JPH0221852A - Ultrasonic endoscope - Google Patents

Abstract

PURPOSE:To obtain an ultrasonic guide sticking function of a sticking needle having short forward end bard portion, which can be favorably inserted in a human body by positioning this side end of the sticking needle accommodating portion on this side of a hinge of a bent piece of the foremost and side. CONSTITUTION:In the forward end portion 1, a sticking needle accommodating portion 20 comprising a portion provided in a forward end block 12 and a connecting pipe 26 is disposed in such a manner that the connecting pipe 26 is projected over this side end of the forward end block 12. This side end of the connecting pipe 26, that is, this side end of the sticking needle accommodating portion 20 is projected out on this side of a hinge 35 of the foremost end side bent piece 33a connected to the forward end portion 1, that is, a hinge connecting the foremost end side bent piece 33a and the second bent piece 33b. This side end of the connecting pipe 26 is projected out so that even if the bent forward end portion and the bent portion 2 are bent, it collide with the inner wall of the bent piece not to give any influence upon bending. Accordingly, in a practical use, bending is started when the length of the forward end portion is small.

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention provides a human body insertion part that is bendable at least in part, which is inserted into a body cavity to perform optical observation inside the body cavity and ultrasonic examination of the surrounding area. This is an ultrasound guide that inserts a needle into an ultrasound tomographic plane and performs puncture after confirming the insertion state of the needle in an ultrasound tomographic image. The present invention relates to the tip structure of an ultrasound endoscope that has a puncturing function.

[Conventional technology] Ultrasonic endoscopes are capable of making good ultrasound diagnoses of the gastrointestinal wall and deep organs such as the pancreas, which are difficult to diagnose with ultrasound diagnosis from outside the body. It has been greatly developed in recent years because it can be inserted safely and the surface of the lumen wall can be observed using optical observation and the inside of the lumen can be observed simultaneously using ultrasound diagnosis. With this development, in order to further improve diagnostic accuracy, it is desired to develop an ultrasound endoscope having an ultrasound-guided puncturing function. This is done by inserting a needle into the lesion visualized in the ultrasound tomography and collecting the tissue.
This is an attempt to confirm the location of the lesion.

Several methods have been considered to achieve this.

One of them is to install a small electronic linear probe at the tip of the insertion section along the long sleeve of the insertion section, provide an outlet for the puncture needle in front of it, and provide a guide mechanism to adjust the protrusion angle of the puncture needle. There is something to be said.

Bend the puncture needle diagonally forward from the front toward the ultrasonic tomographic plane in the lateral direction of the tip of the insertion part using the electronic linear probe, and guide the needle into the ultrasonic tomographic plane by adjusting the angle and protruding the needle. This allows the needle to be seen in ultrasound tomographic images. (Patent Publication No. 56-158646) Another method is to make the tip of the puncture needle used, which is necessary for penetration into human tissue, a hard part, and the part connected to this part to be a flexible sheath part. , install an electronic competition 1x probe in place of the electronic linear probe, provide an outlet for the puncture needle in front of this probe, and connect the puncture needle insertion path leading to this outlet to the tip of the puncture needle. Another idea is to make the length long enough to accommodate the hard part.

This is because the ultrasonic scanning range of the electronic linear is a plane with parallel ends determined by the length of the probe, so the scanning range is narrow and there is a problem that if the needle sticks out too long, it will jump out of the scanning range. Since the electronic convex scans a fan-shaped scanning range that widens as it goes further into the distance, it has the advantage that the scanning range is wide and the needle can be easily confirmed within the scanning range even if the needle sticks out for a long time. Furthermore, since the length of the probe is shorter in the electronic convex than in the electronic linear, it has the advantage that the ultrasonic probe at the tip can be made shorter.

Furthermore, a puncture needle that can actually be used can be thin for drug injection, but in order to make it possible to collect tissue, it must be thick to some extent, and it cannot be bent within the tissue. It must be rigid as it must be able to insert the puncture needle straight and straight, but it must be long enough to accommodate the hard part of the tip of the puncture needle that leads to the outlet. It is said that by setting it in the same position, it can be ejected smoothly. (Patent application 1986-11017
5 Unpublished〉 [Problem to be solved by the invention] However, to date, no method including the above method has been realized, because the required penetration depth for puncturing is approximately 4 degrees, at least approximately 2 mm, and Adding the length of the part to hold and support the puncture needle, the required length of the puncture needle is approximately 5 CIl, which requires at least approximately 3 CIl, and the puncture needle must be straight without bending in the middle. This is because the material must be rigid, which is a major obstacle, as it must be inserted firmly into the tissue and must be thick to be able to collect tissue.

That is, it is impossible to bend the puncture needle in the middle and make it protrude as disclosed in Japanese Patent Publication No. 56-158646 due to the rigidity of the puncture needle. In order to be able to protrude this, as in Japanese Patent Application No. 63-110175, the passage through which the puncture needle connects to the outlet must be long enough to accommodate the hard tip of the puncture needle. In that case, the tip part would be extremely long, which is the length of the ultrasonic transducer plus the length of the accommodation part of the hard part of the puncture needle tip.If you simply connect a curved part to this, the curved part The rigid tip of the ultrasonic endoscope on the distal side of the ultrasound endoscope is extremely long, making it impossible to insert it into the human body.
This is the reason why it has not been possible to achieve this until now, and the major problem is how to shorten the tip.

The present invention was invented in view of the above-mentioned problems, and it is an object of the present invention to provide an ultrasonic endoscope with a short hard tip and an ultrasonic guide puncture function that can be inserted well into the human body.

[Means for Solving the Problems] The ultrasonic endoscope of the present invention is characterized by an ultrasonic probe, a puncture needle that guides a puncture needle to be inserted into an ultrasound tomographic plane, and accommodates a hard part of its tip. In the ultrasonic endoscope, the ultrasonic endoscope has a rigid body insertion tip end portion having a housing portion and an observation window, and a curved portion in which a plurality of curved pieces connected to the human body insertion tip rigid portion are each connected by a hinge. The front end of the puncture needle accommodating portion is positioned closer to the front than the hinge of the curved piece on the distal end side.

[Function] In the ultrasonic endoscope of the present invention, the near end of the puncture needle storage section in the hard part of the distal end for insertion into the human body is located in front of the hinge of the most distal curved piece in the curved part. As a result, a part of the hard part of the tip of the human body insertion tip is included in the curved part, so even though the hard part of the tip of the human body insertion tip is actually long, the curve starts midway along its length.
In appearance, that is, in actual use, the rigid portion of the tip inserted into the human body begins to curve in a short state.

Examples] Hereinafter, one embodiment of the present invention will be described with reference to the drawings.

FIG. 4 is an overall configuration diagram of the present invention. An operating section 9 consisting of a needle insertion lower, an eyepiece section 8, a cord 1-0 through which air/water/suction pipes and signal lines pass, and a cord for connecting this device to an ultrasonic observation device or a light source device (not shown). Connector part 11,
It consists of

The distal end 1, that is, the rigid portion of the distal end for insertion into a human body, will be explained with reference to FIG. 1, which is a detailed side sectional view of the distal end, and FIG. 2, which is a detailed plan view of the distal end.

The tip portion 1 has a tip block 12, and the tip block 1
A so-called convex type ultrasonic probe 13 in which a large number of ultrasonic transducers are arranged in a convex shape is provided at the tip of the probe 2 . On the outer surface of the tip block 12 located in front of the ultrasonic probe 13 on the transmitting/receiving surface side of the ultrasonic probe, there is an opening 14 cut into the tip block 12, which becomes deeper toward the tip.
The opening surface 14 is provided with an objective lens 15 of the observation optical system, an illumination lens 1.6, an air/water supply nozzle 17 for cleaning the lens surface, etc., and a nozzle for suctioning air, body fluids, etc. in the body cavity. A suction port 18 is provided. Furthermore, in this opening surface 14, on the extension line of the scanning line 19 by the ultrasound probe 13, a puncture needle 22 to be inserted into the ultrasound tomographic plane is guided and its tip hard part 23 is accommodated. Puncture needle housing section 20
An outlet 21 for protruding the puncture needle is provided. The puncture needle 22 used in this ultrasonic endoscope has a needle tip portion and an elongated hard tip portion 23 made of a hard material.
It has a structure in which flexible elongated tubular bodies, so-called sheath parts 24, are connected.

This puncture needle accommodating portion 20 is opened in the tip block 12 along the same plane as the ultrasonic tomographic plane 25 formed by the ultrasound probe 13, and the other end is opened in the tip block 12.
It opens on the rear end side, that is, on the front side. A connecting pipe 26 is provided at the opening on the front side thereof, and a flexible puncture needle insertion tube 27 is connected thereto. The puncture needle accommodating section 20 is a general term for a portion bored in the tip block 12 and a portion of the connecting pipe 26.

28 is a signal cable for the ultrasound probe 13; 29 is an image transmission fiber bundle for transmitting the light collected by the objective lens 15 to the eyepiece 8; and 30 is for irradiating light into the body cavity via the illumination lens 16. This is an optical transmission fiber bundle. Note that the observation optical system consisting of the objective lens 15 and the like is provided so that the protruding puncture needle enters its field of view. Reference numeral 31 indicates an air/water supply pipe line communicating with the air/water supply nozzle 17, and 32 indicates a suction channel communicating with the suction port 18. Note that the suction channel 32 and the suction port 18 may be omitted by using the puncture needle insertion tube 27 as the suction channel.

Reference numerals 33a to 33n designate a bending piece that supports the distal end portion 1 and connects a plurality of pieces so as to be bendable to form the bending portion 2. By operating the bending operation portion 5, a wire (not shown) can be pulled or loosened. By bending, it curves in four directions and guides the tip 1. 34 is an outer cover of the curved portion 2 made of a rubber-like elastic body.

The relationship between the tip portion 13 and the curved portion 2 will be explained in detail.

In the distal end portion 1, the puncture needle accommodating portion 20, which is made up of a portion bored in the distal end block 12 and the connecting pipe 26, is located at the front end of the distal end block 12, that is, the operating portion 9fl! The connecting pipe 26 is provided so as to protrude from the end face of the connecting pipe 26. In the case of the -a endoscope, it is best for the front end of the connecting pipe that connects the suction channel to the distal end to stay at the distal end of the hinge on the most distal side of the curved part. However, in this device, the front end of the connecting pipe 26, that is, the front end of the puncture needle accommodating section 20, is connected to the distal end 1.
The hinge 35 of the most tip side curved piece 33a connected to
That is, it protrudes to the front side from the position of the hinge connecting the most distal end side curved piece 33a and the second curved piece 33b. As shown in FIG. 3, which is a cross-sectional view of the distal end and the curved portion in a curved state, the front end of the connecting pipe 26 hits the inner wall of the curved piece even when the curved portion 2 is curved, and has no effect on the curve. Let it stick out to the point where it has nothing to give.

When this device configured as described above is used for insertion into a human body, the curved portion 2 is often curved, and inserting the puncture needle 22 having a long hard tip portion 23 from behind prevents it from getting caught midway. Therefore, the puncture needle 22 must be inserted into the puncture needle insertion tube 27 before insertion into the human body, and the puncture needle 22 must be inserted into the puncture needle accommodation section 20.
The hard tip part 23 of the is stored, and the curved part 2 is inserted into the human body while being optically observed while being bent at the appropriate time. The pipe 26 is enclosed within the bending piece without affecting the curvature, and the starting point of bending, that is, the hinge 35 on the distal end side, is located on the distal side of the near end of the connecting pipe, so the actual distal end portion 1, that is, even if the length from the tip to the front end of the connecting bi 126 is long, a part of it is included in the curved portion 2, and the length of the tip in appearance, that is, in actual use, is short and curved. will begin.

In the above embodiment, the connecting pipe was kept within the second curved piece from the tip, but it is of course possible to extend it to the third or later parts as long as it does not affect the bending. Also, in the above embodiment, a puncture needle was used, but
There is no need to limit it to this, and similar effects can be obtained by using a treatment tool such as biopsy forceps, for example.

Further, in this embodiment, an image transmission fiber bundle is used for the observation optical system, but a CCD image pickup element may be provided at the tip, and in this case, the eyepiece part of the operation part is unnecessary.

Furthermore, although the insertion portion is provided with a bendable flexible portion, this may be a hard rod-shaped portion to which a curved portion and a tip portion are connected.

[Effects of the Invention] As detailed above, in the ultrasonic endoscope of the present invention, the near side end of the puncture needle accommodating section in the hard part of the distal end for insertion into the human body is positioned in front of the hinge of the curved piece on the distalmost side. By positioning it on the side, a part of the hard part of the tip of the human body insertion tip is included in the curved part, so even if the hard part of the tip of the human body insertion tip is actually long, it will curve from the middle of its length. This means that the rigid portion of the tip inserted into the human body begins to curve in a short state in appearance, that is, in actual use. Therefore, when it is inserted into the human body, it can be inserted smoothly with less pain.

[Brief explanation of the drawing]

FIG. 1 is a detailed side cross-sectional view of the distal end of an embodiment of the invention. FIG. 2 is a detailed plan view of the tip of an embodiment of the invention. FIG. 3 is a cross-sectional view of the tip and curved portion in a curved state according to the embodiment of the present invention. FIG. 4 is an overall configuration diagram of an embodiment of the present invention. 1 Tip part 2 Curved part 3a

Claims (1)

[Claims] an ultrasonic probe, a puncture needle accommodating part that guides the puncture needle inserted into the ultrasonic tomographic plane and accommodates its hard tip, an observation window;
In the ultrasonic endoscope, the ultrasonic endoscope has a rigid part at the tip for insertion into the human body, and a curved part in which a plurality of curved pieces connected to the rigid part at the tip for insertion into the human body are each connected by a hinge, in front of the puncture needle accommodating part. An ultrasonic endoscope characterized in that the side end is located in front of the hinge of the distalmost curved piece.