JP2016202645A - Puncture adapter for puncture technique under ultrasonic guide and ultrasonic diagnostic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a puncture adapter which allows a puncture needle to be properly inserted to a target position on a scan line of an ultrasonic probe without depending on a guide hole.SOLUTION: A puncture adapter 1 attached to an ultrasonic probe 2 includes a first mirror surface 11 which is inclined upward and a second mirror surface 12 which is located on the lower side of the first mirror surface 11 and inclined downward. The first mirror surface 11 is provided at a position and angle facing one eye of a user in the use state of the ultrasonic probe 2. The second mirror surface 12 is provided at a position and angle at which the user can visually recognize the lower side of the first mirror surface 11 via the second mirror surface 12 in the state where the user can visually recognize a reflection of one eye of himself/herself on the first mirror surface 11.SELECTED DRAWING: Figure 3

Description

  The present invention relates to a puncture adapter for ultrasonic guided puncture. Specifically, the puncture adapter of the present invention is used by being attached to an ultrasonic probe in order to guide a puncture needle such as an injection needle. The present invention also relates to an ultrasonic diagnostic apparatus comprising the puncture adapter and an ultrasonic probe.

  Conventionally, a puncture needle such as an injection needle is inserted into a living body, and examination such as collection of a tissue such as a tumor, local administration of a drug, or thermotherapy such as microwave or radio wave irradiation from a puncture needle A puncture technique for performing such as is known. Such puncture is performed with an ultrasonic tomographic image generated by an ultrasound diagnostic device for the purpose of avoiding blood vessels that may cause major bleeding due to damage, or for the purpose of reliably puncturing a tissue such as a tumor. It is common to refer to In this manner, puncture performed under the guidance of an ultrasonic diagnostic apparatus is referred to as ultrasonic guided puncture.

  For example, when performing an ultrasound-guided puncture, a puncture adapter for puncture is attached to a diagnostic ultrasonic probe so that the puncture needle can be reliably inserted into a target position. Then, a method of inserting into the living body from the vicinity of the end of the contact surface (probe surface) of the ultrasonic probe with the living body while the puncture needle is guided by the puncturing adapter is used.

  For example, as a puncture adapter, there is known a puncture adapter having a guide hole into which the puncture needle can be inserted in order to guide the insertion direction of the puncture needle onto an ultrasonic scanning line by an ultrasonic probe (Patent Document 1). ). When performing ultrasound-guided puncture, the puncture needle is inserted into the guide hole of the puncture adapter while taking an ultrasonic tomogram inside the living body with an ultrasonic probe, and the puncture needle is inserted into the living body along the guide hole. By inserting the needle into the needle, it is possible to suppress the influence of hand shake by the operator and guide the puncture needle to the target site.

JP 2006-212165 A

  However, conventional puncture adapters with guide holes adhere to the patient's bodily fluid when the puncture needle is advanced or retracted along the guide holes, so that the puncture adapter can be sterilized or disinfected each time an ultrasonic guided puncture is performed, or The puncture adapter itself needs to be disposable, and there is a problem that it takes time and cost. In addition, the conventional puncture adapter has a problem that when the puncture needle is inserted into the guide hole, the direction of insertion into the living body is limited and the degree of freedom of operation is lost, which makes it difficult to perform the operation. . In addition, it is necessary to select a conventional adapter that has a guide hole with an appropriate diameter according to the thickness of the puncture needle, or to change the puncture adapter itself when the puncture needle is changed. There is a risk of delay. Furthermore, when the puncture needle is inserted into the guide hole, the ultrasonic probe and the puncture needle are connected via a puncture adapter, and it is difficult to operate the ultrasonic probe and the puncture needle independently of each other. Become. For example, if the ultrasonic probe is moved in a state where the puncture needle is inserted into the living body along the guide hole, a deviation occurs in the insertion direction of the puncture needle according to the movement of the ultrasonic probe. For this reason, there is a problem that the operation of finely adjusting the imaging position by moving only the ultrasonic probe is dangerous. In addition, conventional puncture adapters have various problems such as easy losing sight of the needle tip of the puncture needle and time-consuming installation.

  Accordingly, an object of the present invention is to provide a puncture adapter that can solve any one or more of the problems of the conventional puncture adapter described above. That is, the present invention provides a puncture adapter that can appropriately insert a puncture needle into a target position on a scanning line of an ultrasonic probe without relying on a guide hole.

  The present invention basically provides the knowledge that the puncture adapter is provided with two mirror surfaces and allows the operator to confirm that the viewing direction of the operator, the insertion position of the puncture needle, and the insertion angle are appropriate. It is based on. According to the present invention, the puncture needle can be easily inserted into a target position on the scanning line of the ultrasonic probe without fixing the puncture needle by a guide hole or the like. More specifically, the present invention has the following configuration.

The first aspect of the present invention relates to a puncture adapter 1 attached to an ultrasonic probe 2. The puncture adapter 1 of the present invention is preferably one that can be detachably attached to the ultrasonic probe 2.
The puncture adapter 1 has a first mirror surface 11 and a second mirror surface 12.
The first mirror surface 11 is inclined upward. On the other hand, the second mirror surface 12 is located below the first mirror surface 11 and is inclined downward.

  If it demonstrates concretely, the 1st mirror surface 11 will be provided in the position and angle which face a user's one eye (dominant eye) in the use condition of the ultrasonic probe 2. FIG. On the other hand, when the user can visually recognize that his / her one eye is reflected on the first mirror surface 11, the user can view the second mirror surface 12 via the second mirror surface 12. It is provided at a position and an angle where the lower area can be visually recognized.

  When performing an ultrasound-guided puncture using the puncture adapter 1 of the present invention, the operator first places his / her head in a position where his / her one eye (dominant eye) is reflected on the first mirror surface 11. Move the part. Thus, the surgeon can confirm that his / her viewing direction is appropriate. Thereafter, the surgeon carries a puncture needle such as an injection needle on the scanning line of the ultrasonic probe 2 while maintaining the state where one eye is reflected on the first mirror surface 11. At this time, the surgeon confirms that the puncture needle is projected on the second mirror surface 12. Then, the operator determines the insertion angle of the puncture needle so that the angle of the puncture needle is substantially parallel to the scanning line of the ultrasonic probe 2 while moving the puncture needle left and right. Thus, the operator can easily confirm whether the insertion position and the insertion angle of the puncture needle are appropriate by visually recognizing the first mirror surface 11 and the second mirror surface 12. Therefore, it is possible to appropriately guide the target position on the scanning line of the ultrasonic probe without guiding the puncture needle through the guide hole.

  In the puncture adapter of the present invention, it is preferable that the inclination angle of both or one of the first mirror surface 11 and the second mirror surface 12 is variable. Thereby, the inclination angle of the first mirror surface 11 and / or the second mirror surface 12 can be finely adjusted to an angle at which the operator can easily perform the treatment.

  The second aspect of the present invention relates to an ultrasonic diagnostic apparatus. An ultrasonic diagnostic apparatus according to the present invention includes a puncture adapter 1 according to the first aspect described above and an ultrasonic probe 2 to which the puncture adapter 1 is attached. The puncture adapter 1 may be detachably attached to the ultrasonic probe 2 or may be detachably attached. That is, in the ultrasonic diagnostic apparatus of the present invention, the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally. In addition, as the ultrasonic probe 2, a well-known thing can be used suitably.

  According to the present invention, it is possible to provide a puncture adapter that can appropriately insert a puncture needle at a target position on a scanning line of an ultrasonic probe without depending on a guide hole.

FIG. 1 is a perspective view showing a state where a puncture adapter is attached to an ultrasonic probe. FIG. 2 is a perspective view showing a state where the puncture adapter is attached to the ultrasonic probe from another angle. FIG. 3 is a side view schematically showing the use state of the ultrasonic probe to which the puncture adapter is attached. FIG. 4 shows an operation method for determining the insertion position and the insertion angle of the puncture needle using the puncture adapter. FIG. 5 is a side view schematically showing a state where the puncture needle is inserted into the living body. FIG. 6 is a perspective view showing a state in which the puncture needle is inserted into the living body.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. This invention is not limited to the form demonstrated below, The thing suitably changed in the range obvious to those skilled in the art from the following forms is also included.

  1 and 2 show a state in which a puncture adapter 1 according to the present invention is mounted on a known ultrasonic probe 2. In FIGS. 1 and 2, the dotted line indicates the line of sight of the operator. As shown in FIGS. 1 and 2, the puncture adapter 1 has a first mirror surface 11 and a second mirror surface 12. The puncture adapter 1 is such that the line of sight of the operator who sees the first mirror surface 11 and the second mirror surface 12 and the direction of the line of sight of the operator who reflects the first mirror surface 11 and the second mirror surface 12 are super It is attached to the upper part of the ultrasonic probe 2 so as to be parallel to the scanning line of the ultrasonic probe 2. That is, as shown in FIGS. 1 and 2, the puncture adapter 1 only needs to be attached so that the first mirror surface 11 and the second mirror surface 12 are located on the side surface of the ultrasonic probe 2.

  The puncture adapter 1 has an adapter body 10. The adapter main body 10 has an attachment mechanism for the ultrasonic probe 2. The configuration of the attachment mechanism is not particularly limited, but the attachment mechanism of the adapter body 10 is preferably one that detachably fixes the adapter body 10 to the ultrasonic probe 2. For example, in the example shown in FIGS. 1 and 2, the attachment mechanism has a configuration for sandwiching and fixing the upper portion of the ultrasonic probe. However, the configuration for fixing the adapter body 10 to the ultrasonic probe 2 is not limited to this.

  The adapter body 10 of the puncture adapter 1 is provided with a first mirror surface 11 and a second mirror surface 12. The first mirror surface 11 is inclined upward in the usage state of the ultrasonic probe 2. For this reason, the first mirror surface 11 has a position and an angle facing the operator's eye. On the other hand, the second mirror surface 12 is located below the first mirror surface 11 and is inclined downward. For this reason, the operator can visually recognize the area below the first mirror surface 11 through the second mirror surface 12 by looking into the second mirror surface 12.

  In the present embodiment, the first mirror surface 11 and the second mirror surface 12 are formed in a substantially rectangular plate shape. The first mirror surface 11 and the second mirror surface 12 are arranged side by side at positions close to each other. Specifically, the first mirror surface 11 and the second mirror surface 12 have upper edges 11a and 12a and lower edges 11b and 12b, respectively. In this case, it is preferable that the lower edge 11b of the first mirror surface 11 and the upper edge 12a of the second mirror surface 12 are in contact with each other or in positions close to each other (for example, within 5 mm). By arranging the upward first mirror surface 11 and the downward second mirror surface 12 in this manner, the lower edge 11b of the first mirror surface 11 and the upper edge 12a of the second mirror surface 12 are stretched toward the operator's hand side. It becomes the shape that comes out.

  FIG. 3 shows the usage state of the ultrasonic probe 2 to which the puncture adapter 1 is attached. As shown in FIG. 3, when the ultrasonic probe 2 is used, the probe surface of the ultrasonic probe 2 (surface that transmits and receives ultrasonic waves) is brought into contact with the living body. In this state, the surgeon looks like the puncture adapter 1 attached to the upper part of the ultrasonic probe 2 from above.

As shown in FIG. 3, the first mirror surface 11 of the puncture adapter 1 is attached at a position and an angle that face one eye (dominant eye) of the operator. For example, the inclination angle θ ₁ of the first mirror surface 11 with respect to the vertical axis of the ultrasonic probe 2 (the one-dot chain line in FIG. 3) is preferably 35 degrees to 55 degrees, 40 degrees to 50 degrees, or 45 degrees. On the other hand, the second mirror surface 12 of the puncture adapter 1 is attached at a position and an angle at which an operator can visually recognize a region below the first mirror surface 11 through the second mirror surface 12. For example, the inclination angle θ ₂ of the second mirror surface 12 with respect to the vertical axis of the ultrasonic probe 2 (the one-dot chain line in FIG. 3) is 10 degrees to 30 degrees, 15 degrees to the inclination angle θ ₁ of the first mirror surface 11 in the opposite direction. It is preferable to incline at 25 degrees or 20 degrees. In this way, by setting the inclination angles of the first mirror surface 11 and the second mirror surface 12, the surgeon can visually recognize that his / her one eye is reflected on the first mirror surface 11, and the second mirror surface. A region below the first mirror surface 11 can be visually recognized through 12.

  Although not shown, the adapter main body 10 of the puncture adapter 1 may have an angle adjustment mechanism for changing the inclination angles of the first mirror surface 11 and the second mirror surface 12. Thereby, it becomes easy to appropriately adjust the angles of the first mirror surface 11 and the second mirror surface 12 according to the distance from the surgeon's eye to the puncture adapter 1 or the like.

  Next, a method for determining the insertion position and insertion angle of a puncture needle such as an injection needle using the puncture adapter 1 will be described. First, the operator looks into the first mirror surface 11 of the puncture adapter 1 from above as shown in FIG. 3 while capturing the puncture target on the ultrasonic screen. Then, as shown in FIG. 4A, it is confirmed that one eye (dominant eye) is reflected on the first mirror surface 11. Thus, the surgeon first moves his / her head to a position where it can be confirmed that his / her one eye (dominant eye) is reflected on the first mirror surface 11.

  Thereafter, as shown in FIG. 4B, the operator carries the needle tip of the puncture needle to the area below the first mirror surface 11 while keeping the position of the head fixed. Further, a guide line 21 indicating a position parallel to the scanning line is provided on a side surface of the general ultrasonic probe 2. Therefore, the operator positions the needle tip of the puncture needle on the scanning line of the ultrasonic probe 2 while confirming the guide line 21. After that, as shown in FIG. 4 (b), the operator can observe the long axis of the puncture needle projected on the second mirror surface 12 with the needle tip of the puncture needle fixed, while checking the long axis of the puncture needle. The long axis of the puncture needle is adjusted so as to be parallel to the scanning line of the ultrasonic probe 2 by shaking the axis to the left and right.

  FIG. 4C shows a state in which the insertion position of the puncture needle is located on the scanning line of the ultrasonic probe 2 and the insertion angle of the puncture needle is parallel to the scanning line of the ultrasonic probe 2. . As shown in FIG. 4 (c), one eye of the surgeon himself is projected at the center of the first mirror surface 11 of the puncture adapter 1. In addition, the center of the second mirror surface 12 of the puncture adapter 1 shows a state in which the puncture needle scanned by the operator is straight. Further, in this state, it can be seen that the guide line 21 formed on the side surface of the ultrasonic probe 2 and the puncture needle projected on the second mirror surface 12 are positioned on a straight line. This state means that the insertion angle of the puncture needle is parallel to the scanning line of the ultrasonic probe 2. Therefore, the surgeon inserts the puncture needle straight into the living body while maintaining the appropriate state shown in FIG.

  Fig.5 (a) has shown typically the state which inserted the puncture needle with respect to the biological body, maintaining the state shown by FIG.4 (c). As shown in FIG. 5 (a), the surgeon operates the puncture needle while confirming the first mirror surface 11 and the second mirror surface of the puncture adapter 1, so that the target of the needle tip of the puncture needle is in vivo. Can be inserted into a specific location. FIG. 5B shows an example of an ultrasonic tomographic image generated by the ultrasonic diagnostic apparatus via the ultrasonic probe 2, and punctures a target in-vivo blood vessel from this tomographic image. It can be confirmed that the tip of the needle has been inserted.

  Therefore, if the puncture adapter 1 according to the present invention is used, the operator can insert the puncture needle on the scanning line of the ultrasonic probe without using the guide hole to regulate the moving direction of the puncture needle as in the conventional adapter. It is possible to appropriately assist the operation of inserting the. Thus, according to the puncture adapter 1 of the present invention, it is possible to solve the problem of the conventional adapter having the guide hole. For example, since the puncture adapter 1 of the present invention can be mounted in a transparent sterilized probe cover, the patient's bodily fluid basically does not adhere to it and can be used repeatedly. Further, since the puncture adapter 1 of the present invention does not physically restrict the insertion direction of the puncture needle, the degree of freedom of operation of the puncture needle is increased, and the ultrasonic probe and the puncture needle are made independent of each other. Can be operated. Furthermore, since the puncture adapter 1 of the present invention can be used with all puncture needles regardless of the thickness of the puncture needle, for example, it is possible to save the trouble of changing the adapter according to the thickness of the puncture needle, The treatment can be performed quickly.

  Moreover, FIG. 6 has shown the further characteristic of the puncture adapter 1 of this invention. As shown in FIG. 6, for example, when the probe surface of the ultrasonic probe is brought into contact with a rounded part such as a human arm, the ultrasonic probe itself may be tilted. In such a state where the ground contact surface is inclined, it has been difficult to accurately guide the puncture needle onto the scanning line of the ultrasonic probe using a conventional puncture adapter. On the other hand, the puncture adapter 1 of the present invention allows the operator himself to finely adjust the puncture needle insertion position and insertion angle while aiming at the first mirror surface 11 and the second mirror surface 12. For this reason, as shown in FIG. 6, even when the ground contact surface is inclined, the tip of the puncture needle can be accurately guided onto the scanning line of the ultrasonic probe by the operator's technique. Thus, it can be said that the puncture adapter 1 of the present invention is highly effective when operated on a tilted ground surface as compared with the conventional adapter.

  The puncture adapter 1 of the present invention may be reusable or disposable. When the puncture adapter 1 is reused, it is preferable to remove the puncture adapter 1 from the ultrasonic probe 2 after use and disinfect by heating. When the puncture adapter 1 is a disposable type, the disposable adapter 1 is preferably made of inexpensive plastic.

  Moreover, in FIG.1 and FIG.2, the article | item shown with the code | symbol 3 is an adjuster. The adjuster 3 is used to confirm that the attachment position and attachment angle of the puncture adapter 1 with respect to the adapter body 10 and the inclination angles of the first mirror surface 11 and the second mirror surface 12 of the puncture adapter 1 are appropriate. More specifically, a guide line 21 indicating a position parallel to the scanning line is provided on the side surface of the general ultrasonic probe 2. Correspondingly, the adjuster 3 is also provided with a linear reference line 31 on its plate-like body. Here, when the puncture adapter 1 is attached to the upper part of the ultrasonic probe 2, the user first places the reference line 31 of the adjuster 3 on a straight line of the guide line 21 provided on the side surface of the ultrasonic probe 2. In such a manner, the adjuster 3 is attached under the ultrasonic probe 2. Thereafter, the user looks into the second mirror surface 12 while projecting his / her one eye onto the first mirror surface 11 of the puncture adapter, and the reference line 31 of the adjuster 3 projected on the second mirror surface 12 is It is confirmed whether it is located on a straight line of the guide line 21 provided on the side surface of the acoustic probe 2. When the reference line 31 of the adjuster 3 projected on the second mirror surface 12 is deviated from the guide line 21 of the ultrasonic probe 2, the user corrects the deviation so that the ultrasonic probe 2 is corrected. The attachment position of the puncture adapter 1 is adjusted. Thus, if the reference line 31 of the adjuster 3 projected on the second mirror surface 12 is aligned with the guide line 21 of the ultrasonic probe 2, the attachment position of the puncture adapter 1 with respect to the ultrasonic probe 2 is correct. Can be confirmed.

  In this specification, the puncture adapter 1 configured to be detachable from the ultrasonic probe 2 has been mainly described. However, the puncture adapter 1 and the ultrasonic probe 2 may be configured integrally in advance and cannot be separated from each other. The configuration of puncture adapter 1 is as described above. On the other hand, the configuration of the ultrasonic probe 2 is not particularly limited, and a known configuration such as that disclosed in Patent Document 1 (Japanese Patent Application Laid-Open No. 2006-212165) can be adopted as appropriate. .

  As mentioned above, in this specification, in order to express the content of this invention, embodiment of this invention was described, referring drawings. However, the present invention is not limited to the above-described embodiments, but includes modifications and improvements obvious to those skilled in the art based on the matters described in the present specification.

  The present invention relates to a puncture adapter for ultrasonic guided puncture. Therefore, the present invention can be suitably used in the medical device manufacturing industry.

DESCRIPTION OF SYMBOLS 1 ... Puncture adapter 2 ... Ultrasonic probe 3 ... Adjuster 10 ... Adapter main body 11 ... 1st mirror surface 11a ... Upper edge 11b ... Lower edge 12 ... 2nd mirror surface 21a ... Upper edge 21b ... Lower edge 21 ... Scanning line guide line 31 ... Baseline

Claims (4)

A puncture adapter (1) attached to an ultrasonic probe (2),
A first mirror surface (11) inclined upward;
A puncture adapter having a second mirror surface (12) inclined downward and positioned below the first mirror surface (11). The first mirror surface (11) is provided at a position and an angle facing the user's one eye in the usage state of the ultrasonic probe (2),
The second mirror surface (12) allows the user to view the second mirror surface (12) in a state where the user can visually recognize that his / her one eye is reflected on the first mirror surface (11). The puncture adapter according to claim 1, wherein the puncture adapter is provided at a position and an angle at which a lower part of the first mirror surface (11) can be visually recognized. The puncture adapter according to claim 1, wherein an inclination angle of both or either of the first mirror surface (11) and the second mirror surface (12) is variable. The puncture adapter (1) according to claim 1,
An ultrasonic diagnostic apparatus comprising: an ultrasonic probe (2) to which the puncture adapter (1) is attached.

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