JP2000232983A - Tissue sampling device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily sample an effective amount of tissue and to easily take out the sampled tissue by slidably mounting a cutter tubular body into a puncture tubular body, pricking the cutter tubular body into the body, sucking the vital tissue and cutting the same by the cutter tubular body. SOLUTION: The tissue sampling device 30 comprises a catheter 31 and a manipulation section 32. A syringe 33 is attachably and detachably connected to the base end of the manipulation section 32. The catheter 31 comprises triple cylindrical members and the outermost peripheral side is a sheath member 34. The puncture tubular body 35, which is disposed in this sheath member 34 and is displaceable to a retreat position and an operating position, opens the front end of a main body pipe 35a and a needle tip 35b is formed. A suction hole 35c is formed in the proximate position on the flank of the main body pipe 35a. The cutter tubular body 36 is mounted in this puncture tubular body 35 and the blade edge 36a at this front end is made slidable and displaceable to the front and rear of the suction hole 35c.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a tissue sampling device used for sampling a living tissue in a body.

[0002]

2. Description of the Related Art A forceps and a cytology brush are typically used as a cell sampling device used for diagnosing the presence or absence of a lesion by collecting tissue cells in the body. JP-A-52-47343 discloses a method in which a cutter is incorporated into a suction tube guided into a body through a treatment tool insertion channel of an endoscope, and the living tissue sucked into the suction tube is cut by the cutter and taken out of the body. A tissue sampling device is disclosed. Therefore, FIG.
FIG. 1 shows a configuration of a main part of the tissue sampling apparatus according to the conventional technique.

[0003] In the drawings, reference numeral 1 denotes a suction tube, which is flexible.
A suction member 2 made of a hard cylindrical member is continuously provided at the tip. The suction member 2 has an opening at the tip, a suction hole 3 formed in a side surface thereof, and a cutter member 4 slidably mounted inside the suction member 2. The cutter member 4 has a main body portion 4a which is attached to the inside of the suction member 2 in a substantially close fit state, and a tissue accommodating portion 5 having a predetermined space is formed by cutting out a part of the main body portion 4a. ing. Moreover, of the wall surfaces defining the tissue storage section 5, the wall on the distal end side is formed into an acute angle to form the cutter section 4b, and further, the inner wall of the tissue storage section 5 and the suction member 2 are formed on the proximal wall. And a communication hole 6 that communicates with.

On the other hand, a partition wall 2a is formed on the base end side of the suction member 2 to which the suction tube 1 is connected, and a ventilation hole 7 is formed in the partition wall 2a. The cutter member 4 is
The tissue storage section 5 can be displaced from a position shown in the figure facing the suction hole 3 to a retracted position shown by a dashed line and an extruded position shown by a two-dot chain line. In order to push and pull the cutter member 4, a wire 8 for pushing and pulling operation is connected to the cutter member 4, and the wire 8 penetrates the partition wall 2 a and is led out into the suction tube 1 for remote operation. Is to be pushed and pulled.

When the cutter member 4 is held at the position indicated by the solid line in FIG. 10, the distal end of the suction member 2 is substantially sealed by the cutter member 4. Then, when the suction hole 3 is brought into contact with the inner wall of the body cavity to apply a negative pressure to the suction tube 1, the negative pressure acts on the inner wall of the body cavity through the suction hole 3 of the suction member 2. The tissue is sucked into the suction member 2 from the suction hole 3 by force. In this state, when the wire 8 is pulled, the cutter portion 4b slides along the inner surface of the suction member 2 and moves to the position indicated by the dashed line in FIG. To be housed. When the wire 8 is extruded and the cutter member 4 is extruded to the position indicated by a two-dot chain line after the tissue sampling device is taken out of the body,
The living tissue housed in the tissue housing section 5 can be taken out.

[0006] By configuring the tissue sampling device in this manner, it can be used for sampling mucosal tissue from the inner wall of a body cavity. However, in recent years, an ultrasonic diagnostic apparatus has been widely used, and in particular, an ultrasonic diagnostic apparatus inserted into a body cavity such as an ultrasonic endoscope or an ultrasonic probe inserted transendoscopically has been developed. Ultrasonic diagnosis of body tissue can be performed from the inner wall of the body cavity. Here, the information obtained by the ultrasonic diagnostic apparatus is a tomographic image of a body tissue,
Diagnosis of the presence or absence of a lesion can be made from this ultrasonic tomographic image, but in order to make a more accurate diagnosis, the tissue must be collected to obtain more detailed information on the lesion and the like. Therefore, when performing a diagnosis by ultrasound, it is necessary to also collect the tissue in the deep part of the body, but since it is not possible to pierce the body with the above-described conventional tissue collection device,
No body tissue can be collected.

[0007] Here, in an ultrasonic endoscope, a puncture treatment tool is used to inject a medical solution or aspirate a bodily fluid into an affected part or the like captured in an observation field by the ultrasonic wave. . This puncture treatment instrument is formed by connecting a puncture needle to the distal end of a tube, and is usually inserted into a body cavity through a treatment instrument insertion channel, and is led out of the distal end of the treatment instrument insertion channel to be inserted into the body. Pierced. Since the tip of the puncture needle is sharp, it is necessary to draw out the puncture needle from the treatment instrument insertion channel and cover the puncture needle until it is actually inserted into the body. A sheath member is used for this purpose. The sheath member covers not only the puncture needle but also the entire tube, and pushes and pulls the base end of the tube so that the puncture needle is protruded and retracted from the distal end of the sheath member. Operate it. Since the puncture device can also be suctioned, the puncture device may be used as a device for collecting tissue in the body.

[0008]

By the way, in order to collect a tissue in the body by using the puncture treatment tool having the above-mentioned structure, a puncture needle is guided to a position where the tissue to be collected exists under monitoring by ultrasonic waves. Then, a tissue is taken into the puncture needle by applying a suction force to the tube. However, since the puncture treatment tool does not have a mechanism for cutting tissue, the tissue contained in the puncture needle can be separated from the body and taken out by repeatedly moving the puncture needle up and down. The tissue must be cut, the operation is extremely difficult, and the damage to the living tissue increases.

Here, the above-mentioned Japanese Utility Model Publication No. 52-47343.
In the tissue sampling device disclosed in Japanese Patent Application Laid-Open No. H10-209, if the distal end of a suction member formed of a hard cylindrical member is sharpened so as to have a shape similar to that of a puncture needle, it can be configured to be pierced into the body. However, if the distal end is sharpened, the suction member must be attached to the sheath member in order to prevent the distal end from being caught on the inner surface of the treatment instrument insertion channel when inserted into the treatment instrument insertion channel. It becomes extremely thin. Since the cutter member is inserted into the inside of the suction member and furthermore, a part of the cutter member is cut out to form the tissue accommodating portion, the volume of the tissue accommodating portion becomes extremely small, and a sufficient amount of tissue can be obtained. Cannot be collected. Also,
Since the cutter member cuts the tissue when pulled back to the proximal end side, a needle tip for puncturing must be formed at the distal end side further than the position where the cutter member is provided. The needle tip will protrude considerably longer. Therefore, in order to extract tissue at a certain position, the tip of the needle must be inserted farther from that position, which also increases the damage to the body tissue. In addition, there are cases where both the needle tip and the suction hole cannot be put into the ultrasonic observation visual field. For the above reasons, simply forming a needle tip on a suction member constituting a known tissue sampling device does not necessarily provide a satisfactory structure as a device for sampling cells.

[0010] The present invention has been made in view of the above points, and it is an object of the present invention to easily collect an effective amount of tissue when piercing the body to collect a living tissue. And to make it possible to easily remove the collected tissue.

[0011]

In order to achieve the above-mentioned object, the present invention provides a pipe member having a predetermined length, which is provided with a suction hole on a side surface near a tip of the pipe member. A puncture tube having a sharp needle tip on the side, and a cutter tube which is slidably inserted into the puncture tube and has an annular cutting edge formed at the tip of a tube member longer than the puncture tube. And a fluid supply / discharge means detachably connected to the base end of the cutter tube.

The tissue sampling apparatus is guided into the body cavity through the guide means. Examples of the guide means include a treatment tool insertion channel of an ultrasonic endoscope. When the insertion path by the guide means is long and passes through a curved path, a sheath member that allows the needle tip to protrude and retract is provided on the outer periphery of the puncture tube body. And, between the base end portion of the sheath member and the puncture tube body, there is provided first operating means for causing the puncture tube body to protrude and retract from the sheath member together with the cutter tube body. Second operating means for slidingly displacing the cutting edge between the base end side and the distal end side of the suction hole is provided between the cutter tube and the cutter end. 2
It is desirable to provide a connecting portion which is derived from the operating means and detachably connects the fluid supply / discharge means. Also,
By forming a step at the distal end of the puncture tube protruding toward the inner peripheral side, it is possible to hold the distal end of the cutter tube so as not to protrude from the distal end opening of the puncture tube. The inner diameter of the reduced diameter portion due to the step is equal to or larger than the inner diameter of the cutter tube.

[0013]

An embodiment of the present invention will be described below with reference to the drawings. Thus, the tissue sampling device for puncturing according to the present invention will be described as being configured to be inserted into a body cavity through a treatment tool insertion channel formed in an ultrasonic endoscope that performs electronic convex scanning. As the guide means of the tissue sampling apparatus, other scanning type ultrasonic endoscopes, treatment instrument insertion channels of ordinary endoscopes without an ultrasonic diagnostic mechanism, and further trocars and the like are used as guide means. When the trocar is inserted into the trocar, the whole can be made of a hard member.

First, FIG. 1 shows a configuration of a distal end portion of an ultrasonic endoscope for guiding a tissue sampling device. In the figure, 1
Reference numeral 0 denotes an insertion portion into a body cavity. This insertion portion 10 is formed by connecting a distal end main body 12 to a distal end of an angle portion 11, and the distal end main body 12 has an endoscope observation at a proximal end side. Part 13
However, an ultrasonic observation unit 14 is provided on the distal end side. The endoscope observation unit 13 is provided on the inclined portion 12a on the base end side of the distal end main body 12, and has an observation field of view obliquely forward. FIG. 1 shows an illumination mechanism 15 provided with a light guide constituting the endoscope observation unit 13, and an observation mechanism is provided together with the illumination mechanism 15, but illustration of the observation mechanism is omitted. Note that a solid-state imaging device or an image guide is used as the observation mechanism. The ultrasonic observation unit 14 has an opening 12 provided at the distal end of the distal end body 12.
b has an ultrasonic transducer unit 16 attached thereto. The ultrasonic transducer unit 16 performs electronic convex scanning, and is configured by arranging a number of strip-shaped ultrasonic transducers 17 in an arc shape.

A treatment instrument lead-out section 18 is formed at a position between the endoscope observation section 13 and the ultrasonic observation section 14. The treatment tool lead-out portion 18 is a passage having a predetermined inner diameter and is formed in the distal end body 12, and a connection pipe 19 is connected to the treatment tool lead-out portion 18. The connection pipe 19 is bent at a predetermined angle, and a flexible tube 20 is connected to a base end thereof. Therefore, the treatment tool lead-out portion 18, the connection pipe 19, and the flexible tube 20 constitute the treatment tool insertion channel 21, and the treatment tool lead-out portion 18 extends obliquely forward with respect to the axis of the insertion portion 10, and Flexible tube 20
Extends in the axial direction of the insertion portion 10, and an intermediate portion of the connection pipe 19 is bent by a predetermined angle.

Reference numeral 30 denotes a tissue sampling device, which is inserted into the treatment tool insertion channel 21 so as to be able to protrude and retract from the treatment tool lead-out portion 18. Then, the distal end main body 12 is brought into contact with the inner wall S of the body cavity, and the ultrasonic observation unit 14 puts the tissue collection location T in the ultrasonic observation field of view, and the tissue extraction device 3
The living tissue, that is, the cells, can be collected after the distal end of No. 0 is pierced from the inner wall S of the body cavity and the distal end is guided to the tissue collection location T. Then, the tissue sampling device 30 is pulled out from the treatment tool insertion channel 21, and the sampled tissue is transferred to a container such as a formalin solution.

FIG. 2 shows the overall structure of the tissue sampling device 30. As is clear from FIG.
Is composed of a catheter 31 and an operation unit 32, and a syringe 33 is detachably connected to a base end of the operation unit 32. The catheter 31 is at least longer than the entire length of the treatment instrument insertion channel 21, and is composed of a triple tubular member as shown in FIG. That is, the catheter 31 includes a sheath member 34, a puncture tube 35 inserted through the sheath member 34, and a puncture tube 35
And a cutter tube 36 inserted therein.

The sheath member 34 is a tubular member having flexibility, and can be formed of a soft tube or the like. The puncture tube 35 is a thin pipe-shaped main pipe 3 having an open end.
By opening the tip of 5a and cutting the tip obliquely, a needle tip 35b with a sharp tip is formed. Then, on the side surface of the main body pipe 35a,
A suction hole 35c is formed at a position close to the base end side of the obliquely cut surface as the needle tip 35b. Further, the cutter tube 36 is a thin-walled pipe that is inserted into the puncture tube 35 so as to slide substantially all around, and the outer peripheral edge of the tip is sharpened in a blade shape. Thus, an annular blade edge 36a is formed. Here, the puncture tube 35 is
Since it is stabbed in the body, at least the tip portion including the needle tip 35b must be hard,
The tip of the cutter tube 36, on which the cutting edge 36a is formed, is also formed of a hard member in order to sufficiently exhibit the function as a cutter.

Here, since the catheter 31 is inserted into the treatment instrument insertion channel 21, it is bent so that it can pass through the bent connection pipe 19 and can be inserted smoothly even when the angle portion 11 is curved. It must be flexible in the direction. For this purpose, the other parts of the puncture tube 35 and the cutter tube 36 may be formed of a flexible tube to connect the tube and the hard pipe.
The cutter tube 36 has a small diameter and can be bent if its thickness is made as small as possible. Therefore, the entire length is formed of a pipe member made of metal or the like.

The puncture tube 35 is movable in the front-rear direction inside the sheath member 34, and the cutter tube 36 is moved in the front-rear direction with almost no clearance from the puncture tube 35. ing. The puncture tube body 35 has a retracted position (the position shown by the phantom line in FIG. 3) in which the needle tip 35b is covered by the sheath member 34, and an operating position (the same position) in which the needle tip 35b protrudes from the tip of the sheath member 34 by a predetermined length. (The position shown by the solid line in the figure).
Further, the cutter tube 36 reciprocates in the puncture tube 35 between a retracted position where the cutting edge 36a is located closer to the base end side than the suction hole 35c and an extruded position where the blade 36a has passed through the suction hole 35c. However, even when the cutter tube 36 is displaced to the pushed-out position, the cutting edge 36a of the cutter tube 36 is held at a position in front of the portion of the puncture tube 35 where the needle tip 35b is formed.

For this purpose, the proximal end of the sheath member 34 is connected to a first operating means 37, and the puncture tube 35 and the cutter tube 36 are integrally formed by the first operating means 37. It comes to appear from the tip of. The proximal end of the puncture tube 35 is connected to the second operating means 38, and the second operating means 38 allows the cutter tube 36
Slides inside the puncture tube 35. These first,
The operation section 32 is constituted by the second operation means 37 and 38, and a specific configuration thereof is as shown in FIG.

The base end of the sheath member 34 is fixedly provided to a connecting member 39, and the connecting member 39 is provided with a first operating means 37.
Is connected to the casing 40 constituting The casing 40 is formed of a cylindrical member having a predetermined length, and a slider 41 is inserted therein so as to be slidable in the axial direction of the casing 40. The slider 41 is hollow, and the base end of the puncture tube 35 is fixed inside. Therefore, when the slider 41 is pushed and pulled, the tip 35b of the tip of the puncture tube 35 protrudes and retracts from the tip of the sheath member 34. A guide hole 42 having a predetermined length is provided in the circumferential direction of the casing 40 in the axial direction, and a pin 43 inserted into the guide hole 42 is attached to the slider 41. Both ends of the guide hole 42 are bent approximately 90 °, and the positioning holes 42a and 42 are directed in the circumferential direction.
b. The moving stroke of the slider 41 is regulated by the entire length of the guide hole 42, and the stroke end positions of both ends are regulated.

When the slider 41 is pulled out of the casing 40 and the puncture tube 35 is retracted into the sheath member 34, this is the retracted position of the puncture tube 35, and the pin 43 is moved from the guide hole 42 to the positioning hole 42a. By shifting, it can be stably held at this retreat position. In the retracted position, the needle tip 35b of the puncture tube 35 is located slightly inside the tip of the sheath member 34, and the needle tip 35b is completely covered by the sheath member 34. At the time of insertion or the like, the needle tip 35b does not pierce or catch on another object, ensuring safety and smoothly performing the insertion operation into the treatment instrument insertion channel 21.

On the other hand, when the slider 41 is pushed into the casing 40, the puncture tube 35 is drawn out of the sheath member 34. When the pin 43 is disposed at a position where the pin 43 engages with the positioning hole 42b at the tip of the guide hole 42, the puncture tube 35 protrudes from the sheath member 34 by a predetermined length. This is an operating position where puncturing is possible, and the protruding length at this operating position is the maximum length of piercing into the body. Here, the maximum piercing length of the puncture tube 35 is such a length that the puncture tube 35 can be pierced to a position where the sheath member 34 comes into contact with the inner wall of the body cavity. 16 must be within the ultrasonic observation field of view. Therefore, the maximum piercing length of the puncture tube 35 is restricted by the ultrasonic observation visual field.

The pin 43 provided on the cutter tube 36 side at the retracted position and the operating position is connected to the guide hole 4 of the puncture tube 35.
In order to shift from 2 to the positioning holes 42a and 42b and stabilize at those positions, the casing 40 and the slider 41 may be relatively rotated. Furthermore, if the width of the transition from the guide hole 42 to the positioning holes 42a and 42b is slightly smaller than the outer diameter of the pin 43, a click feeling can be obtained at the transition, and the pin 43 can be stably held.

As described above, the operation of only the first operating means 37 does not change the positional relationship between the cutter tube 36 and the puncture tube 35. Therefore, when the second operation means 38 is operated, the cutter tube 36 reciprocates by a predetermined stroke in a state in which the cutter tube 36 is in close contact with the puncture tube 35. The moving range of the cutter tube 36 is a retracted position (a position shown by a solid line in FIG. 3) in which the cutting edge 36a is located on the base end side of the suction hole 35c.
And a push-out position (a position shown by the phantom line in FIG. 3) that completely passes through the suction hole 35c but does not protrude from the open end of the puncture tube 35. Thus, the cutter tube 3
6 to reciprocate to these two positions in
Is a guide cylinder portion 41a in which the base end side of the slider 41 in the first operation means 37 is thickened by a predetermined length.
The slide member 44a on the distal end side of the connecting member 44, to which the base end of the cutter tube 36 is connected, is inserted into the guide tube portion 41a so as to be reciprocally slidable by a predetermined stroke. Then, the guide cylinder 41a
A guide hole 45 is formed in the peripheral body of the guide hole 4.
5 have positioning holes 45a, 4 bent approximately 90 °.
5b, the guide hole 45 has a connecting member 44
A pin 46 guided by a guide hole 45 is attached to the slide portion 44a.

Accordingly, by pushing and pulling the connecting member 44 constituting the second operating means 38 with respect to the guide tube portion 41a of the slider 41, the cutting edge 36a at the tip of the cutter tube 36 is moved to the main body of the puncture tube 35. It moves back and forth through a suction hole 35c formed in the pipe 35a. Pin 46
Is engaged with the positioning hole 45 a of the guide hole 45, the cutting edge 36 a of the cutter tube 36 is located at the retracted position slightly proximal to the suction hole 35 c of the puncture tube 35. On the other hand, when the slider 41 is pushed in, the positioning hole 4
5b, the cutting edge 36a of the cutter tube 36 is displaced to an extruded position passing through the suction hole 35c. Here, at the pushing position, the cutting edge 36a
No. 5 does not protrude from the main pipe 35a. By engaging the pins 46 with the positioning holes 45a or 45b, the cutter tube 36 is stably held at the retracted position and the pushed position, respectively. From the guide holes 45 of the pins 46 to the positioning holes 45a, 45b
The transition to can be performed by relatively rotating the slider 41 and the connecting member 44. If the width of the transition portion is made slightly smaller than the diameter of the pin 46, a click feeling can be obtained, and Stability can be ensured.

The cutter tube 36 also functions as a fluid passage. The fluid passage includes a suction passage for applying a negative pressure to the suction hole 35c, and a passage for pressure-feeding a liquid such as formalin liquid in order to discharge the tissue accommodated in the cutter tube 36. Then, a flow path 47 is formed in the connecting member 44 as an extension of the fluid path in the cutter tube 36. The base end of the connecting member 44 is a luer lock 44b to which the syringe 33 for suction and liquid pressure feeding is detachably connected.

The present embodiment is configured as described above. Next, a method for collecting tissue in the body using the tissue collecting apparatus 30 will be described.

First, the distal end main body 12 of the ultrasonic endoscope is arranged at a predetermined position with respect to the inner wall S of the body cavity. In this state,
In the observation field of view of the ultrasonic transducer unit 16 constituting the ultrasonic observation unit 14, the tissue collection location T in the body
Is captured, the catheter 31 is inserted into the treatment instrument insertion channel 21, and the distal end portion is positioned near the distal end of the treatment instrument lead-out section 18. Further, a syringe 33 is connected to the luer lock portion 44b constituting the connecting member 44, and this syringe 33 is used for suction.

As shown in FIG. 5, the puncture tube 35 of the catheter 31 is covered at its distal end with a sheath member 34. In this state, the slider 41 of the first operating means 37 is connected to the casing 40. The puncture tube 35 is drawn out from the sheath member 34 by operating the puncture tube 35 into the inside. Thus, the needle tip 35b at the tip of the puncture tube 35 is stabbed into the body from the inner wall S of the body cavity. Since the puncture path of the puncture tube 35 into the body is captured within the ultrasonic observation field of view, the puncture operation can be performed safely, and the target can be aimed at the tissue sampling point T without fail.

When the needle tip 35b of the puncture tube 35 advances and the suction hole 35c faces the living tissue sampling point T, the syringe is operated to make the inside of the cutter tube 36 a negative pressure.
By the action of this negative pressure, as shown in FIG. 6, tissue enters the suction hole 35c. The distal end of the puncture tube 35 is also open, and negative pressure also acts on this distal opening, so that the living tissue enters from the puncture tube 35 through this distal opening. Since the portions are separated from each other by the wall of the main pipe 35a of the puncture tube 35, the tissues sucked from these two places are separated from each other. Moreover, since the needle tip 35b is cut diagonally forward from the side where the suction hole 35c is formed, as the needle tip 35b is stabbed into the body, the living tissue is pushed back along this oblique wall. . As a result, a compressive force acts on the living tissue in the direction indicated by the arrow in FIG. 6. When a negative pressure is applied to the cutter tube 36, the tissue smoothly enters through the suction hole 35 c opened on the side surface. become. Thus, the puncture tube 3
Since almost the entire inner diameter of the inner tube 5 functions as a storage unit for the aspirated living tissue, a large storage space can be obtained, and a sufficient amount of tissue can be taken in.

When a predetermined amount of living tissue enters the puncture tube 35 from the suction hole 35c, the slide portion 44a of the connecting member 44 constituting the second operating means 38 is pushed into the slider 41, and as shown in FIG. As shown, the cutting edge 36a of the cutter tube 36 advances, cuts the living tissue that has entered the puncture tube 35, and takes it into the cutter tube 36. At this time, a negative pressure is applied to the inside of the cutter tube 36, but no further suction force is applied.
That is, the syringe is held so as not to move. As a result, biological tissue is collected from the body, and the cutter tube 3 is removed.
6. In addition, since the cutting edge 36a of the cutter tube 36 does not act on the living tissue sucked from the opening at the distal end of the puncture tube 35, it is not cut, and damage to the living tissue can be minimized.

After the living tissue is collected by the catheter 31 of the tissue sampling device 30 as described above, the catheter 31 is extracted from the treatment instrument insertion channel 21. At this time, the cutter tube 3 is
The catheter 31 can be safely pulled out by displacing the puncture tube 35 to the retracted position with respect to the sheath member while holding the catheter 6 at the pushing position. Then, instead of the syringe for suction, for example, a syringe for pumping formalin solution is connected to the luer lock portion 44a, and the formalin solution is pumped from the syringe into the cutter tube 36, whereby the collected tissue is placed in the test tube B. And so on. Here, as shown in FIG. 8, the tip of the puncture tube 35 is open, and the suction hole 35c is
6, the tissue collected by the pressure of the formalin solution or the like is reliably discharged from the tip of the puncture tube 35 as indicated by the arrow in the figure, and the tissue is damaged during this transfer operation. A sample in an extremely good state is collected without the risk of occurrence of the above.

The puncture tube 35 has a suction hole 35c formed on the side surface thereof. However, when the cutter tube 36 is displaced to the pushing position, the suction hole 35c can be substantially closed. The syringe 33 is detachably connected to the connecting member 44 at the base end of the cutter tube 36.
From the above, a medical solution can be injected from the syringe 33 with the suction hole 35c closed, and if a syringe for suction is connected, suction of body fluid and the like becomes possible.
Therefore, this tissue sampling device 30 can also be used as a puncture treatment tool for performing suction, injection of a drug solution, and the like.

It should be noted that, as shown in FIG.
5, a step 130 may be formed between the needle tip 135b and the suction hole 135c. The tip opening diameter of the puncture tube 135 formed by the step 130 is equal to or larger than the inner diameter of the cutter tube 36 housed therein, so that the site of this step does not become a throttle portion. I do. Further, it is desirable that the step 130 is formed at a position where the cutting edge 36a does not contact when the cutter tube 36 is displaced to the pushed-in position in a normal state. With this configuration, as shown by the imaginary line in the figure, when the cutting edge 36a constituting the tip of the cutter tube 36 is displaced to the pushing position, the cutting edge 36a is moved to the puncture tube 135.
It can be completely prevented from protruding out of control.

[0037]

According to the present invention, as described above, an effective amount of tissue can be easily collected and the collected tissue can be easily removed when a living tissue is collected by puncturing the body. And the like.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view of a main part showing a state in which a tissue sampling device according to an embodiment of the present invention is incorporated in an ultrasonic endoscope.

FIG. 2 is an overall configuration diagram of the tissue sampling device shown in FIG.

FIG. 3 is a sectional view of a distal end portion of a catheter constituting the tissue sampling device.

FIG. 4 is a cross-sectional view of the tissue sampling device.

FIG. 5 is an operation explanatory view of the tissue sampling device, showing a state immediately before a catheter is inserted into a body.

FIG. 6 is an operation explanatory view showing a state in which the distal end of the puncture tube of the catheter is suctioning a living tissue at a living tissue sampling location.

FIG. 7 is an operation explanatory view showing a state where a living tissue taken into a puncture tube is cut by a cutter tube;

FIG. 8 is an operation explanatory view showing a state where the collected tissue is being transferred.

FIG. 9 is a sectional view of a main part showing another example of the puncture tube.

FIG. 10 is a cross-sectional view of a main part of a conventional tissue sampling device having a configuration suitable for sampling mucosal tissue from the inner wall of a body cavity.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 10 Insertion part 11 Angle part 12 End part main body 13 Endoscope observation part 14 Ultrasonic observation part 21 Treatment tool insertion channel 30 Tissue sampling device 31 Catheter 32 Operation part 33 Syringe 34 Sheath member 35,135 Puncture tube 35a Body pipe 35b , 135b Needle tip 35c Suction hole 36 Cutter tube 36a Blade tip 37 First operating means 38 Second operating means 40 Casing 41 Slider 44 Connecting member 44a Slide section 44b Luer lock section 130 Step

──────────────────────────────────────────────────続 き Continued on the front page (51) Int.Cl. ⁷ Identification symbol FI Theme coat ゛ (Reference) A61M 25/02 A61M 25/02 B

Claims (3)

[Claims] 1. A puncture tube body provided with a suction hole on a side surface near a distal end of a tube member having a predetermined length, and having a sharp needle tip on a distal side from a position where the suction hole is formed; A cutter tube which is slidably inserted into the inside thereof and has an annular cutting edge formed at a distal end of a tube member longer than the puncture tube, and a fluid detachably connected to a base end of the cutter tube A tissue sampling device comprising a supply / discharge unit. 2. A puncture tube body is provided on the outer periphery of the puncture tube body so that a needle tip can protrude and retract, and a puncture tube body is provided between a base end of the sheath member and the puncture tube body. A first operating means is provided for projecting and retracting from the sheath member together with the cutter tube, and between the base end of the puncture tube and the cutter tube, the cutting edge is provided at the base end side of the suction hole. A second operating means for sliding displacement between the second operating means and the distal end side, and a base end portion of the cutter tube body is led out from the second operating means to detachably connect the fluid supply / discharge means. The tissue sampling device according to claim 1, wherein a connection portion is provided. 3. A configuration in which a step projecting toward an inner peripheral side is formed at a tip portion of the puncture tube body, and an inner diameter of a reduced diameter portion due to the step is made larger than an inner diameter of the cutter tube body. The tissue sampling device according to claim 1, wherein