JP2007215731A - Ultrasonic endoscope - Google Patents

Ultrasonic endoscope Download PDF

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JP2007215731A
JP2007215731A JP2006039056A JP2006039056A JP2007215731A JP 2007215731 A JP2007215731 A JP 2007215731A JP 2006039056 A JP2006039056 A JP 2006039056A JP 2006039056 A JP2006039056 A JP 2006039056A JP 2007215731 A JP2007215731 A JP 2007215731A
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treatment instrument
distal end
ultrasonic
ultrasonic transducer
hard
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Shinichi Kono
慎一 河野
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Fujinon Corp
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Priority to DE602007014130T priority patent/DE602007014130D1/en
Priority to EP07003345A priority patent/EP1820437B1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/445—Details of catheter construction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00174—Optical arrangements characterised by the viewing angles
    • A61B1/00179—Optical arrangements characterised by the viewing angles for off-axis viewing

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  • Endoscopes (AREA)
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Abstract

<P>PROBLEM TO BE SOLVED: To extend a part of an endoscope working as a guide surface for a treatment instrument to the maximum without obstructing observation field of the endoscope. <P>SOLUTION: An ultrasonic transducer 2 is installed on the distal end of a distal end hard part 1b. An inclined surface part 5 is formed on the back of the ultrasonic transducer for arranging an illumination unit 3 and an observation section 4, and a flat part 9 is formed between the inclined surface part and the ultrasonic transducer in the axial direction of the distal end hard part 1b. A treatment instrument derivation port 11 is formed on the flat part 9 for deriving a treatment instrument, such as a puncture treatment instrument 10 or the like, diagonally in the forward direction. A treatment instrument insertion channel 12 opening toward the treatment instrument derivation port 11 comprises a treatment insertion channel 13 on the back of an angle part 1a and a tunnel-like passage 14 on the distal end hard part 1b. A hard pipe 15 made of a bent pipe having a bent part in the middle is inserted partially within the passage 14. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

本発明は、体腔内に挿入される挿入部の先端に電子走査式の超音波トランスデューサと内視鏡観察手段とを装着した超音波内視鏡に関するものである。   The present invention relates to an ultrasonic endoscope in which an electronic scanning ultrasonic transducer and an endoscope observation means are attached to the distal end of an insertion portion to be inserted into a body cavity.

超音波内視鏡は、体腔内に挿入される挿入部を有し、この挿入部の先端硬質部には超音波検査手段と内視鏡観察手段とが設けられる。内視鏡観察手段は照明部と観察部とから構成され、観察部は通常固体撮像装置を備える構成となっている。また、超音波検査手段は超音波トランスデューサから構成されるが、この超音波トランスデューサによる走査方式としては、機械走査式と電子走査式とがある。電子走査式の超音波トランスデューサは、所定数の超音波振動子を一定の方向に配列することにより構成され、これら各超音波振動子を順次作動させることによって、所定の範囲にわたって超音波走査が行われることになる。   The ultrasonic endoscope has an insertion portion that is inserted into a body cavity, and an ultrasonic inspection means and an endoscope observation means are provided at the distal end hard portion of the insertion portion. The endoscope observation means includes an illumination unit and an observation unit, and the observation unit is usually configured to include a solid-state imaging device. The ultrasonic inspection means is composed of an ultrasonic transducer, and there are a mechanical scanning type and an electronic scanning type as scanning methods using the ultrasonic transducer. An electronic scanning ultrasonic transducer is configured by arranging a predetermined number of ultrasonic transducers in a fixed direction, and by sequentially operating each of these ultrasonic transducers, ultrasonic scanning is performed over a predetermined range. Will be.

電子走査式の超音波トランスデューサを設けた超音波内視鏡にあっては、特許文献１にあるように、挿入部における先端硬質部の先端側に超音波トランスデューサが配置され、その後方側に照明部及び観察部からなる内視鏡観察手段が装着される。そして、この特許文献１による超音波内視鏡にあっては、超音波トランスデューサを構成する多数の超音波振動子は先端硬質部の軸線方向に向けて円弧状に配列されており、また先端硬質部には、この超音波トランスデューサの配設位置より後端側の位置に傾斜面を設けて、照明部と観察部とからなる内視鏡観察手段はこの傾斜面に装着して、所謂斜視内視鏡を構成している。   In an ultrasonic endoscope provided with an electronic scanning ultrasonic transducer, as disclosed in Patent Document 1, an ultrasonic transducer is disposed on the distal end side of the distal end hard portion in the insertion portion, and illumination is provided on the rear side thereof. An endoscopic observation means comprising a part and an observation part is attached. In the ultrasonic endoscope according to Patent Document 1, a large number of ultrasonic transducers constituting the ultrasonic transducer are arranged in an arc shape in the axial direction of the distal end hard portion, and the distal end hard The part is provided with an inclined surface at a position on the rear end side from the position where the ultrasonic transducer is disposed, and an endoscopic observation means comprising an illumination part and an observation part is attached to the inclined surface, so The endoscope is configured.

超音波トランスデューサを作動させることによって、体内組織の断層情報を取得できる。そして、この体内組織に病変部等が検出されると、穿刺処置具を用いて治療や細胞採取等の処置を施すことができる。このために、挿入部には処置具挿通路が形成されており、この処置具挿通路は挿入部における先端硬質部の手前位置までは、つまり先端硬質部を所望の方向に向けるために設けられるアングル部の位置までは可撓性を有する可撓性チューブで構成して、先端硬質部の内部ではトンネル状の通路を穿設している。可撓性チューブを通路に接続するために接続パイプが用いられる。接続パイプの先端側は通路に挿入され、この接続パイプをアングル部側に所定の長さだけ突出させて、可撓性チューブの先端を嵌合させるようにして接続される。従って、処置具挿通路は、先端硬質部の手前に位置するアングル部までは挿入部の軸線方向に向けて延在させた直進通路となるが、先端硬質部で接続パイプにより斜め前方に向くように方向を変えることになり、この通路は内視鏡観察手段の観察部が装着されている傾斜面に処置具導出口として開口させている。これによって、処置具導出口から導出させた処置具は内視鏡観察視野により捉えることができるようになる。
特開平１０−１１８０７２号公報 By operating the ultrasonic transducer, tomographic information of the body tissue can be acquired. When a lesion or the like is detected in the body tissue, treatment such as treatment or cell collection can be performed using a puncture treatment instrument. Therefore, a treatment instrument insertion passage is formed in the insertion portion, and this treatment instrument insertion passage is provided up to a position before the distal end hard portion in the insertion portion, that is, for directing the distal end hard portion in a desired direction. A flexible tube having flexibility is formed up to the position of the angle portion, and a tunnel-shaped passage is formed inside the hard end portion. A connecting pipe is used to connect the flexible tube to the passage. The distal end side of the connection pipe is inserted into the passage, and the connection pipe is protruded by a predetermined length toward the angle portion side and connected so that the distal end of the flexible tube is fitted. Accordingly, the treatment instrument insertion path is a straight path that extends in the axial direction of the insertion part up to the angle part positioned in front of the hard end part of the distal end. This passage is opened as a treatment instrument outlet on the inclined surface on which the observation part of the endoscope observation means is mounted. As a result, the treatment instrument derived from the treatment instrument outlet can be captured from the endoscope observation visual field.
JP-A-10-118072

ところで、超音波検査対象は体内組織に及ぶことから、超音波検査の結果、体内組織に病変部等の関心領域が検出されると、組織細胞を採取して精査したり、病変部であることが明確であれば、その治療を行ったりする必要がある。従って、超音波内視鏡において使用される処置具としては、体内に刺入される穿刺処置具が用いられる。穿刺処置具は、体内に刺入されることから、先端部分は鋭利になった金属パイプ材からなる針状部となっている。この針状部は所定の長さを有し、この針状部には可撓性チューブが連結して設けられることになる。   By the way, since the object of ultrasonic examination extends to the internal tissue, if a region of interest such as a lesion is detected in the internal tissue as a result of the ultrasonic examination, the tissue cell is collected and examined closely. If it is clear, treatment is necessary. Therefore, as a treatment instrument used in an ultrasonic endoscope, a puncture treatment instrument inserted into the body is used. Since the puncture treatment instrument is inserted into the body, the tip portion is a needle-like portion made of a sharp metal pipe material. The needle-like portion has a predetermined length, and a flexible tube is connected to the needle-like portion.

このように、先端に針状部を有する穿刺処置具は、体腔内壁に接触する前の段階では内視鏡観察手段により監視され、体内に刺入された後は超音波検査手段による監視が行われるが、処置具導出口から導出させた穿刺処置具は、常時、内視鏡観察手段により監視されることが望ましい。従って、処置具が処置具導出口から導出された後、内視鏡観察手段による監視ができない、所謂ブラインド状態となる距離はできるだけ短くしなければならない。また、内視鏡観察手段の視野を広く確保し、視野のけられを最小限に抑制する必要があり、この点からも処置具導出口の開口位置が制約されることになる。そして、特許文献１においては、処置具導出口を内視鏡観察手段が設けられている傾斜面に開口させており、これによって処置具導出口は内視鏡観察手段に近接した位置であって、その観察視野に対する邪魔にならないように配置されている。   As described above, the puncture treatment instrument having a needle-like portion at the tip is monitored by the endoscopic observation means before the contact with the inner wall of the body cavity, and is monitored by the ultrasonic examination means after being inserted into the body. However, it is desirable that the puncture treatment instrument derived from the treatment instrument outlet is always monitored by the endoscope observation means. Therefore, after the treatment instrument is led out from the treatment instrument outlet, the distance to be in a so-called blind state that cannot be monitored by the endoscope observation means must be as short as possible. In addition, it is necessary to secure a wide field of view of the endoscope observation means and suppress the displacement of the field of view to a minimum, and this also restricts the opening position of the treatment instrument outlet. In Patent Document 1, the treatment instrument outlet is opened on the inclined surface where the endoscope observation means is provided, so that the treatment instrument outlet is at a position close to the endoscope observation means. , It is arranged so as not to obstruct the viewing field.

また、処置具導出口に至る通路は処置具の安定性や狙撃性を確保する点で重要なものであって、この点からは、処置具をできるだけ長くガイドさせるように、通路長を十分に取ることが望ましい。先端硬質部において、処置具を処置具導出口から導出させた後、内視鏡観察手段の視野に入るまでに距離があることは、安全性の問題があるだけでなく、この距離分だけ処置具のガイドがない状態となるので、処置具導出口から導出させる処置具の安定性確保という点からも望ましいものではない。   In addition, the passage leading to the treatment instrument outlet is important in terms of ensuring the stability and snipability of the treatment instrument. From this point, the passage length should be sufficiently long to guide the treatment instrument as long as possible. It is desirable to take. In the hard distal end, the distance from the treatment instrument being led out from the treatment instrument outlet to the field of view of the endoscope observation means is not only a safety issue, but also the treatment by this distance. Since there is no instrument guide, it is not desirable from the viewpoint of ensuring the stability of the treatment instrument led out from the treatment instrument outlet.

既に説明したように、挿入部の先端硬質部において、超音波トランスデューサが先端側に設けられ、内視鏡観察手段が後方位置に配置されるが、内視鏡観察手段は傾斜面に設けられ、観察視野は斜め前方を含むものとなる。しかしながら、電子走査式の超音波トランスデューサは、多数の超音波振動子が先端硬質部の軸線方向に向けて円弧状等となるように配列されているので、内視鏡観察手段の観察視野はこの超音波トランスデューサによって必然的にある程度の制限を受けることになる。従って、超音波トランスデューサにより内視鏡観察手段の観察視野が制限される範囲内に配置されている限り、処置具導出口が観察視野に格別の影響を与えることはない。   As already explained, in the distal end hard part of the insertion part, the ultrasonic transducer is provided on the distal end side and the endoscope observation means is arranged at the rear position, but the endoscope observation means is provided on the inclined surface, The observation visual field includes an oblique front. However, since the electronic scanning ultrasonic transducer has a large number of ultrasonic transducers arranged in an arc or the like in the axial direction of the hard tip, the observation visual field of the endoscope observation means is The ultrasonic transducer is necessarily limited to some extent. Therefore, as long as the observation field of the endoscopic observation unit is limited by the ultrasonic transducer, the treatment instrument outlet does not have a special influence on the observation field.

本発明は以上の点に鑑みてなされたものであって、その目的とするところは、内視鏡観察視野を妨げることなく、処置具のガイド面となる部位を最大限に引き延ばすようにすることにある。   The present invention has been made in view of the above points, and an object of the present invention is to extend the portion to be the guide surface of the treatment instrument to the maximum without interfering with the endoscope observation visual field. It is in.

前述した目的を達成するために、本発明は、挿入部の先端硬質部に複数の超音波振動子を配列した電子走査式超音波トランスデューサを装着し、またこの超音波トランスデューサより後方位置から斜め前方に向けて処置具を導出する処置具挿通路の処置具導出口を開口させ、さらにこの処置具導出口より後部側に傾斜面を形成して、この傾斜面に照明部と観察部とからなる内視鏡観察手段を装着した超音波内視鏡であって、前記処置具通路は、前記挿入部の先端硬質部より後方位置では、この挿入部の軸線方向に向けて延在させた可撓性を有するチューブから構成され、このチューブの先端に曲成部を有する接続パイプを介して前記先端硬質部に穿設され、この先端硬質部の軸線に対して傾いた通路部に接続し、前記先端硬質部には、前記超音波トランスデューサの装着位置より後部側の位置に、この超音波トランスデューサより低所であって、先端硬質部の軸線と平行な方向または先端側に向けて立ち上がる平面部を形成して、この平面部に前記処置具導出口を開口させる構成としたことをその特徴とするものである。   In order to achieve the above-mentioned object, the present invention is equipped with an electronic scanning ultrasonic transducer in which a plurality of ultrasonic transducers are arranged at the distal end hard portion of the insertion portion, and obliquely forward from a rear position from the ultrasonic transducer. A treatment instrument outlet of the treatment instrument insertion path for deriving the treatment instrument is opened, and an inclined surface is further formed on the rear side from the treatment instrument extraction opening. The inclined surface includes an illumination unit and an observation unit. An ultrasonic endoscope equipped with an endoscopic observation means, wherein the treatment instrument passage extends in the axial direction of the insertion portion at a position behind the distal end hard portion of the insertion portion. The tube is formed in a tube having a property, and is drilled in the hard tip portion through a connection pipe having a bent portion at the tip of the tube, connected to a passage portion inclined with respect to the axis of the hard tip portion, The hard end of the tip A flat part rising from the ultrasonic transducer in a direction parallel to the axis of the distal hard part or toward the distal end is formed at a position on the rear side from the mounting position of the wave transducer. The treatment tool outlet port is configured to open.

本発明における超音波内視鏡は、その挿入部の先端硬質部において、先端側に超音波トランスデューサが装着され、その後方側に傾斜面を形成して、この傾斜面に内視鏡観察手段を設ける構成としている。そして、これら超音波トランスデューサの装着部と内視鏡観察手段の装着部との間の位置に平面部を形成して、この平面部に処置具導出口を開口させている。平面部は先端硬質部の軸線と平行な平坦面または先端側に向けて立ち上がるように傾斜した傾斜平面部としている。要するに、処置具導出口を平面部に開口させるが、この平面部は内視鏡観察手段が装着されている傾斜面と同じ方向には傾斜させない構成とする。ただし、この平面部は超音波トランスデューサの高さより低所に位置させる。内視鏡観察手段は傾斜面に装着されており、従って観察視野は斜め前方となる。この斜め前方には超音波トランスデューサが配置されており、この超音波トランスデューサによって内視鏡観察視野が制限を受けることになる。特に、超音波トランスデューサが複数の超音波振動子を先端硬質部に円弧状となるように配列されている場合には、この超音波振動子の配列方向が最も高所となる部位が内視鏡観察視野に対する制限となる。従って、この内視鏡観察視野が超音波トランスデューサにより制限を受ける範囲内であれば、処置具導出口が形成される平面により内視鏡観察視野がさらに制限されることはない。   In the ultrasonic endoscope according to the present invention, an ultrasonic transducer is mounted on the distal end side at the distal end hard portion of the insertion portion, an inclined surface is formed on the rear side, and the endoscope observation means is provided on the inclined surface. It is set as the structure to provide. A flat portion is formed at a position between the ultrasonic transducer mounting portion and the endoscope observation means mounting portion, and a treatment instrument outlet is opened in the flat portion. The flat surface portion is a flat surface parallel to the axis of the hard tip portion or an inclined flat surface portion inclined so as to rise toward the front end side. In short, the treatment instrument outlet port is opened in the flat portion, but the flat portion is not inclined in the same direction as the inclined surface on which the endoscope observation means is mounted. However, this flat portion is positioned lower than the height of the ultrasonic transducer. The endoscope observation means is mounted on an inclined surface, and therefore the observation field of view is obliquely forward. An ultrasonic transducer is disposed in front of the diagonal, and the endoscope observation field is limited by the ultrasonic transducer. In particular, when the ultrasonic transducer has a plurality of ultrasonic transducers arranged in a circular arc shape at the distal end hard portion, the portion where the arrangement direction of the ultrasonic transducers is the highest is the endoscope. This is a limitation on the viewing field. Therefore, if the endoscopic observation visual field is within the range restricted by the ultrasonic transducer, the endoscopic observation visual field is not further restricted by the plane on which the treatment instrument outlet is formed.

処置具挿通路は先端硬質部内では斜め前方に向けて立ち上がる通路となるが、この通路内では処置具は常にこの斜め前方に傾斜する面に沿ってガイドされる。そして、処置具を処置具導出口から導出させたときに、ガイド面が長ければ長いほど、導出部分の処置具が安定的に保持される。このために、斜め前方に向かうように傾斜した処置具挿通路において、この通路の内面のうち、実際に処置具がガイドされるのは斜め前方に向けて立ち上がるように傾斜した面であり、従って、処置具導出口を先端硬質部の軸線と平行な方向の平面部に開口させると、観察部が装着されている傾斜面に開口させる場合よりガイド面が長くなる。   The treatment instrument insertion path is a path that rises obliquely forward in the distal end hard portion, and in this path, the treatment instrument is always guided along a surface inclined obliquely forward. When the treatment tool is led out from the treatment tool outlet, the longer the guide surface, the more stably the treatment tool at the lead-out portion is held. For this reason, in the treatment instrument insertion passage that is inclined obliquely forward, it is the surface that is inclined so as to rise obliquely forward, among the inner surfaces of the passage, that is, the treatment instrument is actually guided. If the treatment instrument outlet port is opened in a plane portion in a direction parallel to the axis of the distal end hard portion, the guide surface becomes longer than when it is opened in an inclined surface on which the observation portion is mounted.

内視鏡観察視野を妨げることなく、処置具挿通路のうち、処置具をガイドする面の長さを長くすることができ、もって処置具を導出させたときに、その安定性が図られることになり、その結果体内への刺入操作の操作性が向上する。   The length of the guide surface of the treatment instrument in the treatment instrument insertion path can be increased without interfering with the endoscopic observation visual field, and the stability can be achieved when the treatment instrument is led out. As a result, the operability of the insertion operation into the body is improved.

以下、図面に基づいて本発明の実施の形態について説明する。まず、図１には超音波内視鏡の挿入部における先端部分の断面構造が示され、また図２には先端部分の平面構造が示されており、さらに図３にはその外観が示されている。     Hereinafter, embodiments of the present invention will be described with reference to the drawings. First, FIG. 1 shows a cross-sectional structure of the distal end portion in the insertion portion of the ultrasonic endoscope, FIG. 2 shows a planar structure of the distal end portion, and FIG. 3 shows an appearance thereof. ing.

これらの図から明らかなように、挿入部１のアングル部１ａに連結して設けた先端硬質部１ｂには、超音波検査手段と内視鏡観察手段とが設けられている。超音波検査手段は、先端硬質部１ｂの軸線方向に配列した多数の超音波振動子からなる超音波トランスデューサ２から構成され、この超音波トランスデューサ２を構成する各超音波振動子は先端硬質部１ｂの先端近傍位置から先端硬質部１ｂの軸線方向後端側に向けて配列されており、しかもこの軸線方向において凸湾曲形状となっている。超音波トランスデューサ２を構成するこれら多数配列した超音波振動子は順次駆動されるようになっており、これによって超音波電子走査が行われることになる。   As is apparent from these drawings, the distal end hard portion 1b provided connected to the angle portion 1a of the insertion portion 1 is provided with ultrasonic inspection means and endoscope observation means. The ultrasonic inspection means is composed of an ultrasonic transducer 2 composed of a large number of ultrasonic transducers arranged in the axial direction of the distal end hard portion 1b, and each ultrasonic transducer constituting the ultrasonic transducer 2 is the distal end hard portion 1b. Are arranged from the position in the vicinity of the tip toward the rear end side in the axial direction of the hard tip portion 1b, and the convex shape is formed in this axial direction. These many ultrasonic transducers constituting the ultrasonic transducer 2 are sequentially driven, so that ultrasonic electronic scanning is performed.

一方、内視鏡観察手段は照明部３と観察部４とから構成され、これらは先端硬質部１ｂの後端側の位置に形成した傾斜面部５に設けられている。観察部４は傾斜面部５の概略中央位置に配置され、対物光学系と、この対物光学系の結像位置に設けた固体撮像手段から構成される。照明部３は観察部４を挟んだ左右両側の位置に２箇所形成され、内視鏡が着脱可能に接続される光源装置からの照明光を伝送する光ファイバと照明部３に装着した拡散レンズとを有する構成となっている。さらに、観察部４に向けて洗浄用流体を噴出させる洗浄用ノズル６が装着されている。   On the other hand, the endoscope observation means includes an illumination part 3 and an observation part 4, which are provided on an inclined surface part 5 formed at a position on the rear end side of the distal end hard part 1b. The observation unit 4 is disposed at a substantially central position of the inclined surface unit 5 and includes an objective optical system and a solid-state imaging unit provided at an imaging position of the objective optical system. The illumination unit 3 is formed at two positions on both the left and right sides with the observation unit 4 in between, an optical fiber that transmits illumination light from a light source device to which the endoscope is detachably connected, and a diffusion lens attached to the illumination unit 3 It has composition which has. Further, a cleaning nozzle 6 for ejecting a cleaning fluid toward the observation unit 4 is mounted.

先端硬質部１ｂにおいて、超音波トランスデューサ２の装着部の後端側の位置には円周状の溝７が形成されている。この溝７には図１に示したようにバルーン８が着脱可能に装着されて、内部に超音波伝達媒体を供給することにより膨出させ、もって超音波トランスデューサ２から体内に向けて送信され、体内組織の断層部からの反射エコーを受信する際に、超音波信号が減衰するのを極力抑制している。   In the distal end hard portion 1b, a circumferential groove 7 is formed at a position on the rear end side of the mounting portion of the ultrasonic transducer 2. A balloon 8 is detachably attached to the groove 7 as shown in FIG. 1 and is inflated by supplying an ultrasonic transmission medium therein, so that it is transmitted from the ultrasonic transducer 2 toward the body, When receiving the reflected echo from the tomographic part of the body tissue, the attenuation of the ultrasonic signal is suppressed as much as possible.

照明部３及び観察部４を装着した傾斜面部５の位置より先端側の部位であり、かつ超音波トランスデューサ２の位置より後部側の部位は先端硬質部１ｂの軸線方向に向けた平面部９が形成されており、この平面部９には斜め前方に向けて穿刺処置具１０等の処置具を導出させるための処置具導出口１１が形成されている。この処置具導出口１１に開口する処置具挿通路１２は、アングル部１ａから後方側の部位が処置具挿通チューブ１３であって、この処置具挿通チューブ１３は挿入部１の軸線と概略平行に延在される。先端硬質部１ｂではトンネル状の通路１４が形成されており、この通路１４には金属等からなる硬質パイプ１５が部分的に挿入されており、処置具挿通チューブ１３の先端はこの硬質パイプ１５に嵌合されている。硬質パイプ１５は中間部に曲成部が形成された曲げパイプから構成され、挿入部１の軸線方向に延在させた処置具挿通チューブ１３を斜め前方に向けて導出するように方向転換させている。   A flat portion 9 is a portion on the tip side from the position of the inclined surface portion 5 to which the illumination unit 3 and the observation unit 4 are attached, and a portion on the rear side from the position of the ultrasonic transducer 2 is a flat portion 9 directed in the axial direction of the tip hard portion 1b. A treatment instrument outlet 11 for guiding a treatment instrument such as the puncture treatment instrument 10 is formed in the flat portion 9 obliquely forward. The treatment instrument insertion passage 12 that opens to the treatment instrument outlet 11 has a treatment instrument insertion tube 13 at the rear side from the angle portion 1 a, and the treatment instrument insertion tube 13 is substantially parallel to the axis of the insertion section 1. Extended. A tunnel-shaped passage 14 is formed in the distal end hard portion 1b, and a hard pipe 15 made of metal or the like is partially inserted into the passage 14, and the distal end of the treatment instrument insertion tube 13 is connected to the hard pipe 15. It is mated. The hard pipe 15 is composed of a bent pipe with a bent portion formed in the middle portion, and the treatment tool insertion tube 13 extended in the axial direction of the insertion portion 1 is changed in direction so as to be led obliquely forward. Yes.

従って、先端硬質部１ｂには、先端側から超音波トランスデューサ２，処置具導出口１１及び内視鏡観察手段を構成する観察部４が配列されているが、図３に示したように、超音波トランスデューサ２による超音波断層面と処置具導出口１１の中心と、観察部４による観察中心とがほぼ同一ラインＣ上に配列されている。これによって、処置具導出口１１から導出された穿刺処置具１０は体内に刺入される前の段階では、観察部４による観察視野に、また体内に刺入された後は超音波トランスデューサ２の超音波視野に確実に捉えることができるようになっている。   Therefore, the distal end hard portion 1b is arranged with the ultrasonic transducer 2, the treatment instrument outlet 11 and the observation portion 4 constituting the endoscope observation means from the distal end side, but as shown in FIG. The ultrasonic tomographic plane by the acoustic transducer 2, the center of the treatment instrument outlet 11, and the observation center by the observation unit 4 are arranged on substantially the same line C. As a result, the puncture treatment instrument 10 derived from the treatment instrument outlet 11 is placed in the observation field of view by the observation unit 4 before being inserted into the body, and after being inserted into the body, It can be reliably captured in the ultrasonic field of view.

以上のように構成することによって、内視鏡観察手段を構成する観察部４による観察視野を妨げることなく、処置具導出口１１から導出される穿刺処置具１０等の処置具を安定的に保持させて、患部等への狙撃性を良好にすることができる。   By configuring as described above, a treatment instrument such as the puncture treatment instrument 10 led out from the treatment instrument outlet 11 is stably held without obstructing the observation field of view by the observation unit 4 constituting the endoscope observation means. This makes it possible to improve the sniping ability to the affected area.

処置具挿通路１２内に導かれる穿刺処置具１０は、図１に示したように、先端が鋭利な針先となった金属パイプからなる針状部１０ａに可撓性チューブ１０ｂを連結したものである。この穿刺処置具１０は通常は、その先端における針状部１０ａをシース１０ｃ内に引き込んだ状態で処置具挿通路１２のうちの硬質パイプ１５の位置に配置しておき、超音波トランスデューサ２による検査の結果、例えば患部が検出されると、処置具導出口１１からシース１０ｃを導出させ、さらに針状部１０ａをシース１０ｃから出し、体内に刺入して、組織細胞を採取する等といった処置が施される。図４にこのような処置を行っている状態が示されている。ここで、穿刺処置具１０は、処置具導出口１１から導出されるまでは、その先端部が処置具挿通路１２、特に硬質パイプ１５から通路１４にかけての部位に摺動するようにして移動することになる。処置具挿通路１２は先端硬質部１ｂの軸線に対して傾斜しており、穿刺処置具１０の先端部分が摺動ガイドされるのは、常に、前方に向けて斜め上向きに傾斜する側の面である。先端硬質部１ｂにおいて、観察部４等を設けた傾斜面部５に連なるように平面部９を形成して、この平面部９に処置具導出口１１を開口させている。従って、傾斜面部５を下方に延長させて、この延長部分に処置具導出口１１を開口させた場合と比較して、硬質パイプ１５における曲った部位から穿刺処置具１０のガイドが終了するまでの距離が図１に示した寸法Ｌだけ長くなる。その結果、穿刺処置具１０の安定性が向上し、体内に刺入する際に、狙撃性が良好となり、また体内に差し込む際の推力を大きくすることができる。このために、穿刺処置具１０の操作性が高くなる。   As shown in FIG. 1, the puncture treatment instrument 10 guided into the treatment instrument insertion path 12 is obtained by connecting a flexible tube 10b to a needle-like portion 10a made of a metal pipe having a sharp needle tip. It is. The puncture treatment instrument 10 is usually placed at the position of the hard pipe 15 in the treatment instrument insertion path 12 in a state where the needle-like portion 10a at the distal end is drawn into the sheath 10c, and an inspection by the ultrasonic transducer 2 is performed. As a result, for example, when an affected part is detected, the sheath 10c is led out from the treatment instrument outlet 11, and the needle-like part 10a is taken out from the sheath 10c, inserted into the body, and tissue cells are collected. Applied. FIG. 4 shows a state where such a treatment is performed. Here, until the puncture treatment instrument 10 is led out from the treatment instrument lead-out port 11, the distal end of the puncture treatment instrument 10 moves so as to slide into the treatment instrument insertion path 12, particularly a portion extending from the hard pipe 15 to the path 14. It will be. The treatment instrument insertion path 12 is inclined with respect to the axis of the distal end hard portion 1b, and the distal end portion of the puncture treatment instrument 10 is always slidably guided on the surface inclined obliquely upward toward the front. It is. In the distal end hard portion 1b, a flat portion 9 is formed so as to be continuous with the inclined surface portion 5 provided with the observation portion 4 and the like, and the treatment instrument outlet 11 is opened in the flat portion 9. Therefore, as compared with the case where the inclined surface portion 5 is extended downward and the treatment instrument outlet 11 is opened in the extended portion, the guide of the puncture treatment instrument 10 from the bent portion in the hard pipe 15 is completed. The distance is increased by the dimension L shown in FIG. As a result, the stability of the puncture treatment instrument 10 is improved, the sniping performance is improved when inserting into the body, and the thrust force when inserting into the body can be increased. For this reason, the operativity of the puncture treatment tool 10 becomes high.

観察部４による観察視野は図１の範囲Ｗとなっており、このために穿刺処置具１０の先端が処置具導出口１１から臨むと、直ちに穿刺処置具１０の先端が観察視野Ｗに入ることになる。従って、穿刺処置具１０は処置具導出口１１から導出された直後には観察部４による観察視野に捉えられ、また体内に刺入した後には超音波トランスデューサ２の監視下に置かれることから、穿刺処置具１０を用いた処置を安全に行うことができる。勿論、他の処置具を操作する際にも、観察部４による観察視野内で操作できるので、安全性が確保され、かつ操作性も良好になる。   The observation field of view by the observation unit 4 is in the range W of FIG. 1. For this reason, when the distal end of the puncture treatment instrument 10 faces the treatment instrument outlet 11, the distal end of the puncture treatment instrument 10 immediately enters the observation visual field W. become. Therefore, the puncture treatment instrument 10 is captured in the observation visual field by the observation unit 4 immediately after being guided from the treatment instrument outlet 11, and is placed under the supervision of the ultrasonic transducer 2 after being inserted into the body. The treatment using the puncture treatment instrument 10 can be performed safely. Of course, when other treatment tools are operated, the operation can be performed within the observation field of view by the observation unit 4, so that safety is ensured and operability is improved.

前述したように、処置具導出口１１から導出された処置具は常に観察部４による監視下に置かれるが、この処置具導出口１１が形成されている平面部９は超音波トランスデューサ２より低所に位置しているので、観察部４からの視野は超音波トランスデューサ２の最も突出した部位により制限を受けることになり、この視野が制限される範囲内に平面部９が位置していることから、処置具導出口１１を観察部４の観察視野範囲に入るにしても、その前方視野をそれ以上制限することはない。   As described above, the treatment tool led out from the treatment tool lead-out port 11 is always placed under monitoring by the observation unit 4, but the flat surface portion 9 where the treatment tool lead-out port 11 is formed is lower than the ultrasonic transducer 2. Therefore, the field of view from the observation unit 4 is limited by the most protruding portion of the ultrasonic transducer 2, and the plane part 9 is located within the range where the field of view is limited. Therefore, even if the treatment instrument outlet 11 is within the observation visual field range of the observation unit 4, the front visual field is not further limited.

超音波内視鏡における挿入部の先端部分の断面図である。It is sectional drawing of the front-end | tip part of the insertion part in an ultrasonic endoscope. 挿入部の先端部分の外観図である。It is an external view of the front-end | tip part of an insertion part. 挿入部の先端部分の平面図である。It is a top view of the front-end | tip part of an insertion part. 超音波内視鏡を用いて検査を行っている状態を示す作用説明図である。It is action explanatory drawing which shows the state which is test | inspecting using an ultrasonic endoscope.

符号の説明Explanation of symbols

１ 挿入部 １ａ アングル部
１ｂ 先端硬質部 ２ 超音波トランスデューサ
３ 照明部 ４ 観察部
５ 傾斜面部 ９ 平面部
１０ 穿刺処置具 １１ 処置具導出口
１２ 処置具挿通路 １３ 処置具挿通チューブ
１４ 通路 １５ 硬質パイプ
DESCRIPTION OF SYMBOLS 1 Insertion part 1a Angle part 1b Hard tip part 2 Ultrasonic transducer 3 Illumination part 4 Observation part 5 Inclined surface part 9 Plane part 10 Puncture treatment tool 11 Treatment tool outlet 12 Treatment tool insertion tube 13 Treatment tool insertion tube 14 Path 15 Hard pipe

Claims (2)

挿入部の先端硬質部に複数の超音波振動子を配列した電子走査式超音波トランスデューサを装着し、またこの超音波トランスデューサより後方位置から斜め前方に向けて処置具を導出する処置具挿通路の処置具導出口を開口させ、さらにこの処置具導出口より後部側に傾斜面を形成して、この傾斜面に照明部と観察部とからなる内視鏡観察手段を装着した超音波内視鏡において、
前記処置具通路は、前記挿入部の先端硬質部より後方位置では、この挿入部の軸線方向に向けて延在させた可撓性を有するチューブから構成され、このチューブの先端に曲成部を有する接続パイプを介して前記先端硬質部に穿設され、この先端硬質部の軸線に対して傾いた通路部に接続し、
前記先端硬質部には、前記超音波トランスデューサの装着位置より後部側の位置に、この超音波トランスデューサより低所であって、先端硬質部の軸線と平行な方向または先端側に向けて立ち上がる平面部を形成して、この平面部に前記処置具導出口を開口させる
構成としたことを特徴とする超音波内視鏡。 An electronic scanning ultrasonic transducer in which a plurality of ultrasonic transducers are arranged is attached to the distal end hard portion of the insertion portion, and a treatment instrument insertion path for leading the treatment instrument obliquely forward from a rear position from the ultrasonic transducer. An ultrasonic endoscope in which a treatment instrument outlet is opened, an inclined surface is formed on the rear side from the treatment instrument outlet, and an endoscope observation means including an illumination unit and an observation unit is mounted on the inclined surface. In
The treatment instrument passage is composed of a flexible tube extending in the axial direction of the insertion portion at a position rearward of the distal end hard portion of the insertion portion, and a bending portion is provided at the distal end of the tube. Drilled in the tip hard portion through a connecting pipe having, and connected to a passage portion inclined with respect to the axis of the tip hard portion,
The hard tip portion is a flat portion that is lower than the ultrasonic transducer at a position rearward of the ultrasonic transducer mounting position and rises in a direction parallel to the axis of the hard tip portion or toward the front end side. An ultrasonic endoscope characterized in that the treatment instrument outlet is opened in the flat portion. 前記超音波トランスデューサは前記複数の超音波振動子を前記先端硬質部に凸円弧状に配列して設け、前記処置具導出口は前記超音波トランスデューサによる超音波断層面と前記観察部の観察中心とを結ぶ線上に開口させる構成としたことを特徴とする請求項１記載の超音波内視鏡。

The ultrasonic transducer is provided with the plurality of ultrasonic transducers arranged in a convex arc shape at the distal end hard portion, and the treatment instrument outlet is an ultrasonic tomographic plane by the ultrasonic transducer and an observation center of the observation unit. The ultrasonic endoscope according to claim 1, wherein an opening is made on a line connecting the two.

JP2006039056A 2006-02-16 2006-02-16 Ultrasonic endoscope Abandoned JP2007215731A (en)

Priority Applications (4)

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JP2006039056A JP2007215731A (en) 2006-02-16 2006-02-16 Ultrasonic endoscope
US11/673,739 US8758251B2 (en) 2006-02-16 2007-02-12 Ultrasound endoscope
DE602007014130T DE602007014130D1 (en) 2006-02-16 2007-02-16 ultrasound endoscope
EP07003345A EP1820437B1 (en) 2006-02-16 2007-02-16 Ultrasound endoscope

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013103061A (en) * 2011-11-16 2013-05-30 Hoya Corp Puncture needle for ultrasonic endoscope
JP2014018282A (en) * 2012-07-13 2014-02-03 Olympus Medical Systems Corp Ultrasonic endoscope
JP2017537659A (en) * 2015-02-10 2017-12-21 カン, ユンシクKANG, Yoon Sik Endoscope and endoscope system including the same
CN112674811A (en) * 2021-01-13 2021-04-20 苏州法兰克曼医疗器械有限公司 Intensive laparoscopic surgery tool

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JPH06105847A (en) * 1992-09-28 1994-04-19 Fuji Photo Optical Co Ltd Endoscope
JPH09108224A (en) * 1995-10-19 1997-04-28 Olympus Optical Co Ltd Body cavity ultrasonic probe
JPH11276422A (en) * 1998-03-31 1999-10-12 Fuji Photo Optical Co Ltd Ultrasonic endoscope
JP2001087261A (en) * 1999-09-24 2001-04-03 Fuji Photo Optical Co Ltd Endoscope attachable electronic scanning type ultrasonic inspection device

Patent Citations (4)

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JPH06105847A (en) * 1992-09-28 1994-04-19 Fuji Photo Optical Co Ltd Endoscope
JPH09108224A (en) * 1995-10-19 1997-04-28 Olympus Optical Co Ltd Body cavity ultrasonic probe
JPH11276422A (en) * 1998-03-31 1999-10-12 Fuji Photo Optical Co Ltd Ultrasonic endoscope
JP2001087261A (en) * 1999-09-24 2001-04-03 Fuji Photo Optical Co Ltd Endoscope attachable electronic scanning type ultrasonic inspection device

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013103061A (en) * 2011-11-16 2013-05-30 Hoya Corp Puncture needle for ultrasonic endoscope
JP2014018282A (en) * 2012-07-13 2014-02-03 Olympus Medical Systems Corp Ultrasonic endoscope
JP2017537659A (en) * 2015-02-10 2017-12-21 カン, ユンシクKANG, Yoon Sik Endoscope and endoscope system including the same
CN112674811A (en) * 2021-01-13 2021-04-20 苏州法兰克曼医疗器械有限公司 Intensive laparoscopic surgery tool
CN112674811B (en) * 2021-01-13 2021-11-02 苏州法兰克曼医疗器械有限公司 Intensive laparoscopic surgery tool

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