tank 30 has an air pump 31.
An electromagnetic switching valve 33 is provided to switch between a state in which the tank is connected to the tank 30 and a state in which the tank is opened to the atmosphere. A liquid feed pipe is mounted below the liquid level. The end is detachably connected to the connection part 21. The switching control of the electromagnetic switching valve 33 is performed by, for example, a foot switch or the like. On the other hand, the suction source can also be detachably connected to the connection portion 21. In this case, a negative pressure generating mechanism such as a syringe is used as the suction source.
However, the fluid passage 20 is branched from the connecting portion 21 and connected to the suction device, and the operation of the suction device is controlled by the main body operating portion 10.
The control may be performed by a valve provided in the above.

The present embodiment is constructed as described above, and the ultrasonic endoscope itself is operated in the same manner as the conventional art. However, since the ultrasonic endoscope shown in this embodiment is not provided with a treatment instrument insertion path, even if an affected part is found with this ultrasonic endoscope, it is not possible to perform treatment using the treatment instrument. No, treatment is performed using other mechanisms. However, since the length of the hard portion of the distal end main body 11c of the insertion portion 11 is reduced by the absence of the treatment instrument outlet, the insertion of the distal end main body 11c into a thin and bent insertion path or the like is difficult. The insertion operability is significantly improved, and the pain of the patient is greatly reduced.

When the distal end of the insertion portion 11 is guided to a required observation target portion, the inspection and diagnosis are performed using an endoscope observation mechanism and an ultrasonic observation mechanism. Here, when observing using the endoscope observation mechanism, if a bodily fluid or other dirt is present in the body cavity, a suction source is connected to the connection unit 21,
The dirt is sucked and removed from the groove 19 through the fluid passage 20. In order to clean the inner wall of the body cavity or the like, an ultrasonic transmission medium supply source is connected to the connection unit 21 instead of the suction source, and the ultrasonic transmission medium is supplied from the liquid passage 20 through the concave groove 19. . Of course, the inner wall of the body cavity can also be washed by supplying water from the nozzle 15. As a result, the observation field of view obtained through the observation window 14 is improved, and observation by the endoscope observation mechanism becomes possible.

On the other hand, an ultrasonic inspection using an ultrasonic observation mechanism is performed by operating an ultrasonic transducer 18 provided in a cap 17. Here, the illustrated ultrasonic vibrator 18 is of a type that performs a so-called radial scan, in which the ultrasonic vibrator 18 is rotated to transmit ultrasonic pulses at predetermined angles. However, when performing the ultrasonic scanning, it is necessary to prevent air from intervening between the ultrasonic transducer 18 and the inner wall of the body cavity in order to minimize the attenuation of the ultrasonic waves. Although an ultrasonic transmission medium is sealed in the cap 17, since air may be interposed between the cap 17 and the inner wall of the body cavity, an ultrasonic transmission medium supply source is connected to the connection portion 21. The ultrasonic transmission medium is supplied from the fluid passage 20 into the body cavity through the concave groove 19, and the ultrasonic signal is transmitted and received in a state where the cap 17 is immersed in the ultrasonic transmission medium.

By the way, as shown in FIG. 3, for examining and diagnosing a body cavity such as the esophagus, the distal end main body 1 is required.
1c comes into contact with the inner wall of the body cavity. When the above-described suction is performed in this state, the suction force is applied not only to the body fluid and the like but also to the inner wall of the body cavity. However, in order to shorten the length of the distal end body 11c of the insertion portion 11, the fluid passage 29 is provided at a position away from the endoscope observation mechanism mounting portion 12 and out of the field of view obtained through the observation window 14. Since the opening is formed in the concave groove 19, it cannot be confirmed whether or not the suction force acts on the inner wall of the body cavity.

However, as shown in FIG. 4, the fluid passage 20 is connected to the groove 19, which is open to the outside.
Is opened not only on the side surface of the distal end body 11c actually in contact with the inner wall of the body cavity, but also on the distal end surface 16, and since the openings on these two surfaces are continuous, the concave groove 19 is formed by the inner wall of the body cavity. The whole is rarely completely closed. In particular, a cap 17 projects in front of the opening on the distal end face 16, and the cap 17 exerts a function of reliably preventing the inner wall of the body cavity from contacting the opening on the distal end face 16 side.

Therefore, even if the opening of the concave groove 19 in the distal end body 11c is in contact with the inner wall of the body cavity, there is no danger that the entire concave groove 19 will be hermetically closed. It is kept in the secured state. As a result, although a slight suction force acts on the inner wall of the body cavity, there is no danger of being completely drawn into the fluid passage 20 and being damaged, and there is no danger that the suction becomes impossible. Further, when the suction is stopped, even if the inside of the fluid passage 20 is maintained in a negative pressure state, the inner wall of the body cavity is immediately separated from the concave groove 19, so that even if the insertion portion 11 is immediately moved, The inner wall of the body cavity is not pulled and damaged.

The connecting portion 21 and the fluid passage 20
May have a completely different structure from the treatment instrument introduction section and the treatment instrument insertion channel described in the related art. In this case, the fluid passage 20 has a 90 ° connection at the connection portion to the concave groove 19. It is not necessary to form the bent communication portion 20a. However, an ultrasonic transmission medium supply source can be connected to the connection portion 21, and the fluid passage 20 is branched from the connection portion 21 and connected to a suction device, and the operation of the suction device is transmitted to the main body operation portion 10. In order to control by the provided valve and to increase the passage cross-sectional area of the fluid passage 20 as much as possible, the connecting portion 21 and the fluid passage 20 are connected to the treatment instrument introduction portion and the treatment instrument insertion channel. It is preferable to have the same configuration. As a result, the tip body 11c
There is no need to change other structures.

When the fluid passage 20 is directly opened in the concave groove 19 with the same configuration as the treatment instrument introduction section and the treatment instrument insertion channel, there is a possibility that the operator may erroneously insert the treatment instrument. Since the concave groove 19 is opened at a position out of the field of view of the observation window 14 constituting the endoscope observation mechanism, the treatment tool drawn out of the concave groove 19 cannot be confirmed. Therefore, there is a fear that the inner wall of a healthy body cavity may be damaged by the treatment tool. However, the fluid passage 20
Since the communicating portion 20a to the concave groove 19 is turned by approximately 90 °, even if the treatment tool is inserted into the fluid passage 20, it does not lead out of the concave groove 19 to the outside. Is ensured.

Here, an ultrasonic transmission medium, a body fluid, and the like flow through the fluid passage 20, but the flow speed of these fluids is not so high due to the nature thereof.
Even if it is bent by 0 °, it does not hinder the flow of the special fluid. Further, since the fluid passage 20 is used as a suction passage, it must be cleaned each time it is used. Usually, the cleaning of the pipeline is performed by inserting a brush and rubbing the inner wall.
Since the communication portion 20a bent at 0 ° is provided,
The brush cannot be completely inserted. However, since the communication portion 20a has only a small length in the vicinity of the opening to the concave groove 19, the brush is inserted from the connection portion 21 side to reach the communication portion 20a of the fluid passage 20, and the cleaning is performed. Further, the slightly remaining communication portion 20a may be cleaned from the concave groove 19 side with another brush.

[0025]

As described above, according to the present invention, a groove is formed from the side surface of the distal end body to the distal end surface at a position avoiding the portion where the endoscope observation mechanism is provided. Since the fluid passages are communicated with each other, the fluid passages are substantially continuously opened on two surfaces, the side surface and the distal end surface, of the distal end portion main body. There is no need to open the treatment tool outlet at the front of the installation site, and the hard portion at the tip of the insertion portion can be shortened, the insertion operability becomes good, and the pain of the patient can be reduced, and Even if suction is performed outside the field of view of the endoscope observation mechanism, it is possible to reliably prevent inconveniences such as suctioning the inner wall of the body cavity by the suction force.

[Brief description of the drawings]

FIG. 1 is an external view of a main part of an ultrasonic endoscope showing one embodiment of the present invention.

FIG. 2 is an enlarged view of a distal end portion of the ultrasonic endoscope of FIG.

FIG. 3 is an operation explanatory view of the ultrasonic endoscope.

FIG. 4 is a sectional view taken along line XX of FIG. 3, which shows a state in which other mechanisms are not mounted.

FIG. 5 is an external view of a distal end portion of a conventional ultrasonic endoscope.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Main-body operation part 11 Insertion part 11c End part main body 12 Endoscope observation mechanism mounting part 16 End surface 17 Cap 18 Ultrasonic transducer 19 Concave groove 20 Fluid passage 20a Communication part 21 Connection part

Claims (2)

(57) [Claims] 1. An ultra-computer comprising: an endoscope observation mechanism provided at a distal end main body of an insertion portion to be inserted into a body cavity; a cap mounted so as to protrude from a distal end surface; In the acoustic endoscope, the distal end main body includes:
In position avoiding the disposed position of the endoscope observation mechanism of that, and a side surface
A concave groove is formed on two surfaces of the groove and the distal end surface, and a fluid passage is communicated with the concave groove so that the fluid passage can be connected to an ultrasonic transmission medium supply source or a suction source. A fluid supply / discharge device for an ultrasonic endoscope. 2. The fluid supply device for an ultrasonic endoscope according to claim 1, wherein the fluid passage is bent in the middle so that a treatment tool such as forceps cannot be inserted.