JP2664631B2 - Ultrasonic probe - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic probe,
In particular, the present invention relates to an ultrasonic probe for puncture used in surgery, inspection, and the like using a laparoscope.

[0002]

2. Description of the Related Art In recent years, surgery and examination using a laparoscope have been actively performed.

In surgery or examination using a laparoscope, after a patient's abdomen is inflated by applying air pressure, holes are made in several places in the abdomen, and a hollow tube called a trocar having an inner diameter of about 10 mm is pierced in the holes. A surgical instrument such as a laparoscope, forceps, or an electric scalpel is inserted into the abdominal cavity through the trocar, and the operation is performed while observing with the laparoscope.

In such operations and examinations, recently, an ultrasonic probe is inserted into the abdominal cavity through a trocar to abut on an organ, and the operation is performed while monitoring a real-time ultrasonic tomographic image by the ultrasonic probe. And methods of conducting inspections have been adopted.

FIG. 5 shows a conventional example of such an ultrasonic probe. As shown in the figure, the ultrasonic probe 40 is composed of a probe shaft 42 and a probe head 44 integrally connected to the probe shaft 42, and is an elongate shape that can be inserted into the trocar as a whole. (For example, total length 400mm, outer diameter 10mm
Weak) It has a straight rod shape. On the side surface of the probe head 44, a linear array type ultrasonic transducer 44a is provided.

[0006] In addition to this example, an ultrasonic probe used in an operation using a laparoscope may be a probe whose end portion can be bent, such as an endoscope.

Now, in the above-mentioned surgery or examination,
A so-called puncture may be performed for collecting the affected tissue or for injecting a drug into the affected area. In order to perform this puncturing operation safely and reliably, the above-described ultrasonic probe is used. That is, by performing a puncture operation using an ultrasonic probe while monitoring the state of the inside of an organ, the position of a puncture needle, and the like, it is possible to reliably puncture a target diseased part without damaging blood vessels and the like. Can be. Hereinafter, a puncturing method using such an ultrasonic probe will be described.

First, in the case of using the straight rod-shaped ultrasonic probe shown in FIG. 5, as shown in FIG. 6, the ultrasonic probe 40 is inserted into the abdominal cavity 110 through the trocar 50 penetrating the abdominal wall 100. And the ultrasonic transducer 44a of the ultrasonic probe 40 contacts the organ 120 to be punctured, and
While monitoring 0, a method of inserting a direct needle type puncture needle 60 inserted from another trocar 52 into the organ 120 has been used. The area 130 indicates an ultrasonic wave transmitting / receiving area of the ultrasonic transducer 44a, that is, a scanning surface.

In the case of the endoscope type ultrasonic probe in which the probe shaft can be bent, a guide hole for inserting a puncture needle is provided in the ultrasonic probe itself, and the guide hole is provided. A method has been adopted in which a catheter-type puncture needle is inserted into the hole and puncture is performed with the puncture needle.

[0010]

However, of the two puncturing methods described above, there is a problem that the former puncturing method is technically difficult. That is, in order to monitor the puncturing operation, it is necessary to be able to observe the state in which the puncturing needle is being inserted by an ultrasonic image. For this purpose, it is necessary to insert the puncture needle so that the path through which the puncture needle is inserted, that is, the puncture trajectory falls within the scanning plane of the ultrasonic transducer.
However, since the scanning surface is a very narrow area, it is very difficult to accurately insert the puncture needle through another trocar through the scanning surface, and the insertion direction is slightly shifted from the correct direction. Just by doing so, the puncture needle comes off the scanning plane. Therefore, a skilled technique is required to accurately guide the puncture needle into the scanning plane.

[0011] Further, in this method, it is necessary to pass the trocar through two parts of the abdomen, so that there is a problem that the burden on the patient is large and the operation takes time.

On the other hand, the latter puncture method has an advantage that it is not necessary to provide a separate trocar for puncturing since the puncture needle is guided through the inside of the ultrasonic probe.
Further, since the inserted puncture needle can pass through the scanning surface, there is an advantage that the puncture operation is easy.

However, this puncturing method has a problem that it is difficult to puncture a deep part of an organ because a catheter-type puncturing needle that is easily bent is used.

As described above, the conventional ultrasonic probe is not sufficient as a guide for the puncturing operation. here,
As an improvement plan having the features of the above-mentioned two conventional ultrasonic probes, a method of providing a guide hole in the straight rod-shaped ultrasonic probe shown in FIG. 5 can be considered. With this configuration, a puncture needle of a direct needle type can be used, so it is possible to puncture the deep part of the organ, and since the puncture needle to be inserted can always pass through the scanning surface of the ultrasonic probe, No special procedure is required for puncturing. However, when this ultrasonic probe is used, the positional relationship between the ultrasonic transducer and the puncture trajectory is fixed, and a problem arises that only the vicinity of the ultrasonic transducer, that is, the surface layer of the organ can be punctured.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems, and a puncturing ultra-surgery device capable of performing stable puncturing of a wide part of an organ without requiring a skilled technique. It is an object to provide an acoustic probe.

[0016]

In order to achieve the above object, the present invention provides a probe shaft having an axially formed guide for inserting a puncture needle, and a guide shaft provided at the tip of the probe shaft. And
Equipped with an ultrasonic transducer directed to the puncture path of the puncture needle protruding from the tip of the probe axis, and a probe that can tilt in the opening direction from the straight line with the probe axis while keeping the puncture path in the ultrasonic wave transmission / reception area. It is characterized by including a probe head and angle control means for controlling the inclination angle of the probe head.

[0017]

According to the structure of the present invention, the angle formed between the probe head and the puncture path in the axial direction of the probe axis can be freely changed by tilting the probe head by the angle control means. Can be. Then, even when the probe head is tilted, the puncture needle protruding from the tip of the probe shaft always passes through the ultrasonic wave transmitting / receiving area. Therefore, when the ultrasonic probe according to the present invention is used, the inclination of the probe head is set to 0 degree so that the probe axis and the probe head are in a straight line. Insert the child into the abdominal cavity through the trocar,
Alternatively, it can be withdrawn from the abdominal cavity. Further, when performing puncturing, the inclination angle of the probe head is appropriately adjusted according to the depth of the affected part in the organ, that is, when performing puncturing on a shallow part of the organ, the inclination angle is reduced and the organ is shallow. When the puncture is performed at an angle and the puncture is performed in a deep part, the puncture can be performed on a wide part of the organ by increasing the inclination angle and performing the puncture at a deep angle with respect to the organ. Further, since the puncture path of the puncture needle always passes through the ultrasonic wave transmitting / receiving area of the ultrasonic vibrator, no special procedure is required in the puncture operation.

[0018]

An embodiment of the present invention will be described below with reference to the drawings.

FIG. 1 is an external view showing a preferred embodiment of the ultrasonic probe according to the present invention.

The ultrasonic probe 10 includes a probe shaft 12, a probe head 14 connected to one end of the probe shaft 12 via a joint 16, and a probe shaft 12. And an operation unit 18 connected to the other end.

The probe shaft 12 is in the shape of an elongated circular tube.
The inside thereof is provided with a guide hole 20 for inserting a puncture needle when performing puncture. The outer diameter of the probe shaft 12 is 1
It is about 0 mm, and has a thickness that can be inserted into the trocar. The inner diameter of the guide hole 20 is, for example, 1.5 m
m. When performing puncturing, as shown in FIG. 2, the puncturing needle 60 is inserted into the guide hole 20 from the opening 20a, and is pushed out from the opening 20b in the direction of the arrow. The trajectory of the puncture needle 60 is a linear trajectory oriented in the axial direction of the probe shaft 12,
The puncture track 22 is shown in FIG.

The probe head 14 has a semi-cylindrical shape obtained by cutting off a part of a cylinder having the same diameter as the probe shaft 12.
A linear array type ultrasonic transducer 14a is disposed on the cut surface side. The probe head 14 is connected to the probe shaft 12 so that the ultrasonic transducer 14a faces the puncture track 22 so as not to hinder the advance of the puncture needle. Sound transducer 14a
Are arranged so as to pass through the scanning plane.

The probe head 14 is connected to the probe shaft 12 via a joint 16 and can be tilted in the direction shown by the arrow in the figure. Since the probe head 1 tilts toward the puncture path, the probe head 1
The puncture needle always passes through the scanning surface of the ultrasonic transducer 14a regardless of the inclination angle of the needle 4.

The operation section 18 has an operation lever 18a. By rotating the operation lever 18a,
The inclination angle of the probe head 14 can be changed.

Probe head 14 by operating lever 18a
FIG. 3 shows a mechanism for controlling the tilt angle. As shown in the figure, the operation lever 18a and the probe head 14 are respectively connected to the rotation shaft 32,
34, and the rotating shafts 32 and 34 are connected to the wire 3
6 are connected. Therefore, the operation lever 18a
Is rotated in the direction of the arrow in the figure, the rotation shaft 32 rotates, and the rotation is transmitted to the rotation shaft 34 via the wire 36, and the probe head 14 connected to the rotation shaft 34 tilts in the direction of the arrow. I do.

In this mechanism, the relationship between the rotation angle α of the operation lever 18a and the inclination angle β of the probe head 14 is uniquely determined by the ratio of the diameters of the rotation shafts 32 and 34. For example, when the diameter ratio is 1: 1, the inclination angle β of the probe head becomes equal to the rotation angle α of the operation lever. Therefore, in this example, the operation unit 1
The operation lever 1 is controlled by an angle measuring device 18b provided in
The rotation angle of the probe head 8a is measured, and a measurement signal is sent to an ultrasonic diagnostic apparatus to which the ultrasonic probe 10 is connected, where arithmetic processing is performed to determine the inclination angle of the probe head 14. The tilt angle obtained in this manner is used for displaying a puncture trajectory during puncturing operation monitoring, which will be described later. Here, the rotation angle of the operation lever 18a is measured, and the inclination angle of the probe head 14 is obtained indirectly from the rotation angle. However, the present invention is not limited to this. Alternatively, the configuration may be such that the inclination angle of the probe head 14 is directly measured.

The operating lever 18a is provided with a lock mechanism (not shown) so that the probe head 14 can be fixed at a desired inclination angle with respect to the probe shaft 12. When performing puncturing, the probe head 14 is locked by this lock mechanism to perform work.

Next, a puncturing operation using the ultrasonic probe according to the present embodiment will be described with reference to FIG.

First, the ultrasonic probe 10 is inserted into the abdominal cavity 110 through the trocar 40 penetrating the abdominal wall 100 with the probe head 14 locked at an inclination angle of 0 degree.
Then, in order to specify the affected part 140 to be a puncture target,
Diagnosis is performed by contacting the ultrasonic transducer at various positions of the organ 120. At this time, it is possible to operate the operation lever 18a to perform the diagnosis while appropriately changing the inclination angle of the probe head 14 in order to make the ultrasonic transducer easily contact the organ. In the drawing, an area 130 represents a scanning surface of the ultrasonic transducer.

After specifying the affected part 140, the puncture is performed on the affected part 140. However, if the puncture is performed with the tilt angle of the probe head 14 set at the time of diagnosis, In many cases, the target affected area cannot be punctured. That is, in the ultrasonic probe 10 of the present embodiment, when the inclination angle of the probe head 14 is fixed due to its structure, the puncture needle 6
0 passes through a linear trajectory that forms a fixed angle (that is, a tilt angle) with respect to the probe head 14, but this linear trajectory occupies only a small part in the scanning plane. Therefore, even if the diseased part 140 is displayed on the ultrasonic tomographic image at the time of diagnosis, if the position of the diseased part is out of the straight line, the diseased part cannot be punctured. Therefore, it is necessary to adjust the tilt angle of the probe head 14 and the abutting part in order to ensure that the target affected part 140 can be punctured.

Therefore, in the present embodiment, the expected trajectory of the puncture needle 60 is superimposed and displayed on a normal ultrasonic tomographic image, and the inclination angle and the contact portion of the probe head 14 are changed while viewing the image. The trajectory of the puncture needle 60 can be adjusted so as to pass through the target affected part 140.

That is, in this embodiment, as described above, when the inclination angle of the probe head 14 is determined, the puncture needle 6
The orbit of 0 is uniquely determined as a straight line inclined by a certain angle (that is, an inclination angle) with respect to the ultrasonic transducer. This indicates that the trajectory of the puncture needle 60 is a straight line that is inclined by a certain angle (that is, an inclination angle) with respect to the ultrasonic transducer plane even on the ultrasonic tomographic image. Therefore, if the inclination angle of the probe head 14 is known, the trajectory of the puncture needle 60 can be easily obtained, and the trajectory can be displayed on the ultrasonic tomographic image. Therefore, in the present embodiment, a measurement signal from the above-mentioned angle measuring device is sent to an ultrasonic diagnostic apparatus, and the signal is processed by the ultrasonic diagnostic apparatus to determine a puncture trajectory. To be displayed in a superimposed manner. While monitoring this image, the contact area and the inclination angle of the probe head 14 are changed, and the displayed puncture trajectory becomes the target diseased part 1.
Adjust to pass through 40.

As described above, when the target affected part 140 can be punctured, the operation lever 18a is locked, the probe head 14 is fixed, and the puncture is performed.

When the ultrasonic probe 10 is pulled out of the abdominal cavity after a series of inspection and surgical operations is completed, the inclination angle of the probe head 14 is returned to 0 degrees, and the probe shaft and the probe are moved. The head 14 is aligned so as to be able to pass through the trocar. A marker indicating a tilt angle of 0 degree may be provided around the operation lever 18a so that it can be checked at hand whether or not the trocar can pass.

As described above, according to the ultrasonic probe of the present embodiment, puncturing can be performed while monitoring an ultrasonic tomographic image without any special procedure.

In the above embodiment, the probe head is formed in a semi-cylindrical shape in which a part of a cylinder having the same diameter as the probe axis is cut off. However, the present invention is not limited to this. Any shape may be used as long as it is a shape and does not interfere with insertion and removal through the trocar.
In the above embodiment, the ultrasonic transducer attached to the probe head is of the linear array type. However, the effects of the present invention can be obtained in the case of the convex type or the sector type. Furthermore, in the above embodiment, the probe head is tilted by operating the wire with the operation lever.However, the tilting mechanism of the probe head is not limited to this.For example, a small motor is provided at the joint, A configuration may be employed in which a switch provided on the operation unit is operated to drive the motor to tilt the head.

[0037]

As described above, according to the ultrasonic probe according to the present invention, it is possible to use a straight needle type puncture needle capable of puncturing a deep part of an organ, and to tilt the probe head. Therefore, the puncture can be performed on a wide area of the organ. Also,
Since the puncture needle inserted through the guide always passes through the ultrasonic wave transmitting / receiving area, puncture can be performed while monitoring the ultrasonic tomographic image without requiring any special technique.

[Brief description of the drawings]

FIG. 1 is an external view showing an embodiment of an ultrasonic probe according to the present invention.

FIG. 2 is a diagram showing a state in which a puncture needle is inserted into a guide hole in the ultrasonic probe of FIG. 1;

FIG. 3 is a schematic view showing an example of a tilting mechanism of a probe head.

FIG. 4 is a diagram for explaining a puncturing operation using the ultrasonic probe according to the present invention.

FIG. 5 is a side view showing an example of a conventional ultrasonic probe.

FIG. 6 is a view for explaining a puncturing operation using the ultrasonic probe of FIG. 5;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Ultrasonic probe 12 Probe axis 14 Probe head 14a Ultrasonic transducer 16 Joint part 18 Operation part 18a Operation lever 18b Angle measuring instrument 20 Guide hole 20a, 20b Opening

Claims (1)

(57) [Claims] 1. A probe shaft in which a guide for inserting a puncture needle is formed in an axial direction, and a puncture needle provided at a tip of the probe shaft and protruding from the tip of the probe shaft. A probe head comprising an ultrasonic transducer directed to an orbit, and capable of tilting in an opening direction from a state in which the puncture orbit is aligned with the probe axis while keeping the puncture orbit in an ultrasonic wave transmitting / receiving area; and the probe head. And an angle control means for controlling an inclination angle of the ultrasonic probe.