JP3166541B2 - Ultrasonic inspection equipment - 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 which is inserted into a body cavity to obtain information on a tomographic tissue of the body.

[0002]

2. Description of the Related Art An ultrasonic inspection apparatus to be inserted into a body has a small-diameter insertion section connected to an operation section of a main body, and an ultrasonic vibrator is provided at a tip of the insertion section. The apparatus is configured to be inserted into a patient's body, guide the distal end thereof to a predetermined ultrasonic inspection target section, operate an ultrasonic vibrator, and perform ultrasonic scanning. Here, ultrasonic scanning includes linear scanning in which scanning is performed in a linear direction, radial scanning and sector scanning in which scanning is performed in a rotating direction, and a method in which mechanical scanning in which ultrasonic transducers are mechanically moved is performed. There is also an electronic scanning type in which ultrasonic transducers are arranged in a predetermined direction and these are sequentially operated.

When mechanical scanning is performed in the rotation direction, an ultrasonic vibrator is mounted on a rotating shaft at the tip of the insertion portion, and this rotating shaft is used as a rotation transmitting means, for example, a flexible shaft made of a contact coil or the like. And a rotary drive unit such as a motor is connected to the base end of the flexible shaft. Then, the ultrasonic transducer is rotationally driven by rotating the flexible shaft around the axis by the rotational driving means. Then, the rotation angle of the ultrasonic vibrator is detected by an encoder or the like, and transmission and reception of ultrasonic waves are performed at predetermined angle intervals based on the detection signal. In the ultrasonic inspection apparatus that performs the mechanical scanning in the rotation direction as described above, the rotation axis for rotating the ultrasonic vibrator is generally provided in the axial direction of the insertion portion, and therefore, as a scanning surface thereof, It becomes a plane orthogonal to the axis of the insertion portion.

[0004]

By the way, when a tumor or other affected area is found when an internal examination is performed by an ultrasonic examination apparatus, an injection solution is injected, coagulated by high frequency, or aspirated. And other actions are taken. For this reason, the treatment tool is inserted from the body wall, but it is necessary to monitor with an ultrasonic wave to ensure that the treatment tool reaches the affected part or the like. As described above, since the ultrasonic scanning surface is in the direction orthogonal to the axis of the insertion portion, the treatment tool must be naturally derived from the direction orthogonal to the axis of the insertion portion, that is, the side surface of the insertion portion. Therefore, by providing a treatment instrument raising table at the distal end of the insertion section and guiding the treatment tool while operating the treatment tool raising table by remote operation, the treatment instrument can be oriented in a desired direction. . However, when the treatment instrument raising table is used in this manner, the direction of the treatment instrument changes depending on the elevation angle and the like, and therefore, there is a problem that the aim of the treatment instrument on an affected part or the like deteriorates.

[0005] Further, in order to prevent the treatment instrument raising table from interfering with the rotating portion of the ultrasonic vibrator, it must be disposed at a position deviating from the rotation locus of the ultrasonic vibrator. There is also a disadvantage that the entire derived part cannot be put into the ultrasonic observation field of view.

Further, when the ultrasonic inspection apparatus is configured as an ultrasonic endoscope in which an endoscope observation mechanism is incorporated, a so-called direct-view type in which an observation field of view by the endoscope observation mechanism is directed forward of the insertion portion. In this case, the ultrasonic observation visual field and the endoscope observation visual field do not overlap. Since general treatment tools such as forceps are operated within the endoscope observation field of view, when configured as an ultrasonic endoscope having a direct-view type endoscope observation field, the treatment tool derivation unit Are provided in the direction of the axis of the insertion portion. Therefore, when a puncture treatment tool to be inserted into the body is inserted, there is a problem in that monitoring by ultrasonic waves cannot be performed.

Further, since the inside of the body cavity is narrow, the distal end of the insertion portion can be directed in a desired direction by an angle operation in the body cavity. When ultrasonic scanning is performed in a direction perpendicular to the axis, it is not possible to prevent the occurrence of a blind spot in the depth of the concave body cavity wall or the ultrasonic observation field of view.

In short, when the ultrasonic observation field is oriented in a direction perpendicular to the axis of the insertion section, in view of the above-mentioned various drawbacks, in the present invention, the ultrasonic rotation is performed by the ultrasonic vibrator. It is an object of the present invention to solve the above-described drawbacks and problems of the prior art by directing the scanning direction in front of the insertion section in the scanning in the direction.

[0009]

In order to achieve the above-mentioned object, the present invention provides an endoscope observation unit provided on a distal end surface of an insertion portion inserted into a body cavity or the like, and a distal end of the insertion portion. open to the surface, the puncture instrument having an ultrasonic reflection surface of the concave spherical shape provided on the proximal side of the needle point, the puncture instrument before
And the treatment instrument outlet portion for leading out towards the axial direction of the serial insertion portion, a housing which is provided so as to protrude from the distal end surface of the insertion portion, mounted within the housing, the ultrasonic vibration scanning in the rotational direction And a rotary shaft provided in a direction orthogonal to the axis of the insertion portion to rotationally drive the ultrasonic vibrator.

[0010]

By providing the rotation axis of the ultrasonic vibrator in the direction perpendicular to the insertion portion at the tip of the insertion portion, the ultrasonic scanning direction is directed forward of the insertion portion. Therefore, by turning the distal end of the insertion portion in a desired direction, the back of a narrow place or the like can be included in the range of the ultrasonic observation field.
Further, a treatment tool deriving unit is provided so as to guide the puncture treatment tool from the axial direction of the insertion unit toward the ultrasonic scanning surface, and the affected part in the body is captured within the range of the ultrasonic observation field. Since the puncture treatment tool can be led straight out of the insertion section and inserted into the body wall, it can be surely guided to the affected part. In addition, when an endoscope observation mechanism is provided on the distal end surface of the insertion section, and the endoscope observation mechanism is configured as a direct-view type, the endoscope observation field of view and the ultrasonic observation field of view can be matched. Thus, when a site that may be a lesion is found on the inner wall of the body, it becomes possible to perform an ultrasonic examination on the site without substantially moving the insertion portion.

[0011]

Embodiments of the present invention will be described below in detail with reference to the drawings. In the following description, an ultrasonic endoscope will be described, but the ultrasonic inspection apparatus of the present invention includes:
The present invention is not limited to this, and may not include an endoscope observation mechanism.

FIG. 1 shows the overall configuration of an ultrasonic endoscope. In the figure, 1 is an ultrasonic endoscope main body, 2 is an endoscope observation unit, and 3 is an ultrasonic observation unit. The ultrasonic endoscope 1 includes an insertion portion 10 to be inserted into a body cavity, a main body operation portion 11 connected to a base end of the insertion portion 10, and a universal cord 12 pulled out from the main body operation portion 11. Be composed. The insertion portion 10 is a flexible portion 10a that bends in an arbitrary direction following the insertion path for most of the length from the side of the portion connected to the main body operation portion 11, and the distal end of the flexible portion 10a Is the angle part 10b
However, at the tip of the angle portion 10b, a tip portion main body 10c is provided.
Are sequentially provided. The distal end main body 10c is provided with an endoscope observation mechanism and an ultrasonic observation mechanism, which will be described later. The angle section 10b can be operated at an angle in order to turn the distal end main body 10c in an arbitrary direction. It has a configuration.

The distal end of the universal cord 12 is branched into three, one of which is detachably connected to the light source of the light source / processor 2a constituting the endoscope observation device unit 2. The light source connector 12a is provided. Another one is an electric connector 12b detachably connected to the processor of the light source / processor 2a.
The other is an ultrasonic connector 12c detachably connected to the signal processing unit 3a of the ultrasonic observation apparatus unit 3. The endoscope observation unit 2 and the ultrasonic observation unit 3 further include monitors 2b and 3b for displaying an endoscope image and an ultrasonic image.

FIGS. 2 and 3 show the distal end face of the distal end body 10a and its cross section. As is clear from FIG. 2, an endoscope observation mechanism 20 is provided on an upper side of the distal end surface of the distal end body 10a, and an ultrasonic observation mechanism 30 is provided on a lower side thereof.

The endoscope observation mechanism 20 is provided with an illumination window 21 for irradiating illumination light toward the inside of the body and an observation window 22 for observing the inside of the body under this illumination. A lens is mounted, and a light guide faces the illumination lens. An objective lens is mounted on the observation window 22, and an incident end of a solid-state image sensor or an image guide faces an image forming position of the objective lens. further,
In addition to the illumination window 21 and the observation window 22, a treatment tool deriving unit 23 for deriving the treatment tool is provided, and further, the injection nozzle 2 that supplies a cleaning fluid to the observation window 22.
4 are provided.

The ultrasonic observation mechanism 30 includes a tip main body 10c.
A housing 31 is provided so as to protrude forward from the housing 31, and an ultrasonic vibrator 32 is provided in the housing 31. The ultrasonic vibrator 32 is supported by a rotating member 33. The rotating member 33 has rotating shafts 33a, 33 at both ends thereof.
b, and these rotating shafts 33a, 33b
1 are rotatably mounted on partition walls 31a and 31b via bearings. A cap 35 made of a resin material or the like having excellent acoustic characteristics is mounted between the partition walls 31a and 31b to form a sealed ultrasonic vibrator storage chamber. Child 32
In order to transmit and receive an ultrasonic signal at a time without loss, an ultrasonic transmission medium such as liquid paraffin is filled. The partition 31a and the tip body 10c
Between the position near the end of the tip surface of the second cap 36
Is installed.

From the second cap 36 to the tip body 10c
A rotation transmission means 38 is provided at a portion from the insertion section 10 to the main body operation section 11 through an insertion passage 37 formed in the body. The rotation transmitting means 38 has flexibility by inserting a flexible shaft 38b into a flexible outer sleeve 38a. The flexible shaft 38b is formed by winding a metal wire in the form of a contact coil. When rotating in only one direction, the flexible shaft 38b may be formed by a single contact coil. It is also possible to provide multiple windings by reversing the winding direction, to form a plurality of metal wires at the same time by winding them into multiple strips, or to make them into multiple strips. The flexible shaft 38b is bent by 90 degrees in the vicinity of the distal end, and is connected to the rotating shaft 33a. In addition, the mantle sleeve 38
a is fitted and fixed to the connecting pipe 39 attached to the partition wall 31b .

A signal line for transmitting and receiving signals is connected to the ultrasonic vibrator 32. The signal line is routed to the signal processing section 3a of the ultrasonic observation apparatus unit 3 , but the flexible shaft 38b Is a hollow member, the signal line is inserted through the flexible shaft 38b. Then, the base end of the rotation transmitting means 38 extends into the main body operation unit 11, and as shown in FIG. 4, the end of the outer sleeve 38a is fixed,
The flexible shaft 38b is connected to the hollow rotary shaft 40. A pair of pulleys 41a and 41b are mounted on the hollow rotary shaft 40. One of the pulleys 41a and 41b is connected to an output shaft of a motor 42 for rotational driving. , A transmission belt 43 is wound around and a pulley 41 b is connected to a pulley 44 connected to an encoder 44.
The transmission belt 45 is wound between the transmission belt 45 and the transmission belt 45.

Therefore, when the motor 42 is operated, the hollow rotary shaft 40 rotates, and the flexible shaft 38b is rotated around the axis, whereby the rotational force is transmitted to the rotary member 33 supporting the ultrasonic vibrator 32. The transmission and the rotation angle of the ultrasonic transducer 32 are detected by the encoder 44. In the figure, reference numeral 46 denotes the ultrasonic transducer 32.
And a rotary connector for relatively rotatably connecting a signal line rotating together with the ultrasonic transducer 32 and a signal line on the fixed side.

Rotating member 33 equipped with ultrasonic vibrator 32
Is provided in a direction orthogonal to the axis of the insertion section 10, and the rotation transmitting means 38 is connected to the distal end main body 1.
0c is inserted into an insertion passage 37 provided in the axial direction, and is connected to the rotating shaft 33a. To this end, the rotation transmitting means 38 is turned by approximately 90 ° in the second cap 36. Here, the rotation transmitting means 38 includes a flexible shaft 3 made of a close-contact coil capable of transmitting rotation even in a bent state in a flexible outer sleeve 38a.
8b, the rotation can be reliably transmitted to the rotating member 33 by rotating the base end side portion of the flexible shaft 38b around the axis even if the direction is changed by approximately 90 °. it can. The mantle sleeve 38a
Although it is necessary to provide flexibility at the base end side from the distal end body 10c, the rotation shaft 33a
Up to the point, there is no need to provide exceptional flexibility, and therefore, a rigid pipe can be used for the part of the turning portion of about 90 °. However, regardless of the flexibility, the inner surface of the outer sleeve 38a must be formed of a slippery member.

There are forceps and other various types of treatment tools derived from the above-described treatment tool lead-out section 23, but since they are ultrasonic endoscopes, as shown in FIGS. , A puncture treatment tool 47 having a sharpened needle tip 47a can also be used. When this puncture treatment tool 47 is used, insertion into the body is controlled under monitoring by the ultrasonic observation mechanism 30. The ultrasonic transducer 32, but performs ultrasonic scanning while displacing in the rotational direction as described above, the ultrasonic scanning surface by the ultrasonic transducer 32, Oite <br/> P in FIG. 5 A substantially semicircular surface shown by. On the other hand, the viewing field of the endoscope observation is a substantially conical shape shown by S in FIG. The treatment tool lead-out section 23 is open within the range of the ultrasonic scanning plane P, and as a result, the treatment tool led out from the treatment tool lead-out section 23 falls within the range of the ultrasonic observation field. However, even if the treatment tool deriving unit 23 is the ultrasonic scanning plane P
Even if it is located inside, if there is no surface in a direction substantially perpendicular to the ultrasonic pulse transmitted from the ultrasonic transducer 32, no reflected echo is received by the ultrasonic transducer 32. Therefore, as shown in FIG. 6, the vicinity of the distal end of the puncture treatment tool 47 is bulged to form a concave spherical reflecting surface 4.
8 are formed.

The present embodiment is configured as described above. Next, a case will be described in which the ultrasonic endoscope 1 performs various inspections using an endoscope and ultrasonic waves in a patient's body. The operation will be described.

First, the insertion section 10 of the ultrasonic endoscope 1 is inserted into a patient's body cavity, and is guided to a predetermined examination target section. Here, an angle portion 10b is continuously provided to the distal end portion main body 10c at the distal end of the insertion portion 10.
0b can be bent in a desired direction by an angle operation, so that the distal end of the insertion section 10 can be turned in a desired direction, and the endoscope observation mechanism 20 provided in the distal end main body 10c allows the distal end of the insertion section 10 to be bent. The image is displayed on the monitor 2b of the endoscope observation device unit 2, and the insertion section 10 is inserted while confirming the image on the monitor 2b, whereby the image can be easily and reliably guided to the inspection target section. Of course, the insertion path in the body cavity is bent in various directions, but the flexible portion 10a follows the insertion path and bends in any direction.

When the distal end main body 10c is guided to the object to be inspected, the state of the body is inspected through the endoscope observation mechanism 20. What can be inspected by the endoscope observation mechanism 20 is the state of the surface of the body cavity wall and the like. Therefore, when information on the body tissue is required, the ultrasonic observation mechanism 30 is operated. Here, since the ultrasonic observation field of view by the ultrasonic observation mechanism 30 is in front of the insertion section 10, various field ranges can be obtained by turning the tip main body 10c of the insertion section 10 in an arbitrary direction. For example, as shown in FIG. 7, the pancreatic bile duct is put into the ultrasonic observation field from the inside of the stomach.
The deep part inside the narrow place and other parts can be included in the ultrasonic observation field of view.

Further, based on the observation by the endoscope observation mechanism 20, for example, when a site suspected of a lesion is found, transmission and reception of ultrasonic waves are performed on the site, thereby obtaining an ultra-thin body tissue. The sound image is displayed on the monitor 3b of the ultrasonic observation apparatus unit 3. Here, since the center of the ultrasonic observation field of view is hardly different from the center of the endoscope observation field of view, the position where the ultrasonic observation is performed is positioned at the center of the endoscope observation field of view, so that it is almost accurate. The ultrasonic observation of the necessary place can be performed.

As a result of the ultrasonic observation, if it is necessary to perform a required treatment on the affected part, as is clear from FIG. To reach. Since this operation cannot be performed under the monitoring of the endoscope observation mechanism 20, the operation is performed under the monitoring by the ultrasonic observation mechanism 30, but at this time, the position of the insertion section 10 does not need to be changed, and the state is maintained as it is. Good. The puncture device 47 passes through the ultrasonic scanning plane P of the ultrasonic observation mechanism 30 and has a reflective surface 48 formed at the tip of the puncture device 47.
May not be displayed on the monitor 3b of the ultrasonic observation apparatus unit 3, but at least reflected echoes from the base end and the portion of the reflecting surface 48 are received by the ultrasonic transducer 32. Is reflected on the monitor 3b. Therefore, by using the image on the monitor 3b as a clue, the needle tip 47a of the puncture treatment tool 47 can be reliably guided to the affected part, and the directivity of the puncture treatment tool 47 to the affected part or the like is remarkably improved.

In scanning the ultrasonic transducer 32,
The ultrasonic vibrator 32 is rotated. The direction of rotation is orthogonal to the axis of the insertion section 10, and the rotation transmitting means is provided in the axis direction of the insertion section 10. Therefore, it is necessary to change the direction from the rotation transmitting means, but as shown in FIG. 8, the bevel gear 51 is connected to one rotating shaft 50a of the rotating member 50 supporting the ultrasonic vibrator 32, and the rotation transmission is performed. Outer sleeve 52a constituting means 52
The distal end of a flexible shaft 52b provided therein is connected to a rotating shaft 53, and the rotating shaft 53 is provided with a rotating shaft 50.
The bevel gear 54 that meshes with the bevel gear 51 on the a side may be connected. Also, as shown in FIG.
A pulley 61 is connected to a rotating shaft 60 a of the rotating member 60, a transmission wire 62 is wound around the pulley 61, and the transmission wire 62 is extended into the main body operation unit 11, and an output shaft of the motor 63 is provided. The drive pulley 64 is connected to 63a,
The transmission wire 62 is also wound around the drive pulley 64,
The motor 63 may be driven to transmit a rotational force to the rotating member 60 via the transmission wire 62. Further, if there is room in the distal end body 10c of the insertion section 10, as shown in FIG. 10, a motor 70 is provided on the distal end body 10c, and a bevel gear 71 is connected to an output shaft 70a of the motor 70, A bevel gear 73 is also connected to a rotation shaft 72a of a rotation member 72 that supports the ultrasonic vibrator 32,
The bevel gears 71 and 73 may be configured to mesh with each other. Further, as shown in FIG. 11, a portion of the insertion portion 10 up to the angle portion 10b is formed by inserting a flexible shaft 80b into an outer sleeve 80a, and the outer sleeve 8 is attached to the distal end body 10c.
0a, and a metal bellows 81 is connected to the flexible shaft 80b. The other end of the metal bellows 81 is connected to a rotating shaft 82a of a rotating member 82 provided with the ultrasonic vibrator 32.
May be connected. Here, the metal bellows 81
Is a bellows made of an elastic metal sheet, and can be bent in any direction, but has sufficient rigidity in the torsion direction. Therefore, the connecting portion 81a of the metal bellows 81 to the flexible shaft 80b and the distal end main body 10
The metal bellows 81 is held in a state of being bent by 90 ° by interposing a bearing 83 between the metal bellows 81 and the insertion passage 37 to the c. With such a configuration, the rotational force from the flexible shaft 80b can be accurately transmitted to the rotating member 82. Further, in FIG. 11, a metal bellows can be used instead of the flexible shaft 80b. In this case, however, a bearing must be provided in the insertion passage 37 in this case as well.

[0028]

As described above, according to the present invention, a rotary shaft is provided on the distal end surface of the insertion portion in a direction orthogonal to the axis of the insertion portion, and the ultrasonic vibrator is mounted on the rotation shaft. By connecting the rotation drive means to the rotating shaft and performing ultrasonic scanning in the rotational direction with the observation field in front of the insertion section, the ultrasonic observation can be performed by turning the tip of the insertion section in a desired direction. The field of view covers a wide area, including the back of narrow spaces
The puncture treatment tool from the treatment tool outlet
It is drawn out in the axial direction, but the insertion part
Ultrasound transmitted in the axial direction of the puncture device
The puncture device can be inserted into the insertion section
Deriving toward the axial direction and monitoring this ultrasonic observation field of view
Thus, it is possible to perform a desired treatment .

[Brief description of the drawings]

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

FIG. 2 is an external perspective view of a distal end surface of an insertion section.

FIG. 3 is a sectional view taken along line XX of FIG. 2;

FIG. 4 is a configuration explanatory view of a rotation drive mechanism of the ultrasonic transducer.

FIG. 5 is an operation explanatory view showing a state in which a puncture treatment tool is attached to the ultrasonic endoscope.

FIG. 6 is an enlarged front view showing a distal end portion of the puncture treatment instrument.

FIG. 7 is an operation explanatory view showing an example of an inspection state by an ultrasonic endoscope.

FIG. 8 is a configuration explanatory view showing a second example of the rotation transmitting means.

FIG. 9 is a configuration explanatory view showing a third example of the rotation transmitting means.

FIG. 10 is a configuration explanatory view showing a fourth example of the rotation transmitting means.

FIG. 11 is a configuration explanatory view showing a fifth example of the rotation transmitting means.

[Description of Signs] 1 Ultrasound endoscope 10 Insertion section 10c Tip main body 20 Endoscope observation mechanism 22 Observation window 23 Treatment tool deriving section 30 Ultrasonic observation mechanism 31 Housing 32 Ultrasonic transducer 33, 50, 60, 72, 83 Rotating members 31a, 31b, 50a, 60a, 72a, 83a Rotating shaft 37 Insertion passage 38, 52 Rotation transmitting means 38a, 52a, 80a Outer sleeve 38b, 52b, 80b Flexible shaft 47 Puncture treatment tool 48 Reflecting surface 51, 54, 71, 73 Bevel gear 61 Pulley 62 Transmission wire 63, 70 Motor 81 Metal bellows

Claims (5)

(57) [Claims] 1. An endoscope observation unit provided on a distal end surface of an insertion portion inserted into a body cavity or the like, and a concave spherical shape opened on a distal end surface of the insertion portion and provided on a base end side of a needle tip. a puncture instrument having a reflecting surface of the ultrasound, and the treatment instrument lead-out portion for leading out toward the puncture instrument in the axial direction of the insertion portion, provided so as to protrude from the distal end surface of the insertion portion A housing; an ultrasonic vibrator mounted in the housing and scanning in a rotational direction; and a rotary shaft provided in a direction orthogonal to an axis of the insertion section to rotationally drive the ultrasonic vibrator. An ultrasonic inspection apparatus having a configuration. 2. The rotation drive means comprises a rotation drive means and a rotation transmission means, one end of which is connected to the rotation drive means, extends in the axial direction of the insertion portion, and has a tip. 2. The ultrasonic inspection apparatus according to claim 1, wherein the portion is bent at substantially 90 degrees and connected to the rotating shaft. Wherein the rotation transmission means, according to claim 2, characterized in that formed by inserting a flexible shaft or a metal bellows by winding a metal wire into close contact with the coiled within flexible sleeve super Ultrasonic inspection device. 4. The ultrasonic inspection apparatus according to claim 3 , wherein a bevel gear or a metal bellows is provided at a portion of the rotation transmitting means which is bent by approximately 90 °. 5. The motor according to claim 1, wherein the rotation driving means is a motor provided at a distal end portion of the insertion portion, and the motor is connected to the rotation shaft via a bevel gear. 2. The ultrasonic inspection apparatus according to 1.