JP3042339B2 - Ultrasound endoscope - 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 endoscope used for medical purposes and the like.

[0002]

2. Description of the Related Art An ultrasonic endoscope is provided with an endoscope observation mechanism and an ultrasonic observation mechanism at a distal end of an insertion portion to be inserted into a body cavity. It is as shown in. In the drawing, reference numeral 1 denotes an insertion portion, an endoscope observation mechanism 2 is provided on a distal end main body 1a of the insertion portion 1, and an ultrasonic observation mechanism is provided in front of the endoscope observation mechanism 2. 3 are provided. An angle portion 1b and a flexible portion 1c are sequentially connected to the distal end portion main body 1a, and the flexible portion 1c is provided so as to be connected to the main body operation portion 4.

Next, FIGS. 13 and 14 show a distal end portion of the insertion portion 1. FIG. As is clear from these drawings, the endoscope observation mechanism unit 2a is a flattened endoscope observation mechanism mounting unit 2a formed by chamfering a part of the side surface of the main body operation unit 1a.
Is formed by providing an illumination window 10 and an observation window 11. As is well known, the illumination window 10 is provided with an illumination lens for emitting illumination light supplied from the light source device via the light guide, and the observation window 11 is provided with an objective lens. At the image forming position of the objective lens, a solid-state image pickup device such as an incident end of an image guide or a CCD camera is arranged. Further, a treatment tool lead-out portion 12 for leading out forceps and other treatment tools is provided at a position in front of the observation window 11 in the endoscope observation mechanism mounting portion 2a.
In addition, an air / water supply nozzle 13 that supplies a cleaning fluid toward the observation window 11 is opened at a step portion in the chamfered portion. Although the endoscope observation mechanism section 2 shown in the figure is of a side-view type whose endoscope observation field is in a direction orthogonal to the axis of the insertion section 1, an endoscope observation mechanism mounting section is inserted. By inclining the endoscope 1 at a predetermined angle with respect to the axis thereof, the observing field of the endoscope observation can be made obliquely forward (or backward).

The ultrasonic observation mechanism section 3 has a distal end cap 20 provided so as to protrude from the distal end surface of the distal end portion main body 1a. In the distal end cap 20, an ultrasonic vibrator 21 is provided.
It is provided in a state where it is installed on the support base 22. A flexible shaft 23 composed of a close-contact coil is connected to the support base 22.
Is guided from the insertion section 1 to the inside of the main body operation section 4 and is rotated about an axis by a rotation driving means 24 (or a manual operation or the like) such as a motor, so that the ultrasonic transducer 21 is rotated.
Is rotated by remote control. The portion of the flexible shaft 23 that has come out of the distal end body 1a is inserted through the flexible tube 25.

The ultrasonic endoscope configured as described above is
The insertion portion 1 is guided to a predetermined location in the body cavity, and an inspection is performed by the endoscope observation mechanism 2, and the ultrasonic vibrator 21 in the ultrasonic observation mechanism 3 is placed at the affected part or other predetermined site according to the result or the like. By rotating and driving, it is possible to acquire information on a tissue slice in the body. Then, the information on the in-vivo tissue tomography by the ultrasonic transducer 21 is displayed as an ultrasonic image on the monitor device after subjecting the reflected echo signal to predetermined signal processing.

[0006]

By the way, in the conventional ultrasonic endoscope, the ultrasonic observation field of view of the ultrasonic observation mechanism 3 is in a direction orthogonal to the axis of the insertion section 1. Therefore, as described below, the operability of the ultrasonic observation mechanism is not always good.

[0007] First, the state inspection sites in the upper gastrointestinal tract, for example in the ultrasonic endoscope for stomach, as shown in FIG. 15, with its field of view of the endoscope observation mechanism stomach corners p ₁ by examining in this affected area gastric corners p ₁ is found, when attempting to ultrasonic diagnostic for this site in intact, directing ultrasonic observation viewing the gastric corners p ₁ And the insertion section 1 must be moved. Here, since the inner wall of the stomach corners p ₁ has a concave curvature shape, even if the ultrasonic observation field as was located in the stomach corners p _1, the ultrasonic observation field of view with respect to gastric corners p ₁ Therefore, an ultrasonic tomographic image orthogonal to the inner wall of the body cavity cannot be obtained.

Further, since the esophagus is a thin body cavity tube, if the esophagus is to be placed in an endoscope observation field of view, as shown in FIG. by pressing, to have a predetermined distance with respect to the inner wall of the body cavity p ₂ to be tested the observation window. Therefore, the axis of the distal end portion main body 1a is inclined at a predetermined angle with respect to the esophagus. Here, the hard portion at the distal end of the insertion portion 1 is not limited to the distal end main body 1a.
The portion of the distal end cap 20 that constitutes the ultrasonic observation mechanism 3 protruding from a is also a hard portion, so that the hard portion at this tip is directed obliquely with respect to the axis of the body cavity tube. ultrasound observation field of view is not a direction perpendicular to the inner wall of the body cavity p _2.

Furthermore, as in the duodenum, as shown in FIG. 17, part p ₃ consisting cholangiopancreatography opened to the nipple
, Since it is inclined with respect to the duodenum, the add this site p ₃ in the ultrasonic field of view by the ultrasound observation mechanism, with curving larger angle portion 1b, you are necessary to move the insertion portion 1 Therefore, there is a problem that operability is extremely deteriorated.

[0010] In short, in the conventional ultrasonic endoscope, the ultrasonic observation field of view is in a direction orthogonal to the axis of the insertion portion, so that it is not necessarily reasonable for the operation of performing ultrasonic observation. It is not a simple configuration. The present invention has been made in view of such disadvantages of the related art, and has as its object to bring an ultrasonic observation field of view closer to an endoscope observation field and to perform observation under an endoscope observation mechanism. It is an object of the present invention to make it possible to easily perform ultrasonic observation of a necessary part by using the method.

[0011]

In order to achieve the above-mentioned object, the present invention relates to an ultrasonic vibrator in an ultrasonic observation mechanism protruding from a distal end main body of an insertion portion and a rotation axis of the ultrasonic vibrator. , It is arranged so as to be inclined at a predetermined angle so as to face the direction of the visual field of the endoscope observation mechanism with respect to the axis of the insertion portion , and the ultrasonic observation field by the ultrasonic vibrator.
Connection between the insertion section and the body operation section to control the direction of
In this configuration, a rotation mechanism capable of reciprocating at a predetermined angle is provided in the section.

[0012]

In the ultrasonic endoscope, since the ultrasonic observation mechanism is mounted at a position in front of the main body of the distal end portion of the insertion section, the field of view of the endoscope observation is in a direction perpendicular to the axis of the insertion section. ,
That is, the endoscope is a side-viewing endoscope or a perspective endoscope having a predetermined angle with respect to a direction orthogonal to the axis of the endoscope.
By using a wide-angle lens, the endoscope observation field of view
Although a certain wide viewing field can be obtained, the endoscope viewing field and the ultrasonic observation field are separated from each other by a predetermined distance in the axial direction, regardless of whether they are of a side-view type or a perspective type.
The ultrasonic beam transmitted from the ultrasonic transducer into the body is narrowed down to an extremely small beam diameter in order to enhance directivity, and the ultrasonic observation field of view cuts the body in a fixed plane. However, the cut surface in the body is determined by the angle with respect to the axis of the insertion portion of the ultrasonic transducer.

First, since the ultrasonic observation field of view is located ahead of the center line of the endoscope observation field in the axial direction of the insertion portion, the ultrasonic observation field can be brought closer to the endoscope observation field. The scanning can be performed on an ultrasonic tomographic plane including a substantially central portion of the endoscope observation field of view. This is achieved by tilting the ultrasonic vibrator and the rotation transmitting member that rotationally drives the ultrasonic vibrator toward the viewing direction of the endoscope observation mechanism with respect to the axis of the insertion section. In addition, by inclining the direction of the ultrasonic transducer with respect to the axis of the insertion section, in a narrow body cavity tube, to obtain an endoscope observation field of view,
When the angle portion is curved and the distal end body is tilted with respect to the body cavity tube, the rotation axis of the ultrasonic transducer becomes substantially parallel to the body cavity tube, and while obtaining the endoscope observation field of view, An ultrasonic tomographic image in a direction substantially orthogonal to the body lumen can be obtained. Also, when performing an ultrasonic examination on a concavely curved part such as a stomach corner, the concavely curved part is placed in the field of view of the endoscope and is directed toward the center line of the observation field of view. Moreover, an ultrasonic tomographic image in a direction orthogonal to the inner wall of the body cavity can be obtained. And ultrasonic vibration like this
The tip cap for accommodating the rotor is tilted with respect to the axis of the insertion section.
Direction, there is a direction at the tip of the insertion section.
Become so. Therefore, it is within the endoscope observation field of view.
Depending on the condition of the inner wall of the body cavity, the tip
When the ultrasonic vibrator is operated with the
The tomogram is more inclined to the inner wall of the body cavity
In some cases. Therefore, the insertion section and the main body operation section
By operating the rotating mechanism between them,
It is possible to easily adjust the direction of the ultrasonic transducer. Furthermore, it is extremely easy to insert the insertion portion into the duodenum and insert the pancreatic bile duct, which is inclined in the insertion direction from a direction perpendicular to the insertion direction, into the ultrasonic observation field of view.
At this time, the rotating mechanism must be operated as necessary.
Therefore, the direction of the ultrasonic transducer can be adjusted.

[0014] In short, when examining the upper digestive organ, the ultrasonic observation field is set so as to have a predetermined angle with respect to the axis of the insertion portion, and to face the center line of the endoscope observation field. In addition, to provide an ultrasonic observation mechanism,
There are many advantages. In addition, since the ultrasonic observation mechanism is continuously provided at the distal end of the insertion portion, the rigid portion at the distal end portion of the insertion portion becomes longer, but in the case of the upper digestive organ, the stomach corner and the pylorus in the throat and stomach. There is a part such as a part that changes direction in a curved state. When inserting the insertion portion having a long hard portion at the tip into such a turning portion, the rotating mechanism is appropriately operated so that the ultrasonic observation mechanism is tilted in the turning direction. Thus, it is possible to smoothly pass through the direction changing portion, and at the same time, it is possible to reduce the pain of the patient at that time.

[0015]

Embodiments of the present invention will be described below in detail with reference to the drawings. First, FIG. 1 shows an external appearance of a distal end portion of an insertion portion of an ultrasonic endoscope, and FIG. 2 shows an XX section thereof. In these figures, reference numeral 30 denotes an insertion portion, and a distal end portion of the insertion portion 30 becomes a distal end main body 31, and an angle portion 32 is continuously provided on the base end side of the distal end main body 31. The base portion of the angle portion 32 is a flexible portion, and the flexible portion is connected to the main body operation portion. However, since these structures are well known, illustration and description thereof are omitted. .

The distal end main body 31 is formed with an endoscope observation mechanism mounting portion 31a by chamfering a side surface thereof. The endoscope observation mechanism mounting portion 31a has an illumination window 33 and an observation window. 34 are provided. In addition, a treatment tool lead-out part 35 for leading out a treatment tool such as forceps is provided at a position forward of the mounting portion of the observation window 34, and the observation window 3 is provided at a rear position.
An air / water supply nozzle 36 for cleaning the nozzle 4 is provided. In these respects, there is no particular difference from the prior art.

A connecting portion 31 is provided at the distal end of the distal end main body 31.
b is protruded, and a distal end cap 40 is fitted to the connecting portion 31b. The tip cap 40 is formed of a resin material having good acoustic characteristics, and a support 41 is provided in the tip cap 40.
An ultrasonic vibrator 42 is mounted therein, and an acoustic medium such as liquid paraffin is enclosed. Here, the ultrasonic transducer 42 is for performing radial scanning, and for this purpose, a rotating shaft 43 is connected to the support table 41. The rotating shaft 43 is rotatably supported by a bearing 44 at a connecting portion 31b of the distal end main body 31 and extends through the connecting portion 31b. A flexible shaft 45 composed of a close-coil coil is connected to the shaft. The flexible shaft 45 passes through the insertion passage 37 formed inside the distal end portion main body 31 and is guided into the main body operation unit via the angle portion 32 and the flexible portion. The base end portion is inserted into the flexible tube 46, and the base end portion is connected to a rotation driving means such as a motor, and is driven to rotate around its axis by the rotation driving means. It has become.

Here, the ultrasonic vibrator 42 constituting the ultrasonic observation mechanism, its support 41, and this support 41
Axis A _{1 of} the rotating shaft 43 and the tip cap 40 connected to
It is inclined by a predetermined angle θ relative to the axis A ₂ of the insertion portion 30. The inclination direction is a direction toward the endoscope observation mechanism mounting portion 31a provided on the distal end main body 31. As described above, in order to incline the ultrasonic observation mechanism, the insertion passage 37 provided in the distal end main body 31 is a straight passage portion 37a in a straight line from the angle portion 32 side to a predetermined portion. , An inclined passage portion 37b which is inclined from the middle by the angle θ. The flexible shaft 45 extends from the straight passage portion 37a into the inclined passage portion 37b, and is connected to the rotating shaft 43 in the inclined passage portion 37b or at a position derived from the inclined passage portion 37b.

Here, in the distal end main body 31, the portion where the illumination window 33 and the observation window 34 are provided has the highest filling rate, and each member is provided with the endoscope observation mechanism mounting portion 31a.
It is on the side biased side. By inclining the insertion passage 37 through which the flexible shaft 45 is inserted from the front end side, as shown in FIG.
1, the portion provided with the endoscope observation mechanism can be bypassed, and the space in the distal end body 31 can be effectively utilized.

The ultrasonic endoscope having the above-described configuration allows the endoscope observation and the ultrasonic observation to be performed by inserting the insertion portion 30 into a predetermined portion in the body cavity. here,
The portion from the distal end main body 30 to the distal end cap 40 of the insertion portion 30 is substantially a hard portion, and the hard portion has a considerable length. Therefore, when inserting the insertion portion 30 having such a long distal end hard portion into a body cavity, it is difficult to pass through a curved path, such as a turning portion, and the patient suffers pain. It can be a compelling result.

However, since the tip cap 40 is tilted at an angle θ with respect to the tip body 31, for example, when passing through the throat, as shown in FIG. By turning the insertion path in the bent direction, a predetermined angle of attraction is provided, so that the insertion path can be smoothly inserted into such a bent path such as the throat. Further, the outer diameter of the distal end cap 40 is smaller than the outer diameter of the distal end main body 31, and is directed from the position opposite to the endoscope observation mechanism mounting portion 31 a toward the endoscope observation mechanism mounting portion 31 a. As shown in FIG. 5, the tip cap 40 does not protrude from the outer diameter of the insertion portion 30 because it is inclined. Therefore, when the stenosis is passed through the stenosis, the stenosis is not unnecessarily expanded. Also, when inserting the esophagus into the corner of the stomach and further guiding it to the duodenum via the pyloric part of the stomach, the tip cap 40 is directed in the direction in which the same path is bent, so that it can pass through these turning parts smoothly. Can be.

Therefore, when the esophagus is inspected, the insertion portion 30 is inserted into the esophagus as shown in FIG. 6, and the angle portion 32 is bent by a predetermined angle. Curving direction of this angle portion 32 is a direction to separate the illumination window 33 and observation window 34 from the site P ₁ to be examined in the esophagus. Thereby, the observation field of view by the observation window 34 is secured. Then, the distal end body 31 with respect to the esophagus
Is bent, the tip cap 40 containing the ultrasonic vibrator 42 becomes straight with respect to the esophagus. Therefore,
The ultrasonic vibrator 42 is driven to rotate, an ultrasonic pulse is transmitted at a predetermined angle during this time, and a reflected echo from the body is received, so that an ultrasonic observation field S in a direction substantially orthogonal to the inner wall of the esophagus is obtained. ₁ is obtained.

Next, when positioning the insertion section 30 to the position shown in FIG. 7, an observation window 34 and the ultrasonic vibrator 42 toward the stomach corner P _2, the positional relationship becomes substantially V-shape It will be in the state of having it. Thus, while taking the gastric corner P ₂ in the observation field through the observation window 34, by rotating the ultrasonic transducer 42, the direction of the ultrasonic field of view S ₂ perpendicular to the gastric corner P ₂ You can get it.

Then, as shown in FIG.
Into the duodenum, where the papilla P ₃
In case that is located at the center of the observation field by the observation window 34, the direction of the ultrasonic field of view by the ultrasound transducer 42 becomes S _3. Since this direction is the direction of cholangiopancreatography, while observing the site of entrance of the papilla P ₃ through the observation window 34, a treatment instrument outlet 35 of the treatment instrument C of the cannula or the like from the papilla P ₃ to pancreaticobiliary tube At the time of guiding, by acquiring an ultrasonic tomographic image of the ultrasonic transducer 42 in this direction, it is possible to determine to which depth position the treatment instrument C has been inserted and which direction the pancreatic duct or bile duct has been inserted in. Confirmation can be performed.

By the way, in the stomach inner wall as described above, FIG. 9
A site concavely curved, yet in performing ultrasonic observation at a site indicated by P ₄ relatively no depth as,
First were facing the side on which the observation window 34 is provided at a portion P _4, without to take into endoscopic observation within the field of view, then, rotating the entire insertion portion 30 to the 180 ° axis. Thus, tip cap 40 with a built-in ultrasonic vibrator 42 is substantially parallel with the inner wall of the sites P _4. Therefore, if the rotational driving the ultrasonic transducer 42 in this state, the direction of the ultrasound observation field of view becomes S _4, against the body cavity wall, the direction of the ultrasonic image is obtained that is substantially orthogonal.

As described above, the entire insertion section 30 is inserted into the body cavity 1
In order to rotate about the 80 ° axis, the connecting portion between the insertion section 30 and the main body operation section has a rotation mechanism as shown in FIGS. 10 and 11 . That is, the rotary cylinder 50 is connected to the insertion section 30 and is rotatably inserted into the holding cylinder 51 extended from the main body operation section. An operation ring 52 is fixedly provided on the rotary cylinder 50, and the operation ring 52 is extended so as to cover the holding cylinder 51 at a predetermined interval. Thus, when the operation ring 52 is rotated, the rotating cylinder 50 and the insertion portion 30 are rotated around the axis following the rotation. Here, if the rotation angle of the insertion portion 30 is not regulated,
Is twisted in the member inserted into the member. In order to avoid such a situation, a pin 53 is attached to the holding cylinder 51, and the pin 53 is engaged with a concave groove 54 formed in a circumferential direction on the outer peripheral surface of the rotary cylinder 50. What is necessary is just to comprise so that the concave groove 54 may be formed only for the angle of 180 degrees.

In the above-described embodiment, the ultrasonic endoscope is mainly used for examining the upper digestive organ, but it goes without saying that it can be used for examining other parts. No. Also, the insertion passage provided in the distal end portion main body and through which the flexible shaft is inserted is divided into a straight passage portion and an inclined passage portion. However, the insertion passage can be constituted only by the inclined passage portion, and the entire passage is curved. It may be. Then, the rotation shaft connected to the ultrasonic transducer and the flexible shaft inserted into the insertion portion can be connected via transmission means such as gears. Further, the observation window in the endoscope observation mechanism is of a so-called side-view type in a direction orthogonal to the axis of the insertion portion, but may be of a front or rear perspective type. Furthermore, the present invention can also be applied to an ultrasonic endoscope that does not have a treatment tool lead-out section or the like.

[0028]

As described above, according to the present invention, the ultrasonic vibrator and the rotational axis of the ultrasonic vibrator are directed toward the viewing direction of the endoscope observation mechanism with respect to the axis of the insertion portion. Attach only by an angle and use an ultrasonic transducer
Insertion unit and main unit to control the direction of the ultrasonic observation field of view
A rotation mechanism that can reciprocate at a predetermined angle at the connection with the operation unit
With this configuration, the ultrasonic observation field of view is brought closer to the direction of the endoscope observation field of view, and under the observation by the endoscope observation mechanism, the necessary parts in the endoscope observation field can be easily observed by ultrasonic observation. Yes, and a tip cap from the tip body
Required depending on the relationship between the projection direction of the
May not be able to obtain a perfect ultrasonic tomographic image.
Even in a situation, by operating the rotating mechanism,
This has the effect that the direction of the ultrasonic transducer can be easily adjusted .

[Brief description of the drawings]

FIG. 1 is an external view of a distal end portion of an insertion section of an ultrasonic endoscope showing one embodiment of the present invention.

FIG. 2 is a sectional view taken along line XX of FIG.

FIG. 3 is a sectional view taken along line YY of FIG. 1;

FIG. 4 is an operation explanatory view showing a state where the ultrasonic endoscope of FIG. 1 is inserted into a body cavity through a throat.

FIG. 5 is an external view as viewed from the distal end side of the insertion portion.

FIG. 6 is an operation explanatory view showing a state in which an examination of the esophagus is performed by the ultrasonic endoscope in FIG. 1;

FIG. 7 is an operation explanatory view showing a state in which the inside of the stomach is inspected by the ultrasonic endoscope of FIG. 1;

FIG. 8 is an operation explanatory view showing a state in which the duodenum is inspected by the ultrasonic endoscope in FIG. 1;

FIG. 9 is an operation explanatory view showing a state in which a different part from that of FIG. 7 is inspected inside the stomach by the ultrasonic endoscope of FIG. 1;

FIG. 10 is a half sectional view showing a configuration of a rotation mechanism of the insertion section around the axis.

11 is a sectional view taken along the line ZZ of FIG.

FIG. 12 is a schematic configuration diagram of an ultrasonic endoscope.

FIG. 13 is an external view of a distal end portion of an insertion portion of an ultrasonic endoscope according to a conventional technique.

FIG. 14 is a sectional view taken along line NN of FIG. 12;

FIG. 15 is an operation explanatory view showing a state in which the inside of the stomach is inspected by an ultrasonic endoscope according to a conventional technique.

FIG. 16 is an operation explanatory view showing a state in which an examination of the esophagus is performed by a conventional ultrasonic endoscope.

FIG. 17 is an operation explanatory view showing a state in which a duodenum is inspected by an ultrasonic endoscope according to a conventional technique.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 30 Insertion part 31 Tip part main body 31a Endoscope observation mechanism mounting part 33 Illumination window 34 Observation window 37 Insertion path 37a Straight path part 37b Inclined path part 40 Tip cap 42 Ultrasonic transducer 43 Rotation axis 45 Flexible shaft

Claims (5)

(57) [Claims] 1. An endoscope body provided with an endoscope observation mechanism having an illumination window and an observation window is provided at an end of an insertion portion connected to a main body operation unit, and an ultrasonic vibrator is rotatable in a front end cap. Attached, an ultrasonic observation mechanism that performs ultrasonic scanning by this ultrasonic vibrator is protruded from the tip main body ,
And the ultrasonic vibrator and the rotational axis of the ultrasonic vibrator, to face the sight schematic endoscopic observation mechanism relative to the axis of the insertion portion, and the configuration of providing inclined by a predetermined angle
Ultrasonic observation by the ultrasonic transducer
In order to control the direction of the field of view, the insertion section and the body
A rotation mechanism that can reciprocate at a predetermined angle is installed at the connection with the working part.
An ultrasonic endoscope characterized in that the endoscope is configured to be mounted . 2. A rotation transmitting member for rotationally driving the ultrasonic vibrator is formed of a flexible shaft made of a close-coil coil, and a tip portion of the flexible shaft is bent. 2. The ultrasonic endoscope according to 1. 3. The tip end body according to claim 2, wherein the flexible shaft is provided with an inclined passage for leading the flexible shaft at a predetermined angle with respect to the axis of the tip end body. Ultrasound endoscope. 4. The rotation mechanism is connected with the insertion portion.
Rotating cylinder, and a holding cylinder extending from the main body operation unit.
And insert this rotary cylinder into the holding cylinder,
In order to regulate the rotation angle of the rotating cylinder to almost 180 °,
The holding cylinder has a concave groove, and the rotary cylinder has this concave groove.
Claims characterized by providing a pin to be engaged
Item 7. The ultrasonic endoscope according to Item 1. 5. The outer diameter of the tip cap is adjusted to the length of the tip portion.
Smaller than the outside diameter of the body
The tip cap in the closed state is located outside the tip body.
A construction that does not protrude outward from the diameter
The ultrasonic endoscope according to claim 1.