JP2001037765A - Operation assisting appliance for puncture needle for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To embody a puncture needle operation assisting appliance for an endoscope having a function to prevent the inadvertent protrusion of a puncture needle. SOLUTION: A switching part 34 is provided with a safety ring 63 as a safety device and a lock index 65 fixed through the cylindrical surface of the safety ring 63. A switching groove 71 allowing the intrusion of the lock index 65 is formed on the rear surface of a button head 66 of the button 64 as the switching groove 71, by which the regulation state of prohibiting the depressing operation of the button 64 unless the lock index 65 is aligned to the switching groove 71 by rotationally operating the safety ring 63 around a shaft 67 may be obtained. The positions of the lock index 65 and the switching groove 71 are aligned by rotationally operating the safety ring 63 from this state, by which the regulation release state of enabling the protrusion of the puncture needle by enabling the depressing operation of the button 64 may be obtained.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture needle operation assisting device for an endoscope having a puncture needle which is inserted into a forceps channel of an endoscope and pierces a subject in a body cavity.

[0002]

2. Description of the Related Art In recent years, under observation of an ultrasonic tomographic image with an ultrasonic endoscope, a long puncture needle is guided to a subject portion through a forceps channel using an ultrasonic tomographic image as a guide to a diseased tissue. Techniques for puncturing, collecting cells and tissues, and performing pathological confirmation diagnosis have come to be performed. In order to make such a diagnosis, for example, as described in Japanese Patent Application Laid-Open No. 9-103433, an endoscope puncture needle operation assisting instrument that can be fixed to a forceps channel entrance of an ultrasonic endoscope has been proposed. I have.

In this puncture needle operation assisting device for an endoscope, the puncture needle insertion operation (the forward and backward movement of the needle) is manually performed.
If the subject is relatively hard (not easy to puncture), manual puncturing may not be easy. That is, the tip of the puncture needle hardly sticks to the hard object part, and even if the puncture needle is pushed in, the object part is likely to fall into the back only. It is known that, when performing a puncture on a subject part that is hard and difficult to puncture, the puncture needle is projected at a high speed to facilitate the puncture. In general, the sharpness of a puncture needle is improved as the puncture needle protrudes at a higher speed, but it is difficult to manually protrude the puncture needle at such a high speed.

In order to solve this problem, there has been proposed a device in which, for example, a spring is incorporated as an urging member in a puncture needle operation assisting device for an endoscope, and the puncture needle is inserted by the urging force of the spring. However, in order to accurately insert the puncture needle into a hard object part, it is necessary to project the puncture needle at a very high speed. For that purpose, it is necessary to incorporate a powerful spring into the puncture needle operation assisting device for an endoscope.

However, when using the puncture needle operation assisting device for an endoscope incorporating such a biasing member, there is a possibility that the puncture needle may be protruded at an unintended timing due to an erroneous operation. For example, if the puncture needle is accidentally projected to an unexpected part of the living body, a puncture will be made to a part that does not need to be punctured. Also,
When the puncture needle operation assisting device for an endoscope is attached to, for example, an ultrasonic endoscope, if the puncture needle is protruded by mistake, there is a possibility that the puncture needle of the ultrasonic endoscope may be punctured. Further, if the cleaning tool is erroneously made to protrude during the cleaning operation when the whole surface of the utensil is set to the protruding preparation state for cleaning, there is a possibility that the cleaner may pinch a finger.

[0006]

The puncture needle operation assisting device for an endoscope used under the above-mentioned ultrasonic tomographic image observation is very high-speed in order to accurately insert the puncture needle into a hard object part. It is necessary to protrude the puncture needle. For this purpose, there has been proposed a device in which a strong urging member is incorporated and the puncture needle is inserted by the urging force of the urging member. However, the puncture needle operation assisting device for an endoscope incorporating such a powerful urging member may cause the puncture needle to protrude at an unintended timing due to an erroneous operation.

The present invention has been made in view of these circumstances, and is an auxiliary instrument provided at the entrance of a forceps channel of an endoscope and having a function of protruding a puncture needle by a built-in urging member. Another object of the present invention is to provide an endoscope puncture needle operation assisting device having a function of preventing unintended puncture needle projection.

[0008]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention is provided at an entrance of a forceps channel of an endoscope and is used by being inserted into the forceps channel. A long puncture needle for piercing, a long sheath for accommodating the puncture needle, a slide portion for holding the puncture needle freely reciprocating, and a bias for urging the puncture needle by the biasing force of a biasing member A mechanism, a locking mechanism for temporarily locking the biasing force of the biasing member of the biasing mechanism, and a switch mechanism for releasing the locked state of the locking mechanism,
A safety device is provided which can select a restriction state in which the puncture needle cannot be protruded and a restriction release state in which the puncture needle can be protruded, and does not operate the switch mechanism in the restriction state. And With this configuration, even when the switch mechanism is operated by an erroneous operation, the protrusion of the puncture needle is prevented. That is, unintended protrusion of the puncture needle is prevented.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 9 relate to a first embodiment of the present invention, and FIG. 1 shows the operation of a puncture needle for an endoscope provided at a forceps channel entrance of an endoscope. FIG. 2 is an explanatory perspective view showing an auxiliary device, FIG. 2 is an external view of an endoscope puncture needle operation auxiliary device of FIG. 1, FIG. 3 is a longitudinal sectional view of FIG. 2, and FIG. 4 is an external view of a coil sheath of FIG. 5 is an explanatory diagram showing the puncture needle of FIG. 3, FIG. 6 is an explanatory diagram of the switch unit of FIG. 3, and FIG. 6 (a) is a cross-sectional view showing a restricted state where a button cannot be pressed. 6 (b) is a cross-sectional view showing a regulation release state in which a button can be pressed, FIG. 6 (c) is a cross-sectional view showing a state in which the locked state of the coil spring is released by pressing the button, 7 and 8 are diagrams for explaining the operation of the puncture needle operation assisting device for an endoscope, and FIG. 7A shows a state in which the tip of the puncture needle is housed in a coil sheath. 7 (b) is a longitudinal sectional view showing a piercing preparation state, and FIG. 7 (b) is a longitudinal sectional view showing a state where the tip of the puncture needle is projected from the tip of the coil sheath with the third slide portion advanced to the maximum. FIG. 8C is a vertical cross-sectional view showing a state in which the adjustment cylinder is rotated to set the protrusion length, and FIG.
FIG. 8B is a vertical cross-sectional view showing a state in which the tip of the puncture needle is projected at a high speed by the set projection length. FIG. 8B shows the third state when the puncture needle operation assisting tool is removed from the forceps channel of the endoscope.
FIG. 9 is a longitudinal sectional view showing a state in which the sliding portion is pulled to the proximal end side as much as possible. FIG. 9 is an explanatory view for explaining the operation of the distal end of the puncture needle. FIG. FIG. 9 (b) is an explanatory view showing a stored piercing preparation state, FIG. 9 (b) is an explanatory view showing a state where the tip of the puncture needle projects from the tip of the coil sheath, and FIG. FIG. 9 (d) is an explanatory view showing a state in which the length is set, FIG. 9 (d) is an explanatory view showing a state in which a puncture needle is projected and piercing a lesion in a body cavity, and FIG. 9 (e) performs a suction biopsy. FIG. 7 is an explanatory view showing a state in which the puncture needle is removed at this time.

As shown in FIG. 1, a puncture needle operation assisting device for an endoscope (hereinafter, simply referred to as a puncture needle operation assisting device) 1 is connected to an ultrasonic endoscope or an endoscope 2 through a forceps channel (not shown). It is designed to be guided into the body cavity. The endoscope 2 includes an elongated insertion section 3 inserted into a body cavity, an operation section 4 provided at a rear end of the insertion section 3, and an eyepiece section disposed at a rear end of the operation section 4. 5, a universal cord 6 extending from the operation unit 4, and the universal cord 6
And a connector 7 provided at an end of the operation unit 4.
A treatment instrument insertion port 8 for inserting a treatment instrument such as a treatment instrument is provided. The treatment instrument insertion port 8 communicates with a treatment instrument outlet 9a formed in the distal end portion 3a of the insertion section via a forceps channel 9 disposed in the insertion section 3 (see FIG. 9). For this reason, by inserting the puncture needle operation assisting instrument 1 from the treatment instrument insertion port 8, the puncture needle 11 disposed at the distal end of the puncture needle operation assisting instrument 1 from the treatment instrument outlet 9 a.
Are projected.

[0011] As shown in FIG.
A puncture needle 11 (see FIG. 4) for piercing a subject portion in a body structure, a coil sheath 12 (see FIG. 5) for inserting the puncture needle 11 and inserting into a body cavity, and a coil sheath 12
And the puncture needle 11 inserted from the rear end side.
And an auxiliary device main body 13 projecting from the distal end side together with the coil sheath 12.

The auxiliary instrument body 13 has a hollow fixed cylinder 21 having a detachable fixing portion 21 a at the treatment tool insertion port 8 which is a forceps channel entrance of the endoscope 2. A first slide portion 22 having a hollow structure inserted movably in the longitudinal direction on the inner side, an adjusting cylinder 23 for adjusting the protruding length of the puncture needle 11, and an inner portion movably inserted into the first slide portion 22. A second sliding portion 25 (see FIG. 3) having a hollow structure provided with a finger hook portion 24 on the rear end side;
A third slide part 2 having a hollow structure including a pipe part 26 described later inserted into the second slide part 25 so as to be able to advance and retreat, and a pipe base 27 fixed to a base end side of the pipe part 26.
8 mainly.

Next, referring to FIG.
3 will be described. A groove 31 is provided on one side surface of the fixed cylinder 21 in the longitudinal direction, and a first fixing screw 32 is screwed through the groove 31 to the vicinity of the tip of the first slide portion 22. A male screw part 33 is provided on the outer periphery of the base end side of the first slide part 22, and the adjusting cylinder 23 having a female screw corresponding to the male screw part 33 is screwed to the male screw part 33. In the vicinity of the center of the first slide portion 22, a switch portion 34 provided with a switch mechanism to be described later for projecting the puncture needle 11 is provided.

In this embodiment, it is possible to select a restricted state in which the puncture needle 11 cannot be projected from the switch section 34 and a released state in which the puncture needle 11 can be projected.
A safety device is provided to prevent the switch mechanism from functioning in the restricted state.

The adjusting cylinder 23 has a male screw part 33 at the tip end.
And the second slide part 2 is provided at the rear end side.
5 has a flat adjusting cylinder bottom portion 36 having a hole through which the small diameter portion 35 penetrates, and the second sliding portion 2
5 is provided with a coil spring 37 as an urging member for urging the first slide portion 22 toward the distal end side. The adjusting cylinder 23 can be moved back and forth by rotating it with respect to the first slide portion 22, and can be moved toward the base end until the adjusting cylinder bottom 36 contacts the damper 38 of the finger hook 24. Projection length 39 at the distance between 36 and damper 38
Is defined. (The length of the puncture needle 11 protruding by the urging force of the coil spring 37). In addition, FIG.
In the state (a), since the adjustment cylinder 23 is located at the most distal end side, the projection length 39 is the maximum projection length 40.

The second slide portion 25 includes a large-diameter portion 41, a small-diameter portion 35, and a
The large-diameter portion 41 and the small-diameter portion 35 are inserted into the first slide portion 22. The large diameter portion 41 has an outer diameter that is slightly smaller than the inner diameter of the first slide portion 22. The small diameter portion 35 is a pipe-shaped member having an outer diameter smaller than the inner diameter of the coil spring 37, and has the third slide portion 22 inserted therein. The coil spring 37 is inserted outside the small diameter portion 35 of the second slide portion 25 and inside the first slide portion 22. The proximal end side of the coil spring 37 is fixed to the proximal end side of the first slide portion 22, and the distal end side is the large diameter portion 4 of the second slide portion 25.
1 is fixed to the base end side. This coil spring 37
It is a compression spring and always urges the second slide portion 25 toward the distal end side with respect to the first slide portion 22 as described above.

The finger hanging portion 24 is provided with a disk-shaped damper fixing plate 42 on the distal end side and a disk-shaped finger hanging plate 43 on the proximal end side, and near the center of the finger hanging portion 24 in a direction perpendicular to the longitudinal axis. The second fixing screw 44 is screwed. A ring-shaped damper 38 made of a shock-absorbing material such as rubber is fixed to the tip end of the damper fixing plate 42. An annular groove portion 45 is provided in a part of the inner diameter of the finger hook portion 24, and an elastic ring 46 made of a material such as rubber is fitted therein. The inner diameter of the elastic ring 46 is slightly smaller than the outer diameter of the pipe portion 26 of the third slide portion 28.

A scale 47 (see FIG. 2) is formed on the outer periphery of the pipe portion 26 of the third slide portion 28 toward the front end with the front end surface of the damper 38 being zero.
The scale 47 is provided between the damper 38 and the adjusting cylinder bottom 3.
6 shows said protrusion length 39 defined by between 6. Two click grooves, which are annular grooves, are formed on the outer surface of the pipe portion 26, and the groove at the base end is the first click groove 48 and the groove at the tip is the second click groove 4 respectively.
It is 9. The first click groove 48 and the second click groove 49 are grooves that generate a slight locking force when the elastic ring 46 is fitted, and furthermore make the operator feel a click feeling. The second click groove 49 is formed on the tip side of the first click groove 48, and the distance between the first click groove 48 and the second click groove 49 is longer than the maximum protrusion length 40. Further, the third slide portion 28
The base end of the pipe base 27 is a male screw luer base 50. Note that a puncture needle retraction indicator (not shown) composed of a colored ring can be provided on the surface of the pipe portion 26 of the third slide portion 28, and the third slide portion 28 is completely located on the proximal end side. To the second click groove 49
It is provided at a position where it can be visually recognized only when it is clicked. (In FIG. 2, since the third slide portion is located closer to the distal end, the third slide portion is located inside the second slide portion 25 so that it cannot be visually recognized.) The operator can use the puncture needle retreat index to allow the operator to use it. It can be indirectly recognized that the puncture needle 11 is housed in the coil sheath 12,
By removing the puncture needle retraction index from the endoscope 2 after confirming it, it is possible to prevent the puncture needle 11 from piercing the forceps channel 9 of the endoscope at the time of removal.

Next, the coil sheath 12 removably fixed to the first slide portion 22 of the auxiliary device main body 13 will be described with reference to FIG. The coil sheath 12 includes a coil sheath insertion portion 51, a coil sheath base end portion 52, and a coil sheath mouthpiece 53. The coil sheath insertion portion 51 has the same length as the forceps channel 9 of the endoscope 2 and is formed of a flexible metal coil. The coil sheath insertion portion 51 has an inner diameter larger than the outer diameter of the puncture needle 11 and an outer diameter smaller than the forceps channel 9 of the endoscope 2. It penetrates through the fixed cylinder 21 and protrudes toward the distal end. The coil sheath base 53 is detachably screwed to the tip of the first slide portion 22 of the auxiliary device main body 13. The coil sheath base end 5
Numeral 2 is connected to the base end side of the coil sheath base 53 and is formed of the same coil as the coil sheath insertion portion 51, and is inserted halfway through the third slide portion 28 of the auxiliary device body 13. It has become.

Next, the puncture needle 11 for piercing the subject in the body cavity will be described with reference to FIG. The puncture needle 11 is configured to be detachably attached to a luer base 50 provided on the pipe base 27 of the auxiliary instrument body 13. The puncture needle 11 includes an outer needle 55, an outer needle base 56 fixed to the outer needle 55, an inner needle 57, and an inner needle base 58 fixed to the inner needle 57. The outer needle base 56 and the inner needle base 58 are removably combined with each other, and in this state, the tip of the inner needle 57 projects more toward the tip than the tip of the outer needle 55.

Next, referring to FIG.
Switch portion 34 provided on the first slide portion 22
The structure of will be described. As shown in FIG. 6, the switch seat 61 of the switch section 34 is provided on a cutout 62 formed near the center of the first slide section 22, and the switch seat 61 has a safety ring as a safety device. 63 and a button 64 as a switch mechanism are assembled.

The safety ring 63 is a ring-shaped member, and is attached to the switch seat 61 so as to be rotatable around an axis perpendicular to a longitudinal axis. This safety ring 6
A lock indicator 65, which is a pin-shaped member, is radially penetrated and fixed to the cylindrical surface 3, and protrudes from the inner surface and the outer surface of the safety ring 63.

The button 64 is incorporated inside the safety ring 63 and includes a button head 66, a shaft 67, and a pusher 68. The button head 66
Is a cylindrical member having the same size as the inner diameter of the safety ring 63. The shaft 67 is a rod-shaped member coaxial with the button head 66, and penetrates the switch seat 61 freely to advance and retreat. The pusher 68 is fixed to the other end of the shaft 67 and has a size that can be inserted into the notch 62.

A switch spring 69 is incorporated between the switch seat 61 of the shaft 67 and the button head 66.
4 is always biased upward in the figure. On the lower surface of the button head 66, a switch groove 71 is formed as a recess into which the lock indicator 65 can enter. As a result, as shown in FIG. 6A, the lock index 65 and the switch groove 71 are in a positional relationship shifted from each other by approximately 180 degrees, and the safety ring 63 is rotated around the shaft 67 to rotate the safety ring 63. The lock index 65 is set to the switch groove 71.
If the bottom of the button head 66 and the lock indicator 65 are in contact with each other,
It is in a restricted state in which the pressing operation cannot be performed. Then, when the safety ring 63 is rotated from this state to guide the lock indicator 65 to the same position as the switch groove 71, the lock indicator 6 is rotated as shown in FIG.
The position of 5 and the position of the switch groove 71 match, and the button 64 can be pressed down. That is, the regulation release state in which the puncture needle 11 can be protruded can be set.

The large diameter portion 41 of the second slide portion 25
A part thereof is cut out, and a latch 72 as a locking mechanism for temporarily locking the urging force of the coil spring 37 is incorporated. A swing shaft 73 perpendicular to the longitudinal axis penetrates the base end side of the latch 72, and the latch 72 is supported to be swingable about the swing shaft 73. By the swing of the swing shaft 73, the leading end side of the latch 72 can take a state of being accommodated in the outer diameter of the large diameter portion 41 of the second slide portion 25 and a state of protruding from the large diameter portion 41. Has become. A leaf spring 74 is attached to the leading end of the latch 72, and one end of the leaf spring 74 urges the leading end of the latch 72 to project from the large diameter portion 41.

In FIG. 6A, the leading end of the latch 72 is engaged with the cutout portion 62 of the first slide portion 22, and the second spring biased toward the leading end by the coil spring 37. The forward movement of the slide portion 25 is locked. As described with reference to FIG. 6B, the safety ring 63 is rotated around the shaft 67 to release the restriction, and the button head 66 is pressed down, so that the pusher 68 is cut as shown in FIG. 6C. When the notch 62 enters the notch 62 and the latch 72 locked to the notch 62 is pushed down, the latch between the notch 62 and the latch 72 is released. As a result, the biasing force of the coil spring 37 that biases the second slide portion 25 toward the distal end is released.

The operation of the puncture needle operation assisting device 1 thus configured will be described with reference to FIGS. First, the distal end portion 3a of the endoscope insertion portion is inserted and positioned near a target portion. Next, as shown in FIG. 9A, with the distal end of the puncture needle 11 being housed in the coil sheath 12, the fixing portion 2 of the puncture needle operation assisting instrument 1 is inserted into the treatment instrument insertion port 8 of the endoscope.
1a, the distal end of the puncture needle 11 is inserted into the distal end portion 3a of the endoscope insertion portion.
The coil sheath 12 is located slightly proximal to the distal end of the coil sheath 12.
Housed within. At this time, as shown in FIG. 7A, the first fixing screw 32 is in a tightened state, and the adjusting cylinder 23 is located at the most distal end side as described above. Is the maximum protrusion length 40. Also, the first
The click groove 48 is in a state of being fitted in the elastic ring 46, and the tip side of the latch 72 is locked in the notch 62 of the first slide portion 22, and is urged to the tip side by the urging force of the coil spring 37. The second slide portion 25 is stopped from moving forward.

Next, the first fixing screw 32 is loosened, and the first slide portion 22 is advanced to the distal end side. First fixing screw 32
Is guided by the groove 31 of the fixed cylinder 21 so that the first slide portion 22 moves forward. As shown in FIG. 9B, at the distal end portion 3a of the endoscope insertion portion at this time, the distal end of the coil sheath 12 under the observation of the optical field of view of the endoscope 2 or the ultrasonic image is moved to the vicinity of the target lesion portion 75. Let go forward. The first fixing screw 32 is tightened again to fix the first slide portion 22.

Next, the second fixing screw 44 is loosened so that the third slide portion 28 can move forward and backward with respect to the second slide portion 25. Then, the pipe cap 27 of the third slide portion 28 is gripped and advanced. The third slide portion 28 is provided on the elastic ring 4.
6 and the first click groove 48, it is locked with a light locking force, but the lock can be easily released manually to move forward. Then, as shown in FIG. 7B, the puncture needle 11 advances, and the tip of the puncture needle 11 projects from the tip of the coil sheath 12. By this operation, as shown in FIG. 9C, the patient is inserted up to the target lesion 75 under observation of the ultrasonic image. FIG. 7B shows a state where the third slide portion 28 is advanced to the maximum.

Next, using an ultrasonic observation device (not shown),
The distance from the current tip of the puncture needle 11 to the inside of the target lesion 75, that is, the distance to be projected by the coil spring 37 is measured. According to the measured distance, as shown in FIG. 7C, the adjustment cylinder 23 is rotated while reading the scale 47 to move the third slide portion 28 to a desired position to set the projection length 39. 2 Tighten the fixing screw 44, and
The slide portion 28 is set to be unable to advance and retreat with respect to the second slide portion 25. This is when the coil spring 37 projects
This is to prevent the slide portion 28 from retreating. Then, the safety ring 63 of the switch unit 34 is rotated from the restricted state described with reference to FIG. 6A, and the lock index 65 is the same as the switch groove 71 as described with reference to FIG. Turn until it is in the position. Lock indicator 6
5 protrudes also to the outer surface of the safety ring 63, so that the position of the lock indicator 65 can be grasped visually and tactilely by the operator. And the lock index 65 and the switch groove 7
When the position coincides with the position 1, the button 64 can be pressed down.

When the button head 66 is depressed as described with reference to FIG. 6C, the notch 62 and the latch 7
2 is released. Then, as shown in FIG. 8A, the second slide portion 25 urged to the distal end side by the urging force of the coil spring 37 advances at a high speed by the protrusion length 39. At this time, the damper 38 absorbs the shock when the third slide portion 28 collides with the adjustment cylinder 23.

At this time, the third slide portion 28 is fixed to the second slide portion 25 by the second fixing screw 44, and the puncture needle 11 is further fixed to the third slide portion 28. Therefore, as the second slide portion 25 advances at a high speed by the protrusion length 39, and the third slide portion 28 also advances at a high speed by the protrusion length 39, the puncture needle 11 simultaneously advances at a high speed. That is, when the button head 66 of the button 64 is pressed, the tip of the puncture needle 11 protrudes at a high speed by the length of the set protruding length 39, and FIG.
Is inserted into the target lesion 75 as shown in FIG.

To perform a suction biopsy, the inner needle base 58 is detached from the outer needle base 34 from this state, the inner needle 57 is pulled out as shown in FIG. 9 (e), and a syringe (not shown) is inserted into the outer needle base 56. Is connected to perform suction. After the suction biopsy is completed, the operation of removing the puncture needle operation assisting instrument 1 from the forceps channel 9 of the endoscope is performed as follows. First, the second
Loosen the fixing screw 44 and pull the third slide portion 28 to the proximal end to the maximum as shown in FIG. 8B. When the third slide portion 28 is pulled toward the proximal end as much as possible, the elastic ring 46 is in a state of fitting in the second click groove 49.

When the instrument is to be washed after the inspection, the lock index 65 is shifted and the finger hook 24 is pulled to prepare for cleaning the outer periphery of the pipe 26. Note that the puncture needle 11, the fixed cylinder 21, and the coil sheath 12 are detachable, and thus are removed during cleaning. Then, all the surfaces that may be exposed and contaminated as outer surfaces can be brushed.

The second click groove 49 and the first click groove 48
Is formed at a distance longer than the maximum protrusion length 40, so that even when the protrusion length 39 is set to the maximum and the protrusion is made, if the second click groove 49 and the elastic ring 46 are fitted, the puncture must be performed. The tip of the needle 11 is housed in the coil sheath 12. In this state, the fixing portion 21a
Is released, and the puncture needle operation assisting instrument 1 is removed from the forceps channel 9 of the endoscope. A test tube or the like (not shown) is prepared, and after inserting the distal end portion of the coil sheath 12 into the test tube, the third slide portion 28 is advanced to expose the distal end of the puncture needle 11, and the syringe connected to the outer needle base 56 is operated. Then, the cells of the target lesion 75 sucked into the outer needle 55 are collected in a test tube or the like.

When puncturing is continued, the following operation is performed. The used outer needle 55 is moved to the third slide portion 2
8 from the pipe base 27. By turning the safety ring 63, the lock index 65 and the switch groove 71 are shifted. Next, while holding the second slide portion 25,
3 and pulling it sufficiently toward the proximal end, the distal end of the latch 72 urged outward by the leaf spring 74
To lock. The third slide portion 28 is advanced, and is slid to a position where the first click groove 48 and the elastic ring 46 are fitted. Then, a new puncture needle 11 is prepared, inserted through the pipe base 27 and attached to the luer base 50. Then, since the state is the same as that of FIG. 7B, the same puncturing operation as described above becomes possible.

When the puncture needle operation assisting device 1 is to be washed after the inspection is completed, the lock index 65 is shifted to clean the outer periphery of the pipe portion 26 of the third slide portion 28, and the finger hook portion 2 is moved.
Pull 4 to get ready. The puncture needle 11 and the fixed cylinder 2
1. Since the coil sheath 12 is detachable, it is detached during cleaning. Then, all the surfaces that may be exposed and contaminated as outer surfaces can be brushed.

As a result, the lock indicator 65 of the safety ring 63 is shifted from the switch groove 71 until immediately before the puncture needle 11 is to be protruded by the coil spring 37. Is pressed, the switch 34 cannot be pushed down because the lock indicator 65 and the switch 34 are in contact with each other. Therefore, unintended protrusion of the puncture needle 11 does not occur. The same is true for the cleaning, and if the lock index 65 is shifted, the coil spring 37 does not accidentally work due to brushing or the like.

Further, since the third slide portion 28 can be pulled further toward the base end side than the ready state for projecting to a maximum projecting length of 40 or more and is locked by the second click groove 49, the coil spring 37 Even when the puncture needle 11 is protruded by the urging force, the puncture needle 11 can always be accommodated in the coil sheath 12, and the inner surface of the forceps channel 9 of the endoscope 2 is removed when the puncture needle operation auxiliary device 1 is removed. Does not hurt. Further, the fact that the tip of the puncture needle 11 is housed in the coil sheath 12 can be known by a click feeling. Also, when the contents subjected to the suction biopsy are collected, the coil sheath 12 can be held without directly holding the tip of the puncture needle 11, which is safer.

The present invention is not limited to only the above-described embodiments, but can be variously modified without departing from the gist of the invention.

(Second Embodiment) FIG. 10 is a longitudinal section showing the vicinity of the center of a puncture needle operation assisting device according to a second embodiment of the present invention. In the first embodiment, the switch unit 34 is provided with a safety ring 63 rotatable around an axis 67 and a lock indicator 65 radially penetrating and fixed to the cylindrical surface of the safety ring 63. By forming a switch groove 71 into which the lock indicator 65 can be inserted at one place on the lower surface of the
3 is rotated around the axis 67, and unless the lock indicator 65 is aligned with the switch groove 71, the bottom of the button head 66 is brought into contact with the lock indicator 65, so that the pressing operation of the button 64 is performed. Although it is configured to be in a restricted state where it cannot be performed, in the present embodiment, a bolt is provided as a safety device that suppresses the projecting operation of the slide unit until immediately before projecting the puncture needle. The other configurations are the same as those in FIG. 3, and thus description thereof will be omitted, and the same configurations will be denoted by the same reference numerals.

As shown in FIG. 10, in the piercing preparation state, a bolt hole 111 is provided in the first slide portion 22 of the puncture needle operation assisting device 101, and the second slide portion 2 is provided.
The position of the female screw 112 matches the position of the female screw 112 formed in the fifth female screw 5. A safety bolt 113 as a safety device is screwed into the female screw 112 of the second slide portion 25 through the bolt hole 111. The safety bolt 113 is a member provided with a male screw, and is connected to the first slide portion 22 by a chain 114. The switch portion 34 is provided with a safety ring 115 which is an annular member surrounding the button 64, and has an upper end surface 116 located above the upper end surface 117 of the button.

The puncture needle operation assisting device 101 thus configured is used to pierce a subject in a body cavity. Before using the puncture needle operation assisting device 101, the finger hook portion 24 is pulled to prepare for piercing, and then the safety bolt 113 is screwed into the female screw 112. Then, when using the puncture needle operation assisting instrument 101, the safety bolt 113 is pulled out immediately before the projecting by the urging force of the coil spring 37 is performed. Thereafter, the button 64 is depressed to cause the puncture needle 11 to protrude.

As a result, since the safety bolt 113 is screwed into the female screw 112 of the second slide portion 25, the puncture needle 11 does not project even if the button 64 is pressed by mistake. In addition, since the upper end surface of the safety ring 115 is located above the upper end surface 117 of the button 64, it is difficult to touch the button 64, and the button 64 is depressed except for the operation of intentionally pushing down the button 64. The chances of doing so are very small.

It should be noted that the present invention is not limited to only the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

[Supplementary Note] (Supplementary Note 1) A long puncture needle which is provided at the forceps channel entrance of the endoscope and is used by penetrating the forceps channel, for piercing a subject portion in a body cavity. A long sheath for accommodating the puncture needle, a slide portion for holding the puncture needle freely reciprocating, an urging mechanism for projecting the puncture needle by the urging force of an urging member, and a urging mechanism of the urging mechanism. A locking mechanism for temporarily locking the biasing force of the biasing member, and a switch mechanism for releasing the locked state of the locking mechanism, and a regulating state in which the puncture needle cannot be protruded; and A puncture needle operation assisting device for an endoscope, wherein a safety release device is provided, which can select a restriction release state in which the puncture needle can be protruded, and does not operate the switch mechanism in the restriction state.

(Additional Item 2) When the slide portion is locked by the locking mechanism with the biasing force of the biasing member of the biasing mechanism, the positions of the distal end of the puncture needle and the distal end of the sheath substantially match. A first click mechanism for generating a click in a pressed state, and a second click mechanism for generating a click in a state where the puncture needle is further pulled to the proximal side from the click state of the first click mechanism. The puncture needle for an endoscope according to claim 1, wherein a distance between the first click mechanism and the second click mechanism is equal to or longer than a maximum length that allows the puncture needle to be protruded by the urging mechanism. Operation aids.

(Additional Item 3) The slide portion may be the second
3. The puncture needle operation assisting device for an endoscope according to claim 2, further comprising means for visually displaying that the click mechanism is in a clicked state.

[Additional Effect] (Additional Item 1) In the puncture needle operation assisting device for an endoscope, the switch mechanism for projecting the puncture needle by the urging force of the urging member can be disabled by the safety device. . Therefore, unintended puncture needle (projection mechanism when the puncture needle is removed) can be prevented from protruding during preparation of the test, during the test, and during cleaning of the instrument, and the puncture of the forceps channel of the endoscope can be prevented. In addition, it is possible to prevent unintended perforation of the patient and injury during washing.

(Additional Item 2) When removing the puncture needle operation assisting device from the forceps channel of the endoscope, pull the slide portion regardless of the length of projection of the puncture needle due to the urging force of the urging member. Thus, the tip of the puncture needle can be stored in the sheath. Therefore, it is possible to prevent the forceps channel of the endoscope from being pierced.

(Additional Item 3) The operator can further recognize that the puncture needle is housed in the sheath.

[0052]

As described above, according to the present invention, a puncture needle operation assisting device for an endoscope having a function of preventing unintended protrusion of a puncture needle can be realized.

[Brief description of the drawings]

FIG. 1 to FIG. 9 relate to a first embodiment of the present invention, and FIG. 1 shows a puncture needle operation assisting device for an endoscope provided in a forceps channel entrance of an endoscope. FIG.

FIG. 2 is an external view of the puncture needle operation assisting device for an endoscope in FIG.

FIG. 3 is a longitudinal sectional view in FIG. 2;

FIG. 4 is an external view showing a coil sheath in FIG. 3;

FIG. 5 is an explanatory view showing the puncture needle in FIG. 3;

6A and 6B are explanatory views illustrating a switch unit in FIG. 3; FIG. 6A is a cross-sectional view illustrating a restricted state in which a button cannot be pressed; FIG. FIG. 6C is a cross-sectional view showing a state in which the restriction is released, and FIG.

7 and 8 are views for explaining the operation of the puncture needle operation assisting device for an endoscope, and FIG. 7 (a) is a longitudinal section showing a puncture preparation state in which the tip of the puncture needle is accommodated in a coil sheath. FIG. 7B is a longitudinal sectional view showing a state in which the tip of the puncture needle is projected from the tip of the coil sheath with the third slide portion advanced to the maximum, and FIG. FIG. 3 is a longitudinal sectional view showing a state in which a protruding length is set.

FIG. 8A is a longitudinal sectional view showing a state in which the tip of the puncture needle is projected at a high speed by a set projection length, and FIG.
(B) A longitudinal cross-sectional view showing a state where the third slide portion is maximally pulled toward the proximal end when the puncture needle operation assisting device is removed from the forceps channel of the endoscope.

FIG. 9 is an explanatory diagram for explaining the operation of the tip of the puncture needle,
9A is an explanatory diagram showing a piercing preparation state in which the tip of the puncture needle is housed in the coil sheath, FIG. 9B is an explanatory diagram showing a state in which the tip of the puncture needle projects from the coil sheath tip, FIG. (C) is an explanatory view showing a state in which the distal end of the puncture needle is advanced to set a protruding length, and FIG. 9 (d) shows a state in which the puncture needle is protruded and extracted to a lesion in a body cavity. FIG. 9E is an explanatory view showing a state in which the puncture needle is pulled out when performing a suction biopsy.

FIG. 10 is a longitudinal section showing the vicinity of the center of a puncture needle operation assisting device according to a second embodiment of the present invention.

[Explanation of symbols]

1, 101: puncture needle operation assisting device (endoscopic puncture needle operation assisting device) 2: endoscope 8: treatment tool insertion port (forceps channel inlet) 9: forceps channel 9a: treatment tool outlet 11: puncture needle DESCRIPTION OF SYMBOLS 12 ... Coil sheath 13 ... Auxiliary device main body 21 ... Fixed cylinder 21a ... Fixed part 22 ... First slide part 23 ... Adjustment cylinder 25 ... Second slide part 28 ... Third slide part 32 ... First fixed screw 34 ... Switch part 37 ... Coil spring (biasing member) 44 ... second fixing screw 63 ... safety ring (safety device) 64 ... button (switch mechanism) 65 ... lock index 71 ... switch groove 72 ... latch (locking mechanism) 113 ... safety bolt (safety) apparatus)

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[Procedure amendment]

[Submission date] March 23, 2000 (200.3.2.
3)

[Procedure amendment 1]

[Document name to be amended] Statement

[Correction target item name] Full text

[Correction method] Change

[Correction contents]

[Document Name] Statement

[Title of the Invention] Puncture needle operation aid for endoscope

[Claims]

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a puncture needle assisting device for an endoscope having a puncture needle which is inserted into a forceps channel of an endoscope and punctures a subject in a body cavity.

[0002]

2. Description of the Related Art In recent years, under observation of an ultrasonic tomographic image with an ultrasonic endoscope, a long puncture needle is guided to a subject portion through a forceps channel using an ultrasonic tomographic image as a guide to remove a diseased tissue. Techniques for puncturing, collecting cells and tissues, and performing pathological confirmation diagnosis have come to be performed. In order to make such a diagnosis, for example, as described in Japanese Patent Application Laid-Open No. 9-103433, an endoscope puncture needle operation assisting instrument that can be fixed to a forceps channel entrance of an ultrasonic endoscope has been proposed. I have.

In this puncture needle operation assisting device for an endoscope, the puncture needle insertion operation (the forward and backward movement of the needle) is manually performed.
If the subject is relatively hard (not easy to puncture), manual puncturing may not be easy. That is, the tip of the puncture needle hardly sticks to the hard object part, and even if the puncture needle is pushed in, the object part is likely to fall into the back only. It is known that, when performing a puncture on a subject part that is hard and difficult to puncture, the puncture needle is projected at a high speed to facilitate the puncture. In general, the sharpness of a puncture needle is improved as the puncture needle protrudes at a higher speed, but it is difficult to manually protrude the puncture needle at such a high speed.

In order to solve this problem, there has been proposed a device in which, for example, a spring is incorporated as an urging member in a puncture needle operation assisting device for an endoscope, and the puncture needle is inserted by the urging force of the spring. However, in order to accurately insert the puncture needle into a hard object part, it is necessary to project the puncture needle at a very high speed. For that purpose, it is necessary to incorporate a powerful spring into the puncture needle operation assisting device for an endoscope.

However, when using the puncture needle operation assisting device for an endoscope incorporating such a biasing member, there is a possibility that the puncture needle may be protruded at an unintended timing due to an erroneous operation. For example, if the puncture needle is accidentally projected to an unexpected part of the living body, a puncture will be made to a part that does not need to be punctured. Also,
When the puncture needle operation assisting device for an endoscope is attached to, for example, an ultrasonic endoscope, if the puncture needle is protruded by mistake, there is a possibility that the puncture needle of the ultrasonic endoscope may be punctured. Further, if the cleaning tool is erroneously protruded during the cleaning operation when the entire surface of the utensil is set to the protruding preparation state for cleaning, there is a possibility that the cleaner may pinch a finger.

[0006]

The puncture needle operation assisting device for an endoscope used under the above-mentioned ultrasonic tomographic image observation is very high-speed in order to accurately insert the puncture needle into a hard object part. It is necessary to protrude the puncture needle. For this purpose, there has been proposed a device in which a strong urging member is incorporated and the puncture needle is inserted by the urging force of the urging member. However, the puncture needle operation assisting device for an endoscope incorporating such a powerful urging member may cause the puncture needle to protrude at an unintended timing due to an erroneous operation.

The present invention has been made in view of these circumstances, and is an auxiliary instrument provided at the entrance of a forceps channel of an endoscope and having a function of protruding a puncture needle by a built-in urging member. Another object of the present invention is to provide an endoscope puncture needle operation assisting device having a function of preventing unintended puncture needle projection.

[0008]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention is provided at an entrance of a forceps channel of an endoscope and is used by being inserted into the forceps channel. A long puncture needle for puncturing, a long sheath for accommodating the puncture needle, a slide portion for holding the puncture needle freely reciprocating, and a device for projecting the puncture needle by the urging force of an urging member A biasing mechanism, a locking mechanism for temporarily locking the biasing force of the biasing member of the biasing mechanism, and a switch mechanism for releasing the locked state of the locking mechanism,
A safety device is provided which can select a restriction state in which the puncture needle cannot be protruded and a restriction release state in which the puncture needle can be protruded, and does not operate the switch mechanism in the restriction state. And With this configuration, even when the switch mechanism is operated by an erroneous operation, the protrusion of the puncture needle is prevented. That is, unintended protrusion of the puncture needle is prevented.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 9 relate to a first embodiment of the present invention, and FIG. 1 shows the operation of a puncture needle for an endoscope provided at a forceps channel entrance of an endoscope. FIG. 2 is an explanatory perspective view showing an auxiliary device, FIG. 2 is an external view of an endoscope puncture needle operation auxiliary device of FIG. 1, FIG. 3 is a longitudinal sectional view of FIG. 2, and FIG. 4 is an external view of a coil sheath of FIG. 5 is an explanatory view showing the puncture needle of FIG. 3, FIG. 6 is an explanatory view of the switch unit of FIG. 3, and FIG. 6 (a) is a cross-sectional view showing a restricted state where a button cannot be pressed. 6 (b) is a cross-sectional view showing a regulation release state in which a button can be pressed, FIG. 6 (c) is a cross-sectional view showing a state in which the locked state of the coil spring is released by pressing the button, 7 and 8 are views for explaining the operation of the puncture needle operation assisting device for an endoscope. FIG. 7 (a) shows a state in which the tip of the puncture needle is housed in a coil sheath. 7 (b) is a longitudinal sectional view showing a puncture preparation state, and FIG. 7 (b) is a longitudinal sectional view showing a state where the tip of the puncture needle is projected from the tip of the coil sheath with the third slide portion advanced to the maximum. FIG. 8C is a vertical cross-sectional view showing a state in which the adjustment cylinder is rotated to set the protrusion length, and FIG.
FIG. 8B is a vertical cross-sectional view showing a state in which the tip of the puncture needle is projected at a high speed by the set projection length. FIG. 8B shows the third state when the puncture needle operation assisting tool is removed from the forceps channel of the endoscope.
FIG. 9 is a longitudinal sectional view showing a state in which the slide portion is pulled to the proximal end to the maximum extent. FIG. 9 is an explanatory view for explaining the operation of the distal end of the puncture needle. FIG. FIG. 9B is an explanatory view showing a stored puncture preparation state, FIG. 9B is an explanatory view showing a state where the tip of the puncture needle projects from the tip of the coil sheath, and FIG. FIG. 9D is an explanatory view showing a state in which the length is set, FIG. 9D is an explanatory view showing a state in which a puncture needle is protruded to puncture a lesion in a body cavity, and FIG. 9E is a suction biopsy. FIG. 7 is an explanatory view showing a state in which the puncture needle is removed at the time.

As shown in FIG. 1, a puncture needle operation assisting device for an endoscope (hereinafter, simply referred to as a puncture needle operation assisting device) 1 is connected to an ultrasonic endoscope or an endoscope 2 through a forceps channel (not shown). It is designed to be guided into the body cavity. The endoscope 2 includes an elongated insertion section 3 inserted into a body cavity, an operation section 4 provided at a rear end of the insertion section 3, and an eyepiece section disposed at a rear end of the operation section 4. 5, a universal cord 6 extending from the operation unit 4, and the universal cord 6
And a connector 7 provided at an end of the operation unit 4.
A treatment instrument insertion port 8 for inserting a treatment instrument such as a treatment instrument is provided. The treatment instrument insertion port 8 communicates with a treatment instrument outlet 9a formed in the distal end portion 3a of the insertion section via a forceps channel 9 disposed in the insertion section 3 (see FIG. 9). Therefore, by inserting the puncture needle operation assisting instrument 1 through the treatment instrument insertion port 8, the puncture needle 11 disposed at the distal end of the puncture needle operation assisting instrument 1 from the treatment instrument outlet 9a.
Are projected.

[0011] As shown in FIG.
A puncture needle 11 (see FIG. 4) for puncturing a subject portion in a body cavity, a coil sheath 12 (see FIG. 5) for inserting the puncture needle 11 into the body cavity, and a coil sheath 12
Puncture needle 11 inserted from the rear end side
And an auxiliary device main body 13 projecting from the distal end side together with the coil sheath 12.

The auxiliary instrument body 13 has a hollow fixed cylinder 21 having a detachable fixing portion 21 a at the treatment tool insertion port 8 which is a forceps channel entrance of the endoscope 2. A first slide portion 22 having a hollow structure inserted movably in the longitudinal direction on the inner side, an adjusting cylinder 23 for adjusting the protruding length of the puncture needle 11, and a first slide portion 22 internally provided so as to be able to advance and retreat. A second sliding portion 25 (see FIG. 3) having a hollow structure provided with a finger hook portion 24 on the rear end side;
A third slide part 2 having a hollow structure including a pipe part 26 described later inserted into the second slide part 25 so as to be able to advance and retreat, and a pipe base 27 fixed to a base end side of the pipe part 26.
8 mainly.

Next, referring to FIG.
3 will be described. A groove 31 is provided on one side surface of the fixed cylinder 21 in the longitudinal direction, and a first fixing screw 32 is screwed through the groove 31 to the vicinity of the tip of the first slide portion 22. A male screw part 33 is provided on the outer periphery of the base end side of the first slide part 22, and the adjusting cylinder 23 having a female screw corresponding to the male screw part 33 is screwed to the male screw part 33. In the vicinity of the center of the first slide portion 22, a switch portion 34 provided with a switch mechanism to be described later for projecting the puncture needle 11 is provided.

In this embodiment, it is possible to select a restricted state in which the puncture needle 11 cannot be projected from the switch section 34 and a released state in which the puncture needle 11 can be projected.
A safety device is provided to prevent the switch mechanism from functioning in the restricted state.

The adjusting cylinder 23 has a male screw part 33 at the tip end.
And the second slide part 2 is provided at the rear end side.
5 has a flat adjusting cylinder bottom portion 36 having a hole through which the small diameter portion 35 penetrates, and the second sliding portion 2
5 is provided with a coil spring 37 as an urging member for urging the first slide portion 22 toward the distal end side. The adjusting cylinder 23 can be moved back and forth by rotating it with respect to the first slide portion 22, and can be moved toward the base end until the adjusting cylinder bottom 36 contacts the damper 38 of the finger hook 24. Projection length 39 at the distance between 36 and damper 38
Is defined. (The length of the puncture needle 11 protruding by the urging force of the coil spring 37). In addition, FIG.
In the state (a), since the adjustment cylinder 23 is located at the most distal end side, the projection length 39 is the maximum projection length 40.

The second slide portion 25 includes a large-diameter portion 41, a small-diameter portion 35, and a
The large-diameter portion 41 and the small-diameter portion 35 are inserted into the first slide portion 22. The large diameter portion 41 has an outer diameter that is slightly smaller than the inner diameter of the first slide portion 22. The small-diameter portion 35 is a pipe-shaped member having an outer diameter smaller than the inner diameter of the coil spring 37, and the pipe portion 26 of the third slide portion 28 is inserted therein.
The coil spring 37 is inserted outside the small diameter portion 35 of the second slide portion 25 and inside the first slide portion 22. The proximal end of the coil spring 37 is fixed to the proximal end of the first slide portion 22, and the distal end is fixed to the proximal end of the large diameter portion 41 of the second slide portion 25. The coil spring 37 is a compression spring, and always urges the second slide portion 25 toward the distal end side with respect to the first slide portion 22 as described above.

The finger hanging portion 24 is provided with a disk-shaped damper fixing plate 42 on the distal end side and a disk-shaped finger hanging plate 43 on the proximal end side, and near the center of the finger hanging portion 24 in a direction perpendicular to the longitudinal axis. The second fixing screw 44 is screwed. A ring-shaped damper 38 made of a shock-absorbing material such as rubber is fixed to the tip end of the damper fixing plate 42. An annular groove portion 45 is provided in a part of the inner diameter of the finger hook portion 24, and an elastic ring 46 made of a material such as rubber is fitted therein. The inner diameter of the elastic ring 46 is slightly smaller than the outer diameter of the pipe portion 26 of the third slide portion 28.

A scale 47 (see FIG. 2) is formed on the outer periphery of the small-diameter portion 35 of the second slide portion 25 with the front end surface of the damper 38 set to zero and toward the front end side.
The scale 47 is provided between the damper 38 and the adjusting cylinder bottom 3.
6 shows said protrusion length 39 defined by between 6. Further, two click grooves, which are annular grooves, are formed on the outer surface of the pipe portion 26 of the third slide portion 28, and a groove at the base end is a first click groove 48 and a groove at the tip end, respectively. Are the second click grooves 49. The first click groove 48 and the second click groove 49 are grooves that generate a slight locking force when the elastic ring 46 is fitted, and furthermore make the operator feel a click feeling. The second click groove 49 is formed on the tip side of the first click groove 48, and the distance between the first click groove 48 and the second click groove 49 is longer than the maximum protrusion length 40. The proximal end of the pipe base 27 of the third slide portion 28 is a male screw luer base 50. Note that a puncture needle retraction indicator (not shown) composed of a colored ring can be provided on the surface of the pipe portion 26 of the third slide portion 28, and the third slide portion 28 is completely located on the proximal end side. And is provided at a position where it can be visually recognized only when the second click groove 49 is clicked. (In FIG. 2, since the third slide portion 28 is located on the more distal end side, the pipe portion 26 is located inside the second slide portion 25 and cannot be visually recognized.) Accordingly, the operator can indirectly recognize that the puncture needle 11 is housed in the coil sheath 12, confirm this puncture needle retreat index, and then remove the puncture needle from the endoscope 2, so that the The puncture needle 11 can be prevented from piercing the forceps channel 9 of the endoscope.

Next, the coil sheath 12 removably fixed to the first slide portion 22 of the auxiliary device main body 13 will be described with reference to FIG. The coil sheath 12 includes a coil sheath insertion portion 51, a coil sheath base end portion 52, and a coil sheath mouthpiece 53. The coil sheath insertion portion 51 has the same length as the forceps channel 9 of the endoscope 2 and is formed of a flexible metal coil. The coil sheath insertion portion 51 has an inner diameter larger than the outer diameter of the puncture needle 11 and an outer diameter smaller than the forceps channel 9 of the endoscope 2. It penetrates through the fixed cylinder 21 and protrudes toward the distal end. The coil sheath base 53 is detachably screwed to the tip of the first slide portion 22 of the auxiliary device main body 13. The coil sheath base end 5
Numeral 2 is connected to the base end side of the coil sheath base 53 and is formed of the same coil as the coil sheath insertion portion 51, and is inserted halfway through the third slide portion 28 of the auxiliary device body 13. It has become.

Next, the puncture needle 11 for puncturing the subject in the body cavity will be described with reference to FIG. The puncture needle 11 is configured to be detachably attached to a luer base 50 provided on the pipe base 27 of the auxiliary instrument body 13. The puncture needle 11 includes an outer needle 55, an outer needle base 56 fixed to the outer needle 55, an inner needle 57, and an inner needle base 58 fixed to the inner needle 57. The outer needle base 56 and the inner needle base 58 are removably combined with each other, and in this state, the tip of the inner needle 57 projects more toward the tip than the tip of the outer needle 55.

Next, referring to FIG.
Switch portion 34 provided on the first slide portion 22
The structure of will be described. As shown in FIG. 6, the switch seat 61 of the switch section 34 is provided on a cutout 62 formed near the center of the first slide section 22, and the switch seat 61 has a safety ring as a safety device. 63 and a button 64 as a switch mechanism are assembled.

The safety ring 63 is a ring-shaped member, and is attached to the switch seat 61 so as to be rotatable around an axis perpendicular to a longitudinal axis. This safety ring 6
A lock indicator 65, which is a pin-shaped member, is radially penetrated and fixed to the cylindrical surface 3 and protrudes from the inner surface and the outer surface of the safety ring 63.

The button 64 is incorporated inside the safety ring 63 and includes a button head 66, a shaft 67, and a pusher 68. The button head 66
Is a cylindrical member having the same size as the inner diameter of the safety ring 63. The shaft 67 is a rod-shaped member coaxial with the button head 66, and penetrates the switch seat 61 freely to advance and retreat. The pusher 68 is fixed to the other end of the shaft 67 and has a size that can be inserted into the notch 62.

A switch spring 69 is incorporated between the switch seat 61 of the shaft 67 and the button head 66.
4 is always biased upward in the figure. On the lower surface of the button head 66, a switch groove 71 is formed as a recess into which the lock indicator 65 can enter. As a result, as shown in FIG. 6A, the lock index 65 and the switch groove 71 are in a positional relationship shifted from each other by approximately 180 degrees, and the safety ring 63 is rotated around the shaft 67 to rotate the safety ring 63. The lock index 65 is set to the switch groove 71.
If the bottom of the button head 66 and the lock indicator 65 are in contact with each other,
It is in a restricted state in which the pressing operation cannot be performed. Then, when the safety ring 63 is rotated from this state to guide the lock indicator 65 to the same position as the switch groove 71, the lock indicator 6 is rotated as shown in FIG.
The position of 5 and the position of the switch groove 71 match, and the button 64 can be pressed down. That is, the regulation release state in which the puncture needle 11 can be protruded can be set.

The large diameter portion 41 of the second slide portion 25
A part thereof is cut out, and a latch 72 as a locking mechanism for temporarily locking the urging force of the coil spring 37 is incorporated. A swing shaft 73 perpendicular to the longitudinal axis penetrates the base end side of the latch 72, and the latch 72 is supported to be swingable about the swing shaft 73. By the swing of the swing shaft 73, the leading end side of the latch 72 can take a state of being accommodated in the outer diameter of the large diameter portion 41 of the second slide portion 25 and a state of protruding from the large diameter portion 41. Has become. A leaf spring 74 is attached to the leading end of the latch 72, and one end of the leaf spring 74 urges the leading end of the latch 72 to project from the large diameter portion 41.

In FIG. 6A, the leading end of the latch 72 is engaged with the cutout portion 62 of the first slide portion 22, and the second spring biased toward the leading end by the coil spring 37. The forward movement of the slide portion 25 is locked. As described with reference to FIG. 6B, the safety ring 63 is rotated around the shaft 67 to release the restriction, and the button head 66 is pressed down, so that the pusher 68 is cut as shown in FIG. 6C. When the notch 62 enters the notch 62 and the latch 72 locked to the notch 62 is pushed down, the latch between the notch 62 and the latch 72 is released. As a result, the biasing force of the coil spring 37 that biases the second slide portion 25 toward the distal end is released.

The operation of the puncture needle operation assisting device 1 configured as described above will be described with reference to FIGS. First, the distal end portion 3a of the endoscope insertion portion is inserted and positioned near a target portion. Next, as shown in FIG. 9A, with the distal end of the puncture needle 11 being housed in the coil sheath 12, the fixing portion 21 of the puncture needle operation assisting instrument 1 is inserted into the treatment instrument insertion port 8 of the endoscope.
When a is fixed and inserted, the distal end of the puncture needle 11 is located slightly proximal to the distal end of the coil sheath 12 inserted into the distal end portion 3a of the endoscope insertion portion and is housed in the coil sheath 12. . At this time, as shown in FIG.
The fixing screw 32 is in a tightened state, and the adjusting cylinder 23 is located at the most distal end side as described above.
One projection length 39 becomes the maximum projection length 40. In addition, the first click groove 48 is in a state of being fitted in the elastic ring 46, and the leading end side of the latch 72 is locked in the notch 62 of the first slide portion 22, and the biasing force of the coil spring 37 moves toward the leading end side. The biased second slide portion 25 is stopped from moving forward.

Next, the first fixing screw 32 is loosened, and the first slide portion 22 is advanced to the distal end side. First fixing screw 32
Is guided by the groove 31 of the fixed cylinder 21 so that the first slide portion 22 moves forward. As shown in FIG. 9B, at the distal end portion 3a of the endoscope insertion portion at this time, the distal end of the coil sheath 12 under the observation of the optical field of view of the endoscope 2 or the ultrasonic image is moved to the vicinity of the target lesion portion 75. Let go forward. The first fixing screw 32 is tightened again to fix the first slide portion 22.

Next, the second fixing screw 44 is loosened so that the third slide portion 28 can move forward and backward with respect to the second slide portion 25. Then, the pipe cap 27 of the third slide portion 28 is gripped and advanced. The third slide portion 28 is provided on the elastic ring 4.
6 and the first click groove 48, it is locked with a light locking force, but the lock can be easily released manually to move forward. Then, as shown in FIG. 7B, the puncture needle 11 advances, and the tip of the puncture needle 11 projects from the tip of the coil sheath 12. By this operation, as shown in FIG. 9C, the patient is inserted up to the target lesion 75 under observation of the ultrasonic image. FIG. 7B shows a state where the third slide portion 28 is advanced to the maximum.

Next, using an ultrasonic observation device (not shown),
The distance from the current tip of the puncture needle 11 to the inside of the target lesion 75, that is, the distance to be projected by the coil spring 37 is measured. According to the measured distance, as shown in FIG. 7C, the adjustment cylinder 23 is rotated while reading the scale 47 to move the third slide portion 28 to a desired position to set the projection length 39. 2 Tighten the fixing screw 44, and
The slide portion 28 is set to be unable to advance and retreat with respect to the second slide portion 25. This is when the coil spring 37 projects
This is to prevent the slide portion 28 from retreating. Then, the safety ring 63 of the switch unit 34 is rotated from the regulated state described with reference to FIG. Turn until it is in the position. Lock indicator 6
5 protrudes also to the outer surface of the safety ring 63, so that the position of the lock indicator 65 can be visually and tactilely grasped by the operator. And the lock index 65 and the switch groove 7
When the position coincides with the position 1, the button 64 can be pressed down.

When the button head 66 is depressed as described with reference to FIG. 6C, the notch 62 and the latch 7
2 is released. Then, as shown in FIG. 8A, the second slide portion 25 urged to the distal end side by the urging force of the coil spring 37 advances at a high speed by the protrusion length 39. At this time, the damper 38 absorbs the shock when the third slide portion 28 collides with the adjustment cylinder 23.

At this time, the third slide portion 28 is fixed to the second slide portion 25 by the second fixing screw 44, and the puncture needle 11 is further fixed to the third slide portion 28. Therefore, as the second slide portion 25 advances at a high speed by the protrusion length 39, and the third slide portion 28 also advances at a high speed by the protrusion length 39, the puncture needle 11 simultaneously advances at a high speed. That is, when the button head 66 of the button 64 is pressed, the tip of the puncture needle 11 protrudes at a high speed by the length of the set protruding length 39, and FIG.
Is inserted into the target lesion 75 as shown in FIG.

To perform a suction biopsy, the inner needle base 58 is detached from the outer needle base 34 from this state, the inner needle 57 is pulled out as shown in FIG. 9 (e), and a syringe (not shown) is inserted into the outer needle base 56. Is connected to perform suction. After the suction biopsy is completed, the operation of removing the puncture needle operation assisting instrument 1 from the forceps channel 9 of the endoscope is performed as follows. First, the second
Loosen the fixing screw 44 and pull the third slide portion 28 to the proximal end to the maximum as shown in FIG. 8B. When the third slide portion 28 is pulled toward the proximal end as much as possible, the elastic ring 46 is in a state of fitting in the second click groove 49.

When the instrument is to be washed after the inspection, the lock index 65 is shifted and the finger hook 24 is pulled to prepare for cleaning the outer periphery of the pipe 26. Note that the puncture needle 11, the fixed cylinder 21, and the coil sheath 12 are detachable, and thus are removed during cleaning. Then, all the surfaces that may be exposed and contaminated as outer surfaces can be brushed.

The second click groove 49 and the first click groove 48
Is formed at a distance longer than the maximum protrusion length 40, so that even when the protrusion length 39 is set to the maximum and the protrusion is made, if the second click groove 49 and the elastic ring 46 are fitted, the puncture must be performed. The tip of the needle 11 is housed in the coil sheath 12. In this state, the fixing portion 21a
Is released, and the puncture needle operation assisting instrument 1 is removed from the forceps channel 9 of the endoscope. A test tube or the like (not shown) is prepared, and after inserting the distal end portion of the coil sheath 12 into the test tube, the third slide portion 28 is advanced to expose the distal end of the puncture needle 11, and the syringe connected to the outer needle base 56 is operated. The cells of the target lesion 75 sucked into the outer needle 55 are collected in a test tube or the like.

When puncturing is continued, the following operation is performed. The used outer needle 55 is moved to the third slide portion 2
8 from the pipe base 27. By turning the safety ring 63, the lock index 65 and the switch groove 71 are shifted. Next, while holding the second slide portion 25,
3 and pulling it sufficiently toward the proximal end, the distal end of the latch 72 urged outward by the leaf spring 74
To lock. The third slide portion 28 is advanced, and is slid to a position where the first click groove 48 and the elastic ring 46 are fitted. Then, a new puncture needle 11 is prepared, inserted through the pipe base 27 and attached to the luer base 50. Then, since the state is the same as that of FIG. 7B, the same puncturing operation as described above becomes possible.

When the puncture needle operation assisting instrument 1 is to be washed after the inspection, the lock index 65 is shifted and the finger hook 2 is moved to wash the outer periphery of the pipe section 26 of the third slide section 28.
Pull 4 to get ready. The puncture needle 11 and the fixed cylinder 2
1. Since the coil sheath 12 is detachable, it is detached during cleaning. Then, all the surfaces that may be exposed and contaminated as outer surfaces can be brushed.

As a result, the lock indicator 65 of the safety ring 63 is shifted from the switch groove 71 until immediately before the puncture needle 11 is to be protruded by the coil spring 37. Is pressed, the switch 34 cannot be pushed down because the lock indicator 65 and the switch 34 are in contact with each other. Therefore, unintended protrusion of the puncture needle 11 does not occur. The same is true for the cleaning, and if the lock index 65 is shifted, the coil spring 37 does not accidentally work due to brushing or the like.

Further, since the third slide portion 28 can be pulled further toward the base end side than the ready state for projecting to a maximum projecting length of 40 or more and is locked by the second click groove 49, the coil spring 37 Even when the puncture needle 11 is protruded by the urging force, the puncture needle 11 can always be accommodated in the coil sheath 12, and the inner surface of the forceps channel 9 of the endoscope 2 is removed when the puncture needle operation auxiliary device 1 is removed. Does not hurt. Further, the fact that the tip of the puncture needle 11 is housed in the coil sheath 12 can be known by a click feeling. Also, when the contents subjected to the suction biopsy are collected, the coil sheath 12 can be held without directly holding the tip of the puncture needle 11, which is safer.

The present invention is not limited to only the above-described embodiments, but can be variously modified without departing from the gist of the invention.

(Second Embodiment) FIG. 10 is a longitudinal section showing the vicinity of the center of a puncture needle operation assisting device according to a second embodiment of the present invention. In the first embodiment, the switch unit 34 is provided with a safety ring 63 rotatable around an axis 67 and a lock indicator 65 radially penetrating and fixed to the cylindrical surface of the safety ring 63. By forming a switch groove 71 into which the lock indicator 65 can be inserted at one place on the lower surface of the
3 is rotated around the axis 67, and unless the lock indicator 65 is aligned with the switch groove 71, the bottom of the button head 66 is brought into contact with the lock indicator 65, so that the pressing operation of the button 64 is performed. Although it is configured to be in a restricted state where it cannot be performed, in the present embodiment, a bolt is provided as a safety device that suppresses the projecting operation of the slide unit until immediately before projecting the puncture needle. The other configurations are the same as those in FIG. 3, and thus description thereof will be omitted, and the same configurations will be denoted by the same reference numerals.

As shown in FIG. 10, in the puncture preparation state, the first slide portion 22 of the puncture needle operation assisting instrument 101 is provided with a bolt hole 111, and the second slide portion 2 is provided.
The position of the female screw 112 matches the position of the female screw 112 formed in the fifth female screw 5. A safety bolt 113 as a safety device is screwed into the female screw 112 of the second slide portion 25 through the bolt hole 111. The safety bolt 113 is a member provided with a male screw, and is connected to the first slide portion 22 by a chain 114. The switch section 34 is provided with a safety ring 115 which is an annular member surrounding the button 64, and has an upper end surface 116 located above the upper end surface 117 of the button.

Using the puncture needle operation assisting device 101 thus configured, the subject is punctured in the body cavity. Before using the puncture needle operation assisting device 101, the finger hook 24 is pulled to prepare for puncture, and the safety bolt 113 is screwed into the female screw 112. Then, when using the puncture needle operation assisting tool 101, the safety bolt 113 is pulled out immediately before the projecting by the urging force of the coil spring 37 is performed. Thereafter, the button 64 is depressed to cause the puncture needle 11 to protrude.

As a result, since the safety bolt 113 is screwed into the female screw 112 of the second slide portion 25, the puncture needle 11 does not project even if the button 64 is pressed by mistake. In addition, since the upper end surface of the safety ring 115 is located above the upper end surface 117 of the button 64, it is difficult to touch the button 64, and the button 64 is depressed except for the operation of intentionally pushing down the button 64. The chances of doing so are very small.

It should be noted that the present invention is not limited to only the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

[Supplementary note] (Supplementary note 1) A long puncture provided at the forceps channel entrance of the endoscope and used to penetrate the forceps channel and puncture the subject portion in the body cavity. A needle, a long sheath for accommodating the puncture needle, a slide portion for holding the puncture needle freely reciprocating, an urging mechanism for projecting the puncture needle by an urging force of an urging member, and the urging mechanism A locking mechanism for temporarily locking the biasing force of the biasing member, and a switch mechanism for releasing the locked state of the locking mechanism, and a restricting state in which the puncture needle cannot be projected. A puncture needle operation assisting device for an endoscope, wherein a safety device is provided which can select a restriction release state in which the puncture needle can be protruded and prevents the switch mechanism from functioning in the restriction state.

(Additional Item 2) When the slide portion is locked by the locking mechanism with the biasing force of the biasing member of the biasing mechanism, the positions of the puncture needle tip and the sheath tip substantially coincide. A first click mechanism for generating a click in a pressed state, and a second click mechanism for generating a click in a state where the puncture needle is further pulled to the proximal side from the click state of the first click mechanism. The puncture needle for an endoscope according to claim 1, wherein a distance between the first click mechanism and the second click mechanism is equal to or longer than a maximum length that allows the puncture needle to be protruded by the urging mechanism. Operation aids.

(Additional Item 3) The slide portion may be the second
3. The puncture needle operation assisting device for an endoscope according to claim 2, further comprising means for visually displaying that the click mechanism is in a clicked state.

[Additional Effect] (Additional Item 1) In the puncture needle operation assisting device for an endoscope, the switch mechanism for projecting the puncture needle by the urging force of the urging member can be disabled by the safety device. . Therefore, unintended puncture needle (projection mechanism when the puncture needle is removed) can be prevented from protruding during preparation of the test, during the test, and during cleaning of the instrument, and the puncture of the forceps channel of the endoscope can be prevented. In addition, it is possible to prevent unintended perforation of the patient and injury during washing.

(Additional Item 2) When removing the puncture needle operation assisting device from the forceps channel of the endoscope, pull the slide portion regardless of the length of projection of the puncture needle due to the urging force of the urging member. Thus, the tip of the puncture needle can be stored in the sheath. Therefore, it is possible to prevent the forceps channel of the endoscope from being pierced.

(Additional Item 3) The operator can further recognize that the puncture needle is housed in the sheath.

[0052]

As described above, according to the present invention, a puncture needle operation assisting device for an endoscope having a function of preventing unintended protrusion of a puncture needle can be realized.

[Brief description of the drawings]

FIG. 1 to FIG. 9 relate to a first embodiment of the present invention, and FIG. 1 shows a puncture needle operation assisting device for an endoscope provided in a forceps channel entrance of an endoscope. FIG.

FIG. 2 is an external view of the puncture needle operation assisting device for an endoscope in FIG.

FIG. 3 is a longitudinal sectional view in FIG. 2;

FIG. 4 is an external view showing a coil sheath in FIG. 3;

FIG. 5 is an explanatory view showing the puncture needle in FIG. 3;

6A and 6B are explanatory views illustrating a switch unit in FIG. 3; FIG. 6A is a cross-sectional view illustrating a restricted state in which a button cannot be pressed; FIG. FIG. 6C is a cross-sectional view illustrating a state in which the restriction is released, and FIG. 6C is a cross-sectional view illustrating a state where the locked state of the coil spring is released by pressing a button.

FIGS. 7 and 8 are explanatory views of the operation of the puncture needle operation assisting device for an endoscope, and FIG. 7A is a longitudinal section showing a puncture preparation state in which the tip of the puncture needle is housed in a coil sheath. FIG. 7B is a longitudinal sectional view showing a state in which the tip of the puncture needle is projected from the tip of the coil sheath with the third slide portion advanced to the maximum, and FIG. FIG. 3 is a longitudinal sectional view showing a state in which a protruding length is set.

FIG. 8A is a longitudinal sectional view showing a state in which the tip of the puncture needle is projected at a high speed by a set projection length, and FIG.
(B) A longitudinal cross-sectional view showing a state where the third slide portion is maximally pulled toward the proximal end when the puncture needle operation assisting device is removed from the forceps channel of the endoscope.

FIG. 9 is an explanatory diagram for explaining the operation of the tip of the puncture needle,
9A is an explanatory view showing a puncture preparation state in which the tip of the puncture needle is accommodated in the coil sheath, FIG. 9B is an explanatory view showing a state in which the tip of the puncture needle projects from the tip of the coil sheath, FIG. (C) is an explanatory view showing a state in which the distal end of the puncture needle is advanced to set a protruding length, and FIG. 9 (d) shows a state in which the puncture needle is protruded and extracted to a lesion in a body cavity. FIG. 9E is an explanatory view showing a state in which the puncture needle is pulled out when performing a suction biopsy.

FIG. 10 is a longitudinal section showing the vicinity of the center of a puncture needle operation assisting device according to a second embodiment of the present invention.

[Description of Reference Codes] 1,101: puncture needle operation assisting device (endoscopic puncture needle operation assisting device) 2 ... endoscope 8 ... treatment instrument insertion port (forceps channel entrance) 9 ... forceps channel 9a ... treatment instrument guide Outlet 11 puncture needle 12 Coil sheath 13 Auxiliary device body 21 Fixed cylinder 21a Fixed part 22 First slide part 23 Adjustment cylinder 25 Second slide part 28 Third slide part 32 First fixing screw 34 ... switch part 37 ... coil spring (biasing member) 44 ... second fixing screw 63 ... safety ring (safety device) 64 ... button (switch mechanism) 65 ... lock indicator 71 ... switch groove 72 ... latch (locking mechanism) 113 … Safety bolt (safety device)

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Claims (1)

[Claims] 1. A puncture needle which is provided at a forceps channel entrance of an endoscope and is used by being inserted through the forceps channel, wherein a long puncture needle for piercing a subject portion in a body cavity is provided. A long sheath to be housed, a slide portion for holding the puncture needle freely reciprocating, an urging mechanism for projecting the puncture needle by the urging force of an urging member, and an urging force of an urging member of the urging mechanism A locking mechanism for temporarily locking the locking mechanism, and a switch mechanism for releasing the locking state of the locking mechanism. A puncture needle operation assisting device for an endoscope, wherein a safety device for preventing the switch mechanism from functioning in the restricted state is provided.