JP2018171258A - Ultrasonic endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic endoscope capable of preventing a body cavity wall from coming into close contact with an observation window when causing the body cavity wall to come into close contact with an ultrasonic transducer, and reliably performing observation by an optical image.SOLUTION: An ultrasonic endoscope includes: an ultrasonic transducer 50 having an ultrasonic vibrator; a tip body 36 connected to the proximal end side of the ultrasonic transducer 50; a treatment instrument derivation part provided to the tip body 36, which includes a treatment instrument derivation port 80 from which the treatment instrument is derived; an observation means forming surface 72 provided at a position adjacent to the treatment instrument derivation part of the tip body 36, which includes a normal component heading for a tip side in an axial direction of the tip body 36; an observation window 44 disposed on the observation means forming surface 72 for observing a subject; and a close contact preventive projection 84 formed in the periphery of the observation window 44 so as to project from the observation means forming surface 72 for preventing the subject from coming into close contact with the observation window 44.SELECTED DRAWING: Figure 2

Description

  The present invention relates to an ultrasonic endoscope, and more particularly to an ultrasonic endoscope that prevents a body cavity wall from sticking to an observation window.

  As an ultrasonic endoscope, an endoscope having an electronic scanning ultrasonic transducer at a distal end portion of an insertion portion of the endoscope is known. Then, while acquiring an ultrasonic image of the lesion using the ultrasonic transducer, puncture the lesion with the puncture needle derived from the treatment instrument outlet through the treatment instrument channel, and collect the cellular tissue of the lesion Things are done.

  In addition to the ultrasonic transducer, the ultrasonic endoscope is provided with an imaging means and an illuminating means, and can be observed with an optical image in the same manner as a general endoscope, and a puncture needle approaches the body wall. Until the puncture is performed, the puncture needle can be reliably guided to the target site by observing with the optical image.

  In observation with ultrasonic waves, if there is a gap between the ultrasonic transducer and the body wall, the ultrasonic waves are reflected by the gap and an image inside the tissue cannot be obtained. Therefore, in order to acquire a clear ultrasonic image, it is necessary to bring the ultrasonic transducer into close contact with the body wall. At this time, the body wall may be in close contact with the outer surface of the observation window, and the field of view may be lost from the observation window. If the field of view of the observation window is lost, the puncture point (puncture point) cannot be visually recognized.

  In addition, the puncture point can be confirmed using an ultrasound image without using an optical image, but even in that case, if the body wall is in close contact with the observation window, the whole image becomes a strange red image. There is a problem of giving an unpleasant impression.

  The following Patent Document 1 includes a hook-like portion protruding toward the front of an observation window of an ultrasonic endoscope at the tip of a hood, and when the ultrasonic transducer is brought into close contact with the body wall, the body wall is observed. There is described an ultrasonic endoscope hood that prevents a body wall from sticking to an observation window by interposing a hook-shaped portion between the window and the window.

Japanese Patent Laid-Open No. 2006-59471

  In recent years, in order to smoothly insert the insertion portion of the endoscope into the human body, it is desired to reduce the diameter of the insertion portion of the endoscope. Here, when the ultrasonic endoscope hood as described above is attached, it is possible to prevent the body wall from adhering to the observation window, but on the other hand, the diameter of the insertion portion is increased, and the hood is difficult to attach and detach. There is. In addition, suction is performed to bring the ultrasonic transducer and the body wall into close contact with each other, but the wall surface of the hood suppresses the inflow of air, the space around the observation window becomes negative pressure, and the body wall easily adheres to the observation window. There is a case. Therefore, it is desired not to use a hood.

  The present invention has been made in view of such circumstances. When the body wall is brought into close contact with the ultrasonic transducer, the observation window and the body wall are prevented from coming into close contact, and the optical image using the observation window is used. An object of the present invention is to provide an ultrasonic endoscope capable of reliably performing observation.

  In order to achieve the above-mentioned object, the present invention provides an ultrasonic transducer having an ultrasonic transducer, a distal end portion body connected to the proximal end side of the ultrasonic transducer, and a treatment instrument lead-out portion provided on the distal end portion body. A treatment instrument deriving portion having a treatment instrument deriving port through which the treatment instrument is derived, and a method of being provided at a position adjacent to the treatment instrument deriving portion of the distal end portion main body toward the distal end side in the axial direction of the distal end portion main body An observation means forming surface having a line component, an observation window arranged on the observation means formation surface for observing the subject, and formed around the observation window so as to protrude from the observation means formation surface, so that the subject adheres to the observation window An ultrasonic endoscope comprising a protrusion for preventing adhesion is provided.

  According to the present invention, the protrusion for preventing adhesion between the observation window and the body cavity wall is provided around the observation window by providing the protrusion for preventing adhesion of the object to the observation window. A part can be interposed. Accordingly, since the close contact between the observation window and the body cavity wall can be prevented, the treatment instrument can be guided to the target insertion point while confirming the optical image by the observation window.

  In another aspect of the present invention, the protrusion for preventing adhesion is preferably a bowl-shaped portion protruding from the periphery of the observation window toward the observation visual field range of the observation window.

  This aspect shows one aspect of the protrusion for preventing adhesion, and the hook-shaped part is interposed between the observation window and the body cavity wall by using a hook-shaped part protruding from the periphery of the observation window. It is possible to prevent the enthusiastic wall from sticking to the window. Thereby, the field of view of the observation window can be secured.

  In another aspect of the present invention, when viewed from the distal end side in the axial direction of the distal end portion main body, the adhesion preventing protrusion is preferably provided on the opposite side of the treatment instrument outlet with respect to the observation window. .

  This mode shows one mode of the protrusion for preventing adhesion, and the first direction is the direction in which the treatment instrument is led out and is perpendicular to the axial direction of the distal end body, and the protrusion for preventing adhesion is Even if it is provided in the second direction perpendicular to the first direction of the observation window, the protrusion for preventing adhesion can be interposed between the observation window and the body cavity wall, and the adhesion of the body cavity wall to the observation window can be prevented. Can do. Thereby, the field of view of the observation window can be secured.

  In another aspect of the present invention, it is preferable that the contact prevention protrusion is provided at a position different from the treatment instrument lead-out path led out from the treatment tool lead-out port in the observation field range of the observation window.

  According to this aspect, since the protrusion for preventing adhesion is provided at a position different from the treatment instrument lead-out path, the treatment instrument can be reliably observed through the observation window.

  In another aspect of the present invention, it is preferable that the position of the distal end main body of the observation window in the axial direction is closer to the proximal end than the treatment instrument outlet.

  According to this aspect, by setting the position of the observation window to the base end side from the treatment instrument lead-out portion, the opening of the stand support portion can be disposed within the observation visual field range of the observation window. Therefore, since the treatment tool can be confirmed with the observation window from the position derived from the opening, it is possible to reliably perform treatment at the target position.

  In another aspect of the present invention, the treatment instrument lead-out portion is an upright stand accommodating portion provided continuously with the treatment tool lead-out port, and is one side in the first direction perpendicular to the axial direction of the distal end body. Is an upright stand housing portion having an opening that opens toward the opening direction and a direction having a component toward one side of the first direction and a component toward the tip side in the axial direction of the tip body. And an upright that is provided inside the upright storage part and that changes the direction in which the treatment instrument is led out from the treatment instrument outlet.

  According to the present invention, since the position of the treatment instrument can be reliably observed with the observation window, the ultrasonic endoscope having the upright stand accommodating portion and the upright stand that can change the direction in which the treatment tool is led out is provided. It can be used suitably.

  In another aspect of the present invention, it is preferable that the position of the observation window in the first direction is arranged at a position on the opposite side of the stand support section when the position where the opening is provided is a reference position.

  According to this aspect, since the position of the observation window in the first direction is set to the opposite side of the upright stand accommodating portion with respect to the opening, the blind area where the treatment tool derived from the opening does not enter the observation visual field is formed. Can be reduced. Therefore, it is possible to reliably perform the treatment while confirming with the observation window.

  In another aspect of the present invention, in the first direction, it passes through an arbitrary point on the opposite side of the opening of the tip body, and is parallel to the axial direction of the tip body and the second direction perpendicular to the first direction. Where H1 is the shortest distance from the reference surface to the opening, and H2 is the longest distance from the reference surface to the outer peripheral surface of the ultrasonic transducer, the formula: H1 ≦ H2 may hold. preferable.

  According to this aspect, in the first direction, the treatment instrument derived from the opening can be brought close to the ultrasonic transducer by arranging the above-mentioned formulas. By making it approach, treatment with a treatment tool can be performed at a position observed using ultrasonic observation. The treatment instrument passes through the treatment instrument outlet provided in the distal end portion and is led out from the opening. By arranging so that the above formula is satisfied, the treatment instrument that is derived obliquely toward the distal end side can be derived in the vicinity of the ultrasonic transducer.

  In another aspect of the present invention, it is preferable that the treatment instrument lead-out part has a standing wall part rising from the opening part around the opening part.

  According to this aspect, by having the standing wall portion around the opening portion, it is possible to prevent lateral blurring of the treatment instrument derived from the opening portion, and to reliably perform treatment using the treatment tool at the target position. Can do.

  In another aspect of the present invention, the position of the observation window in the first direction is arranged at a position on the opposite side of the stand support section when the position of the upper edge of the standing wall is the reference position. Is preferred.

  According to this aspect, since the position of the observation window in the first direction is the opposite side of the upright stand accommodating portion with respect to the upper end edge portion of the standing wall portion, the treatment derived from the upper end edge portion of the standing wall portion The blind area where the tool does not enter the observation field of view can be reduced. Therefore, it is possible to reliably perform the treatment while confirming with the observation window.

  In another aspect of the present invention, in the first direction, it passes through an arbitrary point on the opposite side of the opening of the tip body, and is parallel to the axial direction of the tip body and the second direction perpendicular to the first direction. Is the reference plane, H1 is the shortest distance from the reference plane to the upper edge of the standing wall, and H2 is the longest distance from the reference plane to the outer peripheral surface of the ultrasonic transducer. It is preferable that H2 holds.

  According to this aspect, in the first direction, the treatment instrument derived from the upper edge of the standing wall can be brought close to the ultrasonic transducer by arranging so that the above expression is satisfied. By making it approach, treatment with a treatment tool can be performed at a position observed using ultrasonic observation. The treatment instrument passes through the treatment instrument outlet provided in the distal end portion and is led out from the edge of the standing wall. By arranging so that the above formula is satisfied, the treatment instrument that is derived obliquely toward the distal end side can be derived in the vicinity of the ultrasonic transducer.

  In another aspect of the present invention, it is preferable that the observation window is offset from the upright stand accommodating portion in a second direction perpendicular to the first direction.

  According to this aspect, since the observation window is arranged offset in the second direction from the upright stand accommodating portion, the observation field of view of the observation window is blocked by the treatment tool derived from the opening provided in the upright stand accommodating portion. Can be prevented.

  In another aspect of the present invention, the ultrasonic transducer preferably has an ultrasonic transmission / reception surface formed in a curved shape along the axial direction of the distal end body.

  INDUSTRIAL APPLICABILITY The present invention can be suitably used for a convex-type ultrasonic endoscope in which the ultrasonic transmission / reception surface of the ultrasonic transducer is formed on a curved surface along the axial direction of the distal end body.

  According to the ultrasonic endoscope of the present invention, it is possible to prevent the body wall from coming into close contact with the observation window when the ultrasonic transducer is brought into close contact with the body wall.

1 is an overall view of an ultrasonic endoscope according to the present invention. It is the perspective view which showed the external appearance of the front-end | tip part of 1st Embodiment of an insertion part. It is the top view (top view) which showed the external appearance of the front-end | tip part of 1st Embodiment of an insertion part. It is a sectional side view of the front-end | tip part of 1st Embodiment of an insertion part. It is a figure explaining the state which stuck the ultrasonic transducer to the body cavity wall. It is a sectional side view which shows the modification of the stand of a front-end | tip part. It is the perspective view which showed the external appearance of the front-end | tip part of 2nd Embodiment of an insertion part. It is the perspective view which showed the external appearance of the front-end | tip part of 3rd Embodiment of an insertion part. It is the perspective view which showed the external appearance of the front-end | tip part of 4th Embodiment of an image insertion part.

  Hereinafter, an ultrasonic endoscope according to the present invention will be described with reference to the accompanying drawings.

(Ultrasound endoscope)
FIG. 1 is an overall view of an ultrasonic endoscope 1 to which the present invention is applied.

  An ultrasonic endoscope 1 (hereinafter, also simply referred to as “endoscope 1”) in FIG. 1 includes an operation unit 10 that is held by a practitioner and performs various operations, and an insertion unit 12 that is inserted into a body cavity of a patient. And a universal cord 14. The endoscope 1 is connected via a universal cord 14 to a system component device such as a processor device (not shown) and a light source device that form an endoscope system.

  The operation unit 10 is provided with various operation members operated by a practitioner. For example, an angle knob 16, a standing operation lever 18, an air / water supply button 20, and a suction button 22, which will be described later as appropriate, are provided. ing.

  Further, the operation unit 10 is provided with a treatment instrument introduction port 24 for inserting a treatment instrument into a treatment instrument insertion channel that is inserted through the insertion section 12.

  The insertion part 12 is extended from the front-end | tip of the operation part 10, and the whole is formed in the elongate shape by a small diameter.

  Moreover, the insertion part 12 is comprised by the soft part 30, the curved part 32, and the front-end | tip part 34 in order toward the front end side from the base end side.

  The soft portion 30 occupies most of the insertion portion 12 from the proximal end side, and has flexibility to bend in an arbitrary direction. When the insertion part 12 is inserted into the body cavity, the flexible part 30 bends along the insertion path into the body cavity.

  The bending portion 32 is bent in the vertical direction and the left-right direction by rotating the angle knob 16 of the operation unit 10, and the distal end portion 34 is directed in a desired direction by bending the bending portion 32. Can do.

  As will be described in detail later with reference to FIGS. 2 to 4, the distal end portion 34 includes an imaging unit and an illuminating unit for capturing an observation image in the body cavity, an ultrasonic transducer for acquiring an ultrasonic image, and a treatment instrument introduction. An opening for leading out the treatment instrument inserted from the mouth 24 and an upright stand for standing the treatment instrument led out from the treatment instrument lead-out part are provided.

  The universal cord 14 shown in FIG. 1 includes an electric cable, a light guide, and a fluid tube inside. A connector is provided at an end (not shown) of the universal cord 14, and the connector is connected to a predetermined system component device constituting an endoscope system such as a processor device and a light source device. Power, control signals, illumination light, liquid, gas, and the like necessary for the operation of the endoscope 1 are supplied from the component device to the endoscope 1, and observation image data acquired by the imaging unit, and an ultrasonic transducer The ultrasonic image data acquired by the above is transmitted from the endoscope 1 to the system component apparatus. Note that the observation image and the ultrasonic image transmitted to the system component apparatus are displayed on a monitor and can be observed by a practitioner or the like.

(Configuration of tip)
[First Embodiment]
Then, the structure of the front-end | tip part 34 of the insertion part 12 is demonstrated. FIG. 2 is a perspective view showing the appearance of the distal end portion 34 of the first embodiment. FIG. 3 is a plan view (top view). FIG. 4 is a sectional side view.

  The distal end portion 34 has a distal end portion main body 36 that forms an outer wall and an inner partition wall, and each component arranged in the distal end portion main body 36 is accommodated and held in an accommodating portion provided by the distal end portion main body 36. .

  Although details are omitted, a part of the tip portion main body 36 can be detachably removed as a separate block, and each component can be assembled in a predetermined accommodating portion with the separate block removed. After assembling each component into the housing portion, the separate block is attached to the tip body 36, whereby each component is housed and held in the housing portion and fixed to the tip portion 34.

  The tip portion main body 36 is formed of an insulating material having an insulating property, for example, a resin material such as methacrylic resin and plastic such as polycarbonate.

  As shown in FIGS. 2 to 4, the distal end portion 34 includes a base portion 40 that constitutes the distal end portion main body 36, and an extending portion 42 that extends from the base portion 40 toward the distal end side and holds the ultrasonic transducer 50. ing.

  That is, the extension 42 has an ultrasonic transmission / reception surface 52 formed by arranging ultrasonic transducers for transmitting and receiving ultrasonic waves in a curved shape along the direction of the axis 38 of the tip body 36. A transducer 50 is arranged. Data for generating an ultrasonic image of the body tissue is acquired by the ultrasonic transducer 50. The number of ultrasonic transducers is not limited, and may be one, or two or more ultrasonic transducers may be arranged.

  As shown in FIGS. 2 and 3, the distal end body 36 is provided with an observation window 44, illumination windows 46 </ b> L and 46 </ b> R, an air / water supply nozzle 48, and a treatment instrument derivation unit 56 for deriving a treatment instrument. ing. In the first embodiment, the treatment instrument derivation unit 56 includes a treatment instrument derivation port 80, an upright stand accommodating part 62, an upright stand 60, an opening 58, and a standing wall part 68. In the following description, the upright stand accommodating unit 62 may be used in the same meaning as the treatment instrument deriving unit 56.

  The opening 58 is provided at the center of the opening forming surface 70 provided on the extending portion 42 side of the distal end portion main body 36, and the treatment instrument is led out from the opening 58 to the ultrasonic scanning range of the ultrasonic transducer 50. Is done. The opening 58 is provided on the opening forming surface 70, and one side of the first direction perpendicular to the direction of the axis 38 of the tip end body 36 of the standing base accommodating portion 62 provided in the tip end body 36 is defined as the opening direction. Is formed. The opening 58 can also be formed with a direction having a component toward the one side in the first direction and a component toward the distal end side in the direction of the axis 38 of the distal end portion main body 36 as the opening direction. That is, the opening can be formed so that the opening direction opens upward (one side in the first direction) toward the tip of the tip portion 34. Here, the opening direction refers to the normal direction of the surface surrounded by the edge of the opening 58. Further, in this specification, the “first direction” means that the opening 58 of the upright stand accommodating portion 62 is formed perpendicular to the direction of the axis 38 of the distal end portion main body 36 as indicated by an arrow A in FIG. The direction of being. In addition, the “second direction” refers to a direction indicated by an arrow B that is perpendicular to the direction of the axis 38 of the tip end body 36 and the first direction indicated by the arrow A, as shown in FIG. Further, “one side in the first direction” refers to the side where the opening 58 is open. In the present specification, one side in the first direction may be referred to as “upper” and “upper”, and the other side in the first direction may be referred to as “lower” and “lower”. Note that the axis 38 of the distal end portion body 36 refers to a line that coincides with a longitudinal axis of the insertion portion or a parallel line.

  The treatment instrument is inserted from the treatment instrument introduction port 24 of the operation unit 10 illustrated in FIG. 1 toward the insertion unit 12. The opening forming surface 70 shown in FIG. 3 may be provided parallel to the axis 38 of the tip end body 36, or may be provided inclined downward toward the tip end side of the tip end portion 34. The opening 58 is formed on the opening forming surface 70 and refers to a portion where the treatment instrument is led out from the stand receiving portion 62 by the stand 60 described later.

  As shown in FIG. 4, a treatment instrument outlet 80 is disposed on the proximal end side of the upright stand accommodating portion 62. In the treatment instrument outlet 80, the treatment instrument inserted from the treatment instrument introduction port 24 of the operation unit 10 through the treatment instrument insertion channel 82 inserted into the insertion section 12 stands from the treatment instrument outlet 80 (see FIG. 4). It is led out to the base accommodating part 62.

  A stand 60 is disposed at a position in front of the treatment instrument outlet 80 of the stand support section 62. The stand 60 is made of a metal material such as stainless steel, and has a concave guide surface 60 a that curves upward from the proximal end side of the distal end portion main body 36 toward the distal end side on the upper surface side. The treatment tool led out from the treatment tool lead-out port 80 is bent upward along the guide surface 60a with respect to the direction of the axis 38 of the distal end portion main body 36 (for example, the longitudinal axis direction of the insertion portion 12). The upper opening 58 and the edge of the standing wall 68 are led out to the outside.

  Further, the stand 60 is configured to stand up by the operation of the stand-up operation lever 18 shown in FIG. 1, and the opening 58 is adjusted by adjusting the stand-up angle from the lying down state by moving the stand 60 upright. The derivation direction (derivation angle) of the treatment instrument derived from can be changed.

  The treatment instrument insertion channel 82 shown in FIGS. 4 and 6 is also connected to a suction channel (not shown), and by operating the suction button 22 in FIG. You can also.

  As shown in FIG. 4, the position of the opening 58 is the proximal end side of the ultrasonic transducer 50 and, as will be described later, the distal end side of the observation means forming surface 72, whereby the distance between the ultrasonic transducer 50 and the opening 58. Can be approached. Therefore, since the distance of the treatment tool from the position of the treatment tool immediately after being derived from the opening 58 to the treatment position by the treatment tool can be shortened, the lateral blur of the treatment tool can be reduced and the target position can be reduced. The treatment tool can be punctured.

  As shown in FIG. 3, a standing wall 68 is provided around the opening 58. By providing the standing wall portion 68, it is possible to prevent lateral blurring of the treatment tool led out from the opening 58, and it is possible to stably perform treatment at the target position using the treatment tool. The standing wall 68 need only be able to prevent lateral blurring of the treatment instrument, and need not be provided around the entire opening 58. Specifically, it is preferable to form the openings 58 so as to rise upward from both sides in the direction in which the treatment instrument is led out. In the first embodiment, the standing wall portion 68 is provided obliquely upward in the direction of the opening 58 from the entire surface of the opening forming surface 70. Further, the opening forming surface 70 and the standing wall portion 68 may be integrally formed.

  In the example of FIG. 2, in the standing wall portion 68, the standing wall portions 68 are provided at both end portions along the direction of the axis 38 of the distal end body 36 of the opening portion 58. It is also possible to provide the standing wall portion 68 only on the wall. By providing the standing wall portion 68 only on the proximal end side, the body cavity wall (tissue) can be brought into close contact with the proximal end side of the ultrasonic transmission / reception surface 52 of the ultrasonic transducer 50. Since the distance between the opening 58 and the body cavity wall can be reduced by bringing the body cavity wall into close contact with the ultrasonic wave transmitting / receiving surface 52, the position of the treatment instrument derived from the opening 58 is prevented from being significantly shifted. Can be treated at the target position.

  Further, the distal end main body 36 is provided with light guide retreat wall portions 76L and 76R obtained by cutting off the left and right portions of the opening forming surface portion 74 forming the opening forming surface 70 obliquely downward. In this way, by forming the light guide retracting wall portions 76L and 76R, it is possible to prevent the illumination light from the illumination windows 46L and 46R from being blocked, and there are portions where illumination unevenness or shadows occur. Can be prevented. The light guide retracting wall portions 76L and 76R are not limited to being cut obliquely downward, and may be configured to be cut off in the vertical direction or obliquely forward.

  The observation window 44 is disposed on an observation means formation surface 72 provided on the proximal end side of the opening formation surface 70. Inside the observation window 44 is housed an imaging system unit in which an imaging optical system and a solid-state imaging device constituting an imaging unit are integrally assembled. As a result, when light from the treatment unit that becomes the visual field range of the imaging unit is taken in from the observation window 44, the light is imaged as an observation image on the individual imaging element via the imaging optical system. That is, the treatment unit is imaged by the solid-state imaging device.

  The observation means forming surface 72 on which the observation window 44 is arranged is provided at a position adjacent to the treatment instrument deriving portion 56 and is configured by a surface having a normal component toward the distal end side in the direction of the axis 38 of the distal end portion main body 36. . Here, that the observation means forming surface 72 is provided at a position adjacent to the treatment instrument deriving portion 56 means that the treatment tool derived from the treatment instrument deriving portion 56 is disposed on the observation means forming surface 72. As long as the observation means forming surface 72 is arranged at a position that falls within the visual field range, the observation means forming surface 72 is not limited to the case where the observation means forming surface 72 is arranged next to the treatment instrument deriving portion 56. Another member may be disposed between the observation means forming surface 72 and the treatment instrument outlet 56. In the first embodiment, the observation means forming surface 72 is formed as an inclined surface that is inclined upward toward the proximal end side of the distal end portion 34. The observation means forming surface 72 is a surface having a normal component toward the distal end side, and the observation window 44 is provided on the observation means forming surface 72, whereby the position where the treatment tool is led out from the opening 58 by the observation window 44 is set. It is possible to enter the field of view of the observation window 44. Therefore, the treatment tool can be confirmed from the opening 58 to the target treatment position with the observation window 44. Note that the observation means forming surface 72 may be constituted by a vertical surface perpendicular to the direction of the axis 38 of the tip end body 36.

  The illumination windows 46L and 46R are provided on the observation means forming surface 72 on both sides of the observation window 44. The light emission part which comprises an illumination part is accommodated in the inside of the illumination windows 46L and 46R. Illumination light transmitted from the light source unit connected to the universal cord 14 through the light guide is emitted from the light emission unit, and the illumination light is treated through the illumination windows 46L and 46R in the visual field range of the imaging unit. It comes to be irradiated.

  The air / water supply nozzle 48 is provided on the observation means forming surface 72, and the operation of the air / water supply button 20 in FIG. 1 allows the cleaning liquid, water, or water to flow from the air / water supply nozzle 48 in FIG. Air or the like (hereinafter also referred to as “cleaning liquid or the like”) is jetted to clean the observation window 44 or the like.

  Further, the observation means forming surface 72 has an adhesion preventing protrusion 84. The protrusion 84 for preventing adhesion is provided around the observation window 44 and is formed so as to protrude from the observation means forming surface 72. The protrusions 84 for preventing adhesion shown in FIG. 2 to FIG. 4 are formed on the upper side of the observation window 44 as a bowl-shaped hook-shaped portion toward the observation visual field range of the observation window 44. That is, as shown in FIG. 3, in the plan view of the distal end portion 34, the contact prevention protrusion 84 protrudes to a position where it overlaps the position of the observation window 44.

  The protrusion 84 for adhesion prevention is arranged at a position different from the treatment instrument lead-out path led out from the treatment tool lead-out port 80 in the observation visual field range of the observation window 44. As a result, even if the treatment tool is used while confirming the optical image obtained using the observation window 44, the adhesion preventing protrusion 84 does not hinder the observation of the treatment tool. It can be carried out.

  The shape of the adhesion preventing protrusion 84 is not particularly limited as long as the adhesion between the observation window 44 and the body cavity wall (tissue) can be prevented. As shown in FIG. 2 to FIG. 4, it may be formed as an elliptical arc shape, a curved surface shape composed of other curved shapes such as an arc shape or a parabolic shape, or a planar shape, a shape combining two or more planes, and You can also The protrusion 84 for preventing adhesion may be formed integrally with the observation means forming surface 72, or may be fixed separately.

  FIG. 5 is a diagram showing a state in which the ultrasonic transmission / reception surface 52 of the ultrasonic transducer 50 is in close contact with the body cavity wall 94. In order to acquire an ultrasonic image when performing a treatment using the treatment instrument 90, FIG. Suppose that the ultrasound transmitting / receiving surface 52 is brought into close contact with the body cavity wall 94 as shown in FIG. At this time, an adhesion preventing protrusion 84 is interposed between the observation window 44 and the body cavity wall 94. Therefore, the body cavity wall 94 is prevented from coming into close contact with the observation window 44.

  Also, as shown in FIGS. 2 and 3, when the air / water supply nozzle 48 is provided at a position opposed to the observation window 44, the adhesion preventing protrusion 84 is used to change the direction of the cleaning liquid. Can also be used. The cleaning liquid sprayed from the air / water supply nozzle 48 toward the observation window 44 collides with the protrusion 84 for preventing adhesion. The direction of the cleaning liquid or the like that protrudes from the adhesion preventing protrusion 84 is changed toward the opening 58 and is supplied to the opening 58. Thereby, the inside of the opening 58 can be cleaned.

  Next, the positional relationship among the opening 58 of the tip 34, the upper edge 68a of the standing wall 68, the observation window 44, and the ultrasonic transducer 50 will be described.

  As shown in FIG. 4, the position of the observation window 44 in the first direction indicated by the arrow A (vertical direction in FIG. 4) is stored in the stand when the position of the upper edge 68 a of the standing wall 68 is the reference position. It is arranged at a position opposite to the part 62. That is, the axis 45 of the observation window 44 extending in parallel with the axis 38 of the distal end main body 36 from the center position of the observation window 44 is disposed above the reference position. When the standing wall portion 68 is provided, the treatment tool is led out from the upper edge 68a or the front edge 68b of the standing wall 68 to the outside. Thus, by setting the observation window 44 above the upper end edge portion 68 a of the standing wall portion 68, the treatment tool can be placed in the observation field of view of the observation window 44 at a position derived from the standing wall portion 68. Therefore, the treatment tool can be guided to the target position, and the sniping performance can be improved.

  Further, in the first direction indicated by the arrow A of the distal end portion body 36 in FIG. 4, the position where the treatment instrument is led out from the distal end portion body 36 and the position of the ultrasonic transducer 50 satisfy the following relationship. preferable. It passes through an arbitrary point P on the opposite side of the observation window 44 from the opening 58 (for example, the lower end position of the distal end body 36 in FIG. 4), and the arrow B in FIG. When the reference plane 86 is a plane parallel to the second direction, the distance between the upper end edge 68a of the standing wall 68 and the reference plane 86 in the first direction is H1, and the ultrasonic wave of the ultrasonic transducer 50 is detected. When the distance between the outer peripheral surface of the transmitting / receiving surface 52 and the reference surface 86 is the longest distance (the distance between the uppermost surface of the ultrasonic transducer 50 and the reference surface) is H2, the standing wall portion 68 so that H1 ≦ H2 holds. The upper end edge portion 68a is disposed. When the upper end edge 68a is formed obliquely, the distance between the position of the lowermost end of the upper end edge 68a and the reference plane is H1. By arranging the upper end edge 68 a of the standing wall 68 and the ultrasonic transducer 50 so as to satisfy H 1 ≦ H 2, the treatment instrument that has passed through the treatment instrument insertion channel 82 is moved to the upper end edge 68 a of the standing wall 68. Alternatively, the treatment instrument can be led out close to the ultrasonic transducer 50 when being led obliquely upward from the front edge portion 68b. Therefore, it is possible to reliably puncture the treatment tool at a position where ultrasonic observation is performed by the ultrasonic transducer 50.

  On the other hand, the uppermost end of the treatment instrument outlet 80 is the same as the uppermost position of the ultrasonic transmission / reception surface 52 of the ultrasonic transducer 50, or below the uppermost position of the ultrasonic transmission / reception surface 52 of the ultrasonic transducer 50. Preferably it is located. The treatment instrument passes through the treatment instrument insertion channel 82 and is led out obliquely upward from the opening 58 opened upward. Therefore, by providing the treatment instrument outlet 80 below the ultrasonic transducer 50, the treatment instrument can be derived near the ultrasonic transducer 50.

  As shown in FIG. 3, the observation window 44 is preferably arranged offset from the upright stand accommodating portion 62 (the treatment instrument derivation portion 56) in the second direction indicated by the arrow B. Here, the observation window 44 is arranged to be offset from the upright support part 62 in the second direction, for example, as shown in FIG. 3, the center line 44 </ b> A of the observation window 44 is upright in a top view. It means that it is shifted in the second direction indicated by the arrow B with respect to the center line 60A of the table 60. With this configuration, the observation field of the observation window 44 is blocked by the treatment tool and the stand 60 even when the stand 60 is raised and the treatment tool is led out from the standing wall 68. Therefore, the treatment position can be confirmed with the observation window 44.

(Modification of the stand)
FIG. 6 is a side sectional view showing a modification of the upright 61. Here, in the stand 60 of the first embodiment shown in FIG. 4, the front end portion of the stand 60 is the front edge 68 b of the stand wall 68 when the stand 60 is in the lying down position (full down state). Although the stand 61 shown in FIG. 6 protrudes from the standing wall 61 in the full down state, the tip of the stand 61 does not protrude from the standing wall 68 and the entire stand 61 is accommodated in the stand support 62. ing. As in the stand 61 of FIG. 6, the insertion unit 12 can be smoothly inserted into the human body by adopting a configuration in which the entire stand 61 is accommodated in the stand accommodation unit 62 in the full down state. it can.

[Second Embodiment]
FIG. 7 is a perspective view showing the appearance of the distal end portion 134 according to the second embodiment. The distal end portion body 136 of the distal end portion 134 of the second embodiment is configured differently from the distal end portion body 36 of the first embodiment in the direction in which the adhesion preventing protrusion 184 is provided with respect to the observation window 44. In the following description of the embodiment, members that are the same as or similar to those in the above embodiment may be denoted by the same reference numerals and description thereof may be omitted.

  Even when the adhesion preventing protrusion 184 is provided on the opposite side of the treatment instrument lead-out portion 56 in the second direction of the observation window 44 as in the distal end portion body 136 of the second embodiment, the ultrasonic wave of the ultrasonic transducer 50 is used. When the transmission / reception surface 52 is brought into close contact with the body cavity wall, an adhesion preventing protrusion 184 can be interposed between the observation window 44 and the body cavity wall. Therefore, it is possible to prevent the body cavity wall from coming into close contact with the observation window 44.

  The shape of the close-contact preventing protrusion 184 provided on the distal end portion 134 of the second embodiment is not particularly limited as long as the close contact between the observation window 44 and the body cavity wall can be prevented. As shown in FIG. 7, it may be formed as a flat surface, or may be a surface having a circular arc shape, an elliptical arc shape, or a curved shape such as a parabola.

  Further, the tip portion 134 shown in the second embodiment may be provided with a turning portion 178 that protrudes from the observation means forming surface 172 at a position facing the observation window 44 of the air / water supply nozzle 48. Good. The cleaning liquid sprayed from the air / water supply nozzle 48 toward the observation window 44 collides with the turning portion 178. The cleaning liquid or the like that has collided with the turning portion 178 is changed in direction toward the opening 58 and supplied to the opening 58. Thereby, the inside of the opening 58 is cleaned.

[Third Embodiment]
FIG. 8 is a perspective view showing the appearance of the tip 234 according to the third embodiment. The distal end portion main body 236 of the distal end portion 234 of the third embodiment is different from the distal end portion main body 36 of the first embodiment in that it does not have a standing wall portion and a light guide retracting wall portion. The treatment instrument derivation unit 256 includes a treatment instrument derivation port 80, an upright stand accommodating part 62, an upright stand 60, and an opening 258.

  Also in the tip body 236 shown in FIG. 8, by providing an adhesion prevention protrusion 284 around the observation window 44, the adhesion prevention protrusion 284 can be interposed between the observation window 44 and the body cavity wall. The observation window 44 and the body cavity wall can be prevented from coming into close contact with each other. In the distal end portion 234 of FIG. 8, an adhesion preventing protrusion 284 as a hook-shaped portion is provided above the observation window 44 in the first direction.

  By providing the position of the opening 258 below the axis of the observation window 44 in the positional relationship between the opening 258 and the observation window 44, the treatment tool derived from the opening 258 is placed in the observation field of the observation window 44. be able to.

  Further, when there is no standing wall portion, the position where the treatment tool is led out from the distal end main body 236 in the first direction indicated by the arrow A in FIG. 8 is the position of the opening 258, and the ultrasonic transducer 50 and The positional relationship with the opening 258 preferably satisfies the following expression. When the reference plane is a plane that passes through an arbitrary point P on the opposite side of the opening 258 with respect to the observation window 44 and is parallel to the axial direction and the second direction of the tip body 236, the opening 258 in the first direction. When the distance from the reference plane to the reference plane is H1, and the longest distance from the outer peripheral surface of the ultrasonic wave transmitting / receiving surface 52 of the ultrasonic transducer 50 to the reference plane is H2, the opening 258 and the reference plane are set so that H1 ≦ H2. A sonic transducer 50 is disposed. When the opening forming surface 270 shown in FIG. 8 is inclined with a slope inclined downward toward the distal end side of the distal end portion 34, the position of the lowermost end of the opening 258 and the reference surface Is a distance H1. By setting it as such a structure, a treatment tool can be derived | led-out close to the ultrasonic transducer 50 similarly to 1st Embodiment.

(Fourth embodiment)
FIG. 9 is a perspective view showing the appearance of the tip portion 334 according to the fourth embodiment. The distal end portion 334 of the fourth embodiment is configured such that the left observation means forming surface 372L and the right observation means forming surface 372R sandwich the treatment instrument outlet 380 as the distal end surface of the distal end portion main body 336. An observation window 344, an air / water supply nozzle 348 and an illumination window 346L are provided on the left observation means formation surface 372L, and an illumination window 346R is provided on the right observation means formation surface 372R. In the fourth embodiment, the left observation means forming surface 372L on which the observation window 344 is disposed is disposed on the distal side from the treatment instrument outlet 380 and is disposed in the second direction indicated by the arrow B of the opening 358. ing.

  Also in the distal end body 336 of the fourth embodiment, by providing an adhesion preventing projection 384 projecting from the observation means forming surface 372 around the observation window 344, adhesion prevention is provided between the observation window 344 and the body cavity wall. Therefore, it is possible to prevent the observation window 44 and the body cavity wall from coming into close contact with each other. In the distal end portion 334 of FIG. 9, an adhesion preventing protrusion 384 serving as a hook-like portion is provided above the observation window 44 in the first direction indicated by the arrow A.

  The first to fourth embodiments have been described with the convex type ultrasonic transducer, but the present invention is not limited to the convex type ultrasonic transducer, and is also applicable to a radial type ultrasonic transducer. can do.

DESCRIPTION OF SYMBOLS 1 Ultrasonic endoscope 10 Operation part 12 Insertion part 14 Universal cord 16 Angle knob 18 Standing operation lever 20 Air supply / water supply button 22 Suction button 24 Treatment tool introduction port 30 Soft part 32 Bending part 34, 134, 234, 334 Tip part 36, 136, 236, 336 Tip body 38, 138, 238 Tip body axis 40 Base 42 Extension 44, 344 Observation window 44A Observation window center line 45 Observation window axes 46L, 46R, 346L, 346R Illumination window 48, 348 Air / Water Supply Nozzle 50 Ultrasonic Transducer 52 Ultrasonic Transmit / Receive Surface 56, 256, 356 Treatment Instrument Deriving Unit 58, 258, 358 Opening 60, 61 Standing Stand 60a Guide Surface 60A Standing Stand Center Line 62 Standing Stand Housing Portion 68 Standing wall 68a Upper edge 68b Front edge 70, 270 Opening surfaces 72, 172 372 Observation means forming surface 74 Opening forming surface portions 76L, 76R Light guide retracting wall portions 80, 380 Treatment instrument outlet 82 Treatment instrument insertion channels 84, 184, 284, 384 Adhesion prevention protrusion 86 Reference surface 90 Treatment instrument 94 Body cavity Wall 178 Turning portion 372L Left observation means forming surface 372R Right observation means forming surface

Claims (13)

An ultrasonic transducer having an ultrasonic transducer;
A distal end body continuous to the proximal end side of the ultrasonic transducer;
A treatment instrument derivation unit provided in the distal end body, the treatment instrument derivation unit having a treatment instrument derivation port from which the treatment instrument is derived;
An observation means forming surface provided at a position adjacent to the treatment instrument derivation portion of the distal end portion main body and having a normal component toward the distal end side in the axial direction of the distal end portion main body;
An observation window arranged on the observation means forming surface for observing the subject;
A protrusion for preventing adhesion, which is formed around the observation window so as to protrude from the observation means forming surface, and prevents adhesion of the subject to the observation window;
An ultrasonic endoscope comprising:   The ultrasonic endoscope according to claim 1, wherein the protrusion for preventing adhesion is a hook-shaped portion protruding from the periphery of the observation window toward the observation visual field range of the observation window.   The said adhesion prevention protrusion part is provided in the other side of the said treatment tool derivation | leading-out part with respect to the said observation window when it sees from the front end side of the axial direction of the said front-end | tip part main body. Ultrasound endoscope.   The said adhesion prevention protrusion part is provided in the position different from the derivation path | route of the said treatment tool derived | led-out from the said treatment tool derivation | leading-out opening | mouth in the observation visual field range of the said observation window. The described ultrasonic endoscope.   The ultrasonic endoscope according to any one of claims 1 to 4, wherein a position of the observation window in the axial direction of the distal end main body is closer to the proximal end than the treatment instrument lead-out portion. The treatment instrument derivation unit includes:
An upright stand accommodating portion provided continuously to the treatment instrument outlet, wherein one side of the first direction perpendicular to the axial direction of the distal end portion main body is the opening direction, or the first direction An upright stand accommodating portion having an opening with an opening direction as a direction having a component toward one side and a component toward the tip end side in the axial direction of the tip end body;
The ultrasound according to any one of claims 1 to 5, further comprising: an upright that is provided inside the upright stand accommodating portion and changes a direction in which the treatment instrument is led out from the treatment instrument outlet. Endoscope.   7. The ultrasonic wave according to claim 6, wherein the position of the observation window in the first direction is arranged at a position on the opposite side of the stand support unit when the position where the opening is provided is a reference position. Endoscope. In the first direction, a plane parallel to the axial direction of the tip body and the second direction perpendicular to the first direction passing through any point on the opposite side of the opening of the tip body is defined as a reference plane. When
The formula: H1 ≦ H2 is established, where H1 is the shortest distance from the reference surface to the opening, and H2 is the longest distance from the reference surface to the outer peripheral surface of the ultrasonic transducer. An ultrasonic endoscope according to 1.   The ultrasonic endoscope according to claim 6, further comprising a standing wall portion that rises from the opening portion around the opening portion.   The position of the observation window in the first direction is arranged at a position on the opposite side of the stand support unit when the position of the upper edge of the standing wall is a reference position. Ultrasound endoscope. In the first direction, a plane parallel to the axial direction of the tip body and the second direction perpendicular to the first direction passing through any point on the opposite side of the opening of the tip body is defined as a reference plane. When
When the shortest distance from the reference plane to the upper edge of the standing wall is H1, and the longest distance from the reference plane to the outer peripheral surface of the ultrasonic transducer is H2, the formula: H1 ≦ H2 holds. The ultrasonic endoscope according to claim 9 or 10.   The ultrasound endoscope according to any one of claims 6 to 11, wherein the observation window is arranged to be offset from the upright stand accommodating portion in a second direction perpendicular to the first direction.   The ultrasonic endoscope according to any one of claims 1 to 12, wherein the ultrasonic transducer has an ultrasonic transmission / reception surface formed in a curved shape along an axial direction of the tip body.

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