JP3126995B2 - Ultrasonic suction 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 ultrasonic aspirator for performing ablation using an ultrasonic wave and aspirating a resected part.

[0002]

2. Description of the Related Art Conventionally, there is an ultrasonic aspirator that inserts an ultrasonic aspirator into the abdominal cavity transapically to resect and aspirate a lesion site of an organ. In this ultrasonic suction device, together with an endoscopic image of an ultrasonic laparoscope, the ultrasonic suction device reaches a lesion site in the abdominal cavity while observing an ultrasonic tomographic image,
Press the tip of the ultrasonic aspirator against the lesion site. Then, under observation of an endoscopic image and an ultrasonic tomographic image, ultrasonic waves are transmitted from the distal end of the ultrasonic aspirator to the lesion site, the lesion is emulsified, and connected to the rear end side of the ultrasonic aspirator. The lesion was suctioned by the suction pump. As described above, by observing the endoscope image and the ultrasonic tomographic image, excessive excision and aspiration are not performed, and the blood vessels and the like are prevented from being erroneously excised.

[0003]

However, the conventional ultrasonic aspirator not only operates the ultrasonic aspirator to aspirate and resect a lesion, but also always pays attention to an endoscopic image and an ultrasonic tomographic image. The operator has to pay attention to both the operation of the ultrasonic aspirator and the screen in order to ensure safety. For this reason, there is a drawback that the operator is distracted by one of them and performs excessive resection.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned points, and an ultrasonic suction apparatus capable of quickly and easily performing tissue resection and suction of a lesion site using an ultrasonic suction device and preventing excessive resection. It is intended to provide.

[0005]

SUMMARY OF THE INVENTION An ultrasonic oscillator oscillates under observation of at least one of an endoscope image and an ultrasonic image obtained by an ultrasonic endoscope provided with an ultrasonic probe. The excision of the test site is performed by
An ultrasonic suction device having an ultrasonic suction device for performing suction of a resection site, wherein a detection unit that detects an ultrasonic wave emitted by an ultrasonic probe of the ultrasonic endoscope and outputs a signal includes: An ultrasonic probe of the ultrasonic endoscope, or an ultrasonic probe provided to the ultrasonic suction device, or one of them, and the ultrasonic wave of the ultrasonic suction device is changed according to a signal output by the detection means. A vibrator driving means for driving or stopping the vibrator is provided.

[0006]

The vibrator driving means of the ultrasonic suction device drives the ultrasonic vibrator of the ultrasonic suction device when the detecting means does not detect the ultrasonic wave emitted by the ultrasonic probe of the ultrasonic endoscope. In a possible state, and receiving a signal that the detection means has detected the ultrasonic wave emitted by the ultrasonic probe of the ultrasonic endoscope,
The oscillation of the ultrasonic transducer of the ultrasonic suction device is stopped.

[0007]

Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 relate to a first embodiment of the present invention.
2 is a schematic overall configuration diagram of the ultrasonic suction device, and FIG. 2 is an explanatory diagram showing the operation of the device shown in FIG.

An ultrasonic suction device 1 shown in FIG. 1 includes a suction probe 2 as an ultrasonic suction device, a driving device 3 as driving means for controlling driving and stopping of an ultrasonic vibrator described later, and not shown. The apparatus includes a suction bottle, a suction pump, a water supply tank, and a suction / water supply device (not shown) in which a water supply pump is provided.

On the other hand, the ultrasonic suction device 1 is used for observing an endoscopic image and an ultrasonic tomographic image obtained by an ultrasonic endoscope and an ultrasonic diagnostic device, which will be described later, in order to find the position of a lesion in the body. In the above, a lesion is excised using the ultrasonic vibration of the suction probe 2 and a excised portion is suctioned and removed by the suction pump. The ultrasonic endoscope is provided with an ultrasonic probe 12 at an insertion end portion 11 (shown in FIG. 2), and the ultrasonic probe 12 is connected to an ultrasonic diagnostic device 13. The transmission and reception of ultrasonic waves are performed. The ultrasonic diagnostic apparatus 13 includes the ultrasonic probe 12
In contrast, for example, a known linear scan is performed and an ultrasonic tomographic image is obtained using a pulse compression technique.

The suction probe 2 has a probe body 4 having an ultrasonic transducer (not shown) provided therein, and a probe body 4 inserted through the probe body 4 and protruding from the front end side of the probe body 4. ), Which is connected to and communicates with an elongated ultrasonic suction tube 5 made of metal and having a high ultrasonic transmission efficiency at the rear end side of the probe main body 4 and inserted into the ultrasonic suction tube 5. And a flexible suction line 6. The suction line 6 is connected to a suction pump of the suction water supply device. Then, a tube tip 5a of the ultrasonic suction tube 5 is connected to the suction pump via the suction bottle. The ultrasonic vibrator of the suction probe 2 is provided in the probe main body 4 so as to transmit ultrasonic vibration to the ultrasonic suction tube 5. The distal end portion 5a of the ultrasonic suction tube 5 is brought into contact with a lesion site in a body cavity to transmit ultrasonic vibration to the lesion site.

The suction probe 2 comprises a probe body 4
A water supply pipe 7 having a diameter larger than the outer diameter of the ultrasonic suction pipe 5
a in the axial direction, the ultrasonic suction tube 5 is inserted therethrough, and a sheath 7 having a rear end portion connected to the probe main body 4 is provided. The sheath 7 is connected to the ultrasonic suction tube 5.
While it is formed slightly shorter,
A water supply mouthpiece 7b communicating with the water supply pipe 7a is provided. The base 7b connects a water supply line (not shown), and the water supply line communicates with the water supply pump via a water supply tank of the suction water supply device. Therefore, the water in the water supply tank is supplied from the sheath distal end portion 7c of the sheath 7 by the air supply from the air supply pump. Further, an ultrasonic sensor 8 as detecting means for detecting ultrasonic waves emitted from the ultrasonic probe 12 is provided on the outer periphery of the sheath distal end portion 7c of the sheath 7.

The driving device 3 generates a high-frequency current to excite the ultrasonic transducer of the suction probe 2 to generate ultrasonic waves from the ultrasonic transducer, and an ultrasonic sensor. And a drive control circuit 10 for controlling the drive of the drive circuit 9 in accordance with the signal output from the drive circuit 8. The drive control circuit 10 stops the drive circuit 9 when the ultrasonic sensor 8 detects the ultrasonic wave emitted by the ultrasonic probe 12 and stops the excitation of the ultrasonic transducer of the suction probe 2. ing.

With this configuration, as shown in FIG. 2, a description will be given of a case in which a lesion 16 in the body, for example, a tumor 16 generated in the liver 15 is to be resected and aspirated by the ultrasonic probe 2. First, by observing an endoscopic image and an ultrasonic tomographic image, the position of the tumor 16 generated in the liver 15 is searched,
The ultrasonic scanning surface C of the ultrasonic probe 12 of the ultrasonic endoscope
Position the insertion tip 11 of the ultrasonic endoscope so that it is located at the end of the tumor 16. Next, the suction probe 2
Is pressed against the tumor 16. The ultrasonic vibrator in the suction probe 2 is excited with the tube tip 5a of the ultrasonic suction tube 5 in contact with the tumor 16. The ultrasonic vibration of the ultrasonic transducer in the suction probe 2 is transmitted to the tumor 16 via the ultrasonic suction tube 5, and the tumor 16 is gradually emulsified. The emulsified tissue is sucked through the ultrasonic suction tube 5 into the suction bottle of the suction water supply device. At this time, water is supplied from the water supply pipe 7a of the sheath 7 to the tissue that is being emulsified, and this water supply has a role of cooling the ultrasonic suction pipe 5 and promoting suction of the emulsified tissue.

If the tip of the suction probe 2 is displaced during the treatment and moves to the ultrasonic scanning plane C of the ultrasonic probe 12, the ultrasonic sensor 8 provided at the sheath distal end 7c Detects sound waves. At this time, the drive control circuit 10
Receives the detection signal of the ultrasonic sensor 8, stops the drive circuit 9, and stops the excitation of the suction probe 2.

In this embodiment, if the ultrasonic scanning surface C of the ultrasonic probe 12 is disposed at or near the boundary between the lesion and normal tissue, the ultrasonic sensor 8 of the suction probe 2 will Upon reaching the scanning plane C, the ultrasonic vibration of the ultrasonic transducer of the suction probe 2 can be stopped. Accordingly, the operator of the present ultrasonic suction apparatus 1 is less likely to inadvertently perform excessive resection of normal tissue, and does not need to always pay attention to the ultrasonic tomographic image. The burden can be reduced.

The mounting position of the ultrasonic sensor 8 may be in the middle of the sheath 7. In this case, it is necessary to shift the position of the ultrasonic scanning surface C to an appropriate position for positioning.
That is, in any case, it is only necessary to detect that the position of the tube tip 5a of the ultrasonic suction tube 5 has moved to a position other than the necessary resection site. In addition, water supply mouth 7b
May be provided at the rear end of the probe main body 4 to improve the insertability.

FIG. 3 is an external view of a sheath distal end showing a modification of the first embodiment. In addition, the same configurations and operations as those in the first embodiment are denoted by the same reference numerals, and description and illustration are omitted. The sheath 7A shown in FIG. 3 is different from the sheath 7 of the first embodiment in that one ultrasonic sensor 8 is provided, but a plurality of ultrasonic sensors 20 as detecting means are provided over the entire outer periphery of the sheath distal end portion 7c. It is arranged. The plurality of ultrasonic sensors 20 are connected to the drive control circuit 10 of the drive device 3, respectively. The drive control circuit 10 stops the drive circuit 9 when any one of the plurality of ultrasonic sensors 20 detects an ultrasonic wave emitted from the ultrasonic probe 12. The ultrasonic sensor 20 may be arranged, for example, three sensors uniformly on the outer periphery in addition to being arranged over the entire periphery of the sheath distal end portion 7c.

In this embodiment, the suction probe 2
Regardless of the direction in which the ultrasonic probe 12 is located, the ultrasonic sensor 20 of the suction probe 2 detects the ultrasonic scanning surface C without being shaded with respect to the ultrasonic probe 12. be able to. Therefore, in the present embodiment, the ultrasonic scanning surface C can be detected more effectively than in the first embodiment, and it is safer.

FIG. 4 is a block diagram showing an example in which the ultrasonic sensor shown in FIG. 3 is used in place of the ultrasonic probe. In addition, the same reference numerals are given to the same configurations and operations as those of the first embodiment and the modified example, and the description is omitted. FIG.
The ultrasonic diagnostic apparatus 13 shown in FIG.
Instead of the ultrasonic probe 2, the ultrasonic sensor 20 provided at the sheath distal end portion 7c of the suction probe 2 is connected, and an ultrasonic tomographic image is obtained by transmission and reception of the ultrasonic sensor 20. The drive device 21 has a drive circuit 22 that drives the ultrasonic transducer of the suction probe 2. With this configuration, it is not necessary to insert an ultrasonic endoscope provided with an ultrasonic probe separately from the suction probe 2 into, for example, the abdominal cavity, and the pain of the subject can be reduced.

FIG. 5 is a schematic overall configuration diagram of the apparatus according to the second embodiment. Unlike the first embodiment, the ultrasonic suction device 24 shown in FIG. 5 does not require the ultrasonic sensor 8 and uses the reflected wave of the ultrasonic vibrator 12 instead of the ultrasonic sensor 8 to perform the suction. The excitation of the ultrasonic transducer of the probe 2 is stopped. In addition, the same configurations and operations as those of the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In the ultrasonic probe 12 of the present embodiment, the ultrasonic probe 12 also serves as a detecting means, detects a reflected wave from the sheath 7, and sends it to the ultrasonic diagnostic apparatus 25. It is supposed to be sent. In addition to performing processing for obtaining an ultrasonic tomographic image, the ultrasonic diagnostic apparatus 25 detects the presence or absence of a reflected wave signal from the sheath 7 and stops / drives the drive circuit 9 of the drive device 3A. Is output. The drive circuit 9 of the drive device 3A includes an ultrasonic diagnostic device 25
The excitation of the ultrasonic transducer of the suction probe 2 is controlled in accordance with the control signal output by the controller. That is,
If the sheath 7 is formed of, for example, a strong ultrasonic reflector such as a metal, the intensity of the ultrasonic wave reflected by the sheath 7 is significantly higher than that of a reflected wave from a soft tissue such as a living body. . Therefore, the ultrasonic diagnostic apparatus 25 outputs a control signal for stopping the drive circuit 9 when the received reflected wave becomes a certain level or more. When the suction probe 2 reaches the position of the ultrasonic scanning surface C of the ultrasonic probe 12, the driving circuit 9
Are stopped.

In this embodiment, not only the same effects as in the first embodiment can be obtained, but also a normal suction probe without an ultrasonic sensor can be used.

FIGS. 6 to 8 relate to an apparatus for improving safety when an ultrasonic probe is applied to a resectoscope. FIG. 6 is a schematic overall configuration diagram of a resectoscope and an ultrasonic diagnostic apparatus, FIG. 7 is a schematic block diagram of the ultrasonic diagnostic apparatus, and FIG. 8 is an explanatory diagram showing a display screen of a monitor. The resectoscope 30 shown in FIG. 6 is for performing endoscopic observation of the subject 45 and resecting the test site using a high-frequency current. The retractor scope 30 has an elongated sheath 31 inserted into a body cavity.
And a connecting portion 33 and a scope inserting portion 34 are sequentially provided on the rear end side of the sheath body 32 in sequence, while a sheath body 32 and the scope inserting portion 34 are provided between the sheath body 32 and the scope inserting portion 34. A handle (a rigid endoscope) 36 is provided on which a handle 35 is provided and which can be inserted from a scope insertion portion 34 to observe the front end of the sheath 31. In addition, the electrode scope 37 is inserted into the distal end of the vector scope 30 from the scope insertion section 34. The electrode 37 protrudes from the sheath 31 and is brought into contact with the lesion 46 of the subject 45. The electrode 37 is connected to a high-frequency power supply device 38, while the high-frequency power supply device 38 is connected to a subject electrode 39 that is disposed in close contact with an extracorporeal position corresponding to a lesion 46 of the subject 45. ing. The high-frequency power supply 38 allows the lesion 46 to be excised by passing a high-frequency current between the two electrodes.

On the other hand, the ultrasonic probe 40, the ultrasonic diagnostic apparatus 41, and the monitor 42 obtain an ultrasonic tomographic image of the lesion 46 and automatically stop the high-frequency current supplied by the high-frequency power supply 38. belongs to. FIG. 7 shows a configuration example of the ultrasonic diagnostic apparatus 41. Ultrasonic probe 4
Reference numeral 0 denotes a configuration in which an ultrasonic wave is transmitted by a transmission pulse from a transmission circuit (not shown) of the ultrasonic diagnostic apparatus 41, and a reflected wave from the subject 45 is received and converted into an electric signal. The ultrasonic diagnostic apparatus 41 includes a receiving circuit 51 that receives and amplifies an electric signal (reflected wave signal) of a reflected wave output from the ultrasonic probe 40, and outputs a reflected wave signal amplified by the receiving circuit 51 to a signal. A scan converter 52 for processing and converting it into a standard video signal that becomes an ultrasonic tomographic image, and outputting it to the monitor 42. Further, the ultrasonic diagnostic apparatus 41 generates a pattern signal having a circular shape on the monitor 42 to the scan converter 52, for example.
Pattern generation circuit 5 for outputting to scan converter 52
3, a console 54 for freely designating the shape and size of the pattern generated by the pattern generation circuit 53, the reflected wave signal output by the reception circuit 51, and the pattern generation circuit 5
And a comparison circuit 55 that compares the pattern signal output by the control signal 3 with a control signal to the high-frequency power supply device 38 based on the comparison result. The monitor 42 receives a standard video signal output from the scan converter 52, and superimposes and displays an ultrasonic tomographic image and a pattern.

Here, the electrode 37 is made of metal and is a strong reflector. Since the intensity of the ultrasonic wave reflected by the electrode 37 is significantly higher than the reflected wave from a soft tissue such as a living body, the comparison circuit 55 uses the reflected wave from the electrode 37 and the reflected wave from the living tissue. Can be identified. Therefore, the comparison circuit 55 outputs a control signal to the high-frequency power supply device 37 for stopping the supply of the high-frequency current when the electrodes 11 match or go out of the pattern from the circular pattern.

With this configuration, the subject 4
After confirming the position of the lesion 46 in FIG. 5, the ultrasonic probe 40 is positioned at a position facing the lesion 46 as shown in FIG. FIG. 8 shows a display screen 42A of the monitor 42 displaying the ultrasonic tomographic image 60 at the position of the arrow A shown in FIG.
Is shown. The ultrasonic tomographic image 60 includes the lesion 46
And the dotted line indicated by the symbol B indicates the pattern generation circuit 5
3 is a pattern generated in FIG. By operating the console 54,
The shape, size, and position of the pattern B are set, for example, in the ultrasonic tomographic image 60 of the lesioned part 46 to a position and a range that require resection. The operator operates the vector scope 30
While the lesion 46 is being excised by operating the
Is to be out of the pattern B, the supply of the high-frequency current is stopped. Therefore, it is possible to prevent the operator from performing excessive excision or excessive cautery hemostasis without excision other than the necessary excision site. Further, the operator need not always pay attention to the ultrasonic tomographic image, and the burden on the operator can be reduced. The site to be resected is, for example, a prostate or a tumor in the uterus.

[0027]

As described above, according to the present invention, tissue resection and suction of a lesion site by an ultrasonic suction device can be performed quickly and easily, and safety can be improved by preventing excessive resection. This has the effect.

[Brief description of the drawings]

FIG. 1 is a schematic overall configuration diagram of an ultrasonic suction apparatus according to a first embodiment.

FIG. 2 is an explanatory diagram showing the operation of the device shown in FIG. 1;

FIG. 3 is an external view of a distal end of a sheath showing a modification of the first embodiment.

FIG. 4 is a configuration diagram showing an example in which the ultrasonic sensor of FIG. 3 is substituted for the ultrasonic probe.

FIG. 5 is a schematic overall configuration diagram of an apparatus according to a second embodiment.

FIG. 6 is a schematic overall configuration diagram of a resectoscope and an ultrasonic diagnostic apparatus.

FIG. 7 is a schematic block diagram of an ultrasonic diagnostic apparatus.

FIG. 8 is an explanatory diagram showing a display screen of a monitor.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic suction device 2 ... Suction probe 3 ... Drive device 5 ... Ultrasonic suction tube 8 ... Ultrasonic sensor 12 ... Ultrasonic probe 13 ... Ultrasonic diagnostic device

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Takeshi Yokoi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Industrial Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Within Olympus Optical Co., Ltd. (72) Inventor Hiroaki Kagawa 2-43-2, Hatagaya, Shibuya-ku, Tokyo Intra-Olympus Optical Co., Ltd. (72) Tsuyoshi Tsukagoshi, 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. O-Limpus Optical Industry Co., Ltd. (72) Inventor Yoshinao Daiaki 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-Olympus Optical Industry Corporation (72) Inventor Tadao Hagino 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (56) References JP-A-63-281638 (JP, A) JP-A-62-227348 (JP, A) JP-A-63-216558 (JP, A) JP-A-58-192540 (JP, A) JP-A-2-239856 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 8/12 A61B 17/22 A61B 18/00-18/28

Claims (1)

(57) [Claims] An object to be inspected is an ultrasonic wave generated by an ultrasonic transducer under observation of at least one of an endoscope image and an ultrasonic image obtained by an ultrasonic endoscope provided with an ultrasonic probe. An ultrasonic aspirator having an ultrasonic aspirator for performing ablation of an ablation site, and detecting an ultrasonic wave emitted by an ultrasonic probe of the ultrasonic endoscope to generate a signal. Is an ultrasonic probe of the ultrasonic endoscope, or is provided on the ultrasonic aspirator, or one of them, and in accordance with a signal output by the detecting means, An ultrasonic suction device comprising a vibrator driving means for driving or stopping the driving of the ultrasonic vibrator of the ultrasonic suction device.