JP2012192022A - Ultrasonic endoscope and endoscope device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To widen the visual field of ultrasound and to enhance image quality when inspecting, diagnosing, and treating the target site of a subject using surgical tools while looking at an ultrasonic image.SOLUTION: An ultrasonic probe having a plurality of oscillators arranged in an axial direction of a head part in the side surface part of the distal end, the first inserting hole which is opened in the front surface part of the distal end and through which an optical imaging tool for guiding insertion is inserted, the second inserting hole through which the surgical tool is inserted, and the third inserting hole through which a light irradiating tool is inserted are formed in the head part of an inserting part to be inserted into the body cavity of the subject. The openings of the second and third inserting holes are formed in an inclined surface located in the rear end side of the ultrasound probe.

Description

  The present invention relates to an ultrasonic endoscope and an endoscope apparatus, and more particularly, to be used when an ultrasonic endoscope is inserted into a body cavity of a subject to examine, diagnose, treat, etc. a target portion of the subject. The present invention relates to a sonic endoscope and an endoscope apparatus.

  For example, Patent Literature 1 proposes an ultrasonic endoscope including an insertion portion having a head portion and a bending portion, and an operation portion provided on the rear end side of the insertion portion. An opening of an insertion hole through which the CCD is inserted, an opening of an insertion hole through which a treatment instrument such as a puncture needle is inserted, and an opening of an insertion hole through which illumination is inserted are formed on the front surface portion at the tip of the head portion. . In addition, an ultrasonic transducer unit in which a plurality of piezoelectric elements are arranged is provided on the side surface side of the head unit. In particular, according to Patent Document 1, in order to overlap at least a part of the observation range of the CCD and the scanning range (field of view) of the ultrasonic wave, the tip of the head part and a part of the ultrasonic scanning range are overlapped. ing. Thereby, since the depth direction of a CCD image can be observed with an ultrasonic image, it is said that the diagnostic accuracy of a lesion part can be improved. In Patent Document 1, two CCDs having different magnifications are provided, and a high-power CCD is used when diagnosing a lesion site at the cellular level.

JP 2005-118133 A

  By the way, since the ultrasonic endoscope like patent document 1 has overlapped the tip of a head part and a part of field of view of an ultrasonic wave, an ultrasonic wave is disturbed and a part of ultrasonic picture is missing. Become. Therefore, there is a problem that it is difficult to see a target site for operating a surgical instrument such as a puncture needle or forceps while viewing an ultrasonic image. Furthermore, the ultrasonic wave that hits the tip of the head part is reflected, and the image quality of the ultrasonic image is degraded, making it difficult to operate the surgical instrument.

  The problem to be solved by the present invention is to widen the field of view of ultrasonic waves and improve the image quality when examining, diagnosing, treating, etc. the target region of a subject using a surgical instrument while viewing an ultrasonic image There is.

  In order to solve the above-described problems, an ultrasonic endoscope according to the present invention includes a rod-shaped insertion portion having a head portion at a tip thereof, and an operation portion provided at a rear end portion of the insertion portion. The first part is an ultrasonic probe having a plurality of transducers arranged in the axial direction of the head part on the side surface part of the tip, and an optical imaging instrument for insertion guidance that is opened in the front part of the tip. An insertion hole, a second insertion hole that is opened toward the visual field of the ultrasonic probe on the rear end side of the ultrasonic probe, and a third insertion hole through which the light irradiation instrument is inserted. An ultrasonic endoscope comprising a hole, wherein the second insertion hole and the third insertion hole are positioned on an inclined surface formed in the head portion so as to be positioned on the rear end side of the ultrasonic probe. It is characterized by being opened.

  According to this, since the insertion hole of the surgical tool is opened on the inclined surface inclined in the direction away from the ultrasonic visual field toward the rear end side of the head portion, the ultrasonic visual field is prevented from being obstructed. it can. Therefore, the field of view of the ultrasonic wave can be widened and the image quality of the ultrasonic image can be improved. Furthermore, since the insertion hole of the surgical instrument is inclined toward the ultrasonic field of view that goes away from the axis of the head part, the surgical instrument is guided by the insertion hole and directed toward the target site in the ultrasonic field of view. A surgical tool can be entered.

  In this case, by making the shape of the head part a sector type and a linear type, it becomes possible to reduce the insertion diameter of the cable, and the burden on the subject such as a patient when inserting the endoscope can be reduced. .

  Moreover, the opening of the insertion hole through which the optical imaging instrument for the surgical instrument opened toward the ultrasonic field of view can be formed on the inclined surface in which the opening of the insertion hole of the surgical instrument is formed. According to this, it is possible to obtain an optical image of the surface of the target site into which the surgical instrument is entered, and to operate the surgical instrument while viewing the optical image.

  Further, the ultrasonic transmission / reception surface of the ultrasonic probe can be inclined toward the tip side of the head portion. According to this, since the ultrasonic transmission / reception surface is inclined to the body cavity ahead of the insertion direction, the ultrasonic transmission / reception surface can be easily applied to the target site of the subject.

  On the other hand, an endoscope apparatus including the ultrasonic endoscope of the present invention, a control device that controls the ultrasonic endoscope, and a display device that displays an image obtained by the ultrasonic endoscope is configured. Can do.

  In addition, when an endoscope apparatus is configured using an ultrasonic endoscope provided with an optical imaging instrument for insertion guidance and an optical imaging instrument for a surgical instrument, while the ultrasonic wave is being transmitted / received, It is preferable to display the optical image obtained by the optical imaging instrument on the display device. According to this, when inserting an ultrasonic endoscope, an optical image in the insertion direction is displayed on the display device, and while the ultrasonic endoscope reaches the target site and transmits / receives ultrasonic waves, Since the image is switched to the optical image of the sonic field of view, the optical image for insertion guidance and operation tool operation can be displayed with a single display device.

  When inspecting, diagnosing, treating, etc., a target region of a subject using a surgical tool while viewing an ultrasonic image, the ultrasonic field of view can be widened and the image quality can be improved.

FIG. 3 is a cross-sectional view of the head portion of the ultrasonic endoscope according to the first embodiment. FIG. 2 is an overall view of an ultrasonic endoscope including the head unit of FIG. 1. It is a schematic block diagram of an endoscope apparatus provided with the ultrasonic endoscope of FIG. It is a figure which shows the visual field of an ultrasonic wave at the time of using a linear type ultrasonic probe. It is the figure which compared the thickness of the cable connected to a sector type or a linear type probe, and the cable connected to a convex type probe. (A) is a top view of the head part of the ultrasonic endoscope of the second embodiment, (b) is a cross-sectional view of the position of the line Vb-Vb in (a), and (c) is the line Vc-Vc in (a). FIG. It is a schematic block diagram of an endoscope apparatus provided with the ultrasonic endoscope of FIG. (A) is sectional drawing of the head part of the ultrasonic endoscope of Embodiment 3, (b) is an enlarged view of the position of the ultrasonic probe of (a).

Hereinafter, the present invention will be described based on embodiments.
(Embodiment 1)
The ultrasonic endoscope according to the first embodiment and the endoscope apparatus including the ultrasonic endoscope will be described with reference to FIGS. As shown in FIGS. 1 and 2, the ultrasonic endoscope 1 according to the first embodiment includes a rod-shaped insertion portion 3 to be inserted into a body cavity of a subject and an operation provided on the rear end side of the insertion portion 3. Part 5 is provided. The insertion part 3 is formed, for example, in a rod shape with a circular cross section in the axial direction. The insertion portion 3 includes a bending portion 7 formed to be bendable and a head portion 9 provided at the tip of the bending portion 7. The bending portion 7 can be bent vertically and horizontally by rotation of an operation knob 11 provided in the operation portion 5.

  Here, the head unit 9 which is a characteristic configuration of the ultrasonic endoscope according to the first embodiment will be described. The head unit 9 includes an ultrasonic probe 13 having a plurality of transducers arranged along the axial direction of the head unit 9 on the side surface of the tip, and an optical imaging instrument for insertion guidance that is opened at the front of the tip. Is inserted into the insertion hole 15 through which the surgical instrument 13 is inserted, the insertion hole 19 through which the surgical instrument is inserted in the rear end side of the ultrasonic probe 13 toward the visual field 17 of the ultrasonic probe 13 and the surgical instrument. An insertion hole not shown in the figure is provided. That is, the insertion hole through which the light irradiation instrument is inserted is formed side by side with the insertion hole 19 in a direction orthogonal to the paper surface of FIG. The ultrasonic probe 13 is, for example, a sector type ultrasonic probe, and is controlled so that the ultrasonic field of view (the shape of the scanning range) 17 extends in a direction away from the axis of the head unit 9. Is done. A cable 21 that transmits ultrasonic transmission / reception signals is connected to the rear end of the ultrasonic probe 13. The insertion hole 15 is formed on the back side of the ultrasonic transmission / reception surface 23 of the ultrasonic probe 13. The opening 25 of the insertion hole 15 is formed in the front surface portion at the tip of the head portion 9 so that the opening faces forward in the insertion direction when the insertion portion 3 is inserted. The insertion hole 15 thus formed is inserted with an optical imaging device, for example, an optical fiber connected to the imaging device, or a CCD (charge coupled device) connected with a cable, and the insertion portion is illuminated by the illumination of the light irradiation device. Thus, an optical image in the insertion direction 3 can be obtained.

  The opening 26 of the insertion hole 19 is formed in an inclined surface 27 formed in the head portion 9 on the rear end side of the ultrasonic probe 13. The inclined surface 27 is adjacent to the rear end side of the ultrasonic probe 13 and is formed with an upward inclination angle from the rear end side of the ultrasonic probe 13 toward the rear end side of the head unit 9. Yes. That is, the inclined surface 27 is formed to have an angle with respect to the axis of the head portion 9 by being inclined toward the rear end side of the head portion 9. Thereby, the inclined surface 27 is inclined in a direction away from the ultrasonic visual field 17 toward the rear end side of the head portion 9. The insertion hole 19 through which a surgical instrument such as a puncture needle or forceps is inserted is formed to be inclined in a direction away from the axis of the head portion 9 toward the opening 26 of the inclined surface 27. As a result, a surgical instrument such as a puncture needle or forceps inserted through the insertion hole 19 is guided along the insertion hole 19 and enters the ultrasonic visual field 17 from the opening 26. Further, the insertion hole through which the light irradiating instrument is inserted is formed in the inclined surface 27 so as to be parallel to the insertion hole 19 and inclined in the same direction. The inclination angle of the inclined surface 27 is appropriately set according to the viewing angle of the ultrasonic wave so as not to disturb the visual field 17 of the ultrasonic wave.

  Next, an endoscope apparatus provided with the ultrasonic endoscope 1 of Embodiment 1 shown in FIG. 3 will be described. The endoscope apparatus includes an ultrasonic endoscope 1, a control device 29 that controls the ultrasonic endoscope 1, and a display device 31 that displays an optical image and an ultrasonic image obtained by the ultrasonic endoscope 1. And a storage device 33 connected to the display device 31. The control device 29 includes an endoscope observation device 35 connected to the optical imaging instrument inserted through the insertion hole 15, an ultrasonic observation device 37 connected to the ultrasonic probe 13 via the cable 21, and image processing. The apparatus 39 and the optical apparatus 41 which controls a light irradiation instrument are provided. The endoscope observation apparatus 35 generates an optical image in the insertion direction of the insertion unit 3 based on a signal input from the optical imaging instrument inserted through the insertion hole 15. The ultrasonic observation device 37 is configured to output an ultrasonic transmission signal to the ultrasonic probe 13. The image processing device 39 is configured to generate an ultrasonic image based on an ultrasonic reception signal input from the ultrasonic probe 13. The display device 31 is connected to an endoscope observation device 35, an ultrasonic observation device 37, and an image processing device 39, and is provided with a display unit that displays an ultrasonic image and an optical image. For example, the display device 31 displays an ultrasonic image and an optical image at the same time, or switches between an ultrasonic image and an optical image. The storage device 33 is configured to store an ultrasonic image and an optical image input to the display unit.

  The characteristic action of the ultrasonic endoscope according to the first embodiment configured as described above will be described along the operation of the endoscope apparatus. When the insertion portion 3 of the ultrasonic endoscope 1 is inserted into the body cavity of the subject, an optical image in the insertion direction obtained by the optical imaging instrument in the insertion hole 15 is displayed on the display device 31. An operator such as a doctor operates the operation knob 11 or the like while viewing the optical image to insert the insertion portion 3 into the body cavity of the subject. When the head portion 9 at the distal end of the insertion portion 3 reaches a desired position, the position and orientation of the head portion 9 are changed by the operation of the operation knob 11 or the like by the operator, and an optical image corresponding to the operation is displayed on the display device 31. Is displayed. When a target site for examination, diagnosis, treatment, or the like appears in the optical image, the operator moves the head unit 9 closer to the target site and brings the ultrasonic transmission / reception surface 23 of the ultrasonic probe 13 into contact with the target site. Then, an ultrasonic transmission signal is input to the ultrasonic probe 13, and sector scanning is performed in which the ultrasonic field of view 17 extends in a fan shape. The ultrasonic reception signal obtained by the sector scanning is sent from the ultrasonic probe 13 to the image processing device 39, and an ultrasonic image (tomographic image) of the target region is generated and displayed on the display device 31. The operator can operate the surgical instrument while viewing the ultrasonic image. For example, when a puncture needle is punctured into a target site, the needle tip of the puncture needle is displayed in an ultrasonic image, the needle tip is advanced to a desired depth of the target site, and cells are collected, drugs are injected, etc. Can do.

  In such an operation, the head unit 9 of the ultrasonic endoscope 1 according to the first embodiment forms the opening 26 of the insertion hole 19 of the surgical instrument on the inclined surface 27 inclined along the viewing angle of the ultrasonic visual field 17. Since it formed, the inclined surface in which the opening 26 was formed does not disturb the ultrasonic visual field 17. Therefore, the ultrasonic field of view 17 is ensured widely and the image quality of the ultrasonic image can be improved. Further, since the insertion hole 19 of the surgical instrument is inclined toward the opening 26 in the direction away from the axis of the head part 9, the surgical instrument is directed toward the ultrasonic visual field 17 extending in the direction away from the axis of the head part 9. I can guide you. Accordingly, even if the opening 26 for projecting the surgical tool is adjacent to the ultrasonic visual field 17, the ultrasonic visual field 17 is not disturbed.

  The ultrasound probe 13 is preferably a sector type or a linear type. In the sector type, a wide field of view can be secured even with a small number of vibrators by performing sector scanning. As shown in FIG. 4, the linear ultrasonic probe 49 oscillates the ultrasonic visual field 50 not only in the direction directly above the ultrasonic transmission / reception surface 51 but also in an oblique direction (trapezoid). The visual field 50 can be expanded. On the other hand, in order to widen the viewing angle, the convex-type ultrasonic probe widens the ultrasonic transmission / reception surface and arranges the transducer over the entire transmission / reception surface. Will increase. Accordingly, when the ultrasonic field of view is the same, the cable 55 for transmitting and receiving the ultrasonic transmission / reception signal is used by using a sector type or linear type ultrasonic probe as illustrated in FIG. Can be thinned. As a result, the insertion diameter of the cable 55 can be reduced and the insertion portion 3 can be made thinner, so that the burden on the subject such as a patient when inserting the endoscope by making the shape of the head portion a sector type and a linear type. Can be reduced. On the other hand, when a convex type ultrasonic probe is used as shown in FIG. 5B, the cable 57 for transmitting ultrasonic transmission / reception signals becomes thick, and therefore the insertion portion 3 through which the cable 57 is inserted. Becomes thicker and the burden on the subject when the insertion part 3 is inserted increases. 5A and 5B other than the cables 55 and 57 are the surgical instrument insertion hole 61, the light irradiation instrument insertion hole 63, the optical imaging instrument insertion hole 65, and the water supply nozzle hole 67.

(Embodiment 2)
The ultrasonic endoscope according to the second embodiment and the endoscope apparatus including the ultrasonic endoscope will be described with reference to FIGS. The second embodiment is different from the first embodiment in that the inclined surface 27 is opened in the same direction as the opening 26 of the insertion hole 19 through which the surgical instrument is inserted, and the insertion hole through which the optical imaging instrument for the surgical instrument is inserted. 71 is formed. Further, in addition to the insertion hole 75 through which the light irradiation tool opened in the inclined surface 27 is inserted, an optical hole connected to the optical irradiation tool is formed by forming an insertion hole through which the optical irradiation tool for insertion guidance is inserted. 74 is provided in the control device 29. An optical image obtained by the optical imaging instrument for the surgical instrument is displayed on the display device 31 while the ultrasonic probe 13 is transmitting and receiving ultrasonic waves. Since other configurations are the same as those of the first embodiment, the same reference numerals are given and description thereof is omitted.

  An insertion hole 71 is formed on the rear end side of the ultrasonic probe 13 of the head portion 9 so as to open the inclined surface 27 toward the ultrasonic visual field 17 and into which an optical imaging instrument for a surgical instrument is inserted. The insertion hole 71 is formed to be inclined in a direction away from the axis of the head portion 9 toward the opening 73 of the inclined surface 27. The opening 73 is formed at the same height as the opening 26 of the insertion hole 19 of the surgical instrument on the inclined surface 27, and is provided adjacent to the opening 26. Above the insertion hole 71, an insertion hole 75 is formed through which a light irradiation instrument not shown in the drawing of the first embodiment is inserted. The insertion hole 75 is formed to be inclined in a direction away from the axis of the head portion 9 toward the opening 79 that is an illumination window of the inclined surface 27. The opening 79 is formed above the positions of the opening 73 and the opening 26 of the inclined surface 27, and illuminates from above the inclined surface 27. The insertion hole through which the optical irradiation instrument for insertion guidance not shown in the figure is inserted is formed on the back side of the ultrasonic transmission / reception surface 23 of the ultrasonic probe 13 and adjacent to the insertion hole 15. It is opened in the same direction as the opening 25 of the insertion hole 15. With this opening as an illumination window, the insertion direction of the insertion portion 3 can be illuminated.

  Here, the characteristic operation of the second embodiment will be described. When the insertion part 3 of the ultrasonic endoscope 1 is inserted into the body cavity of the subject, an insertion guide optical imaging instrument (an optical imaging instrument inserted through the insertion hole 15) in the insertion direction obtained in the front of the insertion direction is obtained. An optical image is displayed on the display device 31. When the ultrasonic probe 13 is pressed against a target site for examination, diagnosis, treatment, etc. and transmission / reception of ultrasonic waves is started, an optical imaging instrument for guiding a surgical instrument (inserted through the insertion hole 71) together with an ultrasonic image is started. The optical image of the surface of the target part obtained by the optical imaging instrument) is displayed on the display device 31. Accordingly, the surgical tool can be operated while viewing the surface of the target region in addition to the ultrasonic image. For example, the puncture position can be finely adjusted by shifting the tip of the puncture needle while viewing the optical image. In addition, the forceps position can be finely adjusted even when the target part is sandwiched between the forceps.

  According to this, when the insertion part 3 of the ultrasonic endoscope 1 is inserted, an optical image in the insertion direction is displayed on the display device 31, and the head part 9 of the ultrasonic endoscope 1 reaches the target site. While the ultrasonic wave is being transmitted and received, the optical image of the ultrasonic field of view 17 is automatically switched, so that one display device 31 can display an optical image for insertion guidance and operation tool operation.

  When ultrasonic waves are not transmitted / received, the optical image obtained by the optical imaging instrument for guiding the insertion and the optical image obtained by the optical imaging instrument for guiding the surgical instrument are appropriately switched to the display device 31. Can be configured to display. In addition, a switch or the like that can manually switch an optical image can be provided even while ultrasonic waves are being transmitted and received.

(Embodiment 3)
The ultrasonic endoscope 1 according to the third embodiment will be described with reference to FIG. The third embodiment is different from the first embodiment in that the ultrasonic probe 81 is inclined by an inclination angle θ with respect to a plane parallel to the axial direction of the head portion 9, and the ultrasonic transmission / reception surface 83 is changed to the head portion 9. It is the point which made it incline toward the front end side. Since other configurations are the same as those of the first embodiment, the same reference numerals are given and description thereof is omitted.

  According to this, since the ultrasonic transmission / reception surface 83 is inclined to the body cavity ahead of the insertion direction, the ultrasonic transmission / reception surface 83 can be easily brought into contact with the target site of the subject.

  In addition, since the head part 9 will become large if inclination-angle (theta) of the ultrasonic probe 81 is enlarged too much, it is preferable that inclination-angle (theta) is 10 degrees-40 degrees. In addition, the inclination angle θ is preferably smaller than the inclination angle between the inclined surface 27 and the surface parallel to the axial direction of the head portion 9. That is, if the inclination angle θ is too large, the ultrasonic field of view 17 is greatly inclined toward the distal end side of the head unit 9, so that it is difficult to operate the surgical instrument toward the ultrasonic field of view 17.

DESCRIPTION OF SYMBOLS 1 Ultrasonic endoscope 3 Insertion part 5 Operation part 7 Bending part 13 Ultrasonic probe 15 Insertion hole 17 View field 23 Transmission / reception surface 25 Opening 26 Opening 27 Inclined surface 29 Control apparatus 31 Display apparatus

Claims (4)

A rod-shaped insertion part having a head part at the tip, and an operation part provided at the rear end part of the insertion part,
The head portion is inserted with an ultrasonic probe having a plurality of transducers arranged in the axial direction of the head portion on the side surface portion of the tip, and an optical imaging device for insertion guidance opened at the front portion of the tip. A first insertion hole, a second insertion hole that is opened toward the field of view of the ultrasonic probe at the rear end side of the ultrasonic probe and a light irradiation instrument is inserted. An ultrasonic endoscope comprising a third insertion hole,
The ultrasonic endoscope in which the second insertion hole and the third insertion hole are located on the rear end side of the ultrasonic probe and are opened in an inclined surface formed in the head portion. The ultrasonic endoscope according to claim 1,
The inclined surface is opened in the same direction as the opening of the third insertion hole, and a fourth insertion hole is formed through which the optical imaging instrument for the surgical instrument is inserted. The fourth insertion hole is formed in the opening. An ultrasonic endoscope formed to be inclined in a direction away from the axis of the head. The ultrasonic endoscope according to claim 1 or 2,
The ultrasonic probe according to claim 1, wherein an ultrasonic wave transmitting / receiving surface is inclined toward a tip side of the head portion. An ultrasonic endoscope according to any one of claims 1 to 3, a control device that controls the ultrasonic endoscope, and a display device that displays an image obtained by the ultrasonic endoscope. An endoscope apparatus comprising the endoscope apparatus.

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