JP2602830B2 - Ultrasound diagnostic equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Technical Field to Which the Invention Exists] The present invention has an ultrasonic probe at a distal end portion of an insertion portion into a subject, and the probe has a longitudinal central axis of the distal end portion. The present invention relates to a so-called mecha-radial type ultrasonic diagnostic apparatus which is arranged so as to be rotatable around a center.

[Conventional technology]

Ultrasound probes known as ultrasound diagnostic devices usually do not have an observation optical system, and insertion of the probe into the body cavity is performed exclusively based on the ultrasound image,
Optically, it was necessary to perform the required work in a blind state. Recently, an ultrasonic diagnostic apparatus in which an ultrasonic search mechanism is integrally combined with an endoscope has been put to practical use.

In what is known as such an ultrasonic diagnostic apparatus,
Generally, an ultrasonic probe is disposed at a distal end portion of an insertion portion into a subject so as to be rotatable about its central axis, and a driving unit is provided in a driving unit outside the subject to rotate the probe. And a hollow flexible shaft is inserted into the insertion portion as power transmission means for drivingly coupling the probe to the drive motor. The signal conductor from the probe passes through the internal space of the flexible shaft and is guided to an external ultrasonic observation device. It is needless to say that the probe is rotated by the drive motor to search the inside of the subject by ultrasonic waves. Further, as an optical observation means, an objective lens is arranged on the side surface of the distal end portion of the insertion portion, and an optical image obtained by the objective lens is guided to an eyepiece by an image guide fiber.

In the prior art, the ultrasonic probe is arranged at the distal end of the insertion section of the endoscope, and the flexible shaft, which is the drive shaft, occupies the central area of the insertion section. However, any channels provided in parallel with this and used for insertion of forceps for aspiration or biopsy of the liquid in the subject must be arranged on the side surface of the distal end portion as an extremely fine one. Diagnostic devices have been severely restricted in function, for example, only limited forceps can be used in a subject.

[Problems to be solved by the invention]

The present invention has been made in view of the above-mentioned problems in the prior art, and relates to a treatment tool which can secure a large-diameter channel communicating from the operation unit to the distal end surface of the insertion unit and can be used in a subject. An object of the present invention is to propose an ultrasonic diagnostic apparatus capable of relaxing various conventional functions and exhibiting various treatment functions.

[Means for solving the problem]

In order to solve this problem, the present invention provides an ultrasonic probe provided inside a distal end of an insertion section to be inserted into a subject, and an ultrasonic probe provided near a hand of the insertion section. In an ultrasonic diagnostic apparatus having a rotation driving unit that remotely drives and rotates a probe, a hollow cylindrical support member that rotatably supports the ultrasonic probe at a distal end of the insertion portion,
A flexible shaft connected to the support member and having a hollow portion communicating with the hollow portion provided in the support member and extending to the proximal side of the insertion portion, and a hollow portion provided in the flexible shaft are secured. A driving force transmitting means for transmitting the driving force of the rotation driving means to the flexible shaft while being held, and a hollow portion of the support member and a hollow portion of the flexible shaft, which are open to the outside at the distal end surface of the insertion portion. And a hollow channel portion that opens to the outside also on the hand side of the insertion portion.

[Embodiment of the invention]

Hereinafter, the present invention will be described with reference to the illustrated preferred embodiments.

FIG. 1 is a conceptual diagram showing the overall configuration of an embodiment of the ultrasonic diagnostic apparatus according to the present invention. This ultrasonic diagnostic device
For example, it includes a flexible insertion portion to be inserted into a body cavity as a subject, and an operation portion 2 on a hand side for operating the distal end portion 1 of the insertion portion from outside. An ultrasonic probe 3 for performing diagnosis by ultrasonic waves is disposed on the distal end portion 1, and the probe 3 is a mechanical scanning type that can be rotated about a longitudinal central axis of the distal end portion 1, which is a so-called mechanical mechanism. Radial type. Further, a drive unit 4 for rotationally driving the ultrasonic probe 3 is arranged adjacent to the operation unit 2 and the drive unit 4 is mechanically connected to the probe 3 via a power transmission element described later. Drive coupling. In the present invention, the ultrasonic probe 3, the drive unit 4 thereof, and the power transmission element connecting the both are all hollow structures, and a hollow channel is provided in a region near the center axis from the distal end of the insertion unit to the operation unit 2. Are arranged to extend through.

The ultrasonic probe 3 has a known configuration including, for example, an ultrasonic vibrator made of a film of PZT, lithium niobate or a suitable polymer material, and a suitable damping material bonded and fixed to the vibrator. Shall be. As also shown in FIG.
The ultrasonic probe 3 is mounted on a support member 5 having a hollow cylindrical shape, and the support member 5 is rotatably supported by a ball bearing 6 and a slide bearing 7. The front end of the hollow multilayer flexible shaft 8 as a part of the power transmission element is integrally connected to the rear end of the support member 5, and this flexible shaft 8 is inserted into the insertion portion of the ultrasonic diagnostic apparatus. And is extended to the drive unit 4 while being rotatably disposed in the flexible tube 9.

A mechanical scanning ultrasonic probe arranged at the tip of the insertion section into the body cavity is connected to a drive motor in a drive section via a flexible shaft, and a signal conductor from the probe is connected to the inside of the flexible shaft. An ultrasonic diagnostic apparatus having a configuration described in, for example, Japanese Patent Application Laid-Open No.
It is described in JP 90552 and known. However, according to the present invention, the signal conductor is arranged at another location to configure the inside of the flexible shaft as a hollow channel that can be used for other purposes.

That is, in the embodiment shown in FIG. 3, the flexible shaft 8 includes an inner peripheral layer 8a formed of a close-wound coil, and an intermediate layer 8b formed of a coarsely wound coil of a wire rod relatively thicker than the coil rod of the inner peripheral layer 8a. And a three-layer structure of an outer peripheral layer 8c formed of a close-wound coil of a wire having a thickness similar to that of the coil of the inner peripheral layer 8a. Further, a very small coaxial cable as the signal conductor 10 from the ultrasonic probe 3 is slightly inserted into the gap space between the inner circumferential layer 8a and the outer circumferential layer 8c in the adjacent orbiting portion of the coarsely wound coil in the intermediate layer 8b. Place it in a vine with slack. In order to reliably prevent the signal conductor 10 from being crushed between the inner peripheral layer 8a and the outer peripheral layer 8c, the signal conductor 10
A wire thicker than 10 is used.

In the embodiment shown in FIG. 3, it is advantageous that the coil wires of the inner layer 8a and the outer layer 8c and the coil wire of the intermediate layer 8b are wound in mutually opposite directions. This is because such an arrangement makes it possible to realize a flexible shaft with smooth inner and outer surfaces and little disturbance.

Further, in the embodiment shown in FIG. 4, the flexible shaft 8 is made up of an inner peripheral layer 8a and an outer peripheral layer 8c formed of the same close-wound coil as in the embodiment of FIG. A three-layer structure including an intermediate layer 8b 'made of an elastic material such as rubber and arranged so as to form a gap;
And the thickness of the intermediate layer 8b 'is made larger than the diameter of the signal conductor 10 so that the signal conductor 10 can be prevented from being crushed.

In each of the embodiments shown in FIGS. 3 and 4, the signal conductor 10 is connected to the inner peripheral layer 8a of the flexible shaft 8.
And the outer layer 8c are completely protected by the intermediate layers 8b and 8b ', and are arranged with some slack, so that the insertion portion of the ultrasonic diagnostic apparatus is bent when inserted into the body cavity. Even if tensile stress does not act, there is substantially no risk of disconnection. Further, a hollow channel having a sufficient internal space in the flexible shaft 8 and capable of serving a required purpose as described later can be secured over its entire length.

As shown in FIG. 5, the flexible shaft 8 having the above configuration is provided at the rear end side of the insertion portion in the ultrasonic diagnostic apparatus.
It is connected to a normal hollow shaft 11 having no flexibility. The hollow shaft 11 is provided with bearings 12, 1 disposed at appropriate positions in the drive unit 4.
It is rotatably supported by 3 and is drivingly connected to the drive motor 14 by a suitable connecting means 15. As shown in FIG. 5, the coupling means 15 includes a pulley 15a attached to the hollow shaft 11, a pulley 15b attached to the output shaft of the drive motor 14, and a belt 15c hung between the pulleys 15a, 15b. Belt drive coupling mechanism. Also, the first
As shown in the figure, the coupling means 15 may be constituted by a reduction gear mechanism attached to the hollow shaft 11 and the output shaft of the drive motor 14.

According to such an arrangement, by operating the drive motor 14, the output torque of the drive coupling means 15, the hollow shaft 11,
Flexible shaft 8 and hollow cylindrical support member 5
Is transmitted to the ultrasonic probe 3 at the distal end portion 1 of the insertion portion via the, and the probe 3 can be rotated by a required angle about the central axis of the distal end portion 1. Note that the drive unit 4 is provided so that the transmission / reception azimuth of the ultrasonic probe 3 can be detected.
Place the rotary encoder 16 inside the
The transmission / reception azimuth of the probe is detected as the rotation angle of the hollow shaft 11 by the use of the probe 16, and a required signal processing can be performed according to the detected value.

As shown in FIG. 2, the internal space 17 of the distal end portion 1 in the insertion portion of the diagnostic apparatus containing the ultrasonic probe 3 includes:
An ultrasonic transmission medium whose acoustic impedance has a value close to that of a living body, such as liquid paraffin, is filled from the screw sealing portion 18 on the distal end surface of the insertion portion through the above-described flexible tube 9. The sealing portion (not shown) in the operation section 4 is completely filled. In order to fill all the gaps with the ultrasonic transmission medium, for example, a plurality of grooves 19 extending in the axial direction on the non-sliding surface side of the slide bearing 7, that is, on the side screw-coupled to the support member 5. To form

A pair of circumferential mounting grooves 20 for mounting a known balloon (not shown) are formed on the outer peripheral surface of the distal end portion 1 of the insertion portion. A water inlet and a suction port are opened between the mounting grooves 20 so that the deaerated water can be injected into and sucked from the inside of the balloon in a state where the balloon is mounted in these grooves 20. The mouth is connected via a tube 21 to a water injection / suction base (not shown) arranged on the operation unit 2 side.

The signal conductor 10 from the ultrasonic probe 3 is connected to the flexible shaft 8 from the distal end portion 1 of the insertion section to the drive section 4.
The passage between the inner peripheral layer 8a and the outer peripheral layer 8c is as described above with reference to FIGS. 3 and 4. The signal conductor 10 is arranged in a longitudinal groove 22 formed on the outer peripheral surface of the hollow shaft 11, as shown in FIG. Further, although not shown, longitudinal grooves are formed on the outside of the frame used for mounting each component in the drive unit 4, and in these grooves, the deaerated water is injected and sucked into the balloon. It houses the tube 21 and an operation wire for bending operation of a bending portion arranged adjacent to the distal end portion 1 of the insertion section.

The signal conductor 10 arranged in the longitudinal groove 22 on the outer peripheral surface of the hollow shaft 11 is connected to the slip ring 25 on the rear end side of the hollow shaft 11. The contact members 26 are brought into sliding contact with the slip ring 25, and the conductive wires 27 connected to the contact members 26 are introduced into the operation unit 2, and are inserted from the operation unit 2 into a so-called universal cord 28 to It can be connected to the sound wave observation means. As described above, in the present invention, the ultrasonic probe 3, the drive unit 4 thereof, and the power transmission element for coupling the two.
8 and 11 are all hollow structures, and a hollow channel HC is located in the area near the center axis from the tip 1 of the insertion section to the operation section 2.
Are arranged to extend therethrough. Therefore, an endoscope 29 capable of obtaining an optical field of view in front of the insertion direction of the device insertion portion is inserted through the end opening of the operation portion 2 of the ultrasonic diagnostic device into the hollow channel HC as needed. It is possible to do.

As shown in FIG. 8, the endoscope 29 includes an observation lens group 30 for transmitting an optical image in a visual field in front of the insertion direction of the insertion unit in the ultrasonic diagnostic apparatus to the operation unit 2, and an image guide. Fiber, illumination lens group 32 that sends illumination light in the direction of the field of view and light guide fiber, lens group 3 above
A nozzle 34 for discharging water or air to clean the surface on the tip side of 0, 32 as necessary, and a channel 35 for inserting forceps for aspirating liquid in a body cavity or performing a biopsy of tissue. , Itself is of normal construction.
That is, when the endoscope 29 is inserted into the body cavity in the insertion portion, the endoscope 29 illuminates the illumination light from the lens group 32 and looks through an eyepiece (not shown) provided at the end of the operation portion of the endoscope. By doing
Through the lens group 30, an endoscopic image of a tissue to be diagnosed, that is, a tissue surface of a target portion can be observed. It is desirable that the distal end portion of the endoscope 29 itself be configured to be appropriately bent in a required direction by an operation at the operation end thereof.

FIG. 9 shows a use mode in which a relatively large forceps 40 is inserted into the hollow channel HC to perform a biopsy of a tissue at a target site. In addition to those described above, a laser treatment device, a color tube for staining, and the like can be mentioned as those that can be inserted into the hollow channel HC.

〔The invention's effect〕

In the present invention, as described above, the distal end portion 1 of the insertion portion is used.
Using the hollow channel HC extending through the area near the central axis from the control unit 2 to the operation unit 2,
Since the configuration in which 29 can be arranged can be used, it is possible to use an endoscope optical system that can directly look forward in the insertion direction. By using such an endoscope optical system together, there is no restriction on the viewing direction as in the prior art, and even in a narrow organ where the lumen is complicatedly meandering like the large intestine, the insertion direction is forward. The insertion part can be safely inserted to the target part while always checking, and the ultrasonic probe 3
0), a complete ultrasonic diagnostic image of the target site can be obtained easily and reliably without any difficult and complicated operation. Further, since large forceps and other necessary devices other than the endoscope can be appropriately inserted into the above hollow channel HC, an ultrasonic wave having a more abundant treatment function than conventionally known ones An effect that can realize a diagnostic device is achieved.

[Brief description of the drawings]

FIG. 1 is a conceptual diagram showing an overall configuration of an ultrasonic diagnostic apparatus according to an embodiment of the present invention, FIG. 2 is a longitudinal sectional view showing a specific configuration at a distal end portion of an insertion portion thereof, and FIG. FIG. 4 is a perspective view showing one embodiment of a hollow multilayer flexible shaft for connecting a stylus to its driving part, FIG. 4 is a perspective view showing another embodiment of the hollow multilayer flexible shaft, and FIG. FIG. 6 is a longitudinal sectional view showing a specific configuration of the drive unit of the child, FIG. 6 is a transverse sectional view of the hollow shaft along the line VI-VI in FIG. 5, FIG. 7 is a front end face of the insertion unit in the arrangement of FIG. FIG. 8 is an explanatory view showing a use mode in which an endoscope is inserted into a hollow channel, and FIG. 9 is a connection diagram showing a use mode in which a large forceps is inserted into a hollow channel. [Description of Symbols] 1... Tip portion of flexible insertion section 2... Operating section 3... Ultrasonic probe 4... Drive section 5... Support member 8. 8b, 8b '... middle layer 8c ... outer layer 10 ... signal conductor 14 ... drive motor 29 ... endoscope 40 ... forceps HC ... hollow channel

Claims (1)

(57) [Claims] An ultrasonic probe provided at a distal end of an insertion portion to be inserted into a subject; and an ultrasonic probe provided at a hand side of the insertion portion for remotely rotating the ultrasonic probe. An ultrasonic diagnostic apparatus having a rotation driving means for driving, a hollow cylindrical support member rotatably supporting the ultrasonic probe at a distal end of the insertion portion, and a support member connected to the support member; A flexible shaft having a hollow portion communicating with a hollow portion provided in the support member, extending to a hand side of the insertion portion; and a rotating shaft of the rotation driving unit while securing the hollow portion provided in the flexible shaft. A driving force transmitting means for transmitting a driving force to the flexible shaft, including a hollow portion of the support member and a hollow portion of the flexible shaft, which is open to the outside at a distal end surface of the insertion portion and is also close to the hand of the insertion portion. Outside Ultrasonic diagnostic apparatus characterized by comprising a hollow channel section, the opening into.