JPH0444748A - Treating tool - Google Patents

Abstract

PURPOSE:To precisely conform an actual treating part with an observing range by an ultrasonic observation means and facilitate the treatment by holding a treating tool body to which the ultrasonic observing means is fixed and the ultrasonic observing means with a fixed positional relation by a position holding means. CONSTITUTION:In the channel 2 of a hard endoscope preliminarily inserted into the body, the metal pipe 3 of a treating tool body 1 is inserted, and endoscopically guided to the lever 9, a lesion is irradiated with laser beams from a laser probe 4 in this state to form an evaporation coagulated layer 10, whereby the lesion is treated. In this case, the laser probe 4 on the body 1 side and an ultrasonic probe 5 are held with a fixed positional relation by a fixture 6. Thus, the size of the evaporation coagulated layer 10 can be detected by the A-mode information detected by an ultrasonic element on the ultrasonic probe 5 top end. The size of the evaporation coagulated layer 10 is detected during the laser irradiating work of the lesion from the laser probe 4, and this warm treatment state is displayed on the monitor of an ultrasonic observing device 8, whereby the laser beams can be emitted to the lesion from the laser probe 4, and the treatment can be facilitated.

Description

[Detailed description of the invention] [Industrial application fields] The present invention relates to a treatment instrument equipped with ultrasonic observation means.

[Prior Art] Conventionally, as shown in Japanese Patent Publication No. 63-20547, a laser probe is inserted into a body cavity through a channel of an endoscope, and a laser beam is irradiated to the affected area in the body cavity to induce transpiration coagulation. 2. Description of the Related Art Treatment instruments such as an endoscope laser device that performs treatment by forming a layer are known. In this laser device, a tomographic image inside the body cavity is observed from the body surface side using a separately provided ultrasonic imaging device.

[Problems to be Solved by the Invention] In the conventional structure described above, the size of the evaporated and coagulated layer formed in the body cavity by laser light irradiation is observed using an ultrasonic imaging device. When using an ultrasound imaging device to treat liver cancer by inserting a laser probe into the liver, it is necessary to press the ultrasound probe against the liver through laparotomy, which is a time-consuming process and is difficult for the patient. There was a pain or a big problem.

In addition, since the laser device and the ultrasound imaging device were installed separately, it was difficult to accurately match the area to be treated with the laser device or other treatment equipment and the observation range of the ultrasound imaging device. there were.

This invention was made in consideration of the above circumstances, and its purpose is to accurately match the actual treatment area with the observation range by the ultrasonic observation means, thereby facilitating treatment. The aim is to provide the tools.

[Means for Solving the Problems] The present invention fixes the ultrasonic observation means to the treatment instrument main body side, and provides a position holding means for maintaining a constant positional relationship between the treatment instrument main body and the ultrasonic observation means. It is something.

[By holding the treatment instrument main body and the ultrasonic observation means in a fixed positional relationship by the action position holding means, the actual treatment part and the observation area by the ultrasonic observation means can be accurately aligned. This is intended to facilitate treatment.

Embodiment FIGS. 1 and 2 show a first embodiment of the present invention.

FIG. 1 shows a schematic configuration of the entire treatment instrument body including, for example, a laser probe 4. As shown in FIG. This treatment instrument main body is provided with a metal vibrator 3 that is inserted into a channel 2 of a rigid endoscope, for example.

A laser probe 4 and an ultrasonic probe (ultrasonic observation means) 5 are disposed within the metal vibrator 3, respectively. In this case, the laser probe 4 and the ultrasonic probe 5 are arranged substantially parallel within the metal vibrator 3. Also,
A substantially disk-shaped fixture (one position holding stage) 6 is attached to the laser probe 4 . This fixture 6 is equipped with a laser beam.
The j-b mounting holes and the ultrasonic probe holes are respectively formed. Then, by inserting the ultrasonic probe 5 into the ultrasonic probe hole (=J hole) of this fixture 6, the ultrasonic probe 5 is fixed to the laser blower 4 on the treatment instrument main body 1 side, and the treatment instrument is fixed. The main body 1 and the ultrasonic probe 5 are maintained in a constant positional relationship.

Further, the base end side of the laser probe 4 is provided with a laser drive device 7.
is connected to. The laser beam output from the laser driving device 7 is guided to the tip side through the laser probe 4, and is emitted outward from the emission end face of the tip of the laser probe 4.

Furthermore, the base end side of the ultrasound probe 5 is connected to an ultrasound observation device 8 . This ultrasonic observation device 8 has a built-in monitor device. Furthermore, an ultrasonic element is attached to the tip of the ultrasonic probe 5. [5゛C, when the laser probe 4 irradiates the site in the body cavity with laser light to form a transpired coagulation layer for treatment, the ultrasonic 8-wave tip at the tip of the ultrasound probe 5 is used to perform treatment. The thermotherapy status is detected, and the thermotherapy status is displayed on the monitor device of the ultrasonic observation means 8.

Next, for example, treatment of the liver & 1 line will be explained using the treatment instrument main body having the configuration shown below.

First, when using the main body 1, a surgical endoscope, for example, is inserted into the patient's body. In this state, the metal vibrator 3 of the treatment instrument body is inserted into the channel 2 of the rigid endoscope.
and insert the metal vibrator 13 of the treatment instrument main body 1 transendoscopically.
leads to liver 9. Next, in this state, as shown in Fig. 2, a laser beam is irradiated from the laser probe 4 to the affected area such as the liver line to form a transpired coagulation layer on the living tissue to treat the affected area such as liver cancer. . In this case, since the fixing device 6 holds the laser probe 4 and the ultrasound probe 5 on the treatment instrument main body 1 side in a fixed positional relationship, the ultrasound element at the tip of the ultrasound probe 5 detects d1. The size of the transpiration condensation layer can be detected using the A-mode information. Therefore, the size of the evaporative and coagulated layer 10 is detected during the operation of irradiating laser light from the laser probe 4 to the affected area such as liver cancer, and the thermal treatment status is monitored by the ultrasonic observation device 8. By making the table smaller, the laser probe 4 can optimally irradiate the laser beam to the affected area, such as II''f-bearing cancer, thereby facilitating the treatment.

Moreover, FIG. 3 shows a second embodiment of this investigation.

This uses a heat probe as a treatment tool. The probe main body 11 of this heat probe has a distal end portion 1 of a jacket tube 12. The cylindrical metal cap 13 with the joint bottom is removed. Further, inside the probe body 11, a heating element 14, such as a Zener diode, is mounted inside a metal cap 13. This heating element 14 is connected to a heat probe drive circuit 16 via a connection cable 15. Furthermore, a hole 17 is formed at the tip of the metal cap 13 for mounting an ultrasonic transducer;
An ultrasonic transducer 18 is attached within the 7. This ultrasonic transducer 18 is connected to an ultrasonic observation device 2o via an ultrasonic transducer connection cable 19.

Therefore, when using the heat probe configured as described above, the tip of the probe body 11 is pressed against the bleeding site within the body cavity endoscopically. In this state, the heating element 14 is energized to generate heat, thereby causing the tip of the probe body 11 to generate heat.
Coagulate the bleeding site to stop the bleeding. In this case, by driving the ultrasonic transducer 18 at the tip of the probe body 11 to transmit and receive ultrasonic waves, points with different acoustic impedances (
Since the depth of the coagulation layer can be detected by the signal of the boundary between the coagulation layer 22 and the normal tissue 21, the depth of the coagulation layer can be confirmed while using the heat probe, which optimizes hemostasis work. The treatment can be performed in the same state, making the treatment easier.

Furthermore, FIG. 4 shows a third embodiment of the present invention.

This uses a cytodiagnosis brush as a treatment tool, and an ultrasonic element 34 is attached to the tip of an insertion section 32 of a brush body 31 of the cytodiagnosis brush.

In this case, the wires 33 of the insertion section 32 of the brush body 31 are formed by lead wires of the ultrasonic element 34, and brush bristles 35 are implanted between the wires 33 of the insertion section 32.

Therefore, with the above configuration, it is possible to properly detect a lesion in a biological tissue using the ultrasonic element 34 at the tip of the insertion part 32 of the brush body 31, so that, for example, a bile duct or lung can be detected by cytology using a cytology brush. When performing cytodiagnosis, it is possible to reliably prevent erroneous operations such as cytodiagnosis of normal tissue other than the diseased part of living tissue, and it is possible to make the diagnosis more appropriate.

Further, as in the fourth embodiment of the present invention shown in FIG. The same effects as in the third embodiment can be obtained. Note that 44 is a lead wire of the ultrasonic element 43.

Furthermore, as in the fifth embodiment of the present invention shown in FIG. 6, a pressure sensor 52 is attached to the distal end of a drainage tube 5 used for bile duct obstruction, etc., and the pressure sensor 52 is attached to the distal end of a drainage tube 5 used for bile duct obstruction. A configuration may be adopted in which the pressure sensor 52 detects clogging of the drainage tube 51.

Further, FIGS. 7 and 8 show a sixth embodiment of the present invention.

For example, when a lung biopsy tool inserted into the channel of the bronchoscope 62 is used as a treatment tool, dirt is removed from one of the biopsy cups 63a and 63b disposed at the distal end of the main body 61 of the lung biopsy tool. For example, an ultrasonic probe 64 is attached to the tip of a biopsy cup 63H. This ultrasonic probe 64 is connected to an ultrasonic observation device via a lead wire 65.

Therefore, in this case, when using the lung biopsy tool, the ultrasonic probe 64 can properly detect the lesioned part of the living tissue. The diseased part of the living tissue can be sampled more accurately than when using the method.

Furthermore, as in the seventh embodiment of the present invention shown in FIG. 9, an ultrasonic probe 73 is attached to the distal end of the sheath 72 of the lung biopsy device main body 71, or in the present invention as shown in FIG. A pair of biopsy cups 82a of a needle-equipped biopsy tool main body 81 as in the eighth embodiment.

The needle 83 disposed inside the needle 82b may be configured to be formed by an ultrasonic probe, and even in these cases, the sixth
The same effect as in the embodiment can be obtained.

Further, as in the ninth embodiment of the present invention shown in FIG.
The lead wire 6 of the ultrasonic probe 93 is attached around the wire of
5 may be wound around.

It should be noted that this invention is not limited to the embodiment described in Section 2, and various modifications may be made without changing the spirit thereof.

[Effects of the Invention] According to the present invention, the ultrasonic observation means is fixed to the treatment instrument body side 17, and the connection between the treatment instrument body and the ultrasonic observation means is...
Holding the position in a fixed position relationship] "Since we have provided a step,
It is possible to accurately match the actual treatment area and the observation range by the ultrasonic observation means, and it is possible to improve the quality of treatment.

[Brief explanation of the drawing]

1 and 2 show a first embodiment of the present invention, FIG. 1 is a schematic diagram of the overall configuration, FIG. 2 is a schematic diagram showing the state of use, and FIG. FIG. 4 is a plan view of main parts showing a third embodiment of the present invention, and FIG. 2. FIG. 6 is a vertical sectional view of the main part showing a fifth embodiment of the invention, and FIGS. 7 and 8 show a sixth embodiment of the invention. Fig. 7 is a schematic configuration diagram showing the state of use, Fig. 8 is a vertical sectional view of the main part, Fig. 9 is a plan view of the main part showing the seventh embodiment of the present invention, and Fig. 10 is a plan view of the main part.
The figure is a plan view of the main part of the rudder small 1 according to the eighth embodiment of the present invention.
FIG. 1 is a longitudinal cross-sectional view of the main parts showing a ninth embodiment of the present invention. K...Treatment instrument main body, 4...Laser probe, 5.Ultrasonic probe 1.1-bu (ultrasonic observation means), e)...Fixing device (position holding means), ]1... Probe body (treatment instrument body), 3...metal cap (position holding - 1 stage),
18... Ultrasonic transducer (ultrasonic observation means), 3ff...
・Brush body (treatment instrument body), 33... Wire (position holding means) 34. 43... Ultrasonic element (ultrasonic observation means) 42... Cover tube (position holding means)
, 61. ,． 71, 8]... Biopsy tool main body (treatment tool main body), 63 a... Biopsy cup (position holding means),
64.73... Ultrasonic probe (ultrasonic observation means), 72... Sheath (position holding 1 stage), 83. Needle (ultrasonic observation means). 111 Patent Attorney] Atsushi Tsuboi March! Tool body cane turtle ゛2 r-1 -F'5 r-1 U Figure chest) Engraved figure Figure Figure Snake figure

Claims (1)

[Claims] A treatment instrument, characterized in that an ultrasonic observation means is fixed to a treatment instrument main body side, and a position holding means is provided for maintaining a constant positional relationship between the treatment instrument main body and the ultrasonic observation means.