JP2001120496A - Wound sheath for probe - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a wound sheath for probe, which can be wound appropriately and has good operability for pulling out of an endoscope in simple construction and lower price. SOLUTION: A screw cut portion 16 at least longer than a circumference of a sheath portion 15 is arranged at nearer point to an end point on the circumference of the sheath portion 15 which a blockaded end. The screw cut portion 16 is formed as an extension portion 17 and an end of an ultrasonic probe 7 inserted into the sheath portion 15 is formed as an end supporting portion 18 to support the end of the sheath 15 freely to touch and detach. A roll equipment 17 on the extension portion 17 is released when the ultrasonic probe 7 is pushed into the wound sheath 1. With further pushing into the ultrasonic probe 7, moving forward of the end supporting portion 18 is controlled by the extension portion 17. The ultrasonic probe 7 is wound backward by acceleration of the end supporting portion 18.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a probe bending sheath for bending the tip of a probe such as an ultrasonic probe or a laser probe inserted into a forceps channel of an endoscope to be inserted into a body cavity.

[0002]

2. Description of the Related Art In recent years, techniques for performing diagnosis and treatment in a body cavity using an endoscope have been widely performed. On the other hand, as ultrasonic probes have become smaller and smaller, they have to be inserted into the treatment channel of the endoscope and introduced into the body. It has been practiced to obtain an ultrasonic tomographic image such as that described above to assist diagnosis. In this case, it is necessary to appropriately perform the bending operation of the probe distal end in addition to the appropriate bending operation of the endoscope distal end by the endoscope operation unit.

As a technique for performing the bending operation of the probe tip, for example, Japanese Unexamined Patent Publication No. 8-28 by the present applicant has been proposed.
No. 0694 discloses a distal end of a hollow sheath, at least one extending portion extending from the distal end of the sheath in the sheath axial direction, and a distal end of a probe insertion portion provided at the distal end of the extending portion and inserted through the sheath. A technique is disclosed in which a probe bending operation is performed using a probe bending sheath provided with a tip holding portion that freely receives and separates the probe.

That is, according to such a technique, an operator first inserts a probe into a body cavity with the probe inserted through a hollow sheath and the distal end of the probe abutted against a distal end holding portion. It is inserted through the insertion section of the endoscope through the forceps channel. Then, by pushing the probe into the sheath, the distal end of the probe is urged rearward by the distal end holding portion connected to the extension portion, so that the probe can be arbitrarily bent.

[0005]

However, when the bending operation of the probe is performed by using the above-described bending sheath for the probe together, the distal end of the bending sheath is held at the time of insertion into the treatment channel of the endoscope or at the time of the bending operation. In some cases, the tip of the probe may fall out of the section and the bending operation may not be performed. In such a case, it is necessary to remove and reinsert the probe and the curved sheath from the endoscope, which may hinder the diagnosis.

Further, when removing the probe and the curved sheath, the edge of the distal end holding portion may be caught at the outlet of the treatment channel, and the curved sheath may not be easily removed.

[0007] Further, there is a case where the repeated use of the curved sheath causes the extension portion to bend, and the extension portion does not extend straight in the axial direction of the hollow sheath. In such a case, since the curved sheath distal end holding portion is disengaged from the extension of the sheath axis, the operator cannot simply combine the probe with the curved sheath by simply inserting the probe into the curved sheath. The probe distal end and the curved sheath distal end holding portion are combined while supporting with.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has a simple structure that can appropriately bend a probe, is inexpensive, and has good workability at the time of removal from an endoscope. It is an object to provide a curved sheath for use.

[0009]

In order to solve the above problems, a curved sheath for a probe according to the present invention is a curved sheath for a probe inserted into a forceps channel of an endoscope. A spiral notch longer than at least the circumferential length of the sheath portion is provided on the nearer periphery, and this portion is formed as an extension portion that can extend in the axial direction of the sheath portion, and the distal end portion of the sheath portion is formed. Is formed as a distal end holding portion for holding a distal end portion of the probe inserted into the sheath portion so as to be able to approach and separate therefrom.

[0010] That is, the operator first inserts the probe into the hollow sheath portion and abuts the distal end of the probe against the distal end holding portion, and inserts the endoscope into the body cavity. Through the forceps channel. Then, when the operator pushes the probe into the sheath portion, the extending portion provided in the sheath portion is released and is extended in the axial direction. Further, when the operator pushes the probe against the sheath portion, the forward movement of the distal end holding portion is regulated by the extending portion, so that the probe is urged backward by the distal end holding portion and curved. Is done. On the other hand, when the probe is retracted with respect to the sheath portion, the extension portion is restored to the original state by the restoring force. At this time, the distal end of the probe is urged rearward by the restoring force of the extending portion through the distal end holding portion, so that the probe does not come off from the distal end holding portion and the bending operation is not disabled.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 4 relate to a first embodiment of the present invention, FIG. 1 is a schematic diagram showing a state when performing endoscopic diagnosis, FIG. 2 is a cross-sectional view of a main part of a curved sheath and an ultrasonic probe, FIG. 3 is a cross-sectional view of a principal part of the curved sheath and the ultrasonic probe when the extending portion is extended, and FIG. 4 is a side view of the curved sheath and the ultrasonic probe when the ultrasonic probe is curved.

First, an example of an endoscope apparatus to which the probe bending sheath 1 (hereinafter, referred to as a bending sheath 1) according to the present embodiment is applied will be described. As shown in FIG. Is an endoscope 2 such as a videoscope
, A light source device 4, a video processor 5, and a scope monitor 6. The endoscope 2 is connected to a light source device 4 and a video processor 5, and the video processor 5 is connected to a scope monitor 6.
Can insert the insertion portion 2b of the endoscope 2 into the body cavity of the subject 3 and guide the tip of the insertion portion 2b to the vicinity of the observation region 3a in the body cavity, thereby enabling endoscope observation and displaying an image of the object. I can do it.

Further, the endoscope 2 has a forceps hole base 2a into which an ultrasonic probe 7 can be inserted, and the forceps hole base 2a is formed in an insertion portion 2b of the endoscope 2. It communicates with the forceps hole 2c (see FIGS. 3 and 4). The ultrasonic probe 7 attached to the curved sheath 1 is inserted from the forceps hole base 2a, and can protrude from the distal end of the insertion portion 2b to the outside via the forceps hole 2c.

Here, the ultrasonic probe 7 is connected to an ultrasonic observation device 11 and an ultrasonic monitor 12 via a drive unit 10, so that an operator 21 can ultrasonically observe a deep part in a body cavity. It has become.

As shown in FIG. 2, the ultrasonic probe 7
Is provided with an ultrasonic vibrator 8 which is a hard part disposed at the inner end thereof, and a flexible shaft 9 connected to the ultrasonic vibrator 8.

The curved sheath 1 includes an elongated hollow sheath portion 15 and a base 16 provided at the base end of the sheath portion 15 and detachable from the forceps hole base 2a. Have been.

The sheath 15 is made of, for example, PTFE or F
It is made of a resin such as ET, and a spiral cut 16 is provided in the periphery near the tip. Here, the length of the cut 16 is formed to be at least longer than the circumferential length of the sheath portion 15, thereby forming an elastically stretchable extension portion 17 at a position near the distal end of the sheath portion 15. .

The distal end of the sheath 15 is closed, so that the distal end of the ultrasonic probe 7 inserted into the sheath 15 is held at the distal end of the sheath 15 so as to be able to freely contact and separate. A possible tip holder 18 is formed.

That is, the sheath 15 has a tip holding portion 1 capable of holding the tip of the ultrasonic probe 7 at the tip thereof.
8, and further includes an extension portion 17 that is elastically extendable on the base end side of the distal end holding portion 18.

Here, as shown in FIG. 3, the distance D when the extending portion 17 wound spirally is unwound is determined when the probe inserted into the curved sheath 1 is the ultrasonic probe 7. Is set such that the ultrasonic vibrator 8 as a hard part and a part of the flexible shaft 9 connected thereto are sufficiently exposed. Specifically, the distance D is 20 m
It is desirable to be about m to 30 mm.

Next, the operation of the present embodiment having the above-described configuration will be described. First, the operator 21 pushes the ultrasonic probe 7 with its distal end in contact with the inner wall of the distal end holding portion 18 of the curved sheath 1. (See FIG. 2). In this state, the operator 21 inserts the ultrasonic probe 1 attached to the curved sheath 1 into the endoscope 2 through the forceps hole base 2a, and connects the base 16 of the curved sheath 1 to the endoscope 2. (See FIGS. 3 and 4). In addition, in the examples shown in FIGS. 3 and 4, the case where the proximal side of the curved sheath 1 is mounted and fixed to the forceps hole base 2 a via the base 16, but as shown in FIG. 1, the base 16 is mounted and fixed. Alternatively, the operator 21 may hold and operate the ultrasonic probe 7 and the curved sheath 1 together.

Next, the operator 21 pushes the ultrasonic probe 7 into the curved sheath 1. Then, the tip holding portion 18
Is moved in the sheath axial direction (forward) while being rotated in the direction opposite to the winding direction of the stretching portion 17, whereby the stretching portion 1
7 unwinds and extends in the sheath axial direction (see FIG. 3).

Further, when the operator 21 pushes the ultrasonic probe 7 into the curved sheath 1 (when the operator 21 pushes the ultrasonic probe 7 over the extension distance D of the extension portion 17), the tip of the ultrasonic probe 7 On the side, the tip holding section 18 and the extension section 1
7 is bent between the base 14 and the end of the base 14 (see FIG. 4).
That is, the forward movement of the distal end holding portion 18 is regulated by the tension of the extending portion 17, so that the distal end side of the ultrasonic probe 7 is curved between the distal end holding portion 18 and the end of the extending portion 17 on the base 14 side. Is done. Therefore, it is possible to obtain a desired ultrasonic tomographic image by positioning the tip of the ultrasonic probe 7 in a state of being curved with respect to the observation site in the body cavity.

Next, at the stage where the ultrasonic observation has been completed, the operator 21 pulls the ultrasonic probe 7, and the distal end side of the ultrasonic probe 7 extends straight into the endoscope 2 by the restoring force. I will be pulled back. At this time, the tip holding portion 18
Is urged toward the distal end of the ultrasonic probe 7 by the restoring force of the extending portion 17, so that the distal end of the ultrasonic probe 7 is held when the ultrasonic probe 7 is accommodated in the curved sheath 1. There is no deviation from the part 18.

As described above, according to the present embodiment, the distal end holding portion 18 is constantly urged against the distal end portion of the ultrasonic probe 7 by the extension portion 17, so that the ultrasonic probe 7
Of the ultrasonic probe 7 from the distal end holding portion 18 when the ultrasonic probe 7 is attached to or detached from the treatment channel (forceps hole 2c) of the endoscope 2 or when the ultrasonic probe 7 is bent. be able to. Therefore, it is possible to improve the operability at the time of attaching / detaching the ultrasonic probe 7 to / from the endoscope 2 or at the time of bending operation.

Further, by providing the extending portion 17 wound spirally near the distal end of the curved sheath 1, the distal end holding portion 18 can be prevented from being displaced from the extension of the sheath shaft. Since the extension portion 17 has a cylindrical shape integral with the sheath portion 15, the attachment and detachment of the ultrasonic probe 7 to and from the curved sheath 1 can be easily performed.

The bending mechanism for the ultrasonic probe 7 by the bending sheath 1 includes a sheath 15 having a closed end.
Since only the spiral cut 16 is provided near the end of the curved sheath, the curved sheath 7 can be manufactured at a low cost with a simple structure.

In the above-described embodiment, an example in which the ultrasonic probe 7 is combined with the curved sheath 1 has been described. However, the present invention is not limited to this as long as it is necessary to bend the vicinity of the distal end in use. Instead, for example, a laser probe, a microwave irradiation probe,
Or a general treatment tool or catheter.

Next, FIGS. 5 to 7 relate to a second embodiment of the present invention. FIG. 5 is a schematic view showing a state when performing an endoscope diagnosis, and FIG. FIG. 7 is a perspective view of the curved sheath and the ultrasonic probe when the ultrasonic probe is in the state shown in FIG.

Recently, an ultrasonic probe has been inserted into the trachea / bronchi through an endoscope to examine the invasion of lung cancer under an ultrasonic image or to diagnose the presence or absence of lymphoma. ing. In the present embodiment, an example of the probe bending sheath 1 that is often applied particularly when performing the above-described procedure will be described. A balloon 19 is provided near the distal end of the curved sheath 1 in this embodiment at a position covering the extension portion 17, and the balloon 19 is fixed to the distal end holding portion 18 and the sheath portion 1. The other configuration is the same as that of the first embodiment.

Next, the operation of the present embodiment having the above-described configuration will be described. First, the surgeon 21 pushes the ultrasonic probe 7 with its distal end in contact with the inner wall of the distal end holding portion 18 of the curved sheath 1. Insert it up to the position And endoscope 2
The distal end side of the ultrasonic probe 7 is inserted into the body cavity through the forceps hole 2c.

Next, the surgeon 21 inflates the balloon 19 by injecting degassed water into the balloon 19 via the curved sheath 1. Then, when the operator further pushes the ultrasonic probe 7 into the curved sheath 1 in a state where the balloon 19 is inflated to an appropriate size, the ultrasonic probe 7 bends so that the distal end side is pushed laterally, and sends and receives ultrasonic waves. The angle changes. In this state, the endoscope 2 is operated to bring the ultrasonic probe 7 through the balloon 19 close to the affected part 3b to transmit and receive ultrasonic waves.

According to such an embodiment, substantially the same effects as in the first embodiment can be obtained. That is, the probe such as the ultrasonic probe 7 is connected to the curved sheath 1.
Can be combined simply by inserting the probe into the curved sheath 1.
The probe tip can be appropriately curved only by pushing the probe tip against the probe. The bending angle of the probe tip can be easily adjusted by adjusting the amount of pushing of the probe into the bending sheath 1. When the curve is restored, the distal end of the sheath portion 15 (that is, the extending portion 17 and the distal end holding portion 18) returns to the original shape, thereby preventing the edge of the distal end holding portion 18 from being caught at the outlet of the treatment channel. be able to. Then, the restoring force of the extending portion 17 becomes a force for urging the distal end holding portion 18 against the distal end portion of the ultrasonic probe 7, and the ultrasonic probe 7 separates from the bending sheath holding portion and the bending operation becomes impossible. Can be prevented. Further, ultrasonic diagnosis can be selectively performed in the peripheral bronchi rather than the insertion limit of the scope (see FIG. 7).

Further, since the balloon 19 is provided, the attenuation of the ultrasonic wave is small, and the curved ultrasonic probe 7 is used.
And the distance from the living body wall can be kept constant. Thereby, the ultrasonic vibrator 8 can appropriately maintain the distance from the living body, and can obtain a good ultrasonic image.

Further, by combining with a direct-viewing type endoscope, ultrasonic diagnosis can be performed by the balloon method in a state where the diseased part 3b is viewed from the front. The probe to be combined may be a probe for fusion for performing cancer treatment by laser ablation, or a probe for hyperthermia treatment in addition to the ultrasonic probe 8.

[0036]

As described above, according to the present invention, a probe can be appropriately curved with a simple structure, is inexpensive, and has good workability at the time of removal from an endoscope or the like. A curved sheath can be provided.

That is, the two probes can be combined simply by inserting a probe such as an ultrasonic probe into the curved sheath, and the probe tip can be appropriately bent only by pushing the probe such as the ultrasonic probe into the curved sheath. Can be done. The bending angle of the probe tip can be easily adjusted by adjusting the amount of pushing of the probe into the curved sheath. In addition, when the curve is returned to its original state, the sheath distal end returns to the original shape, so that the edge of the curved sheath distal end holding portion can be prevented from being caught at the treatment channel outlet, and the curved sheath can be easily removed. Then, the restoring force of the extending portion becomes a force for urging the curved sheath distal end holding portion toward the ultrasonic probe distal end, and it is possible to prevent the ultrasonic probe from being separated from the curved sheath retaining portion and becoming inoperable.

[Brief description of the drawings]

FIGS. 1 to 4 relate to a first embodiment of the present invention, and FIG. 1 is a schematic diagram showing a state when performing an endoscope diagnosis.

FIG. 2 is a sectional view of a main part of a curved sheath and an ultrasonic probe.

FIG. 3 is a cross-sectional view of a main part of a curved sheath and an ultrasonic probe when an extending portion is extended.

FIG. 4 is a side view of the bending sheath and the ultrasonic probe when the ultrasonic probe is bent.

FIGS. 5 to 7 relate to a second embodiment of the present invention, and FIG. 5 is a schematic view showing a state when performing an endoscope diagnosis.

FIG. 6 is a perspective view of a bending sheath and an ultrasonic probe when the ultrasonic probe is bent.

FIG. 7 is an explanatory diagram showing an example of a bending direction of an ultrasonic probe in a body cavity.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Curved sheath for probe 2 ... Endoscope 2c ... Forceps hole (forceps channel) 7 ... Ultrasonic probe 15 ... Sheath part 16 ... Cut 17 ... Extension part 18 ... Tip holding part

Claims (1)

[Claims] 1. A probe curved sheath inserted through a forceps channel of an endoscope, wherein a spiral cut at least longer than a circumferential length of the sheath portion is formed on a circumference of the sheath portion having a closed distal end near the distal end. And a tip that forms this portion as an extension portion that can be extended in the axial direction of the sheath portion, and that holds the tip portion of the sheath portion so that the tip portion of a probe that is inserted into the sheath portion can be freely contacted and separated. A curved sheath for a probe, which is formed as a holding portion.