JP2010142496A - Overtube for optical probe - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To stably retain an optical probe at a desired observation position and focus a measurement light on a measurement object. <P>SOLUTION: This overtube 700 comprises a tube 701 for optical probes and a tube 702 for endoscopes. The distal end 701a of the tube 701 for the optical probes is closed and the proximal end 701b is opened. The tube 702 for the endoscopes is constituted of a cylindrical member whose outer circumference is integrally connected to the external wall of the tube 701 for the optical probes along the longitudinal axis of the overtube 700 and its distal end 702a and proximal end 702b are opened. The tube 701 for the optical probes is formed with a light incoming/outgoing window 750 for entering/emitting of the measurement light L1 and a reflected light L3, opened by notching the external-wall whole circumference of a predetermined region D including at least a region where a light opening 650 of an OCT probe 600 is located when the distal end of a cap 622 of the OCT probe 600 is brought into contact with the closed distal end inner face. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an optical probe overtube through which an optical probe is inserted.

  Conventionally, as an endoscope apparatus for observing the inside of a body cavity of a living body, an electronic endoscope apparatus that irradiates illumination light inside the body cavity of a living body, captures an image of reflected light reflected, and displays it on a monitor or the like is widely spread. And used in various fields. Many endoscope apparatuses are provided with a forceps opening, and biopsy and treatment of tissue in the body cavity can be performed by a probe introduced into the body cavity via the forceps opening.

  On the other hand, in recent years, development of a tomographic image acquisition apparatus as a light observation apparatus that acquires a tomographic image of a living body without cutting a measurement target such as a biological tissue has been advanced. For example, light using interference by low-coherence light An optical tomographic imaging apparatus using an optical coherence tomography (OCT) measurement method is known (Patent Document 1).

  This OCT measurement is a measurement method that utilizes the fact that interference light is detected when the optical path lengths of the measurement light, reflected light, and reference light match. That is, in this method, the low coherent light emitted from the light source is divided into measurement light and reference light, the measurement light is irradiated onto the measurement object, and the reflected light from the measurement object is guided to the multiplexing means. On the other hand, the reference light is guided to the multiplexing means after the optical path length is changed in order to change the measurement depth in the measurement target. Then, the reflected light and the reference light are combined by the combining means, and the interference light resulting from the combination is measured by heterodyne detection or the like.

  In the OCT apparatus, by changing the optical path length of the reference light, the measurement position (measurement depth) with respect to the measurement object is changed and a tomographic image is acquired. This method is generally called TD-OCT (Time domain OCT) measurement.

  On the other hand, an optical tomographic imaging device based on SD-OCT (Spectral Domain OCT) measurement or SS-OCT (Swept source OCT) measurement is proposed as a device for acquiring tomographic images at high speed without changing the optical path length of the reference light. Has been.

  In the above-described tomographic image, it is possible to acquire a two-dimensional or three-dimensional optical tomographic image of a predetermined scanning region by repeating the measurement while slightly shifting the irradiation position.

  Such an OCT apparatus (optical tomographic imaging apparatus) is capable of observing a measurement site with high precision (resolution of about 10 μm), and an OCT probe (optical probe) is inserted into the forceps opening of the endoscope apparatus. By guiding the signal light and the reflected light of the signal light and acquiring the optical tomographic image in the body cavity, for example, it is possible to diagnose the depth of invasion of the initial cancer.

  On the other hand, an endoscope provided with a balloon and an overtube for the endoscope are disclosed (Patent Document 2). This is a convenient structure for fixing the endoscope in the digestive tract. However, the OCT probe that protrudes from the forceps opening of the endoscope having such a balloon has a drawback that the distance from the wall surface becomes too large.

  An OCT probe with a balloon attached is disclosed (Patent Document 3). Although the operability of the OCT probe alone is good, the combination with the endoscope is usually poor, and it becomes difficult to apply the OCT probe to the affected area via the forceps channel of the endoscope.

  Further, in the conventional OCT apparatus, since the OCT probe is soft and has a substantially cylindrical shape, it is difficult to stably hold an observation position such as abutting with a living tissue or a certain distance from the living tissue for a time required for observation. It becomes.

  FIG. 18 is an example of a diagram illustrating a state in which a tomographic image is obtained using an OCT probe derived from a distal end opening of a forceps channel of an endoscope. As shown in FIG. 18, in the OCT measurement method, the distal end portion 4 of the insertion portion of the OCT probe 3 protruded from the distal end opening portion 2 of the forceps channel of the endoscope 1 is brought close to a desired portion of the measurement target S. A tomographic image is obtained.

  In this case, for example, the elongated OCT probe 3 protruding from the distal end opening 2 has insufficient rigidity because the sheath of the OCT probe 3 is soft, and the protruding portion is easily supported by the distal end opening 2 as a fulcrum. It is curved and observed while maintaining the state where the outer surface of the sheath 5 of the OCT probe 3 is in contact with the surface of the measuring object S by a fold structure or a peristaltic motion of the tissue in the body cavity. It is difficult to observe the outer surface of the sheath 5 of the OCT probe 3 at a position away from the surface.

In view of this, a technique has been proposed in which an optical probe can be positioned and observed at a certain distance from a living tissue (Patent Document 4).
JP-A-6-165784 JP 2005-168990 A JP 2007-75403 A JP 2002-263055 A

  However, in Patent Document 4, a cap is provided at the distal end of the endoscope in order to position the optical probe at a certain distance from the living tissue (measurement target S). However, in this configuration, the optical probe and the living tissue ( There is a problem that the distance to the measurement object S) is limited by the opening position of the forceps channel through which the optical probe is inserted at the distal end surface of the endoscope, and measurement with a desired observation position cannot be performed. In the technique disclosed in Patent Document 4, the cap may fall off from the endoscope tip during observation (measurement).

  The present invention has been made in view of such circumstances, and provides an overtube for an optical probe that can stably hold an optical probe at a desired observation position and collect measurement light on a measurement target. The purpose is to provide.

  In order to achieve the above object, the overtube for an optical probe according to claim 1 inserts an optical probe having an elongated insertion portion having a light irradiation means for irradiating measurement light at least in a radial direction in a distal end portion. A cylindrical first insertion passage, a cylindrical second opening having a proximal end and a distal end that are integrally coupled to the first insertion passage along a longitudinal axis of the first insertion passage. A predetermined region including a predetermined position on the distal end side along the longitudinal axis of the first insertion passage, and the outside is opened to the outside by cutting out the outer wall portion of the first insertion passage, In addition, a light entrance / exit window is formed by communicating the first insertion path and the second insertion path.

  The overtube for an optical probe according to claim 1, wherein an outer wall of the first insertion path is provided in a predetermined region in which the light incident / exit window includes a predetermined position on a distal end side along the longitudinal axis of the first insertion path. Since the first insertion path and the second insertion path are communicated with each other, the optical probe is stably held at a desired observation position to be measured. Measurement light can be condensed.

  An overtube for an optical probe according to a second aspect is the overtube for an optical probe according to the first aspect, wherein the first insertion path has a proximal end opened and a distal end closed, and the predetermined position is From the irradiation position of the measurement light of the light irradiation means or the irradiation position when the optical probe is inserted and the tip of the optical probe comes into contact with the closed inner surface of the first insertion path It is preferable that it is a base end side position along the longitudinal axis of the first insertion passage.

  The over-tube for an optical probe according to claim 3 is the over-tube for an optical probe according to claim 1 or 2, wherein the second insertion path has an outer peripheral wall extending along the longitudinal axis. The light entrance / exit window is formed by cutting out the entire outer wall portion of the first insertion path in the predetermined area. Is preferred.

  The overtube for an optical probe according to claim 4 is the overtube for an optical probe according to any one of claims 1 to 3, wherein the second insertion path includes at least an endoscope insertion portion. It is preferable that the endoscope outer tube is insertable.

  An overtube for an optical probe according to a fifth aspect is the overtube for an optical probe according to any one of the first to fourth aspects, wherein the cross section is perpendicular to the longitudinal axis of the first insertion path. The inner surface shape is preferably substantially trapezoidal.

  An overtube for an optical probe according to a sixth aspect is the overtube for an optical probe according to any one of the first to fourth aspects, wherein the cross section is perpendicular to the longitudinal axis of the first insertion path. The inner surface shape is preferably substantially semicircular.

  The overtube for an optical probe according to claim 7 is the overtube for an optical probe according to claim 1 or 2, wherein the first insertion path and the second insertion path have a layer structure, The first insertion passage is preferably formed in an outer layer of the second insertion passage.

  The overtube for an optical probe according to claim 8 is the overtube for an optical probe according to claim 7, wherein the first insertion path and the second insertion path have a central axis substantially coaxial. It is preferable to form a substantially cylindrical shape with a two-layer structure.

  An overtube for an optical probe according to a ninth aspect is the overtube for an optical probe according to the seventh aspect, wherein a cross-sectional shape of the first insertion path perpendicular to the longitudinal axis is the second insertion tube. It is preferable that it is a long hole shape along the outer periphery of a channel | path.

  The overtube for an optical probe according to claim 10 is the overtube for an optical probe according to any one of claims 1 to 9, wherein the first insertion path is in the vicinity of the light incident / exit window. It is preferable to have a convex part on the outer surface.

  The overtube for an optical probe according to claim 11 is the overtube for an optical probe according to any one of claims 1 to 9, wherein the second insertion path faces the light incident / exit window. It is preferable that the outer peripheral position further includes balloon means that can be inflated and deflated, and further includes balloon control means for controlling the inflation and deflation of the balloon means.

  An overtube for an optical probe according to a twelfth aspect is the overtube for an optical probe according to the tenth aspect, wherein the second insertion path is expanded and moved to an outer peripheral position facing the light incident / exit window. It is preferable that the apparatus further comprises balloon control means that has deflatable balloon means and controls expansion and contraction of the balloon means.

  The overtube for an optical probe according to a thirteenth aspect is the overtube for an optical probe according to the twelfth aspect, wherein the convex portion is a balloon portion that can be expanded and contracted.

  An overtube for an optical probe according to a fourteenth aspect is the overtube for an optical probe according to a thirteenth aspect, wherein the balloon portion is formed integrally with the balloon means.

  The over-tube for an optical probe according to claim 15 is the over-tube for an optical probe according to claim 13 or 14, wherein the balloon control means further controls expansion and contraction of the balloon portion. .

  An overtube for an optical probe according to claim 16 is the overtube for an optical probe according to any one of claims 1 to 15, wherein one end is fixed to an inner surface of a tip end of the first insertion path, It is preferable to further comprise a guide wire provided in the first insertion path along the longitudinal axis.

  An overtube for an optical probe according to claim 17 is the overtube for an optical probe according to any one of claims 1 to 16, wherein a tip end of the closed first insertion path is tapered. Is preferable.

  As described above, according to the present invention, there is an effect that the optical probe can be stably held at a desired observation position and the measurement light can be condensed on the measurement target.

  The best mode for carrying out the present invention will be described below with reference to the accompanying drawings.

First embodiment:
FIG. 1 is an example of an external view showing the diagnostic imaging apparatus according to the first embodiment. As shown in FIG. 1, the diagnostic imaging apparatus 10 mainly includes an endoscope 100, an endoscope processor 200, a light source device 300, an OCT processor 400, and a monitor device 500. The endoscope processor 200 may be configured to incorporate the light source device 300.

  The endoscope 100 includes a hand operation unit 112 and an insertion unit 114 that is connected to the hand operation unit 112. The surgeon grasps and operates the hand operation unit 112 and performs observation by inserting the insertion unit 114 into the body of the subject.

  A universal cable 116 is connected to the hand operation unit 112, and an LG (light guide) connector 120 is provided at the tip of the universal cable 116. By connecting the LG connector 120 to the light source device 300 in a detachable manner, illumination light is sent to an illumination optical system (not shown) disposed at the distal end portion of the insertion portion 114. The LG connector 120 is connected to an electrical connector 110 via a universal cable 116, and the electrical connector 110 is detachably coupled to the endoscope processor 200. As a result, observation image data obtained by the endoscope 100 is output to the endoscope processor 200 and an image is displayed on the monitor device 500 connected to the endoscope processor 200.

  The hand operation unit 112 is provided with an air / water supply button, a suction button, a shutter button, a function switching button, a pair of angle knobs, a pair of lock levers, etc., but description of these members is omitted. To do.

  The OCT probe 600 includes an insertion unit 602, an operation unit 604 for an operator to operate the OCT probe 600, and a cable 606 connected to the OCT processor 400 via a connector 410.

  On the other hand, the insertion portion 114 of the endoscope 100 includes a flexible portion 140, a bending portion 142, and a distal end portion 144 in this order from the hand operating portion 112 side. Although not shown, the distal end portion 144 is provided with an observation optical system, an illumination optical system, and the like. Illumination light is emitted from the illumination optical system into the body cavity, and the image in the body cavity is the proximal end side of the observation optical system. The solid-state imaging device provided in the imaging unit, for example, is imaged by a CCD, and the imaging signal is output to the endoscope processor 200.

  Note that the configurations of the endoscope processor 200 and the light source device 300 are well-known and will not be described. The OCT processor 400 is a processor that uses, for example, an SS-OCT (Swept source OCT) measurement method, and details thereof are well-known, and thus description thereof is omitted. The OCT measurement method may be, for example, a known TD-OCT (Time domain OCT) measurement method or SD-OCT (Spectral Domain OCT) measurement method.

  In the present embodiment, the insertion portion 602 of the OCT probe 600 is inserted into an optical probe tube 701 that is a first insertion path of an optical probe overtube (hereinafter abbreviated as an overtube) 700, The insertion portion 114 of the mirror 100 is inserted into an endoscope tube 702 that is a second insertion path of the overtube 700.

  FIG. 2 is a cross-sectional view showing a cross section of the distal end of the insertion portion of the OCT probe of FIG. The distal end portion of the insertion portion 602 of the OCT probe 600 has a probe outer cylinder 620, a cap 622, an optical fiber 623, a flexible shaft 624, a fixing member 626, and an optical lens 628.

  The probe outer cylinder (sheath) 620 is a cylindrical member having flexibility, and at least a part of the side surface on the distal end side through which the measurement light L1 and the reflected light L3 through the optical lens 628 pass is on the entire circumference. A light opening 650 formed of a material (translucent material) that transmits light is provided.

  The cap 622 is provided at the distal end of the probe outer cylinder 620 and closes the distal end of the probe outer cylinder (sheath) 620.

  The optical fiber 623 is a linear member, and is accommodated in the probe outer tube (sheath) 620 along the longitudinal axis, and guides the measurement light L1 emitted from the OCT processor 400 to the optical lens 628. The measurement light S1 is irradiated to the measurement object S, and the reflected light L3 from the measurement object S acquired by the optical lens 628 is guided to the OCT processor 400.

  Here, the optical fiber 623 is connected to a rotary joint (not shown) or the like in a rotation drive unit (not shown) provided in the operation unit 604 of the OCT probe 600 and is optically connected to the OCT processor 400. It is connected. The optical fiber 623 is disposed so as to be rotatable with respect to the probe outer tube (sheath) 620.

  The flexible shaft 624 is fixed to the outer periphery of the optical fiber 623. The optical fiber 623 and the flexible shaft 624 are connected to a rotation drive unit (not shown), and the rotation drive unit (not shown) rotates the optical lens 628 relative to the probe outer tube (sheath) 620 in the direction of the arrow R2. .

  The optical lens 628 is disposed at the tip of the optical fiber 623, and the tip is formed in a substantially spherical shape for condensing the measurement light L1 emitted from the optical fiber 623 onto the measurement object S. .

  The optical lens 628 irradiates the measurement object S with the measurement light L 1 emitted from the optical fiber 623, collects the reflected light L 3 from the measurement object S, and enters the optical fiber 623.

  The fixing member 626 is disposed on the outer periphery of the connection portion between the optical fiber 623 and the optical lens 628, and fixes the optical lens 628 to the end portion of the optical fiber 623.

  Further, the optical fiber 623, the flexible shaft 624, the fixing member 626, and the optical lens 628 are moved in the direction of the arrow S 1 (OCT sheath portion 622) inside the probe outer tube (sheath) 620 by an advance / retreat mechanism (not shown) of the rotation drive portion. ) And the S2 direction (the distal direction of the OCT sheath portion 622).

  The OCT probe 600 is configured as described above, and the optical fiber 623 and the flexible shaft 624 are rotated in the direction of the arrow R2 in FIG. The measurement object S is irradiated while scanning in the direction of the arrow R2 (the circumferential direction of the probe outer tube (sheath) 620), and the reflected light L3 is acquired.

  3A and 3B are longitudinal sectional views showing the configuration of the overtube of FIG. 1, and FIG. 4 is a view as seen from the arrow B of FIG. As shown in FIG. 3A, the overtube 700 includes an optical probe tube 701 and an endoscope tube 702. The optical probe tube 701 is an elongated and cylindrical member, and its distal end 701a is closed and its proximal end 701b is opened. The endoscope tube 702 includes a cylindrical member whose outer periphery is integrally coupled to the outer wall of the optical probe tube 701 along the longitudinal axis of the overtube 700, and has a distal end 702a and a proximal end 702b. Is open.

  Specifically, the tip 701a of the optical probe tube 701 has a closed (sealed) structure, and has a tapered structure so as not to be caught when inserted into the body. On the other hand, both ends of the endoscope tube 702 are open, and the insertion portion 114 of the endoscope 100 can be advanced and retracted in the endoscope tube 702, and the distal end 702a of the endoscope tube 702 is inserted. Further, the insertion portion 114 of the endoscope 100 can be protruded.

  In addition, although it has set as the structure which obstruct | occluded the front-end | tip 701a of the tube 701 for optical probes, it is good not only this but the structure which opened the front-end | tip 701a of the tube 701 for optical probes as shown in FIG.3 (b).

  When the optical probe tube 701 is brought into contact with the inner surface of the closed end of the cap 622 of the OCT probe 600, the optical opening 650 of the OCT probe 600 includes at least a predetermined region L including an irradiation position where the measurement light is irradiated. A light entrance / exit window 750 for entering and exiting the measurement light L1 and the reflected light L3 that are opened by cutting out the entire outer wall of the outer wall is formed. That is, the light incident / exit window 750 opens to the outside in the optical probe tube 701 and allows the optical probe tube 701 and the endoscope tube 702 to communicate with each other.

  As described above, the optical probe tube 701 and the endoscope tube 702 communicate with each other at the light incident / exit window 750, and the light incident / exit window 750 has an optical probe tube 701 as shown in FIG. The probe outer cylinder (sheath) 620 including the light opening 650 and the inner surface of the endoscope tube 702 can be seen from the side.

  As a result, when the insertion portion 114 of the endoscope 100 is inserted into the endoscope tube 702, measurement is performed by the endoscope 100 from the inside of the endoscope tube 702 through the light incident / exit window 750. The target S can be imaged.

  The light incident / exit window 750 includes a predetermined position including at least an irradiation position at which the light opening 650 of the OCT probe 600 irradiates the measurement light when the front end of the cap 622 of the OCT probe 600 is brought into contact with the inner surface of the closed end. Although it is provided in the region L, the present invention is not limited to this, and the optical aperture 650 of the OCT probe 600 is measured by the above irradiation position (when the tip of the cap 622 of the OCT probe 600 is brought into contact with the closed inner surface of the tip. A predetermined region L ′ (see FIG. 3A) may be set at a position closer to the base end side than the position where the light incident / exit window 750 is formed. In this case, since the position of the light incident / exit window 750 is uniquely determined on the longitudinal axis of the overtube 700, the optical probe of the OCT probe 600 is arranged so that the optical aperture 650 of the OCT probe 600 is disposed at this position. What is necessary is just to adjust the insertion amount to the tube 701 for work. In the case of the configuration shown in FIG. 3B (in the case of the configuration in which the tip 701a is opened), the position of the light incident / exit window 750 may be set similarly.

  5 is a cross-sectional view showing a cross section taken along line AA of FIG. As shown in FIG. 5, the cross section of the optical probe tube 701 on the surface orthogonal to the longitudinal axis of the overtube 700 is formed in a substantially trapezoidal shape, and the cross section of the endoscope tube 702 is formed in a substantially circular shape. By making the bottom surface of the optical probe tube 701 flat, it is possible to stabilize the contact with the measuring object S.

  In the present embodiment configured as described above, first, the operator inserts the insertion portion 602 of the OCT probe 600 into the optical probe tube 701 and also inserts the insertion portion 114 of the endoscope 100 into the endoscope of the overtube 700. Insert into the mirror tube 702. Then, the operator inserts the overtube 700 inserted through the insertion portion 602 of the OCT probe 600 and the insertion portion 114 of the endoscope 100 into the patient's body (inside the lumen) while viewing the image with the endoscope 100. .

  FIG. 6 is a view showing an arrangement example of the overtube of FIG. 2 in the body cavity. As shown in FIG. 6, when the surgeon finds the affected part that is the measurement target S in the body (in the lumen) from the endoscopic image, the operator rotates the overtube 700 so that the light incident / exit window 750 side is the measurement target S. The outer wall of the optical probe tube 701 is brought into contact with the measuring object S. In this state, the optical fiber 623 and the optical lens 628 inside the OCT probe 600 move in the longitudinal axis direction while rotating, and two-dimensional scanning is performed (see FIG. 2). Since information in the depth direction is obtained in the OCT measurement, the data of the three-dimensional structure of the measuring object S is acquired as a result.

  In the present embodiment, as described above, since the overtube 700 includes the optical probe tube 701 and the endoscope tube 702, the rigidity of the entire overtube 700 is increased, and the rigidity of the entire overtube 700 is more stable. Thus, the outer wall of the optical probe tube 701 on the light incident / exit window 750 side can be brought into contact with the measuring object S.

  That is, the overtube 700 collects measurement light with respect to the measurement target S from a desired observation position in which the gap between the light opening 650 and the measurement target S is stably held in the predetermined gap D (see FIG. 6). By guiding the light from the measuring object S to the OCT processor 400, it is possible to acquire the data of the three-dimensional structure of the measuring object S and obtain the optical tomographic image of the measuring object S. .

  In addition, when the insertion portion 114 of the endoscope 100 is inserted through the endoscope tube 702, that is, under endoscopic observation, the overall rigidity of the overtube 700 is further increased, and the bending portion 142 of the insertion portion 114 is increased. By using this bending operation, the contact position between the outer wall of the optical probe tube 701 and the measuring object S can be more stably held.

  FIG. 7 is a diagram illustrating an example of an image of a light incident / exit window from the endoscope tube captured by the endoscope inserted into the endoscope tube of FIG. 3. In the present embodiment, the distal end surface of the endoscope 100 is disposed closer to the proximal end side than the light incident / exit window 750 in the endoscope tube 702, and as shown in FIG. An endoscope image 790 of the OCT probe 600 inserted into the optical probe tube 701 and the measurement target S therebelow can be obtained via the light incident / exit window 750 by the endoscope 100 inserted in the OCT measurement. The optical aperture 650 is aligned with the measuring object S, which is a part to perform the above, while observing with the endoscope 100. It is also possible to insert a treatment tool (not shown) through a forceps channel (not shown) of the endoscope 100 and approach the measurement object S through the light incident / exit window 750. Yes, it is possible to biopsy or treat the measuring object S that has been easily and reliably subjected to OCT measurement.

  FIG. 8 is a cross-sectional view showing a modification of the cross section taken along the line AA of FIG. As shown in FIG. 8, the cross section of the optical probe tube 701 on the surface orthogonal to the longitudinal axis of the overtube 700 may be formed in a substantially semicircular shape.

Second embodiment:
Since the second embodiment is almost the same as the first embodiment, only different configurations will be described.

  FIG. 9 is a diagram illustrating a configuration of the overtube according to the second embodiment, and FIG. 10 is a diagram illustrating a positional relationship between the convex portion and the light incident / exit window in FIG. 9.

  In the present embodiment, as shown in FIG. 9, convex portions 800 having a height of Δd, for example, are provided at positions before and after the light incident / exit window 750 of the overtube 700 (base end side position and distal end side position: see FIG. 10). Is formed. Other configurations are the same as those of the first embodiment.

  As shown in FIG. 9, in this embodiment, as in the first embodiment, first, the operator inserts the insertion portion 602 of the OCT probe 600 into the optical probe tube 701, and the endoscope 100. The insertion portion 114 is inserted into the endoscope tube 702 of the overtube 700. Then, the operator inserts the overtube 700 inserted through the insertion portion 602 of the OCT probe 600 and the insertion portion 114 of the endoscope 100 into the patient's body (inside the lumen) while viewing the image with the endoscope 100. . When the surgeon finds the affected area as the measurement target S from the endoscopic image in the body (inside the lumen), the operator rotates the overtube 700 and adjusts so that the light incident / exit window 750 side faces the measurement target S. Then, the outer wall of the optical probe tube 701 is pressed against the measuring object S. The optical aperture 650 is a desired observation position from the measurement object S because of the convex portion 800. For example, when the distance between the optical aperture 650 and the outer wall of the optical probe tube 701 is D, the optical aperture 650 floats by D + Δd. It will be located in the state. In this state, the optical fiber 623 and the optical lens 628 inside the OCT probe 600 move in the longitudinal direction while rotating, and two-dimensional scanning is performed. Since information in the depth direction is obtained in the OCT measurement, the data of the three-dimensional structure of the measuring object S is acquired as a result.

  As described above, in the present embodiment, in addition to the effects of the first embodiment, a desired distance (D + Δd) is secured as a distance (gap) between the light aperture 650 and the measuring object S by the convex portion 800 and a desired observation position. In the present embodiment, for example, the surface layer portion of the measurement target S is obtained more than the surface layer portion of the measurement target S, whereas the first embodiment acquires the data of the three-dimensional structure of the relatively deep layer portion of the measurement target S. Three-dimensional structure data can be acquired. That is, in the present embodiment, measurement is performed from a desired observation position based on the height Δd of the convex portion 800, and data of the three-dimensional structure of the layer portion of the measurement target S having a desired depth can be acquired. Moreover, in this embodiment, OCT measurement can be performed by this convex part 800, without crushing the surface of the measuring object S.

Third embodiment:
Since the third embodiment is almost the same as the first embodiment, only different configurations will be described, the same reference numerals are given to the same configurations, and descriptions thereof will be omitted.

  FIG. 11 is a diagram illustrating a configuration of an overtube according to the third embodiment. In the present embodiment, as shown in FIG. 11, a balloon 900 is provided on the side surface of the endoscope tube 702 on the side facing the position to be in contact with the measurement target S of the overtube 700, and the balloon 900 is inflated / A balloon control device 901 that is a balloon control means for contracting is configured to be connected to the balloon 900 via an air supply path 902 provided in a side surface of the endoscope tube 702 along the longitudinal axis. Other configurations are the same as those of the first embodiment.

  As shown in FIG. 11, in the present embodiment, as in the first embodiment, first, the operator inserts the insertion portion 602 of the OCT probe 600 into the optical probe tube 701 and the endoscope 100. The insertion portion 114 is inserted into the endoscope tube 702 of the overtube 700. Then, the operator inserts the overtube 700 inserted through the insertion portion 602 of the OCT probe 600 and the insertion portion 114 of the endoscope 100 into the patient's body (inside the lumen) while viewing the image with the endoscope 100. .

  When the surgeon finds the affected area as the measurement target S from the endoscopic image in the body (inside the lumen), the operator rotates the overtube 700 and adjusts so that the light incident / exit window 750 side faces the measurement target S. Then, the outer wall of the optical probe tube 701 is brought into contact with the measuring object S.

  In this embodiment, the balloon controller 901 is operated to inflate the balloon 900 and press the overtube 700 against the inner wall of the lumen to fix the contact portion between the measuring object S and the outer wall of the optical probe tube 701. . In this state, the optical fiber 623 and the optical lens 628 inside the OCT probe 600 move in the longitudinal direction while rotating, and two-dimensional scanning is performed. Since information in the depth direction is obtained in the OCT measurement, the data of the three-dimensional structure of the measuring object S is acquired as a result.

  As described above, in the present embodiment, in addition to the effects of the first embodiment, the endoscope is replaced within the range of entering the endoscope tube 702 while the overtube 700 is fixed to the measurement target S with the balloon 900. Can do.

  For example, when inserting into a patient's body, an endoscope capable of normal observation or special light observation is used, and after the position of the measuring object S is identified, the endoscope is replaced with an endoscope into which a treatment instrument can be inserted. Thus, the measuring object S can be treated.

  Although not shown, for example, for the biopsy of the peripheral part of the lung (bronchi), an overtube 700 having an inner diameter of the endoscope tube 702 of, for example, 1.0 mm is used. Then, a thin endoscope 100 having a diameter of 0.8 mm, for example, is inserted into the tube member 610 having an inner diameter of 1.0 mm. The endoscope tube 702 does not have a forceps opening and is provided with an illumination light unit for fluorescence observation and an observation camera. While observing with this endoscope 100, it is inserted into the peripheral part of the lung (bronchi). When a place that seems to be a lesion is found using fluorescence observation, the place is subjected to OCT measurement. OCT measurement confirms wall thickness and alteration. By inflating the balloon 900, the endoscope 100 is pulled out from the endoscope tube 702 while the overtube 700 is left in place. Then, a biopsy forceps in place of the endoscope 100 is passed through the endoscope tube 702, and the measurement target S subjected to OCT measurement is biopsied. As a result, a biopsy of the lesion can be performed with high accuracy. Note that the endoscope 100 may be left in the endoscope tube 702 and biopsy forceps may be passed through the optical probe tube 701 instead of the OCT probe 600.

  In this embodiment, although not shown, the overtube 700 is configured by forming convex portions 800 at positions before and after the light entrance / exit window 750 of the overtube 700, as in the second embodiment. In this case, the same actions and effects as those of the second embodiment can be obtained.

  FIG. 12 is a diagram showing a configuration of a first modification of the overtube of FIG. As shown in FIG. 12, the convex portion 800 may be constituted by balloons 810 and 811, and the balloon control device 901 can be operated to inflate the balloons 900, 810 and 811 to fix the overtube 700. In this case, first, the first balloon 810 on the distal end side is inflated at the tip of the balloon 900 and the measuring object S, and the overtube 700 is fixed. Then, by pushing the overtube 700 against the measurement target S, the vicinity of the measurement target S is firmly stretched. The second balloon 811 on the proximal end side is inflated and fixed at the place where the measurement object S is extended. Thereby, it is possible to prevent the measurement target S from entering between the balloons 810 and 811 when the periphery of the measurement target S is slack.

  FIG. 13 is a view showing a configuration of a second modification of the overtube of FIG. In this embodiment, as shown in FIG. 13, two ring-shaped balloons 820 and 821 are provided in front of and behind the light incident / exit window 750 in place of the balloons 900, 810, and 811, and the balloon controller 901 is provided. The overtube 700 may be fixed by operating and inflating the balloons 820 and 821, and the same actions and effects as in the first modified example (see FIG. 12) can be obtained.

  In each of the above embodiments, the overtube 700 is used for an endoscope in which the outer periphery is integrally coupled to the optical probe tube 701 and the outer wall of the optical probe tube 701 along the longitudinal axis of the overtube 700. Although it comprised from the tube 702 (refer FIG.3 and FIG.5), it is not restricted to this.

  FIG. 14 is a cross-sectional view showing a configuration of Modification 1 of the overtube according to the present invention, and FIG. 15 is a cross-sectional view showing a configuration of Modification 2 of the overtube according to the present invention.

  For example, on the surface orthogonal to the longitudinal axis of the overtube 700, as shown in FIG. 14, the inner layer of the endoscope tube 702 is used, and the outer layer of the endoscope tube 702 has a cross-sectional shape of the endoscope tube 702. It is good also as the overtube 700 of the layer structure which formed the tube 701 for optical probes made into the long hole shape along outer periphery. Here, it is preferable to provide a slide mechanism capable of sliding the OCT probe 600 in a plane perpendicular to the longitudinal axis of the overtube 700 as shown by an arrow C in FIG. By sliding the OCT probe 600, a wider range of OCT measurement becomes possible. Also in this case, the optical probe tube 701 is formed with a light incident / exit window 750 that opens to the outside and allows the optical probe tube 701 and the endoscope tube 702 to communicate with each other.

  Further, as shown in FIG. 15, in the plane orthogonal to the longitudinal axis of the overtube 700, the light in the coaxial layer is the inner layer of the endoscope tube 702 and the central axis of the endoscope tube 702 is substantially the central axis. The overtube 700 having a two-layer structure in which the probe tube 701 is formed may be used. Also in this case, it is preferable to provide a slide mechanism capable of sliding the OCT probe 600 in a plane perpendicular to the longitudinal axis of the overtube 700 as shown by an arrow C in FIG. By sliding the OCT probe 600, a wider range of OCT measurement becomes possible. In order to hold the two-layer structure, a layer structure holding portion 930 is formed in a predetermined position in the optical probe tube 701. Also in this case, the optical probe tube 701 is formed with a light incident / exit window 750 that opens to the outside and allows the optical probe tube 701 and the endoscope tube 702 to communicate with each other.

  FIG. 16 is a view showing a configuration of a modification of the optical probe tube according to the present invention. In each of the above embodiments, as shown in FIG. 16, a guide wire 940 having one end fixed to the inner surface of the distal end of the optical probe tube 701 is disposed in the optical probe tube 701 along the longitudinal axis of the overtube 700. It is preferable to do. By inserting the OCT probe 600 into the optical probe tube 701 using the guide wire 940 as a guide, the OCT probe 600 is not caught by the light incident / exit window 750, and the distal end of the OCT probe 600 is moved to the distal end of the optical probe tube 701. It can be brought into contact with the inner surface.

  FIG. 17 is a diagram showing a configuration of a modification of the endoscope tube in the first to third embodiments. In the endoscope tube 702 of each of the above embodiments, as shown in FIG. 17, it is more desirable to dispose a mirror part 950 that can be opened and closed at the tip part. In this case, it is opened when inserted into the body or during normal endoscopic observation so that the mirror unit 950 does not interfere with the forward observation. When the overtube 700 is pressed against the measuring object S before the OCT measurement, the mirror unit 950 is closed. When the mirror unit 950 is closed, the mirror unit 950 covers the front of the endoscope at an angle of 45 degrees. Therefore, the lower surface of the endoscope tube 702 can be observed through the light incident / exit window 750, which is convenient for positioning and observation at the measurement location.

  As mentioned above, although the overtube for optical probes of this invention was demonstrated in detail, this invention is not limited to the above example, You may perform various improvement and deformation | transformation in the range which does not deviate from the summary of this invention. Of course.

1 is an external view showing a diagnostic imaging apparatus according to a first embodiment. Sectional drawing which shows the front-end | tip cross section of the insertion part of the OCT probe of FIG. Sectional drawing of the longitudinal axis direction which shows the structure of the overtube of FIG. Arrow view seen from arrow B in FIG. Sectional drawing which shows the AA line cross section of FIG. The figure which shows the example of arrangement | positioning of the overtube of FIG. 2 in a body cavity The figure which shows an example of the image of the light entrance / exit window from the tube for endoscopes which the endoscope inserted in the tube for endoscopes of FIG. 3 imaged Sectional drawing which shows the modification of the AA cross section of FIG. The figure which shows the structure of the overtube which concerns on 2nd Embodiment. The figure which shows the positional relationship of the convex part of FIG. 9, and a light entrance / exit window. The figure which shows the structure of the overtube which concerns on 3rd Embodiment. The figure which shows the structure of the 1st modification of the overtube of FIG. The figure which shows the structure of the 2nd modification of the overtube of FIG. Sectional drawing which shows the structure of the modification 1 of the overtube which concerns on this invention Sectional drawing which shows the structure of the modification 2 of the overtube which concerns on this invention The figure which shows the structure of the modification of the tube for optical probes which concerns on this invention. The figure which shows the structure of the modification of the tube for endoscopes in 1st thru | or 3rd embodiment. The figure which shows a mode that a tomographic image is acquired using the OCT probe derived | led-out from the front-end | tip opening part of the forceps channel of an endoscope.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 ... Image diagnostic apparatus, 100 ... Endoscope, 114,602 ... Insertion part, 200 ... Endoscope processor, 230 ... Image composition part, 300 ... Light source device, 400 ... OCT processor, 500 ... Monitor apparatus, 600 ... OCT Probe, 623 ... Optical fiber, 628 ... Optical lens, 650 ... Optical aperture, 700 ... Overtube, 701 ... Optical probe tube 702 ... Endoscope tube, 750 ... Light entrance / exit window

Claims (17)

A cylindrical first insertion path for inserting an optical probe having an elongated insertion portion having a light irradiation means for irradiating measurement light at least in the radial direction in the distal end portion;
A cylindrical second insertion passage having a proximal end and a distal end opened and integrally coupled to the first insertion passage along a longitudinal axis of the first insertion passage;
With
In a predetermined region including a predetermined position on the distal end side along the longitudinal axis of the first insertion passage, an outer wall portion of the first insertion passage is cut out and opened to the outside, and the first insertion passage and the first insertion passage An over-tube for an optical probe, characterized in that a light entrance / exit window communicating with the second insertion passage is formed. The first insertion passage has a proximal end opened and a distal end closed,
The predetermined position is the measurement light irradiation position of the light irradiation means when the optical probe is inserted and the tip of the optical probe comes into contact with the closed inner surface of the first insertion path, or 2. The overtube for an optical probe according to claim 1, wherein the overtube for an optical probe is a base end side position along a longitudinal axis of the first insertion path from the irradiation position. The outer wall of the second insertion passage is formed integrally with the outer wall of the first insertion passage along the longitudinal axis,
3. The overtube for an optical probe according to claim 1, wherein the light incident / exit window is formed by opening and cutting an entire outer wall portion of the first insertion path in the predetermined region. . The overtube for an optical probe according to any one of claims 1 to 3, wherein the second insertion passage is an endoscope outer tube into which at least an endoscope insertion portion can be inserted. The overtube for an optical probe according to any one of claims 1 to 4, wherein an inner surface shape of a cross section perpendicular to the longitudinal axis of the first insertion path is a substantially trapezoid. The overtube for an optical probe according to any one of claims 1 to 4, wherein an inner surface shape of a cross section perpendicular to the longitudinal axis of the first insertion path is a substantially semicircular shape. The first insertion path and the second insertion path have a layer structure, and the first insertion path is formed in an outer layer of the second insertion path. The overtube for optical probes as described. The overtube for an optical probe according to claim 7, wherein the first insertion path and the second insertion path have a substantially cylindrical shape with a two-layer structure in which a central axis is substantially coaxial. The overtube for an optical probe according to claim 7, wherein a cross-sectional shape of the first insertion passage perpendicular to the longitudinal axis is a long hole shape along an outer periphery of the second insertion passage. The overtube for an optical probe according to any one of claims 1 to 9, wherein the first insertion path has a convex portion on an outer surface in the vicinity of the light incident / exit window. The second insertion path further includes balloon means that can be inflated and deflated at an outer peripheral position facing the light entrance / exit window, and further includes balloon control means for controlling expansion and contraction of the balloon means. The overtube for optical probes according to any one of claims 1 to 9. The second insertion path further includes balloon means that can be inflated and deflated at an outer peripheral position facing the light entrance / exit window, and further includes balloon control means for controlling expansion and contraction of the balloon means. The overtube for an optical probe according to claim 10. The overtube for an optical probe according to claim 12, wherein the convex portion is a balloon portion that can be inflated and deflated. The overtube for an optical probe according to claim 13, wherein the balloon portion is formed integrally with the balloon means. The over-tube for an optical probe according to claim 13 or 14, wherein the balloon control means further controls expansion and contraction of the balloon portion. 16. The guide wire according to claim 1, further comprising a guide wire having one end fixed to the inner surface of the distal end of the first insertion passage and provided in the first insertion passage along the longitudinal axis. The overtube for optical probes as described in any one. The overtube for an optical probe according to any one of claims 1 to 16, wherein a tip end of the closed first insertion path has a tapered shape.

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