JP2002191602A - Ultrasound probe for endoscopic surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasound probe for endoscopic surgery having an indicating means enabling one to easily determine the puncture position of a jig from the surface of a patient's body. SOLUTION: The ultrasound probe 1a includes a body part 10 for insertion into a trocar 62 inserted in the patient's abdominal wall 50, and a head part 20 flexibly attached to the end of the body part 10 via a flexing part 30 and having an ultrasound vibrator 21 at its end. The head part 20 is provided with an indicating means, e.g. a laser pointer, for allowing one to recognize, form the surface of the patient's body, the puncture position of a puncture needle 61 puncturing the abdominal wall 50, and a guide channel 23 as a guide portion for guiding the needle 61.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic probe which is inserted into a living body to perform ultrasonic diagnosis, and more particularly to an endoscope used for performing a surgical operation under an endoscope. The present invention relates to an ultrasonic probe for lower surgery.

[0002]

2. Description of the Related Art An ultrasonic probe is a device for transmitting an ultrasonic pulse to a biological tissue using an ultrasonic transducer and receiving a reflected echo thereof. An image of a biological tissue is created from the received ultrasonic echo data, and ultrasonic diagnosis is performed.

[0003] In recent years, a technique of inserting a plurality of trocar tubes into the abdominal wall of a patient, inserting an endoscope or an electric scalpel into these trocar tubes, and performing an operation while confirming the affected part with an endoscope has been used for liver cancer treatment. And various other treatments.

[0004] At that time, an ultrasonic probe for endoscopic surgery (for Rapallo) is used. Here, the ultrasonic probe for surgical operation under the endoscope is inserted into the abdominal cavity from the trocar tube, scans the affected part with an ultrasonic transducer provided at the distal end thereof, and scans the inside of an organ such as the liver. Is formed.

[0005] The ultrasonic image of the affected part obtained by the ultrasonic probe for surgical operation under the endoscope is used for confirming an incision position with an electric scalpel or the like and a position of a puncture needle.

An example of such an ultrasonic probe for endoscopic surgical operation is disclosed in Japanese Patent Application Laid-Open No. 8-280 by the present applicant.
No. 685, for example.

[0007] The ultrasonic probe is provided with an ultrasonic vibrator and a guide hole used for projecting a jig such as a puncture needle from the distal end of the probe on the distal end surface.
When the ultrasonic probe is inserted into a body cavity, not only ultrasonic diagnosis of an organ or the like, but also treatment of an affected part can be performed by a jig protruding from the guide hole at the distal end.

[0008] In addition to the ultrasonic probe described in the above publication, the tip of the probe is configured to be bendable as in the ultrasonic probe described in JP-A-7-275245. An ultrasonic probe configured to freely change the inclination angle of the probe tip with respect to the probe main body in accordance with the position of the affected part is generally used.

[0009]

SUMMARY OF THE INVENTION The above-mentioned Japanese Patent Laid-Open Publication No. 7-2
An ultrasonic probe having a probe tip portion that is bendable with respect to a probe main body portion, such as the ultrasonic probe described in Japanese Patent No. 75245, can be used to insert ribs or the like when inserting a probe into a body cavity. When the bone is located on the path of the probe, it is possible to avoid the obstacle bone and to make the ultrasonic transducer abut on the affected part at an appropriate angle.

However, the affected part is diagnosed by the ultrasonic probe which can be bent in this way, and while the image is confirmed by the ultrasonic probe, a jig such as a puncture needle is inserted into the body cavity to remove the affected part. It was very difficult to treat.

Therefore, in order to treat an affected part by inserting a jig into a body cavity while confirming the affected part using a bendable ultrasonic probe as described above, an ultrasonic probe provided on the body surface is required. It is necessary to puncture the jig from a position different from the insertion hole of the probe, and to operate so that the tip of the jig is located within the range of the image obtained by the ultrasonic probe. Therefore, skill is required to determine the puncturing position of the jig.

[0012] In view of the above problems, an object of the present invention is to provide an ultrasonic probe having an indicating means for easily determining a puncturing position of a jig from a body surface side.

[0013]

This and other objects are achieved by the present invention which is defined below as (1) to (9).

(1) An elongated body which is inserted into a trocar tube which is inserted into a patient's abdominal wall, a bent portion which is attached to the distal end of the body, and a distal end which is attached to the distal end of the bent portion. A head portion having an ultrasonic vibrator,
Instruction means provided on the head portion for recognizing a puncture position of a puncture needle to be punctured into a patient's abdominal wall from a body surface side, and a guide portion provided on the head portion and guiding the puncture needle, Ultrasound probe for endoscopic surgery.

(2) The ultrasonic probe for endoscopic surgery according to the above (1), wherein the guide portion is a guide groove provided in a longitudinal side surface of the head portion.

(3) The ultrasonic probe according to the above (1), wherein the guide portion is a guide hole penetrating in a longitudinal direction of the head portion.

(4) The pointing means is a light emitting means for irradiating a beam from the head portion toward the abdominal wall, and is used for an endoscopic surgical operation according to any one of the above (1) to (3). Ultrasonic probe.

(5) The ultrasonic probe for an endoscopic surgical operation according to the above (4), wherein the beam emitting means emits a laser beam.

(6) The method according to (4) or (5), wherein the indicating means irradiates a beam from near the base end of the head toward the main body and in the longitudinal direction of the head. Ultrasound probe for endoscopic surgery.

(7) The endoscope according to any one of (1) to (3), wherein the indicating means is an elongated rod-shaped extending indicating member extending from the head portion toward the abdominal wall. Ultrasound probe for surgery.

(8) The ultrasonic probe for endoscopic surgery according to (7), wherein the extension indicating member is a combination of a plurality of tubes having different diameters.

(9) The endoscope according to (7) or (8), wherein the indicating means extends from near the base end of the head portion toward the main body portion and in the longitudinal direction of the head portion. Ultrasound probe for microscopic surgery.

[0023]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the present invention will be described below in detail with reference to the drawings.

FIGS. 1 and 2 are side views showing the entire structure of a first embodiment of the ultrasonic probe according to the present invention. Also,
FIG. 3 is a plan view of a distal end portion of the first embodiment of the ultrasonic probe according to the present invention.

Hereinafter, the ultrasonic probe 1a according to the first embodiment of the present invention will be described. As shown in FIG. 1, the ultrasonic probe 1 a according to the first embodiment of the present invention includes an elongated main body 10, a bent portion 30 attached to a distal end of the main body 10, and the bent portion 30. Attached to the tip of 30,
A head unit 20 having an ultrasonic vibrator 21 at a tip thereof, and a laser which is provided on the head unit 20 and serves as a beam emitting unit serving as an instruction unit for instructing a puncture position of a puncture needle to puncture the abdominal wall of a patient from the body surface side. It has a pointer 24 and a guide groove 23 provided in the head section 20 and serving as a guide section for guiding the puncture needle. The main body 10, the bent portion 30, and the head 20 are formed of resin or the like.

As shown in FIG. 1, the main body 10 has a bent portion 30 at its distal end and a cable 11 for connecting to an ultrasonic diagnostic apparatus (not shown) at its proximal end.
Is connected. Also, inside the main body 10,
An operation cable (not shown) for adjusting the bending angle of the bending portion 30 by remote control is provided.

As shown in FIG. 1, the head 20
An ultrasonic vibrator 21 is provided at the tip. The ultrasonic vibrator 21 transmits and receives ultrasonic waves to and from the affected part, and data for creating an ultrasonic image of the affected part is collected by the ultrasonic vibrator 21.

In the present embodiment, the head 20
An array transducer for sector scanning in which a plurality of ultrasound transducers are arranged in a sector shape is used as the ultrasound transducer 21 attached to the tip of the scanner, and the ultrasound beam is scanned to form a two-dimensional echo data capturing area. Is done. In addition,
The array vibrator is not limited to this embodiment, and may be a linear scan type or a radial scan type.

As shown in FIG. 2, a guide portion for guiding the jig to the affected part when performing treatment using a jig such as a puncture needle is provided on a longitudinal side surface of the head portion 20. Two guide members 22 and 22 are provided, and a guide groove 23 is provided between the guide members 22 and 22.

As shown in FIGS. 1 and 2, an end face of the guide member 22 on the base end side is used for performing an operation using the ultrasonic probe 1a under an endoscope. As shown in FIG. 4, the ultrasonic probe 1a provided on the body surface
And a laser pointer 24 for indicating a position for piercing a jig such as a puncture needle into a body cavity from a position other than the trocar tube 62 and the trocar tube (not shown) of the endoscope 60 by laser light. I have.

The laser pointer 24 is provided in the vicinity of the guide groove 23. As shown in FIG. 4, from the vicinity of the base end of the head section 20, the guide groove provided in the head section 20 is provided. 23 along the longitudinal direction of the abdominal wall 50
Is irradiated with a laser beam 25 toward. Then, the puncturing position of the jig is indicated on the body surface side of the patient's abdominal wall 50 by the laser light 25 emitted by the laser pointer 24.

In this embodiment, a laser pointer 2 is used as a beam emitting device for indicating a puncturing position of a jig.
Although the number 4 is used, the present invention is not limited to this embodiment, and another light emitting device using a light emitting diode, a light bulb, or the like can be used as long as the puncturing position can be indicated.

In the first embodiment, the guide groove 23 formed by the guide members 22 is used as a guide for guiding the jig. However, the present invention is not limited to this embodiment. It is also possible to use a guide hole 42 of the guide member 40 as used in a second embodiment described later.

The bent portion 30 is formed of a flexible material, and has a base end connected to the main body 10 and a front end connected to the head 20. The bent portion 30 is moved by the operation cable (not shown) provided in the main body 10 so that the head portion 20 is bent.
Are bent to the opposite sides of the guide members 22, 22 provided on the front side. The bent portion 30 may be bent at any angle as long as the laser beam 25 from the laser pointer 24 is not blocked by the main body 10.

The procedure for instructing the puncturing position of the jig using the ultrasonic probe 1a according to the first embodiment of the present invention and performing treatment with the jig will now be described.

FIG. 4 is a sectional side view showing a state where a puncturing position is designated by using the first embodiment of the ultrasonic probe of the present invention, and FIG. 5 is a first embodiment of the present invention. FIG. 4 is a cross-sectional side view showing a state where treatment is performed using a jig while performing ultrasonic diagnosis by the ultrasonic probe 1a. In these figures, reference numeral 50 denotes an abdominal wall, 51 denotes an organ located in the abdominal cavity, 60 denotes an endoscope for acquiring an optical image of the abdominal cavity, 61 denotes a puncture needle for treating an affected part, Reference numeral 62 denotes a tubular trocar tube for inserting and guiding the ultrasonic probe 1a of the present invention into the abdominal cavity via the abdominal wall 50.

First, the ultrasonic probe 1a is inserted into the trocar tube 62, and the bending portion 30 is connected to the organ 51 by remote operation using the operation cable (not shown).
Bend according to the angle of inclination of the surface of.

Next, based on the image data obtained from the endoscope 60, the ultrasonic transducer 21 provided at the tip of the head section 20 of the ultrasonic probe 1a is brought into contact with the surface of the organ 51. . Then, the adjustment is performed so that the affected part is located in the image obtained from the ultrasonic transducer 21.

Next, as shown in FIG. 4, a laser beam 25 is emitted from the laser pointer 24 toward the inner wall of the abdominal cavity 50, and the puncture needle 61 is irradiated with the laser beam 25.
Is indicated on the body surface side.

At this time, when the thickness of the abdominal wall 50 is large and the laser light emitted from the laser pointer 24 on the abdominal wall 50 does not transmit to the body surface side, the position where the laser light 25 is applied is confirmed by the endoscope 60. While puncturing.

Next, as shown in FIG. 5, a puncture needle 61 is punctured from the surface of the abdominal wall 50 toward the tip of the ultrasonic probe 1a. At this time, the puncture needle 61 is operated so that the puncture needle 61 passes through the inside of the guide groove 23 of the head section 20. By doing so, the tip of the puncture needle 61 is guided by the guide groove 23 into the image area obtained by the ultrasonic transducer 21 at the tip of the head unit 20.

As a result, the tip of the puncture needle 61 is accurately punctured into the diseased part of the organ 51, and the puncture needle 61 can perform treatment such as collection of the affected part tissue or administration to the affected part tissue. Become like

Next, a description will be given of a second embodiment of the ultrasonic probe according to the present invention. 6 and 7 are side views showing the overall configuration of the second embodiment of the ultrasonic probe according to the present invention. FIG. 8 is a plan view of a distal end portion of a second embodiment of the ultrasonic probe according to the present invention.

Hereinafter, the ultrasonic probe 1b according to the second embodiment of the present invention will be described focusing on the differences from the ultrasonic probe 1a according to the first embodiment. The description of the same items as those of the ultrasonic probe 1a of the first embodiment is omitted.

An ultrasonic probe 1b according to a second embodiment of the present invention
As shown in FIG. 6, similarly to the first embodiment, as shown in FIG. 6, the main body 10 has an elongated shape, a bent portion 30 attached to the distal end of the main body 10, A head portion 20 having an ultrasonic vibrator 21 at an end thereof; It has an exit instruction member 41 and a guide hole 42 provided in the head section 20 and serving as a guide section for guiding the puncture needle. The main body 10, the bent portion 30, and the head 20 are formed of resin or the like.

As shown in FIG. 7, when performing treatment using a jig such as a puncture needle as in the first embodiment, the jig is guided to the affected part on the side surface of the head portion 20. A guide member 40 is provided. Unlike the first embodiment, the guide member 40 has a guide hole 42 penetrating from the base end to the distal end as shown in FIG. Then, a jig such as a puncture needle is attached to the ultrasonic probe 1b.
When used simultaneously, the jig is guided in the guide hole 42 and is guided to the tip of the ultrasonic probe 1b. The guide portion of the second embodiment can have a structure in which the jig is guided by the guide groove 23 formed between the pair of guide members 22 similarly to the first embodiment. is there.

9 and 10, the ultrasonic probe 1b is attached to the end face on the base end side of the guide member 22 while confirming the affected part by means of an endoscope or the like, as shown in FIGS. The trocar tube 62 for the ultrasound probe 1a provided through the abdominal wall 50 when performing treatment using the
Abdominal wall 5 from a position other than the trocar tube (not shown) for
0 is provided with an extension indicating member 41 for indicating a position at which a jig such as a puncture needle is punctured.

The extension indicating member 41 has a structure in which a plurality of tubes having different diameters are combined, and is configured to be extendable and contractable like an antenna. The extension instructing member 41 is expanded and contracted by power of a motor or the like or by manual remote control. The operation of the extension instructing member 41 will be described later in detail.

A procedure for instructing the puncturing position of the jig using the ultrasonic probe 1b according to the second embodiment of the present invention and performing treatment with the jig will now be described.

FIG. 9 is a sectional side view showing a state where a puncturing position is indicated by using the second embodiment of the ultrasonic probe of the present invention, and FIG. 10 is a second embodiment of the present invention. FIG. 6 is a cross-sectional side view showing a state in which treatment is performed using a jig while performing ultrasonic diagnosis by the ultrasonic probe 1b. In these figures, reference numeral 50 denotes an abdominal wall, 51 denotes an organ located in the abdominal cavity, 60 denotes an endoscope for acquiring an optical image of the abdominal cavity, 61 denotes a puncture needle for treating an affected part, 62
Shows a tubular trocar tube for inserting and guiding the ultrasonic probe 1a of the present invention into the abdominal cavity through the abdominal wall 50.

First, the ultrasonic probe 1b is inserted into the trocar tube 62, and the bending portion 30 is connected to the organ 51 by remote operation using the operation cable (not shown).
Bend according to the angle of inclination of the surface of.

Next, based on the image data obtained from the endoscope 60, the ultrasonic transducer 21 provided at the tip of the head section 20 of the ultrasonic probe 1b is brought into contact with the surface of the organ 51. . Then, the adjustment is performed so that the affected part is located in the image obtained from the ultrasonic transducer 21.

Next, the extension indicating member 41 is extended,
The tip of the extension indicating member 41 is positioned near the inner wall surface of the abdominal wall 50.

Then, the inner wall surface of the abdominal wall 50 is pressed by the distal end portion of the extension instructing member 41 and the surface of the abdominal wall 50 is deformed by the pressing of the extension instructing member 41, so that it can be confirmed from the body surface side. The puncture position of the puncture needle 61 is designated as described above. It is also possible to indicate the position of the puncture needle 61 by puncturing the extension indicating member 41 from the inner wall surface of the abdominal wall 50 toward the surface of the abdominal wall 50.

At this time, if the abdominal wall 50 is deformed due to the pressing of the extension instructing member 41 due to the thickness of the abdominal wall 50 or other reasons, it is not possible to give an instruction to confirm the puncturing position of the jig from the body surface side. The state in which the inner wall surface of the abdominal wall 50 located near the distal end portion of the extension indicating member 41 is deformed by pressing from the body surface or the like is confirmed by the endoscope 60 or the like, and the puncturing position is confirmed.

Next, as shown in FIG. 10, the puncture needle 6 is moved from the surface of the abdominal wall 50 toward the tip of the ultrasonic probe 1b.
Puncture 1

At this time, the puncture needle 6 is moved so that the puncture needle 61 passes through the guide hole 42 of the head section 20.
Operate 1 By doing so, the puncture needle 61
The tip of the head portion 2 is guided by the guide hole 42.
It is guided into the image area obtained by the ultrasonic transducer 21 at the zero end. As a result, the distal end of the puncture needle 61 is accurately punctured into the affected part, and the puncture needle 61 can collect the tissue of the affected part or administer the medicine to the affected part.

Finally, it is needless to say that the present invention is not limited to the above-described embodiments, and various changes and improvements can be made within the scope described in the claims.

[0059]

As described above, according to the present invention, since the function of indicating the puncturing position of the jig by the indicating means provided on the head portion of the probe is provided, the puncturing needle or the like can be cured from the body surface side. An ultrasonic probe capable of easily determining a position where a tool is punctured is realized.

[Brief description of the drawings]

FIG. 1 is a side view showing an overall configuration of a first embodiment of an ultrasonic probe according to the present invention.

FIG. 2 is a side view showing the overall configuration of the first embodiment of the ultrasonic probe of the present invention.

FIG. 3 is a plan view of a distal end portion of the ultrasonic probe according to the first embodiment of the present invention.

FIG. 4 is a cross-sectional side view showing a state in which a puncturing position is indicated using the ultrasonic probe according to the first embodiment of the present invention.

FIG. 5 is a cross-sectional side view showing a state in which treatment is performed using a jig while performing ultrasonic diagnosis by the ultrasonic probe according to the first embodiment of the present invention.

FIG. 6 is a side view showing the overall configuration of a second embodiment of the ultrasonic probe according to the present invention.

FIG. 7 is a side view showing the overall configuration of a second embodiment of the ultrasonic probe of the present invention.

FIG. 8 is a plan view of a distal end portion of a second embodiment of the ultrasonic probe according to the present invention.

FIG. 9 is a cross-sectional side view showing a state where a puncturing position is indicated using the ultrasonic probe according to the second embodiment of the present invention.

FIG. 10 is a cross-sectional side view showing a state in which treatment is performed using a jig while performing ultrasonic diagnosis using the ultrasonic probe according to the second embodiment of the present invention.

[Explanation of symbols]

 1a Ultrasonic Probe (First Embodiment) 1b Ultrasonic Probe (Second Embodiment) 10 Main Body 11 Cable 20 Head 21 Ultrasonic Vibrator 22 Guide Member 23 Guide Groove 24 Laser Pointer 25 Laser Light 30 Bending part 40 Guide member 41 Extension indicating member 42 Guide hole 50 Abdominal wall 51 Organ 60 Endoscope 61 Puncture needle 62 Trocar tube

Claims (9)

[Claims] An elongated body inserted into a trocar tube inserted into a patient's abdominal wall; a bent portion attached to a distal end of the main body; a bent portion attached to a distal end of the bent portion; A head unit having an ultrasonic vibrator; an instruction unit provided on the head unit for recognizing a puncture position of a puncture needle punctured on the abdominal wall of a patient from a body surface side; and a puncture needle provided on the head unit, An ultrasonic probe for endoscopic surgical operation, comprising: a guide portion for guiding. 2. The ultrasonic probe according to claim 1, wherein the guide portion is a guide groove provided on a longitudinal side surface of the head portion. 3. The ultrasonic probe according to claim 1, wherein the guide portion is a guide hole penetrating in a longitudinal direction of the head portion. 4. The ultrasonic probe for endoscopic surgery according to claim 1, wherein said indicating means is a beam emitting means for emitting a beam from said head portion toward said abdominal wall. Child. 5. The ultrasonic probe according to claim 4, wherein the beam emitting unit emits a laser beam. 6. The endoscopic surgery according to claim 4, wherein the indicating means irradiates a beam from near a base end of the head portion toward the main body portion and in a longitudinal direction of the head portion. Surgical ultrasound probe. 7. The ultra-surgery device for endoscopic surgery according to claim 1, wherein the indicating means is an elongated rod-like extending indicating member extending from the head portion toward the abdominal wall. Sonic probe. 8. The ultrasonic probe according to claim 7, wherein the extension indicating member is formed by combining a plurality of tubes having different diameters. 9. The endoscopic surgical operation according to claim 7, wherein the indicating means extends from the vicinity of the base end of the head portion toward the main body and in the longitudinal direction of the head portion. Ultrasonic probe.