JP3327950B2 - 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, and more particularly, to an ultrasonic endoscope having a forceps port on a scanning surface of an ultrasonic probe for guiding a puncture needle or the like so as to be freely protruded and inserted into a living body. Related to endoscope.

[0002]

2. Description of the Related Art Japanese Unexamined Patent Publication No. 1-124444 (Document 1) discloses an ultrasonic endoscope in which an ultrasonic probe, a forceps port, and an observation optical system are arranged in a line in this order from the distal end. . Further, the one disclosed in Japanese Patent Application Laid-Open No. 1-131243 (Document 2) is also arranged in a line in the same order as the ultrasonic probe, the observation optical system, and the forceps port from the distal end to the rigid portion at the distal end.

[0003] In each case, the outer diameter (width) of the component supporting the ultrasonic probe and the component supporting the forceps port.
Are the same, and the center axis of the insertion portion and the scanning axis of the ultrasonic probe coincide with each other.

[0004]

However, documents 1 and 2
As described above, the ultrasonic endoscope has an ultrasonic probe, a forceps port, and an observation optical system which are arranged in a line from the distal end, so that the distal end hard length tends to be longer, and the ultrasonic endoscope is continuously connected from the distal end. Because of the same thickness, the subject is painful when inserted into a body cavity. The improvement of the insertability suppresses the pain of the subject and shortens the examination time, but there is a limit even if the miniaturization is advanced while following the configuration disclosed in the above-mentioned literature. .

The present applicant has also proposed another ultrasonic endoscope in Japanese Patent Application Laid-Open No. 1-117133. However, in this ultrasonic endoscope, the rotation center of the rotor that holds the ultrasonic vibrator is eccentric with respect to the center axis of the insertion section, and the rotation center and the center of curvature of the ultrasonic input / output window are matched. However, this method only aims to obtain a uniform good image in the entire circumferential direction, and does not include a forceps port for protruding and retracting the puncture needle within the scanning section of the ultrasonic probe.

SUMMARY OF THE INVENTION Accordingly, an object of the present invention made in view of the above point is that the insertion property can be improved, the pain of the subject can be reduced,
It is an object of the present invention to provide an ultrasonic endoscope capable of shortening an examination time and reducing a burden on an operator.

[0007]

An ultrasonic endoscope according to the present invention that achieves the above object has a cross section smaller than the cross section of the insertion section at the distal end of an elongated insertion section to be inserted into a living body. The ultrasonic probe is provided with the ultrasonic wave transmitting / receiving surface directed in the side direction of the insertion portion, and is provided on one side with respect to a plane including the center axis of the insertion portion in parallel with a scanning cross section thereof, and the ultrasonic probe is provided. In the insertion section closer to the hand, an ultrasonic treatment tool such as a puncture needle is protruded and retracted in a scanning cross section of the ultrasonic probe on a straight line passing through the ultrasonic wave transmitting / receiving surface substantially parallel to the central axis. A forceps port for freely leading out is provided, and an observation optical system and an illumination optical system are provided near the forceps port so as to be deviated toward the plane with respect to the straight line.

[0008]

According to the ultrasonic endoscope of the present invention, the ultrasonic probe has a cross section smaller than the cross section of the insertion section, directs the ultrasonic wave transmitting / receiving surface in the side direction of the insertion section, and is parallel to the scanning cross section. The forceps port is provided on one side of the insertion section closer to the hand than the ultrasonic probe, and the ultrasonic transmission / reception is substantially parallel to the center axis of the insertion section. It is provided on a straight line passing through the wavefront, and the observation optical system and the illumination optical system are deviated on the plane side with respect to the straight line in the vicinity of the forceps port, so that the outer diameter of the insertion portion can be reduced. , And the length of the hard portion of the insertion tip can be shortened.

Therefore, the insertion property can be improved, so that the pain of the subject can be reduced, the examination time can be reduced, and the burden on the operator can be reduced.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows an embodiment of an ultrasonic endoscope according to the present invention, which comprises an elongated insertion section 1, a hand-side operation section 2, a universal cord 3, an endoscope connector 4, and an ultrasonic cord. 5 and an ultrasonic connector 6. The insertion section 1 is inserted into a living body, and the distal end configuration section 11, the bending section 12, and the flexible section 13 form the insertion section 1 in succession.

An operation section 2 is provided continuously with the insertion section 1. The operation section 2 includes a treatment instrument, an insertion port 14 for deaerated water, an air / water supply button 15, a suction button 16, and the bending section 12. Has an angle knob 17 that bends up, down, left, and right directions, and further includes a raising operation knob 18 in the illustrated example. Lifting operation knob
As described later, the elevator 18 is used for operation of an elevator whose elevation angle is regulated by a stopper mechanism. In the illustrated example, the operation unit 2 also includes an eyepiece unit for checking an endoscope visual field.
The endoscope connector 4 is connected to a light source device (not shown) via a universal cord 3 through which a light guide (not shown), a suction tube, an air supply tube, a water supply tube and the like pass. Connected to The ultrasonic cord 5 branches off from the middle of the universal cord 3 and is connected to an ultrasonic diagnostic apparatus (not shown) via an ultrasonic connector 6 to display an ultrasonic tomographic image on a monitor (not shown). ing. In the drawings, reference numeral 20 denotes a sheath to be described later in use, and reference numeral 21 denotes an injection or suction syringe attached to the end of the sheath.

An ultrasonic probe having a cross section smaller than the cross section of the insertion section 1 on its front end side is attached to the front end constituting section 11 which is a hard end section of the insertion section 1 into the body cavity. The transmission / reception surface of the ultrasonic wave is directed to the side, and is provided on one side of a plane parallel to the scanning section and including the central axis of the insertion section 1. Further, on the distal end constituent portion closer to the hand side than the ultrasonic probe, ultrasonic treatment tools such as a puncture needle are arranged in a scanning section of the ultrasonic probe on a straight line passing through the ultrasonic wave transmitting / receiving surface substantially parallel to the central axis 1. And a viewing optical system and an illumination optical system which are deflected in the vicinity of the forceps port on a plane parallel to the scanning section and including the center axis of the insertion portion. Set up a system. Specifically, the distal end component 11 can be formed of an insulating member such as a black plastic, and here, as shown in FIGS.
An ultrasonic probe 26 having a convex shape (convex shape) is attached to the distal end support portion 25 at a slight inclination (for example, at an angle of 5 to 15 °) toward the front side (the distal end side).

FIG. 2 is a plan view of a distal end component portion,
FIG. 3 is a view of the distal end component portion viewed from the distal end side (left side in FIG. 2), and FIG. 4 is a side sectional view of the distal end component portion including the balloon portion (FIGS. 2 and 3). Is shown with the balloon portion removed). FIGS. 5 and 6 are diagrams for explaining the operation (the former shows the case when the elevator is inverted, and the latter shows the case when the elevator is raised). The ultrasonic probe 26 is shown in FIG.
As shown in (4), the ultrasonic wave transmitting / receiving surface 27 is provided on the distal end side supporting portion 25 facing the side direction. The support portion is divided into a front lid 25a and a main body 25b as shown in FIG. 4, and these are connected by a fixing screw 25c and an adhesive 25d filling the inside. The distal-end-side support portion 25 is also positioned at a rear position following the ultrasonic probe 26, on a straight line passing through an ultrasonic wave transmitting / receiving surface 27 substantially parallel to the central axis of the insertion portion 1, and an ultrasonic scanning surface 28 of the ultrasonic probe 26 ( Hereinafter, the scanning section 28 of the ultrasonic probe 26 will be referred to as an endoscopic treatment tool 29 such as a puncture needle (FIGS. 5 and 6).
Port 30 arranged so that it can be extended and retracted freely, and in the illustrated example, the angle at which the endoscope treatment tools 29 are extended by operating a raising operation knob 18 (FIG. 1) of the hand operation unit 2 described later. Is provided. As shown in FIGS. 2 and 3, the elevating base 31 is provided with a lateral lid 32 on one side surface and detachably attached thereto, as shown in FIGS. An example of a configuration related to the elevator 31 will be described later.

An ultrasonic wave transmitting / receiving surface 27 of the ultrasonic probe 26 which is substantially parallel to the center axis of the insertion portion 1 in the other side portion opposing the side lid 32 detachably attached, that is, in the vicinity of the forceps port. The observation optical system and the illumination optical system are provided in a portion parallel to the scanning section 28 of the ultrasonic probe 26 and deviated to the plane including the central axis of the insertion portion 1 with respect to the straight line passing through the line. In the present embodiment, as described above, the distal end main body 33 (FIGS. 2 and 3) on the opposite side of the lateral lid 32 of the forceps port 30 for allowing the puncture needle or the like to protrude and retract into the scanning section 28 of the ultrasonic probe 26 as described above. Observation / illumination optical system 36, consisting of an objective lens 34 and an illumination lens 35, and its objective lens
An air / water supply nozzle 37 for washing the water 34 is mounted in the arrangement shown in the figure. Here, the visual field range 38 of the objective lens 34 shown in FIGS.
Are directed so as to overlap the scanning section 28 while supplementing the blind spot of the scanning section 28 of the ultrasonic probe 26 (see FIG. 4). As described above, the forceps port 30 and the observation / illumination optical system 36 are not arranged in the front-rear direction (the axial direction of the insertion section), but the observation / illumination optical system 36 and the air / water supply nozzle 37 are provided.
Are arranged beside the forceps port 30.

Further, in the present ultrasonic endoscope, as described above, the ultrasonic probe is provided so as to be deviated to one side with respect to a plane including the center axis of the insertion section 1 in parallel with the scanning section thereof, and The outer diameter of the tip component supporting the acoustic probe is made smaller than the outer diameter of the tip component supporting the forceps port. Specifically, as shown in FIGS. 2 and 3, the ultrasonic probe
The scanning section 28 of the ultrasonic probe 26 is set so that there is a displacement x of about 10 mm on the side of the side lid 32 with respect to a plane including the central axis 39 of the insertion section 1 parallel to the scanning section 28 of 26. Have been. Also, as shown in the figures, the outer diameter of the distal end side support portion 25 is based on a slightly smaller outer diameter (width) so as to be substantially within the outer diameter of the forceps opening support portion 33 on the rear end side. I have.

As shown in FIGS. 2 and 3, the forceps port 30 is connected to the scanning section 28 of the ultrasonic probe 26 including the insertion portion central axis 39.
The scanning section 28 of the ultrasonic probe 26 and the forceps port 30 are located on a straight line, so that the ultrasonic guide is used even when the puncture needle (29) is used. Lower puncture is possible, and the outer diameter of the insertion portion 1 is made thinner except for necessary portions while avoiding increasing the rigid length at the tip. At the side, that is, near the forceps port, with respect to a straight line passing through the ultrasonic wave transmitting / receiving surface 27 of the ultrasonic probe 26 which is substantially parallel to the center axis of the insertion portion 1, the insertion portion is parallel to the scanning cross section 28 of the ultrasonic probe 26. The observation / illumination optical system 36 and the air / water supply nozzle 37 are arranged in a plane deviating on the plane side including the central axis 1 and the scanning section 28 of the ultrasonic probe 26 including the insertion section central axis 39 is disposed in the insertion section. The forceps channel and the signal cable of the ultrasonic probe 26 are placed on one side of the parallel plane. Le a, inserting the insertion member and the air and water supply tube for an observation optical system on the other side. The cross-sectional configuration in FIG. 4 shows a cross-section at the scanning cross-section 28 of the ultrasonic probe 26, but a plurality of signal cables 40 from the ultrasonic probe 26 are connected to the forceps port 30 in the distal end portion 11 and a raising table facing the forceps port 30. Go under 31 and operate the ultrasonic code 5
And connected to the ultrasonic connector 6 via the

In addition to the forceps port 30 for leading and retracting the puncture needle into the scanning plane of the ultrasonic probe 26 to the distal end component 11, a raising table
In the case where the piercing needle 31 is provided, in this embodiment, a stopper mechanism for regulating the rising angle of the raising table 31 is provided, and the puncture needle is used when the ultrasonic probe is used at the time of maximum raising (when the raising table is completely raised to the stopper). The setting is made so as to fall within the good image range of the scanning range. Specifically, here, the puncture needle is moved at the center position of the scanning range of the ultrasonic
The distance from the surface is set, for example, within a range of 25 mm ± 15 mm (FIG. 6).

FIGS. 7 and 8 show an example of details of the elevator 31 having the above-described functions. The elevator operating function has an operation wire 45 for raising (FIG. 6) and inverting (FIG. 5) the elevator 31. The operating wire 45 is composed of a guide pipe 46 connected to the distal end main body 33, and a guide tube 47 following the guide pipe 47.
(FIG. 8) and is connected to the raising operation knob 18 of FIG. A coil pipe 48 for preventing buckling of the tube is placed around the guide tube 47 (FIG. 8). Elevator
Although 31 is rotatably mounted on the distal end main body 33 about a rotation shaft 49, in the illustrated example, a stopper pin 50 is fixed to the raising base 31, and on the other hand, the raising of the raising base 31 is performed. A stopper surface 51 for regulating the corner is provided on the forceps opening support portion 33. The stopper pin 50 and the stopper surface 51 constitute a stopper mechanism.

In this embodiment, the rising angle is regulated by such a stopper mechanism. Then the stopper pin 50 is on the stopper surface
The state in which the elevator 31 is brought into contact with the elevator 51 (FIG. 8), that is, the state in which the elevator 31 is completely raised up to the position regulated by the stopper mechanism is the maximum elevation, and the angle at this time is as shown in FIG. The puncture needle (29) is at the center position of the scanning range from the surface of the ultrasonic wave transmitting / receiving surface 27 at the above-mentioned 25 mm ± 15 mm (therefore, the minimum 10 mm, the maximum 45 mm)
Therefore, it is possible to set the projection direction of the puncture needle to be within the good image range of the ultrasonic probe 26 at the time of puncture under the ultrasonic guide.

In FIG. 4, the balloon portion is shown including the balloon portion as mentioned above. As shown, a bag-shaped balloon 55 is detachably fixed around the ultrasonic probe 26 so as to cover it. The distal end of the balloon 55 is fixed with an operating cord 56 or the like so that the balloon 55 does not expand toward the distal end. Although not shown, the inside of the balloon 55 is one in the insertion section 1 of FIG. 1 and branches into two before the air / water button 15 and the suction button 16 in the operation section 2. Degassed water passes through the tube and is operated by these buttons 15 and 16
57 injections / discharges shall be performed. 4 to 6
In the figure, 61 indicates an inner wall of a body cavity, and 62 indicates a test subject.

The ultrasonic probe 26 is provided in the ultrasonic diagnosis by the ultrasonic endoscope having the above-described configuration, the puncture under the ultrasonic guide, that is, the insertion section 1 to be inserted into the body cavity, and the ultrasonic probe 26 is provided in the scanning section 28 of the ultrasonic probe 26. Ultrasonic diagnosis or ultrasonic-guided puncture of the test subject 62 with the forceps port 30 through which the puncture needle is protruded and retracted can be performed as follows. For diagnosis or diagnosis and treatment, the insertion section 1 is orally or transanally inserted into the body cavity of the subject.

In this case, in the present ultrasonic endoscope, the ultrasonic probe 26 is provided so as to be displaced by x from the center axis 39 of the insertion section 1, and the distal end supporting section as the supporting section of the ultrasonic probe 26 is provided. Since the outer diameter of the tip 25 is smaller than the outer diameter of the tip main body 33 as a support for the forceps port 30 for guiding the puncture needle into the scanning cross section 28 of the ultrasonic probe 26 so as to be freely retractable, The pain of the elderly is alleviated. When an ultrasonic probe, a forceps port, and an observation / illumination optical system are provided, they are arranged in a line from the tip in the insertion direction, and in that case, the objective window and the illumination window are provided with an ultrasonic probe. In this configuration, the rigid length of the distal end of the insertion section 1 can be made shorter than that in the case where the forceps ports for protruding and retracting the puncture needle in the scanning cross section are arranged on the left and right sides. The thickness of the tip side support part 25 also
Insert the scanning section 28 of the ultrasonic probe 26 and the forceps port 30 into the insertion section 1
Can be made as thin as possible while ensuring a puncturing function that can be punctured under ultrasonic guidance by being aligned on a straight line parallel to the central axis 39 of the above, and the tip portion does not become thick. As shown in FIGS. 2 and 3, the observation / illumination optical system 36, the air supply / water supply nozzle 37, and the like are arranged on the plane side parallel to the scanning section 28 of the ultrasonic probe 26 and including the center axis of the insertion section 1 on the side of the forceps port 30. As shown in FIG. 4, the forceps channel and the signal cable 40 of the ultrasonic probe 26 are arranged on one side and the observation / illumination optical system is arranged on the other side.
Since the fiber for 36 and the air / water supply tube were inserted, the unnecessary portion of the insertion section 1 was made thinner without increasing the rigid end of the tip, and the unnecessary portion could be made thinner to improve the insertability. Pain can be reduced. The improvement of the insertability is advantageous in shortening the examination time, and also reduces the burden on the operator.

After the insertion section 1 is inserted as described above, after the endoscope observation at the target site in the body cavity, that is, the ultrasonic probe 26
After observing with the observation / illumination optical system 36 directed in the scanning section direction, degassed water 57 is injected from the forceps port 30 or a balloon 55
Ultrasonic scanning is performed by injecting the degassed water 57 into the inside or using both of them (see FIG. 4) to perform ultrasonic diagnosis from inside the body cavity.

When a part to be treated is found based on the ultrasonic tomographic image displayed on the monitor of the apparatus by such ultrasonic diagnosis, a treatment is performed. In this case, even when a puncture treatment is performed, the present ultrasonic endoscopy is performed. The mirror can safely perform good ultrasonic guided puncture. In this embodiment, the ultrasonic probe
26 and the stopper 50 and the stopper surface 51 for regulating the raising angle of the raising table 31 facing the forceps port 30 located in the relationship as described above.
Is set so that the needle enters the good image range within the scanning range of the ultrasonic probe 26 at the time of the maximum raising, so that the stopper pin 50 of the raising base 31 abuts against the stopper surface 51. It is easy to predict the needle projection direction just by raising it up, and the projection angle of the needle is hard to change, so it is possible to perform puncture safely under ultrasonic guide, and the needle comes out in the area of good image If the distal end is moved using a bending mechanism or the like so that the puncture target region comes within this area, the puncture can be performed safely without blind spots.

The specific procedure is as follows. First,
The necessary movement of the tip component 11 is performed. That is, the subject 62 to be treated by puncturing the tissue or by injecting ethanol locally is placed in a good image range in the scanning section 28 (here, 10 mm or more from the surface of the ultrasonic wave transmitting / receiving surface 27). Then, the distal end component 11 is moved by operating the bending portion 12 or the like. here,
As shown in FIG. 6, in the case of 5 mm or less, or in the case of 45 mm or more, it is difficult to obtain a good ultrasonic image. Is good.

Next, a treatment tool 29 for an endoscope such as a puncture needle is
It is inserted from the insertion opening 14 (FIG. 1) of the operation unit 2 at hand. In this case, first, as shown in FIG. 5, the elevator 31 is inserted as shown in FIG. In such a state in which the raising table 31 is inverted, the treatment tool 29 having a long hard portion can be inserted into the body cavity because the treatment tool 29 goes out of the forceps port 30 almost forward without difficulty. When the treatment tool 29 has reached the flexible portion, the raising table 31 is raised from the state of FIG. 5 to the state of FIG. 6 by operating the raising operation knob 9 on the hand side. At this time, as shown in FIG. 8, since the stopper pin 50 that rotates integrally with the elevator table 31 contacts the stopper surface 51, the elevator table 31 stops rising. That is, the elevator 31 takes the position shown in FIG.

Regarding the angle in this case, as described above, in this embodiment, the treatment tools 29 are positioned at the center of the scanning range (18) of the ultrasonic probe 26 from the surface of the ultrasonic wave transmitting / receiving surface 27.
Since the setting is made so as to fall within the good image range F of 25 mm ± 15 mm, when raising the raising table 31, the operator only needs to perform an operation of raising the maximum raising state regulated by the stopper mechanism. Will be. Thus, after the above-mentioned raising, the treatment tools 29 are pushed forward by the sheath 20 on the proximal side, and are directed to the inner wall 61 of the body cavity, and as shown in FIG. To reach. The above-mentioned state can be confirmed in the endoscope field of view by the objective lens field of view 38 up to the inner wall 61 of the body cavity, and thereafter, it is projected on the ultrasonic monitor, and its entry is monitored in the area of a good image. it can. After the tip reaches the subject 62, the syringe 20 for injection or suction may be attached to the end of the sheath 20 as shown in FIG. 1 to perform ethanol injection or tissue biopsy.

As described above, according to the ultrasonic endoscope, it is possible to prevent the projection angle from being changed as in the case where the stopper mechanism is not provided, and it is also possible to prevent a blind spot from being generated. It is only necessary to raise the 31 completely with the stopper mechanism, and the ultrasonic guided puncture can be performed safely and well. In the present embodiment, the stopper mechanism is constituted by the stopper pin 50 and the stopper surface 51. However, it is needless to say that the stopper mechanism is not limited to such a combination of the stopper pin and the stopper surface. A stopper mechanism may be used to restrict the maximum rising state by abutting surfaces of the side surface 60 of the raising table 31 and the bottom surface 61 of the forceps port as shown, and the position of the stopper mechanism is Not only in the vicinity of 31 but also in the operation unit 2, in any case, the puncturing property is improved as in the case of the stopper pin 50 and the stopper surface 51, and it is safe and good by a simple and reliable method. Ultrasonic guided puncture can be realized.

The following is another embodiment of the present invention. In the present embodiment, an ultrasonic probe is provided at the distal end component of the elongated insertion portion as well as the ultrasonic endoscope shown in the previous embodiment, and the ultrasonic probe is on the same side as the ultrasonic wave transmitting / receiving surface and at hand. When the raising part which adjusts the derivation angle of the puncture needle by operating the forceps port which guides the puncture needle to the scanning cross section of the ultrasonic probe so as to be able to protrude and retract into the scanning section of the ultrasonic probe and the operation knob on the hand side is provided at the tip part on the side In the above, a stopper mechanism for regulating the raising angle of the raising table is provided, and the distance from the surface of the ultrasonic transmitting / receiving surface at the center position of the scanning range of the ultrasonic probe at the time of maximum raising is 25 mm ± 15 mm. The present invention can be applied to any of the ultrasonic endoscopes configured to be set to enter.

FIG. 9 is a plan view of a distal end portion of the ultrasonic endoscope according to the present embodiment, FIG. 10 is a view for explaining a main part in section AA, and FIG. 11 is a view in an optical field. Other components shown and not shown may be the same as those according to the embodiment. In the present embodiment, the objective lens 34 and the illumination lens 35 shown in FIGS. 2 and 3 of the above embodiment are arranged in front and back on the side of the elevator 31 as shown in FIG. The direction of the visual field center 65 is inclined toward the scanning section 28 of the ultrasonic probe 26 (FIG. 10), and as shown in FIG. It is arranged near the center of the field of view 66.

Also in this embodiment, it is possible to realize an ultrasonic endoscope with a puncture function without lengthening the rigid end of the tip and making the distal end thicker.
This can be performed more safely and reliably. Figures 12, 13
Are shown in comparison with the cases of FIGS. 9 to 11, and a comparison with this is as follows. That is, assuming that the visual field center 65 is parallel to the scanning section 28 (the path of the puncture needle or the like is on the plane including the broken line) as shown in FIG.
In this case, the treatment tools 29 are drawn around the optical field of view 66 as shown in FIG. On the other hand, in the present configuration, even in the case of the layout as shown in FIG.
The puncture needle and the like are well drawn in the ultrasonic image, and can be well drawn near the center of the optical field of view 66 as shown in FIG. And other endoscope treatment tools can be safely and reliably introduced.

The present invention is not limited to the above embodiments and modifications. For example, the eyepiece shown in FIG. 1 has an eyepiece. However, the eyepiece may be eliminated, and a solid-state imaging device may be provided at the tip to monitor and monitor an endoscopic image in the same manner as an ultrasonic image. Further, the ultrasonic probe may be a linear element, a sector element, or a combination thereof, instead of a convex shape, or may be one that performs mechanical scanning. In addition, various modifications and changes can be made without departing from the improvement of the insertion property and the puncture property which are the aims of the present invention.

[0033]

According to the present invention, the ultrasonic probe has a cross section smaller than the cross section of the insertion section at the distal end side of the insertion section, and directs the ultrasonic wave transmitting / receiving surface in the side direction of the insertion section to scan the same. A forceps port is provided on the insertion portion closer to the hand than the ultrasonic probe, and an ultrasonic wave substantially parallel to the center axis of the insertion portion is provided on one side with respect to a plane including the center axis of the insertion portion in parallel with the cross section. The observation optical system and the illumination optical system are provided on a straight line passing through the transmitting and receiving surface, and the observation optical system and the illumination optical system are provided on the flat surface side with respect to the straight line in the vicinity of the forceps port. The length of the hard portion at the tip can be shortened. Therefore, the insertability can be improved, the pain of the subject can be reduced, the examination time can be reduced, and the burden on the operator can be reduced.

[Brief description of the drawings]

FIG. 1 is a diagram showing an overall configuration of an ultrasonic endoscope according to one embodiment of the present invention.

FIG. 2 is a plan view for describing a tip component of the same example.

FIG. 3 is a view as viewed from the front end side (left side in FIG. 2) of the front end component.

FIG. 4 is a side cross-sectional view (cross-sectional view of a scanning cross section of an ultrasonic probe) of a distal end component portion including a balloon portion, which is also used to explain a state of a scanning range, a visual field range, and the like. .

FIG. 5 is a diagram (when the elevator is turned upside down) for explaining the operation when performing puncture under ultrasonic guide.

FIG. 6 is also a diagram for explaining the operation (when the elevator is raised).
It is.

FIG. 7 is a diagram showing an example of a detailed configuration of a raising stand portion.

FIG. 8 is also a view for explaining a state in which the raising angle of the raising table is regulated.

FIG. 9 is a view showing a main part of another embodiment of the present invention.

FIG. 10 is an explanatory diagram of a main part of a relationship between an ultrasonic scanning system and an optical system when viewed along line AA in FIG. 10 in the same example.

FIG. 11 is a diagram showing an example in the optical field of view in the same example.

FIG. 12 is an explanatory diagram in a comparative example shown in comparison with FIG.

FIG. 13 is a diagram in the optical field of view in that case.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Insertion part 2 Operation part 11 Tip construction part 12 Curved part 13 Flexible part 18 Elevation operation knob 19 Eyepiece part 25 Tip side support part 26 Ultrasonic probe 27 Ultrasonic wave transmitting / receiving surface 28 Scanning cross section 29 Endoscope such as a puncture needle Treatment tools 30 forceps port 31 raising table 33 forceps port support section 34 objective lens 35 illumination lens 36 observation / illumination optical system 38 visual field range 39 center axis 45 operation wire 50 stopper pin 51 stopper surface 60 side surface of raising table 61 forceps port Bottom of exit 65 Objective lens field center 66 Optical field of view

──────────────────────────────────────────────────続 き Continuation of the front page (56) References JP-A-1-280446 (JP, A) JP-A-1-171532 (JP, A) JP-A-4-71542 (JP, A) JP-A-1- 136643 (JP, A) Hikaru Hei 3-116817 (JP, U) Hikaru 2-6001 (JP, U) Jiko 50-39034 (JP, Y1) (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 8/12 A61B 1/00-1/32

Claims (1)

(57) [Claims] 1. An ultrasonic probe having a cross section smaller than the cross section of the insertion section is directed to the distal end side of an elongated insertion section to be inserted into a living body with an ultrasonic wave transmitting / receiving surface directed in a side direction of the insertion section. It is provided on one side with respect to a plane including the center axis of the insertion section in parallel with the scanning section, and the insertion section closer to the hand side than the ultrasonic probe has A forceps port is provided on a straight line passing through the sound wave transmitting / receiving surface to guide an ultrasonic treatment tool such as a puncture needle into the scanning cross section of the ultrasonic probe so as to be freely retractable, and the straight line is provided near the forceps port. An ultrasonic endoscope, wherein an observation optical system and an illumination optical system are provided so as to be deviated on the plane side.