JP2712942B2 - Ultrasonic inspection system with puncture guide - 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 inspection apparatus provided with an ultrasonic observation mechanism at the distal end of an insertion portion, and an ultrasonic inspection apparatus with a puncture guide for guiding a puncture needle such as an injection needle or a cytological needle. It concerns the device.

[0002]

2. Description of the Related Art An ultrasonic inspection apparatus is capable of injecting an ultrasonic pulse into a body, receiving a reflected echo thereof, processing the ultrasonic reception signal, and displaying an ultrasonic image on a display. Although it is made possible, not only the ultrasonic pulse is made to enter the body from the outer skin but also an insertion part to be inserted into the body cavity of the patient, and the tip of this insertion part Ultrasonic transducers are provided, and the body-insertable ultrasonic inspection device in which an ultrasonic pulse is incident from the inner wall of the body cavity has come to be used.In addition to the ultrasonic observation mechanism, a body cavity Ultrasound endoscopes having a mechanism for observing a visible image such as an internal object image (including not only an optical image but also an infrared image and the like) have become widespread.

[0003] An ultrasonic probe inserted into the body,
Ultrasound endoscopes are not only capable of examining body tissue, but also examining the condition of the body tissue, and finding, for example, tumors and other affected areas, and more precise detection of suspected affected areas. To collect cells for testing,
In addition, it is necessary to give a treatment such as injection to the affected part. To perform such treatment, a puncture needle such as an injection needle or a cytological needle is used. The puncture needle is usually formed by inserting a needle made of a hard pipe having a sharp tip into a flexible soft tube. There is a soft puncture needle that is formed by being connected to a hard puncture needle, and a hard puncture needle that is entirely formed of a hard tubular member.

Here, in order to reliably guide the puncture needle to a predetermined site, the affected part is captured in a scanning range by an ultrasonic vibrator, and the puncture needle is moved to the affected part while observing the ultrasonic image. It must be pointed at it. In the case of a soft puncture needle provided with a needle tip at the distal end of the flexible tube, the insertion of the treatment tool can be performed through a treatment tool insertion channel provided for inserting forceps and other treatment tools. By guiding the channel into the body as a guide, projecting a predetermined amount from the treatment instrument insertion outlet provided at the tip of the insertion section under monitoring by the visible image observation mechanism, and capturing it within the scanning range of the ultrasonic transducer It is possible.

[0005]

On the other hand, since the hard puncture needle cannot be inserted into the treatment instrument insertion channel, it is usually inserted directly from the body epidermis and guided to the affected part. However, it is very difficult to operate the puncture needle from outside the body and guide the needle point within the scanning range of the ultrasonic transducer, and aim at the affected part, etc., and the puncture needle is particularly thin, Because its overall length is relatively long, it bends due to resistance at the time of insertion from the inner wall of the body cavity, etc., so its stability is not necessarily obtained.
There is a drawback that the operability is extremely poor.

The present invention has been made to solve the above-mentioned drawbacks and problems of the prior art, and an object thereof is to provide a puncture needle through a route separate from an ultrasonic inspection apparatus. It is an object of the present invention to provide an ultrasonic inspection apparatus with a puncture guide, which makes it easy to aim at an affected part or the like at the time of insertion.

[0007]

SUMMARY OF THE INVENTION In order to achieve the above-mentioned object, the present invention provides a visible front-viewable distal end of an insertion portion.
And an image observation system and the ultrasonic observation mechanism together fixedly provided, this is the tip portion set <br/> Ke and continuously provided a projection projecting forward for guiding the puncture needle to the protruding portion The guide hole is provided, and the visible portion is
A puncture needle for the guide hole is provided by providing a surface in the field of view of the observation mechanism.
By opening the introduction side of this surface to this surface, and by piercing with the exit side facing the arrangement side of the ultrasonic observation mechanism ,
The insertion site of this puncture needle enters the field of view of the ultrasonic observation mechanism
It is characterized by having such a configuration.

[0008]

By adopting the above configuration, when the puncture needle is inserted into the guide hole, monitoring by the visible image observation mechanism is performed.
Below, it can be inserted into the introduction side of this guide hole.
Work can be done smoothly. In addition, since the portion protruding from the guide hole is relatively short and is regulated by the guide hole, it maintains sufficient strength against resistance at the time of insertion into the body, and its pierceability is improved. It will be good.
Moreover, the penetration of the puncture needle into the body is always within the field of view of the ultrasonic observation mechanism, and the puncture needle can be operated under monitoring by the ultrasonic observation mechanism,
The operability becomes extremely good, and by operating while observing both the site to be treated such as the affected part and the puncture needle, the needle tip of the puncture needle can be reliably guided to the affected part and the like. Action is possible.

[0009]

Embodiments of the present invention will be described below in detail with reference to the drawings. Thus, the ultrasonic inspection apparatus of the present invention
Supersonic with integrated wave observation mechanism and visible image observation mechanism
It is configured as a wave endoscope.

First, in FIG. 1, reference numeral 1 denotes an ultrasonic endoscope as an ultrasonic inspection apparatus, 2 denotes a puncture needle, and 3 denotes a puncture needle 2 which is inserted into the body separately from the ultrasonic endoscope 1. 1 shows a rigid endoscope for tracking and confirming the insertion direction.

The ultrasonic endoscope 1 comprises a main body operation section 11 and an insertion section 12 for insertion into a body cavity. The insertion section 12 includes a flexible section 12a, an angle section 12b, and an angle section 12b. The distal end of the distal end hard portion 12c is provided with a visible image observation mechanism 13 and an ultrasonic observation mechanism 1 as shown in FIGS.
4 are provided. As the visible image observation mechanism 13,
An illumination window 13a for irradiating illumination light into the body cavity, and an observation window 13b for optically observing the interior of the body cavity under illumination by the illumination window 13a.
An emission end of a light guide connected to a light source device faces the light source device 3a, and a solid-state image pickup device such as a CCD or the like is disposed at an image formation position of an objective lens provided in the observation window 13b, or an optical image is formed. The entrance end of the image guide to be transmitted faces. In addition, the ultrasonic observation mechanism 14
As shown in FIG. 4, a plurality of ultrasonic transducers 14a are arranged in a convex curved line, and these ultrasonic transducers 14a are sequentially switched by an electronic changeover switch 14b to perform scanning. It is of the electronic scanning type. However, the scanning method of the ultrasonic observation mechanism may be other than the convex type.

Although the visible image observation mechanism 13 and the ultrasonic observation mechanism 14 are provided in the distal end hard portion 12c as described above, the visible image observation mechanism 13 and the ultrasonic observation mechanism 14 are provided.
A protruding portion 15 protruding forward is formed in a portion between the two. The protrusion 15 has a puncture needle 2 in its thickness direction.
In order to guide the needle tip 2a, a guide hole 16 having an inner diameter slightly larger than the outer diameter of the puncture needle 2 is formed. The visible image observation mechanism 13 is located on the introduction side 16a of the puncture needle 2 in the guide hole 16, and the ultrasonic observation mechanism 14 is located on the exit side 16b. Also, the protrusion 1
5 is inclined so that the surface of the guide hole 16 on the introduction side 16a of the puncture needle 2 rises toward the distal end side, so that the introduction side 16a of the guide hole 16 is optically within the visual field of the visible image observation mechanism 13. It can be placed in the observation field of view. Moreover, the guide hole 16 is an inclined hole that is inclined from the introduction side 16a to the exit side 16b.
The direction of the inclination is such that the outlet side 16b is in the forward direction, so that the puncture needle 2 inserted into the guide hole 16 is surely directed to the direction into the observation field of view of the ultrasonic observation mechanism 14.

As is apparent from FIG. 1, the ultrasonic endoscope 1 is guided by the trocar 4 and inserted into the abdominal cavity. The visible image observation mechanism 13 observes the inner wall of the body cavity. In parallel with the above, the state of the tissue in the body cavity is observed by the ultrasonic observation mechanism 14. Then, when a tumor or other affected site or a site suspected of the affected site is found, a treatment such as collecting tissue cells at this site or performing injection is performed. For this purpose, a puncture needle 2 is used. Here, the puncture needle 2 is made of a small-diameter pipe made of metal, and has a sharp tip 2a.
The syringe 21 and the like are connected to the base end.

Therefore, the affected part found by the ultrasonic observation mechanism 14 is held in the field of view, and in this state, the puncture needle 2 is inserted through the body epidermis, and the distal end of the ultrasonic endoscope 1 is inserted. It is directed toward the guide hole 16 formed in the protrusion 15. Then, in order to confirm the directional direction of the puncture needle 2, another observation means such as the rigid endoscope 3 is inserted into the body in addition to the ultrasonic endoscope 1, and the puncture needle 2 is placed under the monitoring thereof. This allows the puncture needle 2 to enter the guide hole 16.

When the tip 2a of the puncture needle 2 enters the vicinity of the distal end of the insertion section 12 in the ultrasonic endoscope 1, not only the above-described monitoring by the rigid endoscope 3, but also the visible image of the ultrasonic endoscope 1 Guide hole 16 of puncture needle 2 under observation by observation mechanism 13
Can be controlled very easily,
Moreover, the needle tip 2a of the puncture needle 2 can be reliably inserted into the guide hole 16. Here, since the hole diameter of the guide hole 16 is only slightly larger than the outer diameter of the puncture needle 2, it is necessary to finely align the two with each other. With the endoscope 1 fixed, the puncture needle 2 can be adjusted to match the position of the guide hole 16. The guide hole 16 is always ultrasound endoscopy
Being in the field of view of the mirror 1 by the visible image observation mechanism 13
Therefore, the positioning of the puncture needle 2 to the guide hole 16 is extremely
When the guide portion is provided on the introduction side 16a of the guide hole 16, the insertion of the needle tip 2a into the guide hole 16 is further facilitated.

When the puncture needle 2 passes through the guide hole 16 and projects from the lead-out portion 16b, the puncture needle 2 is inserted into the body cavity wall. In the observation field of view.
Therefore, by maintaining a state where the affected part enters the observation field of view of the ultrasonic observation mechanism 14, the needle tip 2a can reliably reach the affected part. Here, since the puncture needle 2 is inserted from the body epidermis, the puncture needle 2 has a considerable length, and has a considerably small diameter, so that it is bent by resistance when penetrating into the body. Etc.
Stability cannot always be maintained. However, by inserting a portion near the distal end of the puncture needle 2 into the guide hole 16 and making the diameter difference between the hole diameter of the guide hole 16 and the outer diameter of the puncture needle 2 small, the distal end of the puncture needle 2 is reduced. The vicinity of the part is regulated, and the directivity to the affected part becomes extremely good. When the needle tip 2a reaches the diseased part, cells can be collected by applying a suction force to the syringe 21, and a drug solution can be filled in the syringe 21 and the drug solution can be pushed out to perform injection to the diseased part. It can be carried out.

[0017]

As described above, according to the present invention, a protruding portion that protrudes forward is provided on the distal end hard portion, and this protruding portion is provided with:
A guide hole with the outlet side directed to the side where the ultrasonic observation mechanism is provided is drilled, and when a puncture needle is inserted into the body through this guide hole , a visible image is observed on the protrusion with the guide hole. In the field of view of the mechanism
With a guide hole on the guide hole
Make sure that the needle is open
Punctured because it was configured to be within the field of view of the sound wave observation mechanism
The directivity to the guide hole for inserting the needle becomes better,
And directivity also becomes excellent with respect to the position to be subjected to treatment such diseased part from the guide hole, the operability of the puncture needle can be remarkably improved.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram showing a state where a puncture needle is inserted into an affected part using an ultrasonic endoscope.

FIG. 2 is an external view showing a connection state of an ultrasonic endoscope and a puncture needle with a main part in cross section.

FIG. 3 is an external view of a distal end portion of the ultrasonic endoscope.

FIG. 4 is a diagram illustrating the configuration of an ultrasonic observation mechanism.

[Description of Signs] 1 Ultrasound endoscope 2 Puncture needle 2a Needle tip 12 Insertion section 12c Hard tip section 13 Visible image observation mechanism 14 Ultrasonic observation mechanism 15 Projection section 16 Guide hole 16a Introducing side 16b Outgoing side

Claims (2)

(57) [Claims] 1. A visible image view in which a front end of an insertion portion can be viewed forward.
The observation mechanism and ultrasonic observation mechanism together fixedly provided, this
At the end of the is provided a series of protruding parts that protrude forward,
A guide hole is provided in this protrusion to guide the puncture needle.
The visible image observation mechanism
Provide a surface that enters the field of view, and introduce the puncture needle through the guide hole.
Side is opened on this surface, and the hole is drilled with the outlet side facing the arrangement side of the ultrasonic observation mechanism.
An ultrasonic inspection apparatus with a puncture guide, wherein an insertion site of a puncture needle is configured to be within a visual field of an ultrasonic observation mechanism . 2. A surface on the introduction side of the puncture needle in the projection.
This was configured to an inclined surface which rises toward the tip side
The ultrasonic inspection apparatus with a puncture guide according to claim 1, wherein: