JP3039252B2 - Insertion section of in-vivo examination device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an insertion portion which is provided in an in-vivo inspection apparatus such as an endoscope or an ultrasonic inspection apparatus and is inserted into a body cavity or the like. An in-vivo inspection device having a treatment tool insertion passage that is inserted from the axial direction of the insertion portion, changes direction within the hard distal end portion, and is led out at a desired angle from a treatment tool outlet provided on a side surface of the hard distal portion. It concerns the insertion section.

[0002]

2. Description of the Related Art As an in-vivo inspection apparatus, there are an endoscope and an ultrasonic inspection apparatus, and an ultrasonic endoscope having both functions of the endoscope and the ultrasonic inspection apparatus is used. For example, in an ultrasonic endoscope, a distal end portion of an insertion portion into a body cavity is formed as a distal end hard portion, and the distal end hard portion includes an endoscope observation means having an illumination window and an observation window, and an ultrasonic endoscope. An ultrasonic observation means provided with a transducer is mounted.
Here, there are a mechanical scanning type, an electronic scanning type and the like as an ultrasonic transducer constituting the ultrasonic observation means. In an electronic linear scanning type ultrasonic transducer, a plurality of ultrasonic transducers are linearly arranged. Due to the arrangement, this ultrasonic transducer becomes long. For this,
The illumination window and the observation window constituting the endoscope observation means are provided on the distal end surface of the rigid distal end portion, and the ultrasonic transducer constituting the ultrasonic observation means is provided on the side surface of the rigid distal end portion.

[0003] When an affected part is found by observing a tissue state in the body by an ultrasonic observation means, a puncture device for injecting an injection solution, a contrast medium, or the like into the affected part, performing drainage, or the like. Is inserted through the inner wall of the body cavity, and the insertion operation of the puncture device is performed under monitoring by the ultrasonic observation means. For this reason, a puncture device insertion passage is provided in the insertion portion as a treatment device insertion passage for inserting a puncture device as a treatment device.
The puncture device insertion passage forms a passage with a flexible tube in the insertion portion, and a puncture device passage connected to the flexible tube is formed in the distal end hard portion, and the puncture device passage extends in the axial direction of the insertion portion. In contrast, the direction is changed so as to bend at a predetermined angle, and an opening is formed as a puncture device outlet on the side surface of the hard distal end portion.

[0004]

As described above, the puncture device insertion passage is provided in the treatment tool passage in the hard distal end portion.
In order to change the direction, the puncture device is bent by a predetermined angle. However, since the puncture operation of the puncture device needs to be performed under monitoring by ultrasonic observation means, a portion where the puncture device is pierced from the inner wall of the body cavity. It is necessary to change the angle of the puncture device led out from the puncture device outlet in the hard distal end portion of the insertion portion depending on the depth of the puncture device.

For example, in a side-view type endoscope, a treatment tool insertion passage extending in the axial direction of the insertion portion is led out in a desired direction from the side surface of the distal end hard portion, so that it is close to a treatment tool outlet. The treatment tool raising table is provided at a position where the treatment tool is to be moved, and the direction of the treatment tool is changed by the treatment tool raising table. An operation wire is connected to the treatment instrument raising table, and the operation wire is pushed and pulled to control the angle of the treatment instrument raising table, so that the treatment instrument can be raised at a desired angle. .
However, as in the case of an ultrasonic endoscope, it is necessary to provide an ultrasonic observation mechanism in addition to the observation mechanism of the endoscope. In some cases, the space to be provided cannot be secured.

SUMMARY OF THE INVENTION The present invention has been made in view of the above points, and an object of the present invention is to guide a treatment instrument at a shallow angle from the axial direction of an insertion portion within a hard distal end portion to a predetermined position. When it is protruded to the maximum, it is possible to raise it to a desired angle.

[0007]

In order to achieve the above-mentioned object, the present invention provides an inspection mechanism on a side surface of a hard tip portion.
At the same time, a treatment tool outlet is formed at the base end side of the inspection mechanism, and a treatment tool insertion passage for changing the direction of the treatment tool from the axial direction of the insertion portion and leading it out of the treatment tool outlet. Provided on the side surface of the hard tip portion.
And a treatment instrument passage provided in the axial direction of the insertion portion.
A recess that opens at the end of the road, and each can be fitted into the recess
From a communication passage leading to the treatment tool passage.
Change the angle direction and open as the treatment tool outlet
With turning passages, and the angle of each turning passage is
Although different, the position of the treatment tool outlet is substantially the same
A plurality of types of passage forming pieces and each of these
Fixing the passage forming piece while mounted inside
And a member .

[0008]

Since the passage forming piece is detachable from the rigid distal end portion, a passage forming piece having a structure capable of being led out of the treatment tool outlet at an angle suitable for the purpose is mounted on the rigid distal end portion of the insertion portion, and a fixing member is provided. This passage fixing piece is fixed. In this state, when the treatment instrument is inserted into the treatment instrument passage, the treatment instrument can be led out of the treatment instrument outlet through the direction changing passage in the hard distal end portion. Therefore, a plurality of types of passage forming pieces having different angles of the direction change passage provided therein are prepared, and they are appropriately replaced and mounted on the hard distal end portion. It can be derived in a desired direction. Moreover, each passage is formed
The pieces have different turning passage angles.
However, the position of the treatment tool outlet is substantially the same.
The position of the treatment tool at the rigid distal end is almost always
Will be fixed. Therefore, for example, in an ultrasonic endoscope, when performing a puncture from a body wall in a state where the puncture device is contained in an ultrasonic observation field, an optimal angle with respect to a puncture target portion under observation by an ultrasonic inspection mechanism. Can be stabbed from.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. In this embodiment, an ultrasonic endoscope is shown as an in-vivo inspection device using a treatment tool. However, in addition to this, an endoscope, an ultrasonic inspection device, or the like can be used, and an insertion unit can be used. Although the configuration is shown as a flexible insertion portion bent along the insertion path, the insertion portion may be formed of a hard member. Although a puncture tool is used as a treatment tool to be inserted into the in-vivo examination device, any other treatment tool may be used as long as it needs to be drawn out at a predetermined angle in a body cavity.

First, FIG. 1 shows an overall configuration of an ultrasonic endoscope, and FIG. 2 shows a cross section of a distal end portion thereof. In the figure,
Reference numeral 1 denotes an insertion portion, 2 denotes a main body operation portion, and 3 denotes a universal cord. The insertion portion 1 is a flexible portion which is bent along the insertion path from the portion connected to the main body operation portion 2 for the most part. In the portion 4, an angle portion 5 that can be bent in a desired direction by a hand operation is provided at a tip portion of the flexible portion 4, and a tip end hard portion 6 is sequentially provided at the tip of the angle portion 5.

As shown in FIG. 3, an endoscope observation means having an illumination window 10 and an observation window 11 is provided on the distal end surface 6a of the distal end hard portion 6. The illumination light exit end of the light guide faces the illumination window 10, and the observation window 11 is provided with an objective lens, and a solid-state image sensor as imaging means is provided at an image forming position of the objective lens. An endoscope observation image is converted into an electric signal by a solid-state imaging device and extracted. Further, a treatment tool insertion channel 12 for inserting a treatment tool such as forceps is provided at the distal end surface 6a.
It is open to. Since the endoscope observation means and the treatment tool insertion channel 12 are conventionally known,
Detailed illustration and description are omitted.

An ultrasonic transducer 20 is mounted at a position on the base end side of the portion where the endoscope observation means is mounted. The ultrasonic transducer 20 is configured by arranging a large number of ultrasonic transducers in the axial direction of the distal end hard portion 6 and performs, for example, an electronic linear scanning (or convex scanning). The direction is a direction substantially orthogonal to the axis of the insertion section 1.
Before and after the position where the ultrasonic transducer 20 is disposed, concave grooves 21 and 22 for mounting a balloon are formed, and both ends of a cylindrical balloon 23 are mounted in the concave grooves 21 and 22 to form a rubber ring. And so on. Further, the ultrasonic transducer 20 and the concave groove 22
An ultrasonic wave propagation medium such as degassed water is supplied to a position between the two and can be swollen.

Reference numeral 30 denotes a puncture device.
As shown in FIG. 4, a tube 32 is inserted into an outer tube 31, and a puncture needle 33 having a sharp tip is connected to the tube 32. The puncture needle 33 has a predetermined length. Is formed from a rigid pipe having Puncture device 30
Is a puncture device insertion passage 34 provided extending from the main body operation unit 2 through the flexible part 4 and the angle part 5 of the insertion part 1 to the distal end hard part 6 in a state where the puncture needle 33 is covered with the mantle tube 31. It is inserted inside.

The distal rigid portion 6 has a concave portion 24 at a position proximal to the portion where the ultrasonic transducer 20 is mounted.
Is formed, and the puncture device insertion passage 34 is opened in the concave portion 24. The passage forming piece 40 is mounted in the recess 24. The passage-forming piece 40 has a shape that can be substantially fitted in the recess 24, and a direction-changing passage 41 is formed in the passage-forming piece 40.
The direction change passage 41 is a communication portion 42 having one end connected to the puncture device insertion passage 34, and is linear for a predetermined length from the communication portion 42. A puncture device outlet 43 is formed on the side surface so as to rise from the axis of the hard portion 6 toward the side surface.

Then, as shown in FIG. 5, the angle θ ₁
A passage forming piece 40a having a direction changing passage 41a (for example, 30 °) or a passage forming piece 40 having a direction changing passage 41b having an angle θ ₂ (for example, 20 °) as shown in FIG.
b and the angle θ ₃ (for example, 45 °) as shown in FIG.
A plurality of passage forming pieces having different angles of the direction changing passage, such as a passage forming piece 40c having the direction changing passage 41c. The outer shapes of these passage forming pieces 40a to 40c are the same. Thus, as is apparent from FIG.
All the passage forming pieces 4 including the passage forming pieces 40a to 40c
0 is the minimum size required to form the inclined passage, thereby minimizing the installation space in the hard distal end portion 6, and all the puncture device outlets are open at the same position. . In FIGS. 6 and 7, the components corresponding to those in FIG. 5 are denoted by subscripts b and c, respectively.

The passage-forming piece 40 is detachably mounted in the recess 24. To fix the passage-forming piece 40, a fixing ring 25 as a fixing member is screwed to the distal end hard portion 6. Are to be combined. For this purpose, a screw portion 26 to which the fixing ring 25 is screwed is provided on the base end side of the distal end hard portion 6. When the fixing ring 25 is screwed into the screw portion 26, the puncture device outlet is in a state of covering the upper part of the passage forming piece 40 in an open state.

The present embodiment is configured as described above. The rising angle which can be derived at the most appropriate angle with respect to the diseased part, etc., when derived from the hard end portion 6 of the insertion portion 1 at any angle. Is selected from the path forming pieces 40a to 40c in which the direction change paths 41a to 41c are formed. In this state, the insertion section 1 is inserted into the body cavity, and FIG.
As shown in (2), the ultrasonic transducer 20 is brought into contact with the body wall, and the puncture device 30 is pierced into a predetermined affected part while performing ultrasonic observation. Derivation angle θ of puncture device 30 from puncture device lead-out port changes accordingly.

Assuming that the derived angle θ is, for example, 30 °, a passage forming piece 40a having a direction changing passage 41a having a rising angle θ ₁ (= 30 °) corresponding to the derived angle is used as the path forming piece 40. select. Then, the fixing ring 25 is attached and detached, the entire concave portion 24 of the distal end hard portion 6 is completely opened, and the passage forming piece 40a is inserted into the concave portion 24. Then, the fixing ring 25 is screwed into the screw portion 26 of the hard distal end portion 6 to fix the passage forming piece 40a.

The insertion portion 1 of the ultrasonic endoscope is inserted into a body cavity, and the distal end hard portion 6 of the insertion portion 1 is guided to a predetermined portion. Then, an ultrasonic wave propagation medium is sealed in the balloon 23, an ultrasonic signal is transmitted in a state where the balloon 23 is in close contact with the body wall, a reflected echo is received, and signal processing is performed. And so on within the ultrasonic observation field of view. In this state, the puncture device 30 is inserted into the treatment tool insertion passage 34. The puncture device 30 inserted into the puncture device insertion passage 34 moves to the inside of the direction changing passage 41a in the passage forming piece 40a. and converted into theta ₁ direction, piercing device 30 is plugged is derived from the body wall from the puncture instrument outlet 43. Thereby, the puncture device 30
Can reliably reach the affected area.

If the depth of the puncture site from the body wall, such as the affected part, is different, the passage forming piece 40 is replaced to form a passage having an angle so as to reliably reach the puncture position. Any of the pieces 40b and 40c and any of the path forming pieces having direction changing passages of various angles other than these may be mounted in the recess 24.

In the above-described embodiment, the fixing member for fixing the passage forming piece is constituted by using the fixing ring screwed to the hard end portion. However, other suitable structures may be used. Can be used. For example, as shown in FIGS. 10 and 11, a fixed ring 50 made of an elastic cylinder and having a split is used, and a stepped portion 6 b is provided at the distal end hard portion 6, and the fixed ring 50 is attached to the stepped portion 6 b. No mounting is performed, and the fixing ring 50 has a first position for exposing the puncture device outlet by changing its position in the rotation direction.
By forming the through-hole 51 and the second through-hole 52 large enough to completely expose the recess 24 to the outside, a fixing member can be formed. In this case, the fixing ring 5
0 is rotated to position the second through hole 52 on the concave portion 24, thereby mounting the passage forming piece 40, and then rotating the fixing ring 50 by a predetermined angle.
The first through hole 51 is located at a position on the puncture device outlet 43 in the above, so that the passage forming piece 40 can be prevented from falling off.

[0022]

As described above, the present invention is directed to a passage forming piece having a direction change passage which is turned at a predetermined angle from the axial direction of the distal end hard portion of the insertion portion and opens to the surface as a treatment tool outlet. Is configured to be removably mounted in the recess provided in the hard end of the tip, and the angle of the direction change passage
Are different, but the position of the treatment instrument outlet is substantially the same.
It is possible to replace multiple types of passage forming pieces with
Since was formed, by mounting the recess of the distal end rigid portion to replace the passage forming piece having a different turning path angle, without using the treatment instrument elevator base and the like, substantially a treatment instrument
There are effects such as being able to be derived at the desired angle from the same position .

[Brief description of the drawings]

FIG. 1 is an overall configuration diagram of an ultrasonic endoscope as an in-body inserted ultrasonic inspection apparatus according to an embodiment of the present invention.

FIG. 2 is a sectional view of a distal end portion of FIG.

FIG. 3 is an external view of a distal end surface of FIG.

FIG. 4 is an external view of a puncture device.

FIG. 5 is a sectional view showing an example of a passage forming piece.

FIG. 6 is a sectional view showing another example of the passage forming piece.

FIG. 7 is a sectional view showing still another example of the passage forming piece.

FIG. 8 is an exploded perspective view of a passage forming piece and a fixing member thereof.

FIG. 9 is an operation explanatory view showing a state of a puncturing operation by the puncture device.

FIG. 10 is an external view of a fixing ring showing another configuration example of the fixing member.

FIG. 11 is a plan view showing a state in which a fixing ring is mounted on a hard distal end portion.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Insertion part 6 Tip hard part 20 Ultrasonic transducer 25 Fixing ring 26 Screw part 30 Puncturing tool 32 Tube 33 Puncturing needle 34 Puncturing tool insertion passage 40, 40a-40c Passage forming piece 41a-41c Direction changing passage 42a-42c communication part 43a-43c Puncture implement outlet 50 Fixing ring 50a Notch

──────────────────────────────────────────────────続 き Continuation of the front page (72) Inventor Susumu Hiki 1385-1 Shimoishigami, Otawara City, Tochigi Prefecture Inside the Nasu Plant of Toshiba Corporation (56) References Real Opening Sho 64-20801 (JP, U) (58) Survey Field (Int.Cl. ⁷ , DB name) A61B 1/00-1/32

Claims (1)

(57) [Claims] 1. An inspection mechanism is mounted on a side surface of a hard tip portion .
Rutotomoni, this is the proximal end side of the inspection mechanism to form a treatment instrument outlet, from the axial direction of the insertion portion of the treatment instrument by turning the treatment Gudori path for leading out from the treatment instrument outlet Provided at the base end of the inspection mechanism, and the axis of the insertion portion
A recess provided at the distal end of the treatment tool passage, the recess being open toward the front, and the treatment tool passage being engageable with each of the recesses;
From the communication path leading to the
Provide a direction change passage that opens as a fixture outlet, and
Although the angle of each direction change passage is different, the position of the treatment tool outlet is
And a plurality of types of passage forming pieces having substantially the same shape.
And a fixing member for fixing the path forming piece .